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HomeMy WebLinkAboutSPRING BROOK VISTA #1 BLK 1 LT 5-A1#050-091-38 Municipality of Anchorage +� Development Services Department • ` s" r Building Safety Division On-Site Water 8 Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW040092 PID Number: 050-091-38 Name; WILLIAM AHRENS Wastewater System: in New ❑ Upgrade Address; 12250 EAST PRINCE OF PEACE DRIVE a EAGLE RIVER, AK.99577 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 694-6583 4 ■ Deep Trench O Shallow Trench p Bed O Mound CI Other LEGAL DESCRIPTION SWI "°""°' 1.2 T.tal D.PD f om ad°'"" °` aPD/sa. rt 14.4. 5 R Block: let: Subdivision: 5—Al SPRING BROOK VISTA Depth m pipe bottom bam Oft"l graft: .Grave NPs, behmth pip,1 SEE DWG. R 5.6 e, Township: — Range: — Section: FNI added avow ari°h.t grotle:Gravel bath: — SEE DWG. rL 48 FL WELL: ❑ New ❑ Upgrade Cvvel wdth: 2.5 Number d Mee: Olelnnce between pus: Ckweincetion PNwte, &&C): Tele) Cased Tal Tetol abeerptbn arae: ft1 — rL Plpe material: rt FL 538 90. rt. ' D 3034/ F-810 DDIb: Date areMd: Statk; Water Level: Inetaler. GREEN GENERAL Date kwtol4d: 9/29/2004 rL weld: Puma set AtCaeka Height ew Ground: 6PM rL R. TANK SEPARATION DISTANCES ■Septic 0Holding 0S.T.E.P.i 13 Other To Septic Absorption LNt Holding ub&/Prkgte blanufoeturar. Cepxky 1n °.pone: From Tank Fleki Station Tank sewer unn ANCHORAGE TANK 1250 Well N/A N/A — — 25'+ Wterbl: STEEL Number of aomporbnente: 2 Surface Water 100'+ 100'+ — — — LIFT STATION Lot tine 5'+ 10'+ — _ see M °allem: Memdoeturer; Foundation 5'+ 10'+ — mp on bwl ab p at: Hlgh tater slam ab Curtain DrainNONE KNOWN Pump wok. sl: Electrical knpecDom pw1cv wd by. Remarks: BENCH MARK LaaOon and DeeenPDon: FRONT DOOR THRESHOLD Apunwa Elewtton: 104.23 R ENGINEERS SEAL 0004 Inspections performed by: GEG, Ltd. Dates: list 9/29/2004 2nd 9/29/2004 3rd 9/29/2004 y .. ff Go ess.. P Q Development Services Department Approval 79 °o Reviewed and approved byjz Date:(_19-OLL4��ped"r pe .0 ''meq tRev. 12/01) 0 rof esslon o� 0040000 PES:0092 ER: AS -BUILT DRAWING PARCEL ID NUMBER: 050_091_38 HOUSE N 1250 GALLON SEPTIC TANK C\-, `ALTERNATE SITE WILL REQUIRE THE USE OF AN ADVANTEX TREATMENT SYSEM GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS& GENERAL CONTRACTORS I_C 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE. AK 99507 • PHONE (907)337-6179 • FAX (907)338-3246 PREPARED FOR: PHONE NUMBER: PA WILLIAM AHRENS (907) 694-6583 LEGAL DESCRIPTION: SPRING BROOK VISTA SUBDIVISION; LOT 5A-1, BLOCK 1, TYPE OF WORK: AS -BUILT DRAWING OF NEW SEPTIC SYSTEM • WATER LINE (APPROXIMATE LOCATION) 10/11 R.A.L. LE: 1 " = 40' E NUMBER: 2 OF 3 of r GO ess:' �. CE -7 \d°G Pr I ssl iI�F o0 Pro /essioO� o �OQaaao�o F__A­_F B FCO 13.67 9.59 STt 19.78 18.13 ST2 25.39 25.99 DBL` 28.83 29.37 DBL2 29.89 29.60 CO1 136.681 16.26 MT 135.85 122.67 CO249.95 49.20 • WATER LINE (APPROXIMATE LOCATION) 10/11 R.A.L. LE: 1 " = 40' E NUMBER: 2 OF 3 of r GO ess:' �. CE -7 \d°G Pr I ssl iI�F o0 Pro /essioO� o �OQaaao�o PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SW040092 050-091-38 FINAL GRADE ST7 � 88.28(00.) 5T2 , TOP OF TANK AT INLET 93.43/—OUTLET . 93.43 NEW 1250 GALLON INVERT OF BUNG SEPTIC TANKINVERT OF BUNG AT AT INLET - 92.93 il ' OUTLET - 92.60 FINAL GRADE ORIGINAL GRADE 98.25-101.23 98.92-100.92 'TEST HOLE WAS DEEPENED FILTER FABRIC BY G.E.G. Ltd. ON 9/15/2004. 7 DAY GROUNDWATER MONITORING PERFORMED ON 9/22/2004. TEST HOLE DRY. o INVERT OF PIPE 92.02 (AVG) BOTTOMOF TRENCH 86.42 (AVG) *RELATIVE ELEVATION OF BOTTOM OF TEST HOLE 0 78.92 — DATE: opQp� 10/11/2004 o OF. ll DRAWN BY: GARNESS ENGINEERING GROUP Ltd. R.A.L. _ CONSULTANTS 8 GENERAL CONTRACTORS T SCALE: 1" 4O' 0 :.4 '. T 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 • PHONE (907)337fi179 • FAX (907)339-3246 PREPARED FOR; PHONE NUMBER: PAGE NUMBER: WILLIAM AHRENS (907) 694-6583 1 3 OF 3 GOr ess.: LEGAL DESCRIPTION; QO •• • C SPRING BROOK VISTA SUBDIVISION; LOT 5-A1, BLOCK 1, 4�0,''•.,�a,/ •pc4�oo TYPE OF WORK: 40�d si pyo/esoT`� 00 PROFILE AS -BUILT DRAWING OF NEW SEPTIC SYSTEM Profs ii � GARNESS ENGINEERING GROUP, Ltd. CON3ULTANT3 & GENERAL CONTRACTORS SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION:_.SPRING BROOK VISTA S/D#1; LOT 5—A1 PERFORMED FOR: BILL AHRENS DATE:9/15/2004 DEPTH r-----9 TEST HOLE #11 DEPTH TO GROUNDWATER DATE DRY 9/15/2004 DRY 9/22/2004 • 31141 VZZZA MM NNENO • 111111111 RHM ��� • pl DEPTH TO GROUNDWATER DATE DRY 9/15/2004 DRY 9/22/2004 _____ L J , 00 ARE 1 % �TH#I I / I / ' I j / j SITE PLAN 1'=100' DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) R�SJ�•�S N PERcoo, GNPR�� PERCOLATION RATE — (MIN./INCH) PERC. HOLE DIA. (INCHES) TEST RUN BETWEEN — FT. AND — FT. A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: COMMENTS: GEG, Ltd. DEEPENED CHARLES LEET'S TESTHOLE TO 22' AND FOUND NO GROUNDWATER. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WASP FORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 16141 o •• o �.. v� vc: tap nlAaKa .Kim cng JYI ll.I �V Lyt r•� PERCOLATION TEST Alaska Rim Engim¢edng Inc. PO Bar 1749, Palmer• AK 99645 MUNICIPALITYOFANCHORAGE nI Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT' Initial Date Issued: Apr 28, 2004 Expiration Date: Apr 28, 2005 Permit Number: SWO40092 Parcel ID: 050-091-38 Legal Description stag$rook Vlst3#1"131CCYf:" I&SA-3 Design Engineer: 0041 AK Water & Wastewater Consultant Site Address: 10719 Katlian Drive Owner Name: Williams Ahrens Lot Size: 22010 SQ. FT. Owner Address: 10719 Kadian Drive Total Bedrooms: 4 Permit Bedrooms: 4 Anchorage , A 99577 - This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements speed 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 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. Received By: Date: Issued By. Date: N U11 11 Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. OSo -oi I - 3 6 Permit Number _SW Property owner(s) WILLIAM AHRENS Day phone 694-6583 Mailing address (1) 10719 KATLIAN DRIVE * EAGLE RIVER. AK Mailing address (2) Zip Code 99577 Legal description (Lot, Block & Sub'd.) LOT 5-A1 BLOCK 1 • SPRING BROOK VI TAS#7 BDIVI ION Legal description (Section, Township & Range) N/A Lot Size 22,010 Acre%EE. Number of Bedrooms 4 THIS APPLICATION IS FOR: Sewer Only ® Well Only ❑ Sewer and Well ❑ Water Storage ! ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS. INC. . K'N.I.GmR0t ' Lt Permit Fees: '� t ('n Date of Payment: y )a3 DS Receipt Number: UJI Waiver Date of Payment: Receipt Number: ALASKA WATER & WASTEWATER CONSULTANTS. INC.*tww,rt�nma,uannw.a�mix*axuwuununmxmuuwwnnwwtw, January 13, 2004 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Septic System for Lot 5A-1, Block 1; Spring Brook Vista Subdivision To whom it may concern: The proposed 4 bedroom house will be served by a public water system and a private septic system. A test hole was dug on the property. The drainfield will be designed around the 30 foot radius of this test hole. We are proposing that a new 1250 gallon septic tank and a deep trench type drainfield be installed. On completion of our records research we found there to be a Class "A" well in a well house on Lot 9A-1, Block 1, Spring Brook Vista Subdivision. A site visit was performed on 1/12/2004 to confirm the well location. The well house was checked and no well was found in the well house. It appears the well has been abandoned. (See the attached letter and drawings from AW WU) Comments regarding the design are summarized as follows: 1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. TRENCH DESIGN: a. Percolation Rate: 1.66 minutes/inch b. Proposed Application Rate: 1.2 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 500 ft2 f. Total Depth: 10 feet (max.) g. Effective Depth: 7 feet - It. Width: 2.5 feet i. Reduction Factor: N/A j. Minimum Length: 40 feet long k. Effective absorption area = 560 ft2 3. SURFACE WATERS: There are no surface water concerns. 4. TOPOGRAPHY: The proposed drainfield is to be installed on a toe of a slope that is a 5-15 percent slope running southeast to northwest. In short, there are no slope concerns. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179.Thank you for your assistance. , , M.S. NOTE: Attached is a site plan drawing, a design drawing, a soils log, and a 7 page construction specification letter which are all part of the design package for this septic system. 3701 E. Tudor Road Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com i ; SPRING BROOK VISTA S/D: ,„_ LOT 10, BLOCK 1, WELL Y� ABANDONED SPRING BROOK VISTA S/D; LOT 9A-1., BLOCK 1, Li \ \\� CSEEPC ,tD ) ALT�NATE SITE / 4 / SPRING BROOK VISTA LOT 7, BLOCK 1, / POSED 4 BEDROOM// HOUSE / 7/SPRING SPRING BROOK VISTA 5/D; LOT 5, BLOCK 3, OPOSED SEPTIC SYSTEM DESIGN PAGE 2 OF 2) BROOK VISTA S/D;T 6, BLOCK 3, J / / \SPRING BROOK VISTA S/\ J LOT 7, BLOCK 3, 1/13/2004 _. / �';, ♦a DRAWN BY: ALASKA WATER & NVASTEWATER C.J.G. CONSULTANTS, INC. SCALE: 3701 E. TUDOR ROAD. SUITE 101 , ANCHORAGE. AK 99507 • PHONE (907)357-6179 • FAX (907)338.3246 1 „ — loo, PREPARED FOR PHONE NUMBER: PAGE NUMBER: WILLIAM AHRENS 694-6583 1 OF 2 LEGAL OESCRIPTION: SPRING BROOK VISTA SUBDIVISION; LOT 5A-1, BLOCK 1, TYPE OF WORK: SITE PLAN FOR PROPOSED SEPTIC SYSTEM of r Go 'ness; ;� vo� - e 14'0dp -APPROXIMATE LOCATION OF ABANDONED CLASS 'A' WELL DEPENDING ON THE ELEVATION OF THE HOUSE A UFT STATION OF GRINDER PUMP WILL HAVE TO BE USED. \ INSTALL FOUNDATION / :;`• AOSED SEPTIC250 TANK / ,•yx� TOE OF SLOPE / 4—PROPOSED DRNNFlELD. EXCAVATE A TRENCH / 1 THAT IS 10 FEET DEEP MAXIMUM BY 2.5 FEET WIDE BY 40 FEET LONG. ADD 7 FEET / OF CLEAN, WASHED SEWER DRAINROCK. iNOTE: THE CONTRACTOR SHALL HAVE THE �F SOUTHWEST LOT LINE FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. 41DOUBLE OX. LOCATION OP OF HILL OX. LOCATION PROPOSED ATER LINE 1/13/200 DRAWN BY: ALASKA WATER & WASTEWATER C.J.G. u mQ� CONSULTANTS. INC.SCALE: 37015 Tl'pOR FOap, gill, 'Oi ' CNf NCRA.SE Arc 10s17 ptiOMF cp¢ gp7)3}8d246 1 " = 30' PREPARED FOR: PHONE NUMBER: PAGE NUMBER: WILLIAM AHRENS (907) 694-6583 2 OF 2 LEGAL DESCRIPTION: , SPRING BROOK VISTA SUBDIVISION; LOT 5A-1, BLOCK 1, TYPE OF WORK: DESIGN DRAWING FOR PROPOSED SEPTIC SYSTEM PROX. LOCATION OF KEY BOX 4XN Y�* .J fA. ... GO..59..... 7953 d4 Open_ .... nay UJ ue ue:41P r 3 nlasna r<t® 'ns PERCOLATION TEST TU 1" NO. 1 i.V1Y11VICry 1 J: tits appfication rate per ADEC 18 AAC 72 regulations Table C, WASTEWATER APPLICATION RATES FROM PERCOLATION TEST RESULTS'k 24� a Dry 1 003 .EofAt ... ...4x l( i Clunes A Leet •� j CE 10480 • •V�''ti There aro several m of measuring soil percolation, technically called hydraulic conductivity. The soil percolation test method we performed was conducted in general conformance with the Falling Head Percolation Test Procedure from EPA's Design Manual for Onsite Wastewater Treatment and Disposal Systems dated October 1980. This method is the one most commonly used and can give an approximatc .measure of the soil's saturated hydraulic conductivity. However, normally the percolation of wastewater through the soil below the leach field occurs through unsaturated soils. The unsaturated hydraulic conductivity can vary greatly from the saturated hydraulic conductivity with changes in soil characteristics and moisture content. The hydraulic conductivity accurately. Theresults from this test method can be variable and may not measure the se test results should only be used together with specific soil characteristic data and other site characteristics to design an appropriate soil absorption system. Alaska Rim Engineering Inc. PO Bar 7749. Palmer. AK 99645 S D A PL N MAI WA Perk Raten Rate Comments Faster than Iable Requires sandliner or additionaleatment. 1— S- 1516 MAppli — 30 1- 61 —120a ea Requves mgineenng u�i and ADEC lan approval. i.V1Y11VICry 1 J: tits appfication rate per ADEC 18 AAC 72 regulations Table C, WASTEWATER APPLICATION RATES FROM PERCOLATION TEST RESULTS'k 24� a Dry 1 003 .EofAt ... ...4x l( i Clunes A Leet •� j CE 10480 • •V�''ti There aro several m of measuring soil percolation, technically called hydraulic conductivity. The soil percolation test method we performed was conducted in general conformance with the Falling Head Percolation Test Procedure from EPA's Design Manual for Onsite Wastewater Treatment and Disposal Systems dated October 1980. This method is the one most commonly used and can give an approximatc .measure of the soil's saturated hydraulic conductivity. However, normally the percolation of wastewater through the soil below the leach field occurs through unsaturated soils. The unsaturated hydraulic conductivity can vary greatly from the saturated hydraulic conductivity with changes in soil characteristics and moisture content. The hydraulic conductivity accurately. Theresults from this test method can be variable and may not measure the se test results should only be used together with specific soil characteristic data and other site characteristics to design an appropriate soil absorption system. Alaska Rim Engineering Inc. PO Bar 7749. Palmer. AK 99645 'Ij .UG Description Ue:tlp nlasKa Kim mng e 03 02 02:41p H1asKa klm Lng au. 11.. W, .. r.. mui ito -U'c& r SOIL LOG Lot 6-A1, Block 1 Springbrook Vnta1116101 Lo2eed Bv: Chur_k Loo TEST HOLE NO. l Dept (feet) Description I Top Soil 2 Sand, Gravel (SW) 3 • 4 5 6 7 g 9 10 11 12 13 14 15 16 Bottom of Test Hole 17 Is 19 20 21 22 23 _ 24 AK Rim File No. 01-00799 .F A TEST HOLE LOCATION: Within W of apposed SAS. COMMENTS: No water or impermeable layers were encountered. This soil log was prepared for div -solo purpuw of determining the feasibility of constructing an onsite wastewater disposal system at the location of the teat hole. Soil type ratings aro Wed on visual observation and have not been verified with laboratory analyses. These soils have not been analyzed for structural Properties, structural stability, and seismic stability or for any purpose other than wastewater absorption field construction. Anyone relying on the information in this log for any use other than wastewater absorption field development shall do so at his or her own risk. Alaska Rine Engineering, Inc. PO Bos 2749, Pahner, AK 99645 I ... y Chanes A Leet • CF 10480 •5���,! 19f0.......•..t�� TEST HOLE LOCATION: Within W of apposed SAS. COMMENTS: No water or impermeable layers were encountered. This soil log was prepared for div -solo purpuw of determining the feasibility of constructing an onsite wastewater disposal system at the location of the teat hole. Soil type ratings aro Wed on visual observation and have not been verified with laboratory analyses. These soils have not been analyzed for structural Properties, structural stability, and seismic stability or for any purpose other than wastewater absorption field construction. Anyone relying on the information in this log for any use other than wastewater absorption field development shall do so at his or her own risk. Alaska Rine Engineering, Inc. PO Bos 2749, Pahner, AK 99645 I Page 1 of 1 john@akwwc.com From: Bennett, Wayne. [Wayne. Bennett@awwu.biz] Sent: Tuesday, January 06,2004 10:44 AM To: john@akwwc.com Cc: Putnam, Bill. Subject: Water Well on West Prince of Piece. John, it was good to hear from you. I could not find any records at AW WU that we abandoned this well. Our data base shows the well in the abandoned coverage and I could not find any records that we ever operated the well. My theory is that the well was abandoned when the system was acquired years ago. The attached old record drawing shows the original well house and distribution system was constructed in 1975, but not updated when the well was taken our of service.. I would guess that if the well house or casing cannot be found with a field visit, assumption is that it is not in service: Wayne NEED F�a�il ✓f'aw�c„vo,J R. Wayne Bennett AWWU Planning Section Phone 907.564.2723 FAX 907.562-0824 Email Rwayne.Bennett@awwu.bizo v�1\ Fey .� �,� W�, ✓1A . dW.,,:. ,ee,..,u.„iwG'sn, McL.dN.y ar.y. d/arMn«Js, fs c.,l«,d d .n(y. F.,. Uw nw,..d a”. (>) wnd „wy c,,,z .uq� dm/.bl MwGe,.. 94+ nu.tm./yud.Jy, w+dx! /,. ,. 2 ..y, x.4.d d 6.,:,,aw. �u.o,.ia4d m a n,a�fl.. ,� ..n,..,:n..u. 91dy "" �% .,. �'+wl, AaTdcy'Y r,.a� 'a/m Em"' P A- p,.Ad'[d. YJ L4. .I. ty a 4. ..d and d.4& Uw 1/6/04 12/IQ/03 11:49:32 AM 0."13GI 2 n I flexil ry IV 4AR Municipality of Anchorage • Development Services Department - �+ Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 1. GENERAL INFORMATION Complete legal description HAA# hq Expiration Date: SPRING BROOK VISr 0 6BDMSION: LOT 5—A1. BLOCK 1. Location (site address or directions) 12250 E45r PRINCE OF PEACE DRIVE • EAGLE RIVER, AK. 99577 C rrentPropertyowner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address WIUJAM AHRENS Day phone 694-6583 10719 KATLIAN DRIVE • EAGLE RIVER, AK. 99577 Day phone Day phone Unless otherwise requested, HAA will be held by DSD ►or pickup. 2. NUMBER OF BEDROOMS:. 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Gass Well ❑ Community On-site ❑ Public Water System ■ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or 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 Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal systemis are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I furter verify that based on the information obtained from the Municipality of Anchorage riles 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. Address 3701 E. TUDOR ROAD, SURE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD 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 He of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE ✓ Approved for 4 bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist t� Septic System Advisory Well Flow Advisory Phone 337-6179 Date _(Q bedrooms, with the fllowing stipulations: Manitenance Agreements Supplemental Engineer's Reort Other WATER AND co . PROGRAM 'r By; Original Certificate Date: Qkw.tvoq Municipality of Anchorage • "'` Development Services Department, Building Safety Division ` i On -Site Water & Wastewater Program s " 4700 South Bragaw St.' P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us is (907)343-7904 ) I HEALTH AUTHORITY APPROVAL CHECKLIST 4 Legal Description: SPRING BROOK VISI UBDMSION; LOT 5–A1, BLACK 1, Parcel ID: 050-091-38 A. WELL DATA PUBLIC WATER t Well type if A, B, or C provide PWSID# _ Well Log (y/N1 Date completed Sanitary seal (Y/N)_ Wires properly pro ;i Total depth ft. Cased to ft. Casing h (above ground) in. i FROM WELL LOG INSPECTION Date of test Static water level ft. { Well production g.p.m, g.p.m. a: x WATER SAMPLE TS: Coliform colonies/100 mL Nitrate mg./L. Other bacteria colonies/100 ml. t. enlc: mg./L. Date of sample: Collected by: B. SEPTICIHOLDING TANK DATA Tank Type/Material STEEL Date installed 9/29/2004 Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) 'IES Foundation cleanout (YIN) —YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping NEW Pumper – C. ABSORPTION FIELD DATA Date installed 9/29/2004 Soil rating .p.d./ r ft%bdrm) 1_2 System type DEEP TRENCH Length 48 ft. Width 2.5 ft. Gravel below pipe 5.6 ft. Total depth --L4—.8ft. Eff. absorption area 538 ft' Monitoring tube'SES Depression over field NO i Date of adequacy test NEW Results (Pass/Fail) – For 4 bedrooms ' Fluid depth in absorption field before test in. Water added ew depth _in. Elapsed Time: —min. Final _ in. Absorption rate >= g.p.d. ° A n eatment (past 12 mo.) (Y/N & type) If yes, give date r 04 LIFi$7AIOH: Date installed Size in gallons "Pump on" level at _in. E. SEPARATION DISTANCES High water alarm level at in• Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankflift station on lot Absorption field on lot Public sewer main line PUBLIC WATER On adjacent lots Public sewer manhole/cleanout. Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 5'+ Property Ir5'+ Absorption field 5'+ Building foundation P Y •ne Water main 101+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 5'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+/200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION.`�.1 . ..... i certify that 1 have determined through field inspections and *'.: `+ .. ......... review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. . • . . • ................ of Go ess.- Engineer's Printed Name JEFFREY A. GARNESS s '•. —7953 .•' Date lo'tL/o'f 4�odpor.oswe��o HAA Fee $ 'S% y' 'II Waiver Fee $ Date of Payment 11 Ih� Y Date of Payment Receipt Numbero(a0(r1 Receipt Number (Rev. 12101) \v, -12-2004 01:34P FROM:LAW 8 ASSOCIATES, I 907-522-4625 70:3383246 P:1 t-3 PLOT PLAN _ AS BUILT _ X SCALE 1"-40• GRID NW 252 Project No. 04-054 127 Lan & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 9 907 622-6476 Phone Registered land Surveyors ?907) 622-4625 Fax pO.F.A. www.lanpvurvW*m.com / fnfoOlongsurveyors.com 1 hereby certify that 1 have surveyed the following described property LOT 5—At BLOCK i SPRING BROOK VISTA SUBDIVISION, UNIT 01 PIAT No. 80-210) r .49m Anchorage f%correp mdi district, Alaska, and that the Improveents uated thereon aro ... +' 1••'•••' within the prop" lines and do not encroach onto the property adjacent thereto, that ' no Impmv mgdo on the property lying adjacent thereto encroach an the surveyed ....... ........... ...... premises and that then are no roadways, transmission tines or other visible easements KEHhT N G. an said properly except as Indicated hereon. LS -5202 bated this the le Day of NeVeMfae— Ze04 . of Anchorage. Alaska yam'•••.• '',do B to the responsibility of the owner to determine the existence of ar1y easements. covenants, or restrictions which do not appear an the recorded subdivision plat.