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HomeMy WebLinkAboutSPRING FOREST BLK 1 LT 6ASpring Forest Block 1 Lot 6A #015-321-33 On -Site Wastewater Disposal System Permit Permit Number: OSP161258 Tax Code Number: 01532133000 MUNICIPALITY OF ANCHORAGE Development Services Department w On -Site Water & Wastewater Program �fy ■ 4700 Elmore Road, PO Box 196650 llchar[ancnt Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Work Type: Septic Upgrade Permit Effective Dates: October 10, 2016 to October 10, 2017 Design Engineer: PANNONE ENGINEERING SERVICES Subdivision: SPRING FOREST Site Legal Address: SPRING FOREST BLK 1 LT 6A G:2538 OwnerlAddress: KLIE-TOMASZEWSKI 2014 TRUST 5910 WEST TREE DR ANCHORAGE AK 995076941 Site Mailing Address: 5910 WEST TREE DR, Anchorage Lot Size in Sq Ft: 40820 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: 41/7°/l'iP�l l;/V70%/ Date: Municipality of Anchorage mr.m"`, P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 hftp://www.muni.orgiOnsite Development Services Division On -Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV161109 COSA#: Permit#: OSP161258 PID*: 015-321-33 Legal Description: Spring Forest Block 1 Lot 6A Engineer: Pannone Engineering Services Applicant: Klie-Tomaszewski 2014 Trust Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 5.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: 10/10Z.2016 Approved by: " 11.�& Name of Reviewer ............................................................................... **** VARIANCEMAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE Community Development Department Phone: E Development Services Division Fax: � On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-321-33 Property owner(s) Klie-Tomaszewski 2014 Trust Mailing address 5910 West Tree Drive, Anchorage, AK 99507 Site address 5910 West Tree Drive Day phone Legal description (Sub'd., Block & Lot) Spring Forest, Block 1, Lot 6A Legal description (Township, Range & Section) Lot Size 40,820 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: (® all that apply) Absorption Field ❑X Initial ❑ Septic Tank ❑X Upgrade ❑x Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ TYPE OF DWELLING: Single Family (SF) (w/wo ADU) Duplex (D) Multiple Dwellings (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Field to Lot Line Distance: 6 I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. nature of property owner or Permit/Rush Fees: '`Jioq / Date of Payment: 01 jjq /(i Receipt Number: OI 5�45(„ Permit No. 0S;>f I (a ta6S Permit App_.;. ;-.-c agern7 Waiver Fees: a I� Date of Payment: a by /. Receipt Number: CD � 56o Waiver No. OSV ( � Iiog 8 9 SEP l 3 ZJ'"' ❑X Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com 13 September 2016 Subject: Spring Forest, Block 1, Lot 6A Septic System Upgrade Permit Request Design Narrative This is a design narrative for a permit to install an upgrade septic system to be issued for this property. The proposed system will serve an existing four-bedroom (4Bftjhouse. Currently the lot is developed. This lot and the surrounding lots are served by a community water system. There are no wells within 200' of this system. The existing drain field is in failure and this permit will be to install the reserve system. The septic tank will be verified and replaced if it is found to be leaking. 1. Soils. One test hole was performed by Stanley Burst in May of 1991, and groundwater was monitored for at least seven days. Ground water was not observed to 11.0' below the surface in the test hole monitor tubes in May of 1991. Bedrock was not encountered in the test hole. Based on the results of the percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square feet was used for a conventional wastewater system in the area of the test hole. 2. Soil Absorption System Design. a. See Sheet 1 of the design package. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The proposed system will be placed in front of the existing house. The area slopes from northeast to southwest at approximately 5%. The proposed installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 272-8218. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: stevePi)anengak.com 13 September 2016 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P 0 Box 196650 Anchorage, Alaska 99519-6650 Subject: Spring Forest, Block 1, Lot 6A Lot Line Waiver Request Ladies and Gentlemen: We request a separation distance waiver for the absorption field to the lot line to five feet (5'). Due to space constraints there is not sufficient space to construct a field the required 10' from the lot line. Granting this waiver is not likely to affect the health and safety of this lot or the surrounding lots now or in the future. If you have any questions or concerns, please contact me at 907.272.8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 / A( � \ DRAIN FIELD (E) IN FAILURE RE–USE AS RESERVE SEPTIC AREA (E) 4TH -1991-1. (BURST) INSTALL RESERVE DRAIN FIELD (P) O ` SOLE x 2.5W x S.C'ED x 7.0 -TD GO PLACE 2.5' FILL FOR COVER OR - 0 -5 FILL WITH INSULATION INSTALL MONITCR TUBE AND CLEAN OUT AT EACH END. INSTALL DIVERTER VALVE �4BR � . HOUSE \ SEPTIC AREA (E) = lE) LOT 6A SEPTIC AREA (E)– VERIFY INTEGRITY OF 12508 SEPTIC TANK (E) ' IF FOUND TO BE LEAKING DECOMMISSION PER CODE AND INSTALL 12508 SEPTIC TANK (P) WITH DOUBLE CLEAN ON 20� �a;tiq\ kt -� J 10' SCREEN EASEMENT -- -- 10' T&E EASEMENT– — NOTES: PANNONE ENG SVC, LLC -' ���o/�/za16 FOR CONSTRUCTION of AC P.O. BOX 100217 ANCHORAGE, AK 99510 J L� qSI,) PHONE (907) 272-8218 FAX (907) 272-8211 rCpp ��++ Seele DRAWN BY q. '. URN % ..... ..... .... F.I.D. NO SPRING FOREST, BLOCK 1, LOT 6A / . s s21 -3z KLIE—TOMASZEWSKI 2014 TRUST S'te'ven R"'onnone' j PERMIT NO PF., CE 8149 .'c�`rr/ 5910 WEST TREE DRIVE3 OSP767258 ���sl._�� PLAN ANCHORAGE, AK 99507 �l t19 pV Sheet Z �OIFSylON �1'\ ��� 1 OF 2 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE (MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55. 2. SCOPE OF WORK: INSTALL NEW SOIL ABSORPTION SYSTEM. VERIFY SEPTIC TANK AND REPLACE IF NECESSARY. 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 1 1 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 1 I FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 4, THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE THE WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK. 5, THE CONTRACTOR IS RESPONSIBLE FOR ALL R.0)N. AND OTHER REQUIRED PEPIVITS, OTHER THAN THE ATTACHED. 6. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES- 7, THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND LOCATES WERE IN PLACE PRIOR TO NOTIFYING THE ENGINEER_ 8. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN_ 9. AT THE COMPLETION OF THE WORK, THE CONTRACTOP, SHALL SUBMIT RED -LINE AS -BUILT DRAWINGS TO THE ENGINEER_ THE RED -LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS. 10. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN -OUTS AND MON17OR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING. 11. THE CONTRACTOR SHALL PROVIDE DATA. (UPON 'VvHICH THE RECORD DRAWING WILL BE BASED) THAT REPRESENTS THE PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER (OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE CONTRACTOR. 12, THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE 'NITH THE APPEND PERMIT, AND ANY AND ALL CHANGE ORDERS, AND THAT THE AS -BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED. CONTRACTOR_ BY: - TITLE: NOTES: PANNONE ENG SVC LLC __ � A \\� Dote FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AN 99510 (�" "�Asl1) o/7�zo1s PHONE (907) 272-8218 FAX (907) 272-8211 ir��� '�yf� Scale DRAWN BY: j *: Q TH NTS DRM ""' " P.I.D. NO SPRING FOREST, BLOCK 1, LOT 6A s-3z1—a3 KLIE—TOMASZEWSKI 2014 TRUST ateven R_ Pannone /PERMIT No - Pte'. CE 8149 .'S j 5910 WEST TREE DRIVES ��s .r OSP161258 ANCHORAGE, AK 99507 �� �?F' OES p�'' Sheet DESIGN DETAILS 1 0 2 OF 2 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: N5r6'L,) �71UII7 PID Number: 045—S 1)_112 — Name: 'To, , P_ Wastewater System: L�New ❑Upgrade - Address:// %✓� �> �Y OCa C 7 ABSORPTION FIELD Phone: i / No. of Br oms: Beep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: p�`— GPD/Sq. Ft. - Lot: / Block: / Subdivision:Depth /� to pipe bottom from original grade: Gravel depth beneath pipe D ,—e S / Ft. 1:5 Ft. Township:�/ Range: Section: / Fill added above onginal grade: Gravel length: . 61 _5_<�, WELL:Gravel /j�o4 ❑New El depth: �1' Number of lines: / Distance between lines: -_V_-.���'--' Ft. F1. fbssification (Private, A,B,C): Total Depth: Ft. Cased To: FL Total absorption area: 6_<0 O SC. Ft. Pipe material: X -o 7/1 !=•6'/0 Driller: Date Drilled: Static Water Level: Installer: h, K 1✓ -e ✓ 6 i7— to installed: Yield: Pump Set at: Casing Height Above Ground: (� TANK GPM Ft. Ft. SEPARATION DISTANCES Septic ❑ Holding O S.T.E.P. To Septic Absorption Lilt Holding Public/Private Manufacturer:'. �jif Capacity in gallons: From Tank Field Station Tank Sewer Lines (�rij b7^ [ �4� Well �- .�- -•--- s. Material: Number of Com pg,rtmants: Surface re LIFT STATION e 11/� ` Lot% C� �� /� Size in gallons: Manufacturer: Line Foundation (� y "Pump on" level at: "Pump oft" level at: High water alarm at: Curtain _. __-- Pump Make & Model Electrical Inspections performed by: Drain Remarks: BENCH IIAARK Location and Description: / Assumed Elevation: / �JLL ENGINEER'S SEAL ®F A�4`.slIllAW �� Inspections performed by: Dates: 1st �/:r9TN••�� / ................... NO. 986-E � d Department of Health and Human Services approval ��d °ASG ���. x``';,01 ®Ate Reviewed and approved by: Date: 72-013 (1/91) MOA 25 Permit No. FW 910117 2 3 Page of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box '196650 0 Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Lot 6, Block 1, Spring Forest 01532110 Legal Description: PID No.: SEE DETAIL OLD PROPERTY LINE EPLATTED LINE 09 O TABLE OF REFERENCE DISTANCES POINT DISTANCE TO INVERT REMARKS A B C ELEVATION 1 - 13.5 98.0 FDN.' CO 2 17.5 16.8 97.8 CO 3 20.3 14.2 ST 4 28.0 8.9 ST 5 30.9 8.3 97.7 CO 6 41.3 37.2 95.9 CO 7 42.3 38.2 95.8 CO 8 82.8 58.5 MON. TUBI] 9 95.7 68.5 95.8 CO 72-013 A (2/91) MOA 25 DETAIL 111=40' J M �m w I� f ILL % 0 SILT BARRIER C 1 Q co INVERT ZATco95.8 PIPE SEPTIC LUCK TRENCH CROSS SECTION N.J.S. .--- ®FpC��t ko �,o� ar � . r - 49TH . * I'........... .�1 .t:..� No. 986-E : �/ c;G,1STE C� AW Municipality of Anchorage, } i Department of Health and Human Services dhh5 825 "L" Street Tom Fink, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 September 10, 1991 Stanley Brust, P. E. Brust & Associates 1610 Dimond Drive Anchorage, Alaska 99507 Subject: Waiver Request for Lot 6 Block 1 Spring Forest Subdivision Waiver Request #WR910029, PID #015-321-10, Permit #910117 Dear Mr. Brust: Your request for waiver of the required 10 foot separation between a septic system and a lot line has been approved-. The waived distance is 6 feet. This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sincerely, Susan Oswalt On-site Services SO/ljm Concur: pomui t , P. E. Program Manager On-site Services a BRUST & ASSOCIATES '* Engineers - Planners - Surveyors 1610 Dimond Drive Anchorage, Alaska 99507 (907) 562-7878 L. July 31, 1991 Y Municipality of Anchorage Department of Health and Human Services On-site Services 825 "L" Street Anchorage, Alaska Attn: Susan Oswalt RE: Lot 6, Block 1, Spring Forest Subd. Dear Susan, This will respond to your review comments dated 7-11-91. After the on-site system was built measurements disclosed that the trench had been constructed 56 feet long instead of 50 feet. This caused the separation distance from the front property line to be six feet instead of the required ten feet. The only properties that could be affected by this condition are across the sixty foot wide street. As this subdivision is served by a community water system it is unlikely that any adverse impact will occur. The test hole is shown on sheet three, attached. It was noted that the end of the trench, as actually built, exceeded the thirty foot requirement by six feet. Coincidentally, the trench is six feet longer than it has to be, and is therefore considered to be in compliance with this requirement. During excavation it was visually noted that there was no change in the character of the soil and it was not deemed necessary to perform another percolation test at the time. 7 The location of the driveway has been shown. A replatting action is in process to increase clearances to the northeast lot line. After the permit had been issued the architectural features of the dwelling were finalized. This finalization of the design was not considered at the time to be a significant design change requiring formal approval. A drawing, labelled Sheet 3, showing details of the system, is included. The excavator, Terry Forman, informs me that he is doing business as Knik O/V( River Construction. The water service line has been shown on sheet 3. It is recommended that the on-site system be approved. 444 11 Sincerely, W� ,: '•'•,/�. 4 2 /��:... - Astanley Brust, P.E. ..:. i '••••2 ..... cc: Spring Forest, Inc. ��NO. 986•FQ :� AWAW BRUST & ASSOCIATES Engineers - Planners - Surveyors 1610 Dimond Drive Anchorage, Alaska 99507 (907) 562-7878 July 7, 1991 Municipality of Anchorage Department of Health and Human Services On-site Services 825 "L" Street Anchorage, Alaska RE: Lot 6, Block 1, Spring Forest Subd. After the on-site system was built measurements disclosed that the trench had been constructed 56 feet long instead of 50 feet. This caused the separation distance from the front property line to be six feet instead of the required ten feet. The only properties that could be affected by this condition are across the sixty foot wide street. However, as this subdivision is served by a community system it is unlikely that any adverse impact will occur. It is recommended that a waiver for the on-site system be issued. Sincerely, Stanley Brust, P.E. cc: Spring Forest, Inc. r��� `L}9TH l Permit No. FW 910117 2 Page of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 a Telephone: 343-4744 O6t1Site Wastewater Disposal System and/or Well Inspection Report \ Lot 6, Block 1, Spring Forest /. 01532110 Legal Descripth SEE DETAIL S� 0 00 e C6 �RgIN \ PLAN 111=100' TABLE OF REFERENCE DISTANCES POINT DISTANCE TO INVERT REMARKS A B C ELEVATION 1 — 13.5 98`.0 FDN. CO 2 17.5 16.8 97.8 CO 3 20.3 14.2 ST 4 20.0 14.2 ST 5 30.9 8.3 97.7 CO 6 41.3 3.1 95.9 CO 7 42.3 3.0 95.8 CO 8 82.8 —5r4 MT 9 95.7 --10.1 95.8 CO 72-013 A (2/01) MOA 25 Og C 0 D No.: �32 A DETAIL 1 —40' (li � � u m ELI `I" oQ ENGINEER'S SEAL SILT BARRIER AW p( `'� INVERT `-. �"�. ........ • ' • ®� �����'� G PERFORATED T 95.8 .. /� PIPE O' ••• �..� $EPi1C ROCK 9TH ........ s 0' 1q0,?986-E.....' � TYPICAL TRENCH CROSS SECTIONqtr c N.T.S. 40• AW !ONA1����"� 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:SW910117 DESIGN ENGINEER:BRUST AND ASSOCIATES OWNER NAME:FnR YTHE GRANT H & OWNER ADDRESS:P.O. BOX 90647 DR ANCHORAGE, AK 99509 PARCEL ID:01532110 LEGAL DESCRIPTION: SPRING FOREST BLK LOT SIZE: 40916 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 1 LT 6 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE :IN ACCORDANCE WITH: PAGE 1 OF 1 ,x a//1v//O/ DATE ISSUED: 5/24/91 EXPIRATION DATE: 5/24/92 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: SYSTEM MUST BE INSTALLED BY A CONTRACTOR WHO IS PERMITTED BY DHHS TO INSTALL WASTEWATER DISPOSAL SYSTEMS. ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. JW SMITH CONTACTED MR. GRANT FORSYTHE TO CONFIRM THAT HE IS A PARTNER I RING FOREST INC. AND THAT SPRING FOREST INC. IS DEVELOPI G THK LOT. RECEIVED BY: DATE; ISSUED BY: � Ot-Fr.l cV J>AkT-1-4- DATE: 5A4- cI BRUST & ASSOCIA'T'ES Engineers - Planners - Surveyors 1610 Dimond Drive Anchorage, Alaska 99507 (907) 562-7878 May 12, 1991 Municipality of Anchorage Department of Health and Human Services On-site Services 825 "L" Street Anchorage, Alaska RE: Lot 6, Block 1, Spring Forest Subd. This letter and attachments is to accompany a permit application for an on- site waste disposal system at Lot 6, Block 1, Spring Forest Subdivision. The following are attached. 1. Drawing of proposed on-site system, and separation distances. 2. Soils log and percolation test results. 3. Trench design calculations. 4. Compliance letter from ADEC on Spring Forest public water supply. 5. Applicable portion of plat for Spring Forest Subdivision. This subdivision is served by a Class A well which is not within 200' of the proposed on-site system. Development of the adjacent properties will not be adversely impacted by construction of the proposed system as distances to adjacent features are in compliance with applicable requirements. The closest feature that could be affected is the proposed water line, which is about 28' from the closest point of the proposed replacement system. Slopes on this lot are gentle: about 3%. Drainage is to the drainage easement to the south west. It was noted that the trench on Lot 5 was abandoned and upgraded. Particular attention was paid to the soils on Lot 6, but they appeared to be ideal for a subsurface soil absorption system. They are clean fine sands which perked well. Both the replacement and the main trenches fitted within the 30' radius circle around the test hole. It is recommended that a permit for the on-site system be issued. Sincerely, Az Stanley Brust, P.E. cc: Spring Forest, Inc. ABANDONED FILL - SILT BARRIER RF Z PERFNRATED PIPE SEPTIC RNCK LOT 4 / LOT 3 / _ S WEST �s?c C. 0. ``2 PROPOSED / WATER LINE \ C. 0. --o a Q- LOT 8 O �O s� PROP HOUS LOT 5 LO F 6 a S. T. r C. 0. - W R AROUND TE T HOLE PROPOSED TRENC & REPLACEMENT TRENCH PROPOS DRIVEWAY F LOT 7 � s O'MALLEY ROAD s s z� —w O U NOTES: 1 I. TRENCH IS 50' LONG, EOR A 4 BR DWELLING. 2 ALL MATERIALS TO CONFORPA TO IviOA REQUIREMENTS. 3. SEPTIC TANK CAPACITY ISgDvu,:, 1250 GALLONS. ax, •: (){= [�" ��� TYPIGAL TRENCH CROSS SECTION N.T.S. ' FINAL ELEVATIONS TO BE SET IN THE FIELD CHECKED BY; SB DATE; SCALE; 11-100' J08NUMBER; 91-11 BRUST Sk ASSOCIATES ENGINEERS -PLANNERS -SURVEYORS 1610 DIMOND DRIVE ANCHORAGE .• '''" Aw Ir 0 si: 49TH ...... 9II6 E 'SAW PROPOSED ON-SLTL: SEPTIC SYSTEM I,OT 6., BEOCK 1 SFiL 7 SPRING FOREST SUBDIVISION OF 2 ._ ��� _ �� �� � � � r ; � � � '. �� � � � r i � i � � ���� ■■. .■ C�'� � � � • � '. _ �I r . / �� ��� i � -, .i � � � � � 1 � �f= �ir�� _ 1� 1��►i�� � �'�� I ,r , � tl�l� ��' ��� �� ' � --- ii! . i � Y! n ��■� C�:C' �� .■.. ' �: ::": �... �1. �1 � � �� �...:, e ., �... � ....:... D . ���Qhs�ON/��-�' �"b' b m \ N � d _ Z T— ___ t i� UmmEny onz w I ` Somg_NRY 1$ I o---- 6-00.-00-' ---5-.00 �-- R.O.W. IDEDICA-T-I-ON N0o- 08 5-7°W- _N me 5. 00 R.( 4 30.0 z 75. ----210.00 --285.05 co S979W03 oa CA 849.77 N 0°O3C_T�0FUTILITY ESowOo —D . 0 0of i J 1 W m 2 II o� � 30 - 30 � `3?0 (0 N N i . f0 p n �' NW LnN N,p A At S� !y D 0 28 ' z5 c°0 m 0 ?1 /i�lvYl �, G DU) 8a Ig12\ OD (D w / of L� rQiry T m N OJ Ij z D cn m'/7 °o \SMr� dool v� a N 00 04`00 W p - 167. 80' o /�' /� \ 8110 s4iy 1p is s bo op o\ 4 Q \ 00 v j^ /2 G0 00 0 rni D� 1, I°�i O (pCO(A \. °� O T-) p WO 1. S 0° 04 00'' E m 283.59' p" D ® - i� 183-24 m v1 0° ;TJ 1 (� P s u y y2 0 N Oa 0 m coo Q o l r I Irmn Dco I` r o rn UTILITY ESMT I -Pb O 1 n i-- S70f1-0zF`00"E-t7 ✓ •�`-3£"-32'St' �+ D /9 -C n � N o-- - % 6 gSgg, 176.00 ��� co I i -cn9 T o �92 _ °m 000 5.� o W m zl I �,W (0 C0cy% OB B N 05°0057„ W_ IT 6.00 c O. N i A I ` °� 0 .00 D 6 i 17 n h2 m 00 04 00 °E 11 191.51 m 90 70' � N I i V� 5C) j ()1 w 04 00 W CO O Q -m.a pJ C 1of �N� w cv �A p A- c 1 W 0O / �i N W ti N N DCO \ N / p D (n T m -n o i a4 �/o b CO T c-) -n z m 5.966 20' UTILITY o n / NT EASEME' _ _ n� T36:47 S 0007 53" E ' 305.35 ' w w 125.72 ' \ Q o 0 N 00° 0 7'5 3 W 425.10 �` X, Ne0 I a \ \ \S D 0 U, 5� UJ liNI -W ,A 1 ° I NO - JO (n 75.00 75. 00 'Tl sN 7- OF* y Y SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264.4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: - S�17 �✓� fU `%� s 7 Sump LEGAL DESCRIPTION:_ SLOPE SITEI PLAN DEPTH �.. y-.� F. (FEET) �1T� 1 ----- 2 Tardy ire✓e� 5��[ �uudl��Y"S. /�oI^uo�5 3- / gYa rv✓1 F41 ,e- 4- sP 5- 6 �%J1 e- 7 s 5 9- N 10- _ WAS GROUND WATER / S 11 - ENCOUNTERED? -f—/'�i s L -_ 12 S� 45 t/V 4 � P 13 o / IF YES, AT WHAT' �ra��DEPTH7 S�"i rn 14- 16-- 4 16•- 0t!, Ho 1 L 17- or A�q�1�� .•• A 18 .. b 4.9Tk 19• .t..�� ......, ..Ig�. NO. 986.E Reading. Date Gross Time Depth to Water Net Drop PNet s I4� '�!•'•� PERCOLATION RATE F • GISTE,. COMMENTS �,�@S`r�� ���� sp!! RUN BETWEEN FT AND = C' � Ti //c FOR �� a _(minutes/inch) Tyi FSP PERFORMED BY: s' B�uST CERTIFIED BY: S. 2 us DATE: S 72.008 "(6/79) ° u = --28 5- a _ — — 210.00 i tT _ x`20 ILITY es i -- 08 3 7" li o Y' 49t-8 4 9. 7 7 0 N so soy W / 0 GAN V� f i Ai 1,q 1 d151.23 OD II N + ds R4\ \ r p4y 10' ` N 00 4' 0't W k �! vg , 110 ru 1 7 cii / '10 W l s ° 4' 0 E �' 012 3.59' \ W o X, i>/ 8124 J ! ° a �D v io a i g `w ow ft1 u .1 T e Mr. 0 8 n to :i W I7 , S r 8' a,00 �- 0 _ z '�°S aoe's7' w- 00 c Gi c; c 05 ! �a 0 ..06, 176 176.00 f A ! 71 62 , O n m p' �yy Y' 70 GO 0 `� p o fin° W 00 m .p 0u p° NW �4• /�� N N � N.: D cn IT D Ul c 0 ^; n m 0• m 5.96 u - LIT FAST _— — �S 000 53" E 125.72 N 000 0'53" WZ 425-10 ` In _-142.-41- - t� y°M� . 1 10 / � ��/ �y A• (m o • N o � pg � �7 •lam \ C/� : �,� V S�,/j � � \ � y (JI 0 S 1 ao I -n O`nI No I m I S 00 03'06" E 0 DEPT. OF ENWIBONMENTAIL CONSER"TION ANCHORAGE DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 FOR: Mr. Stan Brust, P.E. May 6, 1991 PWSID #213564 WALTER J. HICKEL, GOVERNOR 563-6775 My review of the records on file in this office reveals that the Spring forest Subdivision Class A Public Water System, is in compliance with the provisions of 18 AAC 80.060, State of Alaska Drinking Water Regulations. Si cerely, /Lt4 Keven K., Kleweno Lead Engineer / LOT 4 0 LOT 8 00 LOT 3 F� Z \ 0 ° O S. T. C.O. WEST ,.a ° 128' ,$ 30' R AROUND TET HOLE PROPOSED TRENC & C.O. 2 70 PROPOSED REPLACEMENT TRENCH 4A;� POSED ,GPFo / ER LINE ��°P sPROP. PROPOSABANDONED TR C.0. HODS DRIVEWAY S. T. F�\ F LOT 5 LOT 6 LOT 7 �FYT O'MALLEY ROAD — LLI FILL i O SILT BARRIER U NOTES: �O Q0 G PERFDRATED 1. TRENCH IS 50' LONG, FOR A 4 BR DWELLING. PIPE 2. ALL MATERIALS TO CONFORM TO MOA SEPTIC ROCK LO REQUIREMENTS. 3. SEPTIC TANK CAPACITY IS 1250 GALLONS. ®���\ .,z�E �tt F.... 40 Ar TYPICAL TRENCH CROSS SECTION �• * : --*'49TH N.T.S. ,/�%f,��•• ' ••.• FINALELEVATIONS TO BE �•�Q •' 0.•986-E• ;•� SET IN THE FIELD �•••• `Q; �J� ��po� FGISTEAV �" DRAWN BY; DB BRLT S ASSOCIATES PROPOSED ON SITE qW. ,KEU BY; SB I SEPTIC SYSTEM OA'fE; 5/12/91 ENGINEERS -PLANNERS -SURVEYORS SCALE; 1"=100' 1610 DIMOND DRIVE ANCHORRAAGEE LOT 6, BLOCK 1 .1JOB NUMBER; 907 562-7878 99507 SPRING FOREST SUBDIVISIOISHT. OF I A AW Aw k N A�\L !ZS' WIN IN IN No A AW Aw k N A�\L !ZS' op v w ti kA. r i � o I ti kA. s �J S\ I r i s �J S\ I i s �J S\ I yr B t 600.00' No°08'57"w 5,00 R.( n _ J0p' R.O.W. DEDICATION ea9.77' ao 0 _O 0 ?10.00— . 2850 o mn 0W uC 849.77 N000837W bT T-20' UTILITY ESMT.z p ~ w co mm c,posRSs�i/Ijr�q W ` m R.O.W. OO m O N C' 30 30- (15 D cnn N ro l (A r\) (31 to0 IV 1,4 44 (31 1,4028,25. coW LD Fu 1 /A/D (A O Gr oo�� 3 ('ry q 2 N— F Y Z�' W 1 00. \ sirs ao uiQ a D - /S O /m ^// `390 N N 00 04' 00" W �9 167. 80 S 31 0 P (R ?9 \ O O ' I s k 30, 'a (b N I n o CCJ 6) P o cn 0' M N W A IN 11 ,;'o O N \ I (O CO W O I Im D� = V / 3° 00 o g.�i �� \v n W O S 0" 0400" E m I °i 283.59 � ' D (n 00 TI y 3 1 / w J► m I O- -P Cn 1,66E 0gZ N ca 1- m p— m cn A o Oq r PN (JI o f o o QItp Op ', I O 0-4� r I r D cn I rn I`q I P O UTILITY ESMT. I "+-rwU0"E— �'9�`- --S'2o32-51L' a n ?9 -( cn t- 148-31 _____. F3&.2Cs— /4 71 m I o----- % i a Sg9 176.00 w /'y IQ ' ) o (o cn / °+' A v w h °m I o 00 S•�s o WEST 17e w m A I W (0 O� C �6 wN 05° OB 57 W_, o0 1 a _ - -MG D �y Ztl o /3p 06, 176.00 m 00 04 00 yE ,r 191.51 Cw Q 001C�l co U1 Cn p 1 4 — C� W 0) / N N D CA D it ' m n -n C) o o -TIh-TI m '/0' Tp 5.96 1 26' UTILITY J EASEMENT - LLD S 0O 07'53" E a / 125.72 ` 305.35 o N OCP 07 53 W 4 25. 10 _ p N 80My I o_ o \ \ N o— cn <� ° ODp.— co 73. 73.00 - ?1 I — L3� SOILS LOG MUNICIPALITY OF ANCHORAGE �PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST //.i :> /»��r �N� DATE PERFORMED: •'s^// ��j PERFORMED FOR: � / / E / // T / /✓� �c7 �T L�5 ! - J �f3Y LEGAL DESCRIPTION: ` u%� �� �3��P F- S�j SLOPE SITE PLAN ucrin (FEET) 1 2 - � • f a„� ply C7 re -✓c � f�,� � /�uul/c�tir"5. �or0� s/ 3- 4 4 Sp 7 (� 8 SP 9 10 11 WAS GROUND WATER 5 ENCOUNTERED? 12 5� ��,, ✓•tll / IF YES, AT WHAT J vrn�6i. � DEPTH? 14 S/�fa s� .c�rlla_T l 15 V { l C v 16Ho1e 17 —�� 0.. 04 .... AU • ••' ,,• a� •� AV .� 18 OATH ° • 0' 19 0 .......X2, �•• •• •NO. 986-E 's 20 ep,Aw PERCOLATION RATE (minutes/inch) AW �QSS�OAt IA1v�;�d. TEST RUN BETWEEN FT AND --- FT COMMENTS��r4���® y/QU%%7' S/� L iUr�/Q✓ /s �� <— S F/BCo%rooPy? 1® Reading Da Gross Time Net Time Drop 6 C l /. 4toNet PERFORMED BY s'uST CERTIFIED BY: 2 i'S DATE: S 72.006 '(6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES • Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLIN��G//������qq Parcei I.D. # 015-321-33_ HAA # L 1. GENERAL INFORMATION Complete legal description Lot b; Block 1 ; Spring Forest Subdivision Location (site address or directions) 5910 West Tree Drive Anchorage, AK Property owner _ Peggy Horan Day phone _ 346-31 63 Mailing address 59 _ 10 West Tree Drive ANchorage, AK 99516 Lending agency Day phone Mailing address Agent Kay England/ Fortune Properties Day phone _ Address — Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well Community well XX Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer - NOTE: if community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev.1/91) Front MOAM21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify 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 compliawith all Municipal and State codes, ordinances, and regulations in effect A9 tai& dpxj Qf tl�s i spection. Name of Firm Address Engineer's signature Alaska Water & Wastewater raonsultat� k, Shall be P ) AID $ or prior to, closing for the Engineering Serrieee pfgVkWd; 6. DHHS SIGNATURE Approved for FOUR bedrooms. Disapproved. Conditional approval for Additional Comments By: 2B Phone '337-6( 79 Date ? / dj� O.F..AL,4 f(�,k Garnets E-7904 . e �1 C bedrooms, with the following stipulations: Date _ r 2 -r,,-- c% `1 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (fiev. 1/91) Back MOA M21 RECEIVED Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES MAY 24 1999A Environmental Services Division MUNKIPAIITY OF ANCH 825 L Street, Room 502 • Anchorage, Alaska 99501 • (90 MQqM40WsERvr-B nlvlstoN D'Health Authority Approval Checklist Legal Description: _ 4171-����� T✓!nG (-QYe56 Parcel I.D.: O%5- 35 A. WELL YPel�DATA B A /� Wall t j4- If A, , or C, attach ADEC letter. ADEC water system number - Log present (Y/N) _ Date completed Total de __ Cased to __ Casing height (above ground) Sanitary seal (Y/N)Wires properly protected (YIN) FWELL LOG AT INSPECTION Date of test Static water level _ Well production_ g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: _ Collected by: B. SEPTIC/HOLDING TANK DATA Date installed w II I/ -- Tank size 49,56 Number of� /Compartments --C Cleanout0/N) Foundation cleanout ON) Depression (Y(9 /` High water alarm (Y/N) Date of Pumping S /`l ���/ _ Pumper CSI YlP C. ABSORPTION FIELD DATA G Ob / Date installed Co �8 g � Soil rating (g.p.d./ft2 or ftz/bdrm) i� 2 SF System type 7re/2eA Length 5Ca Width _ 3 Gravel thickness below pipe (5 Total depth /� 2 Effective absorption area&60 5F, Monitoring Tube present (�fi)- Depression over field (Y/", Date of adequacy testResults (Pass/Fail) P(� 5 5 For __bedrooms 0 C3 & Fluid depth in absorption field before test (in.); 4D. 5 Immediately after gal. water added (in.): 46 Fluid depth 4 (ins) Minutes later: 557 Absorption rate = �� g•p•d• Peroxide treatment (past 12 months) (Y/N) /4YI2- knn(.i Al If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles E. SEPARATION DISTANCES Size in level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewed is service line On adjacent I On adjacent lots "Pump off" level at* Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: i Foundation Property line /3 Absorption field J�f> 4— Water main/service line r54-- Surface water/drainage �� Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line Building foundation /7 Water main/service line a Surface water 1 Dd —I- Driveway, parking/vehicle storage area Curtain drain eY Mk) Wells on adjacent lots R ENGINEER'S CERTIFICATION t certify that I in conformari inspections and review of Municipal rec �s in effect on this date. Signature Engineer's Na e Date 2 r� HAA Fee $ ��FJ , U Waiver Fee $ Date of Payment ©y� �/�,L. 1 Receipt Number T� i� T 3 / -7) � 72-026 (Rev. 3/96)* Date of Payment Receipt Number Got as�a pF A( s are u).em °tl .a •W.ar.w e. A. iP. r CE -7903: { 41.x„ a arES5�d�� v MUNICIPALITY OF ANCHORAGE Ir�A DEPARTMENT OF HEALTH & HUMAN SERVICES 0*_ Division of Environmental Services M}t On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. #�I HAA# -1. GENERAL INFORMATION b Complete legal description Lot -6-; Btock 1; Spking Fane�s Subd�vi3ion Location (site address or directions) 5910 W at Tnee Dni.ve Property owner Robent 9 Donna Sckte_ s -Gingen. Day phone . (303) 293-4003 Mailing address in transit Lending agency Mailing address Agent Cindy 11 Address P. oti.6 PHH/HOMEQUITy Concord, Ca i6on.n.ia 94524-4039 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well Community well XX Public water Day phone Day phone 510-246-6562 NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1191) Front MOA u21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm c w s Phone 17 034 Eagle River Loop Road No. 204 Address 2-EIql-a RiverMaslca y9577 Engineer's signature Date49 mHaaaa a0a asaaamam a ias .aha Naa p�af�a • o a9 ROGER J. CHAFER e� Rju •o No. 8215 Jl as a• .lets: aMaa aa.a .F� �aP 6. DHHS SIGNATURE Approved for`u% bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: CJ c -. C.Liz,.I11t Lt WTIC Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA 921 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: br)-r I_KITr'�G [&(61S7 Parcel I.D. A. WELL DATA Well type1,AMU1JlTV If& B, or C, attach ADEC letter. ADEC water system number oq I �S6 Log present (Y/N) UZA Date completed /U�A Driller &Z/1 _ Totq,J depth _ OZA Cased to /V/X� Casing height NL19 _ Sanitary seal (Y/N)✓v//E — Wires properly protected (Y/N) Date of test Static water level Well flow Pump level FROM WELL LOG g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot AT INSPECTION rn { r -It ®� el � -p — 4 � ry � ,g41.m. r� < aJ 11-0 :y r„ c7 On adjacent lots _AJIA� Absorption field on lot 1) /-) ; On adjacent lots Public sewer main NIA_ Public sewer manhole/cleanout U Sewer service line A_ Petroleum tank WATER SAMPLE RESULTS: Coliform � Nitrate L Za Other bacteria_ Date of sample: AJ� Collected by: f`� .A B. SEPTIC/HOLDING TANK DATA �� p Date installed .�.i—Tank size _ GAS Compartments Cleanouts ON) Foundation cleanout ON) Y4FS Depression (Y/to� - High water alarm (YI69 G^'1A Alarm tested (Y/qq- Date of pumping ! t liY 1?'N_ Pumper ISAAC S i�IWI"VC _ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: / r Well(s) on lot /y —On adjacent lots /`-JM Foundation- To oundation To property line Irl —Absorption field_ 3y r� Water main/service line C2S Surface water/drainage 100 r4- 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE= C. LIFT STATION Date instal -@.d Size in gallons Vent(Y/N) High water alarm level "Pump on el at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y SEPARATION DIST/ C -E FROM LIFT STATION TO: Well o� On adjacent lots D. ABSORPTION FIELD DATA "Pump off" level at Cycles tested Surface water Date installed (/ Soil rating /to GP�/SF System type TZEr�cH Length �6 / Width r r 9 Gravel thickness Total depth �� /2. Total absorption area rJ�O SF Cleanouts present &N) YES Depression over field (Y/PQ No Date of adequacy test 'J/ -clZ Results (Os/fail) j>�SS for bedrooms Peroxide treatment (past 12 months) (Y/& Loa KNOW N If yes, give date N SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 0,)//4 On adjacent lots dUIA Property line- To ine To building foundation j-- To existing or abandoned system on lot On adjacent lots 50 'f Cutbank- _Water main/service line- Surface ine Surface water 100) r�- Driveway,g g r NONE- parkin /vehicle storage area v 3 Curtain drain f ONE- �rve p � WRtu>=>z �ssueo tet-to-ql, Cjc/R �tvo2�� E. ENGINEER'S CERTIFICATION I certify that i have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. "a ft%4 " % 5 &S ENGINEFRING Signature '17334 Facgle Piver Loop Road No. 204 Eagle River- Alaska Engineer's Name Date -92— QYip1o0®YD6Ne4 96o�u��eN a amO9a )�Oa;b u p6 FiOf�Fr� J. I lAF i a y ee No. 8 15 *.,Gov &a, N a�q ROREsrJtt,�«� - •..owner.• - 00 HAA Fee $ %%D Date of Payment -9' -2d• 9 ' Receipt Number�0 72-026(Rev. 3/91)Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number 3 � E OF WALTER J. NICKEL, GOVERNOR lel D D DEPT. OF ENVIRONMENTAL. CONSERVATION ANCHORAGE DISTRICT OFFICE (907) 349-7755 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 September 17, 1992 Mr. Roger Shafer S & S Engineering SUBJECT: Spring Forest Subdivision Class "A" Public Water System, PWSID 213564 Dear Mr. Shafer: I have completed a review of this office's files concerning the monitoring status of the above -referenced Class "A" Public Water System and found the following: The last satisfactory Total Coliform Bacteria Sample results was submitted to this Department on August 10, 1992. This does meet the provisions of 18 AAC 80.200(a) of the State Drinking Water Regulations. 2. The last inorganic Chemical Contaminants Sample results were submitted to this Department on January 28, 1991. This does meet the provisions of 18 AAC 80.200(a). 3. The last Radioactive Contaminants Sample results were submitted to the Department on June 10, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. 4. The last Organic Chemical Contaminants/Volatile Organic Chemicals were submitted to this Department on June 16, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. Issuance of this letter does not imply that the above -referenced Class "A" Public Water System is in compliance with other provisions of the State Drinking Regulations. If you have any questions on the above information, please do not hesitate to contact this office at 349-7755. Sincerely, �W� Michael Lu Enviornmental Eng. Asst. II printed on recycled paper b y C,D. MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services ~}� On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # la\ HAA Qn 1 (_')L1 10,1 1. GENERAL INFORMATION Complete legal description X07 ` e e ,, /�/ Tim Af Location (site address or directions) Property owner ���� - ��ls/r��-'r' Day phone Qz"� Mailing address Lending agency /Day phone S -7— Mailing addrecc Agent — C� Day phone Address v / ���GL _ _ �/ Lfs_z,� Unless otherwise requested, HAA will be held for pickup. �Ia� 2. NUMBER OF BEDROOMS: �z e 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: if community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA x21 5. 91 STATEMENT OF: INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ,�iQf/S� �` �%ss �i �zs Phone SG Z ' 71 7b' Address /K/v �.�c.2 l�ri�ir� e . Xle //-!�7707 Engineer's signature Date DIIHS SIGNATURE XApproved for �?u2 bedrooms. Disapproved. Conditional approval for Additional Comments OF F�ACAs�D4 s CiJ,: •.••j7 �� �e 49rH ' * d ....• . : .............. ' NO. .. 986-E .' : bedrooms, with the following stipulations: BY: &_�'4_Lr Date /o — ! - 9 - — at TIC The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOAM Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: /:�-drdI4arcel I.D. I%ISa 31'V A-9 A. WELL DATA 71 / Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) 1414 Date completed W,1 Driller Total depth— /V/i7 Casedto Casingheight /"� Sanitary seal (Y/N) Wires properly protected (Y/N) IYA MUNICIPAU I! Or ANeHORAGf'r FROM WELL LOG AT INSPECTIONVIRONMENTALSERVICES DIVISION Date of test Static water level Well flow Pump level 'I / V/y SEPARATION DISTANCES FROM WELL TO: 11 I/l/le OCT 7 1991 /4//Y RECEIVED AIX g.p.m. Septic/holding tank on lot �Cy ; On adjacent lots _ "V//,y Absorption field on lot — �� ; On adjacent lots A11i Public sewer main %7�`/ Public sewer manhole/cleanou"tom Sewer service line /✓� Petroleum tank /y h� WATER SAMPLE RESULTS: //j� Coliform ���+' Nitrate ���% Other bacteria Date of sample: A1,141 Collected by: ^/'' — B. SEPTIC/HOLDING TANK DATA AIX Date installed Tank size ���� U / Compartments _ Cleanouts (Y/N)—�Fooundation cleanout (Y/N) T Depressio/n,((Y/N) High water alarm (Y/N) — +� Alarm tested (Y/N)—!A'�'`> _ Date of pumpingJ`% /✓G ��G Pumper W14 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Wel I(s) on lot On adjacent lots // Foundation h _ To property line A _Absorption field Water main/service line Surface water/drainage --/�9 & 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION /U j Date installed Size in gallons Ai Manufacturer /✓h Manhole/Access (Y/N) AX Vent (Y/N) A iii "Pump on" level at "Pump off' level at Alw High water alarm level /Y/7 Cycles tested Meets MOA electrical codes (Y/N) /✓l4 SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot /'/*On adjacent lots Z✓W Surface water 11/1' /� D. ABSORPTION FIELD DATA Date installed Soil rating System type 9 -e- /;7> Length S Width Gravel thickness `'� Total depth Id A- Total absorption area 0 SF Cleanouts present (Y/N) Depression over field (Y/N) �/ Date of adequacy test A/h Results (pass/fail) /Y1 for bedrooms Peroxide treatment (past 12 months) (Y/N) /y/0 If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: �6) i Well on lot iy!% On adjacent lots A��% Property line u>o �V`�, d,-1 �;1 To building foundation To existing or abandoned system on lot —A//V On adjacent lots m Cutbank &6X Water main/service line -1 C i Surface water Driveway, parking/vehicle storage area Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name Date Z2ZZ HAA Fee $ Z 70, Date of Payment 1O- ;;�- ` Receipt Number C,;2s 1,31 �: X<� `i -) 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number ..V 49TH �® . . .......•..'..® .... . )�'• NO. 986-E r$ 01`,%-. GISTSV: `��`� WALTER J. NICKEL, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 October 4, 1991 FOR: Stanley Brust PWSID:2# 13564 (907) 563-6775 My review of the records on file in this office reveals that the Spring Forest Subdivision Class A Public Water System is in compliance with the provisions of 18 AAC 80.060, State of Alaska Drinking Water Regulations. Sincerely, �yO" AV112, Byron Roys Environmental Engineer BR/cf 155 r � z 4 CK /. 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