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Home My WebLink AboutSAND LAKE #2 BLK 3 LT 18Sand Lake Block Lot 18 #011 - 134-07 Municipality of Anchorage On-Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251130PID Number: 01110340700 Dwelling: EN] Single Family (SF) M with ADU El Duplex (D) El Two Single Family Project: ❑ New ENI Upgrade 1 Name CARSON CHRISTOPHER ABSORPTION FIELD ❑ Deep Trench n Wide Trench [I Bed El Mound Site Address 8100 SEAVIEW ST 0 Other Phone Number of Bedrooms Soil Rating Total depth from original grade 715-0909 3 GPD/SF Ft� LEGAL DESCRIPTION Depth to pipe Invert from original grade Ft. Gravel depth beneath pipe Ft Subdivision Block Lot SAND LAKE #2 BLK 3 LT 18 Fill added above original grade Ft, Gravel length I FL Township Range Section Gravel width Ft Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding 1 Sewer Total absorption area Number of trenches Dist between trenches From Tank Field Tank 1 Line F t2 Ft. Well 100,+1 na na 125'+ TANK @! Septic [I S.T.E.P. 0 Holding El Other Manufacturer GREER Capacity 1000 Gal.! Surface Water 100,+ na na I Material PIStc Number of compartments 2 Lot Lim 10,+1 na na NA n a Foundation 101+1 n a LIFT STATION Manufacturer Capacity I Remarks Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank D3034 drainfield Tankt to D30341 Jordan Anderson Drainfield CO/MT D3034 Inspector NorthRim Eng. BENCH MARK (Assumed elevation) 100 ft Inspection at 6130/25 7/11/25 Location and description aro 3,a 7/2/25 2" 01 rear door threshold ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Date 49 1H ......... Steve Eng CE —6256 :FAI Septic System Approved Da AW zotis —fl N approval does not include well permit requirements. 1'4 2 C u C D d F9 D z R) Cil 0 m A O 3A a+ tA ow —u V) ;;U F9 C 9 --1 F— (� F9 V) V) w V) D �o z �;u F— v J/ d 1> ITI 00 Q 0 ro cn m Q 0 ro Q w ro O D ZY Ln O C+ O n S -9 --� 3-Q T- c-) Q ro QQ �� 0 Q < <+ Q 0 0 0 :5 ro O rQ ,D LP (D U1 Q O td O cF O O V) ro cf n Q T- 90 ro n S M (D C3 m D -5 rp V) 3 _ Q O C+ � o Fri O h i n D C1 c h -0 Q n Q Q � O 'D 0 :5O :5 �< < ro � � Q m Q 0 ro Q w ro O D ZY Ln O C+ O n S -9 --� 3-Q T- c-) Q ro QQ �� 0 Q < <+ Q 0 0 0 :5 ro O rQ ,D LP (D U1 Q O td O cF O O V) ro cf n Q T- 90 ro n S (p o V)2: ��O(DZOD� O ro ro �p �x m Z� p �l e v o o 3 rn �_ 3 CD 00 v� o F9 v ---� o w(/) F- D oz n d W D 0 Fo F--y-� W F- �;U D IT1 E-1 a F C �;0 09 ru W o SEAVIEW ST Q --A --i D V) V)2: 1 O ro ro H F- 3 CD -u V) Li o F9 r0 r0 ---� o �u-0 n Q <+ O :5 D C n-3 T -Q 0 3 V) roR)r bd ao o,� W :5 O d T-m� V 9 IE VI SEAVIEW ST Q --A --i D V) n Fo 1 O bd H F- 3 m V) C m fU fU m D 1,0 -,J CJI M z V) roR)r bd ao o,� W 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: OSP251130 Work Type: Septic Upgrade Tax Code Number: 01113407000 Site Legal Address: SAND LAKE #2 BLK 3 LT 18 G:2224 Site Mailing Address: 8100 SEAVIEW ST, Anchorage Owner: CARSON CHRISTOPHER D Design Engineer: NORTH RIM ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft Total Bedrooms: 5/12/2025 5/12/2026 6750 ❑ Disposal Field 2 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 Received Issued By Date: Date: 3 MUNICIPALITY OF ANCHORAGE ,*.e Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 01113407000 Property owner(s) CARSON CHRISTOPHER Mailing address 8100 SEAVIEW ST Site address 8100 SEAVIEW ST Legal description SAND LAKE #2 BLK 3 LT 18 Day phone 715-0909 Number of Bedrooms 3 Engineering Firm NorthRim Eng. Building Permit Number Not Applicable 0 APPLICATION IS FOR: APPLICATION IS AN: (® all that apply) Absorption Field ❑ Initial ❑ Septic Tank Q Upgrade Holding Tank ❑ Renewal ❑ Privy ❑ Well ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Permit/Rush Fees: YO- Date of Payment: s' CQ 2 5 - Permit Permit No. nspo�._Hs 0 Waiver Fees: Date of Payment: Waiver No. Distance: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251130, Ben Cogger, 05/12/25 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251130, Ben Cogger, 05/12/25 SteveEng.com SAND LAKE #2 B3 L18 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: The current septic tank has failed- the field still functions. Replace septic tank near same location, decommission old tank per UPC. This lot is very small, with difficult access. An off-lot private well provides water, well was previously Class C. Separation measurements to be made prior to construction. No adverse impacts are expected from tank replacement. No easements are on the lot. Flat slope is in the area of the septic tank. No conflicts to neighbor properties. Replace/Repair standpipes in the absorption trench. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. New 1000 gallon MOA-approved septic tank. Watertight couplings on inlet & outlet. 5 minimum between the tank and trench. 5 to property lines & 10 to house. 4 of cover or insulation is required for tank; an equivalent of 1 insulation for 1 foot soil cover. Tank & solid pipe must be set on well compacted, stable soil. No large rocks for tank bedding. Plastic/fiberglass tanks require special bedding per MOA- sand or pea gravel. 4 diameter cleanouts with airtight caps are required 1 to 4 from foundation wall, prior to any 90 degree bend in 4 inch line, in 2 nd tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10 from the tank positioned to provide cleanout access towards the tank and towards the absorption field. Manhole Riser required in 1 st tank compartment. All cleanouts must extend to at least ground level. In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. Insulation must be placed over any pipe installed under driveways or parking areas. Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, Sewer Service Line is minimum 2% slope. Septic Tank to be pumped every two years or when required. Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251130, Ben Cogger, 05/12/25 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 ' ' 'q ILEGAL DESCRIPTION .... LOCATION DISTANCE TO: :) ~[. Absorption area Manufacturer Liq. ca DISTANCE TO: IF HOMEMADE: Well Well DISTANCE TO; No. of lines/ Length of each lin~ ¢ Top of tile to finish Dwelling / Inside length Width Dwelling Material Foundationo~, _~ ~..~// Nearest lot line Total length of line~,~./ Trench WLdth, 'i-/Z/-~Oinches MateriaJ beneath tile ~) t~) inches NO. OF BEDROOMS PE"MIT"O'~za/%/ No. of compartments Liquid depth PERMIT NQ. Liquid capacity in gallons PERMIT NO. Distance between line~..~. Length Type of crib Width Crib diameter Depth Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS SOIL TEST RATINGG P-- INSTALLER REMARKS APPROVED DATE LEGAL L~k~ ~ z Blo~k -~ Lo~r Z~ 72-0~3 IRev. 31781 [,EPF.:;.?TP. EHT "'~" HEF!LTH f:IN?. "':'"'""~c,,::: ..., '"'~ ..................... '::;TF-?F'F'T F:LNCHOR!aC:iE., ;2.64 - ......... ':..::~ ~ 476:!. , t- ,... ":F.' SC TL F!E:SORI::'TI 3H S'./STEP! 'IS 'FP::'~::F MRY:II"!._H ,NL!HBEF.: OF E;E:E:,ROOHS; = ]: ::SOIL F-:.:P:TI'NG ,::Si::! FT,.'BF:: ..... ]::~.;F..: THE .REg!U ! RE:[::, 'F T Z'E ']F "FHE S:;O i L :P,B'S;CLF<F'T I ON S'-?STEI"! ~ S · 'T'HE.' LENGTH [:,I.r,'IENSTON I':.:-q 'THE LENGTH ,::IN F'EET) OF THE TRENCH OR [,F'FI]NF'TELL':, ",-~.E [:,EPTH OF F:I 'TRE]'.!::H (),k~: F'iT iS TF!E [:, I !S "F Fi .N C': E E:ETHEE:N 'i"HE: SLIRFf-]CE OF THE ............ ~' * 7~ ~'"'~ - ,! ..... .. . . '3~'r' i'./1": Flf-,![) *f'i-tE' E ']'~T'I"['¢'i OF TNE ~,:~, .f,, h.*- ~,~1'. ,:.!N FEET':,. 'THEF::E ~.::, i",iC! ,:.:-T WZO.rH F'OE: ''"' -'~ .... . ..... F "['HE [:~F-:FWEL [:,EPT.'"I ZS; THE H'rHIH.M DEP]'H 3F GRRVEL E~ETHEEN THE OLFFFRL. L FIi'.~.E:, T-'.4F E;OTTOH ........ r" THE EXC:F!VRTI C!P.,! ,:: :[ ?',l FEET). .::'E];?H Z T F!PF'L I C:RNT H,',::IS THE RESPONS; ! E: .T. L i 'T"./ T ] INFORM TH I 'S ." -';2F'RE'7' ',- El'. 'r [:,UR I NG 'TF!E: ? .......... - ~ - l: .... b . !iq'::;TFIi ! FFr'IcLi'-~ )ji'.,!'..BPECT]:C[,X,!":'5 F FIN'?' ,b~F:'t L'.'S k':'IE:,.J'F:ICEhiT TCI THI':'; .P!-:U,-'E:F-,:! . F!!'.,t[) THE i'*,!UHE:EF: OF !;::ESI[:,E!'.,P]:ES THF:Fi' TPiE WELL NT. LL SEF:',,,'E. E:FICKFI~_._!NG OF RN'./ ....... ':'./'gT.-':'M HZTHOUT FiNFIL .t:NSF'EC:TZE~N FIN[:, FIF'P~'"¢,/Iqi. ...... F",, ..... TH'rS [' EP.PR'T';,1E,%.'.' !.4 :[ LL. E~E :5 .. EL:HE ] T ']-Ci PRO.S..;E(]U]." :r. OhL HINIHUH Di'STFiNE:E E:ETWEEN R HELL RND R.N'¢ ON-'S;ZTE SEHRC:;E DISPOSRL. S'~'STEH IS !e,3 FEET FOR R F'RIVFYFE I.,.iGL.L OR iSE~ TO 20e~ FEET FROM R PUSLZC HELL C:,EPENDZNG UPON 'T'FiE T'¢F'E OF PUBLZC: P.IELL. MINiHUM DISTF!NCE FROM R F'RI',,,'FFFE HELL TO f~ F'RiVRTE SEHER LINE IS 25 FEE"F FIND 'TO FI COHMUNZT'./ SEHER LINE IS 75 FEET. OTHEF?. REg!LtIREhIENTS MF!"/ RPF'L"r'. SPEC!F'IC~T:EONS RNE) CONSTRUCTZO!q DIFIGRF!HS RRE R',,,'FiZLRBL. E TO ):N:StJRE PROF'ER ZNSTFIL. LFiTION. Z i:].'E~:T ! F"r' TFiF!T !: ! RH FF!H):L. ZFff;'. i.,,~I'T,'FI T!4. E REQUiREHENTS FOR ON-SITE SEHEF'.S RND HELLS RS SET F'ORTH B? THE ML!N! E:iPRL. I TY' OF RNC:HORF~GE. 2: I I.,]IL.L INSTF!LL THE S?STEM IN RCC:ORDRNE:E HiTH THE CODES. 3:: Z UNDER:~;'TRN[) 'FHRT THE ON-SITE SEHER S;h.'STEM MR? REQUIRE ENLF~RGEMENT IF' THE RES ZE:,ENCE ZS REHODELED TO iNC:LLIDE MORE 'r'HFml 3 BE[>ROOM'S. ' ~ E3 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: /D/P, LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15- 16- 17 18 19 20 SLOPE DATE PERFQRMED: [ + WAS GROUND WATER S ENCOUNTERED? O 5i1 IF YES, AT WHAT · E DEPTH? SITE PLAN COMMENTS PERFORMED BY: (.~YIQ~. 72-008 (6/79) Gross Net D,,ept h to Net Reading Date Time Time water Drop ~ q:2o I0 ~l~ O.q? O, OZ q: .~0 I0 ~,~ O, YZ O. 03 PERCOLATION RATE 5g (minutes/inch) TEST R.N.E-rWEEN FT *ND CERTIFIED BY: C, Reld, MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water &Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251173 Parcel ID 011 -134-07 Expiration Date Legal description SAND LAKE #2 BLK 3 LT 18 site address 8100 SEAVIEW ST Current property owner(s) CARSON CHRISTOPHER D X The On-site system(s) is/are approved for 3 bedrooms By: 4/15/2026 Conditional approval for bedrooms, with the following stipulations: Comments or conditions: Original Certificate Date: 7/16/2025 This Ce 6ficate of Site Systems Approval (COSA) is intended to demonstrate the subject syst (s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, D elopment Service 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 submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory X Other RIVINNi R Awe Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 01113407000 Complete legal description Location (site address) SAND LAKE #2 BLK 3 LT 18 8100 SEAVIEW ST Current property owner(s) CARSON CHRISTOPHER 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: F-1 Private Well serving # dwelling units 715-0909 0 Other Non-public well as regulated by MOA F-1 Water Storage F-1 Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: FEJ Private Septic n Private Septic serving 2 dwelling units E] Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel I Plastic F-1 Concrete ❑ Fiberglass Age new _ See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: E] AWWTS R Bed RE Deep Trench E] Wide Trench R Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: 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 $ '1� 460-0 Waiver Fee $ Date of Payment ') / 1!5/ Q,5- Date of Payment COSA # 6SCZ-1 1-73 Waiver # COSA Application—Apr2025.doc COSA Checklist Legal Description: SAND LAKE #2 BLK 3 LT 18 Parcel ID: 01113407000 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _ A. WELL DATA ❑■ Well log is filed with Onsite (or attached) Date drilled 4/2/82 Total depth 414 ft Cased to '—ft ft ❑■ Sanitary seal is functioning correctly ❑■ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 4/15/25 Static water level at beginning of test 136 ft. Date 4/15/25 Comments Well is located on Lot 16- Formerly a Class C Well. Arsenic can be reduced by POU treatment. Well production at time of test 10+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑■ No ❑■ Coliform bacteria is Negative Nitrate mg/L XNitrate less than MRL (ND) Arsenic 43.2 ug/L ❑ Arsenic less than MRL (ND) Collected by NRim Eng B. TANK DATA Measured operating fluid level in septic tank na Date of pumping new tank ❑ Required maintenance completed, if AWWTS Comments. To Be Installed Under Conditional D. ABSORPTION FIELD DATA Which system tested (date installed) 6/12/82 ❑■ ALL standpipes present per record drawing Total measured depth from grade 15-18ft (max) Measured depth to pipe invert from grade 10 ft (min) ❑ N/A – pressurized field. ❑ Per record drawings, field is insulated. ❑■ Monitor tubes go to bottom of effective. If not, state depth into effective ❑■ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 4/14/25 date Any rejuvenation treatment (past 12 months) If yes, enter date C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results g Pass Fluid depth prior to test Water added 450 gal 4/15/25 New fluid depth 18 in Elapsed time 60 min Final fluid depth 10 in 5 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 60 in Effective depth used 10 in Effective depth remaining 50 in Comments/Deficiencies: Previous Class C well separations of 150' were waived to 100'. Class C wells are currently classified as "Private" wells; and thereby only require 100' separation. COSA Checklist June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances it less than required or if comm unity well on let) Septic Tank/Lift Station on Lot > 100' Community Sewer Manholeltlleanout > 100' [DYes if No ft ❑ Yes iif No ft NeighbMng Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > ' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' ❑Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ❑ Yes & No ft ❑Yes if No ft _ Man urelAnimal Excreta Storage > 100' Community Sewer Main > 75' ❑Yes if No ft 0Yes if No ft ❑■ NIA— Served by C ornmunity Well (not on lot) or Public Water From Soptic/Holding Tank and Absorption Fields} on Lot to: (Please enter distances If less than required) Building Foundations > 10' ■❑ Yes if No ft Surface Water > 100' ❑■ Yes if No � ft Tank to Property Line > 5' Field to Property Line > 10' Dater Blain 5 10' Water Service Line 10' ■❑ lies if No ft ❑Yes it No ft ■❑ Yes if No ft El Yes if No ft F. ENGINEER'S COMMENTS *Waiver in file. Well is located on Lot 16. Wells on Adjacent Lots: Private Wells > 100' Community Wells 5- 200' D Yes if No ft Yes if No 100+ ft If tank or field is under driveway comment below 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 wkh applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, sinless noted otherwise. Name ofFirm Engineer's Printed Name COSAChackiiist June 2022 Phone 694-7028 Date OF Ar I irk 9THr��I of Stave Eng e� CE -6256 5/14 Arsenic Advisory Certificate of On -Site Systems Approval # OSC251173 Subdivision: Sand Lake #2, Block: 3, Lot: 18 A water sample revealed an arsenic concentration of 43.2 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. 46.3' 39.6' 30.2' 13.4' 16.1' 26.2' RESIDENCE SINGLE STORY SHED 10'x16' ROOF OVERHANG LEGEND FOUND 5/8" REBAR, NO CAP EDGE OF GRAVEL DRIVEWAY UTILITY PEDESTAL DECK CONCRETE FENCE RECORD DATA PER PLAT #P-176 SEPTIC PIPE SEPTIC TANK LID TIMBERLINE SURVEYING AND MAPPING 17035 BARONOFF AVE EAGLE RIVER, AK 99577 907-242-5320 ryan@timberlinealaska.com FILE NO.: 25.162 SCALE: 1" = 20 FEET DATE: 7/10/2025 SHEET: 1 of 1 MOA GRID: SW2224 SCALE: 1" = 20 FEET(11"x17") 20'0' 40' AS-BUILT OF: ADDRESS: 8100 SEAVIEW ST, ANCHORAGE, AK LOCATED IN: ANCHORAGE RECORDING DISTRICT LOT 18, BLOCK 3SAND LAKE SUBDIVISION NO.2PLAT #P-176 02/28/02 15:57 FAX 907 273 8440 PRUDENTIAL VISTA -REAL ES f�002 .._._hh._.— --- 2002 02/28/2002 W4:� 9Qy�, iKYrtiUIC RIMPT ITLE907 25B 45% TO 261MI P.O1/01 op is �:� `,:e;, '�` ,�,• '~�' •• (• �.� j l :' •' - Bgvs s� MI l -M v •Oates flMi i•a •:t M'•'S10'o' ** TOTRL PAW.O1 w* 02/28/1001 TRU 14:44 [=/RX Na 15791 IM001 . 7; :' •' - Bgvs s� MI l -M v •Oates flMi i•a •:t M'•'S10'o' ** TOTRL PAW.O1 w* 02/28/1001 TRU 14:44 [=/RX Na 15791 IM001 Piaiis-f or 'I -ho .construe vraca systed gia ted -inte �ri L' STEVE COWPER, GOVERNOR o o a s o DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE WESTERN DISTRICT OFFICE 563-6775 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 June S. 1990 S & S Engineering 17034 Eagle River Loop, Suite 204 Eagle River, Alaska 99577 PWSID: 0216546 According to the records on file in this office, the Sand Lake 42, Blk U. .Lots 13-18 Water System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, RA E. CRAIG Environmental Field ificer VEC:bas ANCHORAGE WESTERN DISTRICT OFFICE 5636775 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 November 6, 1989 Dr. Leroy C. Reid, Jr. Alaska Environmental Control Services 1412 west 33rd Avenue Anchorage, AK 099503 PWSID& # Class C According to the records on file in this office, the Sand Lake #2, Lot #8, Block #3 Water system is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, Vera E. Cr ig Environmental Field Officer VECsbas ®0'M4r� 14 .cAt OF Az 11 b Bi °" °°O ° O �� o ° o 0 00 4 o o ym i7000°o a400 00 000eaoa 00 0° o 00000 ° 00 2251 ° e Municipality of Anchorage Oevolopment Servi¢os Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell. D. 0il-i3~-0'~- COSA# ~'~(~.,/.~// ~ '~ ~'~ ~ ~:' r .... . Expiration Date: GENER~E!NFORMATIoN Complete legal description '~ &n~ L~ ~Z ~i~c~ ~ Lo{ [~ Current Property owner(s) Mailing address. '" Lending agency Day phone Day phone Mailing address Real Estate Agent ~o~0 no .Address Unless othen~,ise.requeste~, COSA will be held by DSD for pickup. Day phone NUMBER oF BEDROOMS: TYPE 'O~F WATER SUPPLY: Individual Well,' ~ Individual wa~er.storage Community Class ¢-... Well Public Water System 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 On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional ~civil engineer registered in the State of Alaska. Certificates of On-Site System's 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 COSAs upon request to homeowners. Certificates of On-Site Systems 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. (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 theprofessional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER ¸5. 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 Certificate of On-Site Systems 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_ .~?~,c~,..,~ Address ~0.5 ~0. 15~ Ave. Engineer's Printed Name L.A~3 bedrooms. DSD SIGNATURE ~,~"" Approved for Disapproved.. Conditional approval for Phone bedrooms, with the following stipulations: By: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X ArsenicAdvisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: (Rev. 11/05) Municipality of Anchorage. Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: .-~ L~~ ~ A. WELL DATA Date completed. -- Total depth ~ ft. ~oc~Z. 3 Lo't' i~ Parcel ID: C)lt- t~-{-O~ IfA, B, or C provide PWSID # --" Sanitary seal (Y/N).. -- Cased to ~ ft. Well Log (Y/N) "-- Wires properly protected (Y/N) -- casing height (above ground) '" in. FROM WELL LOG AT INSPECTION Date of test --- '--' Static water level --- ft. Well production "=- g.p.m. WATER SAMPLE RESULTS: 'Coliform .~.~b~coloniesll00 mL Nitrate JV'D mg/L Arsenic: q~,~' ug/L date of sample: B; SEPTIC/HOLDING TANK DATA Tank Type/Material ~{'~ I Tank size. [0,09"' '~' ..... gal... ~' *'~ · ;Number of.Compartments' ;~ Foundati~ ~l~a~ut"(Y/N)"?~' ,"'"'.Depression over tank (Y/N) ~ ~' ,~. ,, ..~ . ',~, Date of, pumping .~/~[Zt'IZoI~~'" Pumper C. ABS~P~ION FIELD DATA Date ins{ailed I ~ Soil r~ing (g.p.d./ff2 o ) ~ Length "3~..:.'.' fl. '..~,~ Width H~-~ [.c~ Total depth .i~~ ff. *~' ~ ' Eft. absorption area ~0 ff~ Monitoring tube. Date of adequacy test Results (Pass/Fail) t Fluid depth in absorption r~ld before test. ~ in. Water added [5~ gal. Elapsed Time: [~0 min. Final fluid depth ~ in. Any rejuvenation treatment (past 12 mo.) (WN & ~pe) ...~ g.p.m. Other bacteda/Ve~. 'colonies/100 mL Collected by: /'ar~ Date installed Cleanouts (Y/N) High water alarm (Y/N) System type Gravel below pipe Depression over field ,· For ~ bedrooms · ~ New depth.~,(o in. Absorption rate >= t{,50 g.p.d. If yes, give date - - D. LIFT STATION Date installed ,,,"' "Pump on" level at ~in. Datum / SEPARATION DISTANCES Size in gallons '. /Manhole/Access (Y/N) ' "Pump off" level at ~ High water alarm level at / in. Cycles tested / Meets alarm & arcu nts? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot '-' Absorption field on lot "'- · Public sewer main ~ ~, Sewer/septic service line '- Animal containment areas -'- On adjacent lots """ On adjacent lots - Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation -~ ~' Property line 5 ~ Absorption field Water main /V'. ,~ ~ water service line j'O'~- Surface water · Wells on adjacent lots [{30 ~-I- ~ SEPARATION' DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Co' .¥-. I' Water Service line. lO l' Curtain drain Building foundation Surface water Wells on adjacent lots Water main ~ ,~. Driveway. parking/vehicle storage I0 COMMENTS *' loc)' G. ENGINEER'S ~RTIF~ATION Engineer's Print~ Name _ , Date . ~ .-~ -.~ ...' N-~ COSA Fee $ , ~ ~ 'b Waiver Fee $ Date of Payment ~" ;Z, · "' ! (~ Date of Payment Receipt Number .... ~ ? ,~ ._~ C,,~ Receipt Number (Rev. 11/05) ~ ......... SGS SGS Ref.# I 103776001 Client Name Spurkland Engineering Printed Date/Time 08/09/2010 16:36 Project Name/# Sand Lake #2 B3,L18 Collected Date/Time 07/30/2010 9:50 Client Sample ID Sand Lake #2 B3,L18 Received Date/Time 07/30/2010 16:00 Matrix Drinking Water Technical Director Stephen C. Edt Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic 44.7 * 5.00 ug/L EP200.8 C (<10) 08/02/10 08/05/10 KDC Waters Department TotalNitrate/Nitrite-N ND 0.100 mg/L SM20 4500NO3-F B (<10) 08/02/10 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM20 9223B A 07/30/10 DLC Total Coliform Negative 1 100mL SM20 9223B A 07/30/10 DLC Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Arsenic Advisory Certificate of On-Site Systems Approval # 101178 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 3, Lot 18 of Sand Lake #2 Subdivision. This inspection revealed an arsenic concentration of 44.7 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On-Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. 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.cLanchorage.ak, us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAHILY DWELLING Parcel I.D. 011-134-07 1. GENERAL INFORMATION Expiration Date: Complete legal description SAND LAKE SUBDIVISION #2; LOT 18, BLOCK 3, Location (site address or directions) 8100 SEAVIEW DRIVE * ANCHORAGE,. AK 99502 Current Property owner(s) Mailing address Lending agency DENNIS McDONNELL Day phone 245-4204 8100 SEAVIEW DRIVE * ANCHORAGEi AK 99502 Day phone Mailing address Real Estate Agent Mailing address LARRY SUITER w/ PRUDENTIAL VISTA Day phone 4241 '~" STREET * ANCHORAGE, AK 9950.:3 273-7766 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [] Individual On-site '1~ Individual Water Storage [] Individual Holding tank [] Community Class "C" Well · Community On-site [] Public Water System [] 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 4 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 samples. (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. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ at, or pdor to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER ¢s 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 Anchorege 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Phone ,337-6179 Engineer's Comments: In conducting this evaluation, AWl/CC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulation& The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of afl wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. A WWC, Inc. can therefore nat provide any warranty orfuture estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other peraon or parfy ts nat authorized, nor will it confer any legal right whatsoeve~ 5. DSD SIGNATURE Approved for --~ bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory bedrooms, with the flIowing st pu at ons' , (((fi,fi';',,. ~ -~,-. ~,LmTE ~: WATERANO ~ ; ~)~A,STEW)ZER ~ ' PROG~M Manitenance Agreements ,-9)j ~ ~ ] )~ ) ~))1, Supplemental Engineer's Reo~ Other (Rev. ~'01) Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Dlvisinn On-Site Water & Wsstewater Program 4700 Souffi Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (;07) 343-?;04 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: SAND LAKE S/D 1~2; LOT 18, BLOCK 3~ Parcel ID: A. WELL DATA 011-154-07 Well type ';' If A, B, or C provide PWSID# 21~4~ Well Log (Y/N) Date completed Sanita~/seal ~) ~ ft. Casing height (above ground) FROM WELL LOG AT INSPECTION ~ J g.p.m. g.p;m. Nitrate O0,~ mgJL. Other bacteria Date of sample: 2/27/2002 Collected by: Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform ~) colonies/100 mi. Arsenic: N/A mg./L. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Tenksize 1000 gal. Numbar of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 6/18/2001 Pumper ,~l coicnies/100 mi. AWWC, INC. Date Installed 6/12/1982 Cleanoufe (Y/N) YES High water alarm (Y/N) N/A ROTO ROOTER C. ABSORPTION FIELD DATA Date installed s/12/19s2 Soil rating (g.p.dJff=or(~) 100 System type' ' Length 54 ft. Width 3.7-5.0 fl. Gravel below pipe Total depth 2o.5 .ff. Eft. absorption area 340 fi= Monitoring tuba YES Date of adequacy test 2/27/2002 Results (Pass/Fall) PASS Fluid depth in absorption field bafora test 0 in. Water added 478 gal. Elapsed Time: 20 min. Final fluid depth 20 in. TRENCH 5 It. Depression over field NO For 3 bedrooms New depth 31 in. 450+ g.p.d. Absorption rate >= NONE KNOWN If yes, give date Any rejuvenation treatment (past 12 mo.) (Y/N & type) D. LIFT STATION Date installed Size in gallons "Pump on" level at in. "Pump_.~_JJ~. High wa~r alarm level at ~ ~ Cycles tested Meets alarm & circuit requirements?. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main On adjacent lots Public sewer manhole/cieanout Holding lank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water main N/A Water sen, ice line 10'+ Wells on adjacent lots '100'+ Absorption field Surface water. 5'+ 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Water sewice line 10'+ Curtain drain NONE KNOWN Building foundation. 10'+ Surface water 100'+ Wells on adjacent lots '100'+ Water main N/A .Driveway, parking/vehicle storage 25'+ F. COMMENTS · 100' BLANKETS WAIVERS GRANTED TO CLASS "C" WE'LLR ON LOT 8, BM( .3 & LOT 22, BM( 3. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and revfew of Municfpal records that the above systems ere/n conformance with MOA HAA guidelines in effect on this date. JEFFREY A. GARNCSS Engineers Printe(J Name Date ~/I/OZ.. Waiver Fee $ Date of Payment Receipt Number. .~o~ · /- - ~- "7 - .toc~ ---- l-- %.. ---/---\----:-...-~----'m>. /~,, __.\J "" _~-:,. x i -' ,~ ./ ~,. ,.~ ..--- ~ ~-v~ , ~ ~-, - ALAS~ WATER A~ WASTEWATER CONSULTAmS, ~C. ~-- : ~'i i ~"~:";'~ PAT AND PAU~ WlTHERELL (gO7) 248-5445 ,o,,,,,, I. ".~.~. I '='°°' I~°~ 02/28/02 19:57 FAX 907 273 8440 PRUDENTIAL VISTA REAL ES [~002 ................................................ ~oo; 02/~'$/2Q0~ TEU '14:44 [TX/RX rio 1~3u) 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 ~N/~fPALITy OF ANc ~ ENTAL $~RVm- ~ ~8 DIVi~ioN OCT 09 1997 R CEIvED 1. GENERAL INFORMATION Location (site address or directions) / ./ Property owner Mailing address Lending agency Mailing address / I / / / Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: Day phone Day phone TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA#21 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 ,~]~'/-/-/ ~,,q"z'),~J/,,,2,d/"~ Phone Address /TL~L~ YET.~/)4::~/? C1'7'~/c ~/~772/~C /~ Engineer's signature / Date ! DHHS SIGNATURE ' ~ APproVed for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations; Additional Comments By: The Municipality of A~chorage Department of Health and Human Services (DHHS) issues Health Authority.. Approval certificates based only upon the representations given in paragraph 5 above by an independent professional enginee[ registered in the State of Aleska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain 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(Rev, I/91) Back MOA~e21 Municipality of Anchorage ~IRONM~AL SERVICES ~1~ DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Se~ices Division . . ,0C~ 825 L Street, Room 502. Anchorage, Alaska 99501 Health Authority Approval Checklist Legal Description: ,~0~ ~,/~E~2 /-07c/~, B/~,-~ Parcel I.D.: ~// /,~ 07'000 A. WELL DATA If A, B, or C, attach ADEC letter. ADEC water system number Casing height (above ground) Wires properly protected (Y/N) Well type Log present,N) (r.~/./ ~ F//'/~ Date completed Total depth 4/~-' Cased to 4~' Sanitary seal (Y/N) AT INSPECTION FROM WELL LOG Date of test Static water level Nitrate /V/O/D~t~c'/~d Other bacteria / 0 /0~ /'~/ 7' Collected by: Well production WATER SAMPLE RESULTS: Coliform ~ Date of sample: B. SEPTIC/HOLDING TANK DATA High water alarm (Y/N) ~,//~/,~_ Tanksize /OC)O Number of Compartments ? Cleanouts(Y/N) ~ · Depression over field (Y/N) . . __ For Immediately after ~,/~ gal. water added (in.): Absorption rate = ~ ~'~ g.p.d. If yes, give date /~/'/~ System type ~ Total depth /~'o Z Date installed Foundation cleanout (Y/N) ~ Depression (Y/N) Date of Pumping /~ ~t'~ ?~--Pumper C. ABSORPTION FIELD DATA Date installed ~ Soil rating (g.p.d,/fF o~ Length 3~ ~ Width /-/'/-/"~ ~ Gravel thickness below pipe Effective absorption area ,~ .~'_,~ Monitoring Tube present (Y/N) Y Date of adequacy test ~//~//?~7 Results (Pass/Fail) Fluid depth in absorption field before test (in.); Fluid depth 0 (ins) Minutes later: /.~ Peroxide treatment (past 12 months) (Y/N) bedrooms 72-026 (Rev. 3/96)* D,-.J=[FT STATION --~. Date ins~ Manhole/Access (Y/N) High water alarm level at* Cycles tested Size in gallons *Datum "Pump off" I~Vel at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: -- Septic/holding tank on lot ~ ' /v'/~ On adjacent lots ~E)~, / /~ Absorption field on lot 15ublic sewer main On adjacent lots Public sewer manhole/cleanout Sewer/septic service line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~ Property line _~2.' Absorption field · ~ot~,'~9 ,c~,~c/ Water main/service line ~78 Surface water/drainage /04) ' Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ~,' ~ (~ ' Building foundation .~ .5'~ Water main/service line Surface water I~/O//~i'D~2 ~OU,Od ~1'~ /~' Driveway, parking/vehicle storage area / Cudarn drain ~ Wells on adjacent lots /~ / ENGINEER'S CERTIFICATION ~ Co~C~ ~[~ ~a~ ~-~//~ I ce~ify that I have determined thru field inspections ~ in conformance with MOA H~ guidelines in effect on' this date. Signature ~/2~J~ Engineer's Name / / HAA Fee $ Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ and ~- 5/"/° are Date of Payment .Receipt Number CT&E Environmental Sewices Inc. Drinking Water Analysis Report for Total Coliform Bacteria ~oo w, Anchorage, AK 99818-1805 MUST BE ~ PUBLIC WATER SYSTEM LD. # P~VAT~ WATER SYSTEM Mootb SA M~LE TYPE: Yea r 0 Treated Water O Repeat Sample (for routine sample ~ Uatreated Water ~th lab ~f. no. ~ _ ) ~Special P~rpoae Time Collected SABLE LOCATION Collec~d By gax: (9071 561-5301 TO 1t~ COMPLETI/D BY LABORATORY Satisfacto~ Unsatisfa~o~ Sample over 30 hours old r~sul~ may be unreliable S~pJe too long in transit; s~ple not be over 48 hours old at examination to indicate reIiabl= result, PIeasesend new sample via special deJivem mail, Aaalyttcal Me/bed: ~embrane Filler * Number ofcolonles/IO0 ml, L__ab Ref. No. Result* Analyst 97.6077 ~ ~ Sent to A.D.E.C, Ancl~ FbI~I Jun [] Fazed Client ~otjfied of unsatisfactory results: Fazed BACTERIOLOGICAL WATER ANALYSIS REcoRD MMO.MuG Reault. Total Coliform Membrane Filter: Direet Cnunt __ , --' -- Verification: L'ra _ Co~onie~'100 mi -- .Ga Fec. I Coliform Confirmation __ Fine! Membrane Filter Reslllts Collform/i 00 Time ~ _ hr~ TOTAL P. 01 CT&E Environmental Services Inc. CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By 975466001 S K L H Consultants Sand Lake No. 2 L18,B3 Sand Lake No. 2 L18,B3 Drinldng Water Client PO# Printed Date/Time 09/17/97 19:21 Collected Date/Time 09/12/97 12:07 Received Date/Time 09/12/97 12:30 Technical Director: Stephen C. Ede PWSID 216546 Released By~ ~ Sample Remarks: Allowable Prep Analysis :Parameter Results PQL Units Method Limits Date Date [nit Nitrate-N 0.100 U 0.100 mg/L SM18 4500-NO3F 10 max 09/13/97 JRJ Total Colfform 1 OB, NO COL[/ 100 ML SM18 9222B 09/12/97 TMW 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ~ ~ LI ~ ~)"~ HAA# ~---~ %'--'"~ ~ ~,~ IC'~'~-E-~ ~''') 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Ad dress Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: Individual well Community well X Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system.. 72-025 (Rev. 1/91) Front MOA#21 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. NameofFirm _/-~'¢~-/P/~ ~/~'¢h'///~.~ Z~,~,;¢,.~,'~- Phone Address ~ ~/~~r~ ~,/, .~.~ Engineer s signature ~~~2~ Date DHHS SIGNATURE /~ Approved for ~ __ Disapproved.' COnditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DH HS 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 (Rev, 1/91 ) Back MOA ¢Y21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAl CHECKLIST Legal Description: ,'~--J'-?~,~-~'~ ,'~/-~/', .¢~;','/,'('~//,~.'//,~ Parcel I.D. A. WELL DATA Well type Log present ~)'N) Total depth /.~Z./.,~ / Sanitary seal ~N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed _ ¢/'/~,~//~ Z Driller Cased to --~/~'~ / Casing height ///"~ Wires properly protected~/N) Date of test ' Static water level FROM WELL LOG AT INSPECTION " 1/.~ Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot /~).'~ Absorption field on lot /~-~'z~ / ; On adjacent lots /~ ;5" ; On adjacent lots //.~" Public sewer main Sewer service line WATER SAMPLE. RESULTSi co iform · Date of sample: // SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) / P~blic sewer manhole/cleanout /~A,~- Petroleum tank /'~,~,~' Nitrate Collected by: Other bacteria / -,~ Tank size / Foundation cleanout (Y/N) / Compartments ~ Depression (Y/N) High water alarm (Y/N) Date of pumping Well(s) on lot . ./I//~ On adjacent lots ! To property line ~..,.~- Absorption field .--~- ./ Surface water/drainage Alarm tested (Y/N) P'umper ~ Foundation Water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) High water alarm level "Pump on" level at "PumP'0ff" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ~'/Z//~-~ Length y,,~, Z / Width Total absorption area Depression over field (Y/N) ..,¢¢ Results (pass/fail) yd~ Peroxide treatment (past 12 months) (Y/N) Soil rating Gravel thickness Cleanouts present (Y/N) Date of adequacy test for Total dePth If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water · Curtain drain On adjacent lots //3_~" Property line To existing or abandoned system on lot Cutbank ,,A/~,~,... Water main/service line Driveway, parking/vehicle storage area ~-~,/' E. ENGINEER'S CERTIFICATION bedrooms Signature Engineer's Name Date HAAFee$ l~ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 WALTER J. HICKEL, GOVERNOR (907) 563-6775 December 27, 1991 FOR: Harding Lawson Associates PWSID # 216546 My review of the records on file in this office reveals that Lots 13-18, Block 3, Sand Lake #2 Subdivision, Class "C" Public Water System, is in compliance with the provisions of 18 AAC 80.200, State of Alaska Drinking Water Regulations. Sincerely, Byron Roys Environmental Engineer BR/~ RECEIVED ,lAN 1 4 1992 Munic~pah~y ot Anchorage Dept. Health & Human Services Date Date Date inspector inspector ~ Conditional Approval Date Sewer Installed Permit No. Septic Tank Size Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY /~. Phone Mailing AddressZtT ! Dr' Buyer Address Phone Lending InstiJuJion Address ~-~, Realty Co. & Agent ~eg,.~t? (~e~J~r ~O,:~.~- ~ ' ~ , - .... Phone Street Location ~C~/I ¢0 Type~f Residence . ~ Single Family Q Multiple Family No. of Bedrooms Q Other Water Supply - ' ~ Individual A~ACH WELL LOG. A well log is required for all wells drilled since June ~ Community 1975. For wells drilled prior to that date, give well depth (attach log if ~ Public Utilit~ : available.) Sewage Disposal ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,