HomeMy WebLinkAboutSPRING FOREST BLK 2 LT 15Spring Forest
Block 2
Lot 15
#015-342-24
EG
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program, 4700 S. Bragaw SL
P.O. Box 196650 Anchorage, AK 9951M650 Page of
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
er SUU0104hD PIDNumber. a
Wastewater System: []New upgrade
Well: ❑ New ❑ upgrade
C""rKaoon (Prwate. A e. CF I Total D!p c
Daled
SEPARATION DISTANCES
7o Septic Absorption LiR Hokting
From Tank Field Station Tank
ui J
w.n
sleao water 100-11 IC`Q 'I
Llitt:. tf� 3D
Fanearan ?,D �i3
Crwn Dratn
Remarks
ABSORPTION FIELD
Trw,, D mellow'r ch D Bed D Mane D ovw:
sd Ramq' lar Depen from'"nel lea
o h PIF IU
oepdt 1p Ppe Rpmnt Ran wgi M Rade: C." depth bantam p":
3 Fl.
'Fa.ed.d aep.. atvw pad•: Gr..rollagth 8z
Q / Ft.
u,niew Wlnac Dnurce Eewe
2
V
aR.aplwl are.I I '7an. f7 7ANTANK
eptic ❑ Holding ❑ S.T.E.P.
'l°Cp""./nal J t
/. T•
Ft.
_ 3o3ki
lo�nl
❑ Other.
Caper ry
Gal.
Nu ntm of Caroartmamr
H2On wart« Henn at
N.
"Make a MOM I'Llaw" tnpectl" Wm p
BENCH MARK
Aewmed E�eveom:
Ft
/Engineer's Stamp
Inspections performed by:
0. S Dates: 1" �O/✓1(v/ ;�a.,-r�f .. '' •-•di%%•�i
e o
2ndfkF
L'• ol Tu:.tanti o
Development Se Ices Department Approval ,,, •,^ c ns : , M
[� Date: -2-0 I �� . ' ••...
Reviewed and approved by:
LEGAL DESCRIPTION
elo�a
$Wdnaac
i7 5PRIN6 Fo2F5i
Townanp:
Rang.-. Seam.
Well: ❑ New ❑ upgrade
C""rKaoon (Prwate. A e. CF I Total D!p c
Daled
SEPARATION DISTANCES
7o Septic Absorption LiR Hokting
From Tank Field Station Tank
ui J
w.n
sleao water 100-11 IC`Q 'I
Llitt:. tf� 3D
Fanearan ?,D �i3
Crwn Dratn
Remarks
ABSORPTION FIELD
Trw,, D mellow'r ch D Bed D Mane D ovw:
sd Ramq' lar Depen from'"nel lea
o h PIF IU
oepdt 1p Ppe Rpmnt Ran wgi M Rade: C." depth bantam p":
3 Fl.
'Fa.ed.d aep.. atvw pad•: Gr..rollagth 8z
Q / Ft.
u,niew Wlnac Dnurce Eewe
2
V
aR.aplwl are.I I '7an. f7 7ANTANK
eptic ❑ Holding ❑ S.T.E.P.
'l°Cp""./nal J t
/. T•
Ft.
_ 3o3ki
lo�nl
❑ Other.
Caper ry
Gal.
Nu ntm of Caroartmamr
H2On wart« Henn at
N.
"Make a MOM I'Llaw" tnpectl" Wm p
BENCH MARK
Aewmed E�eveom:
Ft
/Engineer's Stamp
Inspections performed by:
0. S Dates: 1" �O/✓1(v/ ;�a.,-r�f .. '' •-•di%%•�i
e o
2ndfkF
L'• ol Tu:.tanti o
Development Se Ices Department Approval ,,, •,^ c ns : , M
[� Date: -2-0 I �� . ' ••...
Reviewed and approved by:
�------- - - - - -- ---- - - - - --
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Depth to R
LsngM 82 R
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SCALD 1 = 50 FT. /�
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TOBBEN SPURKLAND P.E. SPRING FOREST SEPTIC SYSTEM AS BUILT
203 W 157H. AVENUE LOT 15 BLOCK 2 DATE: OCT. 31, 2001
ANCH. AK. 99501 6151 WI T TREE SHEET. 2/3 GRID: 2538
I PERMIT # SV 010450 PIB # 015-342-24 SPF02152.BV6
0 0
02 1250 gal Septic tank
r D=Aoc
a
m
U
d
a
Standard Trench,
2' Wide
75' Long
10' Deep
7.0' Sewer rock .�
3 Cover �p• �n:..,.(�
49th
NO SCALE
Sil t
84.9 mu
7.0 ft of Septic Rock
Effective
203 W15th Ave
Anchorage Ak 99501
PERMIT / SWO10450
Monitor
Cleanouts
— 3' Cover
NO SCALE X77 u`
SPRING FOREST
LOT 15, BLOCK 2
6151 WW Wr
PARCEL ID / 015-342-24
84.9
IGEN SPURKLAND
No. CE -2225 ,
u
1250 gal. septic tank
a
t°
SEPTIC SYSTEM SCHEMATIC
DATE, OCT. 31, 2001
SHEET, 3/3 GRID, 253
SPF01153.DWG
_ 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
Permit Number: SWO10450
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
l°/rill 6100 FAI
10/3a/01 (—,7'C�C>Pkl
Date Issued: Oct 25, 2001
Expiration Date: Oct 25, 2002
Parcel ID: 015-342-24
Legal Description: SPRING FOREST BLK 2 LT 15
Design Engineer: 0007 Tobben Spurkland, PE Site Address: 006151 WEST TREE DR
Owner Name: Bill Johnson Lot Size: 49885 SO. FT.
Owner Address: 6151 W TREED RIVE Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE. AK 99516-6710
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 specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 1BAAC80 ).
g 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.
5. The following special provisions.
Verify the integrity of the existing septic tank.
Received By:
Issued By:
' ol
Date:
Date: Z /�
' al><ty of Anchorage
\.�Tt,
1Department$ ti -t
.,, Development Services �.;r°
,( Building Safety Division ` 1J
On -Site Water and wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWERIWELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D.
— 2 Permit Number SWC) I OLDS -0
Property owner(s)
Day Phone
Mailing address (1) b l ") V-e� -
Zip Code
Mailing address (2) S o « f
Legal description (Lot, Block & Sub'd.)
Legal description (Section, Township & Range)
Lot Size G�`I AS
Acres/ Number of Bedrooms
THIS APPLICATION IS FOR: ❑ Well Only ❑
Sewer Only Water Storage ❑
Sewer and Well ElE
Sewer Upgrade
THIS PROPLRTY CONTAINS: ❑ Jacuzzi- ❑
Hot Tub Water Softening Unit ❑
Swimming Pool ❑
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 applicile Municipal Codes.
(Signature of property owner or aulholzed agent)
Permit Fees:
Date of Payment:
Receipt Number:
(Rev. 12100)
Waiver Fees:
l 0 /z/n / Date of Payment:
t ��� Receipt Number:
T.31PUPM [,.i M PIE.
203 W 15th. Avenue, Suite 203
ANCHORAGE, ALASKA 99501
(907) 279-3916
Fax (907)-276-6013
SEPTIC SYSTEM DESIGN
LOT 15 BLOCK 2 SPRING FOREST SID
BILLJOHNSON
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
Anchorage, Alaska 99519-6650
Oct. 23' 2001
We are submitting an application for the upgrade of the septic system for this lot. The submittal
consists of three (3) drawings showing the present improvements on the lot and the adjoining
properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is
subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil
logs and percolation tests of applicable testholes are also enclosed. The septic system design is
based on the following:
No Ground Water or Impervious Layer to 16 R.
Use Standard Trench
Soil Rating. From Testholes 10/18/00
15 and 30 mien Use 30 = 0.6 gpfpd
No. of Bedrooms 4
Required Area per Bedroom: I50/ 0.62 = 250 sq.R.
Total area required: 250 x 4 = 1000 sgft
Testhole depth 16 feet
Bottom Rock ALIO feet
Top Rock At 3 feet
Rock Depth 7 feet
Minimum Trench Length 1000 / 14 = 7 1 A ft.
SYSTEM CONFIGURATION
STANDARD TRENCH
TOTALLENGTH
75 FT
TOTAL WIDTH
2 FT
TOTAL DEPTH
10 FT
ROCK DEPTH
7 FT
COVER
3 FT
SEPTIC ANK
EXISTING 1250 GAL
The installation of this septic system will not prevent septic systems from being installed on the adjacent lots.
There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots.
The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface
runoff will not result from this installation.
SQR
sub"sk
UNDEVELOPED
100' OFFSET 1 CREEK
1 1511
1 III �9� sr
II �
1 III
1 _/1 @tit III 33 J
II
1 <0
.Jn I I
z _ II
/ TREF, �RI�
'I - I
50 0 50 tan 150 200 250 xn
SCALEr 1' = 100 FT. I I
ITOBBEN SPURKLAND P.E. SPRING FOREST I I SEPTIC SYSTEM DESIGN
203 W 15TH. AVENUET LOT 15 BLOCK 2 DATE: OCT. 19, 2001
ANCH AK. 99501 6151 {VEST TREE SHEET.• 1/3 GRID: 2538
I PERMIT # SV OIOXXX PID k 015-342-24 SPF02151.DVG
d
i�tt�R Off y
a
Sm1,dord ted,
D.ym f0 n
tmyM 75 n
Hrr mck 7 n
'T l
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203 W
61515{VES� TREE
SEPTIC SYSTEM DESIGN
DATE: OCT. 19, 2001
SHEET: 2/3 GRID 25J8
k SW OIOXXX PID # 015-342-24 SPF02152.DWG
O O
k
H
0 1250 gal Septic tank
_ VUS W
d
V
a
s
3
A
Standard Trencht
Sil t Bo
7.0 Pt of Sc
Effective
2' We
75'
Long
10'
Beep
7.0'
Sewer rock
3'
Cover
.' 49th
iBLN SPURKLAND
No. CE -2225 i
NO SCALE
3
L2
NU )LMLr
TOBBEN SPURKLAND P.E. SPRING FOREST SEPTIC SYSTEM SCHEMATIC
203 W15th Ave LOT 15, BLOCK 2 DATE, OCT. 19, 2001
Anchorage Ak 99501 6151 NW Dom[ SHEET• 3/3 GRID, 2538
I
SPf02153.DW(;
PERMIT ,/ SWOl00XX PARCEL ID / 015-342-24
Performed For:
Legal Description:
Depth
T N a t l?.e''rr"
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
47DO South Bragaw St.
P.O. Box 196650 Anchorage. AK 99519-6650
�I .nom
(907) 343-7904
Soils Log - Percolation Test o
Date Performed: iI
Range. Section:
ar..� • �
f� •(ENGtNEER'S.SEA4).'
rurklund i r` To..ben S
41 O. =. CE -".273 ' ri
44 1`
f1
COMMENTS
WAS GROUND WATER
ENCOUNTERED? S
IF YES, AT WHAT DEPTH? l �
Depth to Water After P
Monitoring? E
Date:
Reading Dale Gross Time
Net Time
Depth to Water Net Drop
cra iG
U
a
t 5
31
to S
1 o
71/
PERCOLATION RATE A.I""'N°y ' PER- HOLE DIAMETER
I
TEST RUN BETWEEN C2FTAND i• FT
CERTIFY THAT THIS TEST AS
PERFORMED BY:
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: rO 1 Z
04I. _.........
F�..,•(INF2S it.
Municipality of Anchorage' ENGEE'SEAL) s,
Development Services Department
Building Safety Division . ��•�
On -Site Water and Wastewater Program D' �f yt`kr✓
• 4700 South Bragaw SL f
II � 70_`.-:n 5•'�: nand ..�
P.O. Box 196650 MUorage, AK 99519.6650 \ CE -2:23
,, A enchomoe ak.us
(907) 343-7904
�'.✓
Soils Log -
Percolation Test
t/nn'. IO eat e
2/ S�'✓I _Dale Performed:
Performed For:
15 1-� Y 2 �yj til f ; Township, Range. Section: _
Legal Description: \
Depth
a
Date: t_
2-
Dale Gronnss��Time
1jing
n r
An..cY
4-
t17
5- ,'
il1-
6-
67
7
a
lifiC
13-
15-
17-
18-
19 -
COMMENTS
WAS GROUND WATER
ENCOUNTERED? 5
L
IF YES. AT WHAT DEPTH? 0
Depth to Water After P
Monitoring? E
fl
PERCOLATION RATE
TEST RUN BETWEEN
:W7
rr7
Net Time i Depth to Water I Net Drop
(mMe~) PERC HOLE DIAMETER b .,
FT AND / FT
f CERTIFY THAT THIS TEST WAS
PERFORMED BY:
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DA
Date: t_
Dale Gronnss��Time
1jing
�7CJ
Flo
t17
fl
PERCOLATION RATE
TEST RUN BETWEEN
:W7
rr7
Net Time i Depth to Water I Net Drop
(mMe~) PERC HOLE DIAMETER b .,
FT AND / FT
f CERTIFY THAT THIS TEST WAS
PERFORMED BY:
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DA
TN Vk3
Municipality of Anchorage
Development Services Department
Building Safety Division
0 On -Site Water and Wastewater Program
4700 South Bragaw SL
P.O. Boz 196650 Anchorage, AK 99519-6650
www can
(907) 3437904
Soils Log - Percolation Test
Performed For: !/I/(/
Legal Description: o 4 Ii
Depth
3- C
4
_ e
Date Perto
1-d r' Township, Range, Section:
•,•.,. {ENGINEER'S SEAL) 'N
WAS GROUND WATER w ` ^
ENCOUNTERED? �V V S
L
IF YES, AT WHAT DEPTH? 0
Depth to Water Amer P
Monitoring? dc%l E
Date: 1-2- O
13Si ( SccK1l�
- ; ti Time Reading Date Gross Time Net me Deplh to Water Net Drop
14-
1s-
16
17- o►- No�C
is-
19-
PERCOLATION RATE ewwtesn^oJ PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
COMMENTS
�e CERTIFY THAT THIS TEST !AS
PERFORMED BY: 11
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: O 2.'Z D
Municipality of Anchorage Page —)_Et 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 * Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW 93002q PIDNumber: 01534224
Name:Wastewater
System: 8' New ❑ Upgrade
PeIFersam irrou , -Tnc. Su,k �Y
Address:
3820 Lnkeoh�s Pcu'ktuo 411cA Ak 94s
ABSORPTION FIELD
Phone: No. of eo drooms:
0 peep Trench ❑ Shallow Trench Based ❑ Mound ❑ Other
.56Z -1170 7
Sod Hating: Total Depth from oripi al grade:
LEGAL DESCRIPTION
`• +.A'111
O.8 GPD/SqFI 7.S °�51
LOC Blpca: Subdivision;
entlom Ilom original grade:
IN qh to p�Mi0 6.
°�""'"7
Gravel depth Deneeth pope
O.8 Ft
15 Z SPRING FOREST
FI
Township:12 N
Range: W
Section: 14
Fill added above original grade:
I Ft
Gravel length: SO FI
Gravel depth:
Number of lines:
Distance between end:
WELL: N.A. ❑ New ❑ Upgrade
l.-2 F1
3
1 S Ft
Classilicatmn (Private. A.B.C):Total
Depm:
Cased To:
Total absorption area:
-TSO
Pipe material: '
4'PE,tF P✓[ F•910
Ft
Ft
so Ft.
Driller:
Delo Drilled:
Stabil K'aler Level:
InslalleC
Date in felled:
(0 3 ISI
Fl.
ICINCAlb AND S3QS
—
Yield:
Pump Set al:
Casing He�gnt Above Ground:
TANK
GPM
fl.
FI
SEPARATION DISTANCES
D(seplic C3 Holding 0S.T.E.P.
To
S.PIIc
Ah.nm4nn
LI11
""m7
h 'rJPuvn...
Manldafl pef
AIDCgoP.A T1t 411
GaI111f.1IY nl gallnnA.
1250
From
Tae+
Feld
Station
7.r•a
sown. a,om
M,1IerIa1
Number of Compartments:
Well
—
—
—
—
STEEL
2
surface
7/001
—
—
> /boa
LIFT STATION (N.,+)
�/001
Lot
1
Size in gallons:
Manufacturer.
Line
I.
2S1
ZDI
�,
Z'S
ump on" level al:
F
"Pump oft" level at:
High water alarm at:
Foundation
2S'
70'
—
—"
O
Curtain
Pump Ma+ea Model
Electrical Inspections performed by:
Drain
—
BENCH MARK
RemaricS: Soslexlle,,f p-ee-
location and Description:
BOTTOM OF SIDfNG NORTHWEST
_C ORNE F OF MOUSE.
Assumed Elevation:
fDo•0 Fr
Rttop Technical Service
ENGINEERS SEAL
4 kit
t�O"�••:;�u^��
o a-** •.:i
p*f
Aachora e, Alaska 9951-
Inspections performed by: —FLATTOP IE(F�.SvCS._ Dates: ist_6III93
s* .6 491-H v
30••1•••••••••••••••.....
0..1
2nd_0!1_J 3
:.......... ..�:7°0
Department of He th d Hum Services ap;4v-7-3
HOD;it F. MCCRE ; r
f� •. CE - 9589 +- 1
Date:
40
4�111111114
Reviewed and approved by: -� — __ _.
v.a'
724)13 (1/91) MOA N
0
A
Permit No. S W 9,500;Z9
Page 2 of 3
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Description: ZoT 15 13LK 2 SPRANG FOREST
I I
I I
M
M
I"=4o L I I
15'x5o' SOIL I
40 Ape,09PTI0N BED
I I
LMT:
• I
c.o."E I
"o-ssosv I I
ouuaI-e; I
1150 GAL.
C.O."D" SEPTIC TARk
T.&M•
c
A 4 SORM
}IOVSE
lo' UTILITY ESMT
WEST TRL>L- oa.
72-015 A 1H... 9911 MOA 25
I HI
r
wI
IF
w
�
J
v
W
I i 1r.
Z
1 0l
o
1 NI
-
c
— — — tJ
38
PIDNO.: 0I63y22y
SWING TIES
HOUSE
CORNERS:
SEP. TANk C.o'D" 40 29
ABS. BEU co'Ek so' s1'
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99516
ENGINEER'S SEAL
4 r^.Tx�y
. —
.... ......................
....................
FHEODORE F. MOORE
CE -3539 r�
. Permit No. St✓ 9 3 oo29
Page 3 0t $
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
95 I
Lor 15 131k 2 SPRINC FoRE ST
I4 SULATI914
1250 6ALLON
SEPTIC TANK
90r I L_
INLET
INVERT 93.7'
I
8S
s0'
75'
'7o
72-013 A IR•.. 9M I MDA 2S
OUTLET
INVeAT 93.5
VERTICAL SCALE: I"=5'
No OaRlzoWrAL SCALE
PIDNO.: 0153`4224
4Rw4o BELOW ABS. FIELD
&1.8'
DISIRIISUTIou PIPE
w✓ERT 7S.1'
SEAL
BDTron of BED°A: A '%M -
Ar
74.3' i �J 49T1 j �
r ........................
10.
DRY / THEODORE F. MOORED
Flattop Technical Services CE. 3589
14530 Echo Street 6s.8' �'••••••••� F��`,
Anchorage, Alaska 99516
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW930029 DATE ISSUED: 3/15/93
DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES EXPIRATION DATE: 3/15/94
OWNER NAME:ADAMS D KATHERINE
OWNER ADDRESS:P.O. BOX 242294
ANCHORAGE, AK. 99524
PARCEL ID:01534224
LEGAL DESCRIPTION: SPRING FOREST BLK 2 LT 15
LOT SIZE: 49885 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT:
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
THIS SYSTEM MUST BE INSTALLED IN
SPECIFICATIONS UNDER WHICH PERMIT
RECEIVED B
ISSUED BY:
ACCORDANCE WITH THE
NO. 910343 WAS ISSUED.
DATE:
DATE'�S4
0
Tom Fink.
Mayor
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage. Alaska 99519-6650
343-4744
October 28, 1992
Katherine D. Adams
PO Box 242294
Anchorage, Alaska
99524-2294
Subject: Perm15 Block 2 it #SW9103421, PID ivision
#015-342-2Forest g
The subject permit, issued October 25, 1991 by this
single family well and/or on-site wastewater system,
expired as of October 25, 1992.
a
office for a
has
A new permit must be obtained from this office for a well
and/or on-site wastewater system NOT installed by the
expiration date.
If you have drilled the well, a well log must be sent to
this office for documentation of the installation and to
close the permit.
If a licensed Professional Engineer has inspected the
installation of the on-site wastewater system, the original
as -built inspection report must be sent to this office for
review, approval and documentation. All inspection reports
must be submitted within 30 days of construction completion.
When applying for a new permit, the fees are: $200.00 for an
on-site wastewater permit; $75.00 for a well permit and
$275.00 for a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
Sin erely,
hn Smits , P. E.
rogram tanager
On-site Services
enc: Copy of Permit
PAGE 1 OF
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW910343 DATE ISSUED:10/25/91
DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES EXPIRATION DATE:10/25/92
OWNER NAME:KATHERINE ADAMS
OWNER ADDRESS:P. 0. BOX 242294
ANCHORAGE, ALASKA 99524
PARCEL ID:01534224
LEGAL DESCRIPTION: SPRING FOREST BLK 2 LT 15
LOT SIZE: 49885 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
DATE: a $
RECEIVED BY:
ISSUED BY:
&Vc,4-e (
6y�`)�
DATE: /
1
{F LA ,. 'TOP TECHNICAL SER S`-
y-
CnU & E4VMONMENTAL ENGL4EERI4G • ENERGY CONSERVATION 6 ANALYSIS
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
THEODORE F. MOORE, P.E. October 24, 1991
PH: (907) 345.1355
John Smith
M.O.A. DHHS
P.O. Box 19-6650
Anchorage, AK 99519
Dear Mr. Smith:
This submittal provides the information requested on Ms. Oswalt's 2nd pink transmittal sheet dated
10/16/91 regarding our application for a sewer permit to serve a proposed residence on Lot 15, Block 2,
Spring Forest S/D.
The reason we anticipate sewage will not come out the side of the 38% slope on the downhill side of
the bed is that the bed is to be constructed 7.5 feet below ground level, and the majority of the overlying
soils are a relatively impermeable sandy silt. Even assuming the unlikely worst case that the sewage were
to attempt to migrate horizontally through the silt from the bed instead of vertically down into the sand, it
would have to pass through 20 feet of undisturbed native soil before daylighting. This is considerably
more horizontal protection than is afforded by a conventional mound system with 2 feet of imported soil
cover and 33% side slopes.
As stipulated by your office we conducted a 9th soil test (log enclosed) in the south portion of the lot.
As previously predicted in my letter dated 10/2/91 the soils encountered are predominantly a sandy silt.
The density increases with depth and we were unable to dig deeper than 13 feet due to the presence of a
large rock. We conducted a percolation test between 4.75' and 5.25' in the zone which visually appeared
to be most permeable. Even during the presoak phase, when there were 11" of head in the pert test hole,
the measured percolation rate was slower than 60 minutes per inch. Based on this test I am still of the
opinion that the south portion of the lot does not offer a suitable location for construction of an on site soil
absorption system. On the other hand, it i9 my opinion that the excellent soils encountered in the location
of the proposed design will result in a good soil absorption system, despite somewhat higher construction
costs.
If this information resolves your concerns regarding our proposed design, we would appreciate your
issuance of the requested permit.
Sincerely,
Ted Moore, P.E.
cc: Jeff Keim RECEIVED
OCT 2 41931
Uu Iicapahty ct Anchorage
Dept. Haalth & Human Services
si J
FLATTOP =T]
BCH QQAL <,SERV,IGES
CIVM & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSE
74530 ECHO ST.
THEODORE F. MOORE, P.E. October 2, 1991 ANCHORAGE, ALASKA 99516
PH: (907) 345-1355 seOIAieg ueuinVI V 411eaH'Id"O
e6ejoy0uV to Il1iled10.an1,%l
Susan Oswalt
M.O.A. DHHS
P.O. Box 19-6650
Anchorage, AK 99519
Dear Ms. Oswalt:
1661 t 100
UARDH
permitrs letter to construct an onds n sitte he wastewater disposal uestions raised on system on Lour 9/25/91 ot 15ink ,Block response, Spring Fore t ication S/D ,for a
While I agree that a bed type soil absorption system is not generally a viable option on sites with slopes
significantly in excess of 10% (partly because such a system is difficult and expensive to construct), in this
situation I felt it was the best solution. Because the proposed bed will be constructed in quite permeable
sand at a chance thatgeffluent wiificant ll ever th daylight out)which the siderof thenain natural slope on the impermeable
side of the rbed little
The water service line is not in yet, and we were not able to find the exact location of the Mueller
valve, however the water main is located in West Tree Drive, so there will be no conflict between the water
service line and the proposed soil absorption system.
Based on the quite extensive soils testing program which we conducted on this lot, it is my opinion
that the proposed site is the most viable location on the lot for construction of on-site soil absorption
system. Research on soils tests conducted on adjacent lots, coupled with the trends established by our 8
test holes on this lot, have convinced me that the subsurface soils on the south end of the lot consist
basically of a tight silt which is generally unsuitable for construction of a soil absorption system. The
December 1982 soils test conducted by Melvin Nichols for Joe Cange, referenced as being on Lots 14 &
15, classifies the soils as being a wet, stiff, sandy gravelly silt. Mr. Nichols was able to get a marginally
acceptable perc rate of 37 minutes per inch in a slightly more gravelly zone between 5 and 7 feet, however
bear in mind that this test was done in December when soil conditions are generally quite dry. I would
expect any system constructed in this material to fill up with groundwater during breakup. Lee Reid's
soils test on Lot 15, Block 1, across the street from the subject property, also showed there to be pure silt
below 2'. 1 would expect the deeper material would perc at a slower rate than the marginal 50 min/n.
which he reported at 2.5 feet.
Our test holes fit in with this continuum, showing sand at depth near the top of the slope, with pure silt
further to the south. Based on this analysis, it is my opinion that the soils near the south end of the lot are
not suitable for construction of a soil absorption system, and I think it would be a mistake to try to install a
system in marginal soils, when we have much better materials at the proposed site. Please give me a call at
345-1355 if you want to discuss this further.
Sincerely,
Ted Moore, P.E.
cc: Jeff Keim
CIVR.6 ENMONS ENTAL ENGLNEERLNG • ENERGY CONSERVATION 6 A.NALYSis
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
THEODORE F. MOORE, P.E. September 19, 1991
PH: (907) 345-1355
M.O.A. DHHS
P.O. Box 19-6650
Anchorage, AK 99519
Dear Sirs:
The purpose of this letter is to provide the required design narrative in support of our application for a
permit to construct wastewater disposal facilities on Lot 15, Block 2, Spring Forest S/D, located at 6151
West Tree Drive. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed
e
for your review.
The proposed system will be constructed in the vicinity of test holes #1 and #6. As can be seen from
the soil log for test hole # 1, the native material below 7.5 feet is a slightly silty sand with a measured pert
rate of 2.2 minutes per inch. Using the soil application rate of 0.8 gpd/sq. ft. specified in the wastewater
ordinance for a bed type soil absorption system constructed in this material, a 4 bedroom residence
requires a total absorption area of (4 x 150)/0.8 = 750 square feet. The proposed 15' x 50' bed design has
a total absorption area of 750 square feet. A similarly sized site for a replacement system is shown
between test holes #6 & #8. In evaluating the soils information for this reserve site it should be
recognized that the natural ground elevation at test hole #8 is approximately 6' higher than at test hole #6,
thus the proposed receiving stratum is at a comparable elevation.
As indicated on the site plan, the topography in the proposed construction area slopes to the northeast
at an average of 27%. Just northeast of the proposed site and of the reserve area the slope steepens to
approximately 38%. Despite these relatively steep slopes, daylighting of effluent from the soil absorption
system should not be a problem because the proposed bed is quite deep, and the overlying ML material
will present a barrier to horizontal migration of effluent further downslope.
It should also be noted that the subdivision plat designates a 20' wide drainage easement along the
eastern boundary of the lot. There is a culvert running under West Tree Drive providing storm drainage
from land located to the southeast. On the date of our initial soils tests on August 2 (immediately after a
heavy downpour) there was a trickle of water running through the culvert, although no surface water was
visible in the ditch upstream. We subsequently monitored the culvert and drainage easement on August 9,
10,12,14, 28 and September 4 and 11. There was no water running through the culvert or in the drainage
swale below on any of these occasions, except that on September 11, after a rainy week, water was
dripping from the outlet of the culvert. Based on these observations, as I have already discussed with
John Smith, one can conclude that this drainage easement does not constitute a surface water source
requiring a 100 foot separation from on-site wastewater disposal facilities.
There is a continuously flowing stream crossing the northeast comer of the lot as shown on the site
plan. Unfortunately, the designated 100 foot offset from this stream does not leave enough room for
construction of a soil absorption system at the toe of the slope in the vicinity of test holes #5 and #7,
however the proposed original and replacement sites are both outside the required 100' setback from that
stream.
f `
�r ``QQ` TT P �TErGHNICAL
SERVICES
CIVR.6 ENMONS ENTAL ENGLNEERLNG • ENERGY CONSERVATION 6 A.NALYSis
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
THEODORE F. MOORE, P.E. September 19, 1991
PH: (907) 345-1355
M.O.A. DHHS
P.O. Box 19-6650
Anchorage, AK 99519
Dear Sirs:
The purpose of this letter is to provide the required design narrative in support of our application for a
permit to construct wastewater disposal facilities on Lot 15, Block 2, Spring Forest S/D, located at 6151
West Tree Drive. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed
e
for your review.
The proposed system will be constructed in the vicinity of test holes #1 and #6. As can be seen from
the soil log for test hole # 1, the native material below 7.5 feet is a slightly silty sand with a measured pert
rate of 2.2 minutes per inch. Using the soil application rate of 0.8 gpd/sq. ft. specified in the wastewater
ordinance for a bed type soil absorption system constructed in this material, a 4 bedroom residence
requires a total absorption area of (4 x 150)/0.8 = 750 square feet. The proposed 15' x 50' bed design has
a total absorption area of 750 square feet. A similarly sized site for a replacement system is shown
between test holes #6 & #8. In evaluating the soils information for this reserve site it should be
recognized that the natural ground elevation at test hole #8 is approximately 6' higher than at test hole #6,
thus the proposed receiving stratum is at a comparable elevation.
As indicated on the site plan, the topography in the proposed construction area slopes to the northeast
at an average of 27%. Just northeast of the proposed site and of the reserve area the slope steepens to
approximately 38%. Despite these relatively steep slopes, daylighting of effluent from the soil absorption
system should not be a problem because the proposed bed is quite deep, and the overlying ML material
will present a barrier to horizontal migration of effluent further downslope.
It should also be noted that the subdivision plat designates a 20' wide drainage easement along the
eastern boundary of the lot. There is a culvert running under West Tree Drive providing storm drainage
from land located to the southeast. On the date of our initial soils tests on August 2 (immediately after a
heavy downpour) there was a trickle of water running through the culvert, although no surface water was
visible in the ditch upstream. We subsequently monitored the culvert and drainage easement on August 9,
10,12,14, 28 and September 4 and 11. There was no water running through the culvert or in the drainage
swale below on any of these occasions, except that on September 11, after a rainy week, water was
dripping from the outlet of the culvert. Based on these observations, as I have already discussed with
John Smith, one can conclude that this drainage easement does not constitute a surface water source
requiring a 100 foot separation from on-site wastewater disposal facilities.
There is a continuously flowing stream crossing the northeast comer of the lot as shown on the site
plan. Unfortunately, the designated 100 foot offset from this stream does not leave enough room for
construction of a soil absorption system at the toe of the slope in the vicinity of test holes #5 and #7,
however the proposed original and replacement sites are both outside the required 100' setback from that
stream.
The proposed project will have no impact on present or future water supply and wastewater disposal
systems serving adjacent properties, nor will it have any impact on reserved space/surface and subsurface,
or on drainage.
Please give me a call at 345-1355 if you have any questions on this submittal.
Sincerely,
Ted Moore, P.E.
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xSOILS LOG
MUNICIPALITY OF ANCHORAGE PERCOLATION
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST
825 L. Street. Anchorage. Alaska 99501 264-0720
SOILS LOG — PERCOLATION TEST
U)eep 6a1ry-1211a1e2
QG /^ DATE PERFORMED: `K ?C51 — 12130�SZ
PERFORMED FOR: C... C
LEGAL DESCRIPTION: LOTS 14� S Ice- 2 5 ISL pE ores l" Sib SITE PLANK STP 3Pc
'Pea, and o ah;cs 5'
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72-008 16/791
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WASGROUNDWATER \1�
ENCOUNTERED?
IF YES. AT WHAT
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Gross
Reading Data Time
12 130/ 10'. 00 Al
Net D.Ojh to Net
Time Water Df00
0 lost O
4110•E,'V CERTI FIEDBY: /"` DATE:
13
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14530 Echo Street ([IJGINI;ER'S
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Anchorage, Alar:ha '0515
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES 4 , r::.a.:.,, : ,ol:.•
c.' c-3sz)
825 "L" Street. Anchorage. Alaska 99502-0650 YQ ;,, , • �.•A7
SOILS LOG — PERCOLATION TEST 441 "'Pit:i:S:�'�:�
T.N•I
PERFORMED FOR: JEFF KE IM DATE PERFORMED: SI2I91
LEGAL DESCRIPTION: IS I2 SPRING FoRESTtownship, Range, Section: SEC I+}i TIZ Ni'R'�w
DEPTH P'1' SLOPE SITE PLAN
TSM REDDISH SANDY LOAM
2
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4
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AND HARD DIGGING
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15 SMALL POCKETS
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is-
19-
20-
COMMENTS
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Date Gross
Time
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Time M,N)
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PERCOLATION RATE —;2-pT (mmutesnneQh(/PERC HOLE DIAMETER I_
TEST RUN BETWEEN _3— FT AND cl /2 FT
PERFORMEDBY: 5LATTOP TECH. SVCSI CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 910191
72-008 (Rev. 4/85)
Tlattop Technical Services
14530 Echo Strcot
Anchorage, f lcaka C0519
Municipality of Anchorage
DEPARTMENT OF HEALTH 8 HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
T.0.it2.
PERFORMED FOR: JEFF KEIM
...
jii
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DATEPCnFOnMED: SI21gj
LEGAL DESCRIPTION: 15/2 SPRING Fog EST-rownship, Range, Section: SEC, "'IT N IT 31✓
SLOPE SITE PLAN
DEPTH PT
1 SM REDDISH S1ND4 LoAM
2
3
4
5
6
7
8
9
10
11
12
13
' tE
1!
21
COMMENTS
M L SAA01 SILT
SM somzwAAr
SILTY SAND
BEGDMiNG SP
AT BoTToM
B.14.
WAS GROUND WATER �-
ENCOUNTEREn7
s
L
IF YES, AT WHAT O
DEPTH? N.A. P
E
Depth to Water Ither 12r6�6.G4.
Monitoring? DRY Dae: 21(1/11
PERCOLATION RATE Immutew.nth) PERC HOLE DIAMETER
TEST RUN LIETWEEN FT AND FT
PERFORMED BY: - FLATTOP -TECN• SVCSI CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: .9 / 1& 191
72-008 (Rev. 4/85)
F_ lattop Technical Services
14530 Echo Street .......... . (E?+cRJ�ER'SSEAL)
r....�..:,..I��
Anchorage, flr.:;.:a COW:Y ��..
Municipality of Anchorage Po"•�•
• v � ::.Ut x..:. i'. ':SAI:: w
DEPARTMENT OF HEALTH & HUMAN SERVICES �.' Ci - 3S.^7 ,• v
825 "L" Street. Anchorage. Alaska 99502-0650�.v� , • * •
SOILS LOG — PERCOLATION TEST ;s; 70 0
T. H.tt3
PERFORMED FOR: JEFF K E IM ,_ DATE PERFORMED: SI2 Irt 1
LEGAL DESCRIPTION: IS /2 SPRING FoReSrrownsnip• Range. Section: SEC 114 T12N
DEPTH I PT
1 SM REDDISH SAWN LOAM
2-
3-
4-
5
-3•4-5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
ML SANDY SILT
H
SANDY SILT WITH
SOME GRAVEL br-7r
14ARD DIGGING
1B.v-
WAS GROUND WATEn
ENCOUNTERED? ly
S
IF VES. AT WHAT L
DEPTH? N.Q• P
E
Depth to Water Alter t2.'84 E •
Monitoring? DRY Dae: sal
11
PERCOLATION RAI E (minutes/inch) PERC HOLE DIAMETER
TEST RUN UCTWEEN FT AND FT
PERFORMED BY: �FLATTOP TE C ii • SVC S I _.1_•e-0��CERT IFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 9/16 /9�
72-008 (Rev. 4/851
.-T
'Pa:116p Technical Services „ " '
14530 Echo Street 1.
r Y� ( —11vr e9'ssEAL1 ;:��„�
so......................:...i1
Anchorage, Al=ka 53516
n ae
Munlclpality of Anchorage 0 'r. ”%CIOR, '
DEPARTMENT OF HEALTH 8 HUMAN SERVICES V• t,: • CE -35,09
825"L" Street, Anchorage, Alaska 99502-0650YdV.�' ,•��•��•�•,: ,o•�
il
SOILS LOG — PERCOLATION TEST
T.N. 4
PERFORMED FOR: JEFF K E I M DATE PERFORMED: 'g A A
LEGAL DESCRIPTION: 1,5 /2 SPRING FoRESnownship, Range, Section: SEG 14, 'T12 Ni•R 3t✓
SLOPE SITE PLAN
1
2
3
a
5
6
7
a
9
10
11
12
1!
21
COMMENTS
PT
ML SArIDY SILT
SDME COBBLES
GM SI1.'rY GRA✓FL
DAMP
ML
6M SAWSY. SILTY 6RA✓EZ
ML SAKWI SILT WAS GROUND WATER
ENCOUNTERED? N
COBBLES
IF YES, AT WHAT
DEPTH? ILA
BO VLD FRS Depth to Water Atter IL 1&4.L.I
B. H. Monitoring? VFi— Date % a
11
EC
PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
PERFORMED BY: FLATTOP ?E C N • S✓O I e—1 a � CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 9
72-008 (Rev. 4/85)
Plattop Technical Services
14530 Echo Strect W �; = .........
Anchorage, Alarka 99516 � Com• ' " "�
Municipality of Anchorage 0' VII " ••""""
• v I..:� ::I:OL..2: F. MOORF ,•'. 17
� DEPARTMENT OF HEALTH 8 HUMAN SERVICES �•• ;1,;,• CE -3509
825 "L" Street, Anchorage, Alaska 89502-0650 4f W.Z j, ,•...... ,.•' e�'o
SOILS LOG — PERCOLATION TEST ,4�VIPro "Ss� ��:~
T. N.Us p
PERFORMEDFOR: JEFF KE IM DATE PERFORMED: R/g Igl
LEGAL DESCRIPTION: IS I2 SPRING FoRESTTownship, Range, Section: SEC I+Fy T12Ni'R 3w
SLOPE SITE PLAN
DEPTH PT I I I�
' 1 I SM REDDISH SANDY LOAM
2
3
41 1 ML
6
6
7
SANDY SILT
8
g GP%GH SANDY
10 WIT14 SOME
SILT
11 (DAnP�
12
13
14
16
16
17
t6SP CLEAN
MEDIUM SAND
19 B.S.
20
COMMENTS
GRAVEL
WAS GROUND WATER �-
ENCOUNTERED?
S
L
IF YES, AT WHAT N A • 0
DEPTH? P
E
Depth to Water Aller 186y &C•L.
Monitoring? DRY Dalt/ 1
Reading Data
Grott Net
Time Time MIN
Depth to
Water
Nat
Drop 6N
FRESo k 9141,11
S:IS:oo
2
S: 24: 30
21 3/1
N 0
5:25:30
3 S/
:30: 30 S
22
1 S/8
4 W20
36 5
22 '/
l a
+ N o
5:36:301
2 3 s
5: 41: 30 S
22
I S/
8v
PERCOLATION RAIE per_ (mmute6/Inch) PERC HOLE DIAMETER ._SL_
TEST RUN BETWEEN FT AND —10 FT
PERFORMED BY: EL ATTOF- TECH • SVCS I !�� ';� ��""— CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINCS IN EFFECT ON THIS DATC. DATE:
72-008 (Rev. 4/851
T_ Iattop Technical Services
14530 Echo Streot r f, (jFlZ ....Eqs'. ;:��,
Anchorage, Alaska 00516 /
Municipality of Anchorage 0"�'""'� "•.•••••••�'••
�. ,., .r;cohca: F. voo /7
DEPARTMENT OF HEALTH & HUMAN SERVICES 1, :I,: , CE - 35 9 �� Ar
825 •L" Street, Anchorage, Alaska 99502-0650 V1�s�}•;,,••••• •fie 4jr
SOILS LOG — PERCOLATION TEST 44;P�:CSS::��:�
PERFORMED FOR: JEFF K E IM DATE PERFORMED: Sl/e I/l
LEGAL DESCRIPTION: 15/:Z SPRING FoRESTTownship, Range, Section: SEC 1$, T12 N�'R 3►✓
1 DEPTH PT SLOPE
� SITE PLAN
SM REDDISH SANDY LOAM
2 i I ML GRAY SANDY SILT
3
4
5
SM SANDY SILT
8 rl POCKETS OF CLEAN SAND
71-7 I I SPASM :SLIGHTLY SILTY SAND
8
9
10
it
12
13
14
15
18
17
18
19
20
POCKETS OF GRAVELLY 5AND
B.N•
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth to Water Alter
Monitoring?
Bit
S
L
N.A. °
E
PERCOLATION RATE Inninutevinch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
COMMENTS T H.'16 DUG TD DEMON STRATE EXTENT OF SPAM 5o/tS IN T.N. Yt /,
NO MT SET GRDUNp AT T.906 ATERoxIMATELN SAME ELEVATION( AS GROUND AT?.N.tf1
PERFORMED BY: FLATTOP TE C N • S VC S I —f -- CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE 7// &/%f
72-000 (Rev. 4/85)
-F_ lattop Technical Seivice3
14530 Echo Street
Anchorage, lilacl:a OJS10
Municipality of Anchorage
DEPARTMENT OF HEALTH 8 HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
T. 9. *7
:.:.............I::.1
VCOUG3C R 61001:: A
i;•.• CE -35-09 KE'p
4e?ro:CSr4I ;;w
PERFORMED FOR: JEFF K E IM DATE PERFORMED: SIIOI9
LEGAL DESCRIPTION:JSI�. SPRING FoRESl'rownship, Range, Section: SEC 14_ i12 N'0'R a14/
SLOPE SITE PLAN
DEPTH pT —rl
1 "1 I SM REDDISIi SANDY LOAM
2
34 1 ML
4
5
6
SANDY S 1 LT
TRACE of 6RA✓E1
7
GM SANDY, SILT`/ GRAVEL
8
9
10
12
13
14
15
16
17
18
19
20
6PJ6M SANDY GRAVEL C
WITH SOME SILIAS GROUNDWATER
ENCOUNTERED?
(NOT AS DAMP AS
T.N. as)
CoEaLES 3e -b4
aH.
IF YES, AT WHAT
DEPTH?
Depth to Water Alter
Monitoring? _
Due:
9
PERCOLATION RATE (mmutesnnch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
COMMENTS 117 DuE TD DEMOP49TRATE EXTE14T of 6P CM jN T. V. 0S.
ND 'M T SCAT
PERFORMED BY: FLATTOP "TECO• SVCSI !fa - CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 9 116 191
72-008(Rev. 4/85)
Flattop Technical Sei rices it . iT+riEgssEAL1 :;��•
14530 Echo Street �.::.::..............0
Anchorage, Alaska 03518 [I '
Municipality of Anchorage
y •^ axrj a: F. MOOGE ii
DEPARTMENT OF HEALTH & HUMAN SERVICES /•• • 1 CE
825
�: r
825 "L" Street, Anchorage, Alaska 99502-0650 �0' /,�,� •,..••••.•, ' �
SOILS LOG —PERCOLATION TEST ��iPrC'eisN;1'"00
T.N.# g
PERFORMED FOR: JEFF I E IA DATE PERFORMED: 9 /41q)
LEGAL DESCRIPTION: 1512 SPRING FoRESTro`�'/nship Range, Section: SEC 114 T12N'T*A /
SLOPE SITE PLAN
DEPTH 1PT1 ,
SM REDDISH SANDY LOAM
2
34 1 ML SArJD4 SILT
4
5
6
7
8
9
10
11
12
13 SP - SP/SM
F.S. FINE CLEAP4 SAND
14SLI`Nr SILT
15 B.H.
16
17
18
19
20
WASGROUNDWATER
ENCOUNTERED? 1�
IF YES. AT WHAT N.A.
DEPTH?
Depth to Water Alter Is, IWA
Monitoring? D RY Date I I
PERCOLATION RATE (msnutesnnth) PERO HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
COMMENTS TN•'4 9 DUC+ ?O prmotfSTRATC cnrgTI.IV^t ITV e)F DFFP SAAR LAy6R _
6ROvND AT -r.0-14V APPROX MATELY C r HICHER 74A4 a RDvND Ar TNS V 1 +- a6
PERFORMED BY: FLATTOP TE C N • S VC$ I '��J %'10-••L CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 9 110 191
72-008 (Row. 4/85)
Flattop Technical Services
�1�4530 Echo �S�treet
F'Alun7cTP gi1/oNacrio age 9516
DEPARTMENT OF HEALTH & HUMAN SERVICES
~ 825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST -
'r H. 1*9
THEOD= F. M002E.%
CE • 3539 �� A
• .•�� nay
PAs_.'•••..• _ c0'> �
PERFORMED FOR: TCff Fctli•s DATE PERFORMED: 10 123191
T• H. T. H.
LEGAL DESCRIPTJON-1-15. 132 S Pin rel ' TOWRSI'tl ,
mange, Section: 7 ir6
DEPTH I Pt.
1 ,$M RedclrSti Sand. (oan,
2
3
a M I, Dry s040/y Srrt
Fairly eafy eVyloy
5 1 bef w. 3' � 6'
6
some COW<( 4fc ger.
7 61 e8r
8 Sand �roe{toe deer¢alo/
�aC f(en In Creb!'t/
10-
11-
12-
13
0•11•12-13
14
r
15
16
17
16
19
20
WAS GROUND WATER N
ENCOUNTERED?
H1. 6 ecam eJ
eohevve 0L IF YES, AT WHAT
harder dr'r rnyDEPTHT
be. (ow y5..,
Depth to Wrier After
(i• f}, �rQ�P mein) MonitorinDT Dale:
Reading Date Gross Net
Time Time (1yr„
Depth to
Water
Net
Drop •r„
10123
3/ n oak : 27 ►n
27 J/F
1 2
2 3/8
?/
7:37 0
SME
7/6
3:S
?6 r/
MMENI
WIMME
�NE11/10
�.INNIIN
MINES
OMEN
1,100011100,AMIN
11MMIN11NN/1MIN
111MMIN�+
KIMIM
f>:1110MORNMEMIN
RIMINNIN
N►Wfs�P�Si®rX■EMENEWMAMIN
IMiiilEM�
rNIMMIN
M�
MEMO
NONE
����
MO■EN
MEMN
Dees
MN
WAS GROUND WATER N
ENCOUNTERED?
H1. 6 ecam eJ
eohevve 0L IF YES, AT WHAT
harder dr'r rnyDEPTHT
be. (ow y5..,
Depth to Wrier After
(i• f}, �rQ�P mein) MonitorinDT Dale:
Reading Date Gross Net
Time Time (1yr„
Depth to
Water
Net
Drop •r„
10123
3/ n oak : 27 ►n
27 J/F
1 2
2 3/8
?/
7:37 0
26 7B
7/6
3:S
?6 r/
1 7/7e
"
PERCOLATION RATE -Z..61L (mmutevinch) PERC MOLE DIAMETER 6
TEST RUN BETWEEN 175' FT AND � u FT
COMMENTS Pere 4-!f Conduejteo( rn Zone of leaJf coAeer✓e So111_ _Un 4*ce&Ida.6/e neer
resfe- m arurrd elute* prero-tk phare wAen &o dy{A -ow it"
PERFORMED BY: Flaf 7'ecA rvc 1 CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 10 / 2V 191
72-008 (Rev. 4/85)
TRACT S
10' TCLEP00 E eSMT. _
_ mr
z4 54 STREAM " W�
LOT
01 1�7�FT.N•N `I Z %
D LO
"O MT. qv s�
�DRAIMFIELb ` 1 , I
42 r T.N.�►7
ToE of
5LoPf
l00' OFFSET
I FROM STREAM
I
I I
�—T.H•�z I
1 70' ^�
63' I n 60' NS' ` m
M N
� ZIT N•sk$
log' T.H. x 3 I I
$6 I
END of
I y CULVERT
11 LIDO' OFFSET I
rl I FRoh ALLIGNMEW
1� OP CULVERT
I =
NOVSE 143' I 1w I
I to
I LOT IS I
t
�< w
a
LOT 14 I I o
O'UTIL ESMT -- "'I
1-15,B2 SPRING FOR 133'
TEST HotE A&CArI
SITE PLAN WEST TREE DRIVE
THIS IS NOT A
SCALE: 1`=yon Fiatto
DATE --$'yl SVRVEY2D PLAT. p Technical Services
ALL LOCATIONS 14530 Echo Street
DVN 8Y' 7t ARE A?FRcaIMATF. Anchorage, Alaska MIR
L
LOT
33
Tlattop Technical Services
14530 Echo Street, Anchorage, AK99516
Thane (907) 345.1355
Lot 15, Block 2 Spring forest S/D
6151 West Tree Drive
Wastewater disposal system installation
Specifications
1.0 General:
1.1 The scope of the project consists of installation of a 1250 gallon septic tank and construction of a
15' wide by 50' long soil absorption bed.
1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor
deviations from these drawings may be allowed or required by the engineer conducting the inspections.
All construction procedures and material specifications shall conform with Municipal and State
requirements.
1.3 All separation distances shall be in conformance with Municipal requirements, unless specifically
waived.
1.4 The contractor shall be responsible to obtain any necessary utility locates, and to work around any
buried utilities.
1.5 Please note that the proposed soil absorption bed site is on a significant slope which will affect
both the ability to maneuver equipment and to stockpile the significant amount of material which will have
to be excavated. The contractor shall take particular care to minimize damage to surrounding trees, and
after the system is installed to restore the site to as near to original conditions as possible.
2.0 Septic Tank:
2.1 The 1250 septic tank shall be Municipally approved with a minimum of two compartments, and
shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole
cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of
approved burial type, rigid insulation.
2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The
waste line from the residence to the septic tank shall have a minimum slope of 1/4"' per foot, and the waste
line between the tank and the soil absorption system shall have a minimum slope of 1B" per foot. A
cleanout shall be installed within 5 feet of the building foundation, and a double cleanout shall be installed
within 5 feet downstream of the septic tank.
3.0 Soil absorption system:
3.1 The soil absorption system shall be constructed by excavating the surficial loam and silt strata to
expose the top of a slightly silty sand stratum at a depth of approximately 7.5 feet in the vicinity of test
hole #1, near the downhill side of the bed. Due to the 27% average slope, the depth of excavation along
the uphill side of the bed will be approximately 12 feet.
3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to
provide proper infiltration.
3.3 A total of 1.0 feet of approved sewer gavel shall be placed in the bottom of the excavation with
the perforated distribution pipes laid level such that the pipe inverts are no less than 6 inches above the
bottom of the sewer gavel. Sewer gavel shall be 0.5" - 2.5" screened gavel, with less than 3% passing
the #200 sieve.
3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on
the design drawings. The portion of the monitor tube extending through the sewer gavel shall be
perforated.
3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gavel before backfill
with unclassified soil. The top surface of the cover material shall be raised a minimum of one foot higher
than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours.
All areas disturbed by the construction shall be covered with a minimum of 4 inches of approved topsoil
and neatly graded. Fill slopes shall be no steeper than 3:1.
3.6 The owner shall be responsible for revegetation of all disturbed areas to prevent erosion.
4.0 Inspections:
4.1 A total of 4 engineering inspections will be required during the course of the project: (1) initial
stakeout with the contractor to establish the location of the system and to discuss the plans, specifications .
and construction procedures, (2) after the native material has been excavated to expose the infiltrative
surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3)
after the sewer gavel is in place and the distribution pipes have been laid and connected up to the septic
tank, but prior to placement of insulation or filter fabric, and (4) after final backfill and grading is
complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to
backfill. This inspection may be incorporated with any of the above inspections.
4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in
advance to ensure the availability of the engineer.
Parcel I.D. 015-342-24
: � TT
Municipality of Anchorag SEP 2 1 201a
On -Site Water and Wastewater Program �f®tCherig<
(907)343-7904
Certificate of On -Site Systems Approval
Expiration Date: I a -A 4 -/�'
1. GENERAL INFORMATION
Complete legal description Spring Forest, Block 2, Lot 15
Location (site address) 6151 West Tree Dr.
Current Property owner(s) Jean & Markayla Corbin Day phone
Mailingaddress PO Box 4569 Houston, TX 77210
Real Estate Agent
Day phone
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
❑
Individual R
Individual Water Storage
❑
Holding Tank ❑
Community Class Well
❑
Community ❑
Public Water System
0 -
Public Sewer ❑
Waiver/Variance request
Received by: �/I /Am m Date:
COSA to be released to the en er, unless otherwise requested by the engineer.
COSA Fee $ 6a Waiver Fee $
Date of Payment g 21115 Date of Payment
Receipt Number Q 2-g1(2 Receipt Number
COSA# 650,in6�,9 Waiver#
5. - STATEMENT OF INSPECTION_B.Y ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined
in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater
disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that.
based on the information obtained from the Municipality of Anchorage flea 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. -
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil
condition, ground water levels that may Fluctuate during the year, and the water usage of the family being servedbythe system. These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed
above. -_
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name. Steven R Pannone
Date 9/18/2015
TH
6. DSD SIGNATURE
V System #1 Approved for bedrooms /` t$ta en .*06AA6rle.
CE -8149
System #2 Approved for bedrooms r
Disapproved ��F1UFE551
Conditional approval for bedrooms, with the following stipulations:
By:/!!?/ ._ -� Original Certificate Date:
The un' Vesentations
chorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the regiven in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's. work.
ATTACHMENTS:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
COSHbluesheet < ..� c
Nitrate Advisory
Arsenic Advisory
Other
If more than 1 septic system is on the lot:
COSA Checklist # + of
Structure served by this system I
Certificate of On -Site Systems Approval Checklist
Legal Description: Spring Forest, Block 2, Lot 15 Parcel ID: 015-342-24
A. WELL DATA
Well type Public If A; B, or C provide PWSID # AVMU Well Log (Y/N)
Date completed Sanitary seal (Y/N) _ Wires properly protected (Y/N)
Total depth ft. Cased to ft. Casing height (above ground) in.
FROM WELL LOG AT INSPECTION
Date of test
Static water level ft.
Well production
WATER SAMPLE RESULTS:
g.p.m.
Coliform colonies/100-mL -Nitrate mg/L
Arsenic ug/L Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel
ft.
Date install ed 6/5/1993
Tank size 1,250 gal Number of Compartments Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping 4/20/2015 Pumper A+ Home Services
C. ABSORPTION FIELD DATA
Date installed Soil rating 10/30/2001 z z 0.6 GPD/SF Deep Trench
g (g.p.d./ft orft /bdrm) System type
Length 82 ft. Width 2 ft. Gravel below pipe 7 ft.
Total depth 10.3 ft. 'Eff: absorption area 1,148 I L Monitoring tube Y Depression over field N
Date of adequacy test .9/17/2015, Results (Pa ss/Fail)"Pass For 4 bedrooms
Fluid depthin absorption field before test 38 in. Water added -64'5 gal. New depth 48 in.
Elapsed Time: 190 min. Final fluid depth 38 in. Absorption rate >= 600+ g,p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date
D. LIFT STATION
Date installed _
"Pump on" level at
Datum
Size in gallons
,in. "Pump off' level at
Cycles tested
in.
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
1E. SEPARATION DISTANCES
WELL ON LOTTO:
Septic tank/lift station on lot
On adjacent lots
Absorption field on lot
On adjacent lots
Public sewer main
Public sewer manhole/cleanout
Sewer /septic service line
Holding tank
Animal containment areas
Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+
Water main 10+ Water service line 10+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation _10+
Water Service line 10+ Surface water 100+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
v
G. ENGINEER'S CERTIFICATION
1 certify that I have determined through field inspections and
review of Municipal, records that ,the above 'systems are in
conformance with -MOA COSA guidelines in effect on this date.
Engineer's.PrintedName Steven R. Pannone
Date 9/18/2015
COSA canary sheet 2-6-15.doc
Absorption field 5+
Surface water 100+
Water main 10+
Driveway, parkingtvehicle storage 10+.
Municipality of Anchorage .
-� Development Services Department
Building Safety Division 7 1
On -Site Water and Wastewater Program,
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D. -341 COSA# a9 030y
Expiration Date:
1. GENERAL INFORMATION
Complete legal description LOT 15; BLOCK 2; SPRING FOREST SID
Location (site address) 6151 WEST TREE DR. ANCHORAGE, AK. 99516
Current Property owner(s) RICHARD THOMPSON Day phone 929-2944
Mailing address SAME
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
❑
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑r
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 On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm S & S ENGINEERING
Address 15861 S. BIRCHWOOD I.P. RD. CHUGIAK AK 99567
Engineer's Printed Name ROBERT C. COWAN
S. DSD SIGNATURE
�� Approved for bedrooms.
Disapproved.
Phone 694-2979
Date
rFV444
. _ �
Conditional approval for bedrooms, with the following s7tlpJPd?it9tf's"
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: Original Certificate Date: — d
(R. 11/05)
r_..
Municipality of Anchorage
' Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: 1-67 LD oei , Tmrtr; 1-oe£3T 3�D Parcel ID:
A. WELL DATA pBUL7L�2 rIWWV
Well type _ If A. B, or C provide PWSID # Well Log (Y/N)
i
Date completed _ Sanitary seal (YIN) _ Wires properly prole /N)
Total depth ft. Cased to ft. Casing h ' (above ground) in.
FROM WELL LOG
Date of test
Static water level
Well production
WATER SAMPLE RESUL
Coliform onies/100 mL Nitrate mg/L Other bacteria colonies/100 mL
Ars en' : ug/L date of sample: Collected by: "
B. SEPTIC/HOLDING TANKDATA
Tank Type/Material PIS T£fL Date Installed (0 3
Tank size IAGQ gal. Number of Compartments Cleanoutsa�N) �//es
Foundation cleanoutdfl !) Depression over tank (Y N ,�A High water alarm (Y/lam �O
Date of pumping (7 Pumper 22+ Lotir- (>£p11CX S
C. ABSORPTION FIE D DATA
Date installed ID b: (� p —�
Soil rating g.p.d./ft r ft /bdrm) System type fir /iarR%Cfi
Length C )r r r
g _r max` _ft. Width Gravel below pipe 'I it
Total depth/'ft. Eff. absorption area �ILrn ft2 Monittor�in,9_I be Depression over field o
Date of adequacy test 8 O ResultPa s/ ail) 17f S For bedrooms
If
Fluid depth in absorption field before test � in. Water added al. New depth in.
n
Elapsed Time: DD min. Final fluid depth 94 in. Absorption rate >= 1 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y(LfA type) !� If yes, give date
ft.
g.p.m.
D. LIFT STATION N/),
Date installed Size in gallons
'Pump on' level at _ in."Pum _ in.
Datum Cycles tested
High water alarm level at in.
Meets alar 8 circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO-:�)L)BI IC Q3171ee
Septic tank/lift station on lot
Absorption field on
Public sewer main
Sewer /septic service line
On adjacent lots
On
sewer manhole/cleanout
Holding tank
Animal coDta'mf5e-nt areas Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
r � i
Building foundation 5 f Property line S -E- Absorption field 5
� t �
Water main aO Water service tine AD f Surface water /110 �
Wells on adjacent lots toL}
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
t
Property line Building foundation Water main !Gb
Water Service line Surface water /Gb 4" Driveway, parking/vehicle storage /O f
Curtain drain AlOM67 /4rVtX) Wells on adjacent lots N !}
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined rou rield inspecti s and
review of Municipal records at the abo ff,o
sta are
conformance with MOA COSA uide ' es in efthi dal
Engineer's Printed Name l�
Date (9,1110 1
COSA Fee
Date of Payment
Receipt Number
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number
;.. saor.
14314
Municipality of Anchorage ,,, ..�
Development Services Department ^_
\ !/ • Building Safety Division
On -Site Water and Wastewater Program .. I .
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
Parcell.D. 015-342-24 HAA# n�Cy�q
Expiration Date: —q -n- 3 O - 0 6
1. GENERAL INFORMATION
Forest Subdiviffipat—
Complete legal description Lot 15 Block 2 Snrinr
Location (site address or directions)
F151 6'est Tref Pr Anchorai+P AK 99516
Current Property owner(s) John 6
Marci
Whitehead Day phone
345-8217
Mailing address same
Day phone
Lending agency
Mailing address
Day phone
Real Estate Agent
Mailing Address
Z
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
TYPE OF WASTEWATER DISPOSAL:
3. TYPE OF WATER SUPPLY:
Cl
Individual On-site
Individual Well
11
Individual Holding tank
❑
Individual Water Storage
❑
Community On-site
❑
Community Class Well
Public Sewer
ElPublic
Water System
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 al are pendentfpr rofessional the transfer civil
engineer registered in the State of Alaska. Certificates of Health Authority App
title (excesteme DSD also issues HAAs for upo'nsrequestto homeowneas.ICertificon-site
a es ofwastewater
Health Authority Approvallwater
are
supply sy rate or Class C well and may be reissued with
valid for 90 days from the date of issue for properties served by a p
new water sample results. (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 files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm S S En Phone 594—?979
Address 17034 N. Ea le RAver Loo Ste. 204 Eagle River, AK 99577
Engineer's Printed Name v Date LJ o >"
S. DSD SIGNATURE 94
7 ^ •••
A. ar
Approved for bedrooms. �"• i�rx J
Disapproved. le`V.,
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
ON-SITE • : cr
M=
1AIA TMATrp
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By: Original Certificate Date: I — 3 0 — a✓T
(Rev. 01/02)
Municipality of Anchorage
Development Services Department ,
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
p.0. Box 196650 Anchorage. AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
S7'rZ1A1
*rcelID:
Legal Description: LOT 1G,3 (?LVeX
A. WELL DATA _T05LIL OWMa- nWlvV
Well type
If A, B, or C provide PWSID # _ Well Log (YIN)
Sanitary seal (YIN) — Wires properly protect )
Date completed _, in
Total depth ft•
Cased to ft. Casing hei ove ground)
FROM WELL LOG
SPECTION
Date of test
ft.
Static water level
Well production
g.p.m. 9.p.m.
WATER SAMPLE RES
Coliform colonies/100 ml. Nitrate m9.11•
Other bacteria colonies/100 ml.
Arse ' . mg.A.
Date of sample: Collected by:
r
B. SEPTICIHOLDING TANK DATA
Dale installed
Tank TypelMaterial
Tank size ikcj - gal. Number of Compartments 2-
Cleanout )
Depression over tank (Yl6) F" High water alarm (YID —
Foundationcleanout�lN) P rye �r.t1t'rA7%+
Date of pumpir;
3U,i!-I+< !7S Pumper
C. ABSORPTION FIELD DATA
Date installed
Lengthft
Soil rating (g.p•d./ft2 or ft2/bdrm) �r
Width
Total depthIC _ ft. Eff. absorption area
1 f !l2�ft2 Monitoring tube
Date of adequacy test C 15 DS Result ail) ,22
Fluid depth in absorption field before test 0„ in. 1
Final fluid depth JT in.
Elapsed Time: r6 min.
System type
Gravel below Pipe
Water added:iMgal -
Any rejuvenation treatment (past 12 mo.) (YJq type)
Depression over field
For _LL bedrooms
New depth 2 in•
Absorption rate >= y + 9 P.d.
10 C) — If yes, give date
D. LIFT STATION
Date installed
'Pump on' level at _ in,
Datum
E. SEPARATION DISTANCES
Size in gallons
.P vel at in.
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
Sewer / service line
(Y/N)
High water alarm level at in
Meets alarm & circuit requirements?
On adjacent
adjacent lots
Public sewer manhole/cleanout
Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
r
Building foundation 25 _ Absorption property line 2S
+ + field _ to
Water main lce) 4- Water service line 50 r +
Surface water I UO f
Wells on adjacent lots fJ 114
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 0
Building foundation33' Water main _ 112C +;
Water Service line SO Surface water 100 J- ,
Driveway, parkingivehicle storage SO 4
Curtain drain "'Wells on adjacent lots N W
F. COMMENTS
G. ENGINEER'S CERTIFICATION
l certify that l have determined through field ins
review of Municipal records that above sysl�t are inions b ° t
conformance with MOA HAA nide as, elf t
Engineer's Printed Name ri t nh..+ 1 fib.:,:.
aroaa
Date ZO O
HAA Fee $
Waiver Fee $
Date of Payment
Date of Payment
Receipt Number � yt,<Q�
(Rev. 12/01) Receipt Number
83-7
SPRING FOREST SUBDIVISION
LOT 15, BLOCK 2
49,885 S.F.
A
BUILDING DETAIL
SCALE: 1 "-20'
AS-
GASTALDI LAND SURVEYING
JEFF A. GASTALDI, R.L.S.
4726 WEST 88TH AVENUE
ANCHORAGE, ALASKA 99502
PHONE 248-5454
I GRID 2338 19/21/2005 I
F.B. JOB N0.
93-04 NO*
N 89°59'31 "E 161.15'
10' T. & E. ESMT.
I� I
'0 I
IN
• SEPTIC SYSTEM
t
• EXISTING
BUILDING
(SEE DETAIL)
I I
I i
4dr I
I 1
A.C. DRIVE I
I I
I I
I
10' lIT1LI-
S 85°49'48"E 138.17'
0
WEST TREE DRIVE
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT 140
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
R IS THE RESPONSIBILITY OF THE OWNER TO
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
NOTE: NO CORNERS SET THIS DATE.
F"
co
0
0
0
.,*su■\1.
4s� P�Y''.OF.. AC'4S ♦♦
MA '•• 't
AV
,k;•49111 * j
�. .....................
• ...... ......a
0♦ a Jeffery A Gastaldl o` N
o • w�
Air
♦ �• '•. LS -6091
*00 4r
`0yessloncl
111=40'
rs
Municipality of Anchorage
,r Development Services Department
Building Safety Division
j On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ek.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0/E- 143 y
HAA #_, / D• Z`y
Expiration Date: I I - 2-'
1. GENERAL INFORMATION
I2EST
Complete legal description
"-7L-tS FG
Location (site address or directions)e-
Current Property owner(s) 3� 1� �t L`L�S Day phone
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
Day phone
`>• S ica �A �� e km,�( Day phone , 7� -� 761
unless otherwise requested, HAA will be held by DSD 7 for pickup.
2. NUMBER OF BEDROOMS: t
3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL'.
Individual Well ❑ Individual On-site
Individual Water Storage ❑ Individual Holding tank ❑
Community Class Well Community On-site ❑
Public Water System L"J 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 5 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 sample results less than 30 days old. (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 ts(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm_ `b,Le S A� r��lc.Kz � l=
Phone
Address
Engineer's Printed Name
"r H2c3
5. DSD SIGNATURE
y Approved for _ bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
C, trc� Date 161BI /o(
ENGINEER'S
STAMP
Additional Comments �Z; WATERAND ;
PROGRAM
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X Maintenance Agreements
Supplemental Engineer's Report
Other
If
By: Original Certificate Date: / - - p
(Rev. 17100(
Municipality of Anchorage ••,
• Development Services Department
Building Safety Division : • r .
Onsite Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519.66W
www.ci.anchorage.ak.us
(907) 343.79N
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: LO I /h 13 K Q.IPi(-� FO��`5f ParrxW ID: 01r5 -3Y2 --.2Y
A. WELL DATA
Well type _ If A, B, or C provide PWSID #_ Weil Log (Y/N)
Date completed _ Sanitary seal (Y/N) _ property protected (Y/N)
Total depthft. Cased to fl. Casing height (above ground) in.
FROM WELL LOG AT INSPECTION
Date of test
J
Static water level
Well production g.p.m. 9—
p.m-WATER SAMPLE RESULTS:
Coliform colon ml Nitrate mg.A. Other bacteria colonies/100 ml.
Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Sep -1-41- s t'', Date installed (` 3
Tank size 1;4Q gal. Number of Compartments Cieanouts (Y/N)
Foundation deanout (Y/N) Depression over tank (YM) ZL High water alarm (YIN) _
Date of pumping —8& 0 Pumper N 0 P-7-14 6. ANI-) -PJ V4 PI N Irl
C. ABSORPTION FIELD DATA
Date installed Io 0 o Soil rating (g•p•d./fe or fFlbdrm) System type 'A/Z
Length $ I ft. Width z ft. Gravel below pipe 7 ft.
Total depth i o ft. Eff. absorption area d fe Monitoring tube Depression over field
Data of adequacy test N�H Results (Pass/Fail) '� For �edrooms
Fluid depth in absorption field before test ✓in. Water added ✓gal. New depth �n.
Elapsed Time: min. Final fluid depth zin.
Any rejuvenation treatment (past 12 mo.) (YIN 8 type)
Absorption rate >= ✓ g.p.d.
!""' If yes, give date
D. LIFT STATION
Date Installed
"Pump on" level at _ In.
Datum
E. SEPARATION DISTANCES
Size in gallons
'Pump oIP I at _ in.
Cyd ted
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankflift station on lot
Absorption Heid on lot
Public sewer main
Sewer /septic service line
ManholelAccess (YIN)
High water alarm level at
Meets alarm 3 circuit requirements?
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation
Property Ane g,
Absorption field
10
Water main 1&0 f
Water service line a0 +
Surface water
•
•9i ' I &
Wells on adjacent lots NIR
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 3D Building foundation 33 Water main / fye f
Water Service line !Tb + Surface water ftd& 100 ♦ Driveway, parldrrg/vedde storage 50 f
Curtain drain N' V Wells on adjacent lots NIA su r J«u I &Lo 4
F. COMMENTS
G. ENGINEER'S CERTIFICATION "•' .' •" i" ° ��
I certAy that I have determined duough field fispectfons and b' n
review of Municipal records that the above systems are in
conformance with MOA HAA gufdefines In effect on this date.
pEngineer's Printed Name 106eu SOV�A.t�
Date
HAA Fee s # 300 Waiver Fee $
Date of Payment / 0 IN101 Date of Payment
Receipt Number Receipt Number
(Rev. 12/00)