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HomeMy WebLinkAboutSAND LAKE #2 BLK 5 LT 8and Lake #2 Lot 8 Block 5 #011-134-29 MUNICIPALITY OF ANCHORAGE \ . DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 0* 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 / �6 oL)G At -1 ANI ❑UPGRADE MAI LING ADDRESS BPJ -LL NCH A- 4zs-rs LEGAL DESCRIPTION SANt> Iti /Vk L 1-4 -2- LOCATION NO. OF BEDROOMS Well Absorption area Dwelling ) PERMIT NO. U DISTANCE TO: 11 _7 p I� 8 g _Y z< W ManufacturerManufacturer c -t4 TA m IL Material S'T 1_. tr L No. of compartments 7 -Le -10 y Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth 100,0 DISTANCE TO: Well Dwelling PERMIT NO. _j 0z O ZQ 2 Z F Manufacturer . Material Liquid capacity in gallons O J DISTANCE TO: Well '�,f� FoundationNearest � lot line )© PERMIT NO. = i•55c)38� J u. Z No. of lines Length of each line Total length of lines Trench width Distance between lines F Z w %,� So inches "— F Top the to finish Material beneath tile Total of grade 7 . effective area p &,r-7- inches Length Width Depth PERMIT NO. Lu 0 a Type of crib Crib diameter Crib depth Total effective absorption area w a Lu W DISTANCE TO: Well Building foundation Nearest lot line Class Depth Driller Distance to lot line PERMIT NO. J Lu � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS / CAgr- re V SOIL TEST RATING ij INSTALLER pp�� 'R �I14 14 i) 1S F-1 1 1-1-14- REMARKS 7ANk Ikiiy c>ti 1NL 1NSvl/il �=� 1 �e OF a� no .. lt, ' 491 .� 3 r...:..,.......... ... Ill t� �.,•. N .2225-E :;�0 i971 `s ;:,• • N ,m .�•.� fI'zFAU:%: ? , L,Vle y G '111-4 APPROVED DATE/ LEGAL 72-013 (Rev. 3178) DEPARTMENT \ , HEALTH AND ENV IRONMENTHL\ -(OTECTION 825 /L' STREET/ ANCHORAGE, HK. 99501 ` ' 264-4720 ^ K�P--1 I -T- I--- 'EF U_ 11�4 F7" F--' 3:7- PERMIT NO. ( 830]88 ) APPLICANT DOUG GALLANT 20] W 15TH 99501 279—]916 LOC8TION LEGAL L8B5 SAND LAKE #2 LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)= 85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: C -A EE F— -F _"E:v ���������= �� �FR���� -__-� THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND HND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). ���URIFREZU-n -1LRZAICIC-1 R_:iF=§R 1������ PERMIT HPPLICHMT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE --- �ll�-J Co < -=-, ."'-A *T 1-4 _,EF. IF:', EF iC -T I Ca F70 F-_ RE ���Li I F --"E=— E -Ii BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET HND TO H COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. ����������EE�� ������E-7 =---- -g - , �1—=9 Eo =-=-- I CERTIFY THAT i: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDERSTAND THAT THE ON—SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO I THAN ] BEDROOMS. 7 SIGNED: — «ISSUED BY --t4 D A T E V4. 0 ����� A SOILS LOG MUNICIPALITY OF ANCHORAGE EJ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION • � TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: Oy Q'LLA•11'j" DATE PERFORMED: 5 3 O 3 LEGAL DESCRIPTION: Lo-{ 'A wDo v.,A sA `fib 1."A%4y. 4R. s^' C' o •TIaN a 1R q SLOPE SITE PLAN SILT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 19 20 %YjU=LL. GRA10 e 0 SW> E GQ`A'Qt. L Cq CJS Iii 9S %OTTn Ed CSF y��w�t'tdt` O *4141s���' 4918 . . •225-E F.,,.• No. .�� JUNE 25,197 ••ems WAS GROUND WATER S ENCOUNTERED? O L 0 P • IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) y� r TEST RUN BETWEEN FT AND FT COMMENTS t RV It N E F --4L PERFORMED BY: 72-008 (6/79) CERTIFIED BY: K S DATE: 1�1'� E pCE 84r • Municipality of Anchorage o On -Site Water and Wastewater Program <" (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. 011-134-29 Expiration Date: Z—/ / 1. GENERAL INFORMATION Complete legal description SAND LAKE #2 BLOCK 5 LOT 8 Location (site address) 8317 SEACLIFF ST., ANCHORAGE, AK 99507 Current Property owner(s) DANIELLE AITCHISON Day phone 947-7430 Mailing address 5537 BIG BEND LP., ANCHORAGE, AK 99502 Real Estate Agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Fx] Individual Water Storage ❑ Holding Tank ❑ Community Class C Well El Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: NONE Distance: COSA to be released to they4ingineer, unless otherwise requested by the engineer. COSA Fee $ LH 1) —/ w^^ Waiver Fee $ Date of Payment R11,5113) dy\ Date of Payment Receipt Number 8,4 uch Receipt Number COSA # �, 13l 044 Waiver # 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. Name of Firm SPURKLAND ENGINEERING Address 203 W. 25TH AVE.,STE.202A, ANCHORAGE, AK 99501 Engineer's Printed Name LARS SPURKLAND 6. DSD SIGNATURE V System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Phone 279-3916 Date 1/30/13 OF A4 l�1 t° S10 t, "., �,; o r '• 1i5G00 t 1�` tFFE t <•a1� Conditional approval for bedrooms, with the following stipulations: By /17�t� ���-`�./�_.- Original Certificate Date: -?J /Z 3 The Municipality of Apehorage 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. ATTACHMENTS: COSA Checklist X Nitrate Advisory > , Septic System Advisory Arsenic Advisory ' X Well Flow Advisory Other c COSAbluesheetL , c If more than I septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: SAND LAKE #2 BLOCK 5 LOT 8 A. WELL DATA Well type PUBLIC Date completed _ Total depth _ ft. Date of test Static water level Z14 $21 If A, B, or C provide PWSID # 246295 Sanitary seal (Y/N)_ Cased to ft. FROM WELL LOG ft. Well production g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate ND mg/L Arsenic 25'2 ug/L Date of sample: 1/7113 B. SEPTIC/HOLDING TANK DATA Tank TypelMaterial SEPTIC/STEEL Tank size 1000 gal. Number of Compartments 2 Parcel ID: 011-134-29 Well Log (Y/N) --- Wires Wires properly protected (YIN) Casing height (above ground) in. AT INSPECTION ft. g. p. m. Collected by: GARNESS ENG. GROUP Date installed 7/8183 Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (Y/N) N Date of pumping 1/9113 - Pumper DENALI SEWER & DRAIN SERVICE C. ABSORPTION FIELD DATA Date installed 7/8183 Soil rating (g.p.d./ft2 or ftz/bdrm) 85 System type TRENCH Length 22 ft. Width 2'5 ft. Gravel below pipe 6 ft. Total depth .13.6 ft Eff. absorption area 264 fl? Monitoring tube Y Depression over field N Date of adequacy test 1/1812013 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 44 in. Water added 550 gal. New depth 63 in. Elapsed Time: 60' min. Final fluid depth 52 in. Absorption rate >= 450 9 p d Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date - D. LIFT STATION Date installed _ Size in gallons -- "Pump "Pump on" level at _ in. "Pump off' level at Datum E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot _ Absorption field on lot Public sewer main _ Sewer /septic service line Animal containment areas Cycles tested Manhole/Access(Y/N) _ in. High water alarm level at - Meets alarm & circuit requirements? On adjacent lots On adjacent lots -- Public Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 'S Property line 'S Water main NA Water service line '10' Wells on adjacent lots '100'* ABSORPTION FIELD ON LOT TO: Property line Building foundation '10' Water Service line '10 Curtain drain >50' (N.O.) F. COMMENTS *WAIVER ON FILE eAPS. Surface water '100' (N.O.) Wells on adjacent lots '1001* Absorption field >5 Surface water '100' (N.O.) Water main NA * Driveway, parkingivehicle storage 01_ UPTiL STAADPIPE IN 09%U WAy PROUCT&V W/ METAL G. ENGINEER'S CERTIFICATION 1 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. Engineer's Printed Name LARS SPURKAND Date 1/3Q/13 COSA brown sheet 10-10-12.doc in. of. atgs9l�i ::49 ,i .w . . .../ lI R SPURKLANO� j 11"0 cis Municipality of Anchorage „ra • '� Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # OSC131044 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 5, Lot 8 of Sand Lake #2 Subdivision. This inspection revealed an arsenic concentration of 25.2 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.or /off nsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. §� UP | j ^ 3 > ƒ0 � D2 f | cj) a Cc) 63 j��°-0 RZ0 f o CD � R. » OD �(f f }«E F� I # ƒ■& Seod|f Street « j ^ 3 > Municipality of anchorage -tel Development Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 / www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0I I- i34 -2a COSA# Qq OZ 15 1. GENERAL INFORMATION Expiration Date: /0 —/ 6-22—q Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address SAND LAKE 42: BLOCK 5, LOT 8 8317 SEACLIFF ST • ANCHORAGE. AK • 99502 ALEKSANDRA SARNOWSKI Day phone 8317 SEACLIFF ST + ANCHORAGE. AK + 99502 Day phone 243-6381 DEBBIE HIGBEE W/ KELLER WILLIAMS Day phone 748-7375 101 W. BENSON BLVD, #503 • ANCHORAGE. AK * 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well N Individual Water Storage ❑ Community Class t^i Well 9 Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site E Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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 riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Finn GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SURE 101 ' ANCHORAGE, AK 99507 I Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date —1 Engineers Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG. LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 2 bedrooms. Disapproved. Conditional approval for bedrooms, with the flowing stipulations: Attachments: �/ v COSA Checklist Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineers Report Nitrate Advisory Other �— q By: „�� Original Certificate Date: (Rax 11M) \ Municipality of Anchorage 1 Development Services Department y Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SAND LAKE X12: BLOCK 5, LOT 8 Parcel ID: A. WELL DATA Well typecoMMurmY If A, B, or C provide PWSID# 216295 Well Log (YIN) Date completed Sanitary seat (YIN)_ Wires properly protecte Total depth ft. Date of test Static water Cased to ft. FROM WELL LOG AT INSPECTION ground) in. ft. reduction g.p.m. System type 9.p.m. Length 22 ft. WATER SAMPLE RESULTS: *ARSENIC REMOVAL SYSTEM IN PLACE INSIDE HOUSE. Coliform 0 colonies/100 ml. Nitrate 0 mg./L. Other bacteria 0 colonies/100 ml. Arsenic: '23 ug./L. Date of sample: 6/22/2009 Collected by: GEG Ltd. B. SEPTICIHOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 7/8/1983 Tank size 1000 gal. Number of Compartments 2 Cleanouts (YIN) YES Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) N/A Date of pumping 5/15/2009 Pumper AROUND THE CLOCK PUMPING C. ABSORPTION FIELD DATA Date installed 7/8/1983 Soil rating (g.p.dJft2o t/bd 85 System type TRENCH Length 22 ft. Width 2.5 ft. Gravel below pipe 6 ft. Total depth • 14.6 ft. Eff. absorption area 264 ft' Monitoring tube YES Depression over field NO Date of adequacy test 7/2/2009 Results (Pass/Fail) PASS Forbedrooms Fluid depth in absorption field before test 26 In. Water added 505 gal. Now depth50 in. Elapsed Time: 255 min. Final fluid depth 20 in. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off' leve High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service areas COMMUNITY 1WELL On adjacent On adjacent lots manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field UNKNOWN Water main N/A Water service line 10'+ Surface water I� 100'+ Wells on adjacent lots "100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '2, Building foundation 10'+ Water main NfA Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage '0' Curtain drain NONE KNOWN Wells on adjacent lots '100'+ F. COMMENTS *SEE ATTACHED LETTER AND WANER REQUEST G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date -7 11010 r1 COSA Fee y9e. Date of Payment io 0 Receipt Number / G 3 a 93 (Rev. 11/05) Waiver Fee $ .700. o n Date of Payment 7 9 Receipt Number. /G -3� 9� Municipality of Anchorage ...R. • '� Development Services Department Building Safety Division ' On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # 090215 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 5, Lot 8 of Sand Lake #2 Subdivision. This inspection revealed an arsenic concentration of 23.0 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.or /og nsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS, -«_. July 10, 2009 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 (907)343-7904 Ref: Sand Lake #2 Subdivision; Block 5, Lot 8. To whom it may concern: GEG, Ltd. made a site visit on 7/2/2009 to the subject property for the purpose of performing a COSA inspection. During our inspection, it was noted that the septic tank and part of the drainfield are located directly under the driveway. Also, the distance from the tank to the drainfield was not defined in the original inspection report and we are unable to determine the separation distance, due to the fact that a post -tank cleanout is not present. We request that your department approve this septic system in its current state. The following items are justification for approval: The drainfield and tank were insulated, per the inspection report. The current system was approved by your department in 1990 in the same condition. The system appeared to be functioning properly and no depression was seen above the tank or drainfield. We also are requesting a 2 foot waiver from the drainfield to the lot line. The neighboring septic system is more than 10 feet from the lot line. We are unaware of any adverse impacts this would have on adjacent wells or septic systems. During our inspection, it was noted that the distance between the septic tank and two Class "C" wells is less than 150 feet. The distances have been noted in a previous COSA for this property and approved by your department. We have included the relevant A.D.E.C. documentation for your review. 1 f you have any goFstions, please contact us at 337-6179. Thank you for your assistance. M.S. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: www.gamessenginecring.com Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage Alaska 99519-6650 • (9071343-7904 • Fax(907)343-7997 http://www.muni.orcl/Onsite Development Services Department On -Site Water and Wastewater Program menr `° S^ c ^ c � [1064 1 I-INA n Department **** VARIANCE/WAIVER REVIEW **** WR#: 090039 HA#:090215 Permit#: PID#: 011-134-29 Legal Description: Sand Lake #2 Block 5 Lot 8 Engineer: Garness Engineering Group Applicant: Atexsandra Sarowski Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 2.0 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. .................. ............... ......e ......... ............................ so Waiver is Granted: X Waiver Is not Granted: Date: 7/158009 Approved by: e`er am o Reviewer ............................................... ..... ......................... Rec#: 7L/_O- C7 Amounts . a' Date Paid: -:7-10-01 **** VARIANCE/WAIVER REVIEW **** SCS ReLN 1092809001 Client Name Garness Engineering Group, Ltd. Project Name/N Sand Lake 92 L35,L8 Client Sample 11) Sand Lake 92 Q5,L8 Slams Drinking Water Sample Remarks: Printed Date/Time Collected Datefl'ime Received Date rime Technical Director 07/012009 12:01 06222009 16:00 06222009 16:30 Stephen C. Ede Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date [nit Metals by SCP/MS Arsenic 23.0 • 5.00 ug/L EP200.8 C (<10) 0625/09 06/30/09 NRB Waters Department Total Nitrmc/Nitrite-N Colony Count Pccal Coliform Labora ND 0.100 mgfl. SS1204500NO3-r 13 (<10) 13 coV100m1. SM20922213 col/100ml. S\120922213 Negative col/100ml- SM20922213 - SSP `E) 0� L blZ6/o j a A (<200) A (<I) A (<I) a 0624109 LCL: 0622/09 SDP 0622/09 SDP 0622/09 SDI' SGS Rcfa 1093045001 Client Name Gamess Engineering Group, Ltd. Project Name/a Sand Lake 92 B5,L8 Client Sample 11) Sand Lake #2 B5,L8 Matrix Drinking Water Sample Remarks: Printed Datcll'ime Collected Date/Time Received Date/Time Technical Director 06/30/2009 17:48 0626/2009 13:30 06262009 13:55 Stephen C. Ede a Allowable Prep Analysis Parameter Results POI, Units Mcthod Container ID Limits Date Date Init Microbiology Laboratory Colony Count Total Coliform Fecal Coliform 0 coUl00mL SM209222B A (<200) 0626/09 SDP 0 col/100ml, SM209222B A (<I) 0626/09 SDP 0 col/100ml. SM209222B A (<I) 0626/09 SDP a n f. _777-7 �-- 1. f n f. SAND LAKE /2 LOT 35, BLOCK 4 / SAND LAKE 12 I LOT 34, BLOCK 4 I SAND LAKE /2 \ LOT 33, BLOCK 4\ SAND LAKE /2 0 LOT 32, BLOCK 4 / / / SAND LAKE #2 / LOT 28, BLOCK 4 +�'iACANT� I SAND LAKE 12 \ \ 1 LOT 4. BLOCK 5 \L \\ c0, I 1 \ SAND LAKE 12 I 1 LOT S, BLOCK 5 I �� ISO CULTS •. WE ' I C u RADIUS I1 --- a / LO D6 LAKE CK 139' HOUSE 24' \ \\ `-VACANT DAM M \ GARNESS ENGINEERING GROUP, Ltd. - • CONSULTANTS 3 GENERAL CONTRACTORS w����W>���• A, L now low. MA[ 101 • Mu101uif. Mt FM (wy).us o • 1iO9R •w.,w�wpw.pawn PREPARED FOR: PHONE NUMBER: PACE NUMBER: ALEKSANDRA SARNOWSKI 907-243-6381 1 OF 1 LEGAL DESCRIPTION: DRAWN BY: SAND LAKE #2; BLOCK 5. LOT 8 A.J.G. TYPE OF WORK: DATE: SITE PLAN FOR SEPARATION DISTANCE WAIVERS 7/9/2009 (R«.01M) SAND INCE /2 LOT 21, BLOCK 5 i SAND LAKE /2 LOT 20, BLOCK 5 SAND LAKE #2 LOT 16, BLOCK 5 CVACANT� MII1lIIYIPOJAlAw A. G 3. rnessi DEPT. OF EIVIROND7IiNTAL EO"%,SEBVAT10N STEVECOWPfR, GOVERNOR ANCHORAGE �,IESTERN DISTRICT OFFICE 3601 C STRZET, SUITE 322 ANCHORAGE, ALASKA 99503 July 23, 1990 FOR: ALASKA DNVILONM NTAL CONTROL SERVICES, INC Attn:oy 563-G775 PS7SID: # .OA Seacliff According to the records 5 n ScndfilS LaY.ein th#iZ oa�eOe� Sy tem is in ubd vision To B q ulations. compliance with the State of Alaska Drinking Slater Reg Sincerely, 2"I." " VERA E. C91G Environmental Field Officer VEC:pf CONSTRUCTION AND OPERATION S CERTIFICATE'., ALASKA PEPARIMENl OF ENVIRONMENTAL CONSERVATION.,`"" PUBLIC WATER SYSTEM :OVAL TO CONSTRUCT s•P�'(� c.. c� ct13D lorlthaconstruction ol'--�-1--- •:. C. ? I - r A (1C el L,i�S tt^ public water r, � 11 e, �1 (s •"4 Alas4a, sL;L4oittcd in accordance with IE n r) to r /'_ A L L Y 'r __ have been rev ,p rR approve. Y ,• ry' conditionally approved (see atta.hcst conn+tions). (dt yCS b61•'Lvicir•1 E Sln fi ^...0 •L••:rwecT G4„c( :jC'jnl rl�•rt.s.'..r 4irr— , -It construction has not started within two years of the approval date, this certificate is 4701ans and specifications must be submitted for review and approval before construction..' Change Icmrocr o.e" •a • o. a•.cn pow r•rn•nc.l Approved by uate of �U rGb •�'{'' 't' � N The "APPROVAL TO OPERATE" section must be completed befure any water is I.l't.TWi•y I�• 1 •: t' ,.;;�,,•: As -built plans submitted during the intcrirn approval l,eriod, or an inspection by the Department•has•::.fi_. eon(irmed the system was constructed accarri,n.f to the approved plans. The system is hereb""canted• L= waina'approval to operalc, ; �'. y}•+,: lls'v y •.� T•I.0 • .:r `•`moi:• ... the public. , ' V TOOPERATE i'+n•�.�t►i•.y ?;: •�' APPROVAL l:) t � .. •public'- ." Y .\til r .•.r i The construction of the c• (date). The system is herehy:�," water system was completed on interim approval to operate for 90 days following the cpmplution date. , i..' `'..•C'` .`j';�r• . granted I.l't.TWi•y I�• 1 •: t' ,.;;�,,•: As -built plans submitted during the intcrirn approval l,eriod, or an inspection by the Department•has•::.fi_. eon(irmed the system was constructed accarri,n.f to the approved plans. The system is hereb""canted• L= waina'approval to operalc, ; �'. y}•+,: lls'v y •.� T•I.0 • .:r `•`moi:• ... \/ MUNICIPALITY OF ANCHORAGE Com//l Department of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519.6650 Date: November 30, 1994 To: File Froml mes 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. Permit No. SW970290 Page 2 of I Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4.744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LT 21 , BLR 4 Sand Lake SID, No. 2 PID No..' 01113532 ■�■—y�y— —x—X A_ G C ap O FENCE WX) ,w.a '. C2 C3 Cq ---� .i 1'000 I l* 1 GRAVEL DRIVE 0 10.0 B seS 1 3 BR Hse. C7 LqLO as x I W n ? d x.n A WELL b0 135.00' 100 -- -- ---- PLAN AS -BLT -_S, 41 .0 :34.6, -- —SZ 4520-35:0?- 1" = 20' _ C247.8 136.8+ '-C3 50.940.71 .. ..... `LEGEtm). .. .5.3. !_MT. _ 42_ 0 _'_47.2T _ • SPI Septic Pump, compartment 1 i ^ CS 43.2 , 50.5 ' - ---.—. SYZ 2 C Clean Out ! ; MT Monitor Tube - - -- - s-----}-- 010 d.... TH-_ / .A1;gL1ELE_AK06'9SON U%. 4331-E :was - It lzbSs�l� ....... _ . -- ' MUNICIPALITY OF ANCHORAGE �fiA • Department of Health & Human Services ` DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # C- . \ � — 1 Z :;4n HAA # \-4 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address'Vrrectii ii (home) Business Telephone Mailing Address (d) Real Estate Company and AgentzlSTb1 Address Telephone (e) Mail the HAA to the following address: (or check her�f hold for pickup.) List contact person and day phone number below: c s a �y-t�s3 2. TYPE OF RESIDENCE Single -Family, Number of bedrooms 3� 3. WATER SUPPLY Individual Well ❑ Community X 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, Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 (b) Property owner. Mailing Add ess (c) Lending Instituti;on.' (home) Business Telephone Mailing Address (d) Real Estate Company and AgentzlSTb1 Address Telephone (e) Mail the HAA to the following address: (or check her�f hold for pickup.) List contact person and day phone number below: c s a �y-t�s3 2. TYPE OF RESIDENCE Single -Family, Number of bedrooms 3� 3. WATER SUPPLY Individual Well ❑ Community X 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, Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 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 1!�z4-C Jr, _2,e-, Telephone a %9—<J -f72 Address go 6 x 2 Yo 66 S' /ori r� 9rrJa?S� Date ,130 / /�; C — w'wNtis 6. DHHS APPROVAL Approved for%j 34edrooms by Date Approved V —Disapproved Conditional Terms of Conditional Approval CAUTION 9- q -9e 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 ANCMUNI IPALITY OF ANCHORAGE (MOA) MUNIC �alth Authority Approval (HAA) a ENVIRON VICES DIV'b?4CKLIST - FEBRUARY 1984 343-4744 J U L 3 0 1990 RECEIVED A. WELL DATA 0 //- / 3V yq Legal Description: 4T -a S slp"d Zx 4 z % /,2N /2't d✓ 5 is Well Classification ;(-'o V/ C If A, 136D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Depth of Grouting Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole Water Sample Collected by Date Ar D Water Sample Test Results d ae.Z, e9 Nj )4rXACr. 'u ID Comments WDs'_'L�P_h4v^ o-1- B. SEPTIC/HOLDING TANK DATA Date Installed i FIM Size /aoo No. of Compartments Standpipes &N) Depression over Tank (Y6) Air -tight Caps (�%i N) Foundation Cleanout (Y/g Date Last Pumped �ZMgrs Pumping/Maintenance°Contact on File (Y/N) � ; for Holding Tan"kHigh-WateroAlarrri (Y/N) Temporary Holding Tank Permit (Y/N) AJ -4 SEPARATION DISTANC,�SsFfRO;M;SEPTIC/HOLDING TANK: To Water -Supply We/ ' " lZT/ To Building Foundation To Property Line . To Disposal Field Y .1 Z O O To Water M81n/Sr�ice Lln<? `4 To Stream, Pond,,Lake or Mpijor Drainage Course ��00 f/ i Comments 7a.4� is owddr paved c�/r��e. 5*6.d..^s �n Me��/ s����pp�s a� .� &te/. 72-026 (Rev. vee) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design rPe„� Date Installed M9A3 Length of Field Z./ Width of Field o�.i� Depth of Field 13 Gravel Bed Thickness / j0 Square Feet of Absortion Area 1;/ Y Statndpipes Presentpy N) -- Depression over Field (Y10 Date of Last Adequacy Test Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well %; i / To Property Line To Building Foundation Z / To Existing or Abandoned System on Lot A_� ; On Adjoining Lots % Z o l To Water Main/Service Line > ZO To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course > /0o " To Driveway, Parking Area, or Vehicle Storage Area (1k4We,, Cl r-1 Ce wr; Comments tie iNrU /z1,1.r .ee)4:o_ lhvf-c /S l/aco^_l �,�r/ A.2s 1'��raineo� (l�cz�� s��e 6CAV" Ar D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Cod Comments Dimensions Manhole/ ss (Y/N) "Check Permitted Bedroom Rating Against HAA Request" ump Off' Level at —_ Vent (Y/N) I certify that I have c eked, verified, or conformed to all MOA and HAA inspection. Signed Company Date 7/19°Z9 0 MOA No. 90 —O / Z_ Ran.aint No / Receint Nn Date of Payment ��y �r�� j� Waiver Fee: $ — Amount: $ �l� ���! Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 Pumping Cycles during Adequacy Test. of this is Seal AE CS ALASKA RUIROWnTAL COUROL a Cngineerinq & 6nuironmental Studies J � 1'1 UE�NO ECT�ION 1200 West 33rd Auenue, Suite B • Anchorage. Alaska 99503 • (907 ECEN ED DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 STEVE COWPER, GOVERNOR July 23, 1990 FOR: ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. Attn: Dr. Leroy Reid, P.E. 563-6775 P6WSID: U10485 According to the records on file in this office, the Seacliff- Subdivision, Lot 8 Dlk 5 Sand Lake ',t2 Water System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, VERA E. CR IG Environmental Field Officer VEC:pf Time APPLIC„ NT FILLS OUT UPPER HAL,-. ; ONLY Property Owner "_-. Time Phone �. ; Date Date Date Date Zip Code Inspector Mailing Address Inspector Inspector V DEPT. OF HF/.LTH l: Buyer ENVIRONMENTAL PROTECTIO Zip Code Address RECEIVED (3) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL Phone Lending Institution'�j ( ) CONDITIONAL APPROVAL' Address �•" v a 3 Zip Code DATE Phone Realty Co. & Agent Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Zip Code Address Well to Tank Septic Tank Size Legal Description• -- Street Location Type of Residence ❑ Single Family ('Multiple Family No. of Bedrooms ❑ Other Water Supply ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. El Individual For wells drilled prior to that date, give well depth (attach log if available). E Community '❑ Public Utility Sewer Disposal - Year Individual Installed: W ndividual When Connected to Public Utility: Public Utility ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORQPROCESSING CAN BE INITIATED.'.' Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector V DEPT. OF HF/.LTH l: Field Notes: ENVIRONMENTAL PROTECTIO RECEIVED (3) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' �•" v a 3 DATE BY:��i.9-- Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size 72-023 (3182) /tel 1 -- j APPLIG NIT FILLS OUT UPPER HAL, ONLY Time Proparty Owner (�"J f%/;/= / �' ✓{ %/ Phone Ji) i, ✓ r v L.l r -`�,, 1 Zip Code Mailing Address � �7 ,. ,�U � �� � L f - _ _, }' 1 Buyer i s` / Addressr „,�, f�,� p9�> y.- Zip Code Date Lending Institution �'. ���SI %��/urt H�✓ / Phone _ c iL, ,� jj Address '' / 50%' / < Cye%o— /fir`... Zip Code Inspector Inspector n �1 Phone Realty Co. & Agent WVLJ ICIIRAUTY OF ANCHORAGE F)( -e'.LTIi -Del`��-' .��1 iuL� a �y - 60 Address '< < S 1 - Zip Code L., i' '¢ ! �r'. C`:>`,..�/C;nc -e � Legal Description lot 000 Street Location Type of Residence - L 01'e ❑ Single Family ( ) APPROVED BEDROOMS yc�y Multiple Family No. of Bedrooms DISAPPROVED L Other ( ) CONDITIONAL APPROVAL` DATE Water Supply BY: ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Individual Date Sewer Installed For wells drilled prior to that date, give well depth (attach log if available). [�. Community Well Log Received Septic Tank Size ❑ Public Utility Well to Tank Sewer Disposal Individual Year Individual Installed: tin =�� _ ❑ Public Utility When Connected to Public Utility:` ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. /tel 1 -- j Time Time - Time Time Date Date Date Date Inspector Inspector Inspector Inspector n �1 Field Notes: C' ,fid 1 WVLJ ICIIRAUTY OF ANCHORAGE F)( -e'.LTIi -Del`��-' .��1 iuL� a �y - 60 i`kONc(`7r, I L': ENVi14-4TAL PROTECIION � OCT 000 L 01'e ( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL - -- -- -A-N- -DISAPPROVED DISAPPROVED ( ) CONDITIONAL APPROVAL` DATE BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank 72023 (3182(