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HomeMy WebLinkAboutSPRING HILLS ESTATES BLK 2 LT 1Spring Hill
Estates
Block 2
Lot i
#015-051-70
On -Site Water and/or Wastewater System
Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number:
OSP161152
Tax Code Number:
01505170000
Work Type:
SepticTank Upgrade
Permit Effective Dates: July 01, 2016 to July 01, 2017
Design Engineer:
GARNESS ENGINEERING GROUP LTD
Subdivision:
SPRING HILLS ESTATES
-�-1 V/& Itt 00
711Z%!6 3r0-0
Site Legal Address: SPRING HILLS ESTATES BILK 2 LT 1 G:2436
Owner/Address: DRUMM BRANDON D & BREEANNA
9200 SPRING HILL DR ANCHORAGE AK 995074369
Site Mailing Address: 9200 SPRING HILL DR, Anchorage Lot Size in Sq Ft: 32057
Total Bedrooms: 3
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 B�
Issued By:
MUNICIPALITY OF ANCHOR y
AIX
Community Development Department ndlAm�l�t�
Development Services x: 907- 343 -
On -Site Water & Wastewater Program 6
Mayor Dan Sullivan
On -Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I.D. 015-051-70
Property owner(s) BREEANNA DRUMM Day phone 301-1818
Mailing address 9200 SPRING HILL DRIVE *ANCHORAGE, AK
Site address 9200 SPRING HILL DRIVE *ANCHORAGE, AK
Legal description (Sub'd,
Block & Lot) SPRING HILL ESTATES; BLOCK 2,
LOT 1
Legal description (Township, Section & Range)
Lot Size
Sq.Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DEWELLING:
(all that apply)
Initial ❑
Single Family (SF)
Absorption Field
®
Z
(w/wo ADU)
Septic Tank
Upgrade
❑
Duplex (D) E]Renewal
Holding Tank
❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR:
Distance: —
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
(Signature of property owner or authorized agent)
Permit/Rush Fees:S.,d/ 6 Waiver Fees:
Date of Payment: 6 - " go Date of Payment:
Receipt Number: O? Receipt Number:
Permit No. �SPl6� lS2 Waiver No.
(Rev. 01/11)
GARNESS ENGINEERING GROUP, Ltd .aaw c r -'s"
CIVIL &ENVIRONMENTAL ENGINEERS
June 30, 2016
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: Proposed Septic System for Spring Hill Estates; Block 2, Lot 1
To whom it may concern:
The existing 3 bedroom house is served by a private well and septic system. The drainfield is in
a state of failure and needs to be upgraded. We are proposing to install a new 1000 gallon
septic tank and 5 -wide trench type system. We are proposing to utilize the 1992 T.H. #2 by
Mark W. Pearson, P.E. and the drainfield is designed within its 30 foot radius. Comments
regarding the design are summarized as follows:
1. SOILS: See the attached 1997 soil log by Mark W. Pearson, P.E. which shows the soil
classifications, groundwater monitoring, and the percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface water concerns.
4. TOPOGRAPHY: The average topography around the proposed drainfield is relatively flat.
There is a 2-4 foot drop toward Abbott Road (north) and towards the west property line. The top
of the effective for the proposed drainfield will be at approximately 3.5 feet below grade. In
short, there is only a 6 inch elevation change from the drainfield and the bottom of the slopes.
Additionally, we believe portions of the proposed drainfield area have been filled in and are
therefore requiring confirmation during the installation of the drainfield that 100% of the effective
depth is in native material.
We are unaware of any adverse impacts this installation or waivers would have on adjacent
wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you
E.. M.S.
3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
I I I> I I
I 1 '= I I
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SAHALEE; BLOCK 1, LOT 45m
I I 'm I I
---------------1 I------------- I A ----------I �----
Im
N
ABBOTT ROAD
SPRING HILL ESTATES;
BLOCK 2, LOT 3
VACANT
/
A. Garness�S*
CE -7 53
\
/
SPRING HILL ESTATES;
m�
BLOCK 2, LOT 2
100' WELL RADIUS_ I
/
SPRING HILL ESTATES;
BLOCK 2, LOT 3
VACANT
I
I
\ / I SPRING WICL ESTATES; 7
/ / I BLOCW 1, LOT 1
TIF
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I
EA
1 I
1 Z O SPRING HILL ESTATES; I
'BLOCK 1, LOT 2
I
- I
I
CSEPTIC AREA
SPRING HILL ESTATES;
BLOCK 2, LOT 4
/ \ I
SPRING HILL ESTATES; / \
BLOCK 2, LOT 5
I 1DO' WELL S I /
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3701 E T11009 ROAD. SIVE 101 • MICH6RAf.E M 99307 • PIIOItE (901) M7-6119 • FM (90T 336-39A6 • We8 M w�.wn1sn01nxMa.mm
FOR: PHONE NUMBER: PAGE
DON & BREEANNA DRUMM 1 (907)301-1818 1 1
AL DESCRIPTION:
SPRING HILL ESTATES;
E OF WORK:
SITE PLAN
I
/
A. Garness�S*
CE -7 53
\
/
/
I
I
\ / I SPRING WICL ESTATES; 7
/ / I BLOCW 1, LOT 1
TIF
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1 Z O SPRING HILL ESTATES; I
'BLOCK 1, LOT 2
I
- I
I
CSEPTIC AREA
SPRING HILL ESTATES;
BLOCK 2, LOT 4
/ \ I
SPRING HILL ESTATES; / \
BLOCK 2, LOT 5
I 1DO' WELL S I /
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3701 E T11009 ROAD. SIVE 101 • MICH6RAf.E M 99307 • PIIOItE (901) M7-6119 • FM (90T 336-39A6 • We8 M w�.wn1sn01nxMa.mm
FOR: PHONE NUMBER: PAGE
DON & BREEANNA DRUMM 1 (907)301-1818 1 1
AL DESCRIPTION:
SPRING HILL ESTATES;
E OF WORK:
SITE PLAN
I
A. Garness�S*
CE -7 53
\
OF BEDROOMS: 3
LETTER THAT PERTAINS TO THIS DESIGN.
PER DAY (GPD): 450
TO A OPY OF THE LETTER
(ION RATE/S: 5.3 MIN INCH
CONTACT GEC. BYTAIN
CONTACT NG FORWARD
0.8
D APPLICATION RATE: 0
WITH THIS INSTALLATION, THE ENGINEER,
DRAINFIELD SO.FT.: 562.5 FT2
WELL DRILLER, CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY
'IELD
HAVE READ THESE SPECIFICATIONS AND
DESIGN:
AGREE TO ACCEPT THE TERMS AND
M DEPTH OF EXCAVATION: 11 FEET
2.5 FEET
35.5 FEET
VE: 8 FEET
SO.FT.: 568 FT'
EXISTING
\ PROPOSED
1 m�
1 0
L�
APPROXIMATE LOCATION
OF 3-4 FOOT DROP TOJ
NATURAL TOPOGRAPHY
INSTALL - BL1 & DBL
/ SPRING HILL ESTATES; BLOCK 2, LOT 2
VACANT
NOTE: THE CONTRACTOR
SHALL HAVE THE NORTH &
WEST LOT LINES, AND ALL
WELL RADII FLAGGED BY A
REGISTERED LAND SURVEYOR
PRIOR TO CONSTRUCTION.
ABBOTT ROAD
APPROXIMATE LOCATION OF
2-4 FOOT DROP AT -30% �
MENT TO ROAD DITCH I
100' WELL
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3101 E. WDOR RONX 500E 101 • WHOR,4E, M 99507 • PHONE (901) 337-9119 • PAC (901) 339-S • WEINNN: wqw, mghwRiq.w,n
'REPAIRED FOR: I PHONE NBER: PAGE NUMBER:
BRANDON & BREEANNA DRUMM (907)3UM01-1818 2 OF 2
.EGAL DESCRIPTION: DRAWN BY:
SPRING HILL ESTATES; BLOCK 2, LOT 1 D.J.G./L.K.B.
YPE OF WORK: DATE:
SITE PLAN 7/18/2016
A.
Ai�Ga 16 9 LF
1C/)
C
w
W
EXISTING 3
BEDROOM HOUSE
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G1R0j
N`��
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3101 E. WDOR RONX 500E 101 • WHOR,4E, M 99507 • PHONE (901) 337-9119 • PAC (901) 339-S • WEINNN: wqw, mghwRiq.w,n
'REPAIRED FOR: I PHONE NBER: PAGE NUMBER:
BRANDON & BREEANNA DRUMM (907)3UM01-1818 2 OF 2
.EGAL DESCRIPTION: DRAWN BY:
SPRING HILL ESTATES; BLOCK 2, LOT 1 D.J.G./L.K.B.
YPE OF WORK: DATE:
SITE PLAN 7/18/2016
A.
Ai�Ga 16 9 LF
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3701 ETUWRROAO.SUITE 101'ANCHORAGE,M995a' PHONE (907)3378179'FM(9N)330 a-MBSITE:x game W^.am9.com
LEGAL DESCRIPTION: SPRING HILL ESTATES: BLOCK 2, LOT 1
PERFORMED FOR: BREENADRUMM DATE: 7/1212016
DEPT ORG
(feet) TEST HOLE #1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
GM
SM
SOIL CLASSIFICATIONS
DEPTH TO DATE
GROUNDWATER
DRY 7/1212016
7/19/016
\. Garners ••.•4
eey
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
IIINII
2:50
-
6"
2
[01'",
30
3/8"
m
3
3:20
-
1811'
-
•
3:50
30
!W*16
5-5/8
5
DEPTH TO DATE
GROUNDWATER
DRY 7/1212016
7/19/016
\. Garners ••.•4
eey
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
7/14/2016 1
2:50
-
6"
2
3:20
30
3/8"
5-5/8
3
3:20
-
6"
-
4
3:50
30
3/8"
5-5/8
5
3:50
-
6"
-
6
4:20
30
3/8"
55/8
19 PERCOLATION RATE 5.3 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 6.5 FT. AND 7.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: E YES ❑ NO
SOILS LOGGED BY: LANDON BRUCE . PERCOLATION TEST PERFORMED BY: ERIK WIDGER
COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH.
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMEP IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:
r 25 16 04:25p
Alaska Quality Sealcoat
907 644-8330 p.1
PuEc 3uf7
EXISTING RIGHT -OF -WAY•'..
-
.^f: RIGHT-OF-WAY REQUIRED
[Q AREA REMAINING --=
r
r--
175+00 176 OQ
ABBOTT ROAD
r ;
N R3w
M
SEC 10 s
a
+= N 89'47'45" E:% 2640'67 P1 TO PI' =+�
_
SEC 15 -
EXISTING_�
50 J %SLOPE OMITS
ROAD
C/ L=31 42'
.10.84
N .89'47'45" E_ R 20 00'�
10' T&E Am
ESMT:v•;:;::?.%r.'•r.'..:"aiwi'vr...•
N 89'47'45" E 117.45' S 83.p
17 50"
/ 1 2 E 83.15' ..
RIGHT OF—WAY—LINE
CTBE
x`30' .
0',
ESMT
10' SLOPE)
.\- \•\ .-
MAINT ESMT
a , :
tiQ 37=
- -
�'
N
N
Z
wu PLAT NO. 83-382 o
o
2 BLOCK 2 �o
.
.� w
�
N
.••r�r�:i I/: r iii r r• �_„_i_ __�_� -
I 12.56
a
L'
R=^1179.87'
25' SLOPES
"�
`{
MAINT ESMT
I
L=26.88'
R-2a.p0'
/ S 72'47'40”
W
L=36,12' �.
ISL=36.14' 38'99
R-50.00'
'1 ��.R=50.00'
1
SPRING
9 20 9 80 4
Scale 1n Feet
STATE OF ALASKA DEPARTMENT OF TRANSPORTATION AND PUBLIC FACILITIES
RIGHT OF WAY REQUIRED FOR
ABBOTT ROAD REHAB
OWNER'S INITIAL
LAKE OTIS TO BIRCH
ATTACHED TO A
PAGE j OF _AM
DATED
_
PROJECT NO. 53942
PLAT 1 OF 1 GROSS TAKE 2.348 S F.
NET TAKE 48 F
DRAWN BY AFF\KMG REMAIN 29.736 S.F.
DATE November 6. 2015 PARCEL NO, 12
PuEc 3uf7
-.4
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825"L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: -��iytyl�`5 �- -- -- - DATE
LEGAL DESCRIPTION: -' Township, Range, Section:
3
4
6
7
8
9
10�
it•
12-
13-
14-
16-
16
17
18
_ 19
20
COMMENTS �Vt
Sid " (f rcavr.( / om -AI I
-5i W- w15:3,.>,I
WAS GROUND WgTER
v�
ENCOUNTERED?
_ i
S
®
IF YES, AT WHAT
L
A O
DEPTH?
P
Oapth-to-Water Ail 1
Manllarin8l _ +S -
--. -
Bale:
PERCOLATION tnunutesanch) PERC HOLE DIAMETER `� u
TEST RUN BETWEEN — PT en,n -T" �r
PERFORMED BY: ''• `��/w� IGY`6'ir�nP.QyIT� 1 , V 1lJ�/�- L`t:�/�5ry� CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:-
72-0081Rev. 4/85) ,
i
�©FURL'
i��nt:�a���:L11�'��dI�eN�'T�
PERCOLATION tnunutesanch) PERC HOLE DIAMETER `� u
TEST RUN BETWEEN — PT en,n -T" �r
PERFORMED BY: ''• `��/w� IGY`6'ir�nP.QyIT� 1 , V 1lJ�/�- L`t:�/�5ry� CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:-
72-0081Rev. 4/85) ,
Municipality of Anchorage i Page � of 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: >VV 9OZ10222 PID Number: o tf
Name pg�y N t S [xDdD> �tt�t
Wastewater System: El New upgrade
Address: 1(0I�r l-F�Q�
�iw�"ivt �Vw `J
ABSORPTION FIELD
`'IY
Phone: o. of _edrooms:
rYhCa,�.(02 41 3
O�'
Deep Trench Ll Shallow Trench 11 Bed 1-1 Mound 11 Other
LEGAL DESCRIPTION
Soil Rating:
112
Total Depth from original grade:
9 F -,T
GPD/sg.FL
Lot Block: Subdivision:
Depth to pipe bottom from orriiyginal grade:
Gravel depth beneath pipee_
(�
1 zit'i(T H -u -L!5;
RR
31 !9 Ft.
T Fl.
Township: Range:
Section:
Fill added above original grade:
I
Gravel length:
Ft.
WELL: L1 New F-1 Upgrade
Gravel width: i�
Number of lines:
(
Distancebetweenlines:
I
`•_� Ft.
Ft.
Classification (Private, A,B,C):
Total Depth:
Cased To:
Total absorption area
Pipe material:
�S'� (✓yf- ,
FL
Ft.
t�: 1 r
•-�' 3 4 SG. Ft.
ASTM 303 4 Puce
Driller:
Date Drilled:
Static Water Level:
FL
Installer ��
C-AZLIS IG�
)(CPA )N
®®
Date installeda: �/ n
O IFi�''[]-1 !r
Yield.
Set ac
asmg Height Above Ground:
TANK
GPM
FL
Ft.
—Pump
SEPARATION DISTANCES
XSeptic El Holding ❑S.T.E.P.
e
To
Septic
Absorption
Lift Holding
Public/Private
Manufacturer:
Capacity ingallons:
From
Tank
Field
Station Tank
Sewer Lines
Well
I c51
I $
Material.
Number of Compartments:
SurfaceWater
��^�
LIFT STATION
Lot
, Q 1
4c),
-3O /
Size in gallons:
Manufacturer:
Line
"�
ONC--
"Pump on" level at:
off" level a :
High water alarm at:
Foundation
4
1 o
Curtain
�ie
Pump Make &Model
Electrical Inspections perfor
Drain
BENCH MARK
Remarks:
•(—
��,lG �• n ���� � ! �
\ , v`•'s- t_i2X?.�
Location and Description:
WG�ft'� �f �1 �'rl`•'�`� irvv K+
L ' � a
r-1 inJ�i lVlf:�lY'Q=� ..' C�N�•�• �'�/`Q
�.�a�J
C�l�i�s ��(7rr' �•P�,aj
- Y+ nl� Assumed Elevation: 1 Z
—~ ENGINEER'S SEAL
i �
SFi1
• -% C
/ �r
Inspections performed by: Dates: 1st_
2nd
ON atty /
�1 ,, CE
Department of Health d Human rvices appy vat
a
Reviewed and approved by: Date: _431ys�
72-013 (Rev. 9,91) MOA 25
Permit No. 5W 9 ZOZ2,2- Page I' 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
72013 A (1193)'
Permit No. 5v1J97-0&Z,2- Page -7- of -3
- 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.C. Box 196650 * Anchorage, Alaska 99519-6650 e Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
I,; 1ix' j+1 t..Le,, Wri ) g L,06AC 1 Pir) Nin
cnto
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............... .................... ....... .... .....
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72013 A (1193)'
Municipality of Anchorage
Department of Health and Human Services dhh5
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
August 18, 1993
Dennis E & Donna P Goodrich
291 Alalani Street
Pukalani, HI 96768 8303
Subject: Lot 1 Block 2 Spring Hills Estates Subdivision
Permit #SW920222, PID #015-051-70
The subject permit, issued August 12, 1992 by this office for a
single family well and/or on. -site wastewater system, has
expired as of August 12, 1993.
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: $320.00 for an
on-site wastewater permit; $120.00 for a -well permit and
$440.00 for a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
S)ince
Jo n Smith, P. E.
Pr ram Ma ager
O site Services
enc: Copy of Permit
cc: Mountain Engineering
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 (UPGRADE) PERMIT
PERMIT NUMBER:SW920222
DATE ISSUED: 8/12/92
DESIGN ENGINEER:MOUNTAIN PENGINEERING
EXPIRATION DATE: 8/12/93
OWNER NAME:GOODRICH DENNIS E &
l °f 41:zlklZ
OWNER ADDRESS:1617 KEEAUMOKU ST #607
Zee
HONOLULU, HI 96822
PARCEL ID:01505170
.e
LEGAL DESCRIPTION: SPRING HILLS ESTATES B 2
L
LOT SIZE: 32057 (SQ. FT.)
/�1a 4teh, 3
?Ul
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:��
DISPOSAL FIELD SYSTEM
ALL CONSTRUCTION MUST 13E 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 PR
RECEIVED B
ISSUED BY:
DATE:
DATE:
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PERFC
LEGAI
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS t"!t��P—
TEST RUN BETWEEN Y - FT AND - FT
PERFORMED BY: "`-"�`^^�+1^' ^1�p--�/I�i I' V `w�`- C "^✓'7%9y\ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: T
72-008 (Rev. 4/85)
� e to
-. .
Iarrr.. V
.,o ox xi exrxu wrLerr.e)a
Municipality of Anchorage fa
DEPARTMENT OF HEALTH &HUMAN SERVICES d d
82.5 "L" Street, Anchorage, Alaska 99502-0650 ito r �"r. CC 7760 pe fi
SOILS LOG - PERCOLATION TEST �p f., X,
,�j-'1'1�F7j'rrTJFtC�t3a1'��',�`�-� -
PERFORMED FOR: �Vim/ DATE PERFORMED: TI IZ(fGC+Z�•.
LEGAL DESCRIPTION: w `—t Township, Range, Section:
-QEPTH T_ SLOPE SITE PLAN
(FE=EL')
1 x .
z
3
IA/(
1
6 C7
7
8 -/`_tea@
9 - `n
10 -
11 � .
12
13'2-
3
14
15
16
17
81920 18-
19-
201
COMMENTS L'
wJC
WAS GROUND WATER t r
ENCOUNTERED? i�
S
L
0
P
E b
�q2
IF YES, AT WHAT
DEPTH?
Depth to Water Alter
Monitoring? Dale:
Reading Date
Gross
Time
Net Depth to
Time Water
Net
Drop
( I Z
11,5111V
to Z`4 416
f8
�
jjaF—
I
PERCOLATION RATE '(minutes/inch) PERC HOLE DIAMETER
f l�J
TEST RUN BETWEEN `0 FT A''rNr^^D F
h cZ . (IPJ P.- <oA <
PERFORMED BY: I-V�_%—' &V-\ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE-. DATE:
72-008 (Rev. 4/85)
V
MUNICIPALITY OF ANCHORAGE
/ 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
NAME
1
CWNEW
iPHONE
5 L)o li/+!r
3 AG 3
❑ UPGRADE
MAILING ADD`R+ESS y /�
LEGAL DESCRIPTION
Alls,2-
LOCATION
NO. OF BEDROOMS.
Corryr� .�}��iv ` alt give w -t e/ ,EddL�'
t)
DISTANCE TO:
Well
po -art_
Absorption are
!
Dwelling
PERMIT y .
g D 2/ Z
Y
Q
Manufacturer /Yeer,
Material
No, of compartments
WF
c/
�.Ieei
N
Liq. capacity in gallons
/UD Lj
IF HOMEMADE:
Inside length
Width
Liquid depth
DISTANCE TO:
Well
Dwelling
PERMIT NO.
O' Z
� Z G
0
Manufacturer
Material
Liquid capacity in gallons
x—r
OWell
W
DISTANCE T0:
hd� J"
Foundation
/ i
Nearest lot line
x f
PERMIT NO.
y
to w
No, of lines
Length of each line
Total length of lines
Trench widtl
Distance between lines
2
P
/o j �O
TO
G l� inches
Q
Top finish
Material beneath tile
Total effective a orption areta
of tile to grade
p
inches
S- 0Z7
Length
Width
Depth
PERMIT N0.
La
U
Q H
Type of crib
Crib diameter
Crib depth
Total effective absorption
area
—
w °-
U!
LU Lj
well
Building foundation
Nearest lot line
DISTANCE TO:
Class
D ti
Dri ler
Distance to lot line
PERMIT N0.
d
w
DISTANCE T0:
_
it fo dation
Se er ine
Septic tank
Absorption areas)
OTHER
PIPE MATERIALS
P VL
SOIL TEST RATING
X4
5 b ,C7
.a
INSTALLER
(D � .J O
Iq
L
REMARKS
�t Gi tle 'rti iidwevo- r'4e' AIg wets r+l"
'}
I�
ay
y7te� r -W, ;n- _mf_ W(o.�p sur'/• 3ecv.7
ij -wide wa5 6u, i{' '7b s'�r.J in 'lie r;�6rt sae%
••
�
6u•'i "I' W«3 jl eep aF cv,./l/e 2n ue
"�G UCrer ASC C/Z pi'r ¢, 1 �CUi /H L'
� Y' 6e/bw tAz 6altory n e 't^-z/j
J
� '7`n iM ciifC' S'�rt �•irrz wcry hc: cuu�'-.- /`�'
we4t dry
/
7 e. f ,m at %Zee `Jere -la
7 '"Co srf3yo
K^j/�/ C! v aC r G t 7
o Wll L✓1 f/ o
l
APPROVED DATE LEGAL
QUI /G 6 S p� by /� ( f3 /uta
rF 72-013 (Rev. 3/78)
k��
PEPWT lAO�
DATE IS�UE�
�PPLICA�T
F0D��SS�
~`T F"" o7"D IL_3:~1- "Y C-) If=-
DEPHRTMENT OF HERLTH HAD ENVIR�N�ENT�LPROTECTION
8�� � STR�ET/ HNC��ORHGE, RK 9g501
264~4720
CONTRCT PHONE
D8:S UNLlMITEJ)
7800 DEBHRR
RNCHORH�E/ HK
]]7~676]
LEGHL DESCRIP�
SUBDIVISIOW SPRING HILLS
LOT: 1
01-00K:
2
SECTION: 15 TOWNSHIP:
1AN RHNGE]W
�OT SIZE�
]2057 (SQFTO� HCRES)
MH� BEDROOMS�
]
L
THF, OPTIONS HVHILH8LE TO
YOU IN D�Sl��I�G
YOU� SEPTIC
SYSTE�[ CHOOSE
THE OPTION THHT 8EST FITS
OTF,
.... ... .... -.�-.�_��-_�_~~�~~~~��_~�~
�����U�
DEPTH TO PIPE BOTTO�
(FT. ) 6 0
6. IN
GRHVEL
0�5
110
TOTHi DEPTH (FT
. �
) � 11 0
�
7 0
8 �
0
GRHVEL WIDTH (FY
5
19.0
5.0
!�- .b
GRHVEL LENGTH
45.0
]6.0
0
63. d
x��J
GRHVEL YOLUME (CUYDS
) 229
25.]
29.�
SOIL RHTI < Sit
FT. /3R) Wi 1�"I
1, 15 Ei
15 C1
** TANK MUST HHYE HT LEHST TWO COMPHATME041-9;
�..". - -.. .. .- - - - -~�.... ����.... �����..... ����... �������..... �....
ICERTIFY TI IH -l':
1 I FAMILIRR WITH THE REQUIREMENTS FOR ON-S/TE SEWERS HND WELL -S HS SET
FORTH BY THE MUNIGIPHLlTY OF MCH[MME (MOA) HND THE STHTE OF HLHSKH.
2 I WILL IN�THLL THE SY�TE� IN HCCORDRNCE WITHHLL MOH CODES HND REGU�HTIONS,
HND IN COMPLIHNCE UITH THE �ESIGN CRITERIH C*11", I'll 1: IT.
�T WILL HDHERE,: T() fit I STRTE OE", FO� THE SET �HC�
DISTRNCES FROM HNY WELL/ SYSTEM OR PUBLIC
5ENERH�E �YSTEM ON THIS OR HNV OT.
4� ��DE�STHND THHT THIS PORMIT IS VHLID FOR H If-`1XIMUI-1 OF
MAY EALHRMEMENT 14I1.1. WQOME HN ADDITIONAL. PITRMIT, '
IF R LIFT STHTHON IS INSTRLLEO IN fill HREH COVERED BY MOH BUI�DI�G COD�S/ "
THEN (i) HN ELECTRICAL PERMIT HND INSPECTION MUST BE OBTHINED/ BUILT:-
WTL� NOT BE HPPR0 WITHOUT RN INSPECTION REPORT.; HN)
ELECTRICHL WORK MUST BE DONE 8Y R LICENSED ELECTRICIRKi
n ^ ^
SOILS LOG
MUNICIPALITY OF ANCHORAGE
o fie; DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
-/ SOILS LOG — PERCOLATION TEST
PERFORMED FOR: L (I"L/ 9 14 DATE PERFORMED: -el-13—&/—
LEGAL DESCRIPTION:_ L f� I CIC,4 . -Z— c- �j� I�S St4Z`�i'V,f,�c,
P SLOPE SITE PLAN
LET�Yfr1�;� 5;/F, I�'/rc%,c%vy �UL,)
1 I I
I I �Ygc7i9/C Si l�'�, �Qf�CliS� �veb��
2 I r'7
3
4
5
6 %
r P !
7
8- t',
a
� , 0
9-
10-
11 10 11 ,
t �
12
e r
13
t ,
14-
15-
16
4 1516 r/4 1
17
18
19
20
COMMENTS Y
evQvel
��vle,, defol, (ivy :Tamd
9P°y (5P)
V/'sw'#1 relAd
/S-6
ONION
Moul
MEMO
Date
Gross
Time
,
ONE
Net
Drop
ONE
in
WAS GROUND WATER A� S
ENCOUNTERED? _ /�'G L
0
P-
IF YES, AT WHAT E
DEPTH?
Reading
Date
Gross
Time
,
11
Net
Drop
ONE
11
1
��
Nil
IMI1.�
MIN
■�1
1
■
MEN
WAS GROUND WATER A� S
ENCOUNTERED? _ /�'G L
0
P-
IF YES, AT WHAT E
DEPTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE
TES/T/ RUN BETWEEN - /- - FT AND
W9- /�O -f-j HP//Ynn IM /
PERFORMED BY: DO Mae / C:rc?j2S CERTIFIED BY:�
72-008 (6/79)
(minutes/inch)
— FT
DATE: YZZ
M ••W DRILLING, Inc.
P.O. Box 10.378 • 10300 Old Seward Highway
(907) 349.8535
ANCHORAGE, ALASKA 99511
DRILLING LOG
(, 1 , ,",�
01
Well Owner J < 0(_Tn/,; t%i L i.:(,.1: Use of Well iciuc. t i.c_
Location (address of: Township, Range, Section, if known; or distance main road
1'A 1u .ii1,uC'E_ i'. i;�5."[".i.1-�.1,' Ili. -. J.:: ,._ fincho2",DV.p
Size of casing ''F Depth of Hole `'J�feet Cased to " JI L- 52 feet
Static water leveLL'-")li ft. (above) (below) land surface. Finish of well (check one) open end
Screen ( ) ; Perforated ( ) .
Describe screen or perforation 't,;='F'"
Well pumping test at JQ gallons per :(hour+) (minute) for .jhours with_ow"' T :.
of drawdown from static level.
Date of completion i z7.;y 3J... :1.9flJi
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
p
TO
TO
2O
TO
3
TO
9U _
�)o
TO
'(U
TO
—TO
TO
_
—TO-
TOTO
TO--
_TOTO_
TO-
TO-
TO
--TO
TO_
—TO-
--TO
TO
ENV!D�pr OpgM OF r1Eq j -H NOPA0,4
G5:'��..Y 1�:'�-_'i;ii1u'r_'u: v'f"I ROiJM,ENreI _ U' a
fia;`€yo. Lo- 1Lueyl
W t;tt'riSlGtl Cct> x
3 — CONTRACTOR
Municipality of Anchorage m`o.
On -Site Water and Wastewater Program
(907) 343-7904 s A I E!
Certificate of On -Site Systems Approval
Parcel I.D. 015-051-70
1. GENERAL INFORMATION:
Expiration Date: /0 -( Z-(
Completelegal description SPRING HILL ESTATES; BLOCK 2, LOT 1
Location (site address) 9200 Spring Hill Drive *Anchorage
Current Property owner(s) Breeanna Drum Day phone 301-1818
Mailing address
Real Estate Agent Day phone
2. TYPE OF DWELLING:
© Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual
V1
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance request for: Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $
Date of Payment `7 o 1
Receipt Number 3 5 2,
COSA # 0,21 1370
Date:
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
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,
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: Garness Engineering Group Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road Suite 101- Anchorage, Alaska 99507
Engineer's Printed Name: Jeffrey A. Garness 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 moo
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,
T
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 � • .... ' J
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) regarding the future performance of-
f .
the well or septic system. GEG makes no representation whether an alternative well or septic system O � ;� , 'Trey
can be installed on the property in the event either of the current systems fail to perform ����IK�f�((( 049j `.I the future. The content of this report is for the sole benefit of the person/party that,
perform the evaluation. Reliance upon the information provided in this report by erson r t7F ��j/ p'ea p
party (including subsequent property purchasers) is not authorized, nor will it ` tf�. ny legal right er/�0r0�
whatsoever.
ga
` / S
r y
6. SIGNATURE � �TFRq�
System #1 Approved for bedrooms J p ARG 1!I�T 0
System #2 Approved for bedrooms
G
Disapproved JJ//JJi't/jCES
Conditional approval for bedrooms, with J06)1611l %iig stipulations:
tom(• -e" -P yve�p- S4,, 0� C rimes I vo-Vt, Q ? -� A"'A qC
q
B �-- Original Certificate Date: -7r-G r Z•1
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the representations given 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.
7. ATTACHMENTS:
COSA Checklist _ C Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
NIA
4
Checklist COSACKiiit
Legal Description: SPRING HILL ESTATES; BLOCK 2, LOT 1 parcel ID: 015-051-70
If more than 1 septic system on lot: COSA Checklist # of Structure served by this system
A. WELL DATA
FM� Well log is filed with Onsite (or attached)
Date drilled 7/31/84
Total depth 241.5 ft
Cased to 241.5 ft
!F# Sanitary seal is functioning correctly
FE -1 Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 6115/21
Static water level at beginning of test 190.8 ft.
Comments
B. TANK DATA
Age of tank(s) 5 years
Tank 'type/material SEPTICMEE
Measured operating fluid level in septic tank
49"
© Standpipes/foundation cleanout per record drawing
Date of pumping 6/21/21
D. ABSORPTION FIELD DATA
Which system tested (date installed) 7123/16
❑ ALL standpipes present per record drawing
Total measured depth from grade 12.25 ft (max)
Measured depth to pipe invert from grade 3.33 ft (min)
❑ N/A — pressurized field
A Monitor tubes go to bottorn of effective. If not, state
depth into effective
F1 M-1 Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced N/A gallons
Comments/Del IClencies: PIPES FOR 1992 RESERVE TRENCH NOT FOUND
COSA Checklist yellow sheet
Well production at time of test 6.8+ gpm
Water storage tank volume N/A gallons
Well disinfected for coliform test? ❑ Yes A N
[Coliform bacteria is Negative
Nitrate PJ 19 rng/L ❑ Nitrate less than MRL (ND)
Arsenic `s ug/L ❑ Arsenic less than MRL (ND)
Collected by GEG, LTD.
Date of Sample 6/15/21 11
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments: N/A
Adequacy test date 6/15/21
Results 0 Pass For 3 bedrooms
Fluid depth prior to test 26 in
Water added 629 gal
New depth 54 in
Elapsed time 120 min
Final fluid depth 35 in
Absorption rate 450+ gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date N/A
NONE
t 10
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
❑ Yes
if No
Community Sewer Manhole/Cleanout > 100'
❑✓ Yes
if No
ft
❑✓ Yes
if No ft
Neighboring Tank > '100' Rl Yes
if No
ft
Private Sewer/Septic Line > 25' 7 Yes
if No ft
Absorption Field on Lot > 100' Q Yes
if No
ft
Holding Tank > 100' 0 Yes
if No ft
Neighboring Absorption Fields > 100'
Water Main > 10'
❑✓
Animal Containment > 50' ❑✓ Yes
if No ft
❑✓ Yes
if No
ft
.Nater Service Line > 10'
F/1
Yes
if No
ft
Manure/Anirnal Excreta Storage > 100'
comment below
Community Sewer Main > 75' ❑✓ Yes
if No
ft
✓❑ Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required
Building Foundations > 10'
❑ Yes
if No
ft
Surface Water > 100'
❑✓ Yes if No ft
Property Line > 5'
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
Absorption Field > 5'
Yes
Yes
if No
ft
Private Wells > 100'
❑ Yes if No ft
Water Main > 10'
❑✓
Yes
if No
ft
Community Wells > 200'
✓❑ Yes if No ft
.Nater Service Line > 10'
F/1
Yes
if No
ft
If septic tank is under driveway
comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
❑✓
Yes
if No
ft
11 absorption field is under driveway comment below
Property Line > 10'✓❑
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
✓❑
Yes
if No
ft
Private Wells > 100' ❑✓ Yes if No ft
Water Service Line > 10'✓❑
Yes
if No
ft
Community Wells > 200' Yes if No ft
Surface Water > 100'
Q
Yes
if No
ft
F. ENGINEER'S COMMENTS
'MET CODE AT TIME OF INSTALL - APPROXIMATELY 5' FROM ST1 TO DECK
STAIRS
G. ENGINEER'S CERTIFICATION �a Or C�C�
i certify that l have determined through field inspections and review
of Municipal records that the above systems are in conformance with y
MOACOSH uidelines in effect on this date. g
g �........ ... ..............
COSA Checklist yellow sheet
Je�vv� A.+CSE-7953
1�ec/ p+0fes5ior�o�
#AECC884
nA
LOT 2
SCALE: V= 50'
EASEMENTS OF RECORD, OTHER THAN
THOSE SHOWN ON THE RECORDED
PLAT ARE NOT SHOWN HEREON
UNLESS OTHERWISE NOTED.
I
ABBOTT ROAD
8327
— — --
PARCEL 98
N89059'00°E 183.92
6.14 8=50.00 ST/3 '_
L=36.14 �Sp
OF • A�
Amr
00
0'
..
0' A . Elizabeth L. Walatka a 00
ATF • • 8036 — LS , • �e A,
OFE'SSI ONA`- �� -ate
l� �,02,
FB 214, pg 24-25
FB 08-2, pg 44-45 BE
BEP
Revised 6-19-21 Added septic ventst'
RECERTIFIED 6-08-21
AS -BUILT NO CORNERS SET THIS DATE
I hereby certify that I have performed a Mortgagee's inspection
in accordance with ASPLS Standards of the following
described property: LOT 1, BLOCK 2,
SPRING HILLS ESTATES SUBDIVISION
Anchorage Recording Precinct, Alaska, and that the
improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
adjacent thereto, that no improvements on the property lying
adjacent thereto encroach on the premises in question and
that there are no roadways, transmission lines or other
visible easements on said property except as indicated
hereon.
Dated at Anchorage, Alaska
this 3th day of APRIL ,2008.
FRED WALATKA & ASSOCIATES, L.L.C.
Engineers and Surveyors
907-248-1666
This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary
survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to
establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original
client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered,
the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650/
Anchorage, AK 99519519-6650
www.muni.org/onsite'
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. nl 5- 10 COSA#
1. GENERAL INFORMATION Expiration Date: /5 —a I — Q S
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
SPRING HILLS ESTATES: BLOCK 2, LOT 1
9200 SPRING HILLS CIRCLE ANCHORAGE AK, 99507
FRANK CARPENTER Day phone 267-4935
9200 SPRINGHILL CIRCLE ANCHORAGE AK, 99507
Day phone
JAN REDNALL W/ KELLER WILLIAMS Day phone
230-6343
101 W BENSON BOULEVARD 503 'ANCHORAGE, AK 99503
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
0
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of 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 samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the 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, functionaf and.adequate .
for the number of bedrooms and type of 'structure indicated herein. I further verify that based onthe
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 . GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date J I ( D
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party Is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for 3 bedrooms.
Disapproved.
Conditional approval for bedrooms, with the fllowing stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
V
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Reort
«
By:
� =L—her
(Rev. 11105)
• � 1llV 1 L.11/l, �,
PROGRAM
Original Certificate Date: _�' �- - OR
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw 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: SPRING HILLS ESTATES: BLOCK 2, LOT 1 Parcel ID: OI r -OSI- %O
A. WELL DATA
Well type PRIVATE If A. B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 7/31/1984 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 241.5 ft. Cased to 241.5 ft, Casing height (above ground) 12+ In.
FROM WELL LOG AT INSPECTION
Date of test 7/31/1984 4/23/2008
Static water level 210 ft. 194 ft
Well production 10 g.p.m. 4.15 9.p -m.
WATER SAMPLE RESULTS:
Coliform colonies/100 ml. Nitrate (' t I mg./L. Other bacteria �Lcolonies/100 ml.
Arsenic: N 0 ug./L. Date of sample: 4/23/2008 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 7/16/1984
Tank size 1000 gal. Number of Compartments E Cleanouts (Y/N) YES
Foundation cleanout (YIN) YES Depression over tank (Y/N) N3 High water alarm (YIN) N/A
Date of pumping 4/23/2008 Pumper MCDONALDS PUMPING
C. ABSORPTION FIELD DATA
Date installed 8/27/1992 Soil rating (g.p.d./ft°o t /bdr 1_2 System type TRENCH
Length 31 ft. Width 3 ft. Gravel below pipe 7 ft.
Total depth • 12.41 ft. Eff. absorption area434 ft' Monitoring tube YES Depression over field NO
Date of adequacy lest 4/23/2008 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 30 in. Water added 686 gal. New depth53 in.
Elapsed Time: 135 min. Final fluid depth 30 In. Absorption rate >= 450+ g.p,d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at in.
E. SEPARATION DISTANCES
Size in gallons Manhole/Access
'Pump off" level High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO
Septic tank/lift station on lot 100'+ On adjacent tots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main N/A
Sewer /septic service line 25'+
Animal containment areas 500+
Public sewer manhole/cleanout N/A
Holding tank N/A
Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation •4' Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+ *PER PREVIOUS INSPECTION REPORT, APPROVED 1992
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 100+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that / 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 Printed Name JEFFREY A. GARNESS
Date __ 5%Ib/0g
COSA Fee S 0-50
Date of Payment 1q Q8
Receipt Number ag(n7(1
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
I
ABBOTT ROAD
'• — — — — — — — —PAR—CEL-99 — — — — — — —
T _ _ N89'6700'E 183.82
LOT 2
EASEMENTS OF RECORD. OTHER THAN
THOSE SHOWN ON THE RECORDED FW 0&1
PLAT ARE NOT SHOWN HEREON. !EC
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SGS Ref.N
1081639001
Client Name
Garness Engineering Group, Ltd.
Project Name/N
Spring Hills Est. LI 132
Client Sample ID
Spring Ililis Est. LI B2
Matrix
Drinking Water
PWSID
0
Sample Remarks:
All Dates/Times are Alaska Standard Time
Printed Date/time
05/012008 10:13
Collected Date/time
04232008 16:00
Recehed Date/time
04232008 16:35
Technical Director
Stephen C. Ede
Allowable Prep Analysis
paramntt Results PQL Units Method Container ID Limits Date Date Init
Metals by ICP/MS
Arsenic ND 5.00
Waters Department
Total Nitrate/Nitritc-N 1.11 0.100
Microbiology Laboratory
Colony Count 0
Total Coliform 0
Fecal Coliform 0
ug/L
EP200.8
C
(<10)
0428/08 04/30/08
NRB
m8/L
SM20 4500NO3-F
B
(<10)
0428/08
LCP
coV100mL SM209222B
coV100mL SM209222D
coVIOOml. 54120 92220
A (200)
A (<1)
A (<I)
04/23/08 DLC
04/23/08 DLC
0423/08 DLC
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information
Application Date 0//3/8
(a) Legal Description (include lot, block, subdivision, section, township, range)
S RlNG H ILLI i"Sr-4Ti5 5_Ec. 15 .r?? �i �h �w . M . Ak.
—
Location (address or direc4ons)
C: 2AI,e. SPA/,VG 4ILL DRIVE o Aag,57-
(b) Applicants Name S/}M �4$4_ Telephone - Home Business 3 y$-6o)q_
Applicants Address
(c) Applicant is (check one) Lending Institution ; Owner/builder
Buyer E:::l ; Other E::� (explain); -
(d) Lending Institution Telephone
Address
(e) Real Estate Co. & Agent
Address
Telephone
(f) Mail the HAA to the following address: r
A) -z' 1��lr r ��'-0
2. Type of Residence
Single -Family Multi --Family ��
Y
Number of Bedrooms 3
3. Water Supply
Individual Well E�:l Community =
Other (describe)
Public El
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 r57< Public Community Holding Tank
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 21
■n:YHA11111low
a ,;
5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information
As certified by my seal. affixed hereto and as of the validation date shown below, I
verify that my investigation of this Health Authority Approval shows that the on-site
water supply and/or wastewater disposal system is safe, functional and adequate for
the number of bedrooms and type of structure indicated herein. I further verify that,
based on the information obtained from the Municipality of Anchorage files and from my
investigation and inspection, the on-site water supply and/or wastewater disposal.
system is in compliance with all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm L3ESSE ,5 e PO rr 5 Telephone � �.SI 6 41151
Address 222-0 t. ae-&-k AvE ANC -N 99'S
! "Goo,,
DateI ooewe(_
(ENGINEER SEAL) "
Dcala R. Pterr. '1 .
t: _
6. DHEP Approval No. 2'15
Approved for L_J3 bedrooms By •, .L.. gate
Approved ,/ Disapproved Condition '
Terms of Conditional Approval
CAUTION
THE MUNICIPALITY OF' ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE
ATIONS GIVEN IN PARAGRA13H 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE
MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA
CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE
OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 21
PROTECTION
REPRESENT -
REGISTERED
HOMES AND
R.EQUIRE-
BEFORE A
FOR ERRORS
7-a19-84
A. WELL DATA
MUNICIPALITY. OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
I)[111. or I c; - 1
Ei]VIRONIAU,11AL P.:.i-c_f101V
NOV 1.6 1984
RITC
Legal Description: Zo? B/Q L 2 —
Well Classification .5/AGt, 4:74,-1_ If A, B, or C, D.E.C. Approved(Y/N)
Well Log Present (Y/N) y Date Completed —7%B� Yield F9.5
Total Depth 2-'-11'/2-1 Cased to _ z H k 1/2.1 Depth of Grouting
Static Water Level 21o/ _ Pump Set At
Casing Height Above Ground Sanitary Seal on Casing
Electrical Wiring in Conduit (Y/N) y Depression Around Wellhead (Y/N) A —
Separation Distances from Well:
To Septic/Holding Tank on Lot l od"r' On Adjoining Lots 1 ucri To Nearest Edge of Absorption Field on Lot loot ; On Adjoining Lots
To Nearest Public Sewer Line NA To Nearest Public Sewer
Cleanout/Manhole A114 � - To Nearest Sewer Service Line on Lot
Water Sample Collected By Date _—
Water Sample Test Results
Comments R�IRjS r TAC_40. —
B. SEPTIC/HOLDING TANK IATA
Date Installed _ 710!/ Size loon No. of Compartments ?--
Standpipes (Y/N) _Air -tight Caps (Y/N) Y Foundation Cleanout (YIN)iv
Depression over Tank (Y/N) A/ Date Last Pumped
Pumping/Maintenanoe Contract on File (Y/N) — ; for
Holding Tank High -Water Alarm (Y/N) -- Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water -Supply Wall loot" To Building Foundation
To Property Line /o'Y To Disposal Field _ 1'7
To Water Main/Service Line N�A _ To Stream, Pond, Lake, or Major Drainage
Course _ IV A -—
Comments
[Page 1 of 21
2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata1502/�sDkM. Type of System Design W. DRAIN
Date Installed Length of Field 7o
Width of Field 5 Depth of Field i
Gravel Bed Thickness z�
Square Feet of Absorption Area 1-15a Standpipes Present (Y/N) o
Depression over Field (Y/N) iV Date of Last Adequacy Test
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water -Supply Well iovfi To Property Line /o*'
To Building Foundation )9 To Existing or Abandoned System cn
Lot ; On Adjoining Lots NL4
To Water Main/Service Line N% To Cutbank(if present) IVA
To Stream/Pond/Lake/or Major Drainage Course "IA
To Driveway, Parking Area, or Vehicle Storage Area N1,a
Comments
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes(Y/N)
Comments
Dimensions
Manhole/Access (YM)
"Pump Off" Level at
. Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect
on the date of this inspection. °
Signed Date
Company &--55E �� /�e7r S MOA No.
Cho oc ce uo
a' S . .
°.n nGoO°Onop °Bocucoce acacc
KB1/d5/s jn
�o Dale R. Merrell
® Coe
(Page 2 of 21
Z,hS a
2-15-84
�> 'C�
F'3 C� o
31,2a"00.
b
61 m
Me roll
un 01�`O No. 2055-12
Location:
BESSE/ EPPS & POTTS
2220 FAST 88 AVENUE
ANCHORAGE, AK 99507
( 907) 349--6451
WATER WELL TEST
Date:^!/ J 7. 9!
Subdivision: :�*1 mg 1411.4c Csf?i
Lot: ( __
Block: Z
Client's Name: 5o4 m 14 (L. t..
Address:
Tester: W. H,
Initial Reading an Meter: 7y/"1
TIME
GPM
GALLONS
16 VOLUME
GALLONS
TOTAL VOLUME
/b: 0'7
--
—1
:1
10'.1s
_-[
6
f o : o
_ 6-
L?
J
'z>
7 Z
NOTES: At 5/044. .U60yea 3� UleM3
Production Rate: (3,5 GPM 24 -Hour Capacity -- Gallons
CHEMICAL, & G.f LOGICAL LABORATORIES F ALASKA, INC.
TELEPHONE (907) 562.2343 ANCHORAGE INDUSTRIAL CENTER
,w �roRe� 5633 B Street
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM: ET—EI -] (") See h on back
I.D. NO.
wa.7yatem Name Phone No.
/G
Mailing Address
City state zip code
SAMPLE DATE:
Mo. Day Year
SAMPLE TYPE:
04outine
❑ Check Sample (for routine sample ❑Treated Water
with lab ref. no. —1 ❑ Untreated Water
❑ Special Purpose
SAMPLE Time Collected
NO. LOCATION Collected B
2
3
4
5
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
Satisfactory
❑ 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.
Date Received ) - I% " g c�
Time Received /C>00
Analytical Method:
❑ Fermentation Tube
❑ Membrane Filter
Lab Ref. No. Result' Analyst
L _ J
L --J m
I I m
•No. of colonies/ 100 ml or No of Positive portions
0e1220(b) BACTERIOLOGICAL WATER ANALYSIS RECORD
Rev. 1983
READ INSTRUCTIONS Membrane Filter. Direct Count
Verification: LTB_ _BGB
Final Membrane Filter Results /
BEFORE —
Reported By -� Date
Time:
COLLECTING SAMPLE TNTC a Too Numerous To Count
CoIIIorrnitOOrnI
COIIIarmlI00rnI
a.m.
p.m.