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SAND LAKE #2 BLK 1 LT 10
Sand Lake Block Lo1' 10 #011-132-39 Municipality of Anchorage .~:, ._=._,,,.,o Development Services Department '- Building Safety DMslon On-Site Water & Wastewater Program, 4700 South Bmgaw St. '~ P.O. Box 196650 Anchorage, AK 99519-6650 wv, v.cl.anchorage.ak, us (907) 343-7904 Page 1 of X On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW010147 PlO Number:. 011--1`32--'39 N°me:KELLY ANDERSON Wastewater System: I-I New · Upgrade ~d.,,: ABSORPTION FIELD 813,3 WILCOX STREET NO, of Bedrooms: Ph°ne:(907) 243 --8310 ,3 · Deep Trench ri Shallow Trench [] Bed [] Mound [] Other LEGAL DESCRIPTION = .~t~. 1.2 ~o/s~ n.I ,~,~ ~ ~ .v..a 6' 10 I SAND LAKE #2 5' MAX n. - - - SEE DWG r~ '32' WELL: [] New [] Upgrede 2.5 .. 1 .~- ~t, r~ 384 so. rt D 3034/ F-810 ~. ~ ~t, o~ s~t~ w~,, t,~ "'-' DENAU o~, ~--~-~ 7/18/01 ~ ~.1~-~ 4~'"~'-~ TA.K SEPARATION DISTANCES =s.pu= [] Holdlng [] $.T.E.P. []Other To Septic Absorption Uft Holding ~ub~/Prlvete ..... ~I~C ~rom Tank Reid Sta~on Tank S..*, U,~ HOP, AGE TANK 1000 w,, N/A N/A N/A N/^ N/A STEEL 2 su,o:, Wot,, lOO'+ lOO'+ ./^ ./~ ~s'+ LIFT STATION ~o~n~o~on ~'~ 10'* ./^ "/^ =~'~ ~'"--~..~[::~-'~'~--~--' '1 Curtain Drain N0~NE KNOW~q ." ~e~o~: ot~ ~ ~ u~vS BENCH MARK ~t~.~t~JDc,,4F--..D ~ Ut0~,. S.E. CORNER OF REAR DECK : =_~ c..,,.~., 100.00 Inspections performed by: AWWC. INC. Dates: 1st 7/13/01 3~d ~/1~/o~ .... ,,~. ~,,/.~ ..... ......,t 4th 7/18/01 ~r-,-~,_ :j~:o__4 ev~. ;,~~" Oop~,mont of ,.,h °nd ..m~n Sor~o. =pprow= ~0~%,-.... c'~ 1 ~g%..."/~ ,e~ewe~ sn~ ~p,rove~ ~y: _~ .-//-~/ ~" '~-~'. ~ot~:~ ~"'~' "~-"*~ ........... .... o~o'~ """"'""'""'":swo..o,,,, AS-BUILT DRAWING "'='"' ,, I bix,anNe C~SS ' C' W~L "~/0-~ e ~, .,, ...,. ,., / ~ ~ ,.,.U_L~I/, '. ' . - / ,~ ~-~l-r-F'~l I I ,....-4:' .',,= / ~,¢ . ~ ~ / __.: itl .,' ·: ~' '". / 3 6EDRO0~ '"~ ~ / ---- I'1 "' "', ~ House ~' ¥ -- I ,. . - ',, - __f~ ---' '~' '~/~. ~' C01 63.5 52.4 '\ \ "~ ~ E ~' ¢.r~' IdT1 63.0 51.7 '. ~" "~ .4~"- :'.:': ::':- ~' ,~',. ..~\~ c02 49.5 58.0 , · ,,~.ONSULTANTS, INC. .# = .~, ~,~..'.,..d-. I..~. ,. ......... KELLY ANDERSON [907) 24~-oo~u I ~ ~r ~ b_ ,.~. o~¢.,.~o.: '0~o~1'.. ,c,~-7~5~ .....'~ SAND LAKE SUBDIVISION //2; LOT 10, BLOCK 1, ~1~[".-," ........... ~l~hK:OF SEPTIC SYSTEM UPGRADE AND WAIVER REQUEST ^ B ST1 40.7 55.9 ST2 47.0 61.0 FD 49.2 59.0 C01 65.5 52.4 MT1 65.0 51.7 C02 49.5 58.0 MT2 49.0 57.2 ,c,.,.u..,.:swo,o,,, AS-BUILT DRAWING B.S.G. ~SJ~ ~'~J~tg ~ ~S'J't~g s~ N.T.S, ~ ............ KELLY ANDERSON 24S-8'10 1 OF 1 SAND~KE ~2 LOT 10, BLOCK 1 PROFILE DRAWING OF SEPTIC SYSTEM UPGRADE DEPT. OF ENVIRONMENTAL CONSERVATION DIVISION OF ENVIRONMENTAL IlEALTll DRINKING WATER and WASTEWATER PROGRAM 555 CORDOVA STREET ANCilORAGE, AK 99501 http:llwww.state.ak.usldeclhomelhtm TONY KNOWLES, GOVERNOR Telephone: (907) 269-7519 Fax: (907) 269-7650 July 12, 2001 Jeffrey A. Gamess, P.E. Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Rd., Suite 2B Anchorage. Alaska 99504 Subject: Lot 10. Block 1, Sand Lake Subdivision Addition # 2. Separation Distance Request between an On-lot Wastewater Disposal System and two Class C Public Water Systems Source Wells (PWSID Number 217314 and 2 ! 7940), ADEC Project # 1216: Waiver Review Dear Mr. Gamess: This is response to your July 11,2001 letter and engineering plans in which you request to modify all four of the waivers issued in my July 3, 2001 letter. This request is based on the fact that the field conditions once the site was ready for consiruction did not match the record information used in the preparation of the original waiver request. Due to the differences noted in the separation distances, the location and design of the proposed wastewater disposal system was also modified. The proposed modifications to the wastewater disposal system was also modified. The proposed modifications to the wastewater disposal system are currently being reviewed by the Municipality of Anchorage. The new ,,,,a;.ver req ests are as follows: · A 110 foot waiver from the class C public water system source well (PWSID # 217314) located on lot 9, Block I, Sand Lake Subdivision # 2 to the proposed septic tank located on Lot 10, Block I, Sand Lake Subdivision # 2. · A 120 foot waiver from the class C public water system source well (PWSlD # 217314) located on Lot 9, Block I, Sand Lake Subdivision # 2 to the proposed drainfield located on Lot 10, Block I, Sand Lake Subdivision # 2. * A 110 foot waiver from the class C public water system source well (PWSID # 217940) located on Lot 12, Block 1, Sand Lake Subdivision # 2 to the proposed septic tank located on lot 10, Block I, Sand Lake Subdivision # 2. · A 120 foot waiver from the class C public water system source well (PWSID # 217940) located on Lot 12, Block I, Sand Lake Subdivision # 2 to the proposed drainfield located on Lot 10, Block 1, Sand Lake Subdivision # 2. I have completed my review of the files on this property and the information that you have submitted on this project. Based on this review, I have the following comments: Based on the existing soil conditions, the submitted test results are satisfactory for total coliform bacteria and nitrate (as nitrogen), and the proposed wastewater disposal system [new 1000 gallon two compartment septic tank and 384 square feet of effective absorption area], it appears that the four waiver requests are reasonable. Therefore, in accordance with the State Wastewater Disposal Regulations (18 AAC 72.020(t)), the following waivers are granted: · The separation distance between the existing class C public water system source ~vell (PWSID # 217314) located on Lot 9, Block 1, Sand Lake Subdivision # 2 to the proposed septic tank located on Lot ! 0, Block 1, Sand Lake Subdivision # 2 has been waived from 150 feet to 120 feet. · The separation distance between the class C public water system source well (PWSID # 217314) located on Lot 9, Block 1, Sand Lake Subdivision # 2 to the proposed drainfield located on Lot 10, Block 1, Sand Lake Subdivision # 2 has been waived from 150 feet to 120 feet. · The separation distance between the class C public water system source well (PWSID # 21790) located on Lot 12, Block !, Sand Lake Subdivision # 2 to the proposed septic tank located on Lot 10, Block !, Sand Lake Subdivision # 2 has been waived from 150 feet to I I0 feet. · The separation distance between the class C public water system source well (PWSID # 21790) located on Lot 12, Block I, Sand Lake Subdivision # 2 to the proposed drainfield located on Lot I 0, Block i, Sand Lake Subdivision # 2 has been waived from 150 feet to 120 feet. The distances noted in the waivers are from your revised submittal. It appears that these distances are from the nearest edge of the waste~vater disposal system component to the nearest edge ofthe existing source wells. Ifthe proposed wastewater disposal system fails or contamination can be traced back to it, the four waivers will become invalid. In closing, I must stongly recommend that prior to submitting requests for construction approval or separation distance waivers, field verifications to confirm existing conditions be completed. Thank you for your cooperation with this office. Ifyou have any questions, please do not hesitate to contact me. Sincerely, William R. Rieth, P.E. Environmental Engineer Jim Cross, MOA/DDS Thomas Tiley, ADEC DEPT. OF ENVIRONMENTAL CONSERVATION DIVISION OF ENVIRONMENTAL HEALTH DRINKING WATER and WASTEWATER PROGRAM 555 CORDOVA STREET ANCHORAGE, AK 99501 http://www.state.ak, us/dec/home]htm TONY KNOWLE$, GOVEFINOFI · Telephone: (907) 269-7519 Fax: (907) 269-7650 July 3, 2001 Jeffrey A. Gamess, P.E. Algska Water & Wastewater Consultants, Inc. 6901 Debarr Rd., Suite 2B Anchorage, Alaska 99504 Subject: Lot l 0, Block 1, Sand Lake Subdivision Addition # 2, Separation Distance ~ :::Request between an'On-lot'Wastewater Disposal System and two :Class C Public /Water Systems' Source Wells (PWSID Numbers 2173:14 and 217940), ADEC Project # 1216: Review Dear Mr. Gamess: This is'response to:your letter and Set of plan§ received in this Office :on May 22¢.2001 .ha which yeu requested four Reparation distanCe'Waivers.. In: addition,.you provided information on the design of the on-site wastewater disposal system that Will be serving the single:thmily home. The design of the wastewater disposal system is currently being reviewed by the Municipality of Anchorage. The requested waivers are as follows: A 120 foot waiver from the class C public water system soume well (PWSID # 217314) I0cated on Lot 9, Block I, Sand lake Subdivision #2 to the proposed septic tank located on Lot 10, Block 1, Sand Lake Subdivision #2. A 132 foot waiver from the class C public water system source well:(PWSID # 2:17314) located on Lot 9, Block I, Sand lake Subdivision #2 to the.proposed drainfield located on Lot 10, Block 1, Sand Lake Subdivision #2. A 110 foot waiver from the class C public water system source well (PWSID # 217940) located on Lot 12, Block 1, Sand lake Subdivision #2 to the proposed septic tank located on Lot 10, Block 1, Sand Lake Subdivision #2. A 126 foot waiver from the class C public water system source well (PWSID # 217940) located on Lot 12, Block 1, Sand lake Subdivision #2 to the proposed drainfield located on Lot 10, Block 1, Sand Lake Subdivision #2. I have completed my review of the files on this property and the information that you have submitted on this project. Based on this review, I have the following comments. Jeffery A. Gamess Page 2 07/03/01 Based on the existing soil conditions, the submitted test results are satisfactory for total coliform bacteria and nitrate (as nitrogen), and the proposed wastewater disposal system [new 1000 gallon two compartment septic tank and 456 square feet of effective absorption area], it appears that the four waiver requests are reasonable. Therefore, in accordance with the State Wastewater Disposal Regulations (18 AAC 72), the following waivers are granted: The separation distance between the existing the class C public water system source well (PWSID # 217314) located on Lot 9, Block 1, Sand lake Subdivision #2 to the proposed septic tank located on Lot 10, Block 1, Sand Lake Subdivision #2 has been waived from 150 feet to 120 feet. The separation distance between the class C public water system source well (PWSID # 217314) located on Lot 9, Block 1, Sand lake Subdivision #2 tO the proposed drainfield · - - i located on Lot 10, Block 1, Sand Lake Subdivision #2 has been waived from 150 feet to - ', 132 feet. The separation distance between the class C public water system source well (PWSID # 217940) located on Lot 12, Block 1, Sand lake Subdivision #2 to the proposed septic tank located on Lot 10, Block 1, Sand Lake Subdivision #2 has been waived from 150 feet to 110 feet. - .The Separation distance between the class C public water system source well (PWSID # · ~ 217940) located on Lot 12, Block 1, Sand lake Subdivision #2 to the proposed drainfield · ' located on Lot 10, Block 1, Sand Lake Subdivision #2 has been waived from 150 feet to 126 feet. The distances noted in the waivers are from your submittal. It appears that these distances are from nearest edge of the wastewater disposal system component to the nearest edge of the existing source wells. If the proposed wastewater disposal system fails or contamination can be - traced back to it, the four waivers will become inYalid. Thanl~ you for your cooperation with this office. If you have any questions, Please do not hesitate to contact me. Sincerely, William R. Rieth, P.E. Environmental Engineer CC~ Jim Cross, MOA/DDS Thomas Tiley, ADEC/DW&WW MUNICIPALITY OF ANCHORAGE Development Sen, ices Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: May 30, 2001 Expiration Date: May 30, 2002 Permit Number: SW010147 ~'Legal Description: SAND LAKE#2 BLK I LT 10 Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: KELLY R. & MICHAEL S. ANDERSON Owner Address: 8133 WILCOX ST Total Bedrooms: 3 ANCHORAGE, AK 99502-4153 Parcel ID: 011-132-39 Site Address: 008133 WILCOX ST Lot Size: 6750 SQ. FT. Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage 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 ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and dosed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Municipality of Anchorage Development Sentices Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bmgaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchorage.ak.us (9O7) 34~-7904 Parcel I.D. ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Permit Number 5 t4/O/l~/4 7 Property owner(s) Mailing address (1) Mailing address (2) KELLY ANDERSON 8133 WILCOX DRIV~ * ANCHORAOE. AK N/A Dayphone 243-8310 ~pCode 99502 LegaldescrlptJon(Lot, Block&Sub'd.) LOT 10. I~LOCK 1: SAND LAKE SUBDMSION ~2 Legal desc~ption (Section, Township & Range) Lot Stze ~.~[/~.~ ~ ~/^ Number of Bedrooms THIS APPLICATION IS FOR: Sower Only Sewer and Well Sower Upgrade THIS PROPERTY CONTAINS: Hot Tub [~ Swimming Pool Therapy Pool [] Well Only Water Storage Jac Water Softening Unit I certify that the above Information is correct. I further certify that this application is being made for a Single Family Dwelling and Is In accordance with applicable Municipal codes. ALASKA WATER &: WASTE-WATER CONSULTANTS~ INC. Permit Fees: ~ Date of Payment: ~c~-O/ Receipt Number. AL A S I(A WATER & WA ST EWAT E R May 17, 2001 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 CONSULTANTS, INC. Reft Septic System Upgrade for Lot 10, Block 1, Sand Lake Subdivision #2 To whom it may concern: The existing 3 bedroom house is served by a class "C" well located on Lot 9, Block 1; Sand Lake S/D #2 and a private septic system. The existing septic system consist of a 1000 gallon septic tank and a deep trench type drainfield. The existing drainfield will not pass an adequacy test and must be upgraded. A test hole was excavated east of the existing septic system in the area of the proposed septic upgrade. The proposed septic system will be designed around the 30 foot radius of this test hole. We am proposing that a new 1000 gallon septic tank and also a deep trench type drainfield be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that due to the overall appearance of the soils, an application rate of 1.0 gallons/day/ft2 should be used. 2. TRENCIt DESIGN: a. Percolation Rate: <1 minutes/inch b. Allowable Application Rate: 1.0 gallons/day/fl2 c. NumberofBedmoms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 450 tt2 f. Total Depth: 11 feet (max.) g. Effective Depth: 6 feet h. Width: 2.5 feet i. Reduction Factor: N/A j. Minimum Length: 38 feet k. Effective absorption area -- 456 112 6901 Dcbarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 33%6179 * Fax: (907) 338-3246 * Website: akwwc.com 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPItY: The area for the proposed drainfield is mostly fiat; in short, there are no slope concerns. 5. LOT LINE WAIVER REQUEST: We request that a 1 foot lot line waiver be granted from the south property line to the proposed drainfield. There are several utilities that are along the north property line. We are unaware of any adverse effects that this waiver would have on the adjacent property. 6. D.E.C. WAIVER REQUEST: We have requested that waivers be granted from two class "C" wells to the proposed septic upgrade. Attached is a copy of the waiver request that has been submitted to the D.E.C. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Sincerell~ NOTE: Attached is a site plan drawing, a design drawing, a soils log. and a 7page construction speciJlcation letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com 4 ~ ,. ~K :; ~ :~. ~ =: , ~ 4. ~ ~- ~ :,. ~ ,: ~ r........ I ~ ~ I T ,, .. ,, - .. , ,. : . . ...... ~ ~. ~,/ ~c I I~ ." ~. '-~ ~ ', /~, '~'~ ~,. ~ f; '~ ,. ~ ,;-- · r ....... ~o ~ ,/~. ,~o ~Z~ -r - I ~ t~ i L ~E~ 82ND A~NUE ~__. ~ ____~.~---.~ ......... ...... ~ .... ~ / ~ ~ % ~ i /0 I .~..~. ~ ,, ,~., ~ I ~,~,, .,~ ~,,. ~,; !~ , . ~0 ~[ S~ ]2 ~ ~Z S/Ol2~ I ~ ~ES~ ~2/ , ~ ~O ~ ~ ~ I I ~.~,, ~-.~: ~1 ~3'~ L ,~,.~.~ 4. ....... CONSULTANTS, INC. 1" = 100' · .~= ~o. P~ NU~: ~ .u~: ~-'~ ~M~'~ ....... :'"~ KELLY ANDERSON 243-8310 1 OF 2 ~,~,~ ..r. p~ .....~:~- SAND ~KE SUBDIVISION ~2~ LOT 10, BLOCK 1, SITE P~N FOR SEPTIC SYSTEM UPGRADE AND WAIVER REQUEST ~ t LOCATED ON LOT 9. \4~k~ t Z. THE 152 FOOT WD-L RADIUS FOR 13-1£ CI.,~SS C WELL ~.0o~._ ~ t ~OCAT[D ON LOT g. eLl( 1; SAND LAKE S/O #2.. · w,¥~,',D, ~ % 3. THE 110 FOOT WELL RADIUS FOR THE CLASS C WEU. "~. ~ % LOCATED ON LOT 12. BLK 1; SAND tAKE S/D ~2; · °4,~o ~'"'"",..~ff~m, ~ 4. THE 126 FOOT WELL RAD!U$ FOR THE CI.~ C WELL '(~o~. ~ ~ LOCATE~ ON LOT 12. ~ %"~ ~ ~ ~ /I . I ',. ! % % , n / "' ' '-' I · ' ' '" :1 .o~ / ~-- D~.~--,/~,, . -- ,, // / .I. /.ti~ ....~;~ .- / I~ /~'~ .~ / It FEEl' DEEP btAXIMtJt4 BY 2.5 ~) // · ..~ AI~SI~ WATER & WASTEWATER e.,.o./,.bu. CONSULTANTS. INC. 1" : 20 ............................., KELLY ANDERSON 243-8310 2 OF SAND ~KE SUBDIVISION ~21 LOT 10, BLOCK 1 '"'"' ' DESION OF SEPtiC SYSTEM UP6RAOE AND WAIVER REQUEST ALASKA WATER & WASTEWATER ?1'"'"" ( ......... ISOIL LOG - PERCOLATION TES~I L...-k:.::~.. :,., ,I.,l,~ .... ::...,¥ ~) ~ T..de :fl ly A Gomess.; LEGAL DESCRIPTION: SAND LAKE SUBDMSION f2; LOT 10t BLOCK 1t VOh~.,~,.: '-. ~E-] '953 ..-' ~' PERFORMED FOR: KELLY ANDERSON DATE: 4,/30,/01 ~[~'~'e '"-. (f ORC, AN1CS ~TEST HOLE#1I ~ --- '~, ISlTE PI.~NI ~,i/' ~ ~ ~w I~ OR~ \1 ~'-,oo'1 GM CL OC o "~.~ F'--. SP CH / ,.o,o, ' [-' ~¥-~,~ GP 4 GC 5 SM OH / ~,~---/--J "-' 6 SC ,~ i~ ~ Ii t11' \ DEPTH TO DATE _ 7q GROUNDWATER .- J~Z, 2/ I ,,;.;.~ np o~ 5/14/01 '-- ~' """ -',7'--'[-- WE~-T~N,D AVEN,UE 10 ' ;"" NET TIME WATER LEVEL NET DROP · ...,, CLOCK ..o... DATE READING TIME (MINUTES) READING 11 "e*,' 4/30/2001 1 3:28 - 6' - 12 "'"' 2 ;3:~ 5.0 O' 6' 13 4 3:38 5.0 O' 6' 1 5 3:39 - 6' 6 3:43 5.0 O' 6" 15 ~ 7 3:44 - 6' - SM 9 ~:5o - 6- - 8 ;3:49.5 4.5 O" 6" 16~ 17~ 10 ;3:54.5 4.5 O" 6" 11 ;3:55 - 6" - 18 -- 12 3:59.5 4.5 O' 6" 19- PERCOLATION RATE <1 (HIN./INCH) PERC. HOLE DIA. 6' (INCHES) TEST Rt~1 BETWEEN 5.0 FT, AND 6.0 FT. 20-- COMMENTS: THE IN$1TU SANDY SOILS SHOULD ACT AS A SAND F1LTER PERFORMED BY ALASKA WATER & WASTEWATER I, JEFFREY ~ GARNESS, CERTIFY THAT THIS W~S P/E:RFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEUNES IN EFFLCT ON THIS DATE:: / ! ALASKA WATER WASTEWATER ...... , CONSULTANTS, INC. May 17, 2001 State of Alaska Department of Environmental Conservation Division of Environmental Health Drinking Water 8: Wastewater Program 555 Cordova Street Anchorage, Alaska 99501 Subject: Waiver Request from the Class "C' Wells located on Lot 9, Block 1; Sand Lake S/D #2 and Lot 12, Block 1; Sand Lake S/D #2 to the Proposed Septic upgrade located on Lot 10, Block I; Sand Lake S/D #2. To whom it may concern, We would like to request that your department issue the following separation distance waivers: A 120 foot waiver from the class "C" well located on Lot 9, Block 1; Sand Lake SfD #2 to the proposed septic tank located on Lot 10, Block 1; Sand Lake S/D #2. A 132 foot waiver from the class "C" well located on Lot 9, Block 1; Sand Lake S/D #2 to the proposed drainfield located on Lot 10, Block 1; Sand Lake S/D//2. A 110 foot waiver from the class "C" well located on Lot 12, Block 1; Sand Lake S/D #2 to the proposed septic tank located on Lot 10, Block 1; Sand Lake S/D #2. A 126 foot waiver from the class "C" well located on Lot 12, Block 1; Sand Lake S/D #2 to the proposed drainfield located on Lot 10, Block 1; Sand Lake S/D #2. A permit has been requested from Municipality of Anchorage's Department of Development Services to upgrade the septic system with this waiver application. See this application for information on the septic system. The following are some mitigating factors for the justification of the requested waiver: The subject well is located uphill from the septic system, so it is impossible for surfacing effluent to migrate towards the well. The only path for contamination would be subsurface. The septic system installed on Lot 10, Block 1, Sand Lake S/D #2 is only about 105 to 100 feet from both class C wells. This encroachment has existed since 1983. Recent water samples from this well (copy attached) indicated no coliform bacteria and undetectable nitrate levels. This is confirmation that the geological conditions are such that the aquifer is not being adversely effected. 6901 Debarr Road, Suite 2B * Anchorage. AK 99504 Ph: {907) 337-6179 * Fax: (907) 338-3246 * Webslte: akwwc.com · Attached are copy of the well driller logs for the wells in the immediate area. As can be seen on the logs, the static water levels range from 108 feet to 185. Most of the well logs show that there is over 100 feet of sandy, clay soils. Clearly, based upon the water quality, these layers have served to protect the aquifer. · Att~iched is a copy of a previous waiver that was granted for the existing septic system that serves Lot 10, Block I; Sand Lake S/D #2. It is our opinion that the same justifications for the existing waiver still should apply for the waiver for the proposed septic upgrade. · Virtually every community well in Sand Lake 02 Subdivision has 100 foot waivers granted to the adjacent septic systems. In my experience with this subdivision, none of the wells have been adversely impacted. Based upon the aforementioned facts, there appears to be minimal risk in granting the requested waivers. If you have any questions, or require additional information, please contact me at 337- 6179, or 244-9612. Thank you for your assistance and consideration in this matter. ~~I.E., M.S. Presi~cnl ~ ~ 6901 Dcbarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 335-3246 * Website: akwwc.com Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw S~reet P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Waiver Review Worksheet WRg: WR010030 PID~: 011-132-39 H~: Date Received: .5/22/01 Legal Description: SAND LAKE #2 SUBDMSION BLOCK 1 LOT 10 Permit: SW010147 Engineer:. JEFFREY A. GARNESS 6901 DEBARR ROAD, SUITE 2B~ ANCHORAGE, ALASKA 99504 Applicant: KELLY ANDERSON Waiver Requested: t FOOT LOT ENE WAIVER TO THE SOUTH PROPERTY ENE TO THE PROPOSED ABSORPTION TRENCH Criteria: Geology A. Water Tabie B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation P~n~: Total: Waiver Is Granted: X Waiver is not Granted:. ListConditionsocReeso~sforabove: .,<'~'E EivE..IIVEER Ye I E~I' E~' ,~F ~Tl.,t ;~"/F/~*,,~/oRI Name of Reviewer Rec~: 04748 Amount: $115.00 Date Paid: 5/30101 Municipality of Anchorage ~ Dx~asion P.O. Box 190350 * 4700 S. Bragaw Strcet Anchorage, Alaska 90519-6650 * (907) 843-8;301 h ttp://www.c!.anchorage.ak.us 05/30101 '" Jeffrey A. Gamess, PE Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B Anchorage, Alaska 99504 Subject: Waiver Request for Sand Lake//2 Subdivision Block 1 Lot 10 Waiver Request #WR010030 Parcel ID #011-132-39 Permit Number SW010147 Department o~ Publi~ Works DearMr. Gamess: Your request for a waiver of the required 10 feet horizontal separation from the $£P~ absorption field to property line has been approved. The approved separation distance is 1.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Daniel J. Roth Civil Engineer On-Site Water & Wastewater Program Municipality of Anchorage Building Safely I)~v~smn 6/4/2001 Jeffrey ~A. Garness, PE Alaska Water & Wastewater Consultants, Inc. 6901 Deban; Rd., Suite 2B Anchorage, AK 99504 Subject: Waiver Request for Sand Lake #2'Subdivision Block 3 Lot 4 Waiver Request #WR010032 Parcel ID #011-134-45 Public ~,Vorks Dear Mr. Gm'ness: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 1.0 foot. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Daniel J. Roth Civil Engineer On-Site Water & Wastewater Program I , ' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONi~iENTAL 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 .P/~CiFIC P-Ih1 CoM~;'TIZUC.'7'/OA/ ~;~.-S~3'? ~ [~ UPGRADE MAILING ADDRESS /40'7 W, 477-// '~ ¢' LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS J Well AbsorlEtion area Dwelling PERMIT NO. _o v DISTANCE TO: /v/~7- //~/ ~ / /VOT' /XJ ~-z ¢ Manufacturer Material No. of compartments O'rLEE. IZ. 5' TE./: ~. Liq. capacity in gallons Insi~.~_~ Width ~ Liquid depth /~O IF HOMEMADE:,~- ~ 6 v DISTANCE TO: Well Dwelling PERMIT NO. O Z ,~ Manufacturer ~' -- I- Material Liquid capacity in gallons 1:3 Well Foundation Nearest lot line PERMIT NO, ~ DISTANCETO: i{'/OT //J /JOT i'/~/ /~ ~ u. ~ No. of lines Length of each line¢ Total length of lines Trench width Distance betw~~ -_z ~ / 3~ ' t~ / .¢;z_ i.chas I- ~ ~ Top of tile to finish grade Material beneath tile Total effective absorption area ~ ~'~ / ~,'~ inches ~-'~"~.~ 2. u~ Length Width Depth PERMIT NO. <[ I- Type of crib Crib diameter Crib depth Total effective absorption area u~ DISTANCE TO: Well Building foundation Nearest lot line .~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area{s) OTHER PIPE MATERIALS SOIL TEST RATING /'~ ~(-"' -- '~-- INSTALLER '" REMARKS ~ ,~.~'rl~J~'"' ~ // APPROVED /~/ DATE LEGAL COMMUNITY WELL Lots 9 & 10, Block 1, Sand Lake Subdivision, #2 Sherwood Builders 345-3816 50' lO ........ 100' radius from well-a systems outside radius ~--10' easement for waterl septic ne Well has Pitless adaptor at a minimum depth of 10 feet. An approved watertight sanitary seal is installed. The top of the well casing extends a minimum of 12" above ground with drainage sloped away from the well,for a minimum of 10'. Main supply line is 1 1/2" Type K copper tubing. Individual service lines are 3/4". Each service line has a "key box". System is buried a minimum of 10' deep with "thaw" provisions, Each house has "Well X Trol" model 202 pressure tank capable of 11.5 gallons of drawdown per tank. Tank capacity is 20 gallons. Power source and controls are located in the house on lot 9~ d C CONSTRUCTION AND OPERATION CERTiFiCATE ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION. PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT Plans for the construction ot /~ ~) 'T' '~' approved. (-~ ~z ,~Z]- .~ ,.C (-~¥ ~ _public water system located , Alaska, submitted in accordance with 18 AAC 80.100 have been reviewed and are conditionally approved (see attached conditions). If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. APPROVED CHANGE ORDERS Change (contract order no. or descriptive reference) la~ Approved by [~T~,~t~f~__c_.~ Co Date The "APPROVAL TO OPERATE" section must be completed before any water is made available to. the public. APPROVAL TO OPERATE \ The construction of the L~T '~'7 /o ~t& ~ S~ ~/~ ~ ) -. public t ~'~ ~ /~ '- ~ '- ~ 2 (date). The system is hereby water system was completed on granted interim approval to operate for 90 days following the cpmpletion date. BY TITLE DATE As-built plans submitted during the interim approval period, or an inspection by the Department has confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate. Mr. Stephen D. Shrader Alaska Development Consultants 624 W. Int'l Airport Road Suite 103 Anchorage, ALaska 99502 RECEIVED E] 457 E. STREET ANCHORAGE, ALASKA 99501 [907) .274-2533 P.O. BOX 615 KODIAK. ALASKA 99615 (907) 486-3350 P,O, BOX 1207 SOLDOTNA, ALASKA 996C~..9 (9077 262-5210 P.O. BOX 1709 VALDEZ, ALASKA 99686 (907) 835-4698 P.O, BOX 1064 WASILLA, ALASKA 99687 (907) 376-5038 SUBJECT: Lot 10, Block 1, Sand Lake SD Class C Contaminate Separation Waiver Request~ Anchorage // ~ Dear Mr. Shrader: /~ J We have reviewed your report and recommendations concerning a reduction of the class 'C" protective radii for a well located on the subject lot. We hereby grant a waiver of 18 AAC 80.020 which requires a minimum separation of 150 feet between a class 'C" well and a septic system to 100 feet in regards to the subject lot. We Will require that the owner contact us concerning a possible upgrade of the pump/storage system to meet the additional water demand caused by the construction of the four plex. If you have any questions, feel free to contact me. Sincerely, , , · .... Thomas Murrell Environmental Engineer ~4/jt cc: D.H.E.P.j 825 L. Street Anchorage, Ali 99501 8-09LH 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 OSC241474 Parcel ID 011 -132-39 Expiration Date: Legal description SAND LAKE #2 BLK 1 LT 10 site address 8133 WILCOX ST Current property owner(s) COOL HAROLD MILTON JR X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 12/5/2024 Thif Ce ficate of On -Site Systems Approval (COSA) is intended to demonstrate the subject sys (s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, velopment 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 work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory _ Tank Age Advisory Arsenic Advisory � Other MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 011-132-39 Complete legal description Sand Lake #2 Block 1 Lot 10 Location (site address) 8133 Wilcox St. Anchorage, AK Current property owner(s) Harold Milton Cool Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑ 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: © Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: 0 Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 23 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed 2 Deep Trench ❑ Wide Trench ❑ 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 $ _� Date of Payment V/z-'J Z COSA # c y / y Ty Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 19.0 Arcterra Consulting 10/31/24 Community well 49” Sand Lake #2 Block 1 Lot 10 011-132-39 7/18/2001 8.8 2.7 11/7/24 19 2000 11/8/24 450 37 600 19 450+ 72 19 53 11/18/24 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. Arcterra Consulting Kenneth Duffus (907)-696-6111 1+* 1+* *Waiver# WR010030 approved 5/30/2001 From: HAROLD COOL <COOLHAROLD@msn.com> Subject: Re: 8133 Wilcox St - Estimate 24157 from ArcTerra Consulting, Inc, Harold & Arlene Cool Date: December 4, 2024 at 5:16:43 PM AKST To: dea arcterra.net <dea@arcterra.net> Cc: Arleen Cool <omacool1@hotmail.com>, Elizabeth Dykes <elizabeth@larrydykes.com>, "Inc. Apple" <larry@larrydykes.com>, "Inc. Apple" <larry@larrydykes.com> Hello Dea The septic system has worked flawlessly over the ten years of owning the property. It has never froze or backed up at anytime I’ve only had normal maintenance completed such as having the septic tank pumped every three years and the addition of Ridx bacteria to keep it clean. I hope this answers the questions about the system. Harold On Dec 4, 2024, at 7:43 PM, dea arcterra.net <dea@arcterra.net> wrote: Arleen and Harold, The MOA is asking for verification from you, as owner, addressing any freezing issues that you may or may not have experienced with the septic field over the years. The issue is that the coverage over the field is about 6 inches too shallow (per code) to prevent freezing. Please send me a statement, they said email is acceptable, and they will approve the COSA. dea MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT o ASIS �. cbE On -Site Water and Wastewater Section www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval # OSC241474 Subdivision: Sand Lake #2 Block:1, Lot: 10 907-343-7904 Fax: 343-7997 The septic tank for this property is 23 years old. The average life of an asphalt coated steel septic tank is 20 years. Typical replacement costs are $15,000 or more, not including engineering, surveying, MOA permitting fees or site restoration. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Arsenic Advisory Certificate of On -Site Systems Approval # OSC241474 Subdivision: Sand Lake #2, Block: 1, Lot: 10 907-343-7904 rax: 343-7997 A water sample revealed an arsenic concentration of 19 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. Municipality of Anchorage .~; Development Services Department Building Safety Dlvtslon On-Site Water & Wastewatsr Program -' · * ~ * .* ' .:- '. ..'CERTIFICATE OF HEALTH AUTHORITY .APPROVAl.. .... · .-" ..· FOR ,6, SINGLE FAHILY DWELLING. '" - ....... ' GENERAL INFORMATION Compl.etalega!description SAND"LAKE-#2 LOT 10 BLOCK 1 L6ca~6ri (site address or direc'Jons) 8135 .WILCOX-SIREET Current P~:operty ~wner(s) MIKE & KELLY ANDERSON Parcall:D.' '01~13~-39' ' 8133 WILCOX ~i'REE-r ' · I.ending age,nc~ Mailing address Real Estate Agent Mailing address Unle'ss"o{he~wlse requested, HAA will be held by DSD for pickup. 2. NUMBER'oF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well [~] Individual Water Storage Community Class Well [~ Public Water System Ex~)iration Dat~: /.0 - .~,-g .- '0 1 ' · Da'y~)hone''2~t3~;8310' :. Day phone Da~, phone ~ TYPE OFWASTEWATER 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. Certificetes of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastawater 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 e As cer~fied by my seal a ff~ed hereto and as of the vafidaUon da te shown below, I yen'fy that my Invesfl'gation, b~s~d oh p~u/~ b~tiined In th'e Health Authbfi~y Approval Guidelines fo'r this applicaEon, shows that the on-site water sUpp~ ahd/or wastawatar disposal system is(are) safe, funCtiOnal and adequate for the number of bedr~oms and type of structum indicated here[n. I further ved~y that basad on the Infon~ation obtained from th~ Munldpall~ of Anchorage files and from my Investigation and Inspoc~ion, the ' on-site water sd~p~' and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordihances, 'and regulations In effect at the time of Installation. Name of Firm: AJ.ASKA W,~TER &: WASTE'WATER CONSULTANTS, INC. Address 6901 DEB,~R RO~, SUITE 2B * ANCHORAGE, ,~X 99504 Engineer's Printed Name 'JEFFREY A. GARNESS, P.E. Engineers C0mmel~ts: ' .... " ' In conducting this evaluation, A~/YC,, Inc. attempted to provide a thorough, . · coneslen#ous engineadng anal~sis of the system In accerdance with ADEC and MOA DSD Guidelines & .Regula§?ns. The reported results desc~bed the performance of the system under the cond~'ons encountered at tho time of the test, and esparaffon distances measured to readi~ Identifiable features. The operational life of all wells and septic systems depend on the Iocal soils condition, groundv~'aler levels that may.. fluctuate dudng ~the year, and the water usage of the family being sen/ed by the system. . These conditions are outalde the con~'ol Of the evaluelor of the system. ,Sa#sfacloo/test results do not gua/antee futore pedorrnanca of the system, nor do they guarantse that there are no hidden'defects or encroachments. AW14/C, Inc. can therefore not provide any werran~y or future estimate of how long the system will continue to/neat tho operational requirements of the ADEC or MOA DSD. The content of thfs report is for the sole benefit of the ovmer listed above. Any rotianca upon or use of this ropc~'t by any other pere?n or ~ is ~o~ t authorizsd, nor will It confer any legal Mght whatsoever. DSD SIGNATURE ~ Approved for --~ bedrooms. Disapproved. Conditional approval for __ Phone 337-6179 ,,,, · .,,: · ON-SITE bedrooms, with ~e ~lowlng s~pula~ons: ' . ..,..," .... Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineers Reort Other Original Certificate Date: '~-' ~;~ "~O / Municipality of Anchorage Development Services Department e~ Saf~V ~ On. Site Water & Wastewater I~ 4700 Soulh Bragaw SL HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: SAND LAKE #2 LOT 10 BLOCK 1 Parcel ID: 011-132-39 WELL DATA Weiltype C IfA. B, orCprovldePWSlD# 8321-FA-223 WeilLog(Y/N) N/^ Cate completed N/A ~arlltery ~eal (y/N) N/A ~ properly protected (Y/N) N/A Total dep~ N/A ~ Cased to N/A ~ Casing height (above gmond) N/A In. &TIN~PI=C'rlON ~ FROM LOG Date of test ~ Static water level ~ It, ~ g.p.m, WATER SAMPLE RESULTS: ~ colonles/10q mi. Nllrate OD ~" regal.. Cate of sample: 7//"//01/ Collected by:. B, SEPTIC/NOLDING TANK DATA Tank Type/Matehel STEEL Tankelze 1000 gal. Number of Comparlmente 2 Capresslon over tank (Y/N) NO Foundation cleanaut (Y/N) YES Date of pumping NEW AB$ORPIION FIELD DATA Cate I~teil~:~ 7/13/01 Length 32 It, Pumper Date Installed 7/13/01 CleallOUte (Y/N) YES H~gh water a~rm (Y/N) N/A N/^ soil rating ;~;~or It'/bdm~) 1.2 ~ 2.5 lt. Total depth 11' It. Eft. absorp~on ama 384 fi' Monlt~ tohe YES Date of adequacy test NEW Results ~all) Fluid depl~ In absori~on field before test In. Water added g~L. Elapsed 'lime: min. Final fluid depl~ In. Any rejuvenation Imatment (past 12 mo,) (Y/N & type) System t~3e DEEP TRENCH Gravel below pipe 6' lt. Capmsslon over field NO For bedrooms New depth in. Absorption rate >=, .g.p.d. N/A If yes, glv~ date - Other bacteria __ AWWCI INC. g.p.m, I colonies/100 mL D. UFT STATION Date installed Size In gallons "Pump on' level et In. 'Pump n. High water elarm level at In. Datu_.._._m Cycles tested Meste alarm & dmuti requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot N/A On adjacent Jots. N/A Absorption field on lot N/A Public sewer main N/A N/A Sewer/septic sen'ice fine N/A SEPARATION DISTANCES FROM SEPTIC/HOlDING TANK ON LOT TO: Building foundation 5% Water main N/A Wells on adjacent Iota *'110'+ On adjacent lots. N/A Public ~wer manhole/cleanout Holding tank N/A Property line ,1 '+ Abeoq~tion field 5' Water service line 10'+ Surface water. 100'+ *WAIVER ISSUED WITH SEWER PERMIT SEPARATION DISTANCE FROM ABSORPTION FIElD ON LOT TO: Property llne 1'+* Butldtng foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Ddveway, paddng/veNcte storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots *'120'+ F. COMMENTS **SEE ATTACHED ADEC WAIVER LETTER G. ENGINEER'S CERTIFICATION I certify that I have determined thfl:~ugh field Inspections end revfew of Municipal reconfs that the above ~ystem~ ere In conformance with MOA HAA guidelines In effect on this date. Engineer's Prl?M I~me dEFFREY A. C.-ARNESS HAA Fee $ ~ECx:3.°O Waiver Fee $ Date of Payment ?/~ ~/oi Date of Payment I ~ Receipt Number '7',~ ~,c~ Receipt Number. MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343.4744 Parcel I.D. # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Location (address o~: 8irections) ": (b) Telephone: (home) Business Property owner Mailing Address ~aS"' "~.' (c) " :' :~/,;6'/¢~)~'-~ Telephone Lending Institution Mailing Address .... Real Estate Company and Agent Address '~/-~ :¢' "7;~¢?~J/~;d Telephone ~'~J'?'- Mail the HAA to the following address: (or check here"j~¢, if hold for pick up.) List contact person and day phone number below: (d) (e) 2. TYPE OF RESIDENCE Single-FamilyC'~. Number of bedrooms 3. WATER SUPPLY Individual Well [] Community~ Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site, S. 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 I of 2 5. 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 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 /~-'-/_.5.% Telephone Address -~'~- ~'''/ Date 6. DHHS APPROVAL Approved for _~--_ bedrooms by Approved ~ Disapproved Terms of Conditional Approval Conditional The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 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. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: /-.~7-' To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results A. WELL DATA Well Classification ¢--z'/-~'~ "~ ~' If A, B~) D.E.C. Approved(~)'N) resent (Y/N) Date Completed Yield Cased to. ___Depth of Grouting __ Static Water Lev'~k,_ Pump Set At __ ~:eS~ :r~c ~,e 'wgihr :n; bi ~ v~- DSeapnr i~ :: ~o~ e/~ Ir ~unn ~ a~i:, ~h (:a/dNiy / N) SEPARATION DISTANCES FROM WEL"~-'b....~ To Septic/Holding Tank on Lot ~ ; On Adjoining Lots ~ ; On Adjoining Lots To Nearest~out/Manhole ; Date Comments SEPTIC/HOLDING TANK DATA Date Installed ~-..-.-30-E'.~' Size Standpipes (~N) Depression over Tank (Y~) Pumping/Maintenance Contact on File (Y/N) ,c)//4. ,' for Hol~jng;T;a.n'~! Higrh,w. ater. Alarm (Y/N) ,/-. Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: /_-",'0 .~- To Building Foundation /O / To Disposal Field No. of Compartments Air-tight Caps (~N) Foundation Cleanout (Y~ Date Last Pumped .: To Property Line · '-To.W~t'br,M~in'/s~'r¢ice I;,in~ /~ ~ ~0'~:t?~'m, Pond/Lake o~' Major Drainage Course Comments':~' -/~E-~.. /.J,c+/v~¢~ ~ )c/DE". 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Type of System Design; Length of Field Depth of Field /2- -- / Gravel Bed Thickness Statndpipes Present'N) Date of Last Adequacy Test Square Feet of Absortion Area Depression over Field (Y~ Results of Last Adequacy Test _ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area ia - / To Property Line / To'Existing or Abandoned System on ; On Adjoining Lots /O To Cutback (if present) I Comments D. LIFT STATION Date Size in Gallons "Pump On" Level at High Water Alarm bbvel at " Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) : "Pump Off" Level at Vent (Y/N) ' __ Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** , uidelines in effecf, o.r~' ~ date of this i certify that I have checked, verified, or conformed t° all MOA and HAA g inspection. Signed Company ...... Date MOA No. Receipt No. ~O~ Receipt No._ Date of Payment Amount: $ 72-026 (Rev. 7/88) Back Waiver Fee: $ Date of Payment Page 2 of 2 DEPT. OF ENVIRONMENTAL CONSERVATION STEVE COWPER, GOVERNOR ANCHORAGE/WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 1334 ANCHORAGE, ALASKA 99503 563-6775 DATE: 10-11-88 PWSID: Class C Well To Whom It May Concern: According to the records on file in this office, the Lot 10 Block l, Sand Lake #~ater System is in compliance with State of Alaska Drinking Water Regulations. the MPL:pkk Sincerely, Michael P. Lewis, PE Environmental Engineer ' ' APPLI( '"NT FILLS OUT UPPER HA[' ' 'ONLY · ~- Phone Property Owner Address Zip Code Lending Institution~' .~ Phone Address Zip Code Realty Co. & Agent Phone Address - Zip Code~__ Type of Resi~nce ~gle Family ~ Multiple Family No. of Bedrooms ~ Other Water Supply ~ Individual A~ACH WELL LOG. A well log is required for all wells drilled since June 1975. ~munity ~ ~ ~ ~ For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility Sewer Disposal ~vidual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE; THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time ~j Ti Time Date~ Date Date Date Insp~tor ~ Insp~tor Insp~tor Insp~tor Field Notes: ~ ~ ~_ ~, MUNICIPALITY OF ANCHO~GE ~ ENVI~I2NTAL PROTectION PPOVD~E~OOM~ '~ONDITION~ OF APPROVAL ( ) DISAPPROVED 8oils Rating Date ~wer Installed Well To Absorption Area~ ~ ~ ~ ~ Well Log Received / t ~¢ ¢ '~0--¢3 WelltoTank~1// Septic T~k Size [,00 ~ 72-023 (3182)