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HomeMy WebLinkAboutJOHNNA'S WOODS LT 1Johnna's Woods Lot 1 #011-161-45 ' Mumc~pahty of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P O Box 196650 · Anchorage, Alaska 99519-6650 · Telephone' 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number ~J,t) ~00-~ PID Number P/} --/~/ -- ~- Name..~H0/A/~..~)/L./i . ~,.~ Wastewater System: ~ew ~ Upgrade Addre,~ 5 / CH/~/~A~/ ~NCH ABSORPTION FIELD . ~ ~pTrench ~ Shallow Trench ~ Bed ~ Mound D Other Lot Block Subd~vm~on ~epth to p~pe boE ~h p~pe ~ Ft Ft Townsh,p I Range IS~t'On F,,I added above or~:a~rade Ft Gravel length ~ Ft Cl~lcatlonH~l ~Pnvate'A'B'C' Total~Depth ,, Cased,o~ ,t ,otalabsorptlon ~;e~ SQ ,, Pipe mater,a,_~ Pump Set at ~ C~mg Height A~ve Ground SEPARATION DISTANCES ~ep*,c a Holding a S T E P Water ~/00 ~ LIFT STATION Remarks BENCH MARK  A~um~ Ele~t~on Inspections pedormed by ~ S Dates 1st ~/~/?~ ""'"*"'~~' - Depa~ment of Heal~ h and F n ~~ices approyal Reviewed and approved by ~,~ ~,~ate O 72-013 (Rev 9/91) MOA 25 Permit No -- Page. 2 of Munrclpollty of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION PO Box 196650 · Anchoroge, Alaska 99519-6650 · Telephone 545-4744 On-S~te Wastewater Dmposal System and/or Well Inspechon Report Legal Description JOHNNA'S WOODS LOT 1 PID No -- 1500 GAL TANK HOUSE W, 86TH AVENUE - 3' ROAD RESERVE EASEMENT WELL / L Fq -H m m SWING TIES A-C = 158 B-C = 454 A-l) = 414 B-D = 22 9 /'~-' UTILITY EASEMENT-- N ELEVATIONS (NOT TO ORIGINAL · - MONITOR TUBE o - SEWER CLEANOUT + - WELL LEACHFIELD EASEMENT SCALE 1'= 50' 7'/2/96 FROM PanaSonic FAX SYSTEM PHONE NO No~, 1J [995 05:50PM P2 STATE OF ALASKA D~;PA'RTMENT OF NATURAL RESOURCI~ DIVISION OF MINII~N~ & wATER MGMT WATE~ WI3.L RECORD 'WELL OWNER: LOCATION~ETCH: ~ ~ wB.L DEPTH: ,~ ,4 ~ DATE OF COMPLETED DEPTHS MF-~-~RED i:ROM~ca~ng t~p [-Ipround surfa Depttt of I~oie: .,~ ~f / ft / / Depth ' Depth of cas]~ I~REHOLE DATA: From To Mater'ml Type and Color -- D~'i'H TO STATIC WATER LEVEL: ME~iIOD O~ ORII~G= USE OF W~I~ ----'--'-- ~ CASING STICK'UP: ' WEL~ INTAKE Qp~I~G SC~ ~PE: ~th: ~ 8~ ~'~""~ V~e ~ ~ De~ to top ~ ~ GRO~ TYPE: Volume' -- -- O~E~PM~ M~ ~MPIHG L~ _ ~ ~ ~~s ~P,~ r ~ ~A~ D~TH: ~ H~: REMARKS. CO~CroR,e~FomvU~TIO~= ~,, ~ R~iS~d Bus~e~ ~ // / ~ ~SE ~IL WHITE ~ OF LOG TO: ~/~ .. DNR~ON OF MIN~G & wAT~ MGMT MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER SW960034 DESIGN ENGINEER EAGLE RIVER ENGINEERING SERVICES OWNER NAME'THOMASSON JAMES P OWNER ADDRESS 2451 CHILLIGAN ANCHORAGE, AK 99517 PARCEL ID 01116145 PAGE 1 OF 1 DATE ISSUED. 3/21/96 EXPIRATION DATE- 3/21/97 LEGAL DESCRIPTION JOHNNA'S WOODS LT LOT SIZE 20388 {SO FT ) NUMBER OF BEDROOMS 5 THIS PERMIT THIS PERMIT IS FOR THE CONSTRUCTION OF DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH- THE ATTACHED APPROVED DESIGN ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15 55 AND 15 65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AA072) AND DRINKING WATER REGULATIONS (iSAAC80) THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343 4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER. A OPENED AMD CLOSED ON THE SAME DAY B COVERED, SEALED AND HEATED TO PREVENT FREEZING THE FOLLOWING SPECIAL PROVISIONS SPECIAL PROVISIONS: ENSURE ADEQUATE RESERVE AREA FOR THE REPLACEMENT SYSTEM, AND SHOW DESIGNATED AREA FOR REPLACEMENT SYSTEM ON ASBUILT RECEIVED BY~'~/~'~' ~/~--~'~ , DATE- , ,'"/" f,/l , Lores Butera, P E Registered C~wl Engineer March 15, 1995 J~m Cross, P E Manager, On-S~te Serwces Mumc~pahty of Anchorage P O Box 196650 Anchorage, AK 99519 Re Johnna's Woods Lot 1 Narratlve & Permit Apphcat~on Dear Mr Cross The proposed sepnc well and septic properties for the following reasons 1 2 3 system will have very hm~ted ~mpact on adjacent The surrounding lots are developed, allowing sufficient room for septic s~tes Immediate ne~ghbonng septic systems are all +30' d~stance Reserve space ~s adequate, due to absorption capacity of the soft and absence of a groundwater table Drmnage will not be affected and ~s not a major consideration ~n our design If you have any questions please call our office at 694-5195 Sincerely, Lores Butera, P E \G \WPDOCS\ 1996\96-010ANAR PO Box 773294 · Eagle River, Alaska 99577 · Telephone {907) 694 5195 · Fax (9071 694 3297 SPECIFICATIONS FOR ON-SITE SYSTEM LEGAL: Lot 1, Johnna's Woods A. GENERAL 1 2 3 4 5 6 7 8 9 10 The well and septic plan are for a single family residence only The drawing and/or site plan shall be a part of this spec~fication All materials and workmanship shall meet the Anchorage Department of Health (MOA- DHHS) reqmrements All soil tests are adwsory to the design and are to verified or modified in the field by the Engineer All excavations and depths are advisory and are to be verified ~n the field by the Contractor to meet MOA-DHHS requirements It is the respons~bdity of the Owner to obtmn all necessary permits or easements and to locate any adjacent multl-famdy wells It ~s the responsibility of the Contractor to secure all utility locates prior to construction The excavation is to be exactly in the area shown on the site plan, any dewatlon requires Engineer approval It is always recommended that a surveyor locate the nearest lot line position and the location of any easements Any remaining open test hole excavations shall be filled LEACHFIELD The leachfield is to follow the natural contour to mamtmn uniform total depth of the trench bottom The bottom of the leachfield shall be level, plus or minus 1 5" The total depth of the leachfield excavation is not to exceed 9' at any point The effluent line within the trench shall be laid level within 0 03' The leach gravel is to be covered w~th typar fabric material Sod or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield The area over the trench is to be fimsh graded to prevent pondlng of surface water runoff The septic tank and leachfield must not be closer than 100' to any emstlng private well, 150' to any Class "C" well, or 200' to any community well RECOMMENDED LEACHFIELD DIMENSIONS TOTAL DEPTH = 9' GRAVEL DEPTH = 6' under pipe, 2" over pipe GRAVEL LENGTH = 52' GRAVEL WIDTH = 3' SOIL RATING = 1 2 gpd/ft2 BEDROOM CAPACITY = 5 SEPTIC TANK SIZE = 1,500 gallons Twenty-four (24) hours notice required for all ~nspectlons \1996\96-010A-SPC 03/13/96 ~ ~ ~PRDP I '~ ~/ELL LOC // I A ~ DRIVE / / ' A , , [500 GAL X ~¢~' / -- TANK X PROP ~ ~ ~ELL X HaUSE +~o, ; .~ / L~T ~ ~ 3XBR' TRENCH ~ ~ / ....... HINSON m ~ HINS~N ~ ~ HINSON LOT 3 ~ L~T 2 E L~T ~ x NO ~ELL ~ ~ F ~ - TEST HOLE · - ~ON~TOR TUBE o - SE~R CLEANOUT NO SURFACE ~ATER ~ - ~ELL - PRQPO~ED LEACHFIELD NO KNOWN CURTAIN DRAINS EASEMENT W E L L / S E P T ~ C S J T E P LA N LEGAL JOHNNA'S WOODS LOT 1 OWNER. HAGMEIER ... EAGLE RIVER, AE 99577 (907) s~-s ~ ~s r~z (907) EAGLE RIVER ENGINEERING SERVICES P O. Box 773294 Eagle R~ver, Alaska 99577 (907) 694-5195 ERE$ Project No 96-010 Calculated By LB Date 3/11/96 Legal JOHNNA'S WOODS LOT 1 Single Family 5 Bedroom Dwelling TEST HOLE Deep Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 750 gallons Percolatmn rate = 1 4 minutes per tach Wastewater appl~cahon rate = 1 2 gallons per day per square foot Reqmred absorption area = 625 square feet Trench width ON) = 3 feet Gravel depth (D) = 6 feet Reqmred length = Reqmred absorpbon area / 2 / D Reqmredlength = 625 / 2 Reqmred length = 52 feet Total Excavahon Depth = 9 0 feet / 6 SINGLE FAMILY ON-SITE WORKSHEET ERES PROJECT NUMBER 96-010 CALCULATED BY LEGAL DESCRIPTION JOHNNA'S WOODS LOT 1 NUMBER Of BEDROOMS WATER USE PER BEDROOM PERCOLATION RATE DEPTH TO GROUNDWATER DEPTH TO IMPERMEABLE LAYER ANTICIPATED DEPTH OF COVER MOUND OR BED SYSTEM WASTEWATER APPLICATION RATE ABSORPTION AREA REQUIREMENT MINIMUM BED LENGTH 12 FEET WIDE BED 15 FEET WIDE BED TRENCH SYSTEM WASTEWATER APPLICATION RATE ABSORPTION AREA REQUIREMENT SHALLOW TRENCH OPTIONS 5 FEET WIDE TRENCH EFFECTIVE DEPTH (FT) 1 2 25 3 35 4 DESIGN SPECIFICS FIELD SYSTEM D GRAVEL DEPTH 6 TRENCH OR BED WIDTH 3 LENGTH 52 TOTAL EXCAVATIO N DEPTH 9 0 FEET LB 5 150 GALLONS 1 4 MINUTES PER INCH 20 FEET 20 FEET USABLE SOIL STRATA 3 FEET TOTAL USABLE DEPTH USABLE SOIL STRATA DEPTH 0 8 GAL/SQ FT 938 SQ FT 78 FEET 63 FEET 14 11 1 2 GAL/SQ FT 625 SQ FT DEEP TRENCH OPTIONS 3 FEET WIDE TRENCH REQUIRED TRENCH EFFECTIVE REQUIRED TRENCH ENGTH (FT) DEPTH (FT) ENGTH (FT) 109 4 78 88 4 5 69 80 5 63 73 5 5 57 67 6 52 63 7 45 8 39 9 35 10 31 11 28 (B=BED, S=SHALLOW TRENCH & D=DEEP TRENCH) FEET FEET FEET OF q i� �aNa SEAt) • �a Munklpallty of Anchorage ..........� .f........ DEPARTMENT OF HEALTH S HUMAN SERVICES ��fi� leul. A. Mora c-- 825 "L" Street. Anchorage. Alaska 99502-0650 I�'ir '.Ct 6736 SOILS LOG - PERCOLATION TEST PERFORMED FOR: ne�..reie/' C. ,77..c T.'•» DATE PERFORMED: LEGAL DESCRIPTION: Tok.".s'L.T / Township. Range. Section: %/ 2 AI 9 Y /O SLOPE SITE PLAN LIQ PEEH IPSO/I 1 3 'Q O SiIT 4- S 5 6 7 4 8 9 4. to - 11 o 11 12- 13- 14 21314 r 15- 16- 17- 19 5 1617 19 20- f� COMMENTS yard W•Th grave-/ cle, 1 loofe'alf' Ty E WAS GROUND WATER . /v l Date Grow rime ENCOUNTERED) Depth to Wath Not Orov S IF YES, AT WHAT OL DEPTH? P E "44 /f:oJ (Ism to War Mn W 7/„ Y /s.'0 Mwwwng7 drti One Rwing Date Grow rime Net Time Depth to Wath Not Orov e/r . "44 /f:oJ W 7/„ Y /s.'0 PERCOLATION RATE 1.0 2 Iminutevman) PERC HOLE DIAMETER TEST RUN BETWEEN KFTANO. Z FT PERFORMED BY:��' CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE 72-Waf ufl51 Municipality at Anchorage DEPARTMENT OF HF-ALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED LEGAL DESCRIPTION DATE PERFORMED -'-~- ~"-~ d Townsh~13 Range Section -7-/2.4/ ~ ~/~" <~. /o 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15- 16- 17- 18 19 2O COMMENTS SLOPE WAS GROUND WATER ENCOUNTEREO~ / S L IF YES, AT WHAT O DEPTH7 P E DepOt to were' Alter Memtermg? o a ~ Oat,* SITE PLAN Gross Net Del3tll to Net Reading Date Time T~me Water Oroo PERCOL.ATION RATE /. ~ (mmutes~,ncn) PERC HOLE DIAMETER O/ '~' TEST RUN BETWEEN 7 5' FT AND /~ ~'- FT FERPORMED BY f/~ ~-~ , ~-~--~;- CERT,~Y THAT T.,S TEST WAS PERFORMED, E A4 • Municipality of Anchorage On -Site Water and Wastewater Program � m (907)343-7904 se e*v i Certificate of On -Site Systems Approval Parcel l.D.011-161-45 Expiration Date:-�� 1. GENERAL INFORMATION Complete legal description Johnna's Woods, Lot 1 Location (site address) 4912 West 86th Avenue Anchorage, AK 99516 Current Property owners) Vernon Campbell Day phone Mailing address 4912 West 86th Avenue Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Five 4. TYPE OF WATER SUPPLY: Individual Well n Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ WalverNariance request Received by.-� COSA to be released TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank ❑ Community ❑ Public Sewer ❑ by the engineer. Date: '5-2 -' COSA Fee $ 5!'6 ' Waiver Fee $ -� Date of Payment 5l>rllS Date of Payment '— Receipt Number. 011aa� Receipt Number COSA # �C�rJ���� Waiver# W5,-/l)V--7L 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that myiinvest applinvestigation, based on procedures outlined in the Certificate of On -Site Systems Approval 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 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for _ bedrooms Date 522-7773 *: 491H P'A o, ; Disapproved '4111 Conditional approval for bedrooms, with the following stipulations: E ANRSON -- m 4381DE By: Original Certificate Date: �� l The Mcunicipa ity A orage 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 At The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Septic System Advisory _ Well Flow Advisory CASA blue sheet_t L= 0 Nitrate Advisory Arsenic Advisory Other_ 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: Johnna's Woods Subdivision, Lot 1 A. WELL DATA Well type Private Date completed 06/96 Total depth 348 ft If A, B, or C provide PWSID # Sanitary seal (YM) Y Cased to 348 ft. Parcel ID: 011-161-45 Well Log (Y/N) Y Wires properly protected (YIN) Y Casing height (above ground) >18 in. FROM WELL LOG AT INSPECTION Date of test 06/96 4/16/15 Static water level 143 ft 115 ft. Well production 30 9.P•m• 6 g.p.m. WATER SAMPLE RESULTS Coliform 0 colonies/100 mL Nitrate ND mg/L Arsenic 55.6 ug/L Date of sample: 4/20/15 Collected by: J. Anderson B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel bate installed_ T k ' 1,500 al Number of Compartments 2 Cleanouts (YIN) T_ 6/24/96 Y size g . — Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N ,S AAGS �i?n Y'tN� S\ Date of pumping ~3-s-i� Pumper. T- — C. ABSORPTION FIELD DATA 6/24/96d.V or fe/bdrm Date installed Soil rating (g.p. ) 1.2 GPD System type Deep Trench Length 52 ft. Width 3 ft. Gravel below pipe 6 ft. Total depth 9'5 ft. Eff. absorption area 624 ftz Monitoring tube Y Depression over field N Date of adequacy test 4/16/15 Results (Pass/Fail) Pass For 5 bedrooms Fluid depth in absorption Feld before test 1 in. Water added 750 gal. New depth 6 in. Elapsed Time: 60 min. Final fluid depth 1 in. Absorption rate >= 750 g•p•d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed Size in gallons ManholelAccess (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: 1 >1 00' Septic tank/lift station on lot On ad acent lots >1 00' 1 9T** Absorption Feld on lot >100' On adjacent lots >75' Public sewer manhole/cleanout >1 OO' Public sewer main >75' >25' Sewer /septic service line Holding tank >50' Animal containment areas >100' Manurelanimal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: >5' Building foundation Property line >5' Absorption field >5 P Water main >10' Water service line >10' Surface water >100' >100' Wells on adjacent lots ABSORPTION FIELD ON LOT TO: Property line >10 Building foundation >10 Water main >100' >10' Water Service line >10 Surface water Driveway, parking/vehicle None Noted Wells on adjacent lots >100' Curtain drain 1 F. COMMENTS **See Waiver Absorption Trench to Well. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 5!9115 COSA brown sheet_10-10-12.d0c Municipality of Anchorage G �"y Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orgionsite (907)343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # 151199 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 1 of Johnna's Woods Subdivision. This inspection revealed an arsenic concentration of 55.6 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. P78-140 JOHNNA'S WOODS SUBDIVISION LOT 1 20,388 S.F. WEST 86TH AVENUE 0 S 85055'00"F 1S0_94' --- L --- I ----- 30.0' GRAVEL DRIVE EXISTING BUILDING 2.a x s.o• IS y F.P. C1Nr j� 30.0' mo• 1 6 n.o iii 0 I� Z I I • SEPTIC VENTS t I I • I I I FENCE (AP%) LOT 1 II I ' ------------------------------------F- 10' T. & E. ESMT. I 111=20' * , OF �� PAF;.....,• <q� �. Z19TH 0 r ........... .......� m ' Jeffery A. Gostoldi � �. LS -6091 so-so 4W a � e •� pl0fes sionol �-°�.� •�aaur*'* J U.7 JG T.7 G IJV./U "FINAL STRUCTURE AS—BUILT' 01 AS—BU I LT I hereby certify that Ihave surveyed the property depicted above and that no GASTALDI LAND SURVEYING encroachments exist except as Indicated. Jett A. Gastaldl, R.L.S. It Is the responsibility of the owner to 4726 West 88th Ave. determine the existence of any easements, Anchorage, Alaska 99502 covenants or restrictions which do not PHONE 248-5454 appear on the recorded subdivision plat. Under no circumstances should any data hereon be used for construction or for GRID DATE establishing boundary or fence lines. 2324 6/27/96 ANCHORAGE RECORDING DISTRICT, ALASKA F. B. JOB NO. 96-07 JWS1 NOTE: NO CORNERS SET THIS DATE. J3361S 30HP I 0 n ,b£'S£L M„6£,80.00 N r ---------_11Y53 3Ai1353Ei QdOY rf ___------ F-- z 0 I I I I I 3 I > I I I I I I I Q I I I I I m I I r l I I � I I L, to LU m1 0 co Z I 00� Jww 0 J oN ,0£ 0 al / J 4Ld OD V) in w N LJ. J ti 3 MI N I /� c>v I m I N W _ zz I I I � I I I I I ,9Z'9£1 M„L£,50.00 N I ier Z- •��:G ml�.�µ1•/ U 'v: 44W Z �•�/ I�I��i• V. .2 :U Municipality of Anchorage ID Ment s C �G J V a N epartment *** VARIANCE/WAIVER REVIEW **** Waiver#: OSV161047 COSA#:OSC151199 Permit#: PID#: 011-161 Legal Descri ` ion: John' S of 1 Engineer: A embn En inderi Applicant: Vernon Campbell Your request for a waiver of the required 100 feet horizontal separation from the absorption field to the private well has been approved., The approved separation distance is 97.0 feet. This waiver approval applies to the existing absorption field only. Any future 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 non -objection have been re-eeived-from-the-owner(s)-of-the--af eeted------ adjacent property. ❑ Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Granted, Date: Approved by: of Reviewer May 27, 2015 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 1, Johnna's Woods Subdivision Absorption Trench to Well Encroachment Waiver Dear Onsite Services Engineer: The existing septic system on Lot 1, Johnna's Woods Subdivision was constructed in July of 1996. The installation was inspected and approved by the Municipality of Anchorage. The inspection report states the absorption trench is located 100' from the well on the lot. Unfortunately a recent surveyor as built indicates the well is only 97' from the east end of the trench. It has been determined that a waiver is now required to allow the absorption trench to remain in its current location less than 100' from the well. Only the easterly 3' of the absorption trench is constructed within the 100' radius. The trench is located downslope from the existing well and any effluent that might surface from the trench would flow away from the well and toward the back of the lot. The surface grade is 2% to 5% away from the well. Surface effluent contamination of the well is virtually impossible. Underlying soils on the lot are silty gravels (GM) based on documentation completed during construction of the septic system. The well on the lot is 348' deep and the static water level has been measured at 143' below the surface. In addition, a recent water sample shows no coliform contamination and no trace of total nitrate/nitrite content a good indicator that the absorption trench has no effect on the water quality. The well log is included for your review along with the water sample results and an as built showing the location of the existing absorption trench illustrating its proximity to the well. We are confident based on the long term performance of the existing septic system and the water quality from the well that contamination from the absorption trench is not likely. We therefore recommend .that the waiver allowing the existing aborption trench to remain 97' from the well be granted. Lot 1, Johnna's Woods May 27, 2015 Page Two ADEC POINT ANALYSIS Bottom of Trench to Highest Water Table -130' 7.20 Points Soil Absorption Type - Sand/Gravel w/Silt 2.50 Points Permeability - Silt or Sandy Gravel 1.00 Points Water Table Gradient - +5% 4.50 Points Horizontal Separation - 97' 2.90 Points TOTAL POINTS 18.40 Almost sure to be free from any form of contamination from household sewage. Sincerely, W i V "" o'er' Michael E. Anderson, P.E. th MICHAEL E. ANDERSON . NO. CE -4381 , Parcel I D # 011-161-45 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Div,slon of Environmental Serwces On-Site Serwces Section P O Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA # GENERAL INFORMATION Complete legal descnpbon Johnna ' s Woods Lot 1 Location (site address or d~rect~ons) NHN West 86th Avenue, Anchorage Property owner Mmhng address Lending agency Mmhng address. Agent Address James Thomasson 2451 Ch~]]~qan, Anchorage, AK Day phone 694-5195 msg 99517 Day phone N/A Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for p~ckup 5 NOTE Indiv~dual well x Commumty well Pubhc water If commumty well system, prowde written confirmation from State ADEC attest- ~ng to the legahty and status of system 4. TYPE OF WASTEWATER DISPOSAL: NOTE Individual on-site Holding tank Commumty on-s~te Pubhc sewer If commumty wastewater system, prowde written confirmation from State ADEC attesting to the legahty and status of system 72-025(Rev 1/91) Front MOA#21 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. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm - Eagle River Engineering Services Phone 694-5195 Address n n wv 7Ti79d F,aglP Vim - Ak 995.77 Engineer's signature `` �'-�� Date %—y;-96 0 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. 12 -=Vv. 141) Beet MOAM 14.•.•......x.,• �'Y, %?� 1 u.J1.M ! II 6. DHHS SIGNATURE"� 7C...... Approved for h �s) bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 0 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. 12 -=Vv. 141) Beet MOAM Legal Descnpbon A WELL DATA Well type DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Serwces D~wslon 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 34j~-~ Health Author, ty Approval Checklist If A, B, or C, attach ADEC letter ADEC water system number Log present (Y/N) ~5 Total depth ~ q ~ t Samtary seal (Y/N) Date completed Cased to ~'Z//' ~:~ / gpm Date of test Stabc water level Well production FROM WELL LOG Casing height (above ground) ~'~ I! W~res properly protected (Y/N) AT INSPECTION O, / /~ ~/Z~ Other bacteria ~ Collected by ~',~--~ ~._~ Number of Compartments ~ Cleanouts (Y/N) /~/) High water alarm (Y/N) WATER SAMPLE RESULTS Cohform ~ N~trate Date of sample ~./~ ~ ?/,~/~, SEPTICJ. MI31;;J~ING TANK DATA Date ,nstalled O~/~V~OTank size Foundabon cleanout (Y/N) ~ Depression (Y/N) Dato o[ ~umpm~ . . ~umpor ~80~TlO~ ~l~D System type Datelnstalled V~/~'J'//?~/ So,lratlng (gpd/ff~~) //, ~ Length .'~- / / ~ / W~dth ~ Gravel thickness below p~pe Total depth ~ / Effect,ye absorpt, on area ~ ~ aon,tonng Tube present (WN) ~ Depress,on over field (WN) ~ Date of adequacy test ~ Results (Pass/Fad) ~ For .~ bedrooms Fluid depth m absorption field before test (m), Immediately a~er ~ gal water added (m) Fluid depth .~/~ 0ns) M~nutes later ~ Absorpbon rate = ~ gpd Peroxide treatment (past 12 months)(Y/N) ~//A If yes, give date ~ ~ 72-026 (Rev 3/96)* D. LIFT STATION N I Date installed Manhole/Aocess (Y/N) _ High water alarm level at* Cycles E. SEPARATION DISTANCES *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Size in at* `Pump off" level at' Septic/Imfding tank on lot / Z 0 On adjacent lots f /00 / Absorption field on lot �0r71 / On adjacent lots 00 /1 Public sewer main NJA Public sewer manhole/cleanout N/fi £ II eweNseptic service line �t75/ lift station N/ili SEPARATION DISTANCES FROM SEPTICM9tBMIGTANK ON LOTTO: q 6�— Foundation % Property line � 7 Absorption field 1 / r Water train/service line _Surface water/drainage f %�� Wells on adjacent lots /-/00 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line3 Building foundation 7-0 Water main/service line S Surface water tl T DO D 515 ' Driveway, parking/vehicle storage area r Curtain drain .Nod f- fi 71-/00PPI3 /T Wells on adjacent lots �00 F. ENGINEER'S CERTIFICATION I cerW that 1 have determined thru field Inspections and review o/ Municipal recd Ce F , s are in conformance with MOA HAA ouidefines in effect on this date. of : •' •• ! 1 Signature.,14 ip Engineer's Name 1-0U1$ ZVr4r"P9!5 ••• «• .?� Data %— 3-96 I�.r,1' 'ceaaaa „,o HAA Fee Date of R Receipt Ni 72-026 (Rev. 3/98)* Waiver Fee $ Date of Payment Receipt Number