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GREENBROOK BLK 2 LT 7
Greenbrook Block 2 Lot 7 #017-023-59 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP241349 PID Number: 017-023-59 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name AMY &JOHN DELESLINE ABSORPTION FIELD ❑ Deep Trench ® Wide Trench ❑ Bed ❑ Mound Site Address 12840 VON SCHEBEN DRIVE, ANCHORAGE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 0.45 GPD/SF 6 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3 Ft. Gravel depth beneath pipe 3 Ft. Subdivision Block Lot GREENBROOK 2 7 Fill added above original grade VARIES 0.3'- 0.6 Ft. Gravel length 160 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES TO SepticAbsorption Lift Statin Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 1379 Ftp 4 (PER CODE & MOA) 6+ Ft. Well-- 1 QQ'+ 25'+ TANK Il Septic [IS.T.E.P. E]Holding ElOther Manufacturer EXISTING Capacity Gal. Surface Water -- 100'+ ( Material Number of compartments j Lot Line 1 -- 101+ NA Foundation-- 1 Q'+ LIFT STATION Manufacturer Capacity Gal. Remarks Existing field decommissioned. Existing septic tank integrity verified. Alarm location Electrical installed by PIPE MATERIAL House to tank Tank to 3034 drainfield Installer Mike N Anderson, PE (MNA) _ Drainfield 3034 CO/MT 3034 Inspector FWC & MNA BENCH MARK (Assumed elevation) 100 ft Inspeection 1s` 11/06/2024 2nd 11/06/24 Location and description 3`d 11/07/24 41h 11/08/24 BOTTOM CORNER OF SHED ON-SITE WATER AND WASTEWATER SECTION APPROVAL OF A Conditional Approval: Date l f " ' • " " " : " C �F••• CE 12 991 n .•�`�% ���c���R•.,I1/13/24..•�C�i Septic Syste Approved / _ Date 1 / ., ri ~ \ PROFESS0kW - ote: this approval does not include well permit requirements. (Rev 05//18) S 87°25'12''E 302.68 a s p h a l t D R I V E W A Y 4-BR HOUSE W O O D W A L K W A Y DE C K 37.0 2 2 . 6 FIRST WATER CONSULTING PID:017-023-59 PERMIT:OSP241349 GREENBROOK BLOCK 2, LOT 7 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: OSP241349 Work Type: Septic Upgrade Tax Code Number: 01702359000 Site Legal Address: GREENBROOK BLK 2 LT 7 G:2839 Site Mailing Address: 12840 VON SCHEBEN DR, Anchorage Owner: DELESLINE AMY & JOHN DAVID Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 10/16/2024 10/16/2025 52137 Q Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing - Reeey y: 5 y &t e j fid /15"'�5 Ooc%e Issued By: Date: Date:La I Zq 4 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 017-023-59 ANCHORAGE Rosk ON-SITE SEPTIC/WELL PERMIT APPLICATION Property owner(s) DELESINE AMY & JOHN DAVID Day phone Mailinq address 12840 VON SCHEBEN DRIVE, ANCHORAGE, ALASKA 99516 Site address 12840 VON SCHEBEN DRIVE, ANCHORAGE, ALASKA 99516 Legal description (Sub'd., Block & Lot) GREENBROOK B2, L7 Legal description (Township, Range & Section) Lot Size 52,137 Sq. Ft. Number of Bedrooms M Phone: 907-343-7904 Fax: 907-343-7997 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field Initial El Single Family (SF) (w/wo, ADU) Septic Tank E] Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (SignAfOeq , of''rt- pi�qpe y owner or authorized agent) Permit/Rush Fees: . 5q 5 3 73 - Date of Payment: 1 a11'4'Zq Receipt Number:.?- I 11) '1 Permit No. 0,51029 1:3 q 9 Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and WastewaterTormsUient FormsTermit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! October 10, 2024 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: GREENBROOK BLOCK 2, LOT 7 The property owner has requested we obtain a permit to upgrade the failed septic system of the above referenced lot. We propose to install 4 shallow trenches per the attached design to serve the existing 4-bedroom residence. The design is based on the recent test hole conducted on October 2, 2024. Groundwater was observed at test hole excavation and at monitoring. Due to this monitoring of groundwater at 10.5’ from grade and proximity to the existing field with a total depth of 11’ from grade, this existing field will be abandoned in place. The slopes are moderate at 8-13% at the proposed upgrade location. The lot and area are served by public water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241349, Deb Wockenfuss, 10/16/24 S 0 ° 0 2 ' 1 9 ' ' E 1 4 2 . 7 2 ' S 89°00'00''W 296.25' S 2 ° 45 ' 00 " ' ' W 1 6 5 . 2 0 S 87°25'12''E 302.68 L = 4 1 . 1 3 D R I V E W A Y SHED 4-BR HOUSE WO O D W A LK W A Y D E C K D E C K VO N S C H E B E N D R I V E 10 ' U TI LI TY E A S E M E N T 67.5 25 ' + - 52 . 0 3 7.0 2 2 . 6 7.0 29 .4 29.9 FIRST WATER CONSULTING GREENBROOK BLOCK 2, LOT 7 DESIGN CALCS: NO WELLS WITHIN 200' OF PROPOSED SEPTIC SYSTEM. NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD. AREA SERVED BY PUBLIC WATER. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241349, Deb Wockenfuss, 10/16/24 S 87°25'12''E 302.68 D R I V E W A Y SHED 4-BR HOUSE W O O D W A L K W A Y D E C K D E C K 25 ' + - 5 2 .0 3 7.0 2 2 .6 7.0 2 9 . 4 29.9 FIRST WATER CONSULTING DESIGN DETAILS: GREENBROOK BLOCK 2, LOT 7 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241349, Deb Wockenfuss, 10/16/24 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: GREENBROOK B2, L7 PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 10/09/2024 DEPTH FEET OG SOILS 1 ORG/OL/ML 2 3 4 5 6 7 8 SM/ML 9 10 11 12 SEEPS 13 14 15 16 17 ML 18 19 BOH 20 Reading Date Gross Time Net Time Depth to Water Net Drop 10/08/24 30 min 6” 0 11/16” 30 min 6” 0 11/16” 30 min 6” 0 11/16” PERCOLATION RATE 44 (MIN / INCH) TEST RUN BEWTWEEN 6 & 7 FT PERC HOLE DIAMETER 6” PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: YES - SEEPS IF YES, AT WHAT DEPTH: 12’ DEPTH TO WATER AT MONITORING: 10.5’ DATE: 10/09/2024 TESTHOLE # 24-1 DATE PERFORMED: 10/02/24 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: JOHN & AMY DELESLINE 10/09/2024 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241349, Deb Wockenfuss, 10/16/24 Municipality of Anchorage _ Development Services Department I� Building Safety Division r . �, �� 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 Onsite Wastewater Disposal System and/or Well Inspection Report Permit Number. SW030453 PID Number. 017-023-59 Name: Wastewater System: ❑ New ■ Upgrade JOHN McCONNAUGHY Address: ABSORPTION FIELD 12840 VON SCHEBEN DRIVE ' ANCHORAGE, AK 99508 Phone: No. of Bedrooms: (907) 333-1235 4 N Deep Trench a Shallow Trench O Bed 0Mound OOther LEGAL DESCRIPTION Sal Ra4rq: 0.6 GPa/sR. R iolel a.PtA hem plpinel eroew 11 (MAX) R Block: Lot: Subdivision: a.Mh to Pb• ealem hem cd0d eras: GnwW dWh beneath pip.: 8.52 2 7 GREENBROOK 2.48 R R Township:—Range: Section: — rll ma.a sew+ erlpind eras.: Gry W NrgN: 59 — SEE DWG. R R Gaw wW . NurM.r N an.e: D41aww k.b«n tMn.: WELL: O New ❑ Upgrade 2.5 R 1 — R Ck,"f4o. Pdrat.. A.B.G :Ce.W To: Tocol oe.orpUen ano: 1003 F$i a nip1 : D 3034/ F-810 UN\� n R so. R tet. X12/2-3/2003 orw.r. GpMM wt. a"l"e: s"�` wm.r L««: YM10A+ HOME SERVICES R Pu" Sot ALCasks Height Ae croons: TANK CPN R R SEPARATION DISTANCES ■septic aHolding as.T.E.P. 0Other Septic Absorption Field Uft station Holding Tank lc/PdWt. sewer Un« VionwlTo OCAN ANCHORAGE TANK ��� In p�ww. 1250 From Tank w oemvedn•n.. Well 200'+ 200'+ — — 25'+ STEELS 2 Surface water 100'+ 100'+ — — — LIFT STATION 5re ti gauorw: Nanufectwer: Lot Une 5'+ 10'+ — — — ' an k«.l at: vol at. Hkih woNr alarm et: Foundation 5'+ 10'+ — — — Punp Nob a.cb4al ewp.aaone p.nomwe Iry: Curtain Drain NONE KNOW Remarks: OLD SEPTIC TANK AND DRAINFIELD BENCH MARK tAOahan ane o..adpuara COMPLETELY ABANDONED. TOP OF CONCRETE SLAB AT GARAGE DOOR 1q1.58 R ENGINEER'S SEA( qOQ� oa 4� AKWWC INC. 12/2/2003 Inspections performed by: r Dates: 1st••• 12/2/2003 .. 2nd 3rd 12/3/2003 ... .: Gar ess:' Development S ices Department Approval �OO� J� ., c 7953 ••'q`FO� E, ��^00'Professlo"o, Reviewed and approved by: Date: Z�' (Rev. "l) PERMTTNUMBER: AS -BUILT DRAWING P017 0 NUMBER: SWO SW030453 017-023-59 APPROXIMATE KEY I BOX LOCATION APPROXIMATE LOCATION OF WATER UNE\\\ _ � I A B LL, i — STI 130.56 18.57 % p ST2 34.50 26.63 II_..._. DBLt 36.25 29.84 %//r. EXISTING%:':�, L DBL2 37.19 30.68 /% 4 BEDROOM G� HOUSE :;1 LLJ C01 106.25 81.55 MT1 104.85 80.10O/ q • : U NEW 1250 GALLON �/B ��•:•!', DBLI fJ7 CO2 79.98 43.27 SEPTIC TANK •`s <.J..• MT2 82.32 46.34 : •;•:!; Z cot 51 �` ': • DBL2 O MT2 I ; �� EXISTING SEPTIC SYSTEM II 512_x:• ABANDONED IN PLACE 8 II TTH/1 •?tip• ,.:�-`----" I I NEW 11 1 11 ' 1110N 12/11/2003 DRAWN BY: •• :7S14�I AI.ASRA «'Xrr,,R S WASTEWATERSSE M.E.W Qp I CONSULTANTS. INC. 1 ^ = 40'...... .. .. .... • ...... A0F TUDOR GOeJ. SURF Ifl pvfwOcnGF pK 995C) R•ONF 190)11p.61)9 • FAX (oN).9A3)4M1 ..... ....... Q of A. Gar ess.-' QQO•Pa 79 .•. FFG PREPARED FOR: PHONE NUMBER: JOHN McCONNAUGHY (907) 333-1235 PAGE NUMBER: 2 OF 3 LEGAL DESCRIPTION: GREENBROOK SUBDIVISION; LOT 7, BLOCK 2, 00 ••.,.•,•,..•'�,o 4���Z%m;-000 TrvAS BUILT DRAWING OF SEPTIC SYSTEM UPGRADE PERMIT NUMBER:AS-BUILT DRAWING PARCEL ID NUMBER: SW030453 017-023-59 FINAL GRADE 100.00-101.16 TOP OF TANK AT STIS 2 INLET 96.97--\ F TANK AT n-/�T - 95.99 THJ1 INVERT OF BUNG AT INLET - 95.39 FINAL GRADE 97.02 (AVO.) ELEVATION OF ATER - 79.32 NEW 1250 GALLON SEPTIC TANK FABRIC INVERT OF PIPE 93.01 (AVG.) "TOM OF TRENCH . 61.52 (AVG.) NERT OF BUNG AT OUTLET . 95.21 Ll—O— RELATIVE ELEVATION OF BOTTOM OF TEST HOLE - 78.02 DATE: /) 12/11/2003 F l /f1 I I'� DRAWN BY. ALASKA IN IT'R & `VASTL«'ATLR SCALE-' G./A.J.G. CONS_ LTANTS• INC.—s---��� N.T.S. 370. F TUDOR ROAD. SUIT- 10. • ANr.ORAGF AK 00507 • F ONF (907)117-179 • FAX (007MR-Mb PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JOHN McCONNAUGHY (907) 333-1235 1 3 OF 3 LEGAL DESCRIPTION: GREENBROOK SUBDVISION; LOT 7. BLOCK 2 TYPE OF WORK: PROFILE AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE ,9 ........ . .........:... � . ............ f A. Orn ss.. OHO C —79 :p io°or •' �d0 �il... eCQv� MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW030453 Legal Description: GREENBROOK BILK `2_L_T-7,' Design Engineer: 0041 AK Water & Wastewater Consultam Owner Name: John McConnaughy Owner Address: 12840 VON SCHEBEN DRIVE ANCHORAGE. AK 99508 - Iz) zj 03-� pm P Date Issued: Oct 22, 2003 Expiration Date: Oct 21, 2004 Parcel ID: 017-023-59 Site Address: 012840 VON SCHEBEN DR Lot Size: 52137 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ❑ Private Well ❑ Water Storage 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 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. Issued By. Date: 10-4-03 Date: 10 2 ZQ3 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.ci.anchorage.ak.us (907) 343-7904 ON—SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel l.D. (�� �Z3 vl Permit Number 5tVQ30453 Property owner(s) JOHN McCONNAUGHY Day phone 333-1235 Mailing address (1) 4219 SAN ERNESTO AVENUE APRT J4 ' ANCHORAGE. AK Mailing address (2) Zip Code 99508 Legal description (Lot, Block & Sub'd.) LOT 7 BLOCK 2• GREENBRO`OK/ SUBDMSION Legal description (Section, Township & Range) 147* I a%"O V 0)'1 SIJ V_—A'n r Lot Size 5; 71 Acresq.Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade N 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. Permit Fees: 4-400 Date of Payment: 10.11.03G Receipt Number:��5- Waiver Fees* Date of Payment: Receipt Number: ALASKA WATER & WASTEWATER .�I CONSULTANTS, INC. September 12, 2003 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System Upgrade for Lot 7, Block 2, Greenbrook Subdivision To whom it may concern: The existing 4 bedroom house is served by a community water system and a private septic system. The existing septic system is in a state of failure and needs to be upgraded. 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. 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. It is our opinion that due to the overall appearance of the soils, an application rate of 0.6 gallons/day/ft2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: 18.5 minutes/inch b. Proposed Application Rate: 0.6 gallons/day/112 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 1000 R2 f. Total Depth: 11 feet (max.) g. Effective Depth: 7.5 feet h. Width: 2.5 feet i. Reduction Factor: N/A j. Minimum Length: 67 feet long k. Effective absorption area = 1005 fl? 3. SURFACE WATERS: There are no surface waters within 100+ feet of proposed septic upgrade. In short there are no surface water concerns. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: akwwc.com 4. TOPOGRAPHY: As can be seen on the attached topography site plan, the average topography in the area of the proposed drainfield is a 5 to 10 percent slope running approximately east to west. 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 us at 337-6179. Thank you for your accict.qnrP M.S. NOTE. Attached is a site plan drawing, a design drawing, a topography site plan, 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 \\\ \\\ CREENSROOK S/D; \ \ LOT D, BLOCK 2, \ \ I \ \ \ I OTE: ALL PROPERTIES 1 \ SHOWN SERVED BY I COMMUNITY WATER \ i SYSTEM I I CREENBROOK S/D; I ' I I LOT B. BLOCK 2, GREENBROOK S/D; I LOT 7, BLOCK 1, I I I EXISTING 1 I i 4 BEDROOM 1 I HOUSE I PROPOSED SEPTIC UPGRADE I I (SEE DESIGN PACE 2 OF 2) I I I 1 I 1 1 I EXISTING C I SYSTEM I 1 I 1 1 I I GREENBROOK S/D; /1 -c •� I LAT 12A, BLOCK 2. I 1 I I I I 1 I I I I 1 I I I CREENBROOK S/D; j LOT 8, BLOCK L, I I ' I W > ' I CREENBROOK S/D; LOT 6, BLOCK 2, O I W W' I I Z/ I 1 GREENBROOK S/D; / CREENBROOK S/D; 2 1 LOT S, BLOCK 1, LAT 5, BLOCK 2. O I I I DATE: 9/12/2003 •... ��� .... �I (1 .�1�. DRAWN BY: C.J.G. _ ALASKA WATER & WASTEWATER 4 4" CONSULTANTS, INC. SCALE 1" = 100. ;'. !`.:...... ....... ....:.°.%1i ,lm c TNnOP PmAy G. IITc "I . AN!'vAQAfc pc OOCOI � V„Mlc (0nlll�l.A-70 . PAX IONMA.}71.w ........ PREPARED FOR PHONE NUMBER: PAGE NUMBER: JOHN McCONNAUGHY 333-1235 1 OF 2 y; if Carne S.: Dy • — 3 '• LEGAL DESCRIPTION:y�+� GREENBROOK SUBDIVISION; LOT 7, BLOCK 2, ............ �.l .......•• cp = z4" TYPE OF WORK: �ofesslo0a SITE PLAN FOR SEPTIC SYSTEM UPGRADE `• .^.nn PROPOSED DRAINFIELD. EXCAVATE A TRENCH THAT IS 11 FEET DEEP MAXIMUM BY 2.5 FEET WIDE BY 67 FEET LONG. ADD 7.5 FEET OF CLEAN, WASHED SEWER DRAINROCK.— NEW 1250 GALLON SEPTIC TANK - NOTE: THE CONTRACTOR SHALL HAVE THE SOUTH LOT LINE FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. �AlASKA WATER S WASTEWATER CONSULTANTS, INC. X701 F TUDOR ROAD $MTF 101 • AWMORAfF AA ROSO? • Re f (001)117.6170 • FAX f00))338171E 2EPARED FOR: PHONE NUMBER: JOHN MGCONNAUGHY 333-1235 .GAL DESCRIPTION: GREENBROOK SUBDIVISION; LOT 7, BLOCK 2, PE OF WORK: DESIGN DRAWING OF PROPOSED SEPTIC UPGRADE •••'•' INSTALL DOUBLE I .:':. CLEANOUT -EXISTING DRAINFIELD TO BE USED AS A RESERVE SITE IF GRAVITY FLOW CAN BE ACHIEVED. TALL ROW DIVERTER 9/12/2003 AWN BY: C.J.G. ALL, 1" = 40• ............. GE NUMBER: 2 OF 2 QQ '•: eff G ess.: Q4°y,J E 7953 •'' `F`e' Ld >I G_ 0 Y APPROXIMATE KEY Z BOX LOCATION Ld ml w APPROXIMATE LOCATION OF WATER UNE (n I ZI i z I i F-T-�� I EXISTING 4 BEDROOM HOUSE EXISTING SEPTIC TANK TO BE COMPLETELY ABANDONED PROPOSED DRAINFIELD. EXCAVATE A TRENCH THAT IS 11 FEET DEEP MAXIMUM BY 2.5 FEET WIDE BY 67 FEET LONG. ADD 7.5 FEET OF CLEAN, WASHED SEWER DRAINROCK.— NEW 1250 GALLON SEPTIC TANK - NOTE: THE CONTRACTOR SHALL HAVE THE SOUTH LOT LINE FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. �AlASKA WATER S WASTEWATER CONSULTANTS, INC. X701 F TUDOR ROAD $MTF 101 • AWMORAfF AA ROSO? • Re f (001)117.6170 • FAX f00))338171E 2EPARED FOR: PHONE NUMBER: JOHN MGCONNAUGHY 333-1235 .GAL DESCRIPTION: GREENBROOK SUBDIVISION; LOT 7, BLOCK 2, PE OF WORK: DESIGN DRAWING OF PROPOSED SEPTIC UPGRADE •••'•' INSTALL DOUBLE I .:':. CLEANOUT -EXISTING DRAINFIELD TO BE USED AS A RESERVE SITE IF GRAVITY FLOW CAN BE ACHIEVED. TALL ROW DIVERTER 9/12/2003 AWN BY: C.J.G. ALL, 1" = 40• ............. GE NUMBER: 2 OF 2 QQ '•: eff G ess.: Q4°y,J E 7953 •'' `F`e' SEPTIC UPGRADE N PAGE 2 OF 2) )OK S/D: BLOCK 2, I 1 6 Ll F T%v+o C: •n9 k.nTP Ali • ANrwPongP nF 00.07 r' ED FOR ��� OHN MCCONNAUGHIL_ WDESCRIPTION: REENBROOK SUBDIVISION; LQ OF WORK: SITE PLAN FOR SEPTIC SYSTEI LOT 3, D, 0 I Co -"To (-S' WATER 4 BEDROOM HOUSE IXISTINCSEPTIC SYSTEA GATE � 9/,Po),z 0 4p � . • •' .. Opp S DRAWN BY: - p / p • nY f00T}LP. VI.n �.. •. �.. .D T. ......p E 5 .p 0 04od 1.1 eio oa o •ore 1 ER: PAGE N MBER• 2 2. 1 ALASKA N'E'ATER & WASTEWATER G, •\ 9 d yp� S'..,-. CONSULTANTNC. s • SOIL LOG - PERCOLATION TEST .. .. ........... LEGAL DESCRIPTION: GREENBROOK SUBDMSION; LOT 7, BLOCK 2 O •• of a A. OQQ�' f•'• —7 Go ness: a PERF?O�RMED FOR: 4 3 8' JOHN McCONNAUGHY • 9 5 DATE. / /2003 4����4000��00000 ••' SFO (f e`) = == TEST HOLE 1 1 =_==� ORGANICS SOIL CLASSIFICATIONS 2 RED r LOAM GW -_ ORG 3 r=: GP ML GM CL 4 GC OL ". •°. o SW MH 5 SP CH s SM ' i OH p 6 SC 7 DEPTH TO DATE GROUNDWATER 8 DRY 9/2/2003 16.2' 9/9/2003 9 SITE PLAN 1100' 10 SM CLOCK NET TIME WATER LEVEL NET DROP 11 DATE READING TIME (MINUTES) READING (INCHES) 9 5 2003 1 1:16 - 6" — 12 2 1:46 30 4 1/4- 1 3/4- 13 3 1:47 — 6' — 4 2:17 30 438" 1 58' 14 5 2:17 — 15 16 17 B.O kl. 18 PERCOLATION RATE 18.5 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19 TEST RUN BETWEEN 7.0 FT. AND 8.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES [-]NO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: SUSAN OSWALT COMMENTS: PERFORMED BY AKWWC, INC. I, JEFFREY A GARNESS, CERTIFY THAT THIS WA P RFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 6 2:47 30 4 3 8' 1 5 B" �\ MUNICIPALITY OF ANCHORAGE \l DEPARTMENT OF HEALTH &ENVIRONMENTAL PROTECTION • ar� ENVIRONMENTAL ENGINEERING DIVISION \, 825 L Street • Anchorage, Alaska 99501 Telephone 264.4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME a t- Q(- G PHONE NEW UPGRADE MAILING ADDRESS LEGALDES IPTION r C LOCATION M«ll �Gve t . NO.OF BEDROOMS DY DISTANCE TO: Well Absorption area Dwelling PERMITO. N s-2Manulxturer w `r A Mate al iC G No of compartments w Liq. capati in allons IF HOME DE: Inside length Width Liquid depth d le Jv2 DISTANCE TO: Well Dwelling PERMIT NO. _? F Manufacturer Material Liquid capacity in gallons O w= DISTANCE TO: Well Foundation Nearest t line PERMIT NO. J LL E f ? W No. of lines/ Length of each line Total length f Ines Trench width inches Distance between lines H o Top of the to finish grade Material beneath Zile VilUL� inches Total effective absorption area SV W Length Width Depth PERMIT NO. Q H W� Type of crib Crib diameter Crib depth Total effective absorption area w DISTANCE TO: Well Building foundation Nearest lot line .r Class Depth Driller Dntance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption areafsl OTHER TO PIPE MATERIALS �//'' P,�/ V. SOIL TEST RATING AA _ INSTALLER [ SCsI REMARKS 13, _ HOVE DATE ry LEGAL 724** ( ev.3/79!'- w rl L l rJ 10 I F1; i t> I T'rm O F Fi rJ C Ij.p Fy In iG E -� DEPARTMENT r' HEALTH AND ENVIRONMENTAL tOTECTION -AllR 825 '� STREET. ANCHORAGE, AK. 99..501 S_ 4irzo 01" !3v _ 264-4720 c7 OtJ— I TE SEWEFR F='EFRM I T PERMIT NO. ( 810152 ) 0i s !�. lt.l_g'l a/ U APPLICANT LOCATION LEGAL I un GEORGE HARRISON Ur SRA BOX 3738 ANCH. Ad. � tw VON SCHEBEN DR. 1p jjQI LOT 7 SLK 2 GREENBINK5U6 LOT SIZE 42032 GRac�%ah'+oK S �i� TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING CSO FT/BP.)= 1251, THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: F>EF=,TH= 1ID L-ErJGTH= 42 (3FRR4-PEL OEF='TH= 1�- THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT I5 THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). FRE:iDLj I FRED SEF='T I iC TFgrJF' S I LE= 1250 GnILLOfJS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- TWO C ^ ? I rJSPEGT I C7tJS nFtE FREGIIJ I FZEI7 --- BACKFILLING 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 SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER. LINE IS 25 FEET AND TO A COMMUNITY SEWER. LINE IS 75 FEET. OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F>EFRrl I T E1:F1 I FRES OECEMFE:EFZ = 1s I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE OM -SITE SEWER. SYSTEM MAY REQUIRE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. ., t SIGNED:rS=` GEORGE HAP.P.ISOFt ISSUED BY I ALiR E51 - AND 1 AND WELLS AS SET ENLARGEMENT IF THE 1111LI CInL ihhh L151111,D164. V4. 0 0 Alaska Testlab 4040 "g" Street Anchorage, Alaska 99507 Second and Fourth Anchorage Limited Partnership 4611 Business Park Blvd. Anchorage, Alaska 99503 Attention: Mr. Les Pace Re: Subsurface Investigation Disposal, Lot 7, Block 2, Greenbrook Subdivision Dear Mr. Pace: n Phone (907) 278-1551 ( Telecopier (707) 772.57 March 30, 1981 •W.O. #A19708 for Suitability of On -Site Sewage Lot 11, Block 4, Lot 2, Block 5, On March 14, 1981, we drilled -a 15 foot boring on each of the .above three lots and placed a perforated, 3/4 inch PVC pipe in each hole so that the water table could be monitored over a period of time and a percolation test run in the hole. The holes were drilled using a Nodwell mounted, Mobile B50 drill rig owned -and operated by Denali Drilling, Inc. The drilling was supervised and the test holes logged by Mr. Ted Krupka, senior technician with Alaska Testlab. After the holes were drilled, our technician returned on March 18 and checked the water level in each of the test holes. Fie then returned again on March 23 and checked the water level again, then saturated the holes, let them stand for 24 hours and returned on March 24 to check the water level a third time and then ran a percolation test. The percolation test was run by monitoring the drop in the water table elevation at 10 minute intervals for a minimum of one hour. The percolation rate listed in this report was computed using the slowest 20 minutes of that percolation test. Included with this report is a test hole location sketch for each lot and a log of the !boring placed on each lot. The results of this exploration are described as follows: n Second and Fourth Anchorage Limited Partnership March 30, 1981 Page Two Lot 7, Block 2 The test hole was placed in the front of the lot, and this is where we would recommend the placement of the on-site sewage disposal system. The lot slopes to the back considerably and it appears there could be a water table problem at the very back end of the lot. At the time of drilling no observed ground water table was located. The soil appeared to be moist as the spring thaw was beginning, and there was some seepage near the top of the hole from thawing seasonal frost. When the water table was checked on March 18, there was water standing in the hole at 8.55 feet. When the water table was checked again on March 23, prior to saturation for the running of the pert test, the water table had dropped to.10.5 feet. The next day when the percolation test was run the hole was dry and there was no water table encountered in the upper 15 feet of the hole. Percolation rate measured was 2.0 minutes per inch. It is our opinion that the relatively high ground water encountered on March 18 was due to thawing seasonal frost and runoff associated with breakup. The water table dropped very quickly. however, it would be prudent to keep the system as high as possible, in the upper 8 to 10 feet, to avoid problems in the spring from breakup on the system. We would also recommend using a more conservative design percolation rate of 5.0 minutes per inch because the upper soils are slightly siltier than the lower soils. Lot 11, Block 4 Again, it would be important to keep the on-site sewage disposal system in the front of the lot near test hole as it appears that there is more of a ground water problem to the back of the lot. No ground water was encountered to 15 feet in the boring at the time of the exploration on March 14, 1981. on returning on March 18, the water table was measured at 10.5 feet. It was again measured at 10.5 feet on march 23, and again on March 24. The percolation rate measured was 15.0 minutes per inch. Again, the system should be kept as high as possible, in the upper 8 to 10 feet, because of the water associated with the spring thaw, but it does appear that we picked up the highest level that the water rose to during this spring. Lot 2, Block 5 At the time the test hole was conditions were encountered a level was checked on march 18, drilled on March 14, t 13 feet. When the standing water was 1981, saturated water table in the pipe, at :A 1 E , AIASKA 1ES(1.,16 Second and rourth Anchorage Limited Partership March 30, 1981 11.5 feet. When it was checked again on ;larch 23, the water level was at 13.5 feet. On March 24, prior to the running of the percolation test, the water level was at 11.5 feet. Measured percolation rate was 2.0 minutes per inch. However, because of the silty nature of the soil we would recommend a more conserva- tive value of 5.0 minutes per inch be used. Also, again, the system should be kept as high as possible to avoid any conflict with any seasonal fluctuation of the ground water associated with thaw. Should you have any questions with regard to these tests, please do not hesitate to contact us. very sincerely, ALASKA TESTLAD kQ. rte. �\ 1 Melvin R. Nichols, P.E. Manager MRN/mg Attachments cc: Ralph Westover, Tryck, Nyman & Hayes Nom• O ...��Z i Mohan R. N;'h'I' f'• No. 4113E "1 I t. I :.IASKA frSTI 'X ^ i o '••°s. Vp �, i e '' .+ •ti! 17].]2 .9 V.. ° 000 p 6.12 6-10 •?1°9.t� o _ _1• • 166.09 V I O •� 0 0 \ ._ " - x•06 ._.' I 329.60 \0 10 I I \ \C.: I II , 183.00 N �%VAO S N 0 O 09 2� 0 ? 00 r B w m - 2 a I-• 10 O _I _ w I _ O O oO - 183.00 1, N89'00'00'E o_, 1 296.23 s. I I , • I O N - O 0. �t IST, n >I NB9'57'ai"E S • _ I „•'l.o �' 180.00 m QI I iF 183.00 N A iO ~ I I 13 30 75-3 ° - . — . NIN Y. •� I . •1 �'O w -:O0 I o Nla NB"2]'12W :ARI =0 n E1 10 I N' 302.68 W:1 4.. S. •O n 163.00 �O O • �ri I o co 0 •� I N84 -10'06-w n , 200.63 + '-------- ?'2O'04 -w co 1 N ' 290 43 No O I O , L• . m= n 0 O I 1 pi• W O ' MM 2 O1 5 ' 103.00 o � n 5 p N7 > NI 646'09- 78•w y 24y1'µ' 0 = "- ?9".89 " 746.94 103.00 A i i w 30 � 30 1 w 1 . V. 0 C; o f tt 103.00 6.68• /. , �` 1 _ • 29'67 �•W ._.. `• � w � \ `-"�'+4.06 _ I i q ,'• Lot 7, Block 2 Depth in Feet From To 0.0 7.0 7.0 15.0 n ^ Table B V7O #A19708 Date: 3/14/81 Logged by: T. Krupka Bottom of Test Hole: Frost Line: Free Water Level: Soil Description F -2/F-4, brown Silty Sand, SM, silt to 408, moist F -2/F-4, brown Si try Gravelly Sand, SDt, particles to 1", silt to 308, saturated by 10' Set 3/4" perforated PVC pipe to run perc test and to monitor water table elevation. Measured perc rhte = 2.0 minutes/inch. Recommended design rate = 5.0 minutes/inch. 15.0 Feet 1.0 Foot 3/14/81 - 10.0 Feet 3/18/81 - 8.5 Feet 3/23/81 - 10.5 Feet 3/24/81 -.No Water Observed 0 n n 'c n1e.]a e1+0 [ 1318.15 T,N.6N. W 1320.00 G.L.O. .—.__ . _ - ,— •-- .220.00-- - f— Rood i 26].6] SO ]0 10•U111. [sm 1. ..__ i O « p O O O N. u t oN ' _ I QST RO • p0 > O T1 vL� ee0 O�:D'1' -.... O •O 00 �•>> 1 ] 0 � BJ 9.40 p 165 C`1 00 °O� Ser•4 / 00 0., 40-, 1]9.40 40•I]'00/' 1T q•$ Tag T.II-fit 149 \Z 28]j Drive 1 J 9..q p P.R. > O J 0' ; �3 p N O p Q JO iI • 8 r \ � V O // ' Q O O ` I A 9 Fiat., 1'27"i ee0 /O N 9 C OO 268.32 •O" p ,0 46J.0' °0 00 B 4 P� .4, :' M1 o . M1 Fi .7 Ur!! Z ,t -r sT �jL'G w V 1• 9 J G1 /2 A- -O.•Ur. 4�gaa flmr i ��!•9,J�000`, t •� L b ,q >b Ot SI- . I - .w 1 r I r 47.t] O N89•56'10 -W 211.00 18].00 1 i r• 1 ' O 105-00 2 IU 3.00 � n . ^Lot 11, Block 4 Table A. Y70 #A19708 Date: 3/14/81 .Logged by: T. Krupka Depth in Feet From To Soil Description 0.0 0.5 Organic cover 0.5 15.0 F -2/F-4, brown Silty Sand, sm, with some gravel (108) to 3 4", silt to 308, firm, moist Bottom of Test bole: Frost Line: Free Water Level: Set 3/4" perforated PVC pipe to run perc test and to monitor water table elevation. Perc rate = 15.0 minutes/inch. 15.0 Feet 1.0 Foot 3/14/81 - Non Observed 3/18/81 - 10.5 Feet 3/23/81 - 10.5 Feet 3/24/81 - 10.5 Feet n � Lot 2, Block 5 Table C WO #A19708 Date: 3/14/81 Logged by: T. Krupka Depth in Feet From To Soil Description 0.0 15.0 F -2/F-4, brown Silty Gravelly Sand, SM, gravel to 3/4", silt content to 40%, saturated by 13.0' Set 3/4" perforated PVC pipe to run perc test and to monitor water table elevation. Measured per rate = 2.0 minutes/inch. Recommended design rate = 5.0 minutes/inch. Bottom of Test Hole: Frost Line: Free Water Level: 15.0 Feet 1.0 Foot 3/14/81 - 13.0 Feet 3/18/81 - 11.5 Feet 3/23/81 - 13.5 Feet 3/24/81 - 11.5 Feet k �uo71 IG' zv i' /LSv o' 3 0 c5 "?p Y-� e `I ►t t �-v u c J..ea� r © (S-c— (� w a -t max- a LUW-IL�3" ;;L `u�. 4A-X-c't v -d - r_-I.f C GQ�P C/� P-oy G2� MUNICIPALITY OF ANCHORAGE Development Services Department NtDA__� Phone: 907-343-7904 On -Site Water & Wastewater SectionFax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 017-023-59-000 Legal description GREENBROOK BLK 2 LT 7 Expiration Date: 9/10/2025 Site address 12840 VON SCHEBEN DR Anchorage AK 99516 Current property owner(s) DELESLINE AMY & JOHN DAVID X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: a Original Certificate Date: 11/14/2024 Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. I� i�T�7: I ►�iL�1► � �+� COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory X Arsenic Advisory Other COSA ApprovaIjune 2022 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Section Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 017-023-59 Complete legal description GREENBROOK BLOCK 2, LOT 7 Location (site address) 12840 VON SCHEBEN DRIVE, ANCHORAGE, AK 99561 Current property owner(s) AMY & JOHN DELESLINE Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ® Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 21 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Waiver Fee $ Date of Payment '0'01 y Date of Payment COSA # sC 2. y % l 4- � Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: GREENBROOK BLOCK 2, LOT 7 Parcel ID: 017-023-59 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA - PUBLIC &/OR CLASS “A” WATER Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume NONE gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 49” Date of pumping 9/10/24 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) NEW FIELD ALL standpipes present per record drawing Total measured depth from grade 6.6 ft (max) Measured depth to pipe invert from grade 3.24 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective (ED). If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date *NA – NEW FIELD Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY *NOT TESTED Effective depth (per record drawings) 36 in (MOA 3’ ED) Effective depth used 0 in Effective depth remaining 36 in Comments/Deficiencies: Approximate total measured depths from existing grade. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 11/13/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 11/13/24 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT o On -Site Water and Wastewater Section www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval # OSC241465 Subdivision: Greenbrook Block:2, Lot: 7 907-343-7904 Fax: 343-7997 The septic tank for this property is 21 years old. The average life of an asphalt coated steel septic tank is 20 years. Typical replacement costs are $15,000 or more, not including engineering, surveying, MOA permitting fees or site restoration. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. C cl Lr C 0 N Di c Ra°nn'nn"\AI 295.25' Of S 4 49 TH SHANE A. HOLT.. m i �40 LS -6914 yo`o0� 44���°Jes sione� �'ocao N ti N W rn N J M r r J LNlWwj'�"�V'jr AS -BUILT SURVEY 1" = 40` NO CORNERS SET THIS DATE OF THE FOLLOWING DESCRIBED PROPERTY LOT73L00(2 G1?,FA131?00KSUB INFORMATIONHEREONISFOR THE USE OFLENDINGINSTITUTIONSSPECIFIC LLYTOSHOWANY ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE FLICTS BETWEEN EXISTING STRUCTURES AND PLA TTED LOTLINESANO/OREASEMENTS. VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN EMENTS OFRECORD, OTHER THAN THOSEAPPEARING ON THERECORD PLAT, ARENOTSHOWN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EON(UNLESSINDICATED) EXIST OTHER THAN NOTED. E. FENCELINESTHATMAYAPPEARONTHISDRAWINGARENOTTOBEUSEDTODETERMNE DATED AT ER THAN NOTED. THIS I I TH DAV OF PERTYLINES ORPOSITIONADOMONAL IMPROVEMENTS. PAVING SHOWN HEREON MA Y BEAPPROXIMA TE DUE TO EXCESSIVESNOWAND/OR ICE. IV�VENlBET� , 2024 HOLT LAND SURVEYING 9309 GROVER DRIVE 9/53 108-25,109-36 239-52 90]23 AK 9950] 8615 e� Municipality of Anchorage • Development Services Department Building Safety Division ` OnSito Water & Wastewater Program i 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-023-59 HAA# 1250501 1. GENERAL INFORMATION Expiration Date: 9 — a 1 Complete legal description LOT 7. BLOCK 2. GREENBROOK SUBDIVISION Location (site address or directions) 12840 VON SCHEBEN DRIVE ' ANCHORAGE. AK 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address MATTHEW do KRISTINA DAGGM Day phone C/O AGENT Day phone KATHLEEN POULIN w/ PRUDENTIAL JW Day phone 762-7560 3801 CENTERPOINT OR. STE. 200 • ANCHORAGE. AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class *A* Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an Independent professional civil 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 cerGlied 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 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 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, SUITE 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 8 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 idontifiable features. The operational life 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 bedrooms. Disapproved. Conditional approval for Phone 337-6179 Date 9 42LI/09 bedrooms, with the following stipulations: UR5T1 E - �TERAND ' . WASTEWATER • • Attachments: / HAA Checklist l/ Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: ' 1 Original Certificate Date: (Rw. 17/01) Municipality of Anchorage • Development Services Department Building Safety Division OnS4e Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196850 Anchorage, AK 99519-WSO www.cl.anchorage.ek.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: GREENBROOK SUBDIVISION; LOT 7. BLOCK 2. Parcel ID: 017-023-59 A. WELL DATA Well type -A" If A, B, or C provide PWSID# 210346 Well Log (Y/N) Date completed Sanitary seat (Y/N)_ Wines props ed (INN) Total depth ft. Cased to ft. WE1a FROM WELL LOG GOMMUNtCf Date of test Static water level WATER SAMPLE RESULTS: Coliform oolonies/100 ml. Nitrate Date of sample: B. SEPTICIHOLDING TANK DATA Tank Type/Material STEEL (above ground) in. AT INSPECTION ft. g.p.m. Collected by: 00 ml. Date installed 12/2-3/2003 Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (YM) NO High water alar (Y/N) N/A Date of pumping 11/3/2005 Pumper NORTHLAND PUMPING C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE Date installed 12/2-3/2003 Soil rating OEr ftibdr) 0_6 System type TRENCH Length 59 ft. Width 2.5 ft. Gravel below pipe 8.5 ft. Total depth 'I > •3 ft. Eff. absorption area 1003 ft' Monitoring tube YES Depression over field NO Date of adequacy test 42 YEARS OLD Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 26 in. Water added =gal. New depth =in. Elapsed Time: = min. Final fluid depth _ in. Absorption rate >= — g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N &type) — If yes, give date — SEPTIC SYSTEM IS LESS THAN 2 YEARS OLD. THE DRAINFIELD HAD 0-26 INCHES OF H2O ON 9/23/2005. D. LIFT STATION Date installed _ "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons Pump�vaFet�ln. High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: COMMUNITY WELL Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manholeldeanout c service line Holding tank SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water t 00'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line t0'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parkingtvehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspecWns and * {4 f r# review of Municipal records that the above systems are in i conformance with MOA HAA guidelines in effect on this date. ....... '•,Jef G esa.: Engineer's Printed Name JEFFREY A GARNESS E— Date 'k 7/os- OO 7G y trSEo4 ��pr6l��tio�d HAA Fee E 4_-V Date of Payment 9 -27 -rte Receipt Number 7y52-7 IBM (Rev. 12101) Waiver Fee $ _ Date of Payment Receipt Number, '■IE |||| ) ||� �§! ■ !| |§�) w� / A / ■ R oX 3n a-------------------- A3e3HOS love-� �/ Vp 27 05 10:18a Kathleen Poulin 086'a4P-26-20015 06:57p FROM: .o Sao .414NLAND PUMPING SERVICE, INC. ;b`ur Professional Septic Pumping Service Company 7,501 E. 14091 Avenue ANCHORAGE. ALASKA 99516 (907) 344-7146 FAX (907) 868-6770 ro - (�istianDaggett 12840 Von Scheben Drive Anchorage, AK 94516 ,�. 907-762-7563 p.1 70:7627563 r:eIc [NVOIGE1 15883 100.00 Thank you for choosmgNorthlaad.PumpingSelli c,ili-Attactied.is.alist of P WeaLiamaiLiii�eminder card Do's;and Dod'ts that we hope you find helpfi+L•• is a years tyme .for year cmvenience. Please don't hesitate;tn call if you have aay.queitacos. 11anlc•, BEV _sf 6.17-1059 17103 125 gallons (new system) S 00 ge THANK YOU Municipality_of Anchorage • "` Development Services Department ° / 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1 f Parcel I.D. 017-023-59 HAA# (N Or-) 14 1. GENERAL INFORMATION Expiration Date:1 fl ks- Complete legal description LOT 7 BLOCK 2. GREENBROOK SUBDIVISION Community On-site ❑ Public Sewer Location (site address or directions) 12840 VON SCHEBEN DRIVE • ANCHORAGE. AK 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address JOHN MCCONNAUGHY Day phone 333-1235 12840 VON SCHEBEN DRIVE • ANCHORAGE. AK 99516 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community ClasswAw_Well Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil 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 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 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the Lime 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, 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. AKWWC, Inc. 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 bedrooms. Disapproved. Conditional approval for bedrooms, with the filowing Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Phone —337-6179 Date I2 it Z 03 `�V ,�yo ' . ON-SITE WATER AND : m Manitenance Agreements Supplemental Engineer's Reort Other riv , ,Ins Lr\ PROGRAM M By: Original Certificate Date: r ILL (Rev. 1201) Municipality of Anchorage Development Services Department Building Safety Division a „ On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www. rd.anctwmge.ak.us (907)343-79W HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: GREENBROOK SUBDIVISION: LOT 7, BLOCK 2. Parcel ID: 017-023-59 A. WELL DATA Well type *A" If A. B, or C provide PWSID# 210,346 Well Log (YIN) Date completed Sanitary seal (Y/N)_ Wires props ed (Y/N) Total depth ft. Cased to ft. � �l g height (above ground) in. FROM WELL LOG �MMUN AT INSPECTION Date of test Static water level W�uction 9.p -m. WATER SAMPLE RESULTS: ft. g.p.m. Coliform colonies/100 ml. Nitrate mg./L. Other bacteria colonies/100 ml. Arsenic: mg./L. Date of sample: Collected by: e. SEPTICIHOLDING TANK DATA Tank Type/Material STEEL Date installed 12/2-3/2003 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 (YIN) N/A Date of pumping NEW Pumper C. ABSORPTION FIELD DATA Date installed 12/2-3/2003 Soil rating .p.d. ft'lbdrm) 0_6 System type TRENCH Length 59 ft. Width 2.5 ft. Gravel below pipe 8.5 ft. Total depth 012.5 ft. Eff. absorption area 1003 ft' Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) — For 4 bedrooms Fluid depth in absorption field before test = in. Water added =gal. New depth =in. Elapsed Time: = min. Final fluid depth = in. Absorption rate >= — g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) — If yes, give date — D. LIFT STATION Date installed "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons High water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption held on lot Public sewer main line COMMUNITY WELL On adjacent lots On Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 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 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and : �•' '\ >r review of Municipal records that the above systems are in conformance with MOA HAA guidelines m effect on this date. $... .... .9....... . rn 7 s. Engineer's Print d N e JEFFREY A. GARNESS � •• Date t L�12.T0; HAA Fee $ 4�0 Waiver Fee $ Date of Payment Date of Payment Receipt Number. j-� T Receipt Number (Rw. rzo1) .n eo�', 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Dale " 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) /q� I ^-r— -7 'r2 t/ n Cdrer=LITkJn.,v SEL K6 Location (address or directions) �� �D lL}kL��tl' ifs E►.I (b) Applicant Name _E� ccso_�Je _ elephone: Home Business Applicant Address (c) Applicant is (check one): Lending Institution O ; Owner/builder ❑ ; Buyer O ; Other O (explain); (d) Lending Institution 40A4_ t= n,7 r 7-y Telephone Address (e) Real Estate Company and Agent Address • T2 Telephone Xb 3 - 'i o 0-0 (1) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single-FamilyA Multi -Family OO Other Number of Bedrooms 7 i 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If com unity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public ❑ Community O Holding Tank ❑ Note: 6 communitywell system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72.025 (11,64) Page 1 of 2 n tocol+ 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this insppection. Name of Firm � r^ Telephone Address Date CIF /t(Zt �P18••.... •'ril'�f h. ••;' j 4 TO yt� � ' __*: „ .........: I'D Seal I ,. 2225-E Y; 25. 1971 : •;', 6. DHEPAPPROVAL (�) / fJ6 Approved for G bedrooms by bate � a! (6 Approved Disappro ed Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) Issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the Stale of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending Institutions In order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11,84) MUNICIPALITY OF ANCHORAGE (MOA) MtJNK:IPALrTY OF ANO10RAt';KHEALTH AUTHORITY APPROVAL (HAA) DEPT. OF HEALTH 6 CHECKLIST - FEBRUARY 1984 INVIRONMENTAL PROTECnOI4 264-4720 . MAY 191986 Legal Description: LOT —7f 5W 2- _C2_�Es: f� N Pe e9 t = e �� �" 12N4 ►ifs A. WELLDATARECE+IVED / Well Classification y -1,&5 , A If A. B. C. D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Total Depth Static Water Level Cased to Casing Height Above Ground _ Electrical Wiring in Conduit (Y/N) Depth of Grouting — Pump Set At Yield Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot On Adjoining Lots To Nearest Edge of Absorption Field on Lot _>�� ; On Adjoining Lots To Nearest Public Sewer Line Cleanout/Manhole _ Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA — To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date Date Installed VZY& Size d No. of Compartments "f !Y/0 Standpipes (Y/N) 'EL100 Air -tight Caps (Y/N) y Foundation Cleanout (Y/N) _ _ y Depression over Tank (Y/N) H Date Last Pumped r11 7/8( Pumping/Maintenance Contract on File (Y/N) W^ ; for KLA Holding Tank High -Water Alarm (Y/N) WA Temporary Holding Tank Permit (Y/N) WA Separation Distances from Septic/Holding Tank To Water -Supply Well > 140"o To Building Foundation To Property Line i 10 To Disposal Fieldy To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course Ney� Comments Page 1 of 2 72-026(11184) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata I fi5 Type of System Design Tftiff WeH Date Installed 0/141ti Length of Field H.Z. Width of Field 3o t Depth of Field Cl Gravel Bed Thickness Square Feet of Absorption Area 5 C 4 Standpipes Present (Y/N) T S* O Depression over Field (Y/N) N Date of Last Adequacy Test 511g, Results of Last Adequacy Test �nqg �... y �o�vo.►w3 Separation Distance from Absorption Field: To Water -Supply Well > J4.0 To Property Line i 20 To Building Foundation Iss To Existing or Abandoned System on Lot NONg ; On Adjoining Lots 1 50 To Water Main/Service Line > 1P To Cutbank (if present) N ON Ic To Stream/Pond/Lake/or Major Drainage Course N w4 L To Driveway, Parking Area, or Vehicle Storage Area V tAJ4%r t e�w4 Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at — High Water Alarm Level at Tested for Electrical Codes (Y/N) _ Comments Dimensions Manhole/Access (Y/N) — "Pump Off' Level at Check Permitted Bedroom Rating Against HAA Request •• Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA Icertify that Ihave checked, verified , r conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date Iv 6 Company Receipt No. 7 q L(qp Date of Payment S - DU -V�- Amount: $ < - c)0 Page 2 of 2 72026 411.80 MOA No. `w N. ♦ e OF /ki It *:.490 2225-E 25.1971 Engineer's Seal 3 W 15th AVE **C*'SUITE 203 / •� U O �' " �+U V �P� WU�1��:1 V ��) PO O � 20ANCHORAGE. ALASKA 99501 •• .CONSULTING ENGINEER TELEPHONE: (9071279-3916 S E P T I C S Y S T E M A D E Q U A C Y T E S T — — — — — — — — — — — — — — — — LEGAL: LOCATION: OWNER: RESIDENCE: WATER SYSTEM: SEP.TI,C j b,YSTEM: 40 No. 2225-E n � •,� J:N: aJ. 1971 :qui f4�)XC cE OF PP LOT 7, BLOCK 2, GREENBROOK 12840 VAN SCHEBEN JACK WEAVER SINGLE FAMILY, FOUR BEDROOMS CLASS A COMMUNITY SYSTEM FROM MUNICIPAL RECORDS: TANK: ANCHORAGE 1250 GAL. ABSORPTION SYSTEM: ABSORPTION AREA: SOIL RATING: INSTALLATION DATE: TANK, STEEL, TWO COMP. TRENCH 504 SQ. FT. 125 MAY 1981 MAY 17, 1986 ANCHORAGE CESSPOOL PUMPING MAY 16, 1986 TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH FOUR FEET OF COVER. LIQUID DEPTH WAS 50.5 INCHES. CLEANOUT WAS FOUR FEET DEEP. HEIGHT ABOVE CROUND 16 INCHES. SUMP WAS 7 FEET DEEP, WITH FOUR INCHES OF WATER. HEIGHT ABOVE GROUND WAS 18 INCHES. WATER WAS ADDED TO THE TRENCH CLEANOUT AT A CONSTANT RATE OF 9.5 GALLONS PER MINUTE. THE WATER LEVELS IN THE TANK AND TRENCH SUMP WERE MONITORED. A TOTAL OF 700 GALLONS WERE ADDED. DURING THE FIRST 550 GALLONS NO RISE WAS NOTED IN THE SUMP. THEN DURING THE LAST 200 GALLONS THE LEVEL ROSE 10 INCHES. NO RISE WAS NOTED IN THE SEPTIC TANK. THE INFILTRATION RATE WAS MONITORED FOR 45 MINUTES. DURING THIS PERIOD A TOTAL OF 62.5 GALLONS WERE ABSORBED. BY EXTENDING THE OBSERVED INFILTRATION RATE A TOTAL ABSORPTION RATE OF 1000 GALLONS PER DAY WAS ARRIVED AT. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on the local soil conditions, 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 this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. DEPT. OF ENVIRONMENTAI.CONSERTIATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 3O3 ANCHORAGE_, ALASKA 99501 DATE: M,v 1 S 198E PWS I.n.N 210346 To Whom it May Concern: BILL SHEFFIELD, GOVERNOR Telephone: !9071 Address: 274-2533 According to records on file in this office the GREENBROOK Water Regulations Water System is in compliance with the State Drinking Sincerely, lvlzc / ' tlichael P. Lewis Environmental Engineer 1", n MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date 1/ V (a) regal Description (include lot, block, subdivision, section, township, range) J (b) Applicants Name i pplicarts M(;; .i. (c) Applicant is,(; Buyer [::� ; .Ot Lending Institution (explain); 2 ner/builder �; (d) Lending Institution Telephone Address (e) Real Estate Co. s Agent 14 Address Telephone 2. Type of residence Single -Family Multi -Family Number of Bedrocros other (describe) 3. Water Supply 1A , /I Individual Fbli Ccmmnityf5<-1 Public Note: If eom arity well system, must have written ecnfirmation from the State Department of Environmental Conservation attesting to the legality and status. Is the well adequate for the number of bedrooms specified in this HAA AN) 4. Sewage Disposal Orsitey Public Ccmelnity Folding Tark Is the wastewater disposal system adequate for the number of bedrooms Y ) (Page 1 of 21 2-15-84 /. 7 n 5. Engineering Firm Providing Inspections, Tests, Data and Information I certify that I have c#iecked, verified, or eonforried to all MSA HAA Guidelines in effect on the date of this inspection. ICIL Name of Address 1210) /i% . =3sz-1 2% 63 Signed by Date ` fr Y `l (ENGINEER SEAL) Approved for 47" bedrooms By Date ��IIF"- 'L. Cls ct^a.Gt Approved Disapproved Q Conditional Terms of Conditional ARproval Sr C. a" Jr. No. !2414 Date a -, olS[ The Municipality of Anchorage Department of Health and Environmental Protection does not guarantee the continued satisfactory performance of the water supply and/os the wastewater disposal system. This approval indicates that, as of the validation date sham above, used on the data and information furnished by an engineer registered in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional for the number of bedrooms and type of structure indicated. (DHEP SEAL) 7. Mail the HAA to the following address: C�cLCf Cl:. -c ba o�- RB2/d5/s [Page 2 of 21 2-15-84 A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION Jull 1 Z' SeA;' CHECKLIST - FEBRUARY 1984 R E C H V E D Legal Description: L ?L d 2 G;aAeoo K Well Class ificationC'QM� If A, B, Cr C, D.E.C. Approved(Y ) 31 . ' Well Log Present (Y/N) Iy /it Date Completed N //I Yield Total Depth AJ 1A Cased to Dep outing Static Water Level AJ /n Rump Set At ,a!/4 Casing Height Above Ground .I/Q Sanitary Seal on Casing (Y/N Electrical Wiring in Conduit (Y/N) �AIIA- Depression Around Wellhead (Y Separation Distances frau Well: �1 To Septic/Holding Tank on Lot 2001-4— On Adjoining Lots To Nearest Edge of Absorption Field on Lot On Adjoining Lots_&/A_ To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot /U*% Water Sample Collected By A/ - Date Water Sample Test Results A & Comments nl/ B. SEPTIC/HOLOING TANK DATA Date Installed 3 / Size 12,5-6 No. of Compartments `L Standpipes ((j'N) Air -tight Caps (VN) Foundation Cleanout & N) Depression over Tank (YVb Date Last Putmped m/ �/ �$�/ U/�/55AC5 L_ Pumping/Maintenance Contract on File (Y/N) P I&for Holding Tank High -Water Alarm (YIN) Temporary Holding Tank Permit (YIN) Al/a Separation Distances frau Septic/Hol ng Tank: To Water -Supply Well ?-On14-To Building Foundation '$')�/b t zwr. To Property Lire 1-20" To Disposal Field /D 40 - To Pmsf ice Lire d -/ To Stream, Pond, Lake, or Major Drainage Cattfsa ..... /� 1 I `1 L CIA UM n.nLie-4-f - 4,AA fnr� [Page 1 of 21 b 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 1 25 a Type of System Design t PeNc N Date Installed V/4/81 length of Field 4.2 Width of Field 4� Depth of Field Gravel Bed Thickness G� Square Feet of Absorption Area 5-04 Standpipes Present &I) Depression over Field (y4pk Date of Last Adequacy TestI4ZA(t Results of Last Adequacy last - �7 Separation Distance from Absorption Field: To Water -Supply Well 4- To Property LineaE- To Building Foundation 3cr,S ' �t- To Existing or Abandoned System on Lot�]y'�`�' ; On Adjoining Lots �[�� r- * To Water Mair4%ervice Line -t- 10 "f To Cutbank(if present) ill /A To Stream/Pond/Lake/or Major Drainage Course P 1A— To Driveway, Parking Area, cr Vehicle Storage Area rIA D. LIFT STATION — �JC)JUt✓ J Date Installed A-) / A . Dimensions Size in Gallons AfJA Manhole/Access (YIN) Jul/A "Pump On" level at NTn "Rmg Off" Level at High Water Alarm level at A//d Vent (Y/N) N/A Tested for AIIA Pumping Cycles during Adequacy Mast. Meets MDA Electrical Codes CLUIT nts ** Check Permitted Bedroan Rating Against HAP. Request ** I cert on the that I have checked, verified, or oonfcrmed to all MOA HAA Guidelines in effect e of this inspection. KBl /d5/s (Page 2 of 21 Date MOA No. 2-15-84 ALASKA bUIROf1 nTAL COnTROL SCRuICCS, InC. Engineerinq 6 Enuironmental Studies JUNE 1 1984 BART RICHARDSON 12840 VONSCIDFN DRDIVE ANCHORAGE AR 99516 SELLER — BART RICHARDSON BUYER — SUBDIVISION — GREE HOOK BLACK — 2 LOT — 7 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 504 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 800 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. THE SEPTIC TANK TAW PLWED 10a-6 4848 ' SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 ADEQUATE FOR THIS 4 BEDROOM HOUSE. 1200 West 334 Auenue. Suite B • Anchoragc. Alaska 99503 • (907) 5645040