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SUNSET HILLS WEST BLK 1 LT 6
uns t Hi lls West lock I Lot 6 018-20 -306 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231349 PID Number: 018-203-06 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name JESSICA DOWLING A RPTION FIELD ❑ De Trench ❑ Wide Trench ❑ Bed ound Site Address 14116 OLD SEWARD HIGHWAY *ANCHORAGE, AK Other Phone 1-425-246-0451 Number of Bedrooms Soil Rating Total depth original grade ��N/SF LEGAL DESCRIPTION 3 Ft. Depth to pipe invert from original Gravel depth beneath pipe Subdivision Block Lot SUNSET HILLS WEST 1 6 Ft. Fill added above original g G I length Township Range Section Ft. Ft. - Gravel width Beds: Number of Lines Dis a between lines SEPARATION DISTANCES ToI-?- on Holding Sewer Lift Station Ft. Total orption area Number of trenches Ft. Dist. between ches From Tank Line Ftz Well ���+ TANK ❑ Septic © S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water ANCHORAGE TANK 1500 Gal. Material Number of compartments Lot Line NA STEEL - EPDXY COATED Foundation LIFT STATION Remarks PER CONTRACTOR - OLD TANK WAS HAULED OFFSITE ANCHORAGE TANK *500 Ga *SECOND COMPARTMENT OF LIFT STATION A cation Electrical installed by cr **SEE ATTACHED WAIVER REQUEST I} L_G� S� n Installer 1 Z`11 t y" PIP M House to tank EXISTI n d a n Tank D 1785 A+ HOME SERVICES Drainfield EXISTING CO/MTD3034 Inspector GEG ENGINEER, DAVID GARNESS BENCH MARK (Assumed elevation) 98.75 ft Inspection 1- 5/31/2024 2"' _ Location and description dates: 3ro _ 4'h _ TOP OF MH1 ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp Conditional Approval: Date 0 f...4 ., ..........: Septic System 0 e CE �a ey A. G ness., Approved Date j � �11� f ' 3 Note: this approval does not include well permit requirements. �p orofessionoQo #AECC884 (Rev 05/02/18) ,14- *_4444— r PLOT PLAN AS BUILT X SCALE 1" 40' GRID SW 3033 Project No. 23-470/A6 P.O. Box 210005 Lang & Associates, inc. Anchorage, Alaska 99521-0005 (907) 522-6476 �,��►� Professional Land Surveyors kenOlongsurvey.com lL 1 jonothanOlongsurvey.com ,�: 'o�! - 4! I hereby certify that I have surveyed the following described property: LOT 6. BLOCK 1. SUNSET HILLS WEST SUBDIVISION (PLAT No. P-600) Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed promises and that there are no roadways, tranamisalon lines or other visible easements on sold property except as indicated hereon. Dated this the , S��' Day of jv 1",v , 1& , at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements ..F. ... ....... ......... .�"'. .'... KENNETH G. LANG o.5202AMW Nj'ROFESS ION AO `t,��-.r'"" L. GROUP,GARNESS ENGINEERING Ltd ENGI , NEERING SALES CONSULTING July 8, 2024 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Waiver Requests for Sunset Hills West, Block 1, Lot 6 To whom it may concern: 1 y 1 .s.. . 6, rn SS t tF CE•7953 �,� pROFE5S10�P`"�� During the design stage for the recent STEP tank upgrade on the subject property it was apparent that there was little room to place the new STEP tank and meet all required separation distances. This became further apparent after the survey control was established (lot line, utility easement, and two well radii). During construction, extra care was taken to ensure the new STEP tank did not encroach into the utility easement or within the protective well radius for Sunset Hills West, B1, L9; however, the new STEP tank (epoxy -coated steel) ended up slightly encroaching into, the well radius for the subject property. The separation distance is believed to be in the range of 98- 99 feet. We are requesting the distance be waived to 98 feet. The design called for monitoring tubes to be installed at the end of each of the two drainfields (5- wide trenches) on the subject property. Based upon the post -construction as -built survey, the westernmost trench encroaches into the well radius for the subject lot. The separation distance between the well and the westernmost trench is estimated to be in the range of 90-92 feet. To be conservative, we are requesting the separation distance be waived to 90 feet. Justification for the subject waivers is summarized as follows: • The well is on the opposite side of the house from both the STEP tank and the drainfield; therefore, overflowing wastewater could not reach the wellhead. • The westernmost drainfield has encroached upon the well since it was installed in 1991. In short, this encroachment has existed for over 33 years. • Based upon the well log, the soil profile from the ground surface to a depth of 85 feet is 32 feet of hardpan followed by 53 feet of silty sandy gravel with a 40% clay binder. The aquifer appears to be confined below 119 feet. In short, the aquifer appears to be protected. • Recent water sampling on 9/26/23 revealed no bacteria present, and a Nitrate/Nitrate level 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com Page 2 of 2 of 0.856 mg/L. Per MOA records, the Nitrate/Nitrite on 10/17/01 (almost 19 years ago) was 0.562 mg/L. In short, the subject drainfield encroachment appears to have had little to no adverse impact on the aquifer. Based upon the facts presented above we request the following waivers be granted: A 90-feet separation distance between the well on property and the drainfield on property A 98-feet separation distance between the well on property and the STEP tank on property. If you have any questions, please contact us at 337-6179. Thank you for your assistance. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www. garnessengineering.com "Z, A Municipality of Anchorage IJ partmrnt r P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services ivy On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV241043 COSA#:OSC241327 Permit#: PID#: 018-203-06 Legal Description: SUNSET HILLS WEST BILK 1 LT 6 Engineer: Garness Engineerinq Group Your request for a waiver of the required 100 feet horizontal separation from the absorption field to the private well has been approved. The approved separation distance is 90.0 feet. Your request for a waiver of the required 100 feet horiztontal separation from the tank to the private well has been approved. the approved separation distance is 98 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on - site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: 1} E l,� Date: E E � Approved by: ; ��— Name of Reviewer **** VARIAN C EMAIVE R REVIEW **** PERMIT NUMBER: OSP231349 RECORD DRAWING PARCEL ID NUMBER: 018-203-06 A B \ / SUNVIEW DRIVE DBL1 69.4 / OBl2 70.5 92.7 93.7 / \ MHl 71.2 93.3 SUNSET HILLS WEST; / MH2 71.5 91.3 BLOCK 1, LOT 5 \ / MT1 83.4 80.0 MT2 MT3 ..3 70 70.4 7070.0 MT4 84.2 89.7 NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE \_ _ ' 1 \ O / METER. SWING -TIES TO HOUSE CORNERS WERE GENERATED I/ AUTOCAD. EXISTING 3-BEDROOM HOUSE /, ( rp -F REQUESTED- �/2 �`� %�' ` EXISTING. DRIVEWAY � / V SUNSET HILLS WEST; / O Co / a, BLOCK 1, LOT 11 / 00. EXISTING CARPORT / N � \ ` 1 NEW 1500-GALLON EPDXY COATED STEEL STEP \ / INSTALLED DOUBLE / TANK - \CLEANOUTS (OBL1 & DBL2) SUNSET HILLS WEST; \\ / BLOCKI,LOT9 / SUNSET HILLS WEST; \ I / BLOCK 1, LOT 10 / x i 100' WELL RADIUS / SCALE: / \\ •� o ®a a z AV e ? •• * `# tffN .l .....::.....9 ....... ........::....., ENGINEERING SALES CONSULTING 0 3701E. TUDOR ROAD, SUITE 701'MCHORAGE, AK99507•PHONE(907)337.0179• rA%(907) 338-3156-WEDSRE. wrm.ganro5seng'vlee,hrg rcm •. .... ................0 .. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: : '$" effrey A. Gamess :• �► JESSICA DOWLING 1-425-246-0451 2 OF 3 �'� � 7 53 •' Zo LEGAL DESCRIPTION: DRAWN BY: . AV F,p' .• I 2.••� SUNSET HILLS WEST; BLOCK 1, LOT 6 J.L.M. TYPE OF WORK: DATE: LICENSE a � `ROFE RECORD DRAWING OF STEP TANK UPGRADE 7/9/2024 #AECC684 PERMIT NUMBER: PARCEL ID NUMBER: OSP231349 RECORD DRAWING 018-203-06 TOP OF MANHOLE = 98.75 TOP OF TANK AT INLET = 92.45 INVERT OF BUNG AT INLET = 91.84 FINAL GRADE = 98.36-98.37 NEW 1500 GALLON EPDXY COATED STEEL STEP TANK GROUNDWATER WAS ENCOUNTERED AT ABOUT THE TOP OF THE TANK GARNESS ENGINEERING GROUP, L ENGINEERING, SALES , CONSULTING 3701 E. TUOOR ROAD, SUITE 101 'ANCHORAGE, AK 99507 -PHONE (907) 337�179 -FAX 1907) 339 324fi WEBSITE: wxw.parn<ssen9ine<rinp com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JESSICA DOWLING 1-425-246-0451 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: SUNSET HILLS WEST; BLOCK 1, LOT 6 D.J.G. TYPE OF WORK: DATE: �_ STEP TANK PROFILE 6/10/2024 TOP OF MANHOLE = 98.70 — TOP OF TANK AT OUTLET = 92.41 f♦ Jeffrey A. GaynessAV ♦ C 7753 _ Ar : ,,�� ��\\ � LIC NSEf,`%FESS`�`�;• #AECC884 ,11AImi,&** MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231349 Work Type: SepticTank Upgrade Tax Code Number: 01820306000 Site Legal Address: SUNSET HILLS WEST BLK 1 LT 6 G:3033 Site Mailing Address: 14116 OLD SEWARD HWY, Anchorage Owner: DOWLING-BRISTOW JESSICA J Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft: Total Bedrooms: �° S� Departnient 10/13/2023 10/12/2024 17687 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing aeeeiv r: !�,_5-,yeA to 6-2EG Issued By: Date: Date: OZZ Z Development Services Department ` ` '�` P P \� Phone. 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 018-20-306 Property owner(s) JESSICA DOWLING Day phone 1-425-246-0451 Mailing address 14116 OLD SEWARD HIGHWAY *ANCHORAGE, AK Site address 14116 OLD SEWARD HIGHWAY *ANCHORAGE, AK Legal description (Sub'd., Block & Lot) SUNSET HILLS; BLOCK 1, LOT 6 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial R Single Family (SF) Q Septic Tank 0 Upgrade pg ❑ (`^�/wo AD U) Holding Tank El Renewal❑ (D) E]Renewal Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: *225 Waiver Fees: Date of Payment: j o [r Zf? 2 3 Date of Payment: Receipt Number: C, Receipt Number: Permit No. 0-5P 2Waiver No. GADevelopment ServicesTuilding Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc ��j � -f V Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231349, Deb Wockenfuss, 10/13/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231349, Deb Wockenfuss, 10/13/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231349, Deb Wockenfuss, 10/13/23 0 �ro Lot 5 F'P L®t 6 17,687 S.F. s 'A 2.0' CANT 2.0' CANT RETAINING WALL 2¢2 WELL -:L- 100' PROTECTIVE RADIUS '0 ry Lot 11 .2 GRAVEL DRIVEWAY 4.0'x10.2' 22.6'x17.0' CARPORT BALCONY 4.9'x15.8' STORAGE \y�y \ SEPTIC PIPES-'( .0 -MANHOLE RETAINING WALL Lot 10 10' UTILIPY EASEMENTS Lot 9 \-CHAIN-UNK FENCE PLOT PLAN AS BUILT —2i— SCALE 1- = 40' GRID SW 3033 _ Project No. 23-47QZL1_ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associafes, inc. (907) 522-6476 Phone ken*lcngsurvey.com Professional Land Surveyors jonothan*lcngsurvey.com Of A. trovis*langsurvey.com I hereby certify that I have surveyed the following described property: TH LOT 6, BLOCK 1, SUNSET HILLS WEST SUBDIVISION (PLAT No. P-600) 49 Anchorage Recording District, Alaska, and that the improvements situated thereon are ........ .. ........ within the property lines and do not encroach onto the property adjacent thereto, that ?A no Improvements on the property lying adjacent thereto encroach on the surveyed J�o premises and that there are no roadways, transmission lines or other visible A0 KENNETH G. LANG easements on said property except as indicated hereon. 'tW o.2 5 of Anchorage, Dated this the Day of A— Alaska 0#'JkP1f;4jV', It Is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plot. State of Alaska AECC963 Municipality of Anchorage Page J of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report _~m~: ~ a-C~O~ ~ ~ ~ Wastewater System: u New ~Upgrade Address:/v//~ ~/~ ~a~ ~) ABSORPTION FIELD Phone: ~y~- ~ y/~ IN°'°fBe~Oms: ~ Deep Trench ~ShallowTre~ch ~Bed ~Mound ~Other LEGAL DESCRIPTION soi, Rating: Total Depth from original grade: Subdivision: 3eplh to pipe bottom from original grade: Gravel deplh beneath pi e --Tow~ship; /~ Ra.ge: ~ I Secflo~ ~- Fgladdedaboveoriginalgrade:z, FL Gravel ,ength:~?,~ Z~?~ Ft. Gravel depth: Number of lines: Distance belwee~ lines: WELL: D New ~ Upgrade ~ ~ ~ ~'~ Ft. ~ ~-Cased To: Total absorption area: Pipe material: Classification (Private, A,B,C): Total ~ r '~ ~~PM~Yield: Pump Set at: Ft.l Casing, Height Above Ground:FL TANK SEPARATION DISTANCES ~ septic ~ Holding ~S.T.E,P, ~ To Sep0c Absorption Lift Holding Public/Private, Manufa turer: .. F~om Tank Field Sm[ion Tank Sewer Lines ~¢2~ ~ ~ ~ Capaci~ in gallons: Lot Line /~ I ~:~/ /~/ /~/ Size in gallons: Manufacturer: Locaiion and Description: Assu~ed Elevation: inspections performed by: /' ~' ~ Dates: lsL~/f / ~ Department of Health and Human Services approval ~:.~~. ..... fleviewed and approved by: . Date: ~ ~- ~ '~' ~v~ 72-013 (1/91) MOA 25 Permit No._ '5'/'~ ~ ~/¢>/9 ',~ Page ~ of ~ _ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LOT 6, Bt< i, SUNSET HILLS NEST LOT 5 i29.33 SCALE " ~"=40" NELL / LOT S 72-013 A t2/91 ) MOA 25 Permit No. 9/O/? ~ Page ~ ~of__~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report I_egal Description: /~ ~/ ~'¢h~'~¢2/-/¢~//~¢~/¢ ~'/~A,/4.3v4 ~'~ PiDNo.:_~/g~O,¢' MUNICIPALITY OF ANCHORAGE DE?ARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT NUMBER:SW910193 DESIGN ENGINEER:AK ENVIRONMENTAL CONTROL SERVICES OWNER NAME:CHAN JACKSON & OWNER ADDRESS:14116 OLD SEWARD }{WY ANCHORAGE, ALASKA 99516 PAGE 1 OF 1 PERMIT DATE ISSUED: 7/12/91 EXPIRATION DATE: 7/12/92 PARCEL ID:01820306 LEGAL DESCRIPTION: SUNSET HILLS WEST BLK 6 1 LT LOT SIZE: 1'7686 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROW[SIONS: CONFIRMATION MUST BE MADE AT THE TIME OF CONSTRUCTION THAT THE SOIL IS 7 MINUTES/IN~.C~ OF FASTER IN THE AREA THAT THE Z / ALASKA eDUIRODITleDTAL CODTROL SeRUICe$, Auuhu~'u~, AK 99524-0~68 (907) 279-5553 *** FAX (907) 276-8706 InC. Municipality of Auchorage Department of ltealth and Human Services 825 1, Street, Fifth Floor Anchorage, KA 99501 RL: Lot 6, Block 1 Sunset Hills July 10, 1991 III 1990 when the septic system was installed, the end of one trench is 3.3 feet too close to the neighbor's well. The lift station buried edge is 3.3 feet too close to 'the well. Last wt~ter we tried to correct the problem, but the grouud had frozen too deep. I would like a permit issued to correct the problem. ~e propose to follow the plan of November 19, 1990. Instead of a waiver for the lift tank, I will move it to 100 feet from the well. Fees for the permit and lot line waiver are enclosed. The owuer requested that I have the existing septic tank moved to clear it from the easement if a surveyor determines that it is inside the easement. Please issue the permit. bCR/sr Sincerely yours, PhD, P,g, DEg ALASKA nuIRoIhmEnTAL CO,TIrOL ~nqineeriM ~, ~nuironmenlal 51uclies (9o7) P. O. BoX 240668 Anchorage, AK 99524-0668 279-§653 *** FAX (907) 276-8706 InC. November 19, lg90 Municipality of Anchorage Department of Health & Human Services 825 L Street, Fifth Floor Anchorage, AK 99§01 ATTN: John Smith, Program Manager HE: Lot 6, Block 1, Sunset Hills Dear John: ! have enclosed my plan to correct the problem with the system being too close to the well on Lot 9. I would llke to immediately excavate the 5 foot wide dralnfield access to cut off the part of the pressure lines that are less than 100 feet from the well, If the frost Is no~ too deep would like to extend both drainfields to the driveway to pick up the lost area. It appears that, at wurst, we will be able to have the same area as before, If it ls too deep we may have to wait until the frost rises. The day after Bob gnieffel told me of the problem I had Mr, Chan turn off the lift station switches. Isaacs has pumped the tank twlee and pumping has been ordered for today. It appears that I will haw~ to apply for a waiver of the distance of the lift tank to the well. I will try to contact the owner of Lot 9 tonight to see if he is amenable 1412 W(~C 33R0 AV6nU6 · Ancho~,q6. AlAskA 99503 · {907) 279-~53 to the llft station being at 98 feet from the well. If lie doesn't agree we will move the tank the several feet necessary to get it 100 feet from the well. The lift station is down drainage from the well. I I~ou].d llke your approval to correct the drainfield problem. 'LCR/sr Sincerely yours, ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 12 ........ ~,:_n:._, 2~2~. ~ ' ANCHORAGE, (907} 56~.,5040 JOB*-- SHEET NO, OF CALCUI.ATED BY DATE CHECKED BY DATE SCALE t' +" · t , ; · : t~ ' t'' ~ '' '~ ', '; i....! ,,. ', ...j : CERTIFICATE of ,SURVEY OWNER OF RECORD Nome ~ City Stale . I hereby ce~tlfy that Ihe following described property~ ha~ been surveyed by me or under rny super- vi,ion, and lhat ~mprove~men s situated thereon do not encroach on adjacent property~ tha. l'improwments on adjacenl property do not encroach on the ~urveyed premJses~ and thai Ihere are no power IJnes~ transmission lines or other viiible easements or rights-of-way except al shown hereonJ '11 CE - 2251 B.L.~A. Brats Cap Monument Fnd. Brass Cap Monument, ItOh Pipe~ 5et~,Fnd. · s/In x 30 R~bar, Survey Hub & Tock~ ASI Ui LT URVE Y FOR I IJNWIN-SCHEBEN-KO RYNTA CONSULTING ENGINEERS ~nd SURVE~RS 2515 A 5l. Anchorage, Alaska 99~3 ...~ ........ ~ ..... = .... ~Ar~ ~ A ... ~,.. f,. ~, C) N S I '1 E S E H Ei R r~ E R q I T Ul]gP z~cle 14116 I]I..D SEW4]R£) ¢~NL,FIOI? ~ ~E'., Al"'. cPgEJ Flax Lo'~ LegaL: Subd:lvifszon~ Sect ion~ Lot ~3izm 176¢7 ~:~e~Jroorns: l'hi~ F'~rmit.: 81 c~c: I,. ~ 1 SEPTII2 ThNI.'.'[ .H~nimum total ~e. pt.J.c tank c~paci'ty:' 1,000 g~%llomz, 'tarik n'm~sL have, a't. ~a~ ~ compaP'bm6)nts, ])e3D'f.h tO top Of' ~2ptit: I:~ERH.[I ISXF'IRES DIECJ~MF;ER 3]~ 19~().' hIOT'IFY I)[.tFIS OF INSP[ECI-IONS AT :34/5--,4744 CIR 3,1;S-'4~81. I..ac.h mept. zc. ~-, 'tm'd~ (s~) < 4.0 ':: I CIk'R £I.F¥ THA'!; '1. 1 ~fn familiaP ;5, for-Eh by thfe Hdnt, cipality of ~nchorag~ (MOA/> and the Stat.~ of A].a~ka. I ~ztl ~rl~'lall the sy~t. em .in ac:tzordarlcea ~t.k; all HCIA codes and r'E~qulat, ion~ a.r~l itl r:ompliarl~ with Lhe de~:¢ign c:riteria of thi~ p~mmtt. ' r ~ill adhere to all HO~ and State of ~%laska requ'irements fop the met back ..) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Envlronmenlal Heallh Division 825 %" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPI--CTION REPORT N,m~ DISTANCFS Addres~ ~ TANK FIELg. WELL Township, Range, S~[ion , , AS-BUILT DIAGRAM [Show Iocahon of welD, sepliC system, prope~y lies, foundabon, TANKS ~' SEPTIC/~ ¢/- B HOLDING __ Manulacturer Capam[y in gallons TYPE OF SYSTE~ ~ TRENCH ~ BED ~ W. DRAIN ~ OTHER CJa~ificatio~ (A,B,C) ~h ~ Cased to I_. /~ ~ ~ f~~/./cedily Ihal Ibis Inspe~lon was p~dermed a~rdlng Jo all ,unMpal and Slats guidelin, l, elfecI on this date: 72-013 (3/85) ALASKA (907) eFIUIROFIme[1TAL COI1TROL ~n(lin~¢rinq 6 ~noironm~lol ~ludics ,,', I~ I I I F~,m ,~ViUkI:~I~ALITY OF ANCHOP, AGI] I(,HUIL, i OF HEALTH & J~NVIROiQMENTAL PROTECTION NOV '1 9 1990 P. O. Box 240668 Anchorage, AK 99524-0668 279-5558 *** FAX (907) 276-8706 RECEIVED November 19, 1990 Municipality of Anchorage Department of tlealth & }Iuman Servlces 825 L Street, Fifth Floor Anchorage, AK 99501 ATTN: John Smith, Program Manager RE: Lot 6, Block l, Sunset Dear John: I have enclosed my plan to correct the problem with the system being too close to the well on Lot 9, I would like to immediately excavate the 5 foot wide dralnfield access to cut off the part of the pressure lines that are less than 100 feet from tile well. If the froot is not too deep I would like to extend both drainflelds to tile driveway to pick up the loot area. It appears that, at worst, we will be able to have the same urea as before. If it is too deop we may have to walt until the frost rises. The day after Bob Knleffel told me of tile problem I had Mr. Chan turn off the lift station switches. Isaacs has pumped the tank twice and pumping has been ordered for today. It appears that I will have to apply for a waiver of tile dtstanee of the lift tank to the well. I will try to contact the owner of Let 9 tonight to see if he is amenable to the lift station being at 98 feet from the well. If doesn't agree we will move the tank the several feet necessary to get it 100 feet from the well. The lift station is dowo drainage from the well. he I would like your approval to correct tile drainfleld problem. LCR/sr Sincerely yours, ,~D, PE, DEE ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 12 .... ' ~:d:,*w~,~[t~ ? ANCHORAGE, Al. AS KA~i~J~-3'- (907) 561-5040 SHEETNO. OF CALCULATED BY__ CATE CHECKED BY CATE SCALE ~. ~//, . : : . : : : ~'~Q~*~ ~ ;~" c%~~ : CERTIFICATE of SURVEY OWNER OF RECORD Name '. City Stale . I hereby c~Hfy that Ihe following describad property'~ ho~ been surveyed by me or under my ~uper- vis~on~ and Ihat Jmp~ovementi iJtuated Ihereon do not encroach on adjacent property~ that'JmprovBmtnl~ adjacent property do nol encroach on Ihe surveyed premi~e~ and thai Ihera are no power JJne~ tron,mJ~ion llne~ or olher ¥1~ible easementi or rJghl~-of.way except as shown hereon: ~0 · LEGEND. / 8.LM. Bro~ Cap Mo~ume~l Fnd. B~all Cap Monumenl Non PJpe~ S~t~Fnd.~ ~J x 30" R~bar, Sur~ey Hub & Toc~Se~-,Fnd.~ ABEILii LT Vli Y FOR UNWIN.SCHEBEN.KORYNTA' CONSUL~[ING £NGIN£ERS ~,nd SURVEYORS 2515 A St. Anchorago, Aloha 99503 ~~, ALASKA ~FIUIROFlmtZFITAL ~OFITROL $t~RUIC~IB~IVED 12~c¢ 33~nuc, ~u~ ~ - ~n;~~ic pality of Anchorage ..... ~ ........ '~" ~6~t;~ealth & Human Serv ces TO / / / / / / / / / CERTIFICATE of SURVEY OWNER OF RECORD Name ~ City Stale , I hereby certify that the follow'hi/ described properl~ hal been ~urveyed by rne or under my super- vhion~ and that Jmprovemenls *ituated thereon do.n.ot encroach on adjacent property~ lhat'improvemmntl on adjacent property do not encroach on Ihe surveye, d pcerni.*eit and that Ihere are no powe( llnel~ tron*m~*ion lines or other vilible ea~ementl or rlghl~oof-way except as shown hereon: 'LEGEND. B.L.M. Bra~ Cap Monument Fnd. Brawl Cai) Monumenl, Set__,Fnd._~ (g Iron Pipe~ S~t~Fnd.~ · 'S./l" X 30" Reba~, 5et~.,Fnd.~ Survey Hub & Tack~5~t.~Fnd.~ :. REID, ,IR, · ..' E - 2251 No. ,%~.s .,;4~,S LOT_._~ BLOCK ~ --,S U B DIVI S I 0 N _/g[J~J~T ASE3UIi LT U VI .Y FOR MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502~ Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT N~ DISTANCES ~dd,e~s -- ~ TANK FIELD WELL Permit No / Ho ol Bedrooms WELL /0~ / TANKS ~ SEPTIC~ ,~ ~ HOt. DING __ ___ TYPE OF ~Y~TEM - original grade I~ FT FT~- To,al absorp,ion ares ~ ¢ SO ~T ~ ~1 WELLS ~ ~ PRIVATE ~ ~ntlfv) Classifica[ion(A,B,C) ~h ~T Casedto -- )IgOr Ce, ~ REMARKS: - Scale; ~1~.~ ~ ~ "~ '~ ENGINEER'S Health Department Approval /~~ , Date: 72-013 (3/85) F'E:F~H]:T I XI ]1 .~ ))1 [,L_It~I I ::!;:l., N[)i:I:F:Y I)l'll'Eil E)I:: ].lLd I.,..L,t .IE)N~!; (VI' , ,, I, I t (::IR ] t::li!!:l:~:t' :!: I:::'Y I!.i~Y[ :~ :J.. ]: Llfii Ii;:lr"t.['l t:~y tine ,'::ir'id ~.ln [:c:)liit::)] J. alnl:::~.~ / ?' Tom Fink, Mayor Municipality ot! Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 16, 1990 Lee Reid, P.E. Alaska Environmental Control Services, PO Box 240668 Anchorage, Alaska 99524-0668 Subject: Waiver Request for Lot 6 Block 1 Sunset Hills S/D Waiver Request #WR900029, PID #018-203-06, SW900204 Dear Mr. Reid: Your request for waiver of the required 100 foot separation of a septic system to a private well has been approved. The approved separation distance is east 'trench 3 feet. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services ~d%/.~C°ncur: j /. J~hn Smith(~P .~T7 Program Manager On-site Services ljm: #6 ALASKA (9o?) enuiRonmenTAL CONTROL SeRUlCe$, ~'n§incerin~I ~ ~nkaJronmcnleJ ~]ucJics P. O, Box 240668 Aachorage, Ali 99524-0668 279-5553 *** FAX (907) 276 8706 inc. MUNICIPALITY OF ANCHORAGI: ENVIRONMENTAL SERVICES DIVISION AUG 1 4 1990 RECEIVED August ]0, ].990 Department of }lenlth & ]laman Services Municipality of Ancborage 825 L Street, Fifth Floor Anchorage, AK 99501 ATTN: Susan Oswalt RE: Lot 6 Block 1, Sunset Hills West Dear Susan When ~,e uncovered the septic tank for this lot we found it to be only 6 inches underground. Tile northwest corner of the tank is about 8 feet from the lot tine, and 10 feet from the lot line at the southwest corner, There is no sewer system within 10 feet of the tank on either side of the lot line. It is in good structural condition, When I sabmitted lily appJication for a perm:it for this system I showed tile east trench to be 8 feet from the lot line, Bnt I forgot to pay for the waiver request. The east trench is as drawn on tile application. There is no system to be encroached upon as the Old Seward IIighi~ay bas a 100 foot right of way, As soon as the electr:[caJ inspect, ion forms are received, I'i1 send in tile As-Built package. [ apologize for the oversight on applying for lhe waive~'. The fee has been paid. Please g~?ant the lot line waiver for the tank and the east l~rench. LCR/sr ALASKA ENVIRONMENTAL ,Z' g* ~ / ~'o ~ s~7~ ///~//~ .~ CONTROL SERVICES, INC. ~,~ ~o / o~_ /~ 1200 West 33rd Avenue, Suite B . ~ -- ~ -- ~,~BCHORAGE, ALASKA 99503 CALCULATED BY /' /: ~-;/ DATE ~(907) 561-5040 --- ~ ~ CHECKED BY BATE -~'~ e /~//~' ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO CALCULATED BY CHECKED BY ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 CHECKED 8Y DATE -- SCALE 825 L Street, Anchorage. Al.a'~a g951~ .1~ t.~%, CE/- 2251 LEGAL DESCRIPTION: ~ /~ / %"'-**¢' /~/~¢'/ Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13- 14- 15- 16- 17- 18- 19- O?/?/f'- ¢ SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Reading Date Gross Time s L 0 P E Net Time 20- PERCOLATION RATE 'rEST BUN BETWEEN (minutes/inch} PERC HOLE DIAMETER FTAND____~ FT PERFORMED BY: ---- '~' /~,P, tO/ _ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) __ CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: To simplify the design of small pressure distribution networks, Table 7- 13, and Figures 7-28, 7-29, and 7-30, may be used. Examples 7-2 and 7-3 illustrate their use. Other design methods may be equally suitable, however. TABLE 7-13 DISCHARGE RATES FOR VARIOUS SIZED HOLES AT VARIOUS PRESSURES (gpm) Pressure Bole Diameter (in.) f_]_t psi 1/_~4 5/16 3/___8_ 7/16 ,i/2. i 0.43 0.74 1.1B 1.66 2.26 2.95 3 1.30 1.28 1.99 2.87 3.91 5.10 4 ]..73 1.47 2.30 3.31 4.51 5.89 5 2.17 1.65 2.57 3.71 5.04 6.59 Example 7-2: Design of a Pressure Distribution Network for a Trench Absorption Field Design a pressure network for an absorption field consisting of five trenches, each 3 ft wide by 40 ft long, and spaced 9 ft apart center to center. Step 1: Step 2: Select lateral length. Two layouts are suitable for this system: centra-~-~an~d (Figure 7-24) or end manifold (Figure 7-26). For a central manifold design, 'ten 20-ft laterals are used; for an end manifold design, five 40-ft laterals are required. The end manifold design is used in this example. Select hole diameter and h61e spacing for laterals. For this example, J1/4-in. diameter holes spaced every 30 in, are used, although other combinations could be used. 284 285 ploj!ue~ pu~ 286 FIGURE 7-30 NOMOGR~PH FOR DETERMINING THE MINIMUM DOSE VOLUME FOR A GIVEN LATERAL DIAMETER, LATERAL LENGTH, AND NUMBER OF LATERALS ' 4.000 3,500 ' 3,000 .2,500 · 2.000 · 600 · 500 · 45o ~oo ,200 ' 150 ~oo .~o / , if/<, ,. (4 u_ 0 '10 '15 2O 287 TYPICAL PUHP PERFDRHANCE CURVE 1-/0 160 150 140 130 110 90 5o Gallons per mlnu-te .~33~?~' NEMA 4X Junc~ NE~/ ITEMS 1' PIPE NIP ~/ELDE: INTL-] RISER ~/AL! KEEP ABOVE 5RADE 1' C[]NBUIT LB 1' PVC MALE ADAPTER 1' PVC CBNDUIT Ret~pleYal ~ t,"~ ~ MUNICIPALITY' OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE MAILING ADDRESS LEGAL DESCRIPTION ~'-/ LOCATION NO, OF BEDROOMS I Well I Absorption, area Dwelling PERMIT NO. Material ~P ~ Manufacture~ ~ ~ ~ ~/~ 2-~ ~/ No. of~mpartments ~ Liq, capacit~ in gallons IF HOMe'DE: Inside lengtl~ Width Liquid depth Well Dwelling ', PERMIT NO, ¢~ ~ DISTANCE TO: ~ Materia) Liquid capacity in gallons ~u~ DISTANCE Well Foundation~ Nearest lot line PERMIT NO. TO: :~. ~ ~ No. of lines Length of ~ach line Total leng~ o{ lines Trench ~dth , . ~ I finish grade ~ ~ --~ Top of ti~to ~ Length Width ~ Depth~ - ~ / PERMIT NO, ~ P Type~f crib .~.~/ 0r'ib ~iame[~r Crib d~h ) ,, Total effective absorption area ~ DiSTANC~ TO: ~ DISTANCE TO: OTHER PIPE MATERIALS -- ~ SOIL TEST RATING INSTALLER REMARKS .... ~ A ~¢ ~A~ ~aymond L, Alexander ~ ~ -- ~P~ROV~D DATE LEGAL : 72-013 (Rev. 3178) <-." I:::1l:::'1:::1. ][ C:t::It",IT THE I.EI",IEiTll I%!H"I[ii:t'q~£;]:CII".I Z::; THE: L.[:!;I",IEi'I'H (::[1",1 I::'IE[~:T) O1::' TI'lIE 't'l'"lli!; [)E::I:::'"I'H Cfi:' I:::1 '['F?.I~:NCH O[;i: I:::']:'1" .'(':':~ THE I::, ]: :~i;Tl::tl",lC:l!i: I'?,tZII.,.IIEEi%I THE :!i!;I..II:;i:I::'t:'tE:E O1:::' TH[i: (:il;[:EIIJI'.,ID FIt",I[)THE: [_:~OI'T()I"I Cd:: 'l"['ff~: [i?,C:F:I',,,'F:I't']:OI",I (:ZI",I I:::I~:tZ"I"). I~F'IE':F?.Iii: ]:'.~i; NO '.E;IET 1,1:I:[::,-I'I.'1 I:::(:)1~: '['1'I[!:. (:~i1:;~'.1::1',,,%!.. I:::,E;I::'TI-f :[:~i; 'THE: PI :[ N ): f'IUI"I [;:,lii:l:::"['l.I (:)F' GI;i:F:I'v%I._ BETI.,.IEI!i:I",I -t'HE OI..IFI;::'I:::IL.I. !:::'ZI:::'IE I::]t'.,ID 'l~Hli[ [!ff')TT(:ll'"l O1:::' 'I"HE I:_::XI::::I:~',?I::T[']:Otq ':ZI",I ]: C:I::':]:,~:T Z t::'"r' Tlli:::IT :L: Z I:::11'"[ I:::'F:ff'I:[L.:[t::II:~'. I.,.I]:TH THE I;?.[E6:!U];F?.[i;Mlii:I",IT'_:il; F:'E[I:;?. Ed",l"".~i;]:'l'[~: :i!!;[i:l,lE:l:;i:::_:; 1:::1l"4[) !,!l:i!:L.l..:i'i; I:::l:ii; :~:;E:-,r t:::Ed:;;:"IH [i?'r' '[HE: PtI..II",I ;!: C: ]: I:::'I:;:II.. ]: l""r' Ell-:: 2: .T. M:[I..L. ]:I".I:!i!;TI:::II.I.. -I'I'IE '.il;"¢!i;Tliiff"l :(1",! i:::ICE:OF~:DI:::INC:IE I.,IZ'['II '[HI!i; ::i!:: ]: I..ll",![)Ei:l:~::!~;'l"f::'llqD TI"IFIT Till!i; O1",I'"':!!;):"1'1!i: ::::;EI'IEI:,J: :i~;"r'!i;'l'tii:f'l PIF:I"i' t:;::Ii![(i:!UZ[,;:[":: I[NL.I::ff;?.(!iEI'"ItEh!T :1:1:::' I:;i:IE:!!;Z[)[:::t",IC:[i: :l:::i!; I:;i:[!i;P1CIE)E:LE!:D 1'O [I",IE:I.LII:)E: i'"IOF~:E ITII:::IN :ii: oompany, Ina,, April 30, 1978 Mr. William Breedlow~ Anchorage, Alaska $901 ~olo~. box 8718. anohorage, alaska · T.D.C. No. 78A-065 Re: Test Hole and Soil Log Report for Sanitary System Lot 6, Block 1, Snnset Hills West Snbdivision, Anchorage, Alaska Dear Mr. Breedlove: We are submitting herewith the test boring resnlts and our comments regarding soil conditions encounter.ed at the subject site. This in- vestigation was perfermed in accordance with your request of April 24, 1978 and those procedures outlined by the Municipality of Anchorage, Department of Environmental Quality. A single test hole was d~'illed within the subject site area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Drilling was accomplished with an auger type drilling rig and the test hole was extended to a total depth of 20 feet below ground surface. The final log of the test hole is enclosed. Groundwater was not encountered in the test hole while drilling. A percolation test was performed from a depth indicated and reflects average infiltration from that depth to the bottom of the hole. We appreciate being given this opportnnity to be of service tO you. Should you have any questions with regard to the ahove, please' do not hesitate to contact us. Very truly yours, / / TIlE DRILLING COMPAN~f, INC. W ILL IAM ~E%--D~NCAN President WED:bi o anohorage · ~alrbank~.alo'~'~?' T.H. 1 4-27-78 _0.0' 0.5~ Silt, trace Sand (ML) NO SCALE Sandy Gravel trace Silt (SW) it, trace Sand (ML) Sandy Gravel some Silt (GM) Some Silt__(SM_~)~. Sand, Soma Silt trace Gravel (SM) Sandy Gravel Some Silt (GM) 4.0! 7,0T ___8.0' I0.0' 14.0' Sandy Gravel Some Silt trace CoBbles (OM) Test Hole Location are approximate only and have not been located by surveyin[ methods. Log of test hole represents location only Lot 6, Block 1 Sunset Hills Subdivision WILLIAM BREEDLOVE Log of Test Hole 20.O'T.D. Lot 6, Block 1,' Sunset Hills West Anchorage, Alaska PERCOLATION TEST William Breedlove T.D.C. No. 78A-065 ELAPSED TIME (minutes INCITES DROP IN INCHES 12:10 12:11 12:12 12:13 i2:14 12:15 12:16 12:17 12:18 12:19 12:20 12:25 12:30 12:35 12:40 1~:50 1:00 1:10 0 1 2 3 4 5 6 7 8 9 10 15 2O 25 30 4O 5O 60 15.0 15.50 16.0 16.50 17.0 17.50 17.50 18.0 18.50 18.50 19.0 20.25 21.0 21.75 22.50 24.75 26.0 27.25 .5 5 5 5 5 0 5 5 0 5 1.25 .75 .75 .75 2.25 · 1.25 12.25 Total Drop (in.) 4.9, Minutes per Inch SiX INCN WATER WELL DRILLED AND CASED OUT to THE DEPTFI OF DRILLED AT THE RATE OF _ $19o00 PER FOOT. PROPERTY OWNER I1~o BZ.bL B]c~e. dJ~tz¢ 344-31.92 RECEIVED LOCATION Of WELL SITE. DRILLER WELl. LOG: 0 ..... 32~ COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS P~OR THE SUM OF THANK YOU VERY MUCH. BERNIE: CLAUS OF RAMPART DRILLING WORKS SERVICE OHARGgOF I~% PEr MONTH WILL ~E A~;SESSED ON PAST DUE A~NT~ Parcel I.D. 018-203-06 Certificate of On -Site Systems Approval Expiration Date: 5/31 /2025 Legal description SUNSET HILLS WEST BLK 1 LT 6 Site address 14116 OLD SEWARD HWY Anchorage AK Current property owner(s) DOWLING-BRISTOW X The On -site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: a Original Certificate Date: 8/29/2024 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 i WMEMMEROM Development Services Department On -Site Water & Wastewater Section Phone: 907-343-7904 Fax: 907-343-7997 �fCertificate of On -Site Systems Approval Application . - 1. GENERAL INFORMATION Parcel I.D. 018-203-06 Complete legal description Sunset Hills West 131 L6 Location (site address) 14116 Old Seward Hwy *Anchorage, AK 99502 Current property owner(s) Jessica Dowling 2. ON -SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 425-246-0451 3. TYPE OF WATER SUPPLY: n Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units . Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: Ail Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: O Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age New - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench R Wide Trench ❑ Seepage Pit Waiver request for:_ L ' % uo 9 Distance: - L' C.i� ; kc 9 9.1 Expedited review requested: ❑ By applying for this entitlement, this property is subject to inspection by municipal On -site staff to verify the accuracy of the information provided. COSA Fee $ j5' Waiver Fee $( fl Date of Payment COSA # . S { / 3 Z Date of Payment Waiver # `7 C C V 3 COSA Applitation June2022 A Legal Description: Sunset Hills West 131 L6 Parcel ID: 018-203-06 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _ A. WELL DATA FN Well log is filed with Onsite (or attached) Date drilled 6/4/1978 Total depth 141 ft Cased to ft d Lf t 04, Al Sanitary seal is functioning correctly X Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 9/27/23 Static water level at beginning of test 67.4 ft. Comments B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping 0 Required maintenance completed, if AWWTS Comments: Well production at time of test 5.3+ gpm Water storage tank volume gallons &12,912V Well disinfected for coliform test? ❑ Yes ® No D. ABSORPTION FIELD DATA 15 0-S �- 5 - Which system tested (date installed) 812911991 Mil ALL standpipes present per record drawing Total measured depth from grade 7.1 ft (max) Measured depth to pipe invert from grade ft (min) A N/A —pressurized field. FN Per record drawings, field is insulated. ( we &+T ❑ Monitor tubes go to bottom of effective. If not, state depth into effective UNK FEW Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 1553 gallons 8/26/24 date Any rejuvenation treatment (past 12 months) none If yes, enter date - 0 Coliform bacteria is Negative Nitrate 0.856 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L R Arsenic less than MRL (ND) Collected by GEG Date 9/26/23 C. LIFT STATION ❑ Required maintenance completed Age of lift station 0�kAJ years Lift station material - Comments: Adequacy test date 8/26/24 Results QPass Fluid depth prior to test C in Water added 555 gal New fluid depth 19.5/25 in Elapsed time 990 min Final fluid depth 8/8 in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 42 in Effective depth used *8/8 in Effective depth remaining *34/34 in Comments/Deficiencies: MT1 & MT2 about 0.8' difference in elevation; MT3 and MT4 are 0.53' difference in elevation. Used deep MT's for all liquid measurement' All Mt's were dry and 8/26/24 pior to the pre-soak. Ran all water through the lift station. COSA Checklist June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' ***98 Community Sewer Manhole/Cleanout > 100' Yes if No ft Fmil Yes if No ft Neighboring Tank > 100' Do Yes if No ft Private Sewer/Septic Line > 25' Yes if No *"uNK ft Absorption Field on Lot > 100' ❑ Yes if No *** 90 ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' * Animal Containment > 50' Q Yes if No ft [] Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Yes if No ft Q Yes if No ft 100 NIA — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' Pil Yes if No ft Surface Water > 100' Yes if No ft Tank to Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ❑ Yes if No ****0.5 f Private Wells > 100' 5-1 Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' M Yes if No ft Water Service Line > 10' Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS c� t 4- iJto 1! t V N K Burial Depth of Drainfields are Unknown, but Ilkley shy on cover. Shallowest tt C,4lJa _. a extends 4.77" below grade. The other Mrs extends S to 7.1' below grade mmm G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on -site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Gamess Engineering Group, LTD. (GEG) Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Garness Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. COSA Checklist June 2022 #AECC884 a ess_ CE—-'a� ��g c� \lrp�o`essiono�o 1 MuniciPality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 018-20-306 - HAA fi: /~//~ ~"'-~ Expiration Date: GENERAL INFORMATION Complete legal description Sunset Hills West Block t, Lot 6 Location (site address or directions) 14116 Old Seward Hwy, Anchorage, AK 99516 Current Property owner(s) Charles Lanning Day phone 563.3012 Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. .2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or class c well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION 'BY ENGINEER Se As certified by my seal affixed hereto and as of the validation date shown below, I vedfy that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms'and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm KND Engineering ~ Phone 696-6111 Address 20441 Ptarmigan Blvd. Eagle River, AK. 99577 Engineer's Pdnted Name Kenneth M. Duffus Date. 10/26/01 DSD SIGNATURE ~ Approved for --~ Disapproved. Conditional approval for bodrooms. bedrooms, with the following stipulafions~ Additional Comments Attachments: HAA Checklist Septic System Advisory. Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date:' -I1-1-ol (Rev. 12/00) Legal Description: A. WELL DATA Well type private Date completed 614/79 Total depth 141 ff. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST SUrlSet Hills West Block 1, LOt 6 Date of test Static water level 120 ft. Well production 6,2 g.p.m WATER SAMPLE RESULTS: Coliform 0..coloniesll00 mi. Nitrate 0.562.. mg.ll. Date of sample: 10117101 Collected by: B. SEPTIC/HOLDING TANK DATA If A, B, or C provide PWSID # Sanitary seal (YIN)Y__ Cased to 141 ft. FROM WELL LOG 614rf9 Parcel ID: 018:20-306 we, Log (Y/N) y Wires properly protected (Y/N) Y Casing height (above ground) 2,5' AT INSPECTION 101t~rt01 '/3 ft. 6 g.p.m. KND En~ilneerln.q Other bacteria 8 coloniesll00ml Tank Type/Material t250 STEP-Anch, Tank ! Steel Date installed 8/29/91 Tank size t250 gal. Number of Compartments 2 Cleanouts ~.__Foundatlon cleanout y__Depression over tank N___High water alarm NA Date of pumping 10113101 ABSORPTION FIELD DATA Date installed 8/29/9t Soil rating Length ~!)' _N/I & 24' (E) Pumper McDonald's (g.p.d./ft2 or ~/bdrm) 0.8 System type ft. Width 5 ft. Gravel below pipe Shallow Trench 2.5' (W) & 3.5' (Et ft. Total depth 4' (iN) & 6' (El ft. Eft. absorption area 448 ft2 Monitoring tube _Y__Depression over field N Date of adequacy test 10117101 Results (Pass/Fail) *Pass For L bedrooms Fluid depth in absorption field before test Dry in. Water added 450 gal. NeW dePth ~,_J~0_L~.5..C~ in. Elapsed Time: 1440 min. Final fluid depth 1,5 (Wll 15 (El in. Absorption'rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) Y Septic Clear-Acid If yes, give date 09111101 Fe D. LIFT STATION Date installed 8129191 'Pump on" level at 44 in. Datum Bottom of tank E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main ?5'+ Sewer/septic service line 25'+ Size in gallons .1250 Manhole/Access (Y/N) Y 'Pump off' level at .40 in. High water alarm level at 44.5 Cycles tested 3 Meets alarm & cimuit requirements?.Y 100'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manholelcleanout Holding tank 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Absorption field 5'+ Building foundation 5'+ Property line 5'+ Water main .10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION OISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line t0'+ Building foundation 10'+ Water main 10'+ Driveway, parking/vehicle storage 25'+ Water Service line 10'+ Surface water 100'+ Curtain drain 50'+ Wells on adjacent lots 100'+ in. COMMENTS The east field's operatinq level is in the top two-thirds of the absorption area ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Kenneth M. Duffus Datet0126101 HAP, Fee $300 Waiver Fee $ Date of Payment IOl?.-'~/0 ~ Date of Payment Receipt Number t ~-~)2..~ ,~-~_~, Receipt Number (Rev. 12/00) Parcel I.D, #. 1. MUNICIPALITY OF ANCHORAGE ~, DEPARTMENT OF HEALTH & HUMAN SERVICES_ Division of Environmental Services On-Site Services Section . P,O. Box 196650 Anchorage. Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address ' Agent Address Day phone ~-7 ~-"~ ~ ~.,I Day phone Day phone Unless otherwise requ-ested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: Individual well ~' "'-" ....... : ....... '"co~i~unity well- Public water NOTE: 4. TYPE OFwAsTEwATER DISPOSAL: Individual on-site CommuD.ity on-site Public sewer , NOTE: lng to the legality and status of system. If community well system, provide written confirmation from State ADEC attest- . '..C',:¢',,, ,~ I")1,1.,., ~, If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. * · 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance .with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ~ '~ ~' ~'~"~ ,-~ u ¢~-~,*-~¢~' ''~'~ Phone Address ~ ~ .JS~ ~ ~ Engin~¢s signature %~ Date 6. DHHS SIGNATURE X' APProved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments · ~.;.. {.,') ~._ .~-~.. ., he MddiciCality of,~chbrage Department of Health and Human Services (DHHS) issues Health Authority ~pproval CIgrtd~cates.'based only upon the representations g~ven in paragraph 5 above by an independent profbssional englheer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending ~nsbtubons in orderto satisfy certa n federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is 'issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work... - 72.025(R6v, 1/91) Back MOAt~I Municipality of Anchorage [:)epartment of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LoT~ A1 Well Data Well type _ '~.-., Log present (Y/N) Parcel I.D. Total depth _ I ~ ~ Cased to Sanitary seal (Y/N) "/ / Date of test Static water level Well flow Pump level1 If A, B, or C, attach ADEC letter. ADEC water system number I"-{//.~_ Date completed ~/~/~(¢ Driller '-'~ ct. 14..1/}o ,~ ~- -.[---- I tit I Casing height ~ f Wires properly protected (Y/N) 7 FROM WELL LOG AT INSPECTION o5LO .g.p.m. ~ g.p.m, r~ SEPARATION DISTANCES FROM WELL 'FO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots __Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform / Date of sample: ~'{L{~-// Nitrate / ~). 5 1 ~-~/~( Other bacteria Collected by: ~-.-'---~ Date of Pumping B. SEPTIC/HOLDING TANK DATA Date installed ¢/~,/ q .~ Tank size ~ ~ ~'O Compartments Cleanouts (Y/N) \/ Foundation cleanout (Y/N) _ _'~ Depression (Y/N) High water alarm (Y/N) 'G'/Zc¥//'~'&~- PumperAlarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I (9 55 On adjacent lots To property line J~ Absorption field Surface water/drainage Foundation ~ Water main/service line_ 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons / ~ ~C~ Vent (Y/N) "7' "Pump on" level at High water alarm level L~ ~. _~ __ Meets MOA electrical codes (Y/N) / SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot I O ~ On adjacent lots Manufacturer Manhole/Access (Y/N) '~' "Pump off" Level at Cycles tested ') ! ~ Suriace water '~ /~-"~ D. ABSGRPTION FIELD DATA Date installed c~//,',L4 - ¢ Length ~¢%~'¢' ¢L~ Width Total absorpti.qn area ~ '~ Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Cleanout present (Y/N) Results (pass/fail) Soil rating (GPD/FF) ¢' ~ System type ~/ Gravel thickness ~. ¢ ~-.~ Total depth / Depression over field (Y/N) _ [ "~ .for ~ Bedrooms After test ~' (~ '{~ ¢¢-~ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot l ~ To building foundation On adjacent lots Surface water Curtain drain On adjacent lots ~ / ~ Property line To existing or abandoned system on Cutbank /k~ ~ ~ 4__ Water main/service line Driveway. parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HA.& guidelines in effect on the date of this inspection. Signature Engineer's Name ~_ Date HAA Fee $ '~ Date of Payment Receipt Number 72-026 (3/93)* Back Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE ,/.~&--'~, r)epartment of Health & Human Services DIVISION OF ENVIRONMENTAl. SERVICES 343-4744 Parcel I.D. #. CERTIFICATE OF INSPECTION FOR HEALTH AUTHORFI'Y APPROVAL OF ON-SITE SEWER AND WATBR FACILITY FOR SINGLE FAMILY DWELLING (4'2/4'~ ~ ~ ~.~0' ¢/ NAA # _//,/-r¢~/'¢¢ 1. GENERAL INFORMATION (Must be completed prior to submittar) (a) Legal Description .(ir~clude lot, block, subdivision, section, township, range) Location (add~'e~"~ r dire~t [~h§) (b) Property owner ~ ~ / ~"~, ~-,~ . Telephone: (home) (c) Lending Institutibn' * ' Telephone Business Mailing Address (d) Real Estate Company and Agent __ Address Telephone - (e}'Mail the HAA to the following address: (or check here ~ if hold for pick bp:) List contact person and day phone number below: TYPE OF RESIDENCE Single-Family,l~ Number of bedrooms WATER SUPPLY Individual Well ¢¢ Community [] Public [] Nole: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status, SEWAGE DISPOSAL On-site ~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status, 72-025 {Rev. 7/88) Page 1 of 2 le^oJddv leUOB!puoo ,Lo SL~J@..L -')%%'F 5 2-.-'7~/ LuJ!=l ,~0 eUJeN MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA} CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: A. WELL DATA Well Classification /Fi O Well Log Present (~.~) _ Date Completed TotaIDepth /~// Cased to / Y /__ Depth of Grouting If A, B, C, D,E.C. Approved (Y/N) Yield __ ~ '~.¢p", / :~,'"~;~/~'/ Static Water Level ___//7 ¢ Casing Height Above Ground __ ~ .~ / Electrical Wiring in Conduit (~.'.'~N) SEPARATION E)ISTANCE-'S FROM WELl.: Pump Set At tJ/,./2., ¢~_,--* , Sanitary Seal on Casing Depression Around Wellhead (Y~'~ To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line ~../,¢- · to Nearest Sewer Service Line on Lot Water Sample Collected by __/, b , Water Sample Test Results /~2~"¢-; (¢') Comments ~.~'e-~=~,s, vCt'e~? /.-~"~¢, /¢~/ / __ .; On Adjoining Lots /D°t ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ; Date /2//~/~/ t¥4~f,~'E~r~l~ SERVICES DIVIStON 0,.(, 2 4 1991 B. SEPTIC/HOLDING TANK DATA Date Installed 1~/:~?'/ Size ~ ~,~'--'~ No. of Compartments Standpipes~) _Air-tight Caps~N) Depression over Tank Pumping/Maintenance Contact on File (Y/N) Helding Tank High-Water Alarm (Y/N) RECEIVE[) Foundation CleanoutL~N) Date Last Pumped ,'~,J ;for ~__~_ Temporary Holding Tank Permit (Y/N) _ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To water-Supply Well To Property Line / To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course To Building Foundation 7'0 Disposal Field ;'¢¢ Comments 72-026 (Rev. 7188) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed __/~¢0 ¥~ /~'¢/ Width of Field ,5"' / Type of System Design Length of Field ,.¢ ¢/~,¢,,~'t Depth of Field Gravel Bed Thickness Square Feet of Absortion Area ~.2.&//~¢~'* 2zzh¢~;a~)'Statndpipes Present CN) Depression over Field (Y,~ Date of Last Adequacy Test Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well /~' ' To Building Foundation ,~,~. ' Lot /-~ To Water Main/Service Line __ ~ To Property Line c~-,¢ To Existing or Abandoned System on ; On Adjoining Lots .~ 23- / To Cutback (if present) /U.//~) To Stream, Pond, Lake, or Major Drainage Course / ,~' To Driveway, Parking Area, or Vehicle Storage Area ,~- Comments D. LIFT STATION (.,,~'T~"-?...) Date installed __ Size in Gallons / "Pump On" Level at High Water Alarm Level at ,~.~z,.% '/ Tested for Meets MOA Electrical Codes CN) Comments Dimensions Manhole/Access (~N) "Pump Off" Level at Vent ~N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA inspection. Signed Company Date MOA No. the date of this I~eer's Seal f~ Receipt No, __ Date of Payment Amount: $ 7~ 026 (Rev. 7/88) Receipt No Waiver Fee: $ Date of Payment Page 2 of 2 CT&E Ref.~ Matrix Client Sample ID CT&E Environmental Services Inc. Laboratory Division ~'~'/~,~'~3~'~,~r~~~~~ 95. 0 -1 Laboratory Analysis Report WATER 6/1 SUNSET HILLS WEST Client Name TOBBEN SPURKID%ND, P.E. WORK Order 15137 Ordered By TOBBEN SPURKLD-ND Printed Date 06/08/95 @ 10:46 hrs. Project Nalne Collected Date 06/02/95 @ 16:00 hrs. Project~ Received Date 06/02/95 ~ 16:15 hrs. PWSID UA Technical Director STEPHEN C. EDE Sample Remarks: SD~4PLE COLLECTED BY: T.S. QC Allowable Ext. A~al Parameter Results Qual Units Method Limits Date Date Init Witrate-N 0.51 m~/L EPA 353.2 10. 06/06/95 OAA See Special Instructions Above UA = Unavailable ** See Sample Relnarks Above NA = Not ~alyzed U, = Undetected, Reported value is th~ practical quantification li~it. LT = Less Than ~] = Secondary dilution. GT = Greater Than 200 W. Potter Drive, Anchorage, AK 9951 8-1 605 -- Tel: (907) 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAl. PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER I:ACILITY 264-4,720 Application Date_ GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) / / / /¥ J Applicant Address u-G q/o Bus,ned 2 7& "' IZ/8 (c) Applicant is (check one): Lending Institution []; Owner/builder E]; Buyer L'"]; Other [~ex;lain); (d) I_ending Institution --/,-'~2//~/,&,/./~-~/~,4.2(, j '~--~elephone ~c~'~'//~' / '7(//c/ (e) Real Estate Company and Agent Address Telephone (f) Mail tbe HAA to the following address: TYPE OF RESIDENCE Single-Family ~Multi-Family Number of Bedrooms Other WATER SUPPLY _- Individual Well ~'/Community F"] Public E] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAG_.,EySPOSAL Onsite ~ Public Fl Community [] Holding Tank [] Note: If corn rnunity well system, must have written confirmation from the State Department of Environmental Conservation altesting to the legality and status. Page 1 of 2 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION .... As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein, I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wasteweter disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. ~/'(: .~ Name of Firm _ ,/~ Date Approved for '""-'~;'-' bedrooms by ~4.~z¢.¢,..~ ~4,,f)~'~..~..~-" Date Approved _ ~ Disapproved ~ Conditional \ CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the repres'entations given in paragraph 5 above by an independent professionar engineer registered in the State of Alaska, The DHEP doss this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements, Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MO~,l HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & L:NVIRONMENT^L PROTECTION o. 19B6 264-4720 ' -- ' '"" D WELL DATA Casing Height Above Groanc Electrica Wiring In Conduit (Y/N) Separation Distances from Well: Well Classification f/'"///'~ If A, B, C, D.E.C. Approved (Y/N). Well Log ~resent [Y/N) ?/¢' .'¢ Date Completed '~U ~ + 7& (Yield Static Water Level Pure ~ Set At ,5 ~ Sanitary Seal on Casing (Y/N) ~[ Depresmon Around Wellhead (Y/N) To Septic/Holding Tank on LOt / 80 f"~' ''/ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot __ ///~) ,-/f'~ On Adjoining Lots / To Nearest Public Sewer Line Cleanout/Manhole _ , -- ~ Water Sample Collected bYl~ [~{/"~'-~ To Nearest Public Sewer ..~ To Nearest Sewer Service Lin~on Lot Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed/' ~"g,¢~/?~"'//~' "(~ Size Standpipes (Y/N)/ "~C¢'[' Depression over Tank (Y/N) Pun' rang/Maintenance Contract on File (Y/N) Holding Tank High~Water Alarrr fY/N) ~ '/[/'/~-- Air-tight Caps (Y/N) No. of ComeaHments Date Last Pumpea ___;~j/_~ Z/ ; for Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-SL, pply Wel TO Property Line /(.~ To Water Main/Service Line / To Building Foundatior 7 (~/ ~ -o DisDosal Field To Stream Pond, Lake, or Major Drainage Course Comments Page ' of 2 72-02E 11184) 3-'? Lc' C. ABSORPTION FIELD Soils Rating in Absorption Date Installed ~'"- Width of Field 3 ¢"lL '-~ Square Feet of Absorption Area Depression over Field (Y/N) '/~'O Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well //'~ ~ TO Building Foundation ~'~-~ Type of System Design Length of Field Depth of Field / ~ / Gravel Bed Thickness "7 / '~'" --..~)(~)/,,,j/~ ~/~?Z Standpipes Present (Y/N) Date of Last Adequacy Test -~ Lot ,/¢...,t /~ To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Property Line To Exi~tin¢~ el' Abandol~ed System Adjoining Lots TO Cutbank (if present)~ -- ~ '~ on To Driveway, Parking Area, or Vehicle Storage A/rea Commen.~ .~'-//~/) ~/~¢~k(~ O[ ~ ,7" D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions ,Manhole/Access (Y/N) g Cy during Adequacy Test. Meets MOA ** Check Per/~t~edi:oo I c e r ti f y t h ?~4h.alv'~ Signed Company Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (t 1/84) Against HAA Request ** r conformed to aJYClOA and H.A.A g ~ideljnes in effect on the date of this inspection, ~--~ MOA No. MUNICIPALITY OF ANCHOR AGE DEPT. OF ,.2AL'¥H & DEPARTMENT OF REAl. TH & ENVIRONMENTAL PROTEO~I~ONMENI'AL PR©TECI'tON 825 L Street - Anchorage, Alaska 99501 5NVtRONMENTAL ENGINEERING DIVISION JUk 1 'L 1979 Telephone 264-4720 R E C E J V E D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed, Please allow ten {10) days for processing, 1. PROPERT .O NE~ PHONE MAILING ADDRESS PROPERTY RESIDEI~T (if different {rom above) 2, BUYER MAILING ADDRESS PHONE PHONE PHONE 3. I. ENDING INSTITUTION 4, REALTOR/AGENT MAILING A D DFI~_S~~ 5. LEGAL DESCRIPTION I STREET LOCATION 6. 'rYPE OF RESIDENCE r'~ ~ SINGLE FAMILY [] MUL'rlPLE FAMILY NUMAR OF BEDROOMS [] One [] Four [] Two [] Five ~ Three [] Six Other 7, WATER SUPPLY INDIVIDUAL' [] COMMUNITY [] PUBLIC UTI _ITY 8. SEWAGE DISPOSAL SYSTEM [~ INDIVIDUAL/ON-SITE~' [] PUBLIC U'FI LITY * ATTACH WFLL LOG, A well log is required for all wells drilled since June 1975, For wells drilled prior to that; date, give well b · depth (attach log if aveila b.) ~ ,~, **If individual/on-site, give installation data "_,/~ . If system Is over two (2) years old an adequac~ test IS required by this Department, NOTE: THE INSPECTION FFE MUST ACCOMPANY EACH RI=QUEST BI."FORE PROCESSING CAN BE INITIA'I'ED. 72-010{3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FiVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified iNSTALLER []Septic Tank or [] Holding Tank Size: __ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line Absorption Area to neorest Lot Line 5, COMMENTS [~APPROVED FOR ? BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Titlel /.7 LEGAL DESCRIPTION 72-010 (Rev. 3/78)