The URL can be used to link to this page

Home My WebLink AboutLAKE HILL ACRES #1 LT 6Loke Hill Acre Lot 6 #05! -052-06 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP171162 PID Number: 051-052-06 Dwelling: ❑■ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑■ Upgrade Name: Preferred Custom Homes ABSORPTION FIELD ❑■ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 148 E. Foxtail Cir, Wasilla, AK 99654 ❑ Other Phone Number of Bedrooms 8NRating Total depth from original grade 376-9136 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe in a from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Lake Hill Acres #1 6 Fill added above original grade Ft:d__ Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between..trenches From Tank Field Tank Line Ft' _Ft. \ Well 101.2' 80' TANK XSeptic ElS.T.E.P. E] Holding [:]Other Manufacturer Greer Capacity 11000 Gal. Surface Water >100' \ Material Number of compartments Lot Line 9,8' Steel 2 NA Foundation 14.7' LIFT STATION Manufacturer Capacity Gal. Curtain Drain NAV"/ Remarks replacement only. Septic tank Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer Dakota Diggers Drainfield CO/MT Inspector Tyler Perron, AK Rim Engineering BENCH MARK (Assumed elevation) 100 ft Inspection1s' g/14/17 Location and description dates: 2nd 3'd 4th Concrete pad in front of garage. COMMUNITY DEVELOPMENT DEPARTMENT APPROVALr, OF A4 t1+rl -. Conditional Approval: Date ��'�P• '•:yPlot 00 :........... '*4�. Z: ... :.j ...................... Mer L. Shreves .:.s CE 9351 Approved CAri�cX Date Inspection Report_9-1-12.doc �S. 19,8719± -1% 8+ NAT'L 7 GAS O~ BM 100' WELL SWING TIES: A B C D z4 2 00�� ry EGPRP�E O~ BM 100' WELL SWING TIES: A B C D C01 8.3 11.2 CO2 23.0371 CO3 24.1 35.7 STl 16.8 34.0 ST2 22.1 36.6 MT 56.2 46.4 WELL 35.0 52.8 WELL REMOTE \ 1 30' PETER STl \T I ST2 1,000—GAL SEPTIC TA \ / S CO 1 ` PROPpRM SFO 3,B C 700' A �- Y- Ro,ecT��F wF\ �q0 s� p p p ��s \ 10' MIN. 10' MIN. BM. GARAGE APRON, 100' C01 LAPP D VENTS CO2///� CO3 10 1 F.G. T 1 4' PVC TO SEPTIC TANK AT A SLOPE OF 2% Co. w *: wo ��, ;• Ma I L. Shreves •� = �j/cir�'•.•� CE 9351OPROFESSOIN •� �� # 1 11111 " 96.72' SEPTIC TANK ' CO3 (EXISTING IOUBLE—SWEEP LOT 6 I� APPROX. 17,000 s.f. MT (EXISTING) REMOTE METER POLE 4'PVC BETWEEN SEPTIC TANK AND WATERTIGHT COUPLERS CO MIN. SLOPE -2R ON INLET AND OUTLET OF SEPTIC TANK SOIL ABSORPTION SYSTEM (DUSTING) moo- I SEPTIC SYSTEM PROFILE Conventional Single Family Residential SEPTIC TANK REPLACEMENT AS BUILT LEGAL DESCRIPTION LAKE HILL ACRES #1 LOT 6 Scaled as shown W0: 17-00392 ALASKA IUM ENGINEERING. INC. ° olAT 6/30/17 COMPL�TD 9/14/17 MUNICIPALITY OF ANCHORAGE nt On-Site Water&Wastewater Program Sr. ate`; PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax (907)343-7997 r r http://www.muni.orglonsiteAli „w t)cpar tmcnt INCH OR PG¢ On-Site Wastewater Disposal System Permit Permit Number: OSP171162 Effective Date: 6/30/2017 Work Type: SepticTank Upgrade Expiration Date: 6/30/2018 Tax Code Number: 05105206000 Site Legal Address: LAKE HILL ACRES#1 LT 6 G:1561 Site Mailing Address: 24540 GRACE ST, Chugiak Owner: PREFERRED CUSTOM HOMES OF Lot Size in Sq Ft: 17000 Design Engineer: ALASKA RIM ENGINEERING Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Date: ‘AC)//7 Issued By: pi L' e r 4 Date: 06/a 0 1 -7 MUNICIPALITY OF ANCHORAGE Community Development Department O Phone: 907 343-7904 Development Services Division Fax: 907-343-7997 On-Site Water& Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-052-06 Property owner(s) Preferred Custom Homes of AK, Inc. Day phone 355-7760 Mailing address 148 E. Foxtail Cir, Wasilla, AK 99654 Site address 24540 Grace Street, Chugiak Legal description (Sub.d., Block & Lot) Lake Hill Acres #1, L6 Legal description (Township, Range & Section) Lot Size 17,000 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field LJ Initial Single Family (SF) U (w/wo ADU) Septic Tank Upgrade [X] Duplex (D) [—J Holding Tank ] Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. '14 / . (Signature of property owner or authorized agent) Permit/Rush Fees: o�I� ^ Waiver Fees: Date of Payment: 41b-49It7 C.,k3C00CO Date of Payment: Receipt Number: al-23 ,a-c 4- OWN-Receipt Number: Permit No. (?t? i' ` ` D?% Waiver No. Permit App_ - : ALASKA RIM ENGINEERING,INC. 411 ENGINEERS—PLANNERS—SURVEYORS 9131 E.Frontage Road A 1 Palmer,Alaska 99645 Telephone(907) 745-0222 Fax(907) 746-0222 Online at: www.alaskarim.com June 27, 2017 Municipality of Anchorage, D.S.D., On-Site Water and Wastewater Department 4700 Elmore Road Anchorage, AK 99519 Re: Lake Hill Acres#1 Lot 6 Septic Tank Replacement ARE Project No. 1700392 The subject property is served by a private well and a septic system. There was a trailer on the lot that was previously removed from the property. The owners intend to construct a new 3-bedroom single- family dwelling. There is an existing garage building on the lot. Our firm conducted a septic adequacy test on this septic system last year. The septic drainfield does not require replacement; however, the septic tank is inside the 100 ft well setback and will be removed and replaced. This design narrative addresses only the septic tank replacement. The design narrative is summarized as follows: GENERAL SITE PLAN AND SEPARATIONS: All surrounding properties are served by private wells and septic systems. See the attached site plan showing proximity to surrounding properties wells. There are no surface waters within 100' of the proposed replacement septic tank. There are no wells within 100 feet of the proposed replacement septic tank. The MOA Onsite Documentation shows the original septic tank was installed 97 ft from the onsite well. The replacement septic tank will be installed outside the 100 ft well protection radius (see attached, Replacement Septic Tank Design drawing). SEPTIC TANK DESIGN: The proposed septic tank will consist of a 1,000-gallon Anchorage Tank septic tank (see attached, Anchorage Tank septic tank information). A benchmark was established on the concrete apron of the existing garage building, elevation 100 ft. The IE's of the tank inlet and outlet are shown on the drawing. These are established based on the elevation of 92 ft of the bottom of the existing septic tank. The outlet line from the new septic tank will be connected to the existing sewerline to the existing CO. The existing septic tank will be excavated and removed from the site. The proposed septic tank will not adversely affect the surrounding properties. If you have any questions, please contact me at 907-745-0222 or at marysalaskarim.com. Sincerely, ALASKA RIM ENGINEERING, INC. ``��\\\\IIIItI �` OF AL i/ Mary L. Shreves, P.E. :QS,rr�I�� Senior Engineer • *i sTH )\ '* Attachments: "" • Septic Tank Replacement Design drawing • • Surrounding Wells drawing 1.1'„,• . Mar 1 . Shreves • Anchorage Tank septic tanks information sheet II�Q%rT•.•• CE 9351 hig/'i ROFESS\0e//1-7 ;;��`_ / ,%\l'.4 / ,s' \\ --.57C . y / 19.8719± N � (�. Y 8-1,4..43+ NAT'L \ 'V� \ / GAS / \ rCV ,f? j $ '-' ' 0. .41' ") EX1ei1 E'N7' el isiG / 00'0 ' •� k. � GPR �ry �O / REMOTE F�1 " = 30' ti r �� ?j9• q3' POLLSR -1 STALL NEW ____/ ,___ G 1,.•e-GAL SEPTIC TANK Un Imo, \ �• PR�POSED�1' °BOUTS • 100' WELL SETBACK PT1P. BM 100' / 5 co(EXISTING) ❑ REMOVE I ? CO(INSTALL FOR P/P 0' WELL \ PpSEpc EXISTING I DOUBLE CO) �p0 1i pRpBpR�' SEPTIC TANK ' „e, 3' LOT 6 700 \ I APPROX. p 17,000 s.f. \ Rp, .-o, 4-44 q o 4'6g;?O is 00 ONUS /G(ExIS nNG) o�` „,.\, 3\ REMOTE C3 el,1 '20'1, \''• 0 -METER �~ �\ / POLE WELL ❑ Elk_ LOT 7 / P/P w/`\ • _1( 10' MIN 10' MIN. BM. GARAGE APRON. too' rim CLEANOUT [CAPPED VENTS GEDPP (PROPOSED) (COSTING) — r -LEVI L-r J SOIL )F / SEPTIC ABSORPTION C6 23' TANK I.E. SYSTEM fl; ( �) 06.00' (EXISTING) / e PVC AT UNIFORM SLAPS. 92' // MIN. SLOPE-2% (N. PER FT.) MAX. SLOPE-A% (1' PER FT) �. PVC AT UNIFORM SLOPE INSTALL FINAL 10' OF e PNC WATERTIGHT COUPLERS BETWEEN SEPTIC TANK AND CO PRIOR TO SEPTIC TANK AT A SLOPE ON INLET AND OUTLET MW. SLOPE-2)[ Q(' PER FOOT) OF 2% Qi PER FOOT) OF SEPTIC TANK SEPTIC SYSTEM PROFILE vo,"".11I.�; Conventional Single Family Residential �� .<P``�`:�'"" A ' 4gS��i� SEPTIC TANK REPLACEMENT DESIGN „.../g TH %� *�% RIPTIDN LAKE HILL ACRES #1 LOT 6 i P..). . It---?? .0 . Mary IU Shreves : �' '/,•13>'••• CE 9351 ''moi .,_ jj fti , „ .•'*G __ ',I'/ii-111r\\\��``7 Scaled as shown ` WO: 17-00392 )1�� l ALASKA RD! EAVINEERtn+c, INL”. n/AGTNF 6/30/17 COM O„TE • N 4/7 / \ / 7 / / \� / G ,;!: '4r \ -0 I 1" = 50' \ IAT 6 %l• / / vii,' ,,,.. \N ‹c-•"6.- .,. // / / ( 7193 / t`) a - NAPE / \ s,?il / , \ / / V (us sk los/ il,... "4'--: .-- '` /IP a'' 4 4 4.f / / :.• iOLF �r • / g}1IC TANG / l" • 100•„11 g1BACK / np rte• �4�' __ I / o PSP NaL \ IATA 17.000 i 1.I 4- / 4,41:0.4,, s `S nr+ci '� Ak• \ / 0 / \ FELL a \ LOT 7 / 17,;„74 ioo 444 444Zl's / 7 , , , \ / / / i . / ��`,,,x illlConventional Single Family Residential _��P,.s' . •••'.14,4,..,11//,,� SURROUNDING WELLS C.•• J� ••• y /*r /\ A :* i oEsauFna, 4:ii, LAKE HILL ACRES #1 LOT 6 • Mary 64 Shreves •• ''/cf>•• CE 9351 ' / lii, 0FESS\0 P�`,� Scaled as shown WO: 17-00392 /� R N 11111\\\�\ANO/a7/1 1 AzAsxa RIM SAVINZIAMV. to ° 6/27/17 C0S tET MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MA~L~G AODRESS LEGAL DESCRIPTION LOCATION DISTANCE TO: ] /~O ! Manufacturer Liq. capacity in gallons ] ·/00 C2 I~- HOMEMADE: DISTANCE TO: We Absorl~tion area ~:~ ! Dwelling ' Materi~ Inside length_~__._~ I Width Dwelling DISTANCE TO: No. of lines . / Length of_each line Top of tile to finish gr~.~ ? Length Width Material Nearest lot line Foundation._~. / ~ O / Total length of lines Trench width Material beneath tile Depth inches PHONE ~NEW 6'2z/._ ?/ ~' ~_ [] UPGRADE NO. OF BEDROOMS PERMIT NO. Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. Distance between lines Total effective absorption area PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area WelJ Building foundation Nearest lot line DISTANCE TO: Distance to lot line PERMIT NO~ .~_e Absorption area(s) Building foundation Sewe / Septic tank DISTANCE TO: ~-o / /~0 OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS DATE LEGAL APPROVED WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological a Geophysical Surveys Drilling Permit No, LOCATION OF WELL (Please complete either la, lb or lc.) A.D.L. No. ~-~.leoroug, Suba,v,,,o. LOt Block I~.1 '/dqtrs. Section No. TownshiPNO Range EO Merldion ~e ~[ ~ ~ ~ ~ -- of-- of--of -- S 0 wO IC.~F~TANCE A~%-~FR~CTION FR6M ROAD mN~RS~CT'ONS ~. ow,[, o~ wE~: Ron Rowl~d ~d~.,,: 620 Jack. S%ree% Street Address o,d Area of Well Location ~chorage, ~aska 99515 2. WEkL LOG Fee~ ~elow 4. WE~L DEPTH: ({inel) 5. DATE OF COMPLETION Sur{ece Material Type Top Bottom 176 ft. 9 - 6 - B~o~ Loam S~d & G~vel 0 1~ e. Oco~m. ,Dom ~,o,or~ ~v.. ~ue R~d & Gravel 15 ~0 OAuger ~deffed OBored ~Other: S~d & Gravel & Bo~ders ~ ~ ~ ,.~.o. ~ .~o,o~e, ~ co.~..,oo, ~o.~der~ 60 80 ~ T.. W~., ~ O,h.~: Bo~ders S~d & Gravel 80 100 e. CAS,Ne= ~ Th~eo~ ~ ~n~ Q~ ~ravel ~n13~m ~00 ~/.~ diam. 6 in. to ~2 ft. Depth Weight ~ lbs./ft. Sand & Gravel " 1~0 1~ diam.~in, to~ff. Depth Stickup~ft. ~ei S~d & Gravel 1~ ~2 9. FINISH OF WELL: Waler Pea & ~?~e! ~ S~8 ~52 17~ ~y,,: ~?~ ~3~ m~t,~: ~" Slot/Mesh Size: Length; Set between fi. and ft. Backfilling Gravel pack ,o. s~*~,c w*~, ~w~= ~52 ". Dote ~ ~ Above or ~ Below land surface Equipment used: ~,~ ~i~ I{. PUMPING LEVEL below land surface and YIELD ..... ~ ~N~O~ ~ ~ft. ~fter ~ hrs. pumping ~ g.p.m. ~[CIP~t ~ ~FPT. O~'~' ~t ~ ft. after ~hrs. pumping ~ g.p.m. ~ 4 ~ ~QZ Motedol: 0 Neat Cemen, 0 Other: ~J [ ~ I~' I3. PUMP: (if available) HP ~ ~ r Ct~l ~ ~ Length of Drop Pipe __ft. capacity I~.,EUARKS: Tight Formation 14 ft. Seapage Aqu~ier, Pea Gravel I~. WATER WEhL CONTRACTOR'S CERTIFICATION: 15, Wefer Tempereture __~ ~ F ~ C Bart Bullock's Well ~lg. Inc. This well wes drilled under my jurisd[cHon end Ibis report is true to the bes~ of my k~owledge e~d belief; $~t mn~.~,~ ~ell ~lg. Inc. ~ R~s~e~us~ness Nome '* '~troct License Number Address: ~ ~ ~nv ~q/qWq L~..411~ /~ /~z e d Repres~hve DEi:'AF;:'t"MEI'..!T OF HEAL.'i'H AND ENVIRONMENTAl_ PROTE:CTION 825 L STF~E:'ET, ANCHOF~AGE, AK 9950:i. 264.-/.I. 720 . PEF?MI T' lq(): DATE ISSUED: 84()796 HAND WR ]; 'I"TEN 09 / 19/84 APPL, I CAN]": ADDRESS: CONTACT PHONE: RON F'.:OWLAND 620 JACK STREIE]" ANCHORAGE, Al< 99515 694-.9192 LEGAL. DESCIRIP~ LOT SIZE: t_OT L. OCAT ION: SLIBD ]: V I !.-.310i'-,!: I_AKEH I t._L AC)RES :I~ 1 SECT~ION: 3 TOWNSHIP: 15N 17000 (SF2.FT,, OR ACRIES) GRACE ROAD L. OT:' 6 BL.OCI<: NA RAIqGIE: IW cert. i {y t. hat: :I.. I am familiar ,/~i'Lh the requir'en'~(.z.~n't:.s fop on-site sewers and we].!s as _ """ .... I ' '~ ' ' F ~,t~,...,, and t. h0:.~ State of Alaska For'th by 'f he M..uq J c.I P ~:,.. ] ~ ¥ c] AI"lchc)rage ¢'¢¢'~' * 2'.. I .(.~:i. I 1 insCa]. 1 the sy~d:.em :Ln ac:c~:~rdal-~Ce ,~w:Lth aI ! MOA (::od(.2s arid r'egulat.:i, orHs~ and in mc:)mpl~ar~c:e wi:Ch t. he design (:r'J. CePia c)f this per'mit., 3, I ~]J.I]. adhere Lc~ all IdOh anti State of Alaska r, equ:LremerrtLt~ fern i:..he ~et ba~k c:tist, an~es fr'c)m any ex2s.t, ing v.~eZZ, ~A, aste~.,,~at, er' d:i. sposa], syst. em c:)r' public: s~Nv~,:.?ra~je syst. e)m mn t. his of" any adjac:eJht cH" r'iear'by ].(:)'~.~ IF: A I_!I'--T S"FA'TION IS INS]'F~I..I....ED IN AN AREA COVE:RED BY MOA BUlL. DING CODES, TFIEiq (1) AN EL~ECTIRICAL PI:T. FRMIT AND ]:NSF'ECTtON MUST BE OBTAIN[I); (2) AS.-BUIL.TS t/~ILI_ NOT BE AI:'F'ROVED WITHOLJT AN ELIECTRICAL INSF'ECTION R1EF'ORT~ AND C3) THE IEI_.IECTF~]:CA!_ WORK t'fiUST BE DONE BY A L. ICENSED EL..ECTRICIAN, S I GNED APF'I_ICANT: RON ROWLAND DATE: ISSUED BY DATE: ~-~,MUNICIPALITY OF ANCHORAGE-~ Departmen' )f Health and Environment. "~Protection ~ Permit ~ Applicant: ~ O ~J 825 L Street, Anchorage, AK. 99501 264-4720 /~, ' * * * q HANDWRITTEN PERMIT * * * ~.DWELL ,AND/~ ON-SITE SEWER PERMIT ~ LA ~ ~ Mailing Address: 62 CP ~..~,~(~-(]gJ~.k~ ~'-~' Location: ~ '~ Phone Number:. Legal Description: ~ ? /,m~ ~_', ~/-~Lot Size: /"7/ Type of Soil ~sorption System Is: Trench; Drainfield: /Seepage Bed: Holding Tank: Maximum N~ber of Bedrooms: ~ '-- Soil Rating(sq.ft/br) /~ DEPTH The Required Size of the Soil Absorption System Is: ~ LENGTH ,~3 . GRAVEL DEPTH '~' WIDTH The length dimension is the length(in 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 ~xcavation(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). REQUIRED SEPTIC(HOLDING) TANK SIZE : /~)O<C~ GALLONS * * * Permit applicant 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° ~ * * * TWO(2) INSPECTIONS ARE~.REQUIRED Backfilling of any system without final inspection and approval by this departmen will be subject to prosecution. ' ' Minimum distance between a well and any on-site sewage disposal system is 100 fee for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other-requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 * * 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 codes. (3) I understand that the on-site sewer system may require enlargement if to include more that 3~bedrooms. Tssued by: ~_~~ ~~--~ Date: the residence is remox~eled S igne~: ~~~~ Applicant SWP/024(i/81) PERFORMED FOR: LEGAL DESCRIPTION: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST 1 2 3 4 5 7 8 9 10 11 12 13 14 15 16 17, 18- 20- 2225-E 1971 SLOPE · I I I IIII ,, SITE PLAN ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop / u,' .~ f~ ~.,,~,/ PER-GO L-A"T"f~f~ R AT E (minutes/inch) TEST RUN BETWEEN FT AND PERFORMED BY: ~~ CERTIFIED BY: ~ ~ MUNICIPALITY 7 1 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. 051-052-06 Expiration Date: 2 1. GENERAL INFORMATION Complete legal description LAKE HILL ACRES #1 LOT 6 Location (site address) 24546 GRACE STREET, CHUGIAK, AK 99567 Current property owner(s) AMANDA & ALEXANDER WOODELL Day phone Mailing address Real estate agent 24546 GRACE STREET, CHUGIAK, AK 99567 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE 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: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ -6-�d Waiver Fee $ Date of Payment 5--6o— 2.621 Date of Payment Receipt Number Receipt Number COSA # SSG 22 >' 7 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed heretoandas of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 5/5/2022 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 The and maintenance. operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or ,r • g�Q: • • • • • �9 �� . discrepancies exist can be given by First Water Consulting & *: � TH •.* F wrs 6. DSD SIGNATURE Curtis Huffman ��<`c�s•,_ XSystem #1 Approved for bedrooms CE 128991 •. ��' �l>,FoPROFES System #2 Approved for bedrooms S NP\� � Disapproved plConditional approval for bedrooms, with the following stipulations: L nn "Jv - b� o6l I ,YGIr$.� c2 C4 e•R./,�tj,:0,P lo jZ ON-SITE WATER AND J ,L PROGRAM —z O 1 By: '�-• �✓ Original Certificate Date: 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: LAKE HILL ACRES #1 LOT 6 - Parcel ID: 051-052-06 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 9/6/1984 Total depth 176 ft Cased to 172 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 5/3/2022 Static water level at beginning of test 163 ft. Comments B. TANK DATA Age of tank(s) 5 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 50" ® Standpipes/foundation cleanout per record drawing Date of pumping 5/2/22 D. ABSORPTION FIELD DATA Which system tested (date installed) 9/13/1984 ® ALL standpipes present per record drawing Total measured depth from grade 7_7 ft (max) Measured depth to pipe invert from grade 6.3 ft (min) ❑ N/A — pressurized field Well production at time of test 5+ gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 0.89 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by NES Date of Sample 5/6/22 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material ••uu-I Adequacy test date 5/3/22 Results M Pass For 3 bedrooms Fluid depth prior to test 18 in Water added 520 gal New depth 24 in (NO BACKING INTO ST WAS VIS.) ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time 18 min depth into effective IR 3' ED SHOTS = 2'ED APPROX. ® Code -required soil cover over field Final fluid depth 1330 in ❑ System presoaked Absorption rate 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: MT / CO AT GRADE. APPEARS FIELD IS OPERATING IN THE TOP 0.5' ED OF THE MOA IR 3'ED. E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) ® Yes Septic Tank/Lift Station on Lot > 100' ft Surface Water > 100' ® Yes if No _ Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No _ Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No _ Water Main > 10' . Yes. if No ft Community Wells> 200' QI Yes if No _ 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 _ 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 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. TM r Curtis Huffman �� F� •. CE 128991 Ri?FESSONA�� ft ft ft ft ft ft ft ft 6 '78910 CD \A . 77, t 10 e..e.n..:''. 2 r3' Mu 1 icipality of Anchorage = On Site Water and Wastewater Program ��•;=:•R (907) 343-7904 4. ti c Cu zi Certificate of On-Site Systems Approval of 6 8 L g' Parcel I.D. 051-052-06 Expiration Date: I O' I Z•- '- I U 1. GENERAL INFORMATION Complete legal description Lake Hill Acres #1 L6 Location (site address) 24540 Grace St. Chugiak, AK 99567 Current Property owner(s) Preferred Custom Homes of AK, Inc. Day phone 907-376-9136 Mailing address 148 E. Foxtail Cir. Wasilla, AK 99654 Real Estate Agent N/A Day phone 2. TYPE OF DWELLING: E Single Family (w/wo ADU) Duplex n Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: ' ,u,-dAZe �-> 2,-c► ,,-,5,-e Date: 7//.3// Sr COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 5 2 Waiver Fee $ Date of Payment 1017141 t Date of Payment Receipt Number It 2.2 (01,036 Receipt Number COSA# n b( igi6,0 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 Alaska Rim Engineering, Inc. Phone 907-745-0222 Address 9131 E. Frontage Rd. Palmer, AK 99645 Engineer's Printed Name Norman K. Gutcher Date 6/26/2018 OF ` ee •® =49TH 6. DSD SIGNATURE el • •0"••••O°°0•° °• 2(, System#1 Approved for (3 bedrooms ® '°' � / tP cc, Normal uZcher System #2 Approved for bedrooms ¢4 -,:sem; ° CE-4919 ° j Disapproved 4 e�pROFESS\°Ns5' Conditional approval for bedrooms, with the following stipulations: v OF HlYi,jy` . ON-SVt Np � WA1ER zRJ.oT W PSCC RpROG tl,: „n- r .,. r (Z7cCaq Original Certificate Date: 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 Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet j '.< 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: Lake Hills Acres #1 L6 Parcel ID:051-052-06 A. WELL DATA Well type Private If A, B, or C provide PWSID# NA Well Log (YIN) Y Date completed 916184 Sanitary seal (YIN) Y Wires properly protected (Y/N) Y Total depth 176 ft. Cased to 172 ft. Casing height(above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 9/6/84 6/13/2018 Static water level 152 ft163.6 ft. Well production 14 g.p.m. 5.5 g.p.m. WATER SAMPLE RESULTS: Coliform A colonies/100 mL Nitrate 0.466 mg/L Arsenic MRL ug/L Date of sample: 6/14/18 Collected by: Brandon Jones B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/ Steel Greer Date installed 9/14/2017 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N Date of pumping NEW Pumper C. ABSORPTION FIELD DATA Date installed 9/13/84 Soil rating (g.p.d./ft2 or ft2/bdrm) 150 System type 5' wide Length 53 ft. Width 5 ft. Gravel below pipe 3 ft. Total depth 7.3 ft. Eff. absorption area 456 ft2 Monitoring tube Y Depression over field N Date of adequacy test 6/13/2018 Results(Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 14 in. Water added 636 gal. New depth 16 in. Elapsed Time: 102 min. Final fluid depth 14 in. Absorption rate >= 636 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 (Y/N) "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 1001+ On adjacent lots 100 + Absorption field on lot 100 + On adjacent lots 100'+ Public sewer main NA Public sewer manhole/cleanout NA Sewer/septic service line 25'+ Holding tank NA Animal containment areas 501+ Manure/animal excrete storage areas 100 + SEPTIC/HOLDING TANK ON LOT TO: 1+ + 5'+ Building foundation Property line Absorption field Water main NA Water service line 101+ Surface water 100'+ Wells on adjacent lots 1001+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 101+ Water main NA Water Service line 101+ Surface water 1001+ Driveway, parking/vehicle storage 101+ Curtain drain None Known Wells on adjacent lots 1001+ F. COMMENTS 2000 Gallon Pre-Soak was performed. G. ENGINEER'S CERTIFICATION ��r OF A� ��A •c RaOCy I certify that / have determined through field inspections and ��' x,"°• °�,'w � review of Municipal records that the above systems are in a'' `* . �� conformance with MOA COSA guidelines in effect on this date. 4 rr••;y ?3 ,,-; ^V.w p,°r7,.. ....o.2on C.1.ao- sa•a:.•.) a J Engineers Printed Name Norman K. Gutcher c�P i/ ryc,�� a¢ 6/26/20181 Skoc3.cr, r..Gira"_:.1er 4..; Date -,‘?4.;:: '%.='= _ �'r jX.\%(:+/);,w i... •—•.-:';`:..,: .'Y"P COSA canary sheet_2-6-15.doc UTILITY ,., ,111°kid" k PEDESTAL MILLER RD. 12. N31'22 30"E 100.00'(R&C) u o 0 — ;i POWER N POLE (TYP.) 23'± _ „ 32.2' re) o WELL 4 GARAGE `'' 0 NAT. I 32.2' GAS �'''—U.G. T GRAVEL DRIVEWAY (A ca _ o- cs) .y. (t1 to 0DECK (17P.)o ».s' b 0.�w oa CANT— 2o.0. 2.0'.s' _ 21'f _ o o V3 -t -n c o owl, O? O cv ^J(s LU W03 ul U` 21't O� _0, ' 2.0' Wcc; ro cv w. ii bro 129' 1g.3' NAT. co GAS (n I•< ri 00 U.G. T&E .--i „ c_ C\2 N-1 0N J, `� LOT 6 4" PLASTIC OH O H0 „ PIPE (TYP.) I i 1-1 - OFF LOT FENCE w ANCHOR . 531'22'30"W 100.00'(R&C) 25' Q U I RECOVERED 5/8" 4. METER POLE ) ----LIGHT POLE REBAR (TYP.) LEGEND: o (C)=CALCULATED DATA to (M)=MEASURED DATA (R)=RECORD DATA PER PLAT ohu=OVERHEAD UTILITIES — — — — U.G.=UNDER GROUND T&E=TELECOM MUNICATION & OLD GLENN IIWY. ELECTRIC NAT.=NATURAL (TYP.)=TYPICAL NOTES: 1. EXCEPTING FOR GROSS NEGLIGENCE, THE LIABILITY FOR THIS SURVEY SHALL NOT EXCEED THE COST OF PREPARING THIS SURVEY. 2. THIS SURVEY REPRESENTS VISIBLE IMPROVEMENTS & CONDITIONS ON THE DATE OF SURVEY. 3. THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEY & IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. 4. THIS SURVEY PERFORMED FOR PREFERRED CUSTOM HOMES, IT SHOULD ONLY BE USED FOR A SINGLE PROPERTY TRANSACTION. REUSE OF THIS DRAWING FOR ANY PURPOSE NOT STATED ABOVE WITHOUT THE EXPRESS WRITTEN CONSENT OF ALASKA RIM ENGINEERING, INC. IS A VIOLATION OF FEDERAL COPYRIGHT LAW. EXCLUSION NOTE: IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. SURVEYED BY: FARMER SURVEYING LLC. MAILING ADDRESS: 6183 N. STEEN RD. WASILLA, ALASKA 99654. OFFICE: 9131 E. FRONTAGE RD. SUITE #20, PALMER, ALASKA 99645. PHONE: (907) 355-0620 EMAIL BCFARMER®MTAONLINE.NET 18-33FSLLC UNDER CONTRACT TO: ALASKA RIM ENGINEERING INC. ,`„"„11 KA ALASKA RIM ENGINEERING, INC. ` s� OF sel�� AS—BUILT 9131 E. FRONTAGE RD. � ' k'.•.. F;.... ........ •••°•A•"r4- I,'g i Wesel P. PH: (907)745-0222 ER, L: SKA FAX:99645 (907)746-0222 S' •.9 EMAIL: akrim®alaskarim.com : WEB: www.alaskarim.com 5*149TH I\ •,, i , 1;1' • WO: 1700392 .. ... ....°°°°°°.....o..°� FB: 18-02 ;J- �� _ Z PAGE: 1 of 1 i'O • e 4 ... Engineers: Planners: Surveyors SCALE: 1 " = 30' FILE: 1700392AS v� .Robert J. Farmer ,o '-';';'• _ I HEREBY CERTIFY THAT A MORTGAGE INSPECTION WAS PERFORMED 10615—S °;° _� c. UNDER MY I�I�•pROFESsiaw.*,_0\ �``` LAKE HILL ACRES TISUBDIVISION ON ON THE F#1, LOT N6, PLAT G RNo.D64R 90ERTY: 1��° tSSI $ ,7 ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA. �2o1a SURVEYED ON THE 27th OF FEBRUARY, 2018. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water ~nd Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 wWW.ci.anchorage.ak, us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING o GENERAL INFORMATION complete legal description t_oqation (site address or directions) Current Property owner(s) ,~aiiing address Lending agency Mailing address HAA* Expiration Date: Day phone Re~t Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: TYI~E OF WATER SUPPLY: Individual Well individual Water Storage Community Class ~ PUblic Water System Welt [] Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil enginee~ 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. CeKificates of Health Authority Approval are valid for 90 days from the date of issue for prope~ies served by a private or C~ass C well and may be ~eissued with new water samp!e results. (Certificates may be reissued for s 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. STATEMENT OF INSPECTION BY ENGINEER ~ As certified by my seal affixed hereto and as of the validation dateI shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the ch- site water supply and/or wastewater disposal system is(aro) safe, ifunctional and adequate for the number of bedrooms and type of structure indicated herein. I further verify thatl based on the information obtained from the Municipality of Anchorage files and from my investigation and iaspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and Slate codes, ordinances, and regulations in effect at the time Name of Firm /~,, Engineer's Printed Name DSD SIGNATURE /~ Approved for 3 Disapproved. Conditional approval for Phone bedrooms. bedrooms, with [he following stiouiations: Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Ftow Advisory By: .... ~ ¢ ~ Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date://'~.~/~,~ (Rev. 01/o2) Legal De~sCfip~ion,: A. 'WELL DA.T~,'" HEALTH:i:AUTFiO RI~':AP..PROVAI~ CHECKLIST' .~:::.~?, .... L..;.,..:.~.. ~..~.: ~. ::' .7';.!.~..: ,......:....'.:.:' ...'.'.i'".' " .... .. 'I[A~. B ~'.o~ Gi,'p~ovide"PWSiD,~t -- Welt Log O'/N): ....... · :.'?.;'.".'i~i~..'.''. .... .' .'.=. :.' .' ...:..i:,"...:;'.. wires, pr~...e..r~y :' pfote~t,e~:i~!N.)' CaSing be~b~(:above.ground:). ']:~ '. in. AT INS'R. EGTION. 4'h,+-/:~'~. , .g!:p.m. F0dndatier~ .'( ove'~ :tank. ~/N)' .../~'o. ·. 'C Otl~..,e.r:bacted~'~ cb!or~ieSL~100 mi. - Cleanouts'(¥1N) ~.~'$'., High water alaCm. (Y/N). '4/:~ Date o~:ad¢~ua.qy:tes, i,'t~[:t~..~>z.-. :., ;.:i"' R~l't~:'(,-.Pass/F~il)::.'-'¢~' For ,~:': :bedroems Fluid:depth in..absoCpii~..fi~t~'befamtest:.-/~i':': :in.';.{.i ' , ' water.add;ed~;4~!.ga!. New.deptfi'z~ '.in. ElapSed.~Time:" .O~..'' .'min.: F.[na'l'fluid. depth....'~'~'i' in. '.Absorption. rate '>'= -'~':~ g:p:d. Any rejuvena[iOn:,treatmen't (pa~(':ii2'mo.)?(YIN 8; type) 'if yes..a ve date Date installed Size in gallons, " MarJhole/Access (Y/N) "Pump on" level at in. "Pump. o~':.level at..? in." .: High Water:.alarm leve at Datum Cycles tested Meets .alarm & circuit requirements? SEPARATION DISTANCES SEPARATION DISTANCES FROM 'WELL ON LOT .TO: Septic tank/lift.station' on 10t 0[~'~ · On adj'~Ceflt On adjacent lots Absorption field on lot ,~<:~ ' Public-sew&r.main. .fi~. w- Public'sewer marihote/cleanout Sewef/~ptic s'ervi(~e line '~-~ ~ -"Holding tank SEPARATi'~N'"DISTANCES'FRO'M 'SEPTICTHOLDING TANK':0N.:'L~3T TO: Building foundation II:'f~ Property line ['~-{' Absorption' field Water main ~N.[. "" t-'~"."Water service line.',~ ~ ..... Surfa";e.'~ater Wells on adjacent lots ;~. toc, '- SEPARATION DISTANCE FR'OM:AB~RPTION FIELD ON LOT TO:" -' · - · Building foundation Surface water We s on.adlace6~ ~.~'. Properly line Water Service ne" COMMENTS ENGINEER'S cERTIFICATION` I certify tha~':/, have determined through'fie/d inspections 'and' review of Municipa/.records that, the above, s,Y~ernS' are4n,, ' conforma~iee with 'MOA"HAA'~/~iagi~e~ in'e~f~"~h'thT§'~g~b".. - Eng,neeCs Printed Nsme ~.', ~:: ~ Date' of Payment Receipt Number (Rev. 12/01 ) Water main D~iveway, par~ihg/vehicle'storag&' '" '"~"~ Receipt Nember liat-Su Test Lab of Alaska Mile 3.2 Palmer-Wasilla Hwy. Midtown Community Business Park P.O. Box 2749 Palmer, Alaska 99646 Phone: 745-3005 Fax: 746-3010 Membrane Filter Analysis Coliform Bacteria Client: Alaska Rim Engineering, Inc. Address: P.O. Box 2749 Palmer, Ak: 99645 PhOne #: Fax #: PWSlD#(if applicable): This Section to be Comoleted by Saml~ler Legal Description of Property: Lake Hills Acres #t Lot 6 Sample Site Location:Kitchen Sink Delivered to Lab By:C. Leet (I.E.: kitchen sink, bathroom sink~ outside hose bib) Time Sampled: 1700 Date Sampled: 1/19/03 Sampled by:C. Leet Sample Type: Routine:r-~ Treated:[-'] Untreated:r-] Repeat Sample #: Analysis Results: [] Satisfactory []* unsatisfactory This Section to Be Com~31eted bv Lab r-i, Sample Rejected: [] Over 48 Hours in Transit [] Confluent Growth [] TNTC: Colonies too numerous to count, *RECOMEND RESAMPLE WIITHIN 24 HOURS Final Membrane Filter Results: 4! Total Coliform Colonies/100 mi ~1 Other Bacteria {Maximum = te0Co~n~s/lO0 mi) 4 t Fecal Coloniestl00 mi Date Analysis Completed: !/A ~/~, Reported By: (~/ Microbiology Laboratory Record,Coliform Analysis Date Received: ~Time Received: ~J3~ Lab Number: ~o~ ~f~J Date Test Started: ~/~ Time Test Started: /,~ Test Results Test Method Direct Count: /~ Membrane Filter Color: Sheen: Tube #: Presumptive (LTB) 24 Hr. 48 Hr. 24 Hr. Confirmatory (BGB) 48 Hr. Tube #: Fecal (EC) 24 Hr. Colonies/100ml Red: Pink: Received by: Analyst: ~.~ ~' Date/Time/Analyst U ? D / P, EBA 7975 GA $ / CO,'VC. TEL E. REMOTE POLE SEP TIC LOT 6 DECK ~,/ APPROX. SfAIR5 TRAILER 17.000 TYP. ~ AOO-ON$ N~ T'L On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 ww~v.ci.anchorage.ak.us (907) 343-7904 Waiver Review Worksheet WR#: WR030002 PID~: 051-052-06 HNk HA030020 Date Received: 1113103 Legal Description: Lake Hill Acres #1 Lot6 Engineer Charles Leet. PE Alaska Rim Enaineerinq Applicant: Linda Manle¥ Permit: Waiver Requested: 97' from well to septic tank Criteria: GeOlogy A. Water Table B; Soil Sorption C. Permeabili~ D. Water TableGradient E. Horizontal Separation Total: Points: Waiver is not OMn~ List Conditions or Reasons ~rabove: ~'L~' ~'-~-v/-//~"~~) Name of Reviewer Rec#: 030033 Amount: $800.00 DatePaid: 01/13/03 George P. lVuerch, Mayor Municipality of Anchorage Building SafeD Division Anchorage Ali-America City 2002 1/23/2003 Charles A. Leet, PE Alaska Rim Engineering, Inc. P.O. Box 2749 Palmer, Alaska 99645 Subject: Waiver Request for Lake Hill Acres #1 Lot 6 Wajiver Request #WR030002 Parcel ID #051-052-06 Health Authority Approval Number HA030020 Dear Mr. Leet: Your request for a waiver of the required 100 feet horizontal separation from the septic tank to private well has been approved. The approved separation distance is 95.0 feet. This waiver approval applies to the existing septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Daniel J. Roth Civil Engineer' On-Site Water & Wastewater Program P.O. Box 196650 · )mchoragc, Alaska 99519-6650 ·Tclcphon¢: (907) $43-8501 · Fax: (907) 848-8200 4700 South Bragaw Strcct ~ Aztchoragc, Alaska 99507 It ttp://wxxav.ci.anchorag¢, ak.us -WELL '~=.ZS"I- 7.~ 6. R.O. 7.3 · ,',", orlo~/ 2.¢ 2.0 (~£L USI ol~ Phone (907) 745-0222 Fax (907) 746-0222 akrim @ rogershsa.com lanuary 3, 2003 P.O. Box 2749 Palmer, Alaska 99645 Dan Roth, P.E. Municipality of Anchorage Development Service Department P.O. Box 196650 Anchorage, AK 99519 RE: Lot 6, Lake Hill Acres, Addition # 1 Subject: Waiver Request Dear Mr. Roth: In December of 2002 our firm prepared an as-built survey of the referenced lot. Based on the enclosed as built, the septic tank and onsite well separation distance appears to be 97'. In December of 2002 our firm performed an adequacy test and the system seems to function correctly for a three- bedroom dwelling. The system was installed in 1984 and was approved by the Municipality at that time. In addition, the septic tank does not appear to be leaking. The well log for the onsite well indicates a cased well to a depth of 172', with a 152'static water level. On 12/16/02 the static water level was measured 162'. The well produced a steady 5.2 gpm with very little draw down. Well logs from neighboring lots were not available on-line and most likely no documentation exists. On Lot 7, another engineering firm measured the static water level to be 152' in 1987, which is consistent with static water level on the Lot 6. In 1987 the neighboring Lot 7 received a separation distance waiver for their onsite well and septic system for 70'. The surface topography slopes away from the well to the east and northeast such that any seepage would be directed away from the well. The subsurface soil were rated as SP type with an application rate of 150 sq.fk/br. The well is located opposite of the house from the septic tank. Water samples were collected on 12/16/02 and 1/2/03 and tested by others for total coliform bacteria and nitrates and found to be satisfactory. Enclosed is a copy of the test results. The lesser separation distance between the septic tank and onsite well doesn't appear to having an adverse effect on the water system. If you have any questions or wish to discuss this matter further, please contact me. Sincerely, A~k, ~ a .Rim Engineering, In~. Professional Engineer Encl: Review Fee HI-IA Check List & Certificate As-built Water Test Results cc: AK Rim File #02-1126 Engineers · Planners · Surveyors WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological ~ Geophysical Surveys LOCATION OF WELL (Please complete either lu~ ib or lc.) so.O.oh Lo, I.D. ~ch ~ ~es 6 B~n Lo~m S~md & Gravel 2.nd & Gravel Sand & Gravel & Bo~ders ~m,~ ~ers ... Boulde~ S~d &/~ravel ~ ~d Gravel ~8 $ Gravel - Wet S~d'& Gravel Water Pea & ~mv~ & S~d Feet Below Surface Top Bottom o ~5 15 40 80 100 100 1%0 140 160 1~') 162 162 1'76 Drilling Permit No. A.D.L. NO. Section N~.1 Township N[~ Range. Er-] Meridian sE] wE] ~. OWNER OF WELL: Ran Rowland A~r.l,: 620 Ja~.. St~et . ~o~ge, ~as~ 99515 ~ Irrigation ~ Tell Well ~ Other: ~. CASING: ~ Threaded ~,.. 6 ~.. ~ 172 ..o.,,h w.nvh~ 1~ ,b../.. Typo: ~p~n T"tO'7 ~' Diameter: STATIC WATER LEVEL= 152 f,. [~ Above or ~ ~low land ,urface Equipment used: ~nt~ ~t~ PUMPING LEVEL below land surface and YIELD fi. offer 3 hrs. pumping 1.~ g.p.m. ff. after . hrs. pamping g,p.m. IE.GROUTINO Well Srouled: [::] Yes Material: ~ Neat Cement ~ Other: 15. PUMP: (if available) ,...E~A..a: Tigh% Faction 14 ft. Seepage Aqu~ier, Pea Gravel 16. WATER WELL CONTRACTOR'S CERTIFICATION.* Bart Bullock's Well ~lg.. Inc. Addr..:. ~.~,Box ~87427~I Waoilla LEGAl. PERMIT NUMBER- From From From " EAGLE RivER ENGINEERING SERVICES I..u E=~e~a, PJg. P.O. Bo~ 773294 Eagle River, Alaska 99577 Te]ephono [007) ~04-~19~ June 4, 1987 Mr. Steve Morris Civil Engineer, On-site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 I%Y O~ ANcHO~AG~ JUN 9 1987 REF: Lake Hill Acres #2, Lot 7 Dear Mr. Morris: Attached, please find information 'necessary for your determination of a waiver of seperation distance, private well to septic leachfield to 80,' and well to septic tank 70'. The septic system, absorption rate has been tested and found adequate for 2 bedroom use. The leachfield was installed in 1970 and was inspected and approved by the Municipality at that time, as per the inspection report enclosed. The existing septic tank is located 48' from the well and will be replaced by a new tank at 70' distance from the well. Our field measurements confirm the leach pit edge to be at 80' from the well. There is no well log for the on-si~e well, but our testing has indicated a cased well to a depth of +218', with a 152' static ~ater level. It appears that water enters at the 218' level. The well produces a steady 4.5 GPM when drawn down to 218' The enclosed well logs show that the neighboring wells draw from sand & gravel confined aquifers at a depth of 162'-189' The local well logs have a similar static water level and are overlain by clay and hardpan soil layers. The surface topography is such that any seepage would be directed away from the well loc~tion on m 10% slope to the south east. The subsurface soil is a GM type with a perc. rating of approximately 150. A water sample for coliform bacteria and nitrate content was satisfactory. The well is located opposite of the house from the septic leachfield and tank locations. The tank separation distance requested should not endanger the aquifer, as the new tank will be sealed on all connections and manholes. Z¥~l. J.I I.~t'~i'X [~'I[1C]['""~.~Z~,4'~ ~' ~ P.( ...3X 1~650 , ANCHORAGE, A~SKA 9951~6650 O~ (907) 2~4111 A chorage MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES June 10, 1987 Lou Butera, P.E. Eagle River Engineering Services P.O. Box 773294 Eagle River, Alaska 99577 subject: Lot 7 Lake Hill Acres Subdivision Waiver Request WR87-034 Dear Mr. Butera: Your request for a waiver of the 100 foot separation required between the septic system and well on the subject property has been granted. The required setback to the well has been waived to 80 feet for the existing seepage pit and to 70 feet for a replacement septic tank. These setback waivers are based on an evaluation of hydrogeological conditions that indicate that there is little potential for well contamination in this case. These waivers are valid for the existing seepage pit only. Should the exiSting pit require upgrade, applicable setback requirements must be met. The new septic tank must be installed with watertight couplings and manhole covers. This waiver is valid for a two bedroom single family dwelling only. Sincerely, stephen S. Morris Civil Engineer On-site Services cc Gus Andress, P.E. Manager, On-site and Water Quality Programs MUNICIPALITY OF ANCHORAGE 825 L. Street, Anchorcge, Alike 99501 264-4720 SmLS L~.- PERCOLATiON,TEST 14- 15- 16- 17- 18- 19- 20- COMMENTS PERFORMED BY: SLOPE SITE PLAN WAS GROUND WATER ~ O S ENCOUNTERED? L E IF yES, AT WHAT · . ~EPTH? Reading Date Gross Net Time Time ,.. ~. o)~uo~.,,-- .~c~'~, PERCOLATION RATE (minutes/inch) BETWEEN FT AND '~" FT TEST RUN Z~ Depth to Net Water Drop Performed For GRE~'R ANCHORAGE AREA BOROUGtt DEPAR'~ ~NT OF ENVtRONM~r~i,~L QUAL.?- 3500 TUDOR ROAD ANCHORAGE, ALASKA- 99502' -' · Robert Bra~-elI Legal Description: Lot23 Block ....... Subdivision This Form Reports Soils--['6-g CASE #____.__ Date' 'Performed 9/21/71 Tatro Percolation Test Depth Feet :/?: '. ~-2" · .' L~.'t'¢ ' Soil Characteristics Brown clavev silt (CL) 'Gray silty sand w/ fine gravel (sM) Gray sand (S?) with silty sand seams and.containing scattered'gravel W~s Ground Water Encountered?_a~___- If Yes, At What Depth? 1% i t i Reading Date Gross Time Net Time Depth to H20 Net Drop t Percolation Rate Minute Proposed Installation: Seepage Pit x Drain Field Depth Df Inlet Depth To Bottom Of Pit Or Trench ..... COMMENTS: 20~ square fee~ of drainage area is required per bedroom. Test Performed By R. E. Carlisle Data Certified By ~ationai '£eat~ng ~ervices Inc. , MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH · DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE f~,' ,4_ i. Oenerai Information Application Date { ..'::-?f (a) Legal DescriptiQn (inclnd~ lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicants Name~ ~ ,,~ le,t, iTelephohe - Home ,us,ness Applicants Address._ ~',(~. ,, i..:~,~~'_J.,~ L~. i:..-- (c)Applicant is (check one) Lending Institution ~-~; Owner/builder ~--~; Buyer ~'; Other ~ (explain); (d) Lending Institution ~fl~!~ f~£~,l~,~ Telephone (e) Real Estate Co. & Agent . /I.~-- [~ ~' ~ n:: / (f) Mail the D to the following address: 2..Type of Residence Single-Family ~ Multi-Family ~-~ Other (describe) Number of Bedrooms __~5 3..W,ater Supply Individual Well ~ Community ~-~ Public ~-~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal O~site ~ ~ublic ~--~ Comm=it.~ F~ Holding Tan~ ~: Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. Engineering Firm Providin~ Inspections~ Tests~ File Search~ Data and Informatid~ As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that, based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. (ENGINEER SEAL) Date DHEP Approval Approved for/~/ bedrooms Approved ~ Disapproved__ Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES ~EALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES kND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER*S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description: Well Classification]. /~ ' c/~'~ Well Log P~esent((Y ~N) ~/ Total Depth / ~ ~3 Card to /?~ Static Water ~1 , J ~ ~ ~t At Casing Height ~ve Ground ~ z Electrical Wiring in ~nduit (Y~) / Sep~ation Distance fr~ ~11: To ~ptic/Holding TaDk on ~t /[3~.~ ~ ~ To ~arest Edge of ~sorption Field on ~t /~ ~ To Nearest Public ~%~r Line ~ OCT 1 19aa Depth of Groutinq Sanitary Sea]. on Casing Depressicn Around Wellhead (Y/N) ; On Adjoining Lots O ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole /~/~/~. To Wearest Sewer Service Line on Lot Water Sample Collected'By fi',l,~/; ~'%~ ~ i.~A ; Date /~ /~ ~ /~ i¢ Water Sample Test Results ....... 7~l~/q '~ ~/~ ~ . ~ . S~L::~'ZC/HOLD~G TANK ~te Install~.~ ? /~ % Size /3 /~'~ ~O. of C~sr~nts Stan~i~s~) ~ / Ai~-tight Caps (Y~' / Foundation CleaQout (Y~) ~pression ~9e~ Ta~ (Y~) ~ Date Last P~d P~ing~aintenan~ Con~act on File (Y~) ~; for Holding Tapk High-Water Ala~ (Y~) ~/~ Te~rary Holding Tank Permit Sep~ation Distan~s ~ ~ptic~{olding Tank: To To o,, d tio. Z¢ TO ~o~rty Li~ ~ ~ To Dis~sal Field To ~ter Main/Servi~ Li~ /O~ To S~e~, Pond, ~e, ~ Major ~aina~ Co.nents Receipt= '~ Date Paid: [Page i of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area DeDression over Field (Y/N) Results of Last Adequacy Test Type of System Design Length of Field ~-~ / Depth of Field 9 / Gravel Bed Thickness ~ / Standpipes Present (Y/N) Date of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well /~)4; ! To Property Line / d To Building Foundation *~' ! To Existing or Abandoned System cn Lot A/~-- ; On Adjoining Lots ~ ~ 7~ To Water Main/Service Line /~; ~- To Cutbank(if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area . ~.O f- Con, rents De Date Installed' Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, or confor~d to all MOA HAA Guidelines in effect on the date of this inspection. Date KB1/d5/s [Page 2 of 2] 2-15-84 EXCAVATION ROBERT A. SHAFER WORK August 30, 1983 CIVIL ENGINEER 694-2979 Carol Monroe Dear Carol, Reference: Lot 6; Lake Hill Acres Addition %1 A sewer system adequacy test was performed on the system located.on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was tested by charging the system-Qith approximately 1700 gallons of water and after a period of 24 ho~rs approximately 532 gallons had percolated out of the crib. It can be concluded from this test that the waste water disposal ~¥stem serving the two bedroom residence located on this property · s currently functioning adequately. However, the system cannot b~guarant~ed against subsequent failure. At' the time the adequacy test was performed an inspection of the' well was also made and found to be in accordance with current codes. A water sample was also taken from the hose bib on the side of the house and submitted to Chemical and Geological Laboratories of Alaska. The results, the coliform bacteria analysis indicated the water to be satisfactory. · ~ ~ m~v ~ cf '~..-i~-.~ ......... ~ -~ ~ serviCe, p~ease do not hesitate to contact Sin(~ y, / · SS cc: Municipality of Anchorage D~partment of Health and Environmental Protection