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HomeMy WebLinkAboutSAND LAKE #2 BLK 4 LT 36Samoa k�2 «a tv oil %No I Isom" 100) Municipality of Anchorage Pageof 7 -- DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: s'W9y0/39 PID Number: allUE17 Name: Wastewater System: ❑ New �( Upgrade '— A A ASE G A�C'rENT Address: ABSORPTION FIELD 2231 E CG./tiF ST. P41Gr1e: 9 No. of Bedrooms: Deep Trench ❑ Shallow Trench El Bed ❑ Mound ❑ Other CNO/2 E l O Z LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: O, CD GPD/Sq. . Ft. IZ Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe (o S- L /iKi u D. 7 Ft. .� Ft. Township: Range: Section: Fill added above original grade: Gravel length: . Ft. SZ Ft. ' ew C3 Upgrade WELL: �X 6S `� Gravel width: 2. s Ft. Number of lines: 3 Distance between lines: /0 ' Ft. Classification (Private, A,B,C): EX /ST. Total Depth: Cased To: Total absorption area: Pipe material: ICIP/O /REKF. /-i-4v.4TE a ( Ft. 2 d I Ft. S20 SQ. Ft. AST/" D303'9 P.V C - Driller: �i>z7 I Date Drilled: Static Water Level: Installer: EXCHVAT/.UG Date installed: N (yctNc, d t,a s4 SSI Ft. AxTE/2 Yield: I() GPM Pump Set at: I Ft. Casing Height Above Ground: 1, 5 Ft. TANK SEPARATION DISTANCES XSeptic EXIST. ❑ Holding ❑ S.T.E.P. To Septic Absorption Lin Holding Public/Private Manufacturer, Capacity in gallons: From Tank Field Station Tank Sewer Lines Q-A rv.-�-F_ Welty r , q6 _ /05-' Material: � ca ss Number of Compartments: '% LIFT STATION Watere /00 a /00 LotSize in gallons: Ma turer: Line 20 11f,7-6 "Pump on" level at: ump off" lev High water alarm at: Foundation 3y r 4 , Curtain NOJJ K OWN Pump M Model Electrical Inspections performed by: Drain Remarks:52 Fs f '2G-/_ swk BENCH MARK �1 t>F- Cs000 Location and Description: TFI)7-- _ OF /2622 DECK G N LONPITION. gqouNv vFw 6 --Cu? S�P7(c Assumed Elevation: &-z zv o /� al ` c Z%L7I C/ /SSJE'� (�6�Gy/ fOG l /vrP . E SEAL g op 1 ky irf 4 ^ , I 5 5 ENGINEERINGQui 17034 Eagle River Loop Road, No. 204 Vp 5 "� °°"` °° Inspections performed by: FaglP Mvar, Alaska 99577 Dates: 1st // - / -9y j�y���• f 2nd av ROBERT C. COWAN i �ot- /CE-8801 Department of Health/afi'd Human/ Services approval t! PROFESS10�iA�� i�>a u4,, Date: Reviewed and approved by: / d 72-013 (Rev. 9/91) MOA 25 Permit NoSW940134 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal DescriptioAAND LAKE SUBD. No.2, BLOCK 4, LOT 36 PID No.: 01 113517 72-013 A (1/93) ` Mmieipality of Anehorage Department of Health and Human Services 825 "L" Street Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor November 28, 1994 Mr. Robert W. Cowan S & S Engineering 17034 Eagle River Loop Road, Suite 204 Eagle River, AK 99577 Subject: Waiver Request for: Lot 36, Block 4, Sand Lake Subdivision #2 Waiver Approval: # WR940064 Dear Mr. Cowan: Your request for waiver(s) of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance(s) are: Well to Tank 96 feet Absorption Field to Property Line 2-1/2 feet This waiver approval applies to the existing septic system to well separation only. Any future upgrades to either will require all separation distances be met or another approval be obtained from this department. Sincerely, Robert W. Robinson Civil Engineer On -Site Services kb MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR940064 PID# 011-135-17 HA# HA940645 Permit # Date Received: 11-21-94 Legal Description: Lot 36, Block 4, Sand Lake Subdivision #2 Engineer: S & S Engineering 1/034 Eagle River Loop Road, Suite 20 Eagle River, AK 99577 Applicant: Karen Largent Waiver Requested: Well to Tank - 96 Feet Absorption Field to Property Line - 21, feet Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability 5 D. Water Table Gradient . E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: List Conditions or Reasons fo Date: Rec #: 00512 Waiver s NOT Granted: iewer Amount: $_625.00 Date Paid: 11-21-94 . .. MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Date: November 30, 1994 To: File From:Jwmes Cross, P.E., Program Manager, On-Site/Water Quality Subject. Separation Distance Waiver. The well located on Lot 34, Block 4, Sand Lake Subdivision #2 is a Class "C" well, which typically require 150 feet horizontal separation from septic systems. However, this well, known as the Sand Lake S/D Lots 19,20,33, and 34 Class C Public Water System, was granted a waiver on its construction and operation certificate. This waiver states: "Waive 150 ft. well to septic separation to 100 ft. 9-9-82." this was signed by Bruce E. Erickson. During the process of reviewing a Health Authority Approval worksheet on Lot 36, Block 4, Sand Lake #2, it was discovered that the septic tank on Lot 36 was located within the 150 ft radius of the Class C well. This tank had not been specifically mentioned in the waiver or the file on Lot 34. A phone discussion with Bill Lameroux of ADEC on 11/28/94 confirmed that this waiver could be applied to the septic tank on Lot 36. S & S \ November 16, 1994 ROBERTC. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTHAUTHORITY Municipality of Anchorage APPROVALS DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street PO Box 196650 Anchorage, Alaska 99519-6650 SEWER&WATER MAIN EXTENSIONS REFERENCE: Lot 36 Block 4, Sand Lake S/D #2 8230 Seacliff Street, Anchorage SEWER&WATER INSPECTION Request you issue the attached Health Authority Approval and grant a waiver for the horizontal separation distance between the well and septic tank located on the referenced property at a distance of 96 feet. Also we request a 2.5 ENGINEERING STUDIES AND REPORTS ft. property line waiver between the north trench and the north property line. The septic system was recently upgraded on November 2, 1994 WELL INSPECTION by Baxter Excavating and inspected by our firm. The &FLOWTEST existing septic tank was excavated and inspected. .Once the tank was uncovered it was determined that the tank was within the 100 ft. well radius. The existing septic tank location shown on the design shows the septic tank location SITE PLANS as it is shown on the inspection report from the original installation on April 10, 1980. This inspection report shows the tank to be 40 feet from the foundation, during the installation we measured the tank to be only 36 feet from ROAD DESIGN the foundation; thus the tank was closer to the house and also closer to the well than what was actually documented on the original inspection report from April, 1980. SOILTEST During the excavation and inspection of the septic tank it was determined that the tank is of good integrity, it showed no signs of effluent outside the tank. PERCOLATION A waiver of the separation distance down to 96 feet should TEST be granted for the following reasons: 1. The well was drilled by Dotten Drilling on MTRUONRAL& October 18/ p 1980. Water samples were taken from MECHANICAL INSPECTIONS the dwelling served by the referenced well and were tested for bacteria and nitrates by Alaska Chemical and Geological Laboratories. No Nitrates were detected. ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page Two Sand Lake S/D #2, L36,B4 11/16/94 This indicates the septic systems on the referenced and surrounding properties have had little or no impact on the well serving the referenced property. 2. The well log indicates the aquifer serving the referenced property is confined by 200 feet of sand and gravel. Such strata serves as a filtering media which cleanses the effluent as it migrates towards the aquifer. 3. A well flow test performed on 11/3/94 shows the well to produce 6.3 gpm after four hours with only a 4 foot drawdown. Such a low drawdown indicates a low hydraulic gradient toward the well. In effect, use of the well will not tend to "draw" effluent toward the well. 6. A soils test on file for the referenced property shows the septic system receiving soils to be a silty sand rated at 0.6 GPD/SF. This type of soil is generally very effective in filtering harmful effluent contaminants as the effluent travels through the soil. If you have any questions or require additional information for your review please contact us. Sincere1 , ow W10VU J ES P. WILLIAMS, C. E. /u , 92 ROBERT C. COWAN, P.E. 7 7y 77, 00/r cls -s)') 7-3 7�1 3� �'�z;4�X2- 3: Ad s 0 PAGE 1 MUNICIPALITY OF ANCHORAGE 15" 6-\,Iijs�44 @ DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940134 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:LARGENT MARTHA KAREN OWNER ADDRESS:8230 SEACLIFF ST ANCHORAGE, ALASKA 99502 PARCEL ID:01113517 LEGAL DESCRIPTION: SAND LAKE #2 BLK 4 LT 36 LOT SIZE: 6750 (SQ. FT.) NUMBER OF BEDROOMS: 2 THIS PERMIT: 2 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: OF 1 I"coPnm 5,0a) P m DATE ISSUED: 5/19/94 EXPIRATION DATE: 5/19/95 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 DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ;u_ DATE : ISSUED BY: f. �{ T� DATE: f_- / �- 1�4 MAY 17 194 15:17 ALASKA REGIONAL HG5P 907264 P. 2/2 ,10,E 4/,0 7`26 8 44 Sand 02 Nlfmc- n q �,�lLt 1C . sit kC�c. c:>- Q ..\ JZ -Q-A— •c r `tomes RECEIVED Y 18 1994 tviu, ;c,,ai;:y iii Alichorage Dept. Health & Human Services F9��E r?/VER, PIX-P'S"P HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSALSYSTEM DESIGN April 29, 1994 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 IL` Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Sand Lake Subdivision #2; Lot 36; Block 4 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 Request you issue a permit to upgrade the septic system serving the two bedroom house on the referenced property_ An adequacy test performed on the existing system for Health Authority Approval purposes found the absorption capacity of the existing system to be inadequate. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The approximate location of the test hole is located on the attached site plan. The monitoring tube within the test hole has been checked and found to be dry. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your review;"ollease contact us. A. Shafer, P.E. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 EXIST. TRENCH TO BE; ROPOSED ABANDONED SUCH THAT TRENCHES IT MAY BE USED IN TH 37 FUTURE. 16 'K � IJ 0' WELL RAD 21 -FA -201 o zs O WELL SEP IC �C CO 36 HSE ARE TH 0 T 36 17 oDS 18 1 HSE ALL PORTIONS OF SYSTEM WITH LESS THAN 3.5' OF COVER REQUIRE INSULATION. CEPTIC> \ /^I �EA EXISTING 1000 GA SEPTIC TANK (19E VERIFY INTEGRITY 38 9 HSE EXIST 2 BDRM HOUSE HSE CLASS 'C' WELL 1 I I I I I I I I I II I i I X45. 31v�r�-� -,,,,CLi NT CLASS 'C' WELL HE ENGINEER FEk MAY V THE EVC1 DIMENSIONS AN,. DESIGN PARAMETERS N THE REID. IF NE.CSAPY, TO IJEET SITE CONDITIONS. LEGA` SAND LAKE SUBDIVISION 2, BLOCK 45 LUT SU thp� DRAWN J. ANDERSON CKD. R.A.S. DATE 5— 4794 1 SHT. 1 OF 1 DESIGN CRITERIA: STRUCTURES, EASEMENTS, OR ENCROACHMENTS SHOWN ON THIS SITE PLAN ARE AS SHOWN ON 2 BDRM = 300 GPD AN AS -BUILT SURVEY DRAWN BY: SOILS = 0.6 GPD/SQ.FT. ROBERT M. SCHWARTZER 300/0.6 = 500 SQ.FT. REQ'D IT IS THE RESPONSIBILTIY OF THE CONTRACTOR TO VERIFY EASEMENTS, REQUIRED SEPARATION DISTANCES, AND PROPERTY LINES PRIOR TO A`PS�tP TRENCH: CONSTRUCTION. 12' DEEP CONTRACTOR IS REQUIRED TO 5' EFFECTIVE OBTAIN UTILITY LOCATES 2.5' WIDE PRIOR TO ANY EXCAVATION 50' TOTAL LENGTH WORK. (1®10',1®15',1®25') / EXIST. TRENCH TO BE; ROPOSED ABANDONED SUCH THAT TRENCHES IT MAY BE USED IN TH 37 FUTURE. 16 'K � IJ 0' WELL RAD 21 -FA -201 o zs O WELL SEP IC �C CO 36 HSE ARE TH 0 T 36 17 oDS 18 1 HSE ALL PORTIONS OF SYSTEM WITH LESS THAN 3.5' OF COVER REQUIRE INSULATION. CEPTIC> \ /^I �EA EXISTING 1000 GA SEPTIC TANK (19E VERIFY INTEGRITY 38 9 HSE EXIST 2 BDRM HOUSE HSE CLASS 'C' WELL 1 I I I I I I I I I II I i I X45. 31v�r�-� -,,,,CLi NT CLASS 'C' WELL HE ENGINEER FEk MAY V THE EVC1 DIMENSIONS AN,. DESIGN PARAMETERS N THE REID. IF NE.CSAPY, TO IJEET SITE CONDITIONS. J Municipality of Anchorage' •' ae fr DEPARTMENT OF HEALTH &HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 j r' SOILS LOG PERCOLATION TEST }„ A, / :-�y PERFORMED FOR: `�'��^'� DATE PERFOR LEGAL DESCRIPTION: SP"" ��"K��F. Loi �� [ Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? �U S L O P E Depth to Water Monitoring? �1� Date: Reading Date Gross Net Time Time Depth to Water Net Drop >z Tp -C — ( o USN y" 5 0 4• Y%z" )s. a PERCOLATION RATE o�2 TEST RUN BETWEEN COMMENTS PERFORMED BY: 17034 Eagle River Loop Road NO. 204 Eagle River, Alaska 99577 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES 72-008 (Rev. 4/85) PERC HOLE DIAMETER 6 AND 16 FT CERTIFY THAT THIS TEST WAS PERFORMED IN THIS DATE. DATE: tzL.0 LGJ r. George Otterson :anchorage, Alaska, Location: Lot 361 Llk 4, Sand Lake sub division #2. :;e11 depth: 2�1' . well diameter: "'ID. vt ~tic vaster level L25' off bottom. tell production 10 G114, 110' off bottom. .e].l finished Oct. 1?76t. hiller: Chardon Smith. T -i. Y. > s *. 10 Jg 84 I�J t2 to to 4 50 92 7.05 157 2i1 2:. t✓ 24C 20. .ti. 66 A f �c7 titiijNICIPAUTv O� ANeHOtAoF D' PT. OP HEALTH&ION ENVIRONIAENTAL PI No6 'pp RECEIVED T"rc n cravel itCJv;tl si7, dry 50 Y=J_low brown clay 9i - Gray silty san;i 1, lilt, green 157 C ley v; i.tt�: so �:E sand gravel 165 dine Sa _- wet 201 206 MiDe 240 me i sand -gr.-vol; dirty, unstable 265 ;i�t4rev€�1 ?65 etor send -7r;avel n1ternetion with 267 strta=: U of til. is dirty, v8=.k ani or onztabl.e until tottomed at 2811. .e].l finished Oct. 1?76t. hiller: Chardon Smith. T -i. Y. > s *. 10 Jg 84 I�J t2 to to 4 50 92 7.05 157 2i1 2:. t✓ 24C 20. .ti. 66 A f �c7 titiijNICIPAUTv O� ANeHOtAoF D' PT. OP HEALTH&ION ENVIRONIAENTAL PI No6 'pp RECEIVED 72-013 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE ® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE NEW ❑UPGRADE MAILING ADDRESS p a P G. Fe LEGAL DESCRIPTION _- 4 NiJ tCF LOCATION %NO. OF BEDROOMS F � DISTANCE TO: Well Absorption area �f6q Dwelling t 4c) PERMIT NO. ,1 B6 8�ks Uy P G Manufacturer �ut3SE Material No. of compartments 17. uJ nc exC�l rn Liq. capacity in gallons Inside length Width Liquid depth IF HOMEMADE: DISTANCE TO: Well Dwelling PERMIT NO. J 2 0z Manufacturer Material Liquid capacity in gallons 0 DISTANCE TO: Well Foundation 53 Nearest lot line PERMIT NO. �� w = � J LU LL 2 No. of lines Length of each line Total length of lines Trench width Distance between lines F2 I 'A _. inches A Top the to finish Material beneath the Total effective Q f of grade \ absorption area ®`( inches J Length Width Depth PERMIT NO. Lu W Q I— Type of crib Crib diameter Crib depth Total effective absorption area Lu LU y Well Building foundation Nearest lot line DISTANCE TO: J Class Depth Driller Distance to lot line PERMIT NO.p l� J w Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS 303W Q`O.STIC SOI L TEST RATI NG INSTALLER 5 EL� REMARKS 5 5 C) U-3 twe ,f eta tI� I C� r 0 ROVED DATE LEGAL 72-013 (Rev. 3/78) -~^ � ����������������� �� ����������� � ^ ' Y"�����^ , ^DEPHRTMENT OF HEHLTH HND ENVIRONMENTHL PROTECTION ^ 825 /L' STREET/ HNCHORHGE/ HK99501 ��|�[�.�� � ~70 264^4720 4 �� ��� ���_���� ����� �����-� , ~ PERMIT 11 Ch ( 780825 ) HPPLICFIN T GEORGE OTTERSON 82]0~SEHCLIFF 24] 0579 LOCHTION 82]0 SEHCLIFF LEGHL L�6 B4 5HND LHKE S/D #2 LOT SIZE 6750 SQUHRE FEET TYPE OF SOIL HBSORB TION SYSTEM IS� TRENCH MHXIMUM NUMBER OF SOIL RHTING ON F 125 THE REQUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS� L, � lk �� r F'.,> 17F.: FIT W 1.1 UETESSPOR-1-1-1—: 171 W low IV" EEE R.. 12, EYE F'" W V 0 Q, 4 1-3 , 3 - ran 'THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTHNCE BETWEEN THE SURFHCE OF THE GROUND FIND THE BOTTOM OF THE EXCHVHTION (IN FEET) THERE IS NO SET WIDTH FQR TRENCHES THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GR8VEL BE7WEEN THE OUTFHLL PIPE HND THE BOTTOM OF THE EXCHVHTION (IN �1C_,!!�X F­�P-, ������ 50114102 W 1: 2! FIE it. 1111 �f.1 E IT,,H A�;� PERMIT HPPLICHNT HHS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTHLLHTION INSPECTIONS OFANY WELLSHDJHCEHT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES THHT THE WELL WILL SERVE. ��T, T"A 0:0 ���� ���EHE,. 1- 1: Ca P41 ST A Not N two M oil U I UZI? 1041 Ex ~~~ BHCKFILLING OF HNY SYSTEM WITHOUT FINAL INSPECTION HND HPPROVHL BY THlS DEPARTMENT WILL BE SUBJECT TO PROSECUTION MINIMUM DISTHNCE BETWEEN H WELL HND HNY ON~SITE SEWHGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVHTE WELL/ OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL WELL LOQS FIRE REQUIRED RND MUST BE RETURNED TO THE DEPHRTMENT WITHIN ]0 DHYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAN" HPPLM SPECIFICHTIONS HND CONSTRUCTION DIRGRHMS HRE HVHILHBLE TO INSURE PROPER INSTHLLHTION jl,� W SAYAW" 1 13- HE: 11; FEZ 1-11 EEC W. F;?. aERTIFY THHT ^--~-J HM FHMILIHR WITH TIE REQUIREMRNTS FOR ON~SITE SEWERS HND WELLS HS SET �TH BY THE MUNICIPHLITY OF HNCHORAGE. I WILL INSTALL THE SYSTEM IN HCCORDHNCE WITH THE CODES �I UNDERSTHND THHT THE ON~SITE SEWER SYSTEM MHY IF THE .. 1//-5 N ` MUNICIPALITY OF ANCHORAGE `--/ i.' 1 PERCOLATION 5^ DEPARTNIENT OF HEALTH AND ENVIRONMENTAL PROTEC�tON TEST Pouch 6.650, Anchorage, Alaska 99502 276-2221 ��� SOILS LOG - PERCOLATION TEST /L DATE PERFORMED: 41,:2 U,s7 /y7 PERFORMED FOR: _EGAL DESCRIPTION:-- L��%/7 O/ L- ���F' ✓r"' / SLOPE SITE PLAN HSC/jp/cr'c��- ' (DEPTH FEET) `.� c;'i,4//7 •.So/7�1y /�`2 X) X/ circ>/�y c s 9- 10- i 2 0 i2 13 i4 15 Q E 10 Bo>�Uiy7 o r c�% C U l/Ci i7"c/J 17 i1M In 20 WAS GROUND WATER -- : - - - - ENCOUNTERED? O - Depth to Water P E IF YES, AT WHAT _----- - - - - - DEPTH? - Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS PERFORMED BY: C• �I q.Sr>')L' S'S E.'/1 CERTIFIED BY:*� lz-w✓L«� ATE: �� ✓c�r7-7cS" /moi, /�4i'r�//rci2 72-008 (7/76) r MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section =� Parcel I.D. 011-135-17 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: /0 —1& -202 0 Complete legal description SAND LAKE #2 BLK 4 LT 36 Location (site address) 6851 CRANBERRY ST, ANCH AK Current property owner(s) CAROL RAZO Mailing address Real estate agent 8230 SEACLIFF ST ANCH AK 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic R Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ In Waiver Fee $ Date of Payment Z 69 Date of Payment Receipt Numbe/r3 Receipt Number COSA # �C 2©f 2 el r Waiver # Distance: 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 5-15-20 e5 or • 4 9--T H* 6. DSD SIGNATURE '°°"°`°°°°°°°°°°'° ,j 3 bedroomsS stem #1 Approved for �pj•n° MICHAEL `'W'AiN°DE° R•SC"I ; s' System #2 Approved for bedrooms ��%� ° CE%- 94 9 dF Disapproved �� t'L� •?P''�°e6 Conditional approval for bedrooms, with the following stipulatiMh� ®_,`� r r r 1 � B �- Original Certificate Date: -7-1(6-2 02Q The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory_ Well Flow Advisory Other COSA Checklist blue sheet Legal Description: SAND LAKE #2 BLK 4 LT 36 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA Al Well log is filed with Onsite (or attached) Date drilled 10(18/84 Total depth 281 ft Cased to 281 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 6/16/20 Static water level at beginning of test 156 ft. Comments B. TANK DATA Age of tank(s) 40 years Tank type/material Measured operating fluid level in septic tank 48 ❑ Standpipes/foundation cleanout per record drawing Date of pumping MAY 16 Z 0Z 0 D. ABSORPTION FIELD DATA DEEP TRENCH Which system tested (date installed) 11/1/94 ® ALL standpipes present per record drawing Total measured depth from grade 12.2 ft (max) Measured depth to pipe invert from grade 7.2 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 0 gallons Comments/Deficiencies: 3 TRENCHES, NORTH TRENCH TESTED COSA Checklist yellow sheet Parcel ID: 011-135-17 Structure served by this system Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic 52.2 ug/L ❑ Arsenic less than MRL (ND) Collected by MNA Date of Sample 6/16120 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 6/16/20 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 500+ gal New depth 0 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate 450+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' * g6 Yes Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ft r7,/ Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' [D Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10' Animal Containment > 50' ❑✓ Yes if No ft ❑✓ Yes if No ft Q Yes if No ft Water Service Line > 10' 7 Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' ❑✓ Yes if No ft . ❑✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: ft Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' ✓❑ Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' 7 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' M Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No **2'5 ft Wells on Adjacent Lots: Water Main > 10'✓❑ Yes if No ft Private Wells > 100' Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' Surface Water > 100' 21 Yes if No ft F. ENGINEER'S COMMENTS *SEE MOA WAIVER IN THE FILE. ** SEE MOA LOT LINE WAIVER G. ENGINEER'S CERTIFICATION l certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet ®✓ Yes if No ft [✓1 Yes if No ft MICHAEL N. ANDERSON ; CE 9 77!1 ��j�®`��� t� Municipality of Anchorage Development Services Department Building Safety Division ;`;r '., On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage; AK 99519-6650 wNA,w.muni.org/onsite (907) 343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # OSC201195 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 4, Lot 36 of Sand Lake #2 Subdivision. This inspection revealed an arsenic concentration of 52.2 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. Lot 38 e . Hurst ". L -1,17064sup ve Yg ACW low 0 15 30 Lot 37 US SURVEY FEET S 89'57'43" E 135.00' Lot 35 S 89'57'43" E 135.00' 0 n z r ITI o lLto> it 3,6 0 p 30.6' y ::E O O 4 2 w, Ln Story � CPedt ": {,, House Z,� UT 0 �, S 89'57'43" E 135.00' Lot 35 r - NOTES X11 dimensions shown are grid bearings and ground distances, record boundaries are per Plat P-176. 9th Star has conducted a physical survey of the property and all details shown on this Asbuilt Survey are correct. Under no rcumstances should any data hereon be used for construction or the establishment of property lines. is the owners responsibility to determine the existence of any easements, covenants, or restrictions; no title research performed. AS BUILT SURVEY LEGEND 49th Star Surveying LLC Lot 36, Block 4, A Elec. Transformer 321 Fireoved Drive Anchorage, AK 99508 Sand Lake Subdivision No. 2, well Ql Mailbox (907)891-6111 Anchorage, Alaska li Tele -comm Pedestal Jeremy@49thStarSurveying.com CP Septic Vent o Septic Cleanout w.0. 2024 1 DATE: 06/24/20 SCALE: 1"=30' n r ITI 77, 30.6' y W a Ln H 0 0 W EDU 60' v I ROW r - NOTES X11 dimensions shown are grid bearings and ground distances, record boundaries are per Plat P-176. 9th Star has conducted a physical survey of the property and all details shown on this Asbuilt Survey are correct. Under no rcumstances should any data hereon be used for construction or the establishment of property lines. is the owners responsibility to determine the existence of any easements, covenants, or restrictions; no title research performed. AS BUILT SURVEY LEGEND 49th Star Surveying LLC Lot 36, Block 4, A Elec. Transformer 321 Fireoved Drive Anchorage, AK 99508 Sand Lake Subdivision No. 2, well Ql Mailbox (907)891-6111 Anchorage, Alaska li Tele -comm Pedestal Jeremy@49thStarSurveying.com CP Septic Vent o Septic Cleanout w.0. 2024 1 DATE: 06/24/20 SCALE: 1"=30' 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 Parcel I.D. # O M 3r17 HAA # _[4A 1. GENERAL INFORMATION Complete legal description Lot 36; B.�_ock 4• Sand Lake Suhd.iviSi,on #2 Location (site address or directions) £230 Seacei 66 Sticeet Anchorage, AK Propertyowner Karen Laxgen;t Day phone 257-0134 Mailing address --CIO REMAX Sinn.s- Lending agency — Mailing address_ Agent Day phone Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: IBJ.. .. J.-_• .. . -.._.. -... .- AK 99503 5. STATEMENT OI: 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 furtherverify 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. G� S& 5 ENGINEERING Phone 69 a-9 7/ Name of Firm __ aq o .:vQr oop Road No. 204 Address Eagle River, Alas a 995 Engineer's signature Date i/ -),o /q y 9�•��1 ... a ....s... Ff 6. DHHS SIGNA'T'URE Approved for Disapproved. Conditional approval for Additional Comments &'L By; bedrooms. .. +...,.....w-........ .......... .. -o..... ROBERT C. COWAN �Q CE - 8801 bedrooms, with the following stipulations: 6/' 6n 6112sr— Date Municipality of Anchorage O Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L-2--,61 ��% r jN>) 441IV7 iel #,2 Parcel I.D. Q/// 39/2 A. Well Data Well type 2/U E. J �If A, B, or C, attach ADEC letter. ADEC water system number Log presentll%N) _ t' Date completed _/�%�lc�(/`% / —Driller /(-CT F Total depth i3f _Cased to 2coj/ Casing height Sanitary seal (&/N) l�5 Wires properly protected Y/) y�S FROM WELL LOG AT INSPECTION M Date of test /Cf 7? 3 7 - — z Static water level Well flow i U 9.p.m. , o A Pump levell z rr1 �p -P m C) o 0 SEPARATION DISTANCES FROM WELL TO: < 1 SepticftkkWank on lot ; On adjacent lots N m Absorption field on lot O�� ; On adjacent lots �Z Public sewer main /tl�A Public sewer manhole/cleanout_ Sewer service line /� Petroleum tank / vC0E )ivhw,u WATER SAMPLE RESULTS Coliform Nitrate -t�m�,7_0. Other bacteria Date of sample: L� 1i %1 Collected by: L S CG�Ni✓,110 B. SEPTIC/HOLDING TANK DATA Date installed /0 CO Tank size Compartments A Cleanouts &N) Foundation cleanout &/N) Depression (YA@ High water alarm (y1@ /A 4_ Alarm tested (Y/6) /1// Date of pumping Pumper .1lnKS SEPARATION DISTANCES FROM SEPTIC/ISG TANK TO: Well(s) on lot On adjacent lots / Od '' To property line oZ I 5 Absorption field 3 6 Water main/service line o�S � Surface water/drainage ddb �- Foundation 72-026 (3/93)' Front CONTINUED ON BACK PAGE C. LIFTS TION � Date installed Size in gallons Manufacturer Vent (Y/N)"I' on" level at "Pump off" Level at _ High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTAN ROM LIFT STATION TO: \ Well on to On adjacent lots _Su water D. ABSORPTION FIELD DATA i 2 1 f) System type Date installed / 9y Soil rating (GPD/Ft) y yp 54 7-07A Total depth Length t to G t S � as' Width 3 Gravel thickness _ -- p Total absorption area 0 resent Y -h Depression over field (Y/g 5 o Cleanout p Date of adequacy test S Results (pass/fail) rJ1A for Bedrooms Water level in absorption field before test N/A After test MI — Peroxide treatment (past 12 months) (Y/N) V�-If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot I OS On adjacent lots /6U Property line 2 •S To building foundation 34/ To existing or abandoned system on lot On adjacent lots /d Cutbank IV� Water main/service line �S Surface watery f Driveway, parking/vehicle storage area a 5 Curtain drain AZA E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature c /2� ., .,�..,I;a. •, r A�3ry,21 �. o�cyan• , Engineer's Name vo9N 1208ER'f C. COWAN ,2 p< cl -sant ,-. Date I 0� ....... .. C' HAA Fee $ to` dD Date of Payment // ;4 //- �// Receipt Number - , I f 7� Waiver Fee $ Date of Payment 191114- Receipt al 1Receipt Number " MAY 17 Y94 15:17 ALASKA PEGI(mAL HOSP 907264 P.2/2 q q b, � �.�.. t.b. ���+_���� � ��•r�� icy. �—''t � �'�1��.. be l 9 9C 1 0 _. .. J 'j i ° RECEIVED 181994 1v1ui,:C:•{+a1;iy ul Hnchcia0 -�� Oept. Health & Human Services bib'd P92L06 8SOH -IUMOI538 13AS7U LT:TT b6. 82 AON I MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date _ /�,tff_ (a) Legal Description (include lot, block, subdivision, section, township, range) /- 3 & B y 5A41 d a4- *&7z - Location (address or direct ions) (b) Applicants Name Telephone - Home Applicants Address, fa� /<fririGO (c) Applicant is (check one) Lending Institution rowne Buyer 1-1 ; Other [� (explain); in ss� 900 (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following addres?s n_ n 2. Type of Residence Single -Family Multi -Family Number of Bedrooms ,z 3. Water SuDDI Other (describe) Individual Well 96- Community =1 Public M Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite Public E:7 Community E:l Holding Tank Note: f community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 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 regula- tions in effect on the date of this inspection. Name of Firm Address Date ff) /�'�`S7,_ Telephone &Z/-SOs/� (ENGINEER SEAL) �0 e 6. DHEP Approval �® Approved for ZA bedroomsDatt Approved k Disapproved Conditional Terms of Conditional Approval CAUTION ®F 41' 4th V tilke° e C. Reid, Jr. THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 21 7-19-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 A. WELL DATA Well Classification Pi"%ve%ye. Well Log Present aY,}N) v Total Depth as(,I Cased to Static Water Level (,`-q, Zd V MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRON -MENTAL PROTECTION OCT 2 6 11984 RECEIVED. Legal Description: ZaQ If A, B, or C. D.E.C. Approved(Y/N) i/0, Date Completed p Yield C,C_,pv_z(D Depth of Grouting - Pump Set At A�yf oY U)f[I 10T_ Casing Height Above Ground b,�5' Sanitary Seal on Casing Y ) W'� Electrical Wiring in Conduit /N) Depression Around Wellhead (X0 Separation Distances from Well: TO Septic/Holdirg Tank on Lot too ! ; On Adjoining Lots Ileo" To Nearest Edge of Absorption Field on Lot lob On Adjoining Lots .,L -loo' To Nearest Public Sewer Line N IN- To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot N Water Sample Collected By_-'-- Water Sample Test Results CcR¢rents = Vb�E GuX�wLL Y�ne ,/JvvvwyA C' A - U7 - 4c rz, !�M t-A4L-e 4V B. SEPTIC/HOLDING TANK DATA Date InstalOYLT ed �( D � Size [OOsCj No. of CompartmentStandpipesAir-tight Caps (/Y)N) Foundation Cleanout Depression over Tank (Y ) Date Last Pumped 16 fir2 Pumping/Maintenanoe Contract on File (Y/N) ; for 10)14 - Holding Tank High -Water Alarm (Y/N) Jv Temporary Holding Tank Permit Separation Distances from Septic/Holding Tank: To Water -Supply Well I DDI To Building Foundation 4D To Property Lire 11% / To Disposal Field To Water Main/Service Line } ��r To Stream, Pond, Lake, or Major Drainage Course Comment Receipt # 2�L� Date Paid: Z(_c,•` i Amount: r_p(�_ ,C7 C [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption S` at / S Type of System Design 2 Date Installed _ /D �Q Length of Field Width of Field 5 Depth of Field Gravel Bed Thickness Square Feet. of Absorption Area Standpipes Present (YMo?) Depression over Field (Y ) Date of Last Adequacy Test 5 Z3 g Results of Last Adequacy st Separation Distance from Absorption Field: To Water -Supply Well /&5- To Property Line /$ To Building Foundation tj:3 To Existing or Abandoned System on Lot _ 7 On Adjoining Lots .- 1 To Water Main/Service Line -1-55 / To Cutbank(if present) X'//'�c To Stream/Pond/Lake/or Major. Drainage Course /- (00 1, To Driveway, Parking Area, /or Vehicle Storage Area 53/ _ Comments 4&11 D. LIFT STATION Date Installed Sire in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical CodesL•. ) Comments 9,/ . ,e s (Y/N ) Off" Level at I',-- Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that. I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the da of this inspection. o^� 0V A k Signed I�r Date 'oe�oaaooaa`%'5��5 Co anY t�,C � �C_- MOA No. � -D -4"- 4!;F- Rs�e� ; yySeooao' 0 0 4 KB1/d5/s (Page 2 of 21 2-15-84 ALASKA 0'AROURTAL COnTnOL SMONS, InC. 6ngineerinq & 6nuironmental Studies OCT 24 1984 KAREN LARGENT 8230 SEACLIFF ANCHORAGE AK 99502 SELLER — KAREN LARGENT BUYER — SUBDIVISION — SANDLAKE #2 BLOCK — 4 LOT — 36 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 380 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 300 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 450 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 2 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON OCT 19 1984 . FLOW TEST ON WELL THE WELL FLOW RATE WAS 6.0 GPM FOR 4 HOURS. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUN,E OF 1000 IS ADEQUATE FOR THIS 2 BEDROOM HOUSE. by C. Raid, Jr. No. 9451.8 1200 West 33rd Auenue, Suite B • Anckorage, Alaska 99503.(907) 561-5040 ALASKA MUIROf MenTAL C0nTROL SIO UIRS, inn. Engineerinq & 6nuironmental Studies October 23, 1984 Department of Health and Environmental Protection 825 L Street Anchorage, Alaska 99501 Legal: Lot 36 Block 4 Sand Lake #2 Subdivision Well Flow Test on Single Family Residence A flow test was performed on the well at the above property on October 22, 1984. The static water level was at-154.20'with Over 450 gallons of water was pumped at a rate of 6.0 gp a drawdown of 5.55'. The recovery time was 60 minutes. 1 consider this well adequate for domestic usage in this 2 bedroom house. Please contact me if you have any questions. Approved: Sincerely, Gwen Turner Environmental Scientist 1200 best 33rd Auenue, Suite B • Anchorage, Alaska 99503 • (907) 561-5040 Its 5. LEGAL DESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS �— TIME TIME TIME DATE DATE DATES SINGLE FAMILY Two ❑ Five / INSPECTOR ( V\ INSPECTOR INSPECT MUNICIPALITY OF ANCHORAGE ��//, ��77 ANCHORAGE DEPARTMENT OF HEALTH 8, ENVIRONMENTAL PROTECTI"�IVICI PT. O 1F 825 L Street - Anchorage, Alaska 99501 DEPT. OF i : _i\LTi'i u ENVIRONiJiE�T:',L i r.'.:ICTION � ENVIRONMENTAL SANITATION DIVISION MAR 2 J 1980 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW Af�f Ifto DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER 6 PHONE /97i YEAR ON-SITE SYSTEM WAS INSTALLED. Y77 MAILING ADDRESS ��' /rD/ W. 4/ Igvc /—I VCyoi2fl��/_ �/� �/1✓63 PROPERTY RESIDENT (If different from above) PHONE 2. BUYER `n 1 / /R27f�A -IoSE? Laos PHONE %y 3/73 MAILING ADDRESS n �j 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4. REALTOR/AGENT y� ,� / /f/esTo A) 1646 �5;T'4tT 4C—: PHONE MAILING ADDRESS /. L � 4c57Y. 5. LEGAL DESCRIPTION �— STREET LOCATION 8->-3 o SEnc i Ff/✓e/o��C 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS ❑ One ED Four E:1 Other SINGLE FAMILY Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY ® INDIVIDUAL* ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** /97i YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 Rev. 6/79 uj j,/jA4j/ 1 THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNI"rY ❑ PUBLIC Ul ILITY Connection Verified_. PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified .- PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or L]Holding 'rank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES _ WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ED APPROVED FOR . _ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72-010 (Rev. 6/79) Municipality 3 April 3, 1980 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION George Otterson 1501 West 41 Avenue Anchorage, Alaska 99503 Subject: Lot 36 Block 4 Sand Lake Subdivision #2 Approval for your individual sewer and water facilities can not be granted until the following items have been - completed: (1) A well log submitted to this department for our, review. (2) The water analysis report be delivered to this office from Chem Lab, 5633 B Street, for our Lreview. \0�p (3) Your permit for the installation of an on-site sewer system has expired as of December 31, 1979. We have not received the as-builts of the installation in this office. If an enginser inspected the AID system, please send us the report for our files and review. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Marston Real Estate 2804 West Northern Lights Boulevard 99503