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Home My WebLink AboutLAKE HILL ACRES #1 LT 28Onsite File #051-052-35 Monitoring tube on east end of southerly dog-leg of drainfield shall be located prior to COSA approval to confirm it is outside the well radius. U110 No Municipality of AnchorageLlb APR Q� 2®i9 Community Development Department Page 1 of 2 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191045 PID Number: 051-052-35 ❑ New Upgrade Name: Rodger & Barbara Buckland ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 24444 Reese Road ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Lake Hill Acres #1 28 Fill added above original grade Ft. 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 89.9* n/a n/aI n/a (e) TANK El Septic [jS.T.E.P. El Holding El Other Manufacturer Greer Capacity 1000G.1. Surface Water 100+ n/a n/a n/a Material Number of compartments Lot Line 5+ n/a n/a n/a Plastic 2 NA Foundation 6.5+ n/a n/a n/a LIFT STATION Manufacturer Capacity Curtain Drain 50+ n/a n/a n/a Gal. Remarks *1985 ADEC Waiver for well to septic tank f or Pump on level at in. Pump off level at in. High water alarm at in. the property. *Tank located outside soil bearing prism see attached Pump make and model Electrical Inspections performed by detail. Installer PIPE MATERIAL House to tank3034 Tank to drainfield 3034 JR'S Septic Services Drainfield Co/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 402.0 ft Inspection5, dates: 3/11/19 2n0 4/3/2019 Location and description 3"' 4'h SW Bottom House Trim COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp OF Conditional Approval: Date��fG • 4�� 49 f tte.ven •f . 'Pafnnonn;' Approved " Date �¢ CE 8149 Ar k SSA V5 Lc_ 4 -a, -,_k inspection Neport_i-i-il.00c ux <� re' &see NO WELLS/ SEPTICS WITHIN 200' 14\ 44-41 41 41 t3` - 2i 2i 11 � o� �w K q N f� REESE ROAD WELL (E) DRAIN FIELD (E) 71 WELL E — / REI 30a SEPTIC TANK E PER MOA CODE \ INSTALLED 1000g SEPTIC TANK I B WITH FOUNDATION CLEAN OUT 36R 395 AND DOUBLE CLEAN OUT AFTER. 3� A SFID 3 u /2— DECK SEPTIC AREA (E) / WELL E 40G 9• WELL (E) j 1� ' w\ w SLOT 28 40 WELL --_�-�.._.��y�______-- (E) i 390 10' Util Esmt A B T1 10.2 20.9 _ X10' U�TI_LITY EASEMENT _— — T2 13.8 26.2 DCO 16.2 23.5 TELL (E) 7' � \� WELL (E) M s.s— I z 0� j <0 0 0 ozz z wo W W _I DW mw �0 :Lill --. FINISHED BASEMENT 402.0 1000 g SEPTIC TANK PROFILE 45•------ 1000 g SEPT�P7 3'.a TANKCO NESTED SCALE: t"=70' "".EA' -AT' -NZ - . BEARING PRISM DISCHARGE LINE PROFILE -- --� SCALE: NTS NOTES: PALVIVO i ENG SVC, LLi. P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211®C,'�P y��F q� l�lDate '�� 'qcS' li —'yf$� ® LIQ * r ... 9/5/2019 RECORD DRAWING Scale 1"=50' DRAWN BY: P.I.D. NO ACP LAKE HILL ACRES #1, LOT 28 ® .•... --.� 'Pannone 53 052-35 ROGER & BARBARA BUCKLAND 24444 REESE ROAD CHUGIAK, AK 99567 Steven R. ® �� c CE 8149®® csT ' A t�loF�PROF PERMIT NO. OSP191045 — PLAN Sheet SSIONP�'�..." 2OF2 LO Lo Olt' j, rqo f'o 00,034 31,00 r-4 Lo Cx Q) 41Ly 0 rz ro C)" rt 0 0 *,0: . = - A t1 �, oa cc rp c a, 0 �, V-4 LU ai Ln XlZ> > lu -Zg E E Lo 0 D < cr 11 C) t1i 3 ;- > !tp 1> Lu V) Q)• co C. Kli Iz >0 LLJ u LU u < c E 0 9 > Qs 7- IN Q) -�e C — > 0i a) co Q) c,-- W m r a, D co CJ M, V) 15 00 0 rq 0 Qi 20 w E 4- LU Q) J Q- u cc AVI 0'0£ LL w tio a > OM7 �7,00-,W-.Oorr co Z, ;7 sz. < r < 0 z m ai Z>wE aj IT �2 P.R r w -'�;5 E'S C.,5 ra ui U)• all-nl �-Il 0 Ln MUNICIPALITY OF ANCHORAGE �tt\C11C On-Site Water&Wastewater Program �� PO Box 196650 4700 Elmore Road • �• Anchorage.Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http:/l�titiv v.muni.orglonsiteCtIgilli ; Doha rumen r CHOH On-Site Wastewater Disposal System Permit Permit Number: OSP191045 Effective Date: 3/6/2019 Work Type: SepticTank Upgrade Expiration Date: 3/5/2020 Tax Code Number: 05105235000 Site Legal Address: LAKE HILL ACRES#1 LT 28 G:1561 Site Mailing Address: 24444 REESE RD, Chugiak Owner: BUCKLAND ROGER H & BARBARA E Lot Size in Sq Ft: 15000 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field El Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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 i Received By: /� Date: Issued By: y r, G Date:� 3 6 Eerge.1ey Ti4NX ePL/MJ MUNICIPALITY OF ANCHORAGE Community Development Department • r 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. 051-052-35 Property owner(s) Roger& Barbara Buckland Day phone Mailing address 1880 Tobacco Road, Eureka, MT 59917 Site address 24444 Reese Road Legal description (Sub'd., Block& Lot) Lake Hill Acres #1, Lot 28 Legal description (Township, Range & Section) Lot Size 15,000 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑X Upgrade 0 Duplex (D) ❑ 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. 1 (Signature of property owner or authorized agent) Permit/Rush Fees: oU 5 Waiver Fees: Date of Payment: c/` 119 Date of Payment: Receipt Number: O(Da276 Receipt Number: 63P/el/Ogg Permit No. Waiver No. Permit App_2-:•:_...c Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191045, Deb Wockenfuss, 03/06/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191045, Deb Wockenfuss, 03/06/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191045, Deb Wockenfuss, 03/06/19 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 PH~--NE MAILING ADDRESSp LEGAL DESCRIPTION LOCATION DISTANCE TO: Manufacturer L/q, ,acity in gallons DISTANCE TO: Manufacturer / ~ Absorption area IF HOMEMADE: Well Well DISTANCE TO: No. of tineA Length olf e~tch line/ } of tile to finish grade ,~1 Length Width ,/ Type of crib Crib diameter ~J/A Well [~NEW ~JJPGRADE Inside length Dwelling Foundation ~. / Total le~.t~o~ lines Material beneath tile Depth Dwelling ~ / Material IWidth Material Nearest lot I'nel~;~ /Jr Trench width ~ inches 7~.. inches NO. OF BEDR'OOC~---~) PERMIT NO. No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons Distance between/lines Total effective absor p..C~n area PERMIT NO. Crib depth Total effective absorption area Building foundation Nearest lot line DISTANCE TO: Class Driller Distance to lot line PERMIT NO. foundation Sewer line Septic tank Absorption area{si DtSTANCE TO: OTHER PIPE MATERIALS SOIL TEST RATING / REMARKS LEGAL MUNICIPALITY OF ANCHORAGE ',' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION r~ , ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE [~NEW MAILING ADDRESS LEGAL DESCRIPTION LOGATION NO. OF BEDEOOMS~ I Wel, Absorption a~ea Dwelling ~ ~ ~ N~. of compartments ~ ~ Manufacturer ~ ~'Ce--~. Mat eria~,f~ Liq, capacity, in gallons Inside le~ Width Liquid depth /~O ~ (J IF HOMEMADE: ~O~ ~ DISTANCE TO: Well ~ e lng PERMITNO. O ~ ~ Manufacturer Material Liquid capacity in gallons DISTANCE TO: 1I~2~ '~ Foundation .earestlotline 1~.)7,~ ~ No. of lines / Length of ea;&lin~ ~ Total leng~o)I~es Trench widt~O inches Distance ~etw es D ~ Top oftileto finish grade ~ 2 Material beneath tile ~- inches Total effective ~so]pt~ a~ ~ Length Width Depth ~ PERMITNO. ~ ~ TgOe of crib Crib diameter C Total effective absorption area m Well . guild~oundation Nearest lot line m DISTANCE TO: ~ Class Depth )~//) ~/ -Drill'~r ~ ) ~ ) ~1 I-~istance to lot line PERMIT NO. ~ Building foUndatiOn Sew~li~ ~ .... ~ptic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS ~ ~ INSTALLER REMARKS -- ·. . ..''~ f' ' -DOC Co~ dba' ": " - SULLIVAN WATER WELLS . .. ?' ' ';' 'P.O. BOX 272' CHUGIAK 'ALASKA 99567 · TELEPHONE688-2759 OWNEROF LAND ~'~'~ $~' -;~ O~.~m~ DEPIH OF WELL ~ ~ I ~ 7 ~ ' ~ ' '' : 'WATER ~DRES~ .. T'~O' '~ ,~'~ ~.~ STATIC~ LEVEL OF FT. [EaA~EscRi~iONd; 'A:~ -Z~~ Zd/Z~' ~{~;;-r ~~ ~oWN~. : -r., - :[ -; · pE~Ii:N~MBE" ~'. '. :', _ ~ ' _ ': _ KIND OF CASING ~ ~O O Fromg,Sr 0 Ft. to'O~5 Ft. ,['~,~7 '6~ffff~c~ From Ft. to ' ' 'Ft. "' From ?~[ Ft.' to c; ~f, Ft. ~Z ~ ~ ,,v · ~ ,~ ~ ~ From Ft. to - Ft.' ' From ~9 Ft. to ~t7 Ft. ,~ ~) ~/ ~vtz ~r From~ .Ft to ~ Ft. From ..'- - Ft. t0 -- ~ Ft. - Lo~ ~75~ ~ -- From Ft. to ' Ft. From ~ t 7 Ft. to ~ ~)-Ft. ff~ 0~, ~ From ' From- Ft.~o "' Ft. - ' From' ( Ft.'t~:" ' Ft.- ' . From - ~ Ft. to Ft: ' ' ' Eiom From ':- Ft. to Ft.-' ....... - ' From ~'- Ft. lo -, ' Ft ' ' " PERMIT DEF'FtRTMENT L,, HERLTH FiND ENVIRONMENTRL ~.OTEC:TION ~ &_._, 'L' STREET, 8.,ICHORFIGE, FIK. ~.=i~tl ~x~4~4_5~ 14ELL RI"-~E:, L]i'-.I--S I TE SEP-IFR F'ERI"I l- T ¢ ,.i 8.'::'-~;',::E'L?- ) HF F L I _.FINT LOCFIT I ON LEGFIL SOUTH FORK L. UN_-.T. LFIKEHtLL FICRES ~1 L28 BOX 567 E. R. LOT SIZE 694-27t? 999999 SQUflRE FEET TYPE OF SC'IL RBSF. iRPTION SYSTEM IS: TRENCH MRXIMUM NLIME:ER OF BEDROOMS c~ l~8 _,~IL RRTING (SQ----~.--~T~m:'~-- ~? , THE REQUIRED SIZE OF THE SOIL BBSORPTION _~T:.TEM I"~: C. EF"TH= :L~3 LEIqISTI, I; 60 Gt~:R'-.-'EL E)EPTH= F.~ THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF ~ TRENCH OR PIT IS THE DIST8NCE BETWEEN THE SURF8CE OF THE GROUND 8ND THE BOTTOM OF THE EXCB98TION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRHYEL DEPTH IS THE MINIMUM DEPTH OF GR8YEL BETWEEN THE OUTF8LL PIPE 8ND THE BOTTOM OF THE E~CBVBTION (IN FEET). F.:EC4Li IRE[:, SEPT I C: Tr-il'-.lk..' S I -?E= -'1 OC-~C-,I i]RLLCd'-,IS PERMIT RF'PLIC:RNT HRS THE REz. PLN_-.IBILIT~ TO INFORM THIS DEPHRTMENT DURING THE INSTRLLBTION INSPECTIONS OF RNY WELLS RDJFICENT TO THIS PF..CPERT~ RND THE NUMBER OF RESIDENCES TH8T THE WELL WILL SER~,,'E. TI-4£, ( ;;'~ ) I F. ISPE,]T I ~]~'-IS RRE REL--4L! I RE[;, BRCKFILLING OF FINY SYSTEM WITHOUT FINRL INSPECTION BND RF'PROV8L BY THIS DEPHF.:TMENT WILL BE SUBJECT TO PROSECLITION. MINIMUM DISTHNCE BETWEEN R WELL RND BNY ON-SITE SEWRGE DISPOSHL SYSTEM IS · 00 FEET FOR B PRIVRTE WELL OR i50 TO 200 FEET FROM ~ PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTBNCE FROM ~ PRIV8TE WELL TO B PRIV8TE SEWER LINE IS 25 FEET 8ND TO ~ COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS BRE REQUIRED 8ND MUST BE RETURNED TO THE DEP8RTMENT WITHIN ~0 D8YS OF THE WELL COMPLETION. OTHER REQUIREMENTS MBY BPPLY. SPECIFICBTIONS 8ND CONSTRUCTION DIBGRBMS 8RE 8V8IL8BLE TO INSURE PROPER INSTRLLBTION. F'ERF1 I T E~:P I RES E:,ECEI'IE:EF~: --?~l- :-t--q~ 8;~ I ,2:ERT I FY THRT l: I FIM FRMILIBR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FiND WELLS RS SET FORTH BY THE MUNICIPRLITY OF FINCHORFIGE 2: I WILL INSTRLL THE SYSTEM IN 8CCORDRNC:E WITH THE CODES. 3:: I IJNDERSTRND THRT THE CN-z, ITE SEWER _.~=,TEM WRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE TH8N ~: BEDROOMS. RDPL. ZC:HHT ~OLITH ~ORK OONST. ~ '; ~" / '' (: '~ ...... 94. 0 ISSUED BY ~ ~4L---~" ....... "'~"'-~ ~_~D TE ..... ./ ~ 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 PERFORMED FOR: I 2 3 4 5 6 7 8 9 11 12 13- 14, 15- 16- 17- 18- 19- 20- LEGAL DESCRIPTION:~ Z ~:~ ~. COMMENTS / SLOPE SITE PLAN ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop TEST RUN BETWEEN 4 FT AND ~ FT /~ I1//1 . -._ /~./ -'-// . Certificate of On -Site Systems Approval Parcel I.D. 051-052-35 1. GENERAL INFORMATION Expiration Date:.hec �3, C?OIQO Complete legal description LAKE HILL ACRES #1 LOT 28 Location (site address) 24444 REESE ROAD, CHUGIAK, AK 99567 Current property owner(s) ROGER & BARBARA BUCKLAND — Day phone Mailing address 1880 TOBACCO ROAD, EUREKA, MT 59917 Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) 1771 Duplex 1771 Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPEOF'WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic "Water Storage 1771 Holding Tank 1771 Community.Well' El Community 0 Public, Water System 1771 Public Sewer 171 Waiver request for: 4D V We_�� Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSAFee $ qu-SD( Waiver Fee $ OU ? Date of Payment 1 -11 -1 Ab 10 Receipt Number 1 .11 -D� A COSA# 0SC-PQ1'1&0 Date of Payment 905� Receipt Number 3 5 3 0 Waiver # 0 3V COSA Checklist Legal Description: LAKE HILL ACRES #1 LOT 28 Parcel ID: 051-052-35 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 8/1982 Total depth 221 ft Cased to 221 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 8/26/2020 Static water level at beginning of test 188 ft. Well production at time of test 3.5 gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample 8/26/2020 Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) 1 years Tank type/material SEPTIC / HDPE Measured operating fluid level in septic tank 49” Standpipes/foundation cleanout per record drawing Date of pumping 8/25/2020 C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 5/1985 ALL standpipes present per record drawing Total measured depth from grade 9.5 ft (max) Measured depth to pipe invert from grade 3.5 ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 2000 gallons Adequacy test date 8/26/2020 Results Pass For 3 bedrooms Fluid depth prior to test 59 in Water added 600 gal New depth 70 in Elapsed time 1380 min Final fluid depth 57 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) N If yes, enter date Comments/Deficiencies: Field operating in the top 20% of the effective depth. 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 *89.9 ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No *92 ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No **75’+ ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No 6.5 ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ 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 Property Line > 10’ Yes if No *5 ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No F. ENGINEER’S COMMENTS *WAIVERS (ADEC 8521-WA-159 & MOA WR88-074). **Per code at time of install. 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. 9/23/2020 Municipality ®f Anchorage P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section * * * * VARIANCEIWAIVER REVIEW Waiver#: OSV201058 COSA#:OSC201480 Permit#: PID#: 051-052-35 Legal Description: Lake Hill Acres #1 Lot 28 Engineer: First Water Consulting Applicant: Roger 8[ Barbara Buckland p,cnr S 4 t^ C�):11'[n1C'nL 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 92.0 feet. See engineer's waiver request for justifications. 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. lrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr■ Waiver is Granted: X Waiver is not Granted: Date: / 3 �� 0 Approved by: l l,e.4e' U' ,- 61L ff Name of Reviewer lrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr■ **** VARIAN C E/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lake Hill Acres #1 Lot 28 T15N, R1W, Sec. Location (address or directions) NHN Reese Road Chuqiak, Ak 99567 (b) Property owner Lomas/Nettelton Telephone : (home) Mailing Address P.O.B. 226407 Dallas, TX 75222 (c) Lending Institution Lomas/Nettleton Telephone Business Mailing Address (d) Real Estate Company and Agent Jean Hohnstein/Marston Realty Address 2804 W. N.L. Anchorage: AK 99503 Telephone 248-2804 (e) Mail the HAA to the following address: (or check here F3, if hold for pick up.) List contact person and day phone number below: Pi~k-up hy lq, ng'in~r TYPE OF RESIDENCE Number of bedrooms 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 [~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status; 72-025 (Rev. 7/88) Page 1 of 2 Single-Family [] WATER SUPPLY Individual Well ~ I~Ao,~ddv leUOp,!puoo jo sLuJeJ. leUOR!puoo peAoJddes!CJ X pe^oJddv ~ ,~oj. peAoJddv 'l'¥AOadd~' SHHa '9 'S A. WELL MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: Well Classification Well Log Present (Y/N) /V Total Depth ,.~Z_~D Cased to Static Water Level. ?E.¢' t Casing Height Above Ground /-'~ Electrical Wiring in Conduit (Y/N) /V SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot /'~'~ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by ~,4~ Water Sample Test Results Date Completed 2_,~A ¢ Depth of Grouting If A, B, C, D.E.C. Approved (Y/N) Yield ,7~-/,,,,~ 7-e'.r.v-,~,~' Pump Set At ~- /dF / Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ! /¢" ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ~-~S,~'~.-,¢j ; Date Comments B~ SEPTIC/HOLDING TANK DATA Date Installed /f¢~i~ Size Standpipes (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) /~J',/. No. of Compartments Air-tight Caps (Y/N) ,Y Foundation Cleanout (Y/N) ~¢' Date Last Pumped L:~- 2').=~ ~'/~ ; for ~//,d Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well /¢'¢ To Property Line /~ / To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course To Building Foundation To Disposal Field J'-/ Comments 72-020 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field '~ Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well 2~ To Building Foundation /~ Lot ~1~11~' ~ ~ .25.~ Type of System Design Length of Field 5-3 7a ,'~ ! Depth of Field /3__ / Gravel Bed Thickness '¢ / Statndpipes Present (Y/N) Date of Last Adequacy Test To Property Line /v ""~' "'""~-°¢ ;'¢" '~'~, On Adjoining Lots To Existing or Abandoned System on To Water Main/Service Line ~¢¢ / To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Cutback (if present) D. LIFT STATION ~.~ Date Installed Size in Gallons "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 Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~ Company ,~'/¢~__~ .r' Date MOA No. 6.._% Receipt No. cK Date of Payment Amount: $ 72-026 (Rev. 7~88) Back ~: ~~'~.,=F~ngmeer s Seal L:~:,;:,,,.,,.:., :. ,., Waiver Fee: $ ,~¢ ¢ ~ Date of Payment ,/~ ~- ~ Page 2 of 2 Tom Fink, Mayo r unicipality of Anchorage. Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 December 22, 1988 Leu Butera, P.E. Eagle River Engineering Services P.O. Box 773294 Eagle River, Alaska 99577 Subject: Waiver Request fo~ Lo% 28 Lake Hill Acres #1 Waiver Request Number WR88~074 Dear Mr. Butera: Your request for waiver of the required 10 foot separation between a septic system and a lot line has been approved. waiver distance is 5 feet. The This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sincerely, Civil Engineer Acting Program Manager On-Site Services DJR/ljw #7 ' EAGLERIVER ENGINEERING SERVICES ~~ ~ O~~ , ~%X~ P.O. Box 773294 Eagle River, Alaska 99577 ~~ ~q~ ;'~ ? ~ 0 ~' Telephone (907) 694-5195 December 15, 1988 Mr. Dan Roth Municipality of Anchorage Health and Human Services 825 "L" Street Anchorage, Alaska 99502 RE: Lot 28, Lake Hill Acres #1 Dear Mr. Roth, On behalf of our client Marston Properties, we are applying for a wavier of separation to lot line distance to 5' total, for an existing septic leachfield to the neighbors lot line. The septic system was installed and inspected in 1985. The septic field is located +30' from the neighbors system, and the lessor separation distance should have no substantial effect on their use. Please process this wavier along with our request for final septic approval. If you have any questions concerning this matter, please call me at my office at 694-5196. Sincerely, Louis A. Butera, P.E. LAB/skb MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONIViENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE (DF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name Applicant Address/O (c) Applicant is (check one): Lending Institution []; Owner/builder~, Buyer []; Other [] (explain); (d) Lending Institution ~.2 ~ ¢kJ ~" Telephone Address (e) Real Estate Company and Agent Address Telephone (f) ~M~r~hl'he HAA to the following address: TYPE OF RESIDENCE Single-Family~r Multi-Family [] Number of Bedrooms ~ Other WATER 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 Onsite~,, 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. Page 1 of 2 72-025 {11/84) ENGINEERING FJR~,'t PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Date Telephone DHEP A P P R O VA~-~'~ Approved Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection ([;)HEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements, 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. WELL DATA MUNICIPALITY OF ANCHORAGE (MOt~JJNiciPALITY OF ANCHORAGE HEALTH AUTHORITY APPROVAL (HAA) DEPT. OF HEALTH & ENVIRONMENTAL PROTECTIO~ CHECKLIST - FEBRUARY 1984 284-4,20 Legal Description: i\iL.~,.,I~ II V DU Well Classification Z3~/U~. ~' If A, B, C, D.E.C. Approve~'4) Well Log PresenCY)N)/?/ Date Completed ~'/~? 2- Yield Total Depth ~_~.~_...'-" 1 . Cased to ~ '~- / Depth of Grouting t.-t. ~ Static Water Level /.~,.¢-- i Casing Height Above Ground ,~'O Electrical Wiring in Conduit (~N) Separation Distances from Well: ¢,~ To Septic/H~l~i~q~Tank on Lot ~ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot /t~O ~ ; On Adjoining Lots To Nearest Public Sewer Line /0/'~ To Nearest Public Sewer Cleanout/Manhole ~ / ~, To Nearest Sewer Service Line on Lot Water Sample Collected by ~' 'I ~' ~"~,/~¢g',¢'/~/',¢"l ~' ; Date Water Sample Test Results - /.~omments Pump Set At C~ ~ Sanitary Seal on Casing(~N) Depression Around Wellhead (Y~ /Oo + · SEPTIC/~ TANK DATA Date Installed /~¢¢~' <¢ ~ Size ,~) ~) NO. of Compartments StandpipesCN) Air-tight Caps0N) Foundation Cleanoutt~N) _ Last Pumped ¢/~7 Depression over Tank (Y(~) Date Pumping/Maintenance Contract on File (Y/N) ~ ~ ~ ~' ; for Holding Tank High-Water Alarm (Y/N) /,] / k'~ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/l~;..~ Tank: To Water Supply Well''~¢' ~ ,~. i - To Building Foundation To Property Line /~O ~'~ To Disposal Field ..5' To Water.A4~/Service Line /0 Cours,~ To Stream, Pond, Lake, or Major Drainage Page 1 of 2 ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date installed /'~P¢ (-- oC~ -- Width of Field ,¢,~O ¢~ Square Feet of Absorption Area Depression over Field (Ye Results of Last Adequacy Test/~/¢.¢ ..¢'~',¢ Separation Distance from Absorption Field: To Water-Supply Well /0,.2 To Building Foundation 20 ' Lot "'L/~,~''¢ '~' To Water ~4~/Service Line /O .¢. To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage .Areal "~. Comments 6~,/O' '~'f?,'¢~ ~-¢/o?'~""¢--¢'¢://¢-'J ¢¢ -'¢- '~'/,-¢'/U' Type of System Design Length of Field ~ / Depth of Field //O Gravel Bed Thickness ~' ~.~,2 ~..~¢ ~ J~ ~ / ~'F Standpipes Presen (t~)N) Date of Last Adequacy Te"-""st ~'~/~ To Property Line ~,¢/d To Existing or Abandoned System on ;On Adjoining Lots .~ To Cutbank (if present) ~ ,2 ~ ~' D. LIFT STATION 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 ~ / V~u~;nt (Y/N) . _ ping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Company;}{ i':~ ?,I~::~? ,:\~ Receipt No. :~ ~'~ Date of Payment Amount: $ Date MOA No. Page 2 of 2 72 026 (11/84) DEPT. O~F £N¥~RONMI~NTA~L CONS~RV/~T]ON ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR 274-2533 May 17, 1985 Mr. Robert A. Shafer, P.E. S&S Engineering SRB 196X Eagle River, Alaska 99577 SUBJECT: Waiver Horizontal Separation between Well and Septic Tank, Lot 28, Lakehill Acres Subdivision, Additional #1, Eagle River, Alaska (8521-WA-159) Dear Sir: The Department has reviewed the subject waiver request and hereby waives the horizontal separation between the well and septic tank to 85 feet on the subject property for a 3 bedroom single family residence only. Sincerely, District Engineer SWE/msm I' "' ' APPLIC'"~IT FILLS OUT UPPER HAL~ ONLY Mailing Address ,,~,~//~ ~/ (,//~,/~ x'-~ ~ ip ce Lending lnstitution ~[~ /~~ /~~ Phone *~re~s ~~ ~/~ ? ~ ~ zi~ Co~ Realty Co. & A~nt ~ ~/~/~ ~ ~T~ Phone Address ~/'[C~/~ ~ / ~ ZJpCode LegalDescript~n ~/~ ~~-- ~/~ ~5~/ Type of Resi~nce ~ Single Family ~ Multiple Family No. of Bedroo~ ~ ~ Other Water Supply Individual · A~ACH WELL LOG. A w~l log is required for all wells dril[ed since June 1975. /~ Community ~[ / For wells drilled prior to that date, give well depth (attach log if available}. ~ Public Utility Sewer Disposal ~lndividual Year IndivMual Installed:..~-- /~ublic Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Dat~.~ _ ~'¢~(~ Inspector Inspector Inspector Inspector Field Notes: MUNiCiPALITY OF ANCHORAGE '-'2-.-'~-' ~;~-~/*..~- DFPT. 0c HE,"LTH ~..,IJ a 2 0 1982 ( '"f'APPROVED BEDROOMS~,~ 'CONmTIONS OF APPBOVAL ( } OlSAPPROWO ( } CONDiTiONAL AFPROVAL' Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size