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HomeMy WebLinkAboutSPRING HILLS ESTATES BLK 1 LT 11Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221313 PID Number: 015-051-49 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New X Upgrade Name COYLE JONATHAN ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed P4ound Site Address 9701 SPRING HILL DRIVE ❑ Other Phone Number of Bedrooms Soil Rating Total depth original grade 1-503-926-2044 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot SPRING HILLS ESTATES; BLOCK 1, LOT 11 Fill added above original gr a Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total orption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100'+ TANK 0 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER TANK Capacity 1250 Gal. Surface water 100'+ Material Number of compartments Lot Line 5'+NA HDPE 12 Foundation 110,+LIFT STATION Manufacturer Capacity Remarks OLD TANK DECOMMISSIONED PER UPC Gal. PER CONTRACTOR Alarm location Electrical installed by PIPE MATERIAL House to tank D3034 Tankto D3034 Installer ARM SEPTIC SERVICES Drainfield D3034/EXISTING Co/MTD3034 Inspector GEG AND MOA BENCH MARK (Assumed elevation) 102.00 ft Inspection 1" 10/20/2022 - Location and description dates:2nd TOP OF MH 3rd _ 4th _ ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp 0�4 _Qo6o 0 ,7�� �-9s4p Conditional Approval: Date , .... .......... ......... .. Q.... • .. ... ......... ......... P i Septic System Approved Date J ffrey A--Ger-Kess•= CE Note: this approval does not include well permit requirements. p� rofeso�°o� #AECC884 (Hev 05/01/18) 014 NAME ... RECORD DRAWING PERMIT NUMBER: OSP221313 MH1 18.5 25.9 ST1 22.7 28.8 DBL1 24.9 30.5 / I DBL2 24.3 31.1 CO 20.8 41.3 / MT 20.7 43.1 NOTE: PIPE LOCATIONS ARE SHOWN' PER THE .DWG FILE PROVIDED BY THE SURVEYOR. SWING TIES WERE GENERATED IN AUTOCAD I I ( \ > I tr a \ EXISTING 4 BEDROOM HOUSE s.. aDRIVEWAY + % ,.:• :.•moi PER CONTRACTOR (ARM SEPTIC SERVICES), IN ORDER TO INSTALL CLEANOUT AND MT IT WOULD HAVE REQUIRED EXCAVATION INTO THE ASPHALT. PER GEG DISCUSSIONS WITH MOA ONSITE A NEW CO AND MT WERE NOT INSTALLED / LOCATION OF DRAINFIELD IS APPROXIMATE AND MAY ENCROACH ON WELL RADIUS —/ DBL PARCEL ID NUMBER: 015-051-49 1250 GALLON HDPE SEPTIC TANK r ENGINEERING oSALES -CONSULTING 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, ALASKA' PHONE (907) 337-6179 • WEEBSITE: vN tgamessengineenng.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MARIAN JONES 1-503-926-2044 2 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: SPRING HILL ESTATES; BLOCK 1, LOT 11 D.J.G. TYPE OF WORK: DATE: SEPTIC TANK RECORD DRAWING 11/21/2022 I � r 1Q O •J eyA�ess.r•cZu® o;; oh • , CEf 7953 _® �'••.. LICEN®E 8�i EESS�®®�®® #AECC884 a�{gy0r® PERMIT NUMBER: PARCEL ID NUMBER: OSP221313 RECORD DRAWING 015-051-49 TOP OF TANK AT INTLET = 96.45 INVERT OF BUNG AT INLET = 95.77 TOP OF MANHOLE = 102.00 FINAL GRADE = 101.75 TOP OF TANK AT OUTLET = 96.43 NEW 1250 GALLON H.D.P.E. SEPTIC TANK INVERT OF BUNG AT OUTLET = 95.57 = M ENGINEERING-SALESi,C0NSULTING �m - 3701 E. TUDOR ROAD. SUITE 101 . ANCHORAGE. AK M07 • PHONE (907) 3716179' FAX (907) 33&3246' WEBSITE: x ..gammaergi—nw cram PREPARED FOR: PHONE NUMBER: PAGE NUMBER. JONATHAN COYLE 11/14/2022 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: SPRING HILL ESTATES; BLOCK 1, LOT 11 D.J.G. 'ePE OF WORK: DATE: SEPTIC TANK PROFILE 11/14/2022 ®®8 AV ®0 ..... .9: ......... ..........� 0 0 I. e'ifrey`A. arness 53 ' Z AV LICENSE ®118��N10 #AECC884 5 UO'04"48" E 216.02' X X X X x 25.0' F O o� 50' r'ont Set`_,ock - 0 100 � � O M s K � aqu0 IN 6uudS 11 101 2l 101z ID is \ coi' �I a 9 ax u y a a -o c a E a a -o CL W a U _ a x -0- C Q V7 U I K F— cu CL X W CL a0ol o c o O uj T Q U Ws �o a, av o C f "o V V co : f6 o v V Cn ' C_ = C .O f r � I 00 E > u E N - ! ui o a C` o E O < Qi it] j � LO f] 0 ; q o> I ^t h o u P u � Q ' Z e I 25.0' F O o� 50' r'ont Set`_,ock - 0 100 � � O M s K � aqu0 IN 6uudS 11 101 2l 101z ID is \ coi' �I a 9 ax u y a a -o c a E a a -o CL W a U _ a x -0- C Q V7 U I K F— cu CL X W CL a0ol o c o O uj T Q U Ws �o a, av o C c O_ C a co : f6 o v V Cn ' C_ = C .O f �� AO _z y� N 7 L y,U) U E > u E o Q � 5. p CU •.+ C "O i O N a C` o v E CL L a u o w .v r— o —i . 0 o u P u � Q ' �! 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The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation_ The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: Date:� r � Date:+' MUNICIPALITY OF ANCHORAGE Development Services Department`✓�°' Phone: 907-343-7904 On -Site Water &Wastewater Section ' - Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-051-49 Property owner(s) C/O MARIAN JONES Day phone Mailing address 9701 SPRING HILL DRIVE *ANCHORAGE, AK Site address 9701 SPRING HILL DRIVE "ANCHORAGE, AK 1-503-926-2044 - -Legal description (Sub'd., Block& -Lot) SPRING HILL ESTATES; BLOCK -1, LOT 11 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial 0 Single Family (SF) El Septic Tank 0 Upgrade ❑ (w/wo AD U) Holding Tank El Renewal❑ (D) ElRenewal Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees:_ /� Waiver Fees: Date of Payment: �/ 5 .20 -22 Date of Payment: Receipt Number: 02 5176 Receipt Number: Permit No. 05A� 2 13 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221313, Deb Wockenfuss, 08/18/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221313, Deb Wockenfuss, 08/18/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221313, Deb Wockenfuss, 08/18/22 IA OdH rJ y U N Q 0 00£' _ h Q O O :3 L � `b f� O 6h .,L'81 971 1:9 ,90 ,90 �C Q S 00'04'48" E 216.02' ani.AQ 11tH tjul,4dS 6 X X X a J. 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L) •a  MUNICIPALITY OF ANCHORAGE ~ .~- S"~-~L~ 0 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT %AME PHONE ~W ~' ~ ~" '~ '~ ~ ~ ~-~ 6 ~ UPGRADE MAI LING ADDRESS LEGAL DESCRIPTION ~'~' ~OCATION NO. OF BEDROOMS Well ] Absorption area ~ Dwelling PERMITNO. ~ DISTANCE TO: ~0'~ ~ i~O'~- (~ ~3 ~ Z Manufacturer Materiel No, of compartments Liq. capacity in.lions Inside length Width Liquid depth IF HOMEMADE: % ~ ~ Manufacturer Material Liquid capacity in gallons PERAIT~O'~) 2) q Well Foundation Nearest I0' line % DISTANCE TO: ~O'~'~ ~ o'~- ;~ :~ ~~ No. of lines Length of each line Total length of lines Trench width Distance between lines ~ ~ Top of tile to finish grade W Material beneath tile .... ~~ '~ ~ inches Total effective ~ ~ :~ ~abs°rpti°n are~ Length Width' Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line m DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO, ~ DISTANCE TO: Building foundation 8ewer line Septic tank Absorption area(s) OTHER ~IPE MATERIALS P v~ ~OIL TEST RATING ~NSTALLER 4., f %~PRovED DATE LEGAL I'"IFI::':: I HI...tH i',IUHE:EF.: OF:' E':EDI:;;:OOI'I:iS ..... ;t. Ei:O I L. F:FFf' i NG = :iii:!~:.; :;I..;2.~:~ :1;.25 ,:: E;Q. F'T. ,."BR ::, L.. :t: '.E; T E E., B E L 0 H FI ~.: I!E T H E I~] F"T ]: E) t'-,i'..::'; FI',,,' I:I :i: L. F~ B I.... E: T 0 "r: 0 [..J '.[ N [])E :i~:: ]] G N ]~ N I~ 'T~ CtlJ j:::: :E; J~!~ F' T ]] I~: ?'r'LE.:TE:i'i. C:HOC~E:Ei 'I"HEi I.']IF'T]iI]]J",J TI'"JFI"i" H .T. D'TH ...... 2...E~ E![ F'I". F:'"t". I::"'T'. C:lj. 61:it....t..:.Cff.,l:ili: ,::TH(::I JE. CJHF:'F:IRTHE'NT 'T'FIt'-,IK) PIEF~tH ]i T. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: ~-~O~,...~ DATE PERFORMED: LEGAL DESCRIPTION:_ 2 3 svJ 4 5 6 7 8 9 10 .11 12 13 14 15 17 19 20- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SLOPE SITE PLAN S L O P E Reading Date Gross Net Depth to Net Time Time Water Drop .,'~':...-' ,:~li, .:.f;,,, ......... , '!~ PERCOLATION RATE (minutes/inch) COMMENTS PERFORMED TEST RUN BETWEEN CERTIFIED BY: FT AND I FT DATE: /~ '~.' ¢' Z~.. 72-008 {6/79) EV~-V~ DRILLING~ Inc. P.O, BO:~ 10-378 . 10300 Old Seward Highway (ga~ 349-s~35 ANCHORAGE, ALASKA 99511 DRILLING LOG Well Owner DOUG gilN Use of WelLlkmaag.i~:_. Location (address of: Township, Range, Section, if known; or distance main road Size of casing fi" Depth of Hole Static water level 23 ft. (~5~%~') Screen ( ); Perforated ( 6~' feet Cased to , 60. i feet (below) land surface. Finish of well (check one) open end ( ). Describe s~K~kor perforation_ Perfarated w/13 shots from 43' to 49' Well pumping test at .35 gallons per fkl~.~) (minute) for 1 hours with of drawdown from static level. Date of completion n .... ~r ~ ~ 9°~ WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness ); ft. 0 TO 2 TO 3 3 TO 35 35 TO 49 49 TO 61 .TO .TO .TO TO_ .TO .TO. __TO TO. TO __ Casing stlcku? · Org~micS Gravel - Loose Gravel - wet __Silt~'jp~n I~WWA Certified Contractor C~_rtificabe ANO'S. ~.'~ o,, ,-,,~ 1 --CUSTOMER „F titer Development Services Department '� Phone: 907-343-7904 On -Site Water & Wastewater Section Fax. 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-051-49-000 Expiration Date: Legal description SPRING HILLS ESTATES BLK 1 LT 11 Site address 9701 SPRING HILL DR Anchorage AK 99507 12/8/2023 Current property owner(s) COYLE JONATHAN P LIVING TRUSTCOYLE JONATHAN P / TRUSTEE X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for Comments or advisories: M bedrooms, with the following stipulations: Original Certificate Date: 9/$/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist Absorption Field Advisory Tank Age Advisory Other X Well Flow Advisory Nitrate Advisory Arsenic Advisory x COSA Approval—June 2022 Development Services Department Phone 907-343-7904 On -Site klVater & VVastevvater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-051-49 Complete legal description SPRING HILL ESTATES; BLOCK 1, LOT 11 Location (Site address) 9701 Spring Hill Drive *Anchorage Current property owner(s) Marian Jones Day phone 503-926-2044 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: 0 Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel 0 Plastic ❑ Concrete ❑ Fiberglass Age 1 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed R Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 5-!570 Waiver Fee $ Date of Payment ��Z3�Z-''� Date of Payment COSA # 05C2-3131 9 Waiver # COSA Application—June 2022 COSA Checklist Legal Description: SPRING HILL ESTATES; BLOCK 1, LOT 11 Parcel ID: 015-051-49 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _ A. WELL DATA N Well log is filed with Onsite (or attached) Date drilled 12/2/83 Total depth 60 ft Cased to 60.1 ft N■ Sanitary seal is functioning correctly 01 Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 7/26/22 Static water level at beginning of test 22.7 ft. Comments B. TANK DATA Tj&-j 101 zD 7 7 - Measured operating fluid level in septic tank Date of pumping N/A ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 11/2/83 ❑N ALL standpipes present per record drawing Total measured depth from grade 10.25 ft (max) Measured depth to pipe invert from grade 6.91 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 35" & 42" ❑ Presoaked required if (Required if house vacant or field not us r more than 30 days prior to date of test Gallons introduced allons date Any rejuvena ' reatment (past 12 months) enter date Well production at time of test 3.8+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes 0 Nc ❑ Coliform bacteria is Negative Nitrate D • mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L SKArsenic less than MRL (ND) Collected by GEG, Ltd. Date 8/10/23 C. LIFT STATION ❑ Required maintenance completed Age of lift station ye Lift station mater' Adequacy test date 7/26/22 Results Q Pass Fluid depth prior to test *21 in Water added 635 gal New fluid depth *27 in Elapsed time 120 min Final fluid depth *23 in Absorption rate 600+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 42 in Effective depth used 23 in Effective depth remaining 19 in Comments/Deficiencies: *ADJUSTED TO ACCOUNT FOR FACT THAT MT USED FOR ADEQUACY TEST ONLY EXTENDS 35" BELOW INVERT COSA Checklist June 2022 N E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' Yes if No ft r-01 Yes if No ft Neighboring Tank > 100' Do Yes if No ft Private Sewer/Septic Line > 25' QYes if No ft Absorption Field on Lot > 100' ❑ Yes if No * ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' [E Yes if No ft R Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' MN Yes if No ft QYes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑m Yes if No ft Surface Water > 100' M Yes if No ft Tank to Property Line > 5' ❑m Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ❑ Yes if No ** ft Private Wells > 100' Q Yes if No ft Water Main > 10' Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' rol Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS *CLOSE TO 100' BUT CANNOT BE VERIFIED WITHOUT EXPOSING TRENCH. **5'+ PER 1983 INSPECTION REPORT PORTION OF DRAINFIELD IS UNDER DRIVEWAY G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Gamess Engineerinq Group, LTD, (GEG) Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Gayness Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regardin the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. COSA Checklist June 2022 o -,.Poo QQ X7953 0 kk �o LICENSEE 'Oro fesslon o #AECC884���0�'��� Nitrate Advisory Certificate of On -Site Systems Approval # OSC2313129 Subdivision: Spring Hill Estates, Block: 1, Lot: 11 A water sample revealed a nitrate concentration of 12.4 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "(Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Mailing Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org 5 00'0448" E 216.02' - — — G4401M 6uud-S tl 101 Zt lel � I X X X X x t , cry O AW c v c v c cu v v v -o a 0 v_ v - °- x 6 0 o v ° °1 I U -v In 2i U 'X L O "UX c QU a c 0 3 U v �o € 41 U a -, O uO c LO 3 c C c •O = LO x,40 E3cu u E� U C ` C N V O N N = c to ei p m u o,uw O j i l li w f c o i i E 3o a, y Z fl- a LO n c O c 00 _M "I s .- ai v c 0 Y U z Q Z s a 0 v >. aTt v o acv °Q o o i0 ? s v esti � N Oa p. 2 z CL W m a o nnL-,, s u • O +� ~ v v p �lJ /•� X 6 c O Q lu C a ., ._ (n c = L O c0 N U1\ LL aL'' 0 25.0' ��h h Z v o v a U N U c E oZ (� O, _ NU LL, (o Z c a c v O v a v 3 u �N w >.o v j L m L4.3 d nOC v M. 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Q w v Z -o 0 N Oa p. 2 z CL W m a o nnL-,, s u • O +� ~ v v p �lJ /•� ,( Q c O Q lu C a ., ._ (n c = L O c0 N U1\ LL aL'' Q F v 3 K y Z v o v a U N U c E oZ (� O, _ NU LL, (o Z c a c v O v a v 3 u �N w >.o v X:a Ey p L m L4.3 d nOC N O1 J U c t=i O 3 a ftC Q (ti c�ii vO w Oa u O v ¢m U L 4—� Q YQ\1 LnZ _0 13.0 — } U r O m 4� > W O W/ c L _ m a`!'�� N U u v c 7. _ LL o a0i i 3 s G 82 +i u u c v V c 3 mz U W o c OZ 2-� cn .C40 Cd w to p .� 'U Qa 3 c� =10 1 J, 11 Ad P % Z .• J ILL.: _ � t , cry O AW MUNICIPALITY OF ANCHORAGE DI~'PARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) L.¢_'/-:. Il; BI. tlr .~ Location (address or directions) Applicant Name Applicant Address :(c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [] (explain); (b) Telephone: Home ~' ~/¢-~'"? 8 Business (d) Lending Institution L/~/~,'.~'("~,- .~7f~l/~' ~ , ~:~¢ ~-' Telephone (e) Real Estate Company and Agent ~0¢~4¢ ¢¢~ - Address ~¢00 '~" ~/ 2 ~4c~0~¢ ~ ~ Telephone ,~- 7~ (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family [] Multi-Family Number of Bedrooms ¢t Other WATER SUPPLY Individual Well [~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite [] Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. Page 10i 2 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my sear affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe. functionar 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 flies and from my investigation and inspection, the on-site water supply and/or westewater 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 ,¢(~/'¢-o;~ -,/"~¢-~.~¢~:'-/' ~'/"¢'~'C~ Telephone Address I~',~ ~ ~ ~ ~nc~¢ ~ ~ DHEP APPROVAL Approved for /7?F~z. _ bedrooms by Approved ?~..~_ Disapproved Terms of Conditional Approval Conditional Date Engineer's Seal ' ....... % HEODORE F. MOORe ~ ~ ~,~,'% CE.3589 ,'.~ CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ' .': :,: Page 2 of 2 72-025 (11/84) " MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: MUi',~iCIPALI~Y OF ANCIIORAG~ DEPT. OF HEAl,TH & ENVIRONMENTAL PRO rECI'ION RECEIVED IlI 1~(oc.[¢ O WELL DATA Well Classification ~r~¢¢~'~_ tf A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) _ Y' Date Completed I "~ ,/~/~ff Yield Total Depth 6/' _ Cased to _ ~. ! Depth of Gr-0'-~i~g N,/~. Static Water Level '~-.? ' Pump Set At (.4',I ~ Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot Y To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments 5"/'~/ t" ~/~'..~ Sanitary Seal on Casing (.Y/N) __ ~ Depression Around Wellhead (Y/N) k/ -~ C, o.'~/; On Adjoining Lots ~' ~oo ' I01' /', On Adjoining Lots ~,. too ' To Nearest Public Sewer To Nearest Sewer Service Line on Lot /~, ; Date 7 / ~ 3'/,~" L-~'~- B. SEPTIC/HOLDING TANK DATA Air-tight Caps (Y/N) Date Installed Size Standpipes (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well I0,~, To Property Line ~ ~¢' To Water Main/Service Line Course ~ ! OO I ~.UO..~I _ No. of Compartments _ c~- Foundation Cleanout (Y/N) Date Last Pumped :3/~'o /~¢o/~ ; for N, Temporary Holding Tank Permit (Y/N) Y To Building Foundation lo ' To Disposal Field ~ ~' ' To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed It /2./~J Width of Field ~D Square Feet of Absorption Area ,~°~ Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well lC' ! To Building Foundation '"~ t,, Lot To Water Main/Service Line ,N,~, To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments .~ ,/~¢ ~e/~ I /:::/'/'.G o(r~ Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) m~e o~ Last ~dequ~cy Tes~ To Property Line ,.~ ~ To Existing or Abandoned System on ; On Adjoining Lots '~ ~o ¢ To Cutbank (if present) ~d' ~ D, LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that t have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed .~¢~7'.~ ~- "~-.o"~ Date 7/~-~/~' Company l~lct~ 7'~¢/,n~ca{ ~'ur~ MOA No. Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal iOP TECHNICAL TItEODORE F. MOORE, P.E. PH: (907) 345-1355 CIVIL & ENVIRONMENTAl. ENGINEERING · ENERGY CONSERVATION & ANALYSIS _ ,.,~oglAdo~O ECHO ST. .... p/~'tCl{O~..'~G~., ALAS KA 99516 July 24, 1986 u .... -¢~, ?.0~~' Health Authority Approval - L ].1, B 1, Spring Hills Estates M.O.A, Dept. of Health and Iluman Services P.O. Box 6-650 Auchorage, AK 99516 Dear Sirs: The enclosed "Checklist" and "Certificate" provides background information supporting a request for Health Authority Approval for the subject property. The purpose of this letter is to provide additional information regarding the construction of a driveway over a portion of the absorption field° Subsequent to construction of the septic system a paved driveway was constructed which appears to cover approximately 50% of the absorption trench. Based on as-built records and field measurements, there are 42 inches of gravel beneath the perforated pipe and an additional 4 feet of cover between it and the ground surface. Although there is no record of insulation having been installed at the time of driveway construction, there been no problem reported with freezing of the line during the past two winters. When I tested the system on July 23, the working fluid level was 84 inches below ground surface, and the system accepted fluid at a more than adequate rate° The presence of the driveway over the drainfield was noted on the June, 1984 Health Authority Approval paperwork. While the potential for freezing in the future cannot be totally discounted, it appears that the low working level in combination with the continuous injection of heated effluent does provide the nessary frost protection, and it is my recommendation that you issue the requested Health Authority Approva]., Please call me if you have any qnestions. ~,'w.. ~ '.f~ v. Sincerely, · THEODORE F MOORE ~ Ted Moore, P.E. Flatlop Technical Services 14530 Echo Street Anchorage, Alas,,a"~ 99516 INVOICE NO. 5549 5OLD TO SHIPPED TO STREET & NO. STREET & NO. STATE ZtP CITY STATE ZIP 7L721/01723 NORTHERN TESTING LABORATORIES, INC, 600 UNIVERSI'rY PLAZA WEST, SUITE A FAIRBANKS, ALASKA 99709 907-479-3115 6957 OLD SEWARD HIGHWAY, SUITE 101 ANCHORAGE, ALASKA 99518 907-349-8623 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY CLIENT [] PUBLIC WATER SYSTEM I.D. # . ~PRIVA'I'E WATER SYSTEM NAME Mailing Addre s C[~ ~ State Zip Code SAMPLE DATE: ~' ~--~ ~d' Phone ~' ~/--~'/~'"~- Mo. Day Year Purchase Order No, SAMPLE TYPE: [] Routine [] Special Purpose [] Treated Water [] Untreated Water [] Check Sample (for original contaminated sample with lab reference no. Sample Time V~b No. Location Collected Collected by oratory Ref. No. 3 4 5 6 7 8 9 10 Signature of Representative FOR LABORATORY USE ONLY CASH CHARGE PflEPAIO TRANSMIT[AL GPECIAL INSTRUCTIONG MAIL NOLD FOR PIC~(UP TO BE COMPLETED BY LABORATORY Received at: [~ Anch.. [] Fbks. Date Received i~/~.~ l~..c~ Time Received_ I ~ ~ Next Sample Due COMMENTS: SATISFACTORY UNSATISFACTORY RESAMPLE OTHER BACTERIA TOO NUMEROUS TO COUNT U R OB TNTC Direct Verification Final Count LSB BGB Result' Date Time INVOICE "~m~, ¢¢ ~ CLEANING SERVICE P.O. BOX 4-2841 PHONE 345-2513 Job Address ANCHORAGE, ALASKA 99509 ROTOR ROOTER SERVICE CALL PUMPING SERVICE [ '~0 (GAL) HRS HRS. @ STEAM THAWING HRS. @ i.~ / TRIP CHARGE HRS. OVERTIME CHARGE HRS. ADDITIONAL LABOR CHARGE HRS. PLUMBING REPAIR CHARGE HRS MATERIALS -' %% PLEASE PAY FROM THIS INVOICE TOTAL ¢5- TOTAL FOOTAGE CLEANED OR THAWED PROBABLE CAUSE OF STOPPAGE BLADESUSED -LINE CLEANED MUNICIPALITY OF ANCHORAGE DIVISION OF E/~UIRONMENTAL HEAL~.~q DEP~HiTMEN~£ OF HfI~LTH AND E~VIRONMENTAL PROI'ECI'ION APPLICATION FOR HEAL%~{ AD'mORITY APPROVAl, CERTIFICATE 1. General Information Application Date I.~gal D~scription (include lot, ~lock, subdivision, section, township, range) (c) Applicant is' (checR~ o~) ~nding Institution ~'; ~er~uil~r :L~; Burr ~; Othe~ ~ (e~lain); ' (d) [mnding Institution ____ Telephone Address (e) Real Estate Co. & Agent Address Te le phone 2. ~l~ of Pesidence Single-Family _~_~][ Nuat~e of Bedroon~ 30 Water _Supply_ aivi al Mu].t i-FL .ily C: ¥' O~e~ (~s~i~) Co~nunity ~ Public Note: If c~[mity %911 system, ~mst have w~itten confirmation fr~n the State Depa~t~nt of Env:[ror~m~ntal Con~rvation attesting to the legality and status~ Is the ~11 adequate for the nu~er of bedrcx~ns specified in this I{~A 4. S__e_wa_~93~ Disposal Onsite ~_~_[ Public [~_~[ Community !'7'--~I Holdin~ Tank Is the wastewater disposal system adequate fo~ U~e P~mbet, of t~droc~ns ~(~/N) [Page 1 of 2] 2-15-84 5. En~ineerlng_~rm _P~'ovidin~q__~pections, Tests, Data and Information I certify that I have d%ecked~ verified, o~. conformed to all MOA HAA QJidelines in effect on the date of thi.s inspection° Name of Fi_~m Signed by 6. DHEP A~roval Approved for Approved [~ Disapproved L-~~ Conditional Date Terms of Conditional Approval The Municipality of Anchorage Depa~tn~nt of Health and Environmental Pmotection does not ~%lara~tee the continued satisfactoy:y performan¢~ of t~ water supply and/or the wastewate~, disposal system° %~is approval indicates that, as cf the validation date shcwn above, based on the data and information furnished ~ an engir~er registered in the State of Alaska, the w~ater supply and wastewater disposal system is safe al~.d func ticnal fo]t the numbe~, of bedrooms and type of structu~te indicated. (DflEP SEAL) 7. Mail the []AA to the foil.owing address: KB2/d5/s [Page 2 of 2] 2-15-84 A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Well Classification p~_ i' :/~3 _ Well Log P~esent O~N) Total Dept3t <~ ! Cased to Static Water Level ~ ~./ . Casing Height Above Ground _ Electrical Wiring in Conduit--/~/N) Separation Distances f~om Well: To Septic~{olding Tank on Lot To Nearest Edge of Absorption Field on To Nearest Public Sewer Line '/vlUNICIFALITY OF ANCHORA(~E I)EPF. Ot: HEAL'tH & ENVIRONMENTAL PROTECTION~ RECEI LEi Legal Description: ~9'~-// ~/b~d .I . . ~ . ~' , ,. ~' Sanit~y ~al on ~sing ~p~ession ~ound ~l~ead (Y~. . ; On Adjoining Lots C leanout/Manhole Water Sample Collected By ; On Adjoining Lots ~/'Oe~ To Nearest Public Sewer To Neazest Sewer Service Lir~ on Lot B. Date Installed ' Ii/~ ~ Standpipes .,~./~Q) Depression over Ta~ .(Y~ size. Ai~-tight Caps ~/N) Date Last Pumped No. of Compartments Foundation Cleanout ~'~N ) Pumping/Maintenance Contract on File (Y/N) /J/~; for Holding Tank High-Water Alarm (..Y/N) ttJ/,--~- Temporary Holding Tank Permit (Y/N) Separation Distances f~om Septic/Holding Tank: To Water-Supply Well ~/o?-~ To P~cperty Li~e ~to/ TO Wate~ Main/Service Line CoU~ ; ;> ~Oo / To Building Foundation +~20/ To Disposal Field ~ ~ To Stream, Pond, l~nke, c~ Major Drainaga Com~snts [Pag~ 1 of 23 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ///~ Width of Field Square Feet of Absorption A~ea __. ~-,~ / Depression over Field ..(.Y~) Date of Last Adequacy Test Results of Last Adequacy~Test Separation Distance f~cm Absorption Field: To Water-Supply Well 77~O/ To P~operty Line To Building Foundation To Existing or Abandoned System cn Lot /<~/~ ; On Adjoining Lots ~.~7/ To Water Main/Service Line ~O/~ To Cutbank(if present) To Stream/Pond/Lake/c~ Major Drainage Course To Driveway, Parking A~ea, c~ Vehicle Sto~age A~ea ~j%~ Type of System Design LenGth of Field ~--~ / Depth of Field ~ / Gravel Bed Thickness 'Standpipes P~esent ~/N) D. LIFT STATION Date Installed ra3//~ Size in Gallons ~),~- "Pump On" Level at . /[Jl~ High Water Alarm Level at Tested for /[J/~- Electrical Codes(Y/N) ;~'//~ Dimensions ~/~ Manhole/Access (Y/N) "Pump Off" Level at f~c Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA Contents ** Check Permitted Bed~cc~ Rati~.g AGainst HAA Raquest ** certify that I have checked, verified, o~ confc~med to all MOA HAA Guidelines in effect on the date of this inspection. [Page 2 of 2] 2-15-84 /~ ! ~ Ci'i'EMICAL & GEOLOGIC~.tL LABORATORIES OF ALASKA, INC. ~t:. :~ '~L~-O~ (-~ ~'~2--~4~ ANCHORAGE INDUSTRIAL CENTER = ' 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER CZEZ] r' i E3 © See hon back I.D. NO. WATER SYSTEM: Water/'~System~o Name(.,~ 7'~J~---'( E ~,'~(... {~ Phone No. Mailin~ Address / I City State Mo, Day Year Zip SAMPLE TYPE: ED Check Sample (for routine sample with lab reft no. ) [] Special Purpose [] Treated Water [;~,-'d ntreated Water SAMPLE Time Collected Collecled By TO BE COMPLETED BY LABORATORY ~/,~sr%lysis shows this Water SAMPLE to be: atisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. ¢?F Tirne Received /~. 3 ~3 Analytical Method: ~ Fermentation Tube ~ Membrane Filter L. ab Ref. No. Result* Analyst J ~ *No of(olon,e&/~OOmf or NO of Posdwe purl,ohS 06.1220 (b) Rev. 1983 BACTERIOLOGICAL WATER ANALYSIS FIECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Membrane Filter: Direct Count ........... Coilform/100ml Verification: LTB BGB Final Membrane Filter Results ....... ~ _ Coilformll00ml Time: %~ a.m. TNTC= Too Numerous To Count