HomeMy WebLinkAboutFISCHER BLK 1 LT 3A5 Onsite File Fischer Block 1 Lot 3A5 #015 - 292 - 14 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP171030 PID Number: 015-292-14 Dwelling: 0 Single Family (SF) [' Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New 0 Upgrade Name: Ludwig Perullo ABSORPTION FIELD Address 0 Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound 5111 Seldon Circle ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-830-6242 4 1 .2 GPD/SF 13.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 5.0 Ft. 8.0 Ft. Fischer 1 3A5 Fill added above original grade Gravel length Township Range Section 0 Ft. 32.0 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 3.0 Ft. Ft. To', Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From 1 Tank Field Tank Line 512 Ft2 1 Ft. Well *82' >100' N/A N/A >25' TANK DI Septic El S.T.E.P. ❑Holding El Other Manufacturer Capacity Surface Water >100' >100' N/A N/A Anchorage Tank 1250 Gal. Material Number of compartments Lot Line >5' *0' N/A N/A Steel 2 NA Foundation >5' >10' N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. Pump on level at Pump off level at High water alarm at Remarks * Waiver OSV171015 for separation distances in in. in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034 Tank to D3034 Installer drainfield Wilco Excavating Drainfield D3034 CO/MT D3034 Inspector Ben Schiller BENCH MARK (Assumed elevation) 100 ft Ins ecction tes 15' 4-18-17 2ntl 4-19-17 Location and description d3rO 4'^ Garage slab COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL • • En.i -- Stamp Conditional Approval: Date 4' • $ • • v,....• . . d0 i i 41' s, *• p -- ) SIA - '••:- A• iZ.•' a Approved f k.tte,Cy, 6t,7[,o�C,f' Date q/2_7/7017 w#k'` EssiGit4 � Inspection Report_9-1-12.doc FOIST--CRECK St11BDIw.SION Municipality of Anchorage 1 Page 2 of 3 D LOT 1 1 EVELOPMENT SERVICES DEPARTMENT I LOT 6 4700 South Bragaw Street Anchorage, AK. 99519-6655\- 343-7904 Permit Number: O$P171030 On-Site Wastewater pisposa System or Well Inspectign Report PID No.: 051-292-14 S' I ® NO OTHER WELLS ARE WITHIN 100' T S PROJECT AREA s�_pF' g1� I FISCHER SUBDIVISION I ��gtp �.���� BLOCK 1 *; m *�� 1 LOT 3A5I \ f B aurin Schiller ``' 1 A B r �� �'��• •AEL 12592 .•�`�% \ FCO 4.0'(C) 5.5'(D) I � Aw ql F,p1:6:.:°...•P� , 4 2017 ' :: \ , ROFESSIO-� o SV1 9.0' 28.3' LOT 3A6 ������� SV2 15.5' 30.5' \ 2C0 18.0' 31.5' 19.0' 32.5' X 100' WELL RADIUS (TYP) CO1 20.0' 28.5' \ /\ MT 35.5' 53.0' \CO2 38.5' 56.0' EXISTING HOME 1 NEW 1250–GAL SEPTIC \ O TANK / \ V FCO I LOT 4A2 \ / \ M02 TH2 (NEW) / e N 100' WELL RADIUS \ 7 ...,„ 0 LEENIMT – Mit�-Tbe — ' FCO – F undation Clean Out CO TH – Telt Hole I LOT 3A4 CO – Clqan Out I . 1 32 LFx3'x8' EFF DEPTH 2C0 – Dpuble Clean Qut ® – Ekisting Well I SEPTIC TRENCH o I 20 I 40 / FEET 1 I / 100' WELL RADIUS SELDON CIRCLE i Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655- 343-7904 Permit Number: OSP171030 On-Site Wastewater Disposal System or Well Inspection Report PID No.: 015-292-14 FISCHER SUBDIVISION, BLOCK 1 LOT 3A5 99.5 ir> cNn / 2CO 1I 94.86 III oG 1 Finished Grade 1,250 Gallon 94.61 Septic Tank 194.82 cv F- U2 U 99.0 - - Finished Grade / OG 93.96 Drainfield Rock \ 93.96 85.96 32'(Trench Length) i - 82.0 Bottom of hole NO GROUNDWATER 3/29/17 A'roct:• *4-10# PROFILE AS-BUILT . Benjami iller : No Scale f �F'. CE 1 592 �al'l•. Apr 26,2017 .• +t' \-."PCOrESS1�NA`� ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) April 20, 2017 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Fischer Sub, Block 1 Lot 3A5 Separation Distance Waiver- Bottom of trench to bedrock/impermeable layer Dear On-Site Services Engineer: A test hole was dug on this lot down to a depth of 17' in preparation for the design of the new septic system. The soils were very clean sand for the entire depth. The design called for a deep trench (8' effective depth), since there was very limited room on the lot. During construction, the trench was very difficult to dig, due to the non-cohesive nature of the soils. Every effort was made to keep the trench to the correct elevation, since digging deeper was more difficult. However, after placing the septic tank at the level required by existing pipe from the home, and digging the 8' effective depth, we discovered that we were 2' lower than design, and the bottom of the trench was at 13' instead of 11'. We have investigated the surrounding test logs and well records. Several of the test pits go down to 20 or 22', and none of them indicate bedrock or an otherwise impermeable layer. The two well logs for the properties to the north also indicate continuous soil layers at that depth. We do not anticipate any likelihood that there is bedrock or impermeable soils at 19', and there are no additional problems or detriment to this system or the wells in the area by this system. The small size of the lot, along with the collapsibility of the sand, make digging another test hole to 19-20' to be extremely difficult. We would like to request that you grant a waiver from the 6' separation distance to proven impermeable layers, and allow for a 4' separation. Thank you for considering this request. * •s. ,11% Sincerely, •et. •O*•*•.*-1 Nit •a44• ;f- ZigBenjamin Schiller, P.E. v.0 �+ ! Schi!k-T ��, , f • • CE-• 12592 1'� ' Attachment � A••.`3411?•.•.,' -Jm- �F ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) March 8, 2017 Municipality of Anchorage, Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Fischer Sub, Block 1 Lot 3A5 COSA Adequacy of current absorption trench Dear Onsite Services Engineer: During the preparation for submitting paperwork on this system, it came to our attention that the absorption trench for the property at 5111 Seldon Circle has been questioned. It seems that a contractor was fixing or installing a monitor tube in the trench, and in the excavation did not find sewer rock where the trench was supposed to be. This system is an older one, installed in 1977, and it seems that the location of the trench has been problematic. Notes during the original installation indicate that a portion of the trench had to be turned out away from the home, due to the well on the neighboring property. During the most recent COSA process, it was discovered that a portion of the trench (perhaps that same leg, it is not specified) was in the ROW, and a waiver was pursued for this. At this time the engineer says that the `standpipes were relocated' to all be on-property. It may be possible that the contractor was not digging in the correct spot for the trench. In the year when it was installed, there is an inspection report signed by Cory Willis stating that there was 48" of gravel in the trench. On Oct 9, 2016, our inspector also went to the property to drive in monitoring tube. A spot was chosen in the middle of where the trench was supposed to be located, and our inspector verified that the driving process went as expected, and that he appeared to hit a 4' gravel layer buried under 5' of soil. In addition to this, it can be verified that the trench has been working well for the 30 years. The soils at trench level were well-graded sand and gravel, rated at 85 SF/bedroom. The initial adequacy test passed, and during the 2002 COSA the trench absorbed more than 225 gallons in 10 minutes. During the adequacy test in October, in the 6 hours it took to supply 600 gallons, there was no liquid present in the monitoring tube. Fischer Subdivision, Block 1 Lot 3A5 March 8, 2017 Page Two Finally, all the water tests for the on-site well have passed with no evidence of contamination. We are confident that the system is operating as designed, with no adverse impact or health threat to this or neighboring properties. There is no practical advantage to excavating the trench to verify the presence of sewer rock. We would like to request that this system be approved as adequate. PP.4 �. Sincerely, .1 J -,„ . • 9 -77".• ... Q Zoo: 1 . � Benjamin Schiller, P.E. ,r0. • V. o4' ss �. ; .. __.�' , ) Municipality of Anchorages. Aoki. Ihpcnnr/ P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV171015 COSA#: Permit#: OSP171030 PID#: 015-292-14 Legal Description: Fischer Blk 1 Lt 3A5 Engineer: Anderson Engineering Applicant: Ludwig Perullo III The following waivers have been approved for the septic system upgrade. 5, Seva.Asji o n --o , 1. The tank may be 82 feet from the well on Lot 3A6 u,,,, , 61._ booc-Luut 2. The application rate may be 1.2 GPD/sf �,,,d �,, d in)C...-1, ,,,, • 3. The field may be 0 feet to the property line. cie..ena, ie.J b i, subm// 4. The proposed field may be adjacent to the existing field. so�'I 17 ..51,-,.�-?d'� See the engineer's waiver request. tors, 0^ a//owed by f'2/'ase cl code .4/4./I 1 This waiver approval applies to the proposed wastewater disposal system only. Any future C-- upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ® The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. r Waiver is Granted: X Waiver is not Granted: Date: `1/6/7 Approved by: pai, ,f Review MUNICIPALITY OF ANCHORAGE T Head and Environmental Protee^�I' Fourth Floor West 825 L Street Anchorage, Alaska 99501 279-2511, x 224, 225 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAt.1E �i "Ice MAILING ADDRESS —r1i_)v.�—�..b M-/���` PH{ONE�,,..Ty LOCATION C -t2 -S"" LEGAL DESCRIPTION L-?A� I "3`�'" S/ 0 SEPTIC TANK: DISTANCENUMBER OF( FROM WELL I0 O MANUFACTURER --- MATERIAL J ' �" � COMPARTMENTS INSIDE LENGTH — INSIDE WIDTH--_ LIQUID DEPTH LIQUID CAPACITY 13'1'>Gpp ALLONS. TILE DRAIN FIELD:�?s F 1 TOTAL LENGTH �j DISTANCE FROM WELL IOs .%� FOUNDAT ION �� NE A^RE'ST LOT LINE 10 OF LINE —Lf_ F_ #'Of' Lines I QQ DISTANCE BETWEEN LINES I v16ITRENCH WIIDTHH`:�4e IN. TOTAL EFFECTIVE ABSORPTION AREA �_.L 50. FT. LENGTH OF EACH LINE (—L G t DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE —,j—MATERIAL BENEATH TILE ABOVE TILE �IN. SEEPAGE PIT: DIAMETER _OR WIDTH_. LENGTH_. DEPTH 14 Log Crib _Rings_ Crib Size: DIAMETER —DEPT H—DISTANCE FROM; WELL -- -- ---- -- TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT. Well - ,Z Class: Depth: Well Distance To: Lot Line LO Bldg:-��01 Sewer 'L} e• too Pipe Materials: Ls u S of Bedrooms: Installer: Remarks: DATL-�/i8/1 APPROVED i CC j J DATL-�/i8/1 APPROVED i MUNI 0IA=�RL_ I TY OF FlNCF?qFZF (3E � 'U DEPARTMENT HEALTH AND ENVIRONMENTAL .OTECTION -7, 825 'L' STREET, ANCHORAGE, AK. 99501 J i ?.. 279-2511 WELL- F iN[? ON-SITE SEWER F�'EFZ mI T n�C1I t PERMIT NO. C 77401 > ;'� 1-� 1) t APPLICANT (40 LGTSCONSTRUCTION 3419 NEWCOMB-�333-5436 LOCATION DEL CIRCLE L LEGAL L385 B1 FISCHER SUBD LOT SIZE 11500 SQUARE FEET TYPE OF SOIL ABSORSTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS e 4 SOIL RATING CSO FT/BR)- 95 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: dEF:'TH- 3 0 LENGTH- 48 GFZFik+EIL OEF?TH- 4 THE LENGTH DIMENSION IS THE LENGTH CIN FEET> OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN 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 CIN FEET). FZEQU I FZEO SEFm'T I C TFI"K S I ZE= 1230 OFiILLONS. TWO <2> I NSF='ECT I ONS nFZE FZEGiU I FZEa BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTA14CE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED, TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. FP'EFZM I T VFiIL I O F= OFZ ONE VE FIFZ F= FZOM I SSUE I CERTIFY THAT 1: I AM 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. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE JS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. CRNT NO ISSUED ION � n GREn,ER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMFUTAL QUALITY 3330 "C" Street ' ANCHORAGE, ALASKA 99503' Case 0 Performed For 1 ouuew Lk&+n 6osTaS& Dated Performed Legal Description: Lot 3A5 Block 1 Subdivisionlen34 A3o. Eurx%%HCA SS,,e This Form Reports Soils Log ,lel Percolation Test . F ,- - Soil Test I -lust Be Logged To 4' Below Proposed Seepage System - Depth Feet Soil Characteristics I- 2- 3- 4- 5—. 6- 7- 8- 9— .12- 14— Was Ground Water Encountered? Wo If Yes, At What Depth? • " mwwww 2 � 002 MM Tri Reading Date OK'DnIL Net Time Depth to lQ�••TJet��D'v'o• B.r , Sa•�sk , i�r... , da..p Ff'dm lelml , loot , e1a,.p (yw �85AFi/wM I _-�. —�L • W.fINfY -6: iNO. 343J.1 9 ; fsMS 6% Sa, {fir, ,da+js 54R,�or+M — ti :,. ►s'6 E.y, sa lwsc.d S W-125-i�F/Doan kZli yra�a b;°• .�.' 7 6a, 5a/6rl,Ims< cia p iNirrlwla«I seKl-6n�1r/ 8S $p Ft well y.,Vw .V, Was Ground Water Encountered? Wo If Yes, At What Depth? • " mwwww 2 � 002 MM Tri Reading Date Gross Time Net Time Depth to lQ�••TJet��D'v'o• 1 � I _-�. —�L • W.fINfY iNO. 343J.1 Percolation Rate � 1.1inute! Proposed Installation: Seepage Pit Drain Field Depth of Inlet _! _ Depth to Bottom oPit or Trenc / COMMENTS:., Test Performed r�. 99), q �Azj" A, 0- if u0 ----------------- d 7�0 4&� `� Alpine Drilling & Enterprises INVOICE Domestic - Commercial N° 216 4 Pump & Water Systems P.O BOX 110496 isN me I LOC I An Alaska 99511 g qc (907) 345-0202 TO. /T e CS 5! / /%✓,wLi Thank You SIGNATURE 0 Hereby AcknowleNe the Satisfactory Corrol~ of the Above Described Work.) TERMS: ACCOUNTS PAYABLE AT 101H OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.6% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. J •^ _�.A��L ice...✓ �_.� ' 14111 WM70 F� _ Thank You SIGNATURE 0 Hereby AcknowleNe the Satisfactory Corrol~ of the Above Described Work.) TERMS: ACCOUNTS PAYABLE AT 101H OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.6% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. J •^ Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Mark Begich Anchorage, AK 99507 Mayor www.muni.oralortsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: _ Parcel Identification Number: Legal Description Property Owner Name & Address: tioU 6gRvtJd VAvICh, V%K 59Sc%� Pump Installation Date: :7-/1� Pump Intake Depth Below Top of Well Casing: feet Pump Manufacturer's Name: t; d Pump Model: 'J`O G q� l t 9, s1 o^ Pump Size S/:? -hp Pitless Adapter Burial Depth: 10 feet Pitiless Adapter Manufacturer's Name: J Pitless Adapter Installer: / Well Disinfected Upon Completion?es ❑ No Method of Disinfection: C L 0 o2 y V7%-(vk1?-L£T5, Comments: Pump Installer Name: Avw ' - S` 6,c,&v146 ice Attention: The pump installer shall provide a pump installatiSn log to the DSD within 30 days of pump installation. 0 • 1 6. 8 9 7,9 7i 13� ( •tkr Municipality of Anchorage , On-Site Water and Wastewater Program .�.'( •f Q o (907) 343-7904A F E T Y MAR 0 g 217 ` Certificate of On-Site Systems Approf--- Parcel I.D. 015-292-14 Expiration Date` a 6 8 L g 7/21/111 1 1. GENERAL INFORMATION Complete legal description Fischer, Block 1 , Lot 3A5 Location (site address) 5111 Seldon Circle Anchorage, AK 99516 Current Property owners) Ludwig A. PeruIto Day phone 350-1860 Mailing address 5111 Seldon Circle Anchorage, AK 99516 Real Estate Agent, - Day phone 2. TYPE OF. DWEL�.ING: O Single~Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Q Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: /PAflLI[J1( mer - Date: 4//)---07- COSA to be released to the engineer,unless of wise requested by the engineer. COSA Fee $ 6-P40 Waiver Fee $ Date of Payment 3/q/1/-j/- Date of Payment Receipt Number 6qRW6 Receipt Number COSA# 05C1?1()J1 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 Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Benjamin Schiller, P.E. Date 3/8/17 .A .;;.et•• j 45.Sh• + ' ' "..‘;11;r:?"- 4 9 ‘; r:?"-49 (r * �z�oy 6. DSD SIGNATURE L System #1 Approved for z.7 bedrooms411"13 ' System #2 Approved for bedrooms � +ti CI-,12182 :�, " De. •0,. Disapproved co �9 e. 3tJ:7.•• pp qt RQFESS:7*r, Conditional approval for bedrooms, with the following stipul'i01a3 �``� \e��l-cY OF AN.e0 ON- SfTE ;' WATER AND WASTEWATER oz • �` PROGRAM By: 76C('L, ()fivo-r.-e Original Certificate Date: Va.2 7 1 7 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 X Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet c If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Fischer Sub., Block 1 , Lot 3A5 Parcel ID: 015-292-14 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (Y/N) N Date completed Unknown Sanitary seal (YIN) Y Wires properly protected (Y/N) Y Total depth 103+ft Cased to 103+ ft. Casing height (above ground) >12 in. FROM WELL LOG AT INSPECTION Date of test N/A 10/10/16 Static water level ft. 60'S ft. Well production g.p.m. 1 '63 g.p m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 7.62 mg/L Arsenic 0 ug/L Date of sample: 3/3/2017 Collected by: Anderson Engrg. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Steel/Septic Date installed 4/18/2017 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) N Date of pumping Pumper New Construction C. ABSORPTION FIELD DATA Date installed 4/19/2017 Soil rating (g.p.d./ftz or ftz/bdrm) *1 .2 GPD System type Trench Length 32 ft. Width 3 ft. Gravel below pipe 8 ft Total depth 13 ft. Eff. absorption area 512 ft2 Monitoring tube Y Depression over field N Date of adequacy test NeW Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date *Waiver OSV171015 for use of 1.2 GPD/SF for sand < 1min/in D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >1 00On adjacent lots >� 00 Absorption field on lot 1 00' _ On adjacent lots 100 Public sewer main 100 Public sewer manhole/cleanout 100 Sewer/septic service line >25' Holding tank >75' Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: 5' Building foundation 5 Property line 10 Absorption field Water main 10Water service line 1 Surface water 100 Wells on adjacent lots *82, ABSORPTION FIELD ON LOT TO: Property line *01 Building foundation 1 �� Water main 10' Water Service line 10 Surface water 100 Driveway, parking/vehicle storage 0'S Curtain drain None Noted Wells on adjacent lots 1 ��, F. COMMENTS *Waiver OSV171015 for noted separation distances G. ENGINEER'S CERTIFICATION ` atk" I certify that 1 have determined through field inspections and •Gy:�+• +' • ��A review of Municipal records that the above systems are in i*:• 49 T-" ; • :+�p, conformance with MOA COSA guidelines in effect on this date. _ o Benjamin Schiller P.E. •N.• Engineer's Printed NameIam h J Settler. ; 4/21/2017 •i •'•. 2 • ' "Q Date 1,0 o.•yl'•L•'l••.` a� Q i!'ud�S ;4;�� COSA brown sheet 10-10-12.doc Municipality of Anchorage �; t� Development Services Department Building Safety Division ti On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Systems Approval # OSC 171071 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 3A5 of Fischer subdivision. This inspection revealed a nitrate concentration of 7.52 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/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. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. N89'56'50.00"W e e - ti 75.00' 10' LTI'_ITY EASEMENT 'WP �° EiSCH�ER SUBDIVISION 34 CD 0O°� L 0 rT 3A 5 sem+ GRAPHIC SCALE 14.4 • 1/4-r• /�} O 30 LEAN-TO '09 mss, l J T 3A6 b cL0 7O Z c 26 �,•00•• SCALE: 1"= 30' TWO ' � r- ' WOOD m PORCH STORY't,' SHED, NO FDN. PHYSICAL ADDRESS: N- kg:FRAME • 5111 SELDON CIRCLE ',HOUSE • ANCHORAGE, AK. t 5' HIGH 6p 000 GARAGE WITH 99516 HI FENCECHAIN LINK T . 2 ��•$ DECK A80VELEGAL NS : i23 -11 LOT 3A5, BLOCK 1 w 9 4 pZ ® FISCHER SUBDIVISION (70-170) Zr U 28.0 3 / / . 2 AC DRIVE ANCHORAGE RECORDING DISTRICT J QO,� ` , ��� �����f\ter, ZONE: R1A CI 13.9 b 1-'S \ ..4.! ,., OF 44 .. . 1 • * \3 ��r� �`•�'•••• '••' 1 ♦ EXCLUSION NOTES: It is the owners responsibility to o \ O� \ vl 1_ 9 determine the existence of any easements, h •• 49th /� •: '` covenants, or restrictions which do not appear on // • =• • the recorded subdivision plat. NOTE: Under no %••• ••r� circumstances should any data hereon be used for CAR RACK % /',j I9,_ construction or for establishing property lines. LOT �A (JACK HOIST) Q►� f" fr,(�T _ f,ek Ronald R. Mitchell c SURVEY CERTIFICATION: I hove conducted a physical / survey of this property as shown on this drawing SELDON CIRCLE %� s� LS-4125 and determined that the improvements situated `_ ,S3 '•. 4/27/1.7•�.•'• C• thereon ore within the property lines and no x).* `PN�. encroachments exist other than as noted. �i4 1.i�i11i 4- (RE—CERT) AS—BUILT SURVEY RE-CERTIFCATION: AS-BUILT SURVEY LEGEND: FOR: RONALD R. MITCHELL LOT 3A5, BLOCK 1, P. O. BOX 141884 SUBJECT LOT EDGE OF PAVEMENT Q SANITARY CLEAN OUT Anchorage, AK. 99514-1884 UNSURVEYED AC DRIVEWAY = POWER POLE FISCHER SUBDIVISION (907) 272-3778 — __ — — EASEMENT CENTER LINE o 0 o FENCE UNE JOB N : SCALE: DATE: SURVEY DATE: ORDERED BY: PLAT NUMBER: GRID NUMBER: RECORDING DISTRICT: FIELD CREW: FIELD BOOK/PAGE: CHECKED BY: DRAWN BY: 17008 1"= 30' 4/27/17 4/27/2017 RYAN 70-170 SW 2537 ANCHORAGE B ORR 2/47 RRM JDG/RM NO CORNERS SET THIS SURVEY Municipality of Anchorage n Development Services Department C5;&Building Azz- Safety Division ❑ On-SiteWater & Wastewater Program ❑ 4700 South Bragaw SL ❑ P.O. Box 196650 Anchorage, AK 99519-6650 ❑ www 7e.ak.us ❑ (90) 343-7904 ❑ CERTIFICATE OF HEALTH AUTHORITY APPROVAL Or FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-292-14 HAA# 0? 0 S9 q 1. GENERAL INFORMATION Expiration Date: Complete legal description FISCHER SUBDIVISION: LOT 3A5 Location (site address or directions) 5111 SELDON CIRCLE * ANCHORAGE, AK 99516 Current Property owner(s) MARK ROEHL Day phone 346-4673 Mailing address 1555 LATOUCHE STREET • ANCHORAGE. AK 99501 Lending agency Day phone Mailing address Real Estate Agent DALE LAMOREUX w/ REMAX PROPERTIES Day phone 257-0155 Mailing address 2600 CORDOVA • ANCHORAGE. AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well n Individual On-site N Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or 8 wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid S at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verifythat.my investigatior- tiased on procedures outlined in the Health Authority Approval Guidelines for this application, shows :thatlheror site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the nGe ttn r of bedrooms and type of structure indicated herein. I further verify that based on'the .; ``.iniointation obtained from the Municipality of Anchorage riles and from my investigation and inspection,the v pn-site water suPP1Y and/or wastewater disposal system is(are) in compliance with all applicable Municipal `and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone 337-6179 Address 6901 DEBARR ROAD, SURE 28 • ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 7!/ )-+jdZ Engineer's Comments: In conducting this evaluation, AWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 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. AMC, WC, Inc. 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 DSO. 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 Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory By: Qj1i (Rm. bedrooms. bedrooms, with the fllowing stipulaxQ••' •.'yp�% .•'A �`�� ON-SITE WATERANU t. WASTEWATER ; FRUUHAM :. ate••. � ti; Manitenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: R�J 1-Z 1 .... ..... ........ . ' e pOo j e A. arne s.: '•, Q C E-79 .� v i �c°G ..... ' e o� 0 bedrooms, with the fllowing stipulaxQ••' •.'yp�% .•'A �`�� ON-SITE WATERANU t. WASTEWATER ; FRUUHAM :. ate••. � ti; Manitenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: R�J 1-Z Municipality of Anchorage Development Services Department Suit" Safety Division On.Sfte water & wastewater Program 47W South Bragaw St. P.O. Box 196650 Anctarege. AK 995196650 www.cLanchorape.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Wen type PRIVATE Date completed UNKNOWN Total depth 103'+ ft. FISCHER S/D: LOT 3A5 0 aur•. Parcel ID: 015-292-14 If A, B, or C provide PWSID# N/A Well Log (Y/N) NO Sanitary seat (YM) YES Wires property protected (YM) YES Cased to 103'+ ft. Casing height (above ground) 12"+ in. FROM WELL LOG AT INSPECTION Date of test 4/9/2002 O� Static water level 0 Hf �% V ft. 70 ft. N Well production g,p.m. 1.34 g,p.m. WATER SAMPLE RESULTS: Coliform _ 0 colonies/100 mi. Nitrate fM mg./L. Other bacteria colonies/100 ml. Arsenic: N/A mgJL. Date of sample: 7/0� Collected by: AKWWC. INC. S. SEPTIC/HOLDING TANK DATA TankType/Material STEEL Date installed 8/18/1977 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (YM) YES Depression over tank (YM) NO High water alarm (YM) N/A Date of pumping 4%►S/o2- Pumper ���•►+-� �-''� ��r"t C. ABSORPTION FIELD DATA *MT EXTENDS ONLY 2.32' BELOW INVERT Date installed 8/18/1977 Soil rating (g.p.dJft'or<C� 95 System type TRENCH Length 49 ft. Width 3.0 ft. Gravel below pipe 4 ft. Total depth 9 ft. Eff. absorption area392 ft' Monitoring tube 'YES Depression over field NO Date of adequacy test 4/9/2002 Results (Pass/Fall) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 552 gal. New depth 30 in. Elapsed Time: 110 min. Final fluid depth 15 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) NONE KNOWN If yes, give date - E O. UFT STATION Date installed Size in gallons Manhole/Acrpes (YRJ) "Pump on" level at _lo. "Pump off, IPvel at _in. High water alarm level at Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllifi station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots '93.5' *WAIVER IN PLACE SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 0 Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehide storage 0'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA NAA guidelines in effect on this date. Engineers PrintNa a JEFFREY A. GARNESS Data 77QZ HAA Fee $375 4- I50'525 Date of Payment 2/'S/02- Receipt Number ) 3 14tro (Rev. ivol) Waiver Fee $ Date of Payment Receipt Number r s C'r-795C.-* 9¢ "'• •ff -- A.$r tie C't 0" Pr o fe 59'o�a.�3� 15D n8/81M 2z o1qf in. Municipality of Anchorage Gcorgc IL 117ucrch, Mayor Bttildint, Safety M isioll P.o. I1ox MG50 • 4700 S. Dragaw Street Anchorage, Alaska J<)519•6650 • (007) 343•&.401 h Up://�����r.cLnnduin�{;c.ak.us 8/9/2002 Jeff Garness Alaska Water and Waste Water Consultants, Inc. Subject: Waiver Request for 0 lot line waiver Waiver Request #WR020062 Parcel ID #015-292-14 Dear Jeff: 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 0.0 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, Go all Civil Engineer On -Site Water & Wastewater Program Municipality of Anchorage Development Services Department � Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.d.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: 020062 PID#:016-292-14 Date Received: I= Legal Description: Fischer SID. LOt 3A6 Engineer. Jeff Gayness HA#:020994 Permit#: Alaska Waste Water Consultants. Inc Applicant: Mark Roehl Waiver Requested: 0 foot lot line waiver Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Points: Waiver is Granted: Waiver is not Granted: List Conditions or Reasons for above: Date: !�/ t (07 _ By: J � _�wr(R" I I Name of Reviewer .anges................0"weseassaa...........................................� Rec#: Z �9 `f Amount: $ 15`0 Date Paid: 8/9/2002 ALASKA WATER Fy WASTEWATER CONSULTANTS, INC. -- July 24, 2002 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water &: Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Lot Line Waiver for Lot 3AS Fischer Subdivision. To whom it may concern: During our HAA evaluation for the subject property, it was noted that the septic system has been installed partially in the road right-of-way. Attached is an as -built drawing of the property showing the approximate location of the drainfield. All standpipes have been relocated so that they are within the property's lot lines, but a portion of the drainfield still lies in the road. Attached are letters of non -objection from the Utility companies concerned with the encroachment, and the road right of way department of the MOA. We request that your department issue a 0 foot lot line waiver from the south east property line to the existing drainfield. I am unaware of any adverse impacts this waiver would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistan in rel Je ry Cram s '.E., M.S. Pr ide t i 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com �y LOT 1 LOT 2 N 89'56'50" W 75.00' w 10' UTILITY EASEMENT - [ POWER Paz 0 o`o C [ � . ND Ln m N C rn LOT 4A I LOT 3A5 N S9�B.T0, LOT 3A4 In `A,HOUSE V. ARPaar /DECK �— 5 ABOVE 05 Prz,orL J vr-- p►P� .V..v.... ........ David M. Dreyer j LS -10392 ..... •A`'' 3A6 SELDON CIRCLE N� E - (DEL CIRCLE) a�.iCieLL4[i[iC tri[ga Mo1Ie-i[�ilLl WKVIKATXj EXCLUSION NOTES: It N the owoeri responsibility to Oetermins LEGEND: SET FIND MARK ROEHL the existence of any easements, covenants, or restrictions 5/5'Re [[/two 5/e' Re 0 which do not appear on the recorded wbdivision plat. NOTE: 125• ALMgrL 4bWONUYENT Under no circumstances Mould any data hereon be used for IAIB • TACK �C.11K Kig WKIII[V, y constrvction or Iw establishing property lines, rtma- �R� X — SURVEY CERTIFICATION: LANTECH hos conducted a OVETMANG- physkol survey of this property as shorn on this Waco DEOtS- drawing and that the improvements titaated there- CONCRETE - ARM ore within the property lines and no Mcrooch- ASPHALT- - Tents exist other than noted. CRAVEL- A S —BUILT OF: LEGAL DESCRIPTION: SEPTIC STANtYPES- LAND & CONSTRUCTION SURVEYORS—PLANNERS—ENGINEERS WATER WIDUL- 440 BENSON BLVD. N 103 (fox) 561-6626 AN ANCHORAGE. ALASKA 99503 907j 562-5291 LOT 3A5, BLOCK 1, PARK ORDER NUWKR: WN.: soon: RAT TeA[e[R 2002—L_���MAY S. 2002 I T _30' I 70_170 FI SCH ER SUBDIVISION w e< O [a a oto RIAAQA IKOKAACL C.IB DMD 2537 REF: 93-L-e35A August 7, 2002 Municipality of Anchorage George P. ll'uerch, Mayor Development Services Department P.O. Box 196650.4700 S. Bragaw Street Anchorage, Alaska 99519-6650 (907) 343-8101 Office (907) 343-8125 Fax http://w .cl.anchorage.ak.us Mark A. Roehl 6901 Debarr road, Suite 2B Anchorage, AK. 99504 Dear Mr. Roehl: RE: Septic System Encroachment, Lot 3A5, Block 1, Fischer Subdivision, Grid 2537. 0V p E'" T „SE 9 d m DEPARTMENT Right of Way Section has reviewed a request from Mr. Roehl for a letter of non -objection to an exiting septic system leach field which encroaches four (4') into the fifty feet (50') Seldon Circle Right of Way on the southern property boundary. The petitioner has indicated the existing septic system leach field on the As -Built survey, dated 7/22/2002, submitted with the request. Right of Way Section issues this letter of non -objection with stipulations, and by using it the petitioner is agreeing to the following: 1. Municipality of Anchorage (MOA) will be held harmless, now and forever, for any damages or injury to any person as a result of the encroachments. 2. All applicable codes and regulations will be observed and maintained within the easement. 3. This letter of non -objection will in no way preclude MOA from full use and enjoyment of its rights within any portion of the easement. 4. Additional and extraordinary costs incurred during any future required construction, repair or reconstruction of MOA improvements to accommodate any or all of the encroachments shall be paid by the property owner. 5. Obtain letters of non -objection from the following utilities: Anchorage Water & Wastewater Utility, Chugach Electric Association, Inc., Alaska Communications Systems, Enstar Natural Gas Company, and GCI Cable of Alaska. 6. This letter of non -objection is issued based on there being no above ground structures (vent or inspection pipes) in the right of way. It is valid for only the below ground leach field. All letters of non -objection should be retained in your permanent files. Should you have any questions, please call me at 343-8033. Sincerely, Jack L. Frost, Jr. Right of Way Supervisor Concur, t roperty Owner 07/22/2002 14:53 July 22, 2002 561-0356 Mr. Jeffrey Garness Alaska Water 6 Wastewater Consultants 6901 Debarr Road, Suite 28 Anchorage, AK 99504 ATU OSP ENGINEERING PAGE 02 ACSMnns ACS has no objection to the encroachment of the septic into the Seldon Circle Right -of -Way located on Lot 3A5, tishor Subdivision, as depicted on the as -built drawing submitted. Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: I. ACS will be held harmless, now and forever, for any damages or injury to any person or property as a result of this encroachment. 2. Any ACS facility damaged or destroyed, as a result of this encroachment will be repaired at no cost to ACS. 3. Any costs incurred by ACS for special construction necessitated by this encroachment will be borne by the property owner. 4. All applicable safety code regulations will be observed and maintained. 5. This letter of non -objection will in no way preclude ACS from full use and enjoyment of its rights within any portion of its right-of-way. Sincerely, Greg chmid, Foreman Outside Plant 6naineeri, DATE: r �V— F-OEN2 -7 AM T.lenhme Avenues AnAnana, Alaska 99503.6091 tel 907564.1000 www.acsabskaxom CHUGA POWERING ALASKA'S /UTURr July 2, 2002 Alaska Water & Wastewater Consultants, Inc. 6901 DebarRoad, Suite 2-13 Anchorage, Alaska 99504 Attention: Jeffery Gamess, P.E., M.S., President Subject: Letter of Non-objcetion for Existing Well and Septic in Road ROW Lot 3A5, Block 1, Fischer Subdivision/015-292-14 SE'/. of Section 3, T12N, R3 W, S.M., Alaska Grid 2537, OB02026 Dear Mr. Gamess: Chugach Electric Association, Inc. (Chugach) does not object to the existing well and septic system within the Seldon Circle right of way adjacent to the above referenced property, as shown on the submitted As -Built by Lantech dated May 8, 2002. It must be your understanding that the installation of the well and septic system within the road right of way is at your risk, and that this non -objection is given without prejudice to Chugach's full enjoyment of any and all rights it may have in and to such road right of way. Enclosed for your information are the Locate Call Center card, and Chugach's What is an Easement? and Electrical Facility Clearance Requirements handouts. If you have any questions, please call Susan Truskett, Right -of -Way Agent, at 7624735. Sincerely, Jim K. Topolski Manager, Land Services Enclosure cc: Mark Roehl, 5111 Seldon Circle, Anchorage, Alaska, 99516 Chugach Electric Association, Inc. 3601 Annesoro Drive, P.O. Box 196300, Anchoroge, Alosko 995196300 - 1907) 5637494 Fox 190715620027 - 1800) 4787494 www.chugochelect,ic.com - inloechugocheleunc.com ANCHORAGE WATER & WASTEWATER UTILITY George A Wuerch, Mayor Jeff A Garness 6901 Debarr Road, Suite 2-13 Anchorage, Alaska 99504 Engineering Division 3000 Arctic Boulevard Anchorage, Alaska 99503-3898 http://www.awwu.ci.anchorage.ak.us July 1, 2002 Re: Fischer, Block 1, Lot 3A5 (Grid 2537) Encroachment into Right-of-way Dear Property Owner: Owned by the Municipality ojAnchorage The Anchorage Water & Wastewater Utility received a request on July 1, 2002, for a letter addressing AWWU's position regarding the existing septic system that encroaches into the Seldon Circle right-of-way. A property asbuilt drawing was submitted with the request. AWWU water and sanitary sewer mains are not available to the referenced lot. AWWU has no objection to the encroachment. If you have any questions, please call me at 343-8009 or the AWWU Planning Section at 564-2739. Sincerely, Hallie Stewart Engineering Technician Cc: Robert C. Cowan. S & S Engineering G:1EngineeringlPlanningWlanningWMS\encroachments\ROW-no w -s -no obj.doc July 2, 2002 Jeffrey Gamess 6901 Debarr Road Suite 2B Anchorage, Alaska 99504 Dear Mr. Gamess; E.,J61,fr--5P r,.�Ahr` t'fz, Fa`Or6vrr7 bw�16:z . Subject to your agreement to indemnify the company as set forth below, GCI Cable Inc. of Alaska has no objection to the well encroaching into the Seldon Circle Right if Way easement on the Southeast property line of Lot 3A5, Block 1, Fischer Subdivision. Known as 5111 Seldon Circle, in city grid 2537. This letter of non -objection in no way precludes GCI Cable from full use and enjoyment of any rights it may have within any portion of the Seldon Circle Right of Way easement and or the right-of-way, including unlimited access for servicing its facilities. Also any additional and extraordinary costs incurred during any future required construction, repair or reconstruction of GCI's facilities to accommodate any or all of the encroachments shall be paid by the property owner. By signing below, you agree to indemnify and hold GCI Cable harmless, now and forever, for any damage, costs, expense (including reasonable attorn y's fees), liabilities and injury to any person or property occurring as a result of the enc9prachment. Please indicate your acceptance by signing and address below. / Sincer'e'ly/, Cheryl Patterson OSP Design Engineer Date t i myself at the `".�•�; �y eSS 1 OvNF� -7 AV/0-Z M aa -l- foF-+' L 5151 Fairbanks Street • Anchorage, Alaska 99503 • 907/868-5600 JUL 22 2002 2:20PN 7/22102 ENSTAR NATURAL GAS Alaska Water & Wastewater Jeffrey Gamess, P.E. M.s 6901 Debarr Road, Suite 2-13 Anchorage, Alaska 99504 To whom it may concern: 907 SG2 0053 eEeNSTAR Wsatuur�r rdnGeermr� nCaaorrnWy 6nr"Anng 401 E Intamabonat Airport Road P.O. Box 190288 Andwspa,Akska 995194288 (907) 264-0743 FAX (907) 562-0053 Re: Letter of Non -objection Grid A2537 ENSTAR Natural Gas Company has no objection to a septic encroachment, situated in the Sekfon Circle road right of way situated adjacent to the southeast property boundary located on Lot 35A, Block 1. Fischer Subdivision . Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: ENSTAR will be held harmless, now and forever for any damages or injury to any person or property as a result of this encroachment. Any ENSTAR facility damaged or destroyed, as a result of this encroachment will be repaired at no cost to ENSTAR. Any costs incurred by ENSTAR for special construction necessitated by this encroachment will be borne by the property owner. All applicable safety code regulations will be observed and maintained. This letter of non -objection will in no way preclude ENSTAR from full use and enjoyment of its rights within any portion of its right -of --way. Sincerely, File P.1 MUNICIPALITY OF ANCHORAGE Ar Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-292-14 1. GENERAL INFORMATION Complete legal description FISCHER BLOCK 1 LOT 3A5 Expiration Date: O -2,1 , 20 Location (site address) 5111 SELDON CIRCLE ANCHORAGE AK 99507 Current property owner(s) GUILD MORTGAGE COMPANY Day phone Mailing address Real estate agent 5898 COPELY DRVIE SAN DIEGO CA 92111 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYP� OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distan Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ ��j S� - a '� Waiver Fee $ Date of Payment '51Waoaa Date of Payment Receipt Number a IQ 13 ! Receipt Number COSA # 05C 26 cie Waiver # COVID-19 25% DISCOUNT APPLIED 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below,./ 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 FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 5/15/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. 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 in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. 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 .r well and septic system. Therefore, any estimate of how long a system will function satisfactory P� •' • :7��[ for current or future occupants or guarantee that no unseen encroachments, deficiencies or ��� .' • •�Y�� discrepancies exist can be given by First Water Consulting & f �'� 7 • .•* ��J 6. DSD SIGNATURE �� • • • • • • • • •' • Curtis Huffman System #1 Approved for bedrooms CE 128991��/r System #2 Approved for bedroomso •5i15(2o�,� lli PROFESSIO N Disapproved Conditional approval for bedrooms, with the following stipulations: IM r' Original Certificate Date: �r�� _2V 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 Legal Description: FISCHER BLOCK 1 LOT 3A5 Parcel ID: 015-292-14 If more than 1 septic system on lot: COSA Checklist # _of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled UNKNOWN Total depth *103'+ ft Cased to *103+ ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 5/18/2020 Structure served by this system Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 7.95 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) FRES Collected by =-f Static water level at beginning of test 65 ft. Date of Sample 5/13/2020 Well production at time of test 1.5 gpm Comments *Per MOA record docs. Well flow at wellhead by FWCS w/ Hefty Drilling assistance. B. TANK DATA Age of tank(s) 3 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 50" ® Standpipes/foundation cleanout per record drawing Date of pumping 5/5/20 D. ABSORPTION FIELD DATA Which system tested (date installed) 4/19/2017 ® ALL standpipes present per record drawing Total measured depth from grade 14.6 ft (max) Measured depth to pipe invert from grade 7_0 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective If not state C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 5/6/2020 Results f g Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 600 gal New depth 5 in depth into effective 7.6 Elapsed time 10 min ® Code -required soil cover over field Final fluid depth 0 in ® System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced 1200 gallons FWCS Comments/Deficiencies: Presoak Calcs: 321 x 3'W x 8'ED = 780 x.40 = 308 gal minimum. 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' ® Yes if No ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Surface Water > 100' ® Yes Animal Containment > 50' ® Yes if No ft ® Yes if No ft Manure/Animal Excreta Storage > 100' 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 5'+ ft Surface Water > 100' ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ❑ Yes if No *82 ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Water Service Line > 10' ® 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' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No *0 ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ®Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No _ ft F. ENGINEER'S COMMENTS *MOA WAIVER OSV171015 G. ENGINEER'S CERTIFICATION l certify that l 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. �.' 7H .. • Curtis Huffman • ' , ��� �Fc : CE 128991 .• i``�i MUNICIPALITY OF AN'CHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On -Site water and wastewater SectionFax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC201193 Subdivision: Fischer, Block: 1, Lot: 3A5 A water sample revealed a nitrate concentration of 7.95 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/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. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of',the subject Certificate of On -Site Systems Approval. Maif�ng Address PCO Box 196650 *Anchorage, Alaska 99529 6650 *wQ Nat ww rriuni org From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They reccgmmend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples., Mad�ng Address p O Box 196650' Anchorage, Alaska 99519 6650 * www�muni or O MUNICIPALITY �ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES 1 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 Parcell.D.N tQ1e+-A.gia• 1Lj HAA# VIPASIDJKLk 1. GENERAL INFORMATION , Complete legal description L,', Location (site address or directions) 5111 SI... -toe^ -t C r Property owner N i 1� rn urt i -� $.e w vl -t-_ _ Day phone Mailing address Lending agency Day phone Mailing address Agent 1\11 {�aN^���x``-�Q Day phone A-76-33330 3`14 -117,i Address 3333 ,-c3.lZ 110 495 v 3 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: q- 3. TYPE OF WATER SUPPLY: / Individual well t/ Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-0251Rw. 1/971 From MOA 621 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. l 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'ofFirm 1 !'J'e1l �(1Vi�lAtifl' lel= Phone ��-3`llb Address Engineer' 6. DHHS SIGNATURE ,A— Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an Independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of 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 (i1ay.1/91) Bwk MOA R21 . Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lei 3A5 FL",V— Parcel I.D. A. Well Data Well type �If A, B, or C, attach ADEC letter. ADEC water system number N/A Log present (Y/N) IJ Date completed Driller Total depth R I Cased to �ZR Casing height Sanitary seal (YM)Wires properly protected (Y/N)y FROM WELL LOG Date of test Static water level Well flow Pump levetl , SEPARATION DISTANCES FROM WELL TO: AT INSPECTION Lid / Q 3 MUNICIPALITY OF ANr.HOMAGE G ENVIRONMENTAL SERV ICES DIVISION g.p m 1 4 1993 p.m. S/ RECEIVED Septic/holding tank on lot %05 ; On adjacent lots — R 3. S Absorption field on lot / ;Ll) ; On adjacent lots /010 Public sewer main IY/A Public sewer manhole/cleanout Sewer service line /a Petroleum tank C) WATER SAMPLE RESULTS: Coliform / ) Nitrate y 3�O•th�er bacteria 116 Date of sample: 1114 3 Collected by: o B. SEPTIC/HOLDING TANK DATA Date Installed 4/9-/77 Tank size D Compartments '2' Cleanouts (Y/N) Foundation cleanout (Y/N) Depression (YM) _tj High water alarm (Y/N) N A, Alarm tested (Y/N) wzi t Date of pumping 3 Pumper A SEPARATION DISTANCES FROM SEPTICIHOLDING TANK TO: Well(s) on lot On adjacent lots q 3e .1 Foundation A % J To property line Z— Absorption field 1-5 Water maintservice line ;? /(7 Surface water/drainage NO q E- 72-026 (3193)* F=1 72-0x6(3183)•F=1 CONTINUED ON BACK PAGE C. LIFT STATION 1 X10 0 Data Installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) 'Pump on' level at 'Pump off' Level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date Installed o[/B /7% Soil rating (GPD/Ft2) gr-� System type TA -('C4" Length q q Width 3L, y Gravel thickness Total depth q Total absorption area 3 Cleanout present (Y/N) Depression over field (Y/N) 1-4 Date of adequacy test Results (pass/fail) !—' for '7 Bedrooms Water level in absorption field before test _ �f 4 After test cif Peroxide treatment (past 12 months) (Y/N) N If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ir24 2 On adjacent lots to 3 Property line !D To building foundation (% Z To existing or abandoned system on lot N b N �'- On adjacent lots Cutbank tj d N C_ Water main/service line > S -O Surface water N C vl Driveway, parkingNehicle storage area Curtain drain N /b E. ENGINEER'S CERTIFICATION l certify that I have checked, verified, or conformed to all MOA and HAA guidelines in Signature l- J Engineer's Name I to/ r e Date 11 u' 13 HAA Fee $ /7b v 0 Date of Payment rd -?3 Receipt Number 72-026 (393)• Back e G c' Waiver Fee $ Date of Payment Receipt Number �He6t on the date of this inspection. . « •�[�Ftf MUNICIPALITY OF ANCHORA • Department of Health 6 Human SeGErvices �1 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. # Q/r 2 92 _14- HAA n OAR— 0 it 1 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) <oT 3,4r Ae4C ,44 f/ICER Tz.✓ eSa1 3EG /S Locationladdress ordir¢ctiohs) (b) Property owneriG Telephone: (home) Business „ Mailing Address. • ` (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent 5274 K ms✓ bX/ffir/ Address Telephone 5toX-7453 (e) Mail the HAA to the following address: (or check here3K If hold for pickup.) List contact person and day phone number below: AF -e s .ill— AW u9 . 2. TYPE OF RESIDENCE Single-FamilyX 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 K 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 -MS IS". 7/N) 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 verifythat 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 4645 Telephone y?9-5339 Address Date 9-7-7-if8 �ho�a• 6. DHHS APPROVAL Approved for bedrooms by Date/0-4-98 Approved Q—Disapproved Conditional Terms of Conditional Approval ' CAUTION 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 orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before certificate Is issued. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. 72 -MS (R". 7/88) Ba<k Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) • Hea1tl�Authority Approval (HAA) I9tST - FEBRUARY 1984 0 PN E50 343-4744 \QP1 St, 0"' 4cVZN Legal Description: "r'A% $ ��� �ilri✓ER E��Ra sEP Z? �9�a 7740/ A. WELL DATA Well Classification ^'"` If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y6 Date Completed 1477 Yield /•3S bPH i i - Total Depths—Cased t ��—Depth of Grouting e%/� i / Static Water Level �' G6 Pump Set At � %f Casing Height Above Ground _ f Sanita Seal on Casin ©1 N) Electrical Wiring in Conduit &N) SEPARATION DISTANCES FROM WELL: ry to Depression Around Wellhead (Y& i To Septic/Holding Tank on Lot /0'0 f ; On Adjoining Lots /OV f To Nearest Edge of Absorption Field on Lot /0'o % ; On Adjoining Lots SOV t To Nearest Public Sewer Line 4LA To Nearest Public Sewer Cleanout/Manhole e�� To Nearest Sewer Service Line on Lot zS "'/' Water Sample Collected by i¢EGS /i. *JIF✓ ; Date 9_Z5-80 Water Sample Test Results BIiG Y �— All TX ! j• Comments E' 44, j"W 7£'1T . 9 M, B. SEPTIC/HOLDING TANK DATA Date Installed 8-1-1'77 Size /LS No. of Compartments Standpipes ®'N) Air -tight Capse)N) Depression over Tank (Y,() - Z_ Foundation Cleanout &(N) Date Last Pumped d iifi /JilrkS Pumping/Maintenance Contact on File (Y/N) ��� ; for Holding Tank High -Water Alarm (Y/NTemporary Holding Tank Permit (Y/N) 'd 4 SEPARATION DISTANCES SROM SEPTIC/HOLDING TANK: To Water-Suppl�Well /O f To Building Foundation Z8 To Properly.Line 'f To Disposal Field S To Water Main/Service Line. - To Stream; Pond. Lake or Mal Drainage Course /� f Comments ' ''.,.....• ,�:'' 72-M (R«. vee) Front Page 1 of 2 Z aAf fjrWrA C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 9S Type of System Design T.��W Date Installed X8'%7 Length of Field 07 Width of Field 3 Depth of Field 9 ' Gravel Bed Thickness el Square Feet of Absortion Area 9Z Statndpipes Present ©N) Depression over Field (Y& Date of Last Adequacy Test 8 Z Results of Last Adequacy Test ADEQuAfE SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well oda f To Property Line h%AA/L i To Building Foundation 3o To Existing or Abandoned System on Lot J1A ; On Adjoining Lots /o P t i To Water Main/Service Lin0 f To Cutback (if present) J. To Stream, Pond, Lake, or Major Drainage Course oU .0 To Driveway, Parking Area, or Vehicle Storage Area MWrWA)/ A176f f o✓FR ?emsy?r -)Zr,/e//, Comments D. LIFT STATION Size in Galion "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) 'Pump Off' Level at "Check Permitted Bedroom Rating Against HAA Request' Vent(Y/N) : , �. Pumping Cycles during Adequacy Test. certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed GC�-F • l�i-- � OF A� %/k Company AEGS i�Q�••......a0.0 & 4♦ Date MOA No. d Receipt No. 3 Receipt No. Date of Payment Waiver Fee: $ — a Amount: $ �, -ate Date of Payment — 72-M (Rw.7/88) Back Page 2 of 2 ,w 49T" GV 01*4tr's Seat i oY C REID, JR.- / CE - 2251 ; • g& • Q/S,/ Municipality of Anchorage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 October 4, 1988 Lee Reid, P.E. Alaska Environmental Control Services, Inc. 1412 West 33 Avenue Anchorage, Alaska 99503 Subject: Waiver Request for Lot 3A5 Fischer Subdivision - Waiver Request $WR88-061, #H88-0416 Dear Mr. Reid: Your request for waiver of the required 100 foot separation of a septic system to a private well has been approved. The approved separation distance is 93.5 feet (Lot 3A6 well to Lot 3A5 septic). This waiver approval applies to the existing septic well separation only. Any future upgrade to either require all separation distances be met or another from this department. Sincerely, Daniel J.�Roth Civil Engineer On-site Services DJR/ljw$6 system to will approval •asALASKA EIIUIf�011 nTAL COIITROL SEI aces, inn. PGt Engineering 5 enuironmental Studies pysEkv Ct DN�\oN SE4 2 �Q Mun is—t Of Anchorage Depa. ment of Health & Human Services 825 L Street Anchorage, AK. 99501 Attn: Dan Roth Re: Lot 3A5, Block 1, Fischer Subdivision Dear Mr. Roth: September 26, 1988 From the Health Authority inspection, we find the separation distance from the subject septic tank cleanout to the well on lot 3AG, Block 1 to be 93.5 feet. The sewer systems for lot 3A4, 3A5 and 3A6 were all installed at the same time in August 1977. There are no well logs available for these lots. The subject well has been verified to be 102 feet deep. Records show lot 3A4 well to be more than 255 feet deep. In September 1984, this office performed a well flow test on lot 3AG. Static level was 62.3 feet. Yield was 6.16 GPM for 3 hours. The well drew down below 75 feet, but could not be monitored further due to an obstruction in the well. The well recovered in 30 minutes after water was turned off. Total depth is unknown. The subject septic tank is a steel, 2 compartment, 1250 gallon tank. This tank is downslope from the well on lot 3AG. We request you grant a waiver of 93.5 feet from septic tank to lot 3A6 well. If you have any questions, please call. Sincerely / J Alan C. Wien Engineering Technician .Approved by: ..,�� OF qt' �•�.......•q �� P. *�. T ' ROY C. AVD, Y. ♦r CE -2251 �' ti r *XesI 33rd Auenut. Suite Bo Anchorage. Alaska 99503.(907) 561.5040 /D12�j0ts31 01: 31Y0 AB 03»03140 31Y0 AB 031Y1naiY0 !� /Z'✓ so 'ox 133Ns 1 wX11 �6YlN lIQO 0405.195 U06) £0566 VHSVIV '30VZJOHONV gapris 'anuanV PJE£ ISOM OOZi 'ONI '001A83S 10HIN00 1tl1N3WNOHIAN3 tlNSVIV ALASKA MIROfl nTAL WOOL SCRUIRS, InC. Enginttring G Enuiranmeatal Studies JANUARY 30 1984 ROBIN & NANCY BERNARD SRA BOX 792 ANCHORAGE AK 99516 SELLER — ROBIN & NANCY BERNARD BUYER — SAME SUBDIVISION — FISCHER BLOCK — 1 LOT — 3A5 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 392 SOFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF Wg TER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 1000 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 4 BEDROOM HOUSE. Or At a 2 O D >k LeroyCJ Reid, Jr. No, 1251E 1200 West 33rd Auenue, Suitt B • Anchorage, Alaska 99503 9 (907) 2161361 n n Vezia d OrIM ng & 6dezpzided STAR ROUTE A - BOX 1560 - ANCHORAGE. ALASKA 99507 - (907) 345-4417 1/19/84 5111 Seldon Circle L 3A5 B 1, Fisher Subdivision 1/18/84 Pump test started. Well pumped 5gpm for 15 minutes and dropped to 2}gpm. Well was pumped for 151 hours C 21gpm, holding steady flow at end of test. Total water pumped 2,3621 gallons. Municipality of Anchorage n POUGs 16-650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES. MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION December 15, 1983 Susan J. Hansen Box 57 --- Overton, Nevada 89040 Subject: Lot 3A5, Block 1, Fischer Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: • A well log sub fitted to this Aof/� ice for our files and review. GUso d G� O i • The water facilities were not turned on at the time of the scheduled inspect on. P1 ase all h_s office for /t�G�� appoactta n o The nk u wit aCpti ed this e�uJ department. ���/�, �p • An adequacy test needs to be performed on the existing 4` leaching area. This test will determine if the system is -adequate according to National Standards. A listing of G private firms performing the test is enclosed. This repo needs Jtpb�esubmitted to his office/.jb�p�rounr r view Please notify this Department for a reinspection when the // noted discrepancies have been corrected. if there are any Al er ue tions, please ca 10124 of is 4472 � Df� incerely, Jim Roberts Associate Environmental Specialist JR12/ej/E1 Enclosure 610 (— 7 J, r o 1 -11 -fl- r ' APPLIC.r"IT FILLS OUT UPPER HAL"'ONLY Property Owngri •Susaq Jr HC(nsQn Phone Mailing Address96�( Date Zip Code _ Buyer / / Address Inspector Zip Code Lending Institution h Inn 141 r r I Phone Address Zip Code Realty Co. d Agent y) r R �. / r„0 u) n ea l bi `7�iQ'iC�e c/ 1- l.� T O Phone/ Address MUNICIPALITY OF ANgiORAG Zip Code Legal Des riptbn � �j/ // / r� J` `/ /1 � -s` �(�� •S/ Street Location �' Type of Residence qX.ngle Family ❑ Multiple Family No. of Bedrooms O Other ( APPROVED BEDROOMS 'CONDITIONS OF APPROVAL Water Supply ❑ Individual ���J S' ATTACH WELL LOG. A well log Is required for all wells drilled alnce June 1975. log It Community n �`��5 For wells drilled prior to that date, give well depth (attach available). Public Utility Sewer Disposal Year Individual Installed: Vindlvldual Public Utility When Connected to Public Utility: O Holding Tank Date Sewer Installed Well To Absorption Area / �� Well Log Received NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 0 Time Time Time Tlme Date OateDai / / Date 1a-1u-li�3 Inspector Inspector I��C/i • tor InsDep(or FI gtes:v MUNICIPALITY OF ANgiORAG lY� TX' -46 7ff,/4J46• CEPT. OF H4l.LTIi & •d ENVIRO,�,1.4=NTAL PROTECTION DEC RECEIVED ( APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVA — 3 /-P DATE B Solis Rating Date Sewer Installed Well To Absorption Area / �� Well Log Received Septic Tank Size 2 S 72 Well to Tank 72O CbT