HomeMy WebLinkAboutLAKE HILL ACRES #1 LT 32Lake Hill Acres
Lot 32
#051-052-31
Municipality of Anchorage
On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 1
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP 181372 PID Number: 051 052 31
Dwelling: ❑t Single Family(SF) ❑with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New L Upgrade
Name
Jeremy Cordie ABSORPTION FIELD
Site Address
24423 Grace ❑ Deep Trench ❑Wide Trench N Bed ❑ Mound
0 Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
3 0.4 GPD/SF 2 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 1.25 Ft._0.5 Ft.
Lake Hill Acres#1 Lot 32 Fill added above original grade Gravel length
Township Range Section 2.3 Ft. SEE PLAN Ft.
Gravel width Beds:Number of Lines Distance between lines
SEPARATION DISTANCES SEE PLAN Ft. 8 VARIES Ft.
To Septic !Absorption 1 Holding Sewer Total absorption area Number of trenches Dist.between trenches
Tank 1 Field Lift Station Tank Line z
From I 341 Ft Ft.
Well _ _ _ TANK 1:1 Septic 0S.T.E.P. E1 Holding El Other
+ I oo I +25 Manufacturer Capacity
Surface Water I _
+100 i - - existing Gal.
Material Number of compartments
Lot Line - +0.5 - - NA
Foundation - +1 _ _ LIFT STATION
Manufacturer Capacity
Remarks old tank remains per owners request Gal.
Alarm location Electrical installed by
PIPE MATERIAL House to tank _ Tank to
Installer drainfield-
J Rs Drainfield PVC CO/MT 3.034
Inspector CHARLES BALZARINI BENCH MARK (Assumed elevation) 100 ft
Inspection 1" 5/28/19 5/29/19 Location and description
dates: 2",
3rd 4`" STEP TANK MANHOLE LID .
ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp
Conditional Approval: Date ,`Q.•••'
� • f-
, ,1
j*: TH 49 ' ••*fir/
/4 CHARLES G BALZARINI •
Septic System ,_' / / •�� �F'• CE 13854 .•���i
Approve: '� w` t ''0 Date b Z� Os �s�'•. ,.• AllY
Note: this approval does not include well permit requirements. Asp-
11leoppOFESSIONP�
(Rev 05/02/18)
2/17/19
41\\\� \�
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4 94-1,1i
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SWING TIES f CHARLES G BALZARINT l
A B r 1'.•. CE-13854 .•�`�."
C 53.3 49.4 �� `rl�' .,6iisi:;• ���r
- --r---- - _ 83.9 79.4 GARAGE 119FoPROFESsiovs_'�. .
3 BEDROOM ` _ 1
HOME
a c•
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a
al
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` _ _ DECK /
a
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` •
\ ORIGINAL 1250 a 1
GAL TANK f. a f
CARPOR BM STEP TANK MANHOLE
P. o d c /
p 4 i .d
\a . � Q, . /
� — _ _ --\---Qa • ..a a
II I I I 4 ° I
I I .I I I \\ • . °DRIVEWAY . :I
ORIGINAL ABSORPTION --�.I I I \ a ° I
AREA 794 SQFT I --=—_•. MO \ • 1,
— — —� \ 4 0
LEGEND D \
o CLEANOUT 1 \
NEW ABSORPTION )
• MONITOR TUBE AREA 341 SQFT GRACE STREET \\
® TEST HOLE
PLAN — SCALE: 1" = 30'
BM: LIFT STATION LID:+100
ONITOR TUBE
BLUE BOARD INSULATION
100.8
FILTER ABRIC �-FINISHED
/ GRADE :STHOLE,
AWWC
_ I , 2.3' _98.5'COVER ORIG. GRAD
. .___ —
96.5 dP• .:•�.�.Z.f.:.10:111: 97.0 INVERT
1.25"0 DISTRIBUTION PIPE 96.5
SCHEMATIC PROFILE VIEW SHOWS ELEVATIONS OF INSPECTED 0.5'EFFECTIVE SEWER ROCK
ELEMENTS BUT DOES NOT DEPICT SYSTEM IN ITS ENTIRETY. 94.5 BOTTOM
OF SAND 88 GWT 6/29/99
SCHEMATIC ELEVATION - SCALE: NTS 86.5 BOH
LEGAL DESCRIPTION: LAKE HILL ACRES#1 LOT 32
C&M ENGINEERING SERVICES OWNER: CORDIE DATE:06/15/19 REV: 11 DRAWN: CB REF:
907-854-5558
SEPTIC RECORD DRAWING
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP181372
Work Type: Septic Upgrade
Tax Code Number: 05105231000
Site Legal Address: LAKE HILL ACRES #1 LT 32 G:1561
Site Mailing Address: 24423 GRACE ST, Chugiak
Owner: CORDIE JEREMY P
Design Engineer: C & M Engineering
This permit is for the construction of:
Q Disposal Field i Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date
Lot Size in Sq Ft:
Total Bedrooms:
r.
v�i .1 0-
Deepartment
10/24/2018
10/24/2019
16260
3
❑ 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 B
Issued By:
y Date:
Date: w Z
Municipality of Anchorage
P.O. Box 196650 ® 4700 Elmore Road
Anchorage. Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997
http://www.muni.org/Onsite
Development Services Division
On-Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSV181086 COSA#: Permit#: OSP181086
PID#: 051-052-31
Legal Description: Lake Hill Acres #1 Lot 32
Engineer: CM Engineering
Applicant: Jeremy Cordie
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 90.0 feet.
This waiver approval applies to the proposed 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.
(
Waiver is Granted: X Waiver is not Granted:
Date: lO49//G Approved by: j�A4:114-4—:
Name of Rev' er
**** VARIANCE/WAIVER REVIEW ****
Lith S
MUNICIPALITY OF ANCHORAGE
/• fr
Development Services Department �j Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 051 052 31
Property owner(s) Jeremy Cordie Day phone
Mailing address 24423 Grace
Site address 24423 Grace
Legal description (Sub'd., Block & Lot) Lake Hill Acres#1 Lot 32
Legal description (Township, Range & Section)
Lot Size 16,260 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field ❑ Initial ❑ Single Family (SF) ❑
(w/wo ADU)
Septic Tank ❑ Upgrade ❑ Duplex (D) ❑
Holding Tank ❑ Renewal
Multiple Dwellings
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Drainfield to Neighboring Well Distance: 90'
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
Charles Balzarini, C&M Engineering
(Signature of property owner or authorized agent)
Permit/Rush Fees: 5-609 Waiver Fees: // 3
Date of Payment: /6051(8 Date of Payment: /(,)/7—z-g
Receipt Number: 33-q"I 51-) Receipt Number: 0/17/D
Permit No. QS IP 1Y1,379, Waiver No. U 1k,// 0/006
G: Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
MAmicipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181372,Deb Vt4 ckenfuss. 10/24/18
C&M ENGINEERING SERVICES
Ph:907-854-5558
Municipality of Anchorage
Onsite Water&Wastewater Program
4700 Elmore Rd Anchorage, Ak 99507
RE: Proposed Septic System Upgrade for Lake Hill Acres#1 Lot 32
Dear Reviewer,
The above referenced property is currently served by a 2 bedroom septic system. The owner wishes to
upgrade the to a 3 bedroom system so the existing home can be sold with 3 bedrooms.
An adequacy test was performed on the existing bed system in early Oct 2018 and it was determined to
be adequate.
Our review of available documentation and field investigation show that this project will not adversely
impact any nearby Wells, Wastewater disposal systems, replacement disposal sites, ordrainage flowing
onto and off of the subject property. Except, that the proposed extension requires that a waiver be
granted between the proposed bed and the neighboring well on Lot 33. We are requesting that the waiver
be granted for 90.0' between the well and the new portion of the bed.
The waiver is justified for the following reasons:
• Previous review granted a waiver between the Lot 32 well and the tank for a similar distance, and
the lot 32 well also has a waiver on file to the adjacent lot 29 absorption field of 87 feet. This
indicates a history of approved wells and the supporting waiver calculations are on file.
• The area has a history of low nitrates and poorly draining soils which indicate despite the
development density, water quality remains good. Nitrate Levels at Lot 33 have been historically
low in 2007, they were measured as 0.628 mg/L when I collected them in 2007. Current results
from the lot 32 well show nitrate levels at 1.14 mg/L. The two wells are of similar construction and
it can be expected that nitrates remain similarly low in the Lot 33 well water.
• Lot 33 is served by a Cat III AWWTS which has a reduced nitrate input into this area.
• Nearly the entirety of this lot is covered by protective well radii and the extension area minimizes
impacts to wells.
• Potential overuse of the 2 bedroom system could result in the premature failure of the system,
increasing the risk of water contamination.
• Approximately 70% of the absorption area remains outside of the 100' protective radius.
Additionally, we are requesting that a lot line waiver be granted for the new portion of the bed to be within
0.5' of the South property line. A waiver is currently on file for the existing bed system. The lot line
encroachment minimizes the systems proximity to the lot 33 well.
The lot is served by a private well and the proposed septic system will be installed outside of the well's
100' protective radius.
Included with this letter is a permit application and design package, including plans, specifications, and
calculations. The design references the existing testhole performed by AWWC in 1999. .
Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854-
5558 or by email cgbalzarini(a�gmail.com with any questions or concerns.
Sincerely, Charles Balzarini, PE
/ _ �' )
Munidpality of Anchorage
On-site Water and wastewater
REVIEWED FOR CODE CONPLJANCE
CBM ENGINEERING SERVICES OSP181372,DebVYbckenhnss, 1O'24/18
907-854-5558
Septic Design Calculations
Residence: Lake Hill Acres#1 Lot 32
RESIDENCE/LOT INFO
number of bedrooms 3 br Upgrade
Water usage/bedroom 150 gpd/br
Water Usage 450 gpd
DRAINFIELD
system type: Conventional
type: Bed
Application Rate 0.4 gpd/sqft
required absorption area 1125 sqft Total
Existing area 794 sqft
New Area 345 sqft
Total Area 1139 sqft
Bed width (W) see plan ft
Bed length(L) see plan ft
gravel depth (D) 0.5 ft bel ow distribution pipe
Sand layerthickness 2 ft
Total Excavation Depth: 5 ft
Cover: 3 ft
Insulation: 2" bl ueboard
Effluent Pipe: 1.25" PVC(verify and match exist)
Calc By: CGB Date: 10/20/2018
i /49,m ! rI
CHARLES G BALZARINI
0# A CE13854 Al
'I
l i PROFESS\0�� -�
A\>»��
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPUANCE
OSP181372 Deb Wockenfuss, 10/24/18
C&M ENGINEERING SERVICES
Ph:907-854.5558
SPECIFICATIONS FOR ONSITE SEPTIC SYSTEM - MOA CERTIFIED INSTALLER
LEGAL: Lake Hill Acres#1 Lot 32
October, 2018
A. GENERAL
1. The septic design is for a 3 bedroom, single family residence only.
2. The site plan and drawings shall be a part of this specification.
3. The Wastewater system shall be installed by a certified installer in accordance All
materials and workmanship shall meet the Anchorage Department of Health and
State Department of Environmental Conservation requirements.
4. All soil tests are advisory to the design and are to be verified or modified in the field
by the engineer. The engineer shall perform percolation tests and groundwater
monitoring prior to finalizing design. An additional Test hole and percolation test is
required during construction.
5. All excavations and depths are advisory and are to be verified in the field by the
contractor to meet Municipality of Anchorage, Department of Environmentof
Conservation requirements.
6. It is the responsibility of the owner to obtain all necessary permits oreasements and
to locate any adjacent multi-family wells. A licensed surveyor should locate all
nearby lot lines, easements, exact 100' radius from the existing and neighboring on-
site wells, and any nearby surfacewater.
7. The excavation is to be exactly in the area shown on the site plan, any deviation
requires engineer approval.
8. Any remaining open test hole excavations shall be filled and monitor tube removed,
after construction of the Drainfield.
9. The contractor shall familiarize himself with the new code requirements for
inspection notification and notify the engineer at least 24 hours prior to beginning
work.
B. SEPTIC TANK
1. The Existing 1250 Gallon Step Tank will be re-used.
Munidpality of Anchorage
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o CLEANOUT ••• ••• �• •• •• /
\ tHARLES G BALZARINJ
• MONITOR TUBE Q��' \\ \\ q l'Fj•�• CE-13854 �.•��`�_/
® TEST HOLE LOT 29 4'/ ,0CrF�'••;oiisi.s.•F��.i
•�� \ L0� 31 �,l`F�PROFESS10NP
0.5%\ SLOPE INDICATOR ���,"11�
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EXISTING WELL t _ - - ' -
11__. - .14L -
LOT 32 , - � ' --
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71-' � iO /� l t \
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/ LOT 31 2 BEDROOM E _ . I
HOME / i �- - _ I
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/ / / /
5X35 RESERVE
QpJ/ / SITE REQIURES USE
4Z-/ OF CATEXPLORATION III AWWTS
CARPORT / / / AND ADD'L SOILS
1p _
o/ loaf WELL RADIUS �
\ ` // EXISTING 1250 Y LOT 33
x GAL TANK TC o
'
/ \ REMAIN. /
OPTIONAL REPLACE 1250 i IIl l D13JV AY 1
GALLON STEP TANK IN KIND :,'WITH NEW 1250 GAL STEP ON I \ -cr- EXISTING WELL
TANK. DEMOLISH OLD TANK • . -' ' \
PER CODE REQUIREMENTS.. _ 4 _ - '_) t �. EXTENAREA SIOE' t \ !Po,i,_
IF•"t TM 1 , \`ETAI L PLAIN\ I RGI\S
A14N� \\
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l_�_li \'`� ' TOE FILL \ i
- - - VIA _ 90' WAIVER DISTANCE
T JIGTO WELL. I
EXIST FIELD J \ :;:c.-1�
\ GRACE 3/
NEIGHBORING WELLS NOTE:
\ \ 1. THE PROPOSED SEPTIC SYSTEM IS
TO THE SOUTH ARE GREATER THAN:
+200' FROM PROPOSED 100' FROM ANY PRIVATE WELLS ,
—SYSTEM 200' FROM ANY PUBLIC WELLS
100' FROM ANY SURFACE WATER
—50' FROM ANY STEEP SLOPES
10' TO ANY PROPERTY LINE OR FOUNDATION
_5' TO ANY TEST HOLES
FILL AND/OR INSULATION SHALL BE PLACED OVER ALL LINES.
mut joi ai , (EXCEPT WHERE SHOWN)
LEGAL DESCRIPTION: LAIC HILL ACRES r Lot 32
CMI ENGINEERING SERVICES mot jERDify CORDE I DATE:10/10/4 REV: I DRAWN: CBI REF:
907-854-5558
SITE PLAN
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
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`_ /---__ 1b' - (9) 1 .25"OLATERALS
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s , ' W CAPPED ENDS
I 1 INSTALL (2)
• I 0I � _ �\ MONITOR TUBES
' I 4 MANIFOLD MATCH
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1 I , '' EXIST. PIPE SIZE
1
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LOCATE AND TIE INTO _ _J- . , ��
EXIST. MANIFOLD _.- --- 1 ! '
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80 \
DRILL (2) 3/16"0 - - .
HOLES IN EACH LATERAL 11.0
AT EQ. SPACING (1 /3 PTS)
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,
NOTES:
MATCH EXISTING BED DEPTH.
N
INSTALL 2' MOA FILTER SAND
_ BELOW BOTTOM OF BED. N
\
MATCH EXISTING PIPE SIZES.
SCA F• NTS
LEGAL DESCRIPTION: LANE FULL ACRES #1 Lot 32
C&M ENGINEERING SERVICES oMINE1t JEREMY CORDIE I DATE:10/10M REV: I DRAM: CBS REF:
907-854-5558
SITE PLAN
Municipality of Anchorage Page 1 of 3
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. SW990409 PID Number. 051-052-31
Name:
EVA LOKEN Wastewater System: 0 New • Upgrade
Address:
9123 HILAND ROAD ANCHORAGE, AK 99577 ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 689-6476 2 0 Deep Trench 0 Shallow Trench ■Bed ❑Mound ❑Other
Soil Rating: Total Depth from original grads:
LEGAL DESCRIPTION 0.4 leo/s,. Ft. **4.0 — 5.0 Ft.
Lot: Block: Subdivision: Depth to pipe bottom frau original rod. Gravel depth ben.ath pips:
32 — LAKE HILL ACRES #1 1 .24 — 2.24 Ft. 0.53 Ft
Township: Range: Section: — Fill aided above original grade: Gravel Gravel 1.gt
2.0 — 3.5 Ft. 34' n.
Grp width: Number of Ins= Dletanoe between hose:
WELL: 0 New 0 Upgrade 20' — 26' Ft. 7 2 — 4 Ft.
Classification (Private A,B,C): Total Depth: Cased To: Total absorption arm Pips =twit*
Ft. Ft.
794 sG Ft ASTM D-3034/F-810/SCH 40 PVC
Driller: \\ Date Drilled: Static water Level: Installer: Date Installed:
.-X\S GREEN GENERAL CONT. 10/22/99-11/9/98
y{elck Pump Set At: Casing Height Above Ground: TANK
GPM Ft. Ft
SEPARATION DISTANCES ❑Septic ❑Holding IN S.T.E.P.
To Septic Absorption Lift Holding Pubtic/Prlvats Marwfocbunw: Comb in gallon=
From Tank Field Station Tank Sower Lines ANCHORAGE TANK 1250
Material: Number of compartments
Well *90'+ 100'+ *90'+ — 25'+ STEEL 2
Surface 100'+ 100'+ 100'+ — —
Water LIFT STATION
She In gallon= Manufoctunr
Loti5'+ *1' 5'+ — — 1250 ANCHORAGE TANK/ORENCO PRODUCTS
'Pump on' level at Pump off level at: High water dorm at:
Foundation 5'+ 10'+ 5'+ — — 42" 42" 44"
Curtain Pump Mala a Model: Electrical Inspections performed by
Drain NONE KNOWN 20 OSI 05 HHF WALKER ELECTRIC
Remarks: *WAIVERS GRANTED BENCH MARK
Location and D.safptlon:
**2.23 OF M.O.A. APPROVED SAND FILTER WAS ADDED. BOTTOM OF DOOR THRESHOLD NEXT TO POINT "A"
EXCAVATION WAS LIMITED TO 1 FOOT BELOW THE EXISTING
Assumed Devotion` 100.00 Ft
BED AND ALL CONTAMINATED MATERIAL WAS REMOVED.
ENGINEER'S SEAL
NOTE: ORFICES WERE ADDED AND HOLES WERE INSTALLED FACE UP. oo6oOpp,,
0
F `
Q,0', S.,..- ... q X40
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AWWC, INC. p0�� A : !H .l
'•�O�
Inspections performed by: Dates: 1st 1 1/30/99 0 .1. A
2nd 11/30-12/1/99
3rd 12/7/99 ' re . A. Carness.: o
Department of Health and Human Services approval �4ms • . 7953 . ' ,�o�
P PP 9"f ''' o
Reviewed and approved by: A Al. /'« Date: I- 3 .6° 4��OQaprofes51oc\oo`��
72-013 Rev. g 91 MCN 25 (/ //1% � O� 0" " '
( / )
PERMIT NUMBER: AS-BUILT DRAWING PARCEL IDNUMBER:
SW990409 051 -052-31
10' UTILITY EASEMENT \ 1\ N
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NEW 1250 GALLON
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\ -- • •m WELL
——1 MT2 9�
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MT1 I \
NEW DRAINFIELD I MT4
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1 FOOT LOT LINE I 1 FOOT LOT LINE A B
WAIVER GRANTED 1 WAIVER GRANTED
C01 32.9 34.5
\ ST1 41 .6 45.0
\ ST2 41 .5 43.7
MH 41 .7 43.4
N MT1 53.1 56.6
GACI- ST. L_ f- T \ MT2 54.2 MT382.3 54.0
\ MT4 82.0 79.9
ALASKA WATER & WASTEWATER CONSULTANTS, INC. o. 000O
6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 � •F ,.'• Q
PHONE: (907) 337-6179/FAX: (907) 338-3246 •••• S44
LEGAL DESCRIPTION: ���� '- O
LAKE HILL ACRES SUBDIVISION #1 ; LOT 32, •„'1 ii-\.
0
TYPE OF WORK: VA
AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE —1 ............
•J 'f :y A. •••mess.:
PREPARED FOR: PHONE NUMBER: o0 3. E-7953 o OQ�
EVA LOKEN (907) 689-6476 Q s • • .�c0
DATE: DRAW N BY: SCALE: PAGE: 44�0te0. 0 `��A_
12/16/99 J.L.M. 1 = 30' 2 OF 3 0�0�fessiQoo
O�o�o
R NUMBER: AS-BUILT DRAWING PARCEL ID NUMBER:
SW -
SW990409 051-052-31
FINAL GfAl2 - 101.00+ tOt'OF MANHOLV - 10137
IN5I,LA110N
511 512 MH
IOP OF TANK TOP OFLANK
At INLt- 95.92 At 01..11f1 s 95.95
i—ri _____ —r_c___I1
NEW 120 GAI..ON
INVt?T"OF HUNGNVttyf OF pm
At INLZ1- 95.43 5�� I TANK At 0U11.ft- 95.51
I
ORIGINAL GM ORIGINAL G
- 99.75 Al FINAL Gtr - 102.6-103,6 - 100.75 Al
L0Wf5t POINT"— NIGISt POINf
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INVERT Of 1.25" PI511Z11311110N
LIN - 98.51 (AVG.)
NOT:EXCAVATION WAS LIMIIWn Of OF SANG'FILtk
101 F00f BELOW 11-E FXI5111\16 60T"tOM OF I3f;n - 9198(AVG.)
13W,Al CONfAMINAfE17 MA1��IAI
WAS COMPLETELY mMOVE17, - 9515(AVG.)
ALASKA WATER & WASTEWATER CONSULTANTS, INC. _ �o�oo\.
6901 DEBARR ROAD, SURE 2B. ANCHORAGE, AK. 99504 G Ol � 4`01N4
PHONE: (907) 337-6179/FAX: (907) 338-3246 Qoo� .,.• .ut' 'f-ti
LEGAL DESCRIPTION: •
//'
LAKE HILL ACRES SUBDIVISION #1; LOT 32, , *' �, �\ •. *�0
TYPE OF WORK: •4 .. .... ... ....0\ D
PROFILE AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE '. s.
PREPARED FOR: PHONE NUMBER: QO 9�• • 7953 :, o $
EVA LOKEN (907) 689-6476 Q • •c0
DATE:
12 16 99 'DRAWN BY:J.L.M. SCALE: 1 = 30� PAGE: 2 OF 3 44�4pap'afesg`o 0\c•
�0000�o
12/09/1999 16: 47 907-696-1805 GREEN GENERAL CONT. PAGE 01
WALKER ELECTRIC
CLINT WALTER
10319 Colville St.
EAGLE RIVER AK,99577
Phone 696-8964 Cel 11223-6304
Email ClintAlan@aol.com
To:State Of Alaska
Date :12-2-99
Ref :L32 Lake Hill Subdivision I
Permit :
This is to certify that on site sewer lift station at above mentioned
property has been wired in accordance with the standards of the National
Electrical Code and manufactures specification.
Systems were checked and performed as specified in the systems
manual.
Clint Walker
I lel 5 PFC1 b►�
99P0T-WPv
MUNICIPALITY OF ANCHORAGE r
Department of Health and Human Services I f ll r I�pj (
On-Site Services Program I
825 L Street, Room 502 �_c) p, e-- 3
P.O. Box 196650, Anchorage, AK 99519-6650 I I '-'pf►1
(907)343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Nov 12, 1999
Expiration Date: Nov 11, 2000
Permit Number: SW990409 Parcel ID: 051-052-31
Legal Description: LAKE HILL ACRES #1 LT 32
Design Engineer: 0041 AK Water& Wastewater Consulta Site Address: 024423 GRACE ST
Owner Name: Eva Loken Lot Size: 16260 SQ. FT.
Owner Address: 9123 HILAND RD Total Bedrooms: 2 Permit Bedrooms: 2
EAGLE RIVER , AK 99577-9411
This permit is for the construction of:
✓ Disposal Field ✓ Septic Tank Holding Tank Privy Private Well I Water Storage
All construction must 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. The following special provisions.
THE SAND USED IN THE FILTER LAYER MUST BE A CLEAN COARSE SAND WITH 4% OR LESS PASSING
THE #100 SIEVE AND 2% OR LESS PASSING #200 SIEVE. A SIEVE ANALYSIS SHALL BE PROVIDE ON THE
SAND USED OR OBTAINED FROM AN APPROVED SOURCE.
Received By- Y1( 1/( Date: //'`
y� q
Issued By: Dhvel {� �'(i Date: / /-12 ` 7 7
Municipality of Anchorage A AA ,
k,
Department of Health and Human Services cit1hs
825 "L" Street
Rick Mystrom. P.O. Box 196650 Anchorage, Alaska 99519-6650
Mayor
http:r/www.cranchorage.ak.us
January 13, 2000
Jeff Gamess
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2B
Anchorage, AK 99504
Subject: Waiver Request for Lake Hill Acres#1, Lot 32
Waiver Request#WR990079
Parcel ID #051-052-31
SW990409
Dear Mr. Gamess:
Your request for a waiver of the required 100 feet horizontal separation from the
on-site wastewater disposal system to private well has been approved. The approved
separation distance is 90.0 feet. Your request for a waiver of the required 100 feet
horizontal separation from the on-site wastewater disposal system to the private well
serving Lake Hill Acres #1, Lot 31 has also been approved. The approved separation
distance is 92.0 feet.
This waiver approval applies to the existing on-site wastewater disposal system 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 343-4744.
Sincerely,
p_a_474:// r?"0_,Itt
Daniel J. Roth
Civil Engineer .
On-Site Water Quality Program
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR# WR990079 PID# 051-052-31 HA# Permit #
Date Received: September 29, 1999
Legal Description: Lot 32 Lake Hill Acres #1
Engineer: Jeff Garness, PE, Alaska Water & Wastewater Consultants. Inc.
6901 De Barr Road, Suite 2B, Anchorage, ALaska 99504
Applicant: Eva Loken
******
Waiver Requested: Private well to proposed S.T.E.P. tank of 90 feet_and 92 feet
from the well to on Lot 31 Lake Hill Acres 111.
Criteria: 1 . Geology: Points :
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2 . Special Conditions :
3 . Other:
�/
******
Waiver is Granted: >4 Waiver is NOT Granted:
List Conditions or Reasons for above : s (E47T4( -?E12
Date : f)/2 - . By: 42/9A/
Name of Reviewer
******
Rec # : 05403/9958 Amount: $ 625.00 Date Paid: Sept 29, 1999
y
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Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2B —Anchorage—Alaska 99504
(907) 337-6179—Fax(907)338-3246
Consulting Engineers
September 24, 1999
Municipality of Anchorage
Department of Health&Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage,Alaska 99519-6650
Ref: Septic System Upgrade Design and Waiver Request for Lots 32, Lake Hill Acres S/D#1
To whom it may concern:
1. GENERAL: The existing 2 bedroom house is served by a private well and septic system. The
existing septic system consists of a 1000 gallon septic tank, a lift station, and a bed type
drainfield. The existing bed is surcharged and must be upgraded. One test hole was excavated
east of the existing septic system. Due to the limited area because surrounding well radii, we are
proposing that a new bed be installed in the same area as the existing bed. All contaminated
soils/drainrock,piping, filter fabric, etc., is to be removed completely to a maximum depth of the
1 foot below the existing bed and then place 2 feet of filter sand. Commentregarding the
proposed design are summarized as follows:
2. WAIVER REQUESTS: As can be seen on the design, we are proposing to install the 1250
gallon S.T.E.P. tank 90 feet from the well serving this property and 92 feet from the well serving
Lot 31, Lake Hill Acres S/D #1. We request that your department issue these separation distance
waivers. The general area of Lot 31 and Lot 32 is mostly flat and well vegetated; in short, there is
minimal risk of effluent migrating towards the wells. Attached is the copy of the well log for Lot
32 which shows a confining layer of clay from 37 feet to 44 feet. We also request that 1 foot lot
line waivers from the west and south property lines to the proposed bed be granted. We are
unaware of any adverse effects on the neighboring properties with the granting of these waivers.
3. SOILS: Attached is the log which shows the soil profile, and the percolation test results of
test hole. The soils below the organics are a SM/ML material to a depth of 12 feet (bottom of test
hole). Groundwater was encountered at 12 feet during the excavation of this test hole and was
found to be at 10.5 feet five days later. A percolation test was perfomed between the depth of 2.5
feet to 3.5 feet and found the rate to be 18.5 minutes/inch.
4. TRENCH DESIGN:
a. Percolation Rate: 18.5 minutes/inch
b. Allowable Application Rate: 0.4 gallons/day/ft2
c. Number of Bedrooms: 2
d. Design Flow: 300 gallons per day
e. Minimum Absorption Area: 750 ft2
f. Total Depth: 1 feet below existing bed elevation
g. M.O.A. Approved Sand Filter: 2 feet
h. Effective Depth: 0.5 feet
i. Width: See Attached Detail
j. Minimum Length: See Attached Detail
1. Effective absorption area= 789 ft2
5. SURFACE WATERS: There are no surface waters within 100 feet of the proposed
upgrade.
6. TOPOGRAPHY: The proposed septic upgrade area is generally flat; in short, there are no
slope concerns.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you
for your assistance
Sin erel
�
1� 1 A�
eff -y • . t.rness, '.E., M.S.
Pre-id- t
NOTE: Attached is a site plan drawing, a design drawing, a detail drawing, a soils log and a 4
page construction specification letter which are all part of the design package for this septic
system.
// \ \
/ / \ \
( 11
REESE ROAD I __--
'1 I � 1I \
1\ \ �� ^� /// ,� \\ 1Z\APS
I h / A'170•
\O _O� P //y I Fp v0, A
1 \\Z+�ii ���� \7��\ I Ove ry yi \\
I
LOT 1A, BLOCK 1, I / - / /
BENBECCA S/D --- 11
/ _
,.....
WI I I 4, All I NN �1Vce ryo
> \
1 PGS - I '— PTIC
\ \ p EXISTING ,_� �
1 J'
ip, / 2 BEDROOM A \0 I " SEPTICG // / HOUSE <v \ QT 24, LAKE HILL ACRF15 f
— J I \ \\SYSTEM I �,// ��P- N \�---'�'c�
HEI
` O F
W ���F3? T"
�f11 � 1\ v /11
LOT 2A, BLOCK 1, Y 1 \ / LOT 23, LAKE HILL ACRES #1
BENBECCA S/D i ROPOSED SEPTIC SYSTEM
GRACE STREET SEE DESIGNS PAGE 2_O-F 3)
--- ,
�"� C4-2 O i , ,\ //
h
NY
/-NN/ l'' '
LOT 3A, BLOCK 1, I ��O / /
BENBECCA S/D I /
UP / / LOT 22, LAKE HILL ACRES #1
H
O ,/ AlN.
H �I1 /
1
/ EHILLAC
/ LOTRES #1 /LOT 4A, BLOCK 1, (BENBECCA S/D 1 //
ALASKA WATER AND WASTEWATER CONSULTANTS, INC. v„�F A`o ,
6901 DEBARR ROAD SUITE 2B, ANCHORAGE, AK 99504 „ 4
PHONE: (907) 337-6179/FAX: (907) 338-3246 Q00, •'• •
' 400
LEGAL DESCRIPTION: A • T14L
•,-,*000LAKE HILL ACRES SUBDIVISION #1; LOT 32,TYPE OF WORK: DD
SITE PLAN FOR SEPTIC UPGRADE ;• 1 Q
PREPARED FOR: PHONE NUMBER: OO •03 . f e' G. G� - OQ
EVA LOKEN 689-6476 Q .o C a, 7953 ••' 0 0
0 ! �• • \c0
DATE: DRAWN BY: SCALE: PAGE: 444e�edpWO O0
11/4/99 J.L.M. 1 = 100' 04rofess1 OF 3 � p0000
1\
- - ___� -
10' UTILITY EASEMENT N
1\
EXISTING EXISTING
WELL WELL d I
100 FOOT WELL RApIUg
I i
w / /
\ \
D
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PROPOSED 1250 GALLON
\ -""
-S.T.E.P. TANK
.-o= s / .EXISTING
� � \ \ — �� / WELL
_ •
__-
0 \
�
EXISTING SEPTIC TANK ' L-1/ MT9�- PROPOSED BED UPGRADE. EXCAVATE
AND LIFT STATION TO BEpppp o 1 FOOT BELOW THE EXISTING BED
ABANDONED COMPLETELY L. _.. _. I V THP ELEVATION AND THAN ADD 2 FEET
(LIFT STATION AREA IS TO I y * OF M.O.A. APPROVED SAND FILTER
BE FILLLED WITH SAND) MT )/ AND THAN 0.5 FEET OF CLEAN,
WASHED SEWER DRAINROCK. SEE
DETAIL DRAWING FOR DIMENSION
EXISTING BED. ALL CONTAMINATED IN' OF OUTER LIMIT AND PIPING
J
MATERIAL, PIPING, FILTER FABRIC, I \ LOCATION. THIS IS TO BE A
ETC., IS TO BE REMOVED COMPLETELY. PRESSURIZED BED SYSTEM.
o MT MTo I (SEE DETAIL, PAGE 3 OF 3)
1 FOOT LOT LINE I \1 FOOT LOT LINE
WAIVER REQUESTED WAIVER REQUESTED
NOTE: THE CONTRACTOR SHALL HAVE THE 100 FOOT
WELL RADII THAT ARE MARKED ON THIS DRAWING
AND THE PROPERTY LINES ADJACENT THE PROPOSED
_ BED FLAGGED BY A REGISTERED LAND SURVEYOR
GR AC b. ST. H - T PRIOR TO ANY CONSTRUCTION.
\
ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 06���, „.
6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 'c OF 1` �"��
PHONE: (907) 337-6179/FAX: (907) 338-3246 QOo\�' 1•
LEGAL DESCRIPTION: �� •• O
LAKE HILL ACRES SUBDIVISION #1; LOT 32, �, .� ,,
TYPE OF WORK: a /
DESIGN FOR SEPTIC UPGRADE Q
PHONE NUMBER: 0•� •• 47953
vGaess•PREPARED FOR: e p
EVA LOKEN (907) 689-6476 09 •• .,<mp
DATE: DRAWN BY: SCALE: PAGE: 41)1(6' ••..•••..•••.
ct�
CN
9/24/99 J.L.M. 1 = 30' 2 OF 3 0%�0 fessioo
O�o�o
THESE 4 LATERAL ARE TO
IBE 17 FEET LONG EACH
WITH 03/16" DIA. HOLES
SPACED 3.4 FEET O.C.
z
0
MT
0 • m 0 MT FcrQ
ZL
o O m O
o O 0 0
o 0 O O
e O O O O i..._ ,___]
L---1
o O O O 0 0
o O O O O O
THESE 3 LATERAL ARE TO
BE 22 FEET LONG EACH _
WITH #3/16" DIA. HOLES OMT MTO
SPACED 3.67 FEET O.C. , L
J
L.
26' I
NOTE: MAXIMUM EXCAVATION DEPTH IS TO BE 1 FOOT
BELOW THE EXISTING BED ELEVATION. ALL CONTAMINATED
SOILS/DRAINROCK, PIPING, FILTER FABRIC, ETC., IS TO BE
REMOVED COMPLETELY. TWO FEET OF M.O.A. APPROVED
SAND FILTER IS TO BE ADDED. 1
ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 0• 000
0
6901 DEBARR ROAD, SUITE 28. ANCHORAGE, AK. 99504 OF ; 1 '/i •. 'NO
PHONE: (907) 337-6179/FAX: (907) 338-3246 Qoo�' •. 4 .I .6A1LEGAL DESCRIPTION: Q .. 1 .- ��
LAKE HILL ACRES SUBDIVISION #1; LOT 32, //`''x/• ,lif
. *O01,TYPE OF WORK: • VAV
DETAIL OF BED FOR SEPTIC UPGRADEvn ••• •••• •••• lll��.
Q . f A. • ess,
PREPARED FOR: PHONE NUMBER: 0/1/3 ;—7953 oQO
EVA LOKEN (907) 689-6476 "� ••• • •••• .cep
DATE: DRAWN BY: SCALE: PAGE: 4 �Q,•cen. fessio_0o.
9/24/99 J.L.M. N.T.S. 3 OF 3 k401.000�
ALASKA WATER & WASTEWATER CONSULTANTS, INC. a��° '`'%
6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK. 99504 Od .C(•. '" 4
PHONE (907) 337-6179 ' FAX (907) 338-3246 � ... + •��44
OA
SOIL LOG - PERCOLATION TEST d c . H i ..-7 V
LEGAL DESCRIPTION: LAKE HILL ACRES SUBDIVISION #1; LOT 32, P 6
PERFORMED FOR: EVA LOKEN 'Q . •• j•'
(/oo-/•,h ,, A. Gayness;
DATE PERFORMED: 6/23/99 O ! •• 1E-7953 •'\c7
DEPTH TEST HOLE #1 v,..e,o, ••....••.•••. �-°A�
(feet) ; r ^ ORGANICS Op%Opop000�
• + SOIL CLASSIFICATIONS // /'`�_ ���%'N\ `\ I SITE PLAN •
2— \I
• ' _4,,Z,'' GW EORG // `\ I = 100'
3— J �
GP ' ML -/- ---- - L 'r
• * 11;1115 GM Ji/`l CL L -1- ,\ __
l�� 1 1 1 �I r`� --��
4— / GC , , OL 1 1
+ o°0., SW 1 J MH , / 1 I `
_ • ���y� \\CH EXISTING
5 • , k m[3 SM SP f OH i / 2 BEDROOM
�RE i i \ EXISITNG p
/ / HOUSE
• • rico
\ SEPTIC / /
6— , • ►ic/� SC \\ �NSYST C , � / //
SM/ML t' . •
7— • + DEPTH TO ��� -- ' t—
GROUNDWATER DATE 6/7�e��? I'I�TH#1
• , L--J
8— , 9 12' 6/23/99 \\
. . 10.5' 6/28/99 --------"--- ---�/
9— • , GRACE STREET
-- --
10- • . V
11 — • • DATE READING CLOCK NET TIME WATER LEVEL NET DROP
• • TIME (MINUTES) READING (INCHES)
12 • • 6/28/99 — PRESOAKED PERK CAVITY FOR 4+ HOURS PRIOR TO TEST.
B.O.H. 1 1:35 — 6" —
13— 2 2:05 30 MIN. 4-3/8" 1-5/8"
3 2:06 — 6" —
14— 4 2:36 30 MIN. 4-7/16" 1-9/16"
5 2:37 — 6" —
15—
6 3:07 30 MIN. 4-3/8" 1-5/8"
16-
17
6-17—
18— -- --
19— PERCOLATION RATE 18.5 (MIN./INCH) PERC. HOLE DIA. 6" (INCHES)
20 TEST RUN BETWEEN 2.5 FT. AND 3.5 FT.
COMMENTS: AT 9 FEET, CLAY CHUNKS WERE ENCOUNTERED (HARDPAN).
PERFORMED BY ALASKA WATER & WASTEWATER I, , CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS
DATE. DATE:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
i� b,• i q ENVIRONMENTAL ENGINEERING DIVISION '
825 L Street-Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE L�NEW
W\ i C1'\f\- t !i f -')
� /6~i" _ ❑UPGRADE
MAILING ADDRESS
1 .7 O a,,-.0. .,,a lc,v,-r,/ G D—..
LEGAL DESCRIPTION
L 3 1-,161 e_ h.lk s ekCire S 1
LOCATION ` NO.OF BEDROOMS s
N ?.e-ve( S C r .
Well bO / Absorption area Dwelling PERMIT NO.%1
U Y
DISTANCE TO: ���
wZZ Manufacturer �i t. ..e r Materials,`P e l No.of compartments
WWI- v J
Liq.sip yty j igallons IF HOMEMADE: Inside length Width Liquid depth
Y DISTANCE TO: Well Dwelling PERMIT NO.
..
I�FQ- Manufacturer Material Liquid capacity in gallons
O Well Foundation Nearesj�,pyline PERMIT NO.
w= DISTANCE TO: --
((J
J LL Z No.of lines Length of each line Total length-of lir es Trench width Distance between lines
p 2 winches JL'vQ inches
clTop of tile to finish grade lc/ Material beneath tile , ` Total effec6
tyvg abs�tion area
p 14 inches /u
Length Width ' Depth PERMIT NO.
w
<t- Type of crib Crib diameter Crib depth Total effective absorption area
as
Ili
y Well Building foundation Nearest lot line
DISTANCE TO:
' J Class Depth Driller Distance to lot line PERMIT NO.
J
w DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
PIPE MATERIALS kCV e-
pbs Ac
SOIL TEST RATING , .
,s6 ° /4/71_- ... 4 oel, s -- 1")
INSTALLER
P V D zoiNv, L.r., 5 . A
REMARKS I W
Weed ivalvf,r of dhsi2., 7<-1 /4 Ni
TC-k Ps e_ic isii 7 1-,,,-// servI'j ` �r ti' 1153 To Te
hOuse eve e/OS C., (?,1`_/ Imo. �J -`C 6 < n
..19,A.,?,0,
,ZS NQt c k 6�s- Ai-ells Ivo Close , i1
V
M Ors CI . e -----^ Z4110 ii 1 it
!C
Z
ci
V Y
;4''1:- ‘if _____ -17 ,
APPROVED DATE LEGAL
�_s��rs/ L 3 2- Lit Alt i/s �It-.
72-013 (Rev.3/78)
i-'y A_1 t-•1 I a-: I F°F=1 LL_ I 11"-r° O F- F I t-4 C4-1 Ce F:!R c E
DEPARTMENT HEALTH AND ENVIRONMENTAL ' `''UTEC:T I ON
25 STREET, ANCHORAGE. AK. __1_ 11.
° 254-4720
rvt-.t--:: 11-E _•E I-°1EF: F°EF:tel I -r
PERMIT NO. 810324.
APPLICANT WILLIAM M RAE:E: 170 GRAND LARRY #C2 275-1555
LOCATION
LEGAL L32 LAKE HILL ACRES LOT SIZE 1.5200 SQUARE FEET
TYPE OF SOIL AE:SORPTION SAYS TEV I_ : TRENCH
MAXIMUM NUMBER OF BEDROOMS = _ _OIL RATING <SQ FT''E:R: = 150
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM I_ :
(GM 1-_F7*-I-1-1= 8 I-1 ;-- Ci F=:F !E_ G•E F- r I-1= --
THE LENGTH DIMENSION IS THE LENGTH ( IN FEET) OF THE TRENCH OR DRA I NF I ELD.
THE DEPTH OF A TRENCH OR P I T IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND:' AND THE BOTTOM OF THE EXCAVATION I N FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIFE
AND THE BOTTOM OF THE EXCAVATION ( IN FEET).
F: .- C.:7!lit I F:E.E_:° :_:E F'i- 11_ u FR t-41-==_ _• I .= __ t=-e l-il%-e Cii F a i,L to N1 E
PERMIT APPLICANT HAS THE RESPONSIBILITY Ti i INFORM THIS DEPARTMENT DURING THE
INSTALLATION IN_F'ECTIONS OF ANY WELLS ADJACENT TO i THIS PFCIF'ERT'T AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL _ER'','E.
—--— --1---1 CI °:_ -=: _' I t-4_.F°E c:-j-- I il_e FA F=R F.:E F:E Cz!L I IR E E:' ——---
E:FIC KF I LL I NG OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL _Y_TEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF F'LIE:LIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE I S 75 FEET.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F'E=1-�:1-'-1 I -r E_::-.:F' I E*:E IS E-°E.s_:E.1-'1 E:IE IF! : ::1 _-;:=:
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 I N ACCORDANCE WITH THE CODES.
3 : I UNDERSTAND THAT THE ON-SITE _EWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REt OD'ELED TO INCLUDE MORE THAN 3 E:EDROOMS,.
SIGNED ' (1 1//1 atilli
FIPPLI ANT WI LIAM M RABE:
,
I_'7UEC' BY Cl/
- DATE- 40" V4. 0
L'onst:uction JC 41. _!-QV
s <
"one icsi is u-x-tt c ,}.^vtan2 r i.r.iLnf"
• 2204 Cleveland Anchorage , Ales,.a 99503'
•
Performed F o r George Zwicker Date Performed 8-26-78
Lenal nestrintion : Lot 32 -Block SubdivisionLake Hill Acres
This Form Reports Soils Lon des Percolation Test •
nenth
Feet • Soil Characteristics 1 t._______ , _J
Peat & Reddish Silt J
2 — 1 I _. 1 1
, ,
, ,
1
4 — -
Brown Silty Sandy GravelIly ___Ct -
111
'O
MR
10 — —
II ..� ; I : i 1
12 -- I I � V
Bottom of Test Hole • I ',
1 4 — . II v; j
I } 1
16 — , QC
.18 - 1 Ilir
20- 1 I , ,
I • �
� •
Was Ground Water Encountered? N° `Flo P�. I
If Yes , At what Depth? - i
i I
•
i
1 Reading Date . Gross Time Net Time Depth to H2O Net Dronj
i.-- _
I - _
I
}
I .
—
l
Percolation Rate Minute
Proposed Installation: Seenaoe Pit Drain Field _
Depth of Inlet Depth To Bottom Of Pit Or Trench
Cnmt'EWTS : 150 Sq'. Ft. drainage area required per bedroom.
-
T est Performed By David Paul _ Data Certified Ey: CTL
• Date: 8-26-7-8
ftET. w 10: Division of Geological and Secphysic•I Surveys (DGGS) STATE CF ALASKA
•
. 3001 aorcuoine Drive (' ' m'ne: 277-6615) DEPARTMENT OF NATURAL RESOURCES
Anchorage. Alaska 99501
WATER WELL RECORD
Drilling Company Name Cotten-Magnuson Drilling u.s.G.S. Local No.
Drilling Permit No.
t LOCATION Or wELL •lease complete either la, lb. or lc. A.O.L. No. /A S /6
r la. Borough Subdivision Lot Block lb. Fraction Section No. Township Range Meridian
r Anch Lake HillAd
32 d ># 1/ / / N/S E/W
1
Ic. Distance and Olrecttb�Srf�o R�� Cw - /.��_/ r 3 OWNER OF WELL: Mr. George Zwicker
I1tv`f nk r? n E e ole e' /0 1vJ A 1 'l•
�(�(,� (J/(� Address: Chugiak, Ak.
,/ 7 ' W / 8 4 X18 3
Street Address and Area of Well location
2. WELL LOG Feet Below Ir. i -• PTH: (completed) Surface Elevation Date of
Surface Completion
Material Type Top Bottom 228 ft. NA 6-22-79
Dirt 0 2 S. ❑Cable tool otary 0 Driven ['Dug
Gal. 2 37
Clay 37 44 ❑Auger ❑Jatted ❑Bored p Other:
Gravel 44 95 6. USE: jaDomestle. DPub1Ic Supply ['Industry
Grey clay 95 103 0Irrigation ❑Recharge ❑Commercial
Gravel and boulder 1051 163 205 Nest Well ❑other:
Grovel and clay ' 205 224
Sand and gravel, water 1 224 228 + 7. CASING: 0 Threaded Welded
./. 6 in. to 228 ft. Depth Weight 17 lbs/ft.
pflICHO `'E In. to ft. Depth
NICIP"U" oF4c/..511
(�EY1•$F ngoit'.'10g 8. FINISH OF WELL:
ENV11tot;)A_N14
Typo: Open Hole Diameter: n
'
v-
i,\(j� /3 tomSlot/Mesh Size: Length:
�s� r 1 Set between ft. and ft.
RK` 1 �V Fittings:
9. STATIC WATER LEVEL: 195 ft.
DAbove JBelow land surface
Type of Measurement:
10. PUMPING LEVEL below land surface
ft. after hrs. pumping 10 9.p.,
ft. after hrs. pumping 9•P•e-
11. WELLMEAD COMPLETION: 0 In Approved Pit
\ J1L
XEPitless Adapter inches above grade
12. GROUTING: Well Grouted: CI Tee }aao
Material: ❑Neat Cement ❑Other:
• 13. PUMP: (If available) HP 3./4 _____1
Length
yyottfppDD�rop Pipe 222 ft. capacity 7 g.o at
Type: n;[ay�submersible ❑Peciprocating
CIJet ❑Other. I
' lit. REMARKS:
Drive shoe at 228 ft. Bail tested
I 1_ at 10 G,P.M.
I5. WATFR WELL CONIPACIOR'S CERTIFICATION: //11 / S<
This .r11 mac drilled under my jurisdiction and this report is true to the best of my knowledge and belief: G&r 0 G C
Cotten-Magnuson Drilling 76-77-5385 *IldAdt
keg•stered Business Name Contract License Number
Address: P.O. Box 504 Eagle River , Ak, 99577 L.h S /D 4?
.Signed . • .ii �.'1 .r / .' 1' Date: JO 2, 1919r7n
%-uth0;(Zed Representative
MUNICIPALITY OF ANCHORAGE
DE ITMENT OF HEALTH AND HUMAN SERI IS
. Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name DISTANCES
=,.)-rvL ��' - 6.........'--= '3�— TO SEPTIC ABSORPTION
Address
FROM TANK FIELD WELL
t�. golc- n i 0 5LD7 - i_l 2_kor:,4-419 5r7q -2- 1 11 1
Phone(s) Permit No. No of Bedrooms WELL
Lo9`) -LV2v51 85v.GTh 1 2-
LOT LINE 1 Q' y C
LEGAL DESCRIPTION -1 7 __________
Lot Block Subdivision
32 L-"14-e- 011-A- / c-R-,e--S*) FOUNDATION .3-01+- l,00:.'
Township.Range.Section
k5-1-3 J� AS-BUILT DIAGRAM(Show location of wen.septic system.property lines.foundation.
) �\\� SGS •' �r'` ' driveway.water bodies.etc.)
TANKS
154, SEPTIC E HOLDING ---+—
__
Manufacturer Capacity in gallons
cle -- I GD1 ‘If( -
Material No of Compartments _
��. -7---- 2.P3 L..
TYPE OF SYSTEM
1. vivo4
❑ TRENCH Z BED ❑ W. DRAIN ❑ OTHER
. _ _____ ______,,
Depth to pipe bottom from Total depth from original grader .
original grade 2.,S FT _ FTI Go
Fill added above original grade Gravel depth beneath pipe
I FT 0,`S-- FT Lod'
_
Gravel length Gravel width 1l bL' � 1 I
L
2 3 -,i+i: S t�c-N FT ZZ � 1G 514�1�kri FT r n TD.+.tt \odi:-A l
Total absorption area Distance between lines 1 `l t �1
11$8,S SO FT 1` /A- FT ter` tp(•D
Number o h es Soil rating Pipe material
tv
�A 1.5O SQ FT — tai
er
Installer Date Installed .e 1
r73WELLS � 5
r
PRIVATE 0 OTHER (Identify)
Classification(A.B.C) Total Depth Cased to II M
FT FT Z2`
Installer Date-aretc'<f,
REMARKS:
Scale: ..•N, Rs SEAL
1 1.) Lp-rc_i' , ‘-'nG W `N/ i, Inspections Performed by. ,
pa. /sca--r-k 11,.- -111.4--i.-6:: lf•--i 1.-1 I Date air , k
///
I SSD 19AX ce ity that his inspection was performed according to all
,r> I�,VER. ALASKAALASKA 'r7,,.t l; // s sr
;,;.;
Municipal and State iltl', if.�Iyt�911 Thisvvdate:
Health Department Approval: /,Ky I/ � ~4v Date ////2-/g
72-013(3/85)
^ .
��L..PINI 1[2:: ��fr411._ C3F- IPaN4C:0--ICIFRIPIC3UE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREET, ANCHORAGE, AK 99501
264-4720
1:13k.E1,41EFZ IF�IEEF-6M11: -F
PERMIT NO: 850597 UPGRADE
DATE ISSUED: 09/17/85
APPLICANT: S&S ENGINEERING SO FORK CONSTRUCTION
ADDRESS: SRB 19X
EAGLE RIVER, AK 99577
CONTACT PHONE: 694-2979
LEGAL DESCRIP: SUBDIVISION: LAKE HILL ACRES #1 LOT: 32 BLOCK: NA
SECTION: 3 TOWNSHIP: 15N RANGE: 1W
LOT SIZE: 0. 5A (SQ. FT. OR ACRES)
I certify that:
1. I am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
3. I will adhere to all MOA and State of. Alaska requirements for the set back
distances from any existing well , wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN ( 1) AN ELECTRICf PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPRO WI HOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRICAL WORK USTB�' }mNE BY A LICENSED ELECTRICIAN. •
SIGNED �� ^ DATE:
.4001///
APPLICANT: r ENGINEERING SO FORK CONSTRUCTION
ISSUED BY ��_ ��, ~�� DATE:
_______________
v
• ••
Municipality P.O. BOX 6650
ANCHORAGE, ALASKA 99502-0650
of (907) 264-4111
Anchorage TONY KNOWLES.
MAYOR
DEPARTMENT OF HEALTH&HUMAN SERVICES
November 13, 1985
Robert A. Shafer, P.E.
S & S Engineering
SRB 196-X
Eagle River, Alaska 99577
Subject: Waiver Request 85-052
Lot 32 Lake Hill Acres Subdivision #1
Dear Mr. Shafer:
Your request for a waiver of the required 100 feet horizontal
separation distance between the well and septic tank on the
subject lot has been approved. The required minimim separation
has been waived to 93 feet. This waiver is valid for a two
bedroom single family dwelling only.
Sincerely,
/<2. �^
Stephen S. Morris
Civil Engineer
On-site Services
SSM/ljw
4 r'C., '
C
® ENGINEER'S SEAL)
':
r
Municipality of Anchorage � ,
DEPARTMENT OF HEALTH & HUMAN SERVICES ._•.,• ., •
- 825 "L" Street, Anchorage, Alaska 99502-0650 '�', 'gyri A. Shafer P. ..1
SOILS LOG — PERCOLATION ��6, • No. 1457-E :
•
tigt4pter
r
ROBERT A.SHAFER
' 41` '40• CIVIL ENGINEER
694.2979
A & /0
'
November 3, 1985
F4C4F RIVER,{* `'�/"
!v. +4114,
HEALTH AUTHORITY �' � � (
APPROVALS4,!‘k
F
Municipality of Anchorage /j_ ,•l ,
Department of Health and Human Services F
SEWER&WATER 825 L Street lO
MAIN EXTENSIONS
Anchorage, Alaska 99501
ATTENTION: Susan Oswalt
SEWER&WATER REFERENCE: Lot 32; Lakehill Acres #1
INSPECTION
Request you issue a waiver for the horizontal separation distances
between the existing well located on the referenced property and the
newly installed septic tank in accordance with our previous conversation
ENGINEERING STUDIES
AND REPORTS and the agreement made between Robbyundersigned.Robinson and the
In accordance with our original agreement the existing septic tank
which was located 90 feet from the well was to be waived upon inspection
WELL INSPECTION and verification of its integrity. This was to be accomplished at
&FLOW TEST the same time the absorption area was upgraded. During an inspection
of the existing septic tank it was found to be less than adequate
and a new septic tank was installed at the maximum distance obtainable
while at the same time the absorption area was reduced in size to
SITE PLANS fit within available area. This reduced the overall bedroom capacity
from the desirable three bedrooms to the existing two bedrooms.
A lift station was also required in order to hold the bottem level
of the bed a minimum of five feet above the existing gravel surface
ROAD DESIGN in the old trench.
If you r.-. re additional information, please contact us.
SOIL TEST Si• erely,
PA
PERCOLATION (� BERT A. SHAFER, P.E.
TEST I '/• /ss
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN SRB 196X EAGLE RIVER,ALASKA 99577
t)..6,... .-T
6 fk.ftNS
JUL a ZOITVIUNICIPALITY OF ANCHORAGE goo,
r , 'N
(, ,,.7,;Development Services Department �� Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
d5 !
Certificate of On-Site Systems Approval RUSH
Parcel I.D. 052 31 Expiration Date: i ` Zi —
1. GENERAL INFORMATION
Complete legal description Lake Hill Acres#1 Lot 32
Location (site address) 24423 Grace
Current property owner(s) Jeremy Cordie Day phone
Mailing address
Real estate agent Day phone
2. TYPE OF DWELLING:
• Single Family (w/wo ADU)
n Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well 0 Private Septic x
Water Storage ❑ Holding Tank n
Community Well ❑ Community ❑
Public Water System ❑ Public Sewer I l
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee $ vc 0 o Waiver Fee $
Date of Payment (01141 Lq Date of Payment
Receipt Number OC1(o5Jap Receipt Number
COSA# 056(9t a3(4 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 C&M ENGINEERING Phone 8545558
Address 20182 TULWAR
Engineer's Printed Name CHARLES BALZARINI Date 6/10/2019
•
. vl
i*: 49TM *�I
6. DSD SIGNATURE
1)( System #1 Approved for 3 bedrooms '' 41
CHARLES G BALZARINI
System #2 Approved for bedrooms fo`s ;. CE-13854 .�`<,Ales
rF
Disapproved t <4;0PROFEsso-
Conditional approval for bedrooms, with the following stipulations:
•
ON-SITE ti' 7
WATER AND m
c3 WASTEWATER z�
RAM
'vi SFRVI
1>>-)))))»)111�}l
By: ( ' / Original Certificate Date: 2S9- /9
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 Checklist b!ce sheet
COSA Checklist
Legal Description: LAKE HILL ACRES#1 LOT 32 Parcel ID: 051 052 31
If more than 1 septic system on lot: COSA Checklist# 1 of 1 Structure served by this system 1
A. WELL DATA
0 Well log is filed with Onsite (or attached) Well production at time of test +5 gpm
Date drilled 6/22/79 Water storage tank volume NA gallons
Total depth 228 ft Well disinfected for coliform test? El Yes 0 No
Cased to 228 ft 0 Coliform bacteria is Negative
0 Sanitary seal is functioning correctly Nitrate 1.31 mg/L ❑ Nitrate less than MRL (ND)
0 Wires are properly protected Arsenic ug/L 0 Arsenic less than MRL(ND)
Casing height (above ground) 24 in. Collected by C&M ENGINEERING
Date of flow test for COSA 10/5/18 Date of Sample 10/5/18
Static water level at beginning of test 190 ft.
Comments
B. TANK DATA C. LIFT STATION
Age of tank(s) 19.5 years 0 Required maintenance completed
Tank type/material STEP Age of lift station 19.5 years
0 Standpipes/foundation cleanout per record drawing Lift station material STEEL
Date of pumping 1/3/ 1 Comments: TANK LEVELS CHECKED, OK
TANK IS STEEL STEP TANK
D. ABSORPTION FIELD DATA BED SYSTEM
Which system tested (date installed) 99/2019 Adequacy test date 10/5/18
0 ALL standpipes present per record drawing Results E Pass For 3 bedrooms
Total measured depth from grade 4.3 ft(max) Fluid depth prior to test 0 in
Measured depth to pipe invert from grade ft(min) Water added 450 gal
N/A—pressurized field
❑
■ New depth 0 in
Monitor tubes go to bottom of drainfield. If not, state Elapsed time 10 min
depth into effective
0 Code-required soil cover over field Final fluid depth 0 in
❑ System presoaked Absorption rate 450 gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NO
date of test) If yes, enter date NA
Gallons introduced gallons
Comments/Deficiencies:ORIGINAL SYSTEM TESTED.BED EXTENSION NOT TESTED
COSA Checklist yellow sheet
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' Community Sewer Manhole/Cleanout> 100'
0 Yes if No 90 ft E Yes if No ft
Neighboring Tank > 100' QYes if No ft Private Sewer/Septic Line>25' ✓❑Yes if No ft
Absorption Field on Lot> 100' EYes if No ft Holding Tank > 100' 0 Yes if No ft
Neighboring Absorption Fields > 100' Animal Containment> 50' 0 Yes if No ft
❑✓ Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' E Yes if No ft E Yes if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' E Yes if No ft Surface Water> 100' ❑✓ Yes if No ft
Property Line > 5' E Yes if No ft Driveway/Parking > 0' E Yes if No, comment
Absorption Field > 5' E 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' E Yes if No ft
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10' Q✓ Yes if No ft Driveway/Parking > 0' 2 Yes if No, comment
Property Line > 10' ❑ Yes if No 0.5 ft Wells on Adjacent Lots:
Water Main > 10' E✓ Yes if No ft Private Wells > 100' 0 Yes if No 90 ft
Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' 0✓ Yes if No ft
Surface Water> 100' ✓❑ Yes if No ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION �` of qk ,l‘
I certify that I have determined through field inspections and review ,siivCO'<P'• '� !�.9++
of Municipal records that the above systems are in conformance with j*:'4g TH ' '..4e4 to,
MOA COSA guidelines in effect on this date. 6/15/2019
0 /1! /
r� •• CHARLES G BALZARIHJ ••Al
0r c• CE-13854 ••�%/�
¶,,eipi. •-•'c���
`�kW'I'ROFESSIO\ '..
COSA Checklist yellow sheet kW'
I I --'4.\
G
1 to
NORTH 162.60 to
25 81.7 v
SEPTIC rn CHAIN LINK FEN(, Iv I
c,+ I
/U Q o • Zr-) • . , 11.—sj:i4D nCAR PORT TWO STORY rR-
�D j' 8.2 WOOD FRAME w i _ m
_ HOME E Cl)
IF] . \ 36.1 I
O 1`. -" `_
rel 0
� T
_I1( n 0
`. ' 0 j I s 0
1 --
—
28.3
� o
IWo
FT-
:i.. GARAGE
4.
[T]: 28.3
I___I co ca
on ba
25 SOUTH 162.60
I
Date Scale Legal Description
6/5/2019 1" = 30' Lot 32 .400.-.1.:16:1160"
i
Grid
NW 1561 As-Built LAKE HILL ACRES GRAPHIC SCALE: 1 Inch = 30 Feet� � .. 4 4 4
1I •
Drawn by Field Book ADDITION #1 1515 30 60 �� ��—
BFB ASB2019 PLAT # 64-90 / ,k4!..„17,01....."7...,t• #
I hereby certify that the property described hereon has been surveyed
BOBBY F. BURNETT by me, or at my direction, and that the improvements situated thereon 1 • BOBBY F. BURNETT 1/
are within the property lines and do not overlap or encroach on the Ls-
2941 Carriage Drive property lying adjacent thereto unless otherwise shown. That no + -cO-S--% -
/
Anchorage, Alaska 99507 improvements on the property lying adjacent thereto encroach on the ' '"�`L�• • • • ye
Alf
(907) 350-5541 premises in question and that there are no roadways, transmission \ sstoNtl /'
lines or other easements on said property except as shown. �`_.��► /
Municipality of Anchorage
Development Services Department :x.14.1",.
Building Safety Division �s
On-Site ite Water&Wastewater Program W '
4700 Bragaw Street
P.O. Box 196650
Anchorage,AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 05 I - ,06'2- \ COSA# O a 0113
1. GENERAL INFORMATION Expiration Date: g / 3 - t�
Complete legal description LAKE HILL ACRES #1, LOT 32
Location (site address) 24423 GRACE STREET * CHUGIAK, AK 99567
Current Property owner(s) DON OXLEY Day phone 688-1198
Mailing address PO BOX 671025 * CHUGIAK, AK 99567
Lending agency Day phone
Mailing address
Real Estate Agent DIANE SHEARER w/KINGS REAL ESTATE Day phone 688-2276
Mailing address 21708 OLD GLENN HIGHWAY * CHUGIAK, AK 99567
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 2
3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well U Individual On-site U
Individual Water Storage ❑ Individual Holding tank ❑
Community Class Well ❑ Community On-site ❑
Public Water System ❑ Public Sewer ❑
The Municipality of Anchorage Development Services Department(DSD) Issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer
of title (except between spouses)for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
information obtained from the Municipality of Anchorage 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 GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 516/C5'
Engineer's Comments:
In conducting this evaluation, GEG,LID. attempted to provide a thorough, 0.006�OppO44
conscientious engineering analysis of the system in accordance with ADEC and MOA o Q A�
DSD Guidelines&Regulations. The reported results described the performance of the 4.5:v„<\v �• Ai,
system under the conditions encountered at the time of the test, and separation ' .,'1
distances measured to readily identifiable features. The operational life of all wells and i* i4 ..7 0O
septic systems depend on the local soils condition, groundwater levels that may ;
fluctuate during the year,and the water usage of the family being served by the system. , VA
These conditions are outside the control of the evaluator of the system. Satisfactory test /. l ; ( V
results do not guarantee future performance of the system,nor do they guarantee that Oa J rgy •. • ess.• 0�
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide Q 9s . CE-79 3 •••.c`Op
any warranty or future estimate of how long the system will continue to meet the �4 f () • a‘p
operational requirements of the ADEC or MOA DSD. The content of this report is for 404Pa p .
the sole benefit of the owner listed above.Any reliance upon or use of this report by any \\\\,..,\Z e s s�o a—'
000 0
other person or party is not authorized,nor will it confer any legal right whatsoever. `��,((((1
OF d,,A,
5. DSD SIGNATURE \\��` 0QP•' .•.C7.14I-',..
Approved for2 bedrooms. ON-SITE WATERAND
Disapproved. ` : WASTEWATER
Conditional approval for bedrooms, with the fllowing stipulations: (6. PROGRAM
/1/111)))1.
Attachments:
COSA Checklist L/— Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory • Other
By: lt . .0 Original Certificate Date: ..5--- I -0 9
,i)
(Rev.11/05)
Municipality of Anchorage •
! '-e Development Services Department
Building Safety Division ,. .:$ '•
On-Site Water&Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: LAKE HILL ACRES #1, LOT 32 Parcel ID: 957- v ! -31
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 6/22/1979 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 228 ft. Cased to 228 ft. Casing height (above ground) 24 in.
FROM WELL LOG AT INSPECTION
Date of test 6/22/1979 4/23/2009
Static water level 195 ft. 191 ft,
Well production 10 g.p.m. 5.1 6 g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate°.(DO7mg./L. Other bacteria C) colonies/100 ml.
23
Arsenic: 4 2009 Collected ug./L. Date of sample: / / by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material S.T.E.P./STEEL Date installed 11/30/99-12/1/99
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES
Date of pumping 9/5/2008 Pumper JR'S PUMPING
C. ABSORPTION FIELD DATA 'BELOW EXISTING GRADE
Date installed 11/30/99-12/1/99 Soil rating ( orft2/bdrm) 0.4 System type BED
Length 34 ft. Width 20-26 ft. Gravel below pipe 0.53 ft.
Total depth •4.25-5.41 ft. Eff. absorption area 794 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 4/23/09 Results (Pass/Fail) PASS For 2 bedrooms
Fluid depth in absorption field before test DRY in. Water added 310 gal. New depth DRY in.
Elapsed Time: 0 min. Final fluid depth DRY in. Absorption rate >= 310+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N &type) NONE KNOWN If yes, give date -
D. LIFT STATION
Date installed 11/30/99-12/1/99 Size in gallons 1250 Manhole/Access (Y/N) YES
"Pump on" level at 42 in. "Pump off' level at 42 in. High water alarm level at 44 in.
Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot *90 + On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots **87
Public sewer main N/A Public sewer manhole/cleanout N/A
Sewer/septic service line 25 + Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots *92'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line *1' Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
*WR990079 **WR930001
G. ENGINEER'S CERTIFICATION �� OF A L N
I certify that I have determined through field inspections and Q* 4 9 T r %..�0O
review of Municipal records that the above systems are in •
' V
conformance with MOA COSA guidelines in effect on this il vAvAdate. '/ i-f • arness.
Engineer's Printed Name JEFFREY A. GARNESS 0009 ' ./ CE-79 3 ...•\c P;
Date / / %,0 d
a�'r0 f ession°o
�D.0000. a
COSA Fee$ `-1 4l Waiver Fee $
6
Date of Payment 3 e /0 1 Date of Payment
Receipt Number 0_36566 Receipt Number
(Rev. 11/05)
��Apr 23 2009 11 : 31AM 907-688-2275 p. 1
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ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694-0829
I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE
FOLLOWING DESCRIBED PROPERTY' ..
e-~"iJ�/kl fftlP,/XsP'id,Ge4,G4,",e' DATE: y P'� •O�'A�'q0`�` .
AND THAT NO ENCROACHMENTS EXIST E�CCEPT AS ,c/�,0 ,r k -. e
INDICATED. IT 1S THE RESPONSIBILITY OF THE ;;'=•:' •4 ( Y �'
OWNER TO DETERMINE THE EXISTENCE OF ANY GRID! ,� i
EASEMENTS, COVENANTS, OR RESTRICTIONS '4'44" /s"�� I .. - . . -
WHICH DO NOT APPEAR ON THE RECORDED SUBD1•' #�4 -..
Duene Mefk 9.w•.d /
/ISI ON PLAT. UNDER NO CIRCUMSTANCES SHOULD FB` T�!� •• LS-69)8 ••' 4�'
kNY DATA HEREON MUSED FOR CONSTRUCTION 1 �, •..- ,.• r
DF FENCE LINES, OR FOR ESTABLISHING BOUND- DRAWN: A14k "K*rsk, \-7.5:-.....
CRY LINES. � k4x,•►,r•
.d.-9k
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services .�
On-Site Services Section
P.O. Box 196650 Anchorage,Alaska 99519-6650
(907)343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILLY DWELLING
Parcel I.D. # 051-052-31 HAA# ,(/)GCl,''
1. GENERAL INFORMATION
Complete legal description LAKE HILL ACRES SUBDIVISION #1. LOT 32
Location (site address or directions) 22423 GRACE ST. CHUGIAK, AK 99567
Property owner EVA LOKEN Day phone (907) 659-6476
Mailing address 9123 HILAND ROAD, ANCHORAGE, AK 99577
Lending agency Day phone
Mailing address
Agent Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 2
3. TYPE OF WATER SUPPLY:
Individual well XXX
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site XXX
Holding Tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
ing to the legality and status of system.
72-025(Rev.1191)Front MOA 421 Computer Version
Note:Alaska Water and Wastewater Consultants, Inc. shall be paid$800.00 at,
or prior to, closing for the engineering services provided.
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 further verify that based on the information obtained from the Municipality of
Anchorage files and from my investigation and ins ection, the on-site water supply and/or wastewater
disposal system is in compliance with all Munici and State codes, ordinances, and regulations in effect
on the date of this inspection.
Name of Firm ALASKA WATER &WAS'GE A ER CONSULTANTS. INC. Phone (907)337-6179
1 / I: / f/. I
Address 6901 DEBARR ROAD, STD 2B ANCHORAGE, ALASKA 99504
Engineer's Signature __ i ��i!� Date i /3 /012t i /.
In conducting this evaluation,AWWC, In . attempted to provide /
a thorough, conscientious engineer/ng analysis of the
system in accordance with ADEC and MOA DHHS Guidelines& Regulations. The reported results described the
performance of the system under the conditions encountered at the time of the test, and separation distances
measured to readily identifiable features. The operational life of all wells and septic systems depend
on the local soils condition, ground water levels that may fluctuate during the year, and the water 0000p��
usage of the family being served by the system. These conditions are outside the control of O A
the evaluator of the system. Satisfactory test results do not guarantee future performance .,•==,`C.., ... . . q l i
of the system, nor do they guarantee that there are no hidden defects or encroachments. Op ► / 1.1..-f-10,,
AWWC, Inc. can therefore not provide any warranty for future estimate of how long the p(�; r • Tsystem will continue to meet the operational requirements of the ADEC or MOA DHHS. ��* r �* 0D
The content of this report is for the sole benefit of the owner listed above.Any g�� I
reliance upon or use of this report by any other person or party is not authorized, .. .
nor will it confer any legal right whatsoever. vA '•.Jef:rey A.' Gorness. ��
VA m
CE-7953 i .•' mp
6. DHHS SIGNATURE QO%rte' ."- -'
�c�0
0
Approved for — bedrooms d4�e A o goo
a
rofessio0 o
Disapproved
��00000��
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
By: ,../04.--1...-L.,_ l SCJ• de-- Date 7 - ( -
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of
homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of
DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
72-025(Rev. 1/91)Back MOA#21 Computer Version
i«CEIVED
Municipality of Anchorage JUL 05 2000
LcD° DEPARTMENT OF HEALTH & HUMAN SERVICES
•
::;
Environmental Services Division MUNICIPALITY OF ANC•—•,.,,_,A1
825 "L" Street, Rm 502 Anchorage,Alaska 99501 (907) 343-4TOMENTAL SERVICE-61111.
Health Authority Approval Checklist
Legal Description: LAKE HILL ACRES S/D #1; LOT 32 Parcel I.D.: 051-052-31
A.WELL DATA
Well Type PRIVATE If A, B, or C, attach ADEC letter. ADEC water system number N/A
Log present(Y/N) Y Date completed 6/22/79
Total depth 228' Cased to 228' Casing height(above ground) 18"+
Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
FROM WELL LOG AT INSPECTION
Date of test 6/22/79 6/28/2000
Static water level 195' 197'
Well production 10 g.p.m. 5.3+ g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 Nitrate 0.633 mg/L Other bacteria 0
Date of sample: 6/28/2000 Collected by: A.W.W.C., INC.
B. SEPTIC/HOLDING TANK DATA
Date installed 11/30/99-12/1/99 Tank size 1250 Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout(Y/N) YES Depression (Y/N) NO High water alarm (Y/N) N/A
Date of Pumping NEW Pumper —
C.ABSORPTION FIELD DATA *2.23' OF M.O.A. APPROVED
SAND FILTER BELOW TOTAL DEPTH.
Date installed 11/30/99-12/1/99 Soil rating k.p.d./ft�or ft2/bdrm) 0.4 System type BED
Length 34' Width 20' — 26' Gravel thickness below pipe 0.53' Total depth *4.62'-5.62'
Effective absorption area 794 SQ.FT. Monitoring Tube present(Y/N) YES Depression over field (Y/N) NO
Date of adequacy test NEW Results (Pass/Fail) — For 2 Bedrooms
Fluid depth in absorption field before test(in.); — Immediately after — gal.water added (in.): —
Fluid depth — (ins) Minutes later: — Absorption rate= —
Peroxide treatment (past 12 months) (Y/N) — If yes, give date —
72-026(Rev.3196)'Computer Version
D. LIFT STATION
Date installed 11/30/99-12/1/99 Size in gallons 1250
Manhole/Access (Y/N) YES "Pump on" level at* 42" "Pump off' level at* 42"
High water alarm level at* 44" *Datum BOTTOM OF TANK
Cycles tested NEW
E. SEPARATION DISTANCES *WAIVER GRANTED (WR990079)
SEPARATION DISTANCES FROM WELL ON LOT TO: **WAIVER GRANTED (WR930001)
Septic/holding tank on lot *90'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots **870
Public sewer main N/A Public sewer manhole/cleanout N/A
Sewer/septic service line 25'+ Lift station *90'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: *WAIVER GRANTED (WR990079)
Foundation 5'+ Property line 5'+ Absorption field 5'+
Water main/service line 10'+ Surface water/drainage 100'+ Wells on adjacent lots *92'+
SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO:
*WAIVER GRANTED
Property line *1' Building foundation 10'+ Water main/service line 10'+
Surface water 100'+ Driveway, parking/vehicle storage area 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'
F. ENGINEER'S CE TIF ATI' v�• OF �, �O
I certify that I :ve e i + hri field inspections and review p . , • o�
of Municipal :cord t t , : :boy systems are in conformanceA '0
with MOA H' . gui effect on this date. Iift •.:32:0°h
Signature i
JEFFREY A. GARNESS Q�. . -f; e�A. Carne-
Engineer's Name QO 9.' er-7953 .. i pO
4s J ,coo
Date 7(3/OD 46%, ...c\
P,, '••• ..... ••o•co°o
4o rofessio�o�
04000. '.
HAA Fee$ 3 O•U ' D-DWaiver Fee$
Date of Payment -7-, - 6'4' Date of Payment
Receipt Number 4'7 6' �� 7 x38'' Receipt Number
72-026(Rev.3/96)*Computer Version
of Ancl!rage
Muni4palitY ��
Department of Health and Human Services
825 "L" Street
Tom Fink, P.O. Box 196650 Anchorage, Alaska 99519-6650
:' Mayor
February 19 , 1993 .
Roger Shafer, P.E.
S & S Engineering
17034 Eagle River Loop Road
Suite 204
Eagle River, Alaska 99577
Re: Waiver Request for Lot 29 Block 1 Lake Hill Acres #1
Waiver Request #WR930001, PID #051-052-34 , SW930006
Dear Mr . Shafer :
Your request for waiver of the required 100 foot horizontal
separation of a septic system to a private well has been
approved. The approved separation distance is 87 feet from the
well on lot 32 to the proposed absorption trench on the subject
lot . The waiver requests for; 1) proposed absorption field to
foundation, 5 feet, 2) proposed absorption field to existing
absorption field, 5 feet , and 3) proposed absorption field to
property line, 5 feet have also been granted approval.
This waiver approval applies to the existing septic system to
well separation only. Any future upgrade to either will require
all separation distances be met or another approval from this
department .
Sincerely, Con ur :
Ai
Daniel J. Roth ohn Sm, h, P.E.
Civil Engineer Program Manager
On-Site Services On-Site Services
OSS#196
Time ' Time .e
Date Date Date
Inspector Inspector Inspector
Comments Conditional Approval4_`,y2A ' � 2.)4,7
�--
Soft O /I-LA-7 ,oma- t-A
/ -- - 3
c 41-&-tS96^-
zQ 62)4.10
Date Sewer Installed Permit No. Septic Tank Size !CC
` Holding Tank Size
Soils Rating Well To Absorption Area Well Log Received
Well to Tank
APPLICANT FILLS OUT LOWER HALF ONLY
Property Owner /(/ //( /�l` Phone
Mailing Address ?�y ( ,/ / 4/2,c,c-
Buyer c1).,Ci
Address, - 7 27c) ,<-/-(-72:4-7/ - /-74„,r"
Lending Institution Phone
,
Address
Realty Co. &Agent Cc) ✓ / ce P� , o r? Phone
Address 'C),r5- CW /9 ' e ��� c/{ ,99. 11/
Legal Description .42/ _17_2 ,<a //// 44.5-
Street Location (91/- a 4 Q -f
Type ofiesidence
Single Family
:=7 Multiple Family No. of Bedrooms
• Other
Water_ Sy.ply
C5 Individual ATTACH WELL LOG. A well log is required for all wells drilled since June
❑ Community 1975. For wells drilled prior to that date, give well depth (attach log if
❑ Public Utility available.)
Sewagt,Disposal / 9(/
LTlndividual Year Individual Installed:
❑ Public Utility When Connected to Public Utility:
C Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.