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FOREST VIEW HEIGHTS LT 12
oPe t View Heights Lots 9 thru #014-141-19 Municipality of Anchorage Page · 1 of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Bo,~ 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well ~nspection Report Permit Number:. SW980346 Carol Epton 3605 Arctic Blvd. #1452 Seven (7) 344-8484 LEGAL DESCRIPTION - Forest View Hts. WELL: Number:. 01 4-1 41 -1 9 Wastewater System: [] New ~Upgrade ABSORPTION FIELD Yie~c: ]{D{Deep Trench t'l $1~allow Trench [] Bea t~ Moun" ~ Other 1.2 GP!D/So. To~al DeDU~ from originel graae: 14' 5.5' ~,. 8.5 Gra-,,~ lengm: 56 Existing ~t. ~t. 952 ~c.¢~.IASTM D3034 PVC ~L Acreage Svst~ 9/22/98 GPM FL FL Well SEPARATION D I STAN CES N/A N/A Sudace Water >100't N/A N/A >100' I N/A N/A > 10 ' N/A N/A >10' I N/A N/A on Lo~ To S4o~c ~. >100'J >100 >5' None TANK Remarks: ~i, Sel3tio [] Holding t-1 $.T.F_P. Manufac~ure~ t Ca, achy m gaJIon3: Anch, T~nk I 2r000 MaIe~: J Num~ Of Steel I TWn f2 1 LI~ STATION ' N/A Lot N / A :$~ze ,n gallons: Manutacturer. Line Founaauon N / A 'Pump on" I~el a: 'Pump o~ l~el a: High ~tmr ala~ a: Cu~ain P~o Maxe & M~e ~ ~1 l~D~ons ~O~ b~ D~n I BENCH MARK Existing Septic Tank and Absorption Crib Crushed, Backfilled and Abandoned on Site. Concrete Pad Southwest End of House. Inspections performed by: MEA Dates: 1st 9/22/98 2~d. 9/22/98 Department of Health and Human Services approval Reviewed and approved by: d.4/'///~,~// ~/. ]~ Date:/¢-;:2. q- v/ ,_/// ->" - _ . Municipality of Anchorage Page 2 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, AK 99519-6650 - 343-4744 On-Site Wastewater Disposal System or Well Inspection Report Permit Number SW980346 PID No. 014-141-19 Driveway TBM 100.0 C5 8' M1 C2 43.7 6~.3 C3 43.6 62.8 C4 72.8 99.1 C5 56.3 59.8 S1 27.6 55.5 S2 38.7 60.0 M1 56.3 99.0 Seven Bedroom H me C1 Sl S2 C2 C3 2/000 Gallon Septic Tank oC.4 56' Long X 3' Wide X 8' Effective Depth Absorption Trench Parking Area Driveway Property Line NOTE: Existing Septic Tank and AbsorptiQ4~. Were Crushed, Backfilled and PLAN A~:BUILT ,~_ _--~'~ ~.~ Municipality of Anchorage Page 3 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, AK 99519-6650 343-4744 On-Site Wastewater Disposal System or Well Inspection Report Permit Number SW980346 PID No. 014-141-19 Septic Tank EN lS (10/781 Natural Backfill Drainfield \" Rock ~ ~*~'. PROFILE AS BUILT i, ~.~~ ...... /~'~'. MIlL E. ANDERSO~ '~ SCALE 1" = 10' '~ ~81-E .~? MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 PO. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Sap 11, 1998 Expiration Date: Sap 11, 1999 Permit Number: SW980346 Legal Description: FOREST VIEW HEIGHTS LT 12 Design Engineer: 0014 Anderson Engineering Owner Name: Carol Epton Owner Address: 3605 Arctic Blvd. #1452 Anchorage, AK 99503-5789 Parcel ID: 014-141-19 Site Address: 007349 LEWIS PL Lot Size: 8015 SQ. FT. Total Bedrooms: 7 Permit Bedrooms: 7 This permit is for the construction of: [~,"~ Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well ~ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. Received By: Date: ANDERSON ENGII September 7, 1998 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lots 9 through 12, Forest View Heights Subdivision Septic System Design Impacts to Adjacent Properties Dear Onsite Services Engineer: The absorption pit on Lots 9 through 12, Forest View Heights Subdivision has failed and must be replaced. We therefore request a permit to construct a new absorption trench to serve the seven bedroom home on the lot. The attached site plan and backup documentation identify the size and location of the new septic system designed to serve the house. The plan also shows the existing well on the lot and the 100' protective radius. The existing septic tank and absorption pit will be crushed, backfilled and abandoned on site. The new absorption trench will be constructed more than 40' away from the existing pit in the area currently serving as the driveway. The driveway will be abandoned and replaced with a landscaped lawn and garden area. Access to the house will be provided from the northwest along the existing right of way. A new driveway will be constructed as part of this project. In addition, the slope to the south of the new trench is currently being flattened to a 6:1 slope or flatter. A testhole was placed on the lot at the location shown. Well graded gravel with sand was found to the 18' depth and was underlain by a shallow layer of silt. The material in this area is consistent throughout as noted by the material currently being used to flatten the slope to the south. This material percolated at a rate of 2 minutes per inch. No groundwater was encountered nor was any measured during the monitoring period. We are therefore proposing to construct anew 55' long X3' wide X8' effective depth absorption trench. The distribution piping will be placed at 3' below the original ground surface. Total depth of the system will be 11' below Lots 7 - 12, Forest View Heights September 7, 1998 Page Two the original ground surface. The surface of the lot is flat with very little slope in either direction. The trench will be constructed a minimum of 10' from all lot lines. If the system is constructed as designed the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. ~.~?~,,~,~i~' ¢,'~,,¢,I: ' '~ .... ~' '~ ~ "~ Attachments ~.~: ~.~ MEMORANDUM DATE: September 8, 1998 TO: Dan Roth FROM: Mike Anderson, P,E. ~q/l ~(~ SUBJECT: Lots 9-12, Forest View Heights Septic System Upgrade Permit We are reapplying for a permit to upgrade the septic system on the subject lots, Several changes have been made since the original design was submitted for review. The slope to the south of the property has been flattened to a 6:1 grade which allows more usable m'ea on the property for a new absorption trench, A testhole placed in the area of the proposed trench revealed well graded gravel with sand which percolated at a rate of 2 minutes per inch. This material can be easily seen in the material used to flatten the slope, The owners of the property have decided to close the driveway and parking ama which will be used for the new absorption trench. Once the trench is in place the surface will be recontoured, topsoiled, landscaped and turned into a lawn and garden area. Access to their garage will then come from the northwest via the dedicated right of way, A new driveway will be constructed as part of this project. ~mcc can bo mci with the absorption trench il:ed site plan, We Ihcrcforc request a permit be ic syslem Io serve this properly. Vacant Vaca THIS PROJECT --~ ~'-----'~ ~/?~ City Water [ o AREA MAP SCALE ~" = 50' U.I 0 n" .f SPRUCE ROAD Proposed driveway access Seven Bedroom Home 55' Long X 3' Wide X 8' Effective Depth Trench Existing 1,250/o~ ~ New 2,~00 Gallon Septic Tank ~o/ ~ ~ Septic Tank Minimum 10' Separation From Slope in This Area Currently Being Flattened to 6:1. SYSTEM PLAN SCALE 1" = 20' LOTS 9 - 12 FOREST VIEW HEIGHTS DESIGN FACTORS: Seven Bedroom Home Perc, Rate: 2 Min./Inch Application Rate: 1,2 GPD/SF SYSTEM REQUIREMENTS: Deep Trench System 2,000 Gallon Septic Tank 8' Drainfield Rock 7 Bedrooms X 150 GPD / 1.2 GPD/SF = 875 SF of Absorption Area 875 SF/16 SF/ LF of Trench = 55 LF Trench Length Therefore: Construct a Deep Absorption Trench System With One Laterals 55' in Length with 8' of Drainfield Rock Beneath the Lateral. Distribution Pipe in Trench Placed at 3' Below the Original Ground Surface. 1! Natural Backfill Geotextile Fabric 4" Perforated PVC (Slots Down) )rainfield Rock NOTE: I 3' I TYPICAL DEEP TRENCH SECTION ~.~.~" ~ °~ (NO SCALE) ~ ~,,'° Grade Area Over Trench to Drain Awa?. ~; '" " '"~ Maintain ~0' Separation From Cot PERFORMED FOR; MunicipaF~' of Anchorage DEPARTMENT OF HEAL.TH & HUMAN SERVICES 825 'L" Street, Anchorage, Alaska 99502-0F~50 SOILS LOG -- PERCOLATION TEST LEGAL DE.qCRIP"FION: ~1"~' ~',- ~ Township, Range, Section: 1 6 9 I1 12 14 15 16- 17 I8 · ~ L. 19 ill ,I I I WA3 GROUND WATER ENCOUNTERED? IF YES, AT WHAT ~ L E I I'1 PE]:ICOLATION RATE ~" {rrunutes,/mcn) PERC HOLE DIAMETER TEST ~U. a~V~.~ ~ m AND ~ /"' ~' ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELJNE.S IN EFFECT ON THJ$ DATF_ DA'['~: ' . g/.~/~ ,(,;/-, IN ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOTS 9 - 12, FOREST VIEW HEIGHTS SUBDIVISION GENERAL: 1. The scope of this project includes the demolition of the existing 1,250 gallon septic tank and absorption crib. It also includes the placement of a new 2,000 gallon septic tank and the construction of a new 55' long X 3' wide X 8' effective depth absorption trench at the location shown on the site plan. The distribution piping in the trench must be placed at 3' below the original ground surface. Total depth of the trenches will be 11' from the original ground surface. The slope immediately to the south of the new trench must be flattened to 6:1 or less prior to placing the trench in service. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION A new 2,000 gallon septic tank must be procured from an approved source and installed outside the 100' protective radius from the existing well. Lots 9-12, Forest View Heights Subdivision September 7, 1998 Page Two 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop alevel bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2'1 of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. Lots 9-12, Forest View Heights Subdivision September 7, 1998 Page Three 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). Lots 9-12, Forest View Heights Subdivision September 7, 1998 Page Four 5. A permeable geotextile fabric (Typar, Mirafi or equal)must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: A minimum of two inspections are required by Municipal Ordinance. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as-built of the completed system. GR TER ANCHORAGE AREA BOROI.' q D~..,~RTMENT OF ENVIRONMENTAL 0. UALI 3§00 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME_ LOCATION SEPTIC TANK: z NUMBER OF DISTANCE FROM WELL ~,**~'~A'*')-J''' /'~'~" MATERIAL ,.j'--~'-.~__~b..- COMPARTMENTS ~ ~¢7~/~c ~- ~-r~r~/- ~- ~ /~L:~ LIQUID LIQUID CAPACITY /~--L.L/ GALLONS INSIDE LENGTH~ ~ INSIDE WIDTH ~ DEPTH SEEPAGE SYSTEM: SEEPAGE Pi]; NUMBER OF PITS__ / OUTSIDE DIAMETER ~ OR WIDTH '"'~___z~/' , LENGTH , DEPTH LINING MATERIAl ~"/~'~"'"~ -- ~ ~ ~: ' DISTANCE FROM WEL[~)~ /~/ / , BUILDING FOUNDATION NEAREST LOT LiNE ~ L) / ~/~ ..... [OTAI EFFECTIVE ABSORPTION AREA (WALL AR[A) SQ. FL. TILE DRAIN FIELD: DISTANCE FROM WELL ......--.zZ~'O~NDATION__ NUMBER OF LINES /DISTANCE BETWEEN LINES__ ABSORPT~t~ARFA __ SQ. Fl. LENGTH OF EACH LiNE DEPTH: TOP OF fiLE TO FINISH GRADE_ 1OTAL LENGTH , NEAREST I Ol LINE~'"~ , OF LINES 1RENCH WIDTH / IN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENFAIH TILE IN. ABOVE TILE WELL: LOT LINE , DISTANCE FROM WATER TYPE ,~:~,,,,(_/z~-'~' , DEPTH ~'~ ~'~ , BUILDING FOUNDATION ~_~ _SAMPLE ~: , NEAREST NEARESI SEPTIC ~//~ ~-' SEEPAGE ~-~-t. (~~)OTHER /'/-' / ~ , SEWER LINE ~ ,TANK /~ , SYSfFM_ ~"~'~ ' , CESSPOOL ~ , SOURCES~ DISTANCES: DIAG RAM"OF SYSTEM DATE APPROVED GrEal'Er ANCHORAGE AREA BONdUgH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT BOIL TEST RESULTS COMPLETION DATE ANTICIPATED PHONE NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION, MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION tO SEEPAGE PIT , DRAIN FIELD SEPTIC TANK TO seePAGe PIT WALL SEPTIC TANK , SEEPAGE PIT ~, DRAIN FIELD tO NEAREST LOT LINE. WELL TO SEPTIC TANK ~'~ SEEPAGE PIT DRAIN F]eLD ~ ALSO CONS[DER AREA WELLS. WATER MAIN TO SEPTIC Tank /L~ , SEEPAGE Pit DRAIN FIELD . GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH /~LrU T~lO R ITY OR LICENSED DESIGNER SEEPAGE AREA SIZE TYPe ~J~ DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 2B-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.~~~ ~/~/2~~ DATE APPLICANT'S SIGNATURE R&M ENG, .EERING & GEOLOGIC, . CONSULTANTS 229 EAST 51st. AVE, - P.O, BOX 6087 - ANCHORAGE, ALASKA 99503 TELEPHONE 907--279--0483 TELEX 090-35419 Civil Engineers Geologists Land Surveyors JAMES W. ROONEY, P. E. MALCOLM A. MENZIES, P.E., L.S. JAMES H. WELLMAN, P.E. June 9, 1972 R & M No. 26524 RALPH R. MIGLIACCIO Engineering Geologist Mr. Edward Saulnier P. O. Box 4-500 Spenard, Alaska 99509 RE: Test Hole and Soil Log Report for Sanitary System Lots 11 and 12, Forest View Heights Subdivision Dear Mr. Saulnier: We are submitting herewith the test boring results and our comments regarding soil conditions encountered at the subject site. This investi- gation was performed in accordance with your request of June 9, 1972, and those procedures outlined in a letter dated September 13, 1971, by Mr. Roll Stricldand of the Greater Anchorage Area Borough Department of Environmental Quality. A single test hole was put down within the Lot 11 area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Excavation was accomplished with a tractor-mounted backhoe and the test hole was extended to a total depth of 12 feet below ground surface. One sample was recovered from the bottom of the test hole and retained for grain size analysis. The sample will be held in storage, up to approximately one month, for possible testing before it is discarded. The final log prepared for the test hole has been included in Drawing A-01. Ground water was not encountered in the test hole. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & M ENGINEERING & GEOLOGICAL CONSULTANTS ~// James W. Rooney ~' JWR: wb Enclosure cc: Greater Anchorage Area Borough ANCHORAGE FAIRBANKS JUNEAU T,H.-I 6-9-72 0.01 SANDY GRAVEL (SW) Grey SILT SOME SAND '(ML) Grey ~ dense SANDY GRAVEL (SW) Grey Grey~ dense SANDY GRAVEL (SW) Grey SILT SOME SAND Grey ~ dense SANDY GRAVEL (SW) Grey )~ / 2.0' ~ ? ~ 7.51 No water table Note: Hole ,excavation with tractor mounted backhoe, Engineering ~ Geological Consultants A N CHORAOIE FAIRBANKS ALASKA JUNEAU DATE 6-9-72 J$CALE I" : 2' IDWN BY (]AW Edward Saulnier Property LOG OF TEST BORING Anchorage Alaska lCHKD BY WED IPROJ. NO. 26524 JDwe NO. A-01 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 FOR A OF 0N-SITE SYSTEHS APPROVAL SINGLE FAHILY DWELLING Parcel I.D. 014-141-19 1. GENERAL INFORMATION Expiration Date: Complete legal description FOREST VIEW HEIGHTS S//D; LOTS 9-12 Location (site address) 7348 SPRUCE STREET * ANCHORAGE, AK * 99507 Current Property owner(s) FORECLOSURE Day phone Mailing address Lending agency Day phone Mailing address Real Estate Agent TAMMY GILLS W/ DYNAMIC Day phone Mailing address 3111 C STREET * ANCHORAGE, AK * 99503 C/O AGENT 727-8115 Unless otherwise requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: 7 3. TYPE OF WATERSUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well · Individual On-site · Individual Water Storage [] Individual Holding tank [] Community Class Well [] Community On-site [] Public Water System [] 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, 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. Phone 337-6179 Address ,3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 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. DSD SIGNATURE ~,// Approved for Disapproved. bedrooms. Conditional approval for WATER AND ' m: ~ [ WASTEWATER . -: with the following stipulation~,.,,,'"'°'oo PROGRAM .o.. ~ bedrooms, Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory By: (Rev. 11/0~ Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: B= Municipality of Ancho'rage DevelOpment ServiCes Department Building Safety Division On-Site Water & Wastewater Program 4'700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni, org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Legal Description: FOREST VIEW HEIGHTS S/D; LOTS 9-12 *PER WELL INFORMATION DOCUMENT (DATED 4/7/1979) IfA, B, or C provide PWSID# N/A Sanitary seal (Y/N) YES Cased to *40 ft. WELL DATA Well type PRIVATE Date completed UNKNOWN Total depth ,1 10 .ff. Date of test Static water level Well production FROM WELL LOG g.p.m. WATER SAMPLE RESULTS: CHECKLIST Parcel ID: 0 I ~ - [/'7///- / C~ FROM W.E.L.T.S. DATABASE. SEE A'I'rACHED. Well Log (Y/N) NO Wires properly protected (Y/N) YES Casing height (above ground) 24+ in. AT INSPECTION 8/,'50/2010 57 ft. Coliform 0 colonies/lO0 mi. Arsenic: ND ug./L. 2.68 g.p.m. Nitrate ND mg./L. Other bacteria __ Date of sample: 8/31/2010 Collected by: 0 colonies/1 O0 .mi. GEG Ltd. SEPTIC/HOLDING TANIK DATA Tank Type/Material SEPTIC/STEEL Date installed 9/22/1998 Cleanouts (Y/N) YES High water alarm' (Y/N) N/A MCDONALDS PUMPING .Number of Compartments 2 Depression over tank (Y/N) NO Pumper ~'BELOW EXISTING GRADEI Absorption rate >= System type TRENCH Gravel below pipe 8.5 ft. Depression over field NO For 7 bedrooms New depth DRY in. 1050+ g.p.d. If yes, give date - Tank size 2000 gal. Foundation cleanout (Y/N) YES - Date of pumping 8/30/2010 C. ABSORPTION FIELD DATA Date installed 9/22/1998 Soil rating ~or ft2/bdrm) 1.2 Length 56 ft. Width 5 ft. Total depth '11 .~3 ft. Eft. absorption area 952 ft2 Monitoring tube YES Date of adequacy test *'8/31/2010 Results(Pass/Fail) PASS Fluid depth in absorption field before test DRY in, Water added 1150gal. Elapsed Time: - min. Final fluid depth DRY in. Any rejuvenation treatment (past 12 mo.) (Y/N &.type) NONE KNOWN NOTE: HOUSE WAS VACANT PRIOR TO TEST. DRAINFIELD WAS PRE-SOAKED WITH 2000 GALLONS PRIOR TO TEST. LIFT STATION Date installed "Pump on" level at.__ in. Size in gallo;ns Manhole/Access (Y/.~ ~ "Pump off" level.~~. High water alarm level at. in. E. SEPARATION DISTANCES Cycles tested Meets alarm & circuit requirements~ SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main 75'+ Sewer/septic service line 25'+ Animal containment areas~ 50'+ 100'+ On adjacent lots 100'+ On 'adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water main 10'+ Water service line. 10'+ Wells on adjacent lots 100'+ Absorption field 5'+ Surface water. 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line * 10,+ Building foundation 10'+ Water service line 10'+ Surface water 100'+ Curtain drain NONE :KNOWN Wells on adjacent lots. 100'+ Water main 1 O'-I- Driveway, Parking/vehicle storage 10'+ F. COMMENTS *PER INSPECTION REPORT. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date COSA Fee $ I~ ~ 0 Date of Payment ~/~,0//0 Receipt Number {~) ~'~{:~)~ (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Well Information - loq not available (complete this form after searching WELTS and other sources for the missing log) Date: ,~ /, -~ / ~ ~ LAS This information obtained from: ~ Data supplied by: Well location: Well depth: !\ (~- Property description: Type of well: Static water level: Diameter of well: .... , Cased? Y / N, Remarks: Screened? Y / N Location map (sketch): ~ I09 ~ ~ ~LO9 ~L:~/P. 0 fAF-sDs ~1~! ~ E O FLCOR EL:~. OrA% ~3~ I N G CO~NER ZONING DISTRICT FRONT BUILDING SETBACI( SIDE BUILDING S--TBACK REAR BUILDING .~iETBACK LOT 1 `3 LOT 8 133.58 S89' 58' 30"E 1.33.58 1 '5.4 74.0 60 bURAVEL' ~ELL {;0.00 [:RIVEWA' "34.¢)XISTING STRUCTURE34.( IO'IO'i'I!LIIT JEIS~_ASE. LEWIS PLA(:~_-19.3 _ I'll 74.0 IIIh~A~//~//.~/////~m,r~----~__________ SPRUCE ',;TREE NO0' 08' nn"w ~ _ soo' c8' G I ~AV~-~ '~'"'0 I 60. ~0 ~J~O.O0 GRAVEL 30' ~ . ~4.~..~_ · ---~l~q: ~' -~O"W 133.58 -5' PUBLIC WALKWAY- 1'S.4 74.0 60 '(,,,-/~)PAVEL ~/ELL ~ RIVEWA' "~'P'XIb/INLf STRUCTURE54.( IO'IU~IILIIT LII~SEASE. LEWIS PLAC ~_-19.3 _ 74.0 NO0' 08' nn"w ~ _ / SOO' C Gl ~AV~.I,~ DR VEWI 60. 30 (~ GRAVEL r DRIVEW~ Y~~-~- ~ `30' k ' 1,',.5..5;4_ · -~-'R['R~q' ~a' -~O"W 133.58 , UNDER NO CIRCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. -HE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ~~ LIABILITY ONLY FOR THE COST OF THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. [] LOT SURVEY SURVEY TYPE SYMBOLS [] FOUNDATION AS-BUILT S EXl TtlPCA3P SE [] FINAL STRUCTURE AS-BUILT ° ET REBAR ~ ~ BRAINAGE ~ ASPHALT [] PLOT PLAN · . o AS-BUILT . . . LOT SURVEY . . . TOPOGRAPH o~ FOUND REBAR %~, ..' WOOD FENCE ~ CONCRETE [] AS-BUILT . . NO COF[~EI~C~IFICATION AS-BUILT . . . NOC~sA~jMED ELEVx X X METAL FENCE ~ WOOD DECl PLOT PLANS & LOT SURVEYS NOTE: IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. SURVEY CERTIFICATION ~~,,,~ Prepared by 'LOT PLAN -~¢ T E · A L ^~. Robert E~ Johns, Jr. & Assoc. / hereby certify that i hqve p,hysic.,l~l~-A~ur, v,~(~ ........ ~he 16f drqwn an~ aCs/znee~ ,, ner~-b-lan~-tTfdt i % K ~'~, Professional Land Surveyors nave fOUnd or estanusnea ( /i o,t,~h~ I.¢: c. orners A '. A ~'~ ps shown on the, pj-dn an/;l ~o ~i~e. oe.~t, of mY .~/L % ~ ~'a 842 E. 12 AVE. Knowl~due and aDifiues, a,, ]~o~s nave been~.,~' : ~L~'.. ANCHORAGE, ALASKA 99501 measured true anU' correct. _-- ~-: ~,~\ o ~. : 49th ~'~ ~ ~ Scale: ~ Rec. Lot S.F. Rec. Plat File Nc )UNDATION AS-BUILT ...: .......................... -._......., I ~ ~- h Robert. E. Johns, ,Jr., .ber, b,i~irCv~rtifyf'that , ............... pave o.erformea an ^s-I~uilt me 9/8/10 Checked fpundfibon on-~hjs, lot-qiga ~h~..~t~/..~°~ ..................................... I~ Date Surveyed: Drawn by: SWL bY:REJ a,me~as,ons ona,mormat,on a~S~6x~l~sn are true and.no encroacnm.~F E. dOHNS, dR.~ r shown otlfierwlse. ~ : .." o~ Date Drawn: 9/8/10 Grid: SW2134 W.O. 1264 IAL STRUCTURE AS-BUILT ~'~;gs:,> "'. 4121 S .... veY~ b c ~f~ t ~ I ...' %_%r~ Legal Description: ,, Robert. E. Johns, Jr., ~be.,q~~u I~Y~l~L.dU~ nnve nerformea an As--uUH~ i and FOREST ~Fruct~Fe on ~Eis. 'l~t an~t VIEW HEIGHTS a~meDs~ons gna information a snow er · al L are true and no encroacnm ;hSts e>~l~,~le_ ssion_aJ.~..~¢ LOTS 9.10.11&12 shown otherwise. Municipality of Anchorage Development Services Department Building Safety Dlvlslon On-Site Water & Wastewater Program 4700 sauth Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchomge.ak.us CERTIFICATE OF HEALTH AUTHORITY ,/~PPROVAL FOR A SINGLE FAHILY DWELLING Pa=ll.D. o14- 41- 9 1. GENE~ INFO~ON ~lmfion Date: Complete legal description FOREST VIEW HEIGHTS SUBDMSION; LOTS 9-12, * Location (site address or dirsctions) 7348 SPRUCE STREET * ANCHOARAGE, AK 99507 Current Property owner(s) Mailing address · Lending agencY CAROL EPTON Day phone 344-8484 7348 SPRUCE STREET * ANCHORAGE, AK 99507 Day phone Mailing address Real Estate Agent Mailing address BRIAN BRODERICK w/ PRUDENTIAL VISTA Day phone. 4241 "B' STREET * ANCHORAGE, AK 99505 273-7261 Unless otherwise requested, HAA wfll be held by DSD for pickup. 2. NUMBEROF BEDROOMS: 7 3. TYPE OFWATER SUPPLY: Individual Well E~ 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 Deparlment (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an Independent professional civil engineer registered In the State of AJaska. Certificates of Health Authority Approval are required for the transfer cf flue (except between spouses) for properties served by a single family on-site wastewater disposal andJor water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date cf issue for properties served by a private or Class C well and may be reissued with newwater sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells er a public water system. The Municipality of Anchorage is not responsible for eh'Ors or omissions In the professional engineer's work. Note: Alaska Water and Wastswater Consultants,/nc. shall be paid $1000.00 at, or prf~r to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As cer~'fied by my seal affixed hereto and as of the validallon date shown below, I verify that my invesllgallon, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastawator disposal system is(are) safe, functional and adequate for the number of bedrooms and type of s~uctum Indicated herein. I further ye#fy that based on the Information obtained from the Munidpallly of Anchorage files and from my Investigation and inspecffon, the on-site water supply and/or wastawater disposal system Is(are) In compliance v/~b all applicable Municipal and State codes, ordlnancee, and regulations In effect at the time of installation. Name of Firm , ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Address 6901 DEBARR ROAD. SUITE 2B * ANCHORAGE, AK 99504 Englnee?s Printed Name JEFFREY A. CARNESS. P.E. Phone 337-6179 Date Engineer's Comments: In co. duc#rig ~1~ evalua#oe, AI4/WC, Inc. affempted to provue a ff~rough, consdenffous englneedng analys/s of the wstern ln accordance wi~h ADEC end MOA DSD Guidelines & Regulaffons. The repor~ results desc~bed the pedorrnance of the system under E~e condiffo~s encountemd at the fme of the tost, and sepa/affon operat~o~E requlreme~ of ~ ADEC ~ MOA DSD. The coete~t of ff~la report ls for DSD SIGNATURE J~ . Appmvedfor Disapproved. "7 bedrooms. Conditional approval for __ bedrooms, with the fllowtng stipulations: Atlachments: HAA Checldist Septic System Adviso~ ' Well FlowAdvlsory Manltenance Agreements . Supplemenlal Engineer's Reort . Other Original Certificate Date: c~. ~.. O ! Municipality of Anchorage Development Services Department 8u~lnO S~;a~ ~ Or-r~te Water & Wastewater P~gram 4700 8oulh Bmgaw SL Legal Descdplk~: A, WELL DATA Weft type PRIVA'I~ HEALTH AUTHORITY APPROVAL CHECKLIST FOREST VIEW HEIGHTS S/D; LOTS 9-12~ PamellD: 014-141-19 If A, B, or C provide F¥/SID~ we~ Log (Y/N) NO Total depth lO3+ ft. UNKNOWN Casedto 40+ ~ Dateoftest Stafie water level Well production WATER SAMPLE RESULTS: FROM WELL LOG N/A N/^ ~. N/A g.p,m. Oate of.ample: 8/22/01 B. SEPTIC/tlOLDING TANK DATA Tank Nze 20OO gal. Foundation cleanout (Y/N) ~S D~ of ~0 8/~ 8/Ol C. ABSORPTION FIELD DATA STEEL Number of Compm'allents 2 Oep _re~___dm over tank (Y;N) NO Pumper Date Installed g/22/~8 ,~11 rallng {~or ~/1xlrm) 1.2 Lenglh 56 It. ~ 3 It. AT INSPECTION 8/23/2oo~ 71 rc 2.9 g.p,m. YES 12+ Otherbectmta ~ colonle~/lOOmL AWWC~ INC. Datelnsta~ed 9/22/;8 Cie~m~s(Y~) ~s H~hwateralam~(y/N) ROTO ROu~ 11.8 ri;. E~.Bb~2~2tJmB,'~ g52 It* Total depth Date of adequacy test 8/23/01 Flulddepthlnabeoq~lontleldbefomtest o In. E]apeed Time: O min. Rnalfluld depth O Any reJuvenafien Imatment (past 12 mo.) (Y/N & t3~e) System type TRENCH Gravel below pipe 8.5 lt. Monl~ tube YES Oepresslon over field NO Results(Pas~Fall) PASS For 7 bedrooms Wateradded1522gal. ' Newdepth o In. In. Abeorption rate >= 1050 g.p.d. NONE KNOWN If yes, give date - D. LIFT STATION Pump on level at Irt. 'Pump n. High water alarm level at In. ~ Cycles tested Meets alan. & drcuti requlmmente? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WI:, I ON LOT TO: Se~o tenl~ift ste~n on lot 100'+ Ab~on tield on Int. 100'+ Public eswer m~n N/A 8ewer fesptio ~ewlce line 25'+ On adjacent lots 1 oo'+ On adjacent lots lOO'+ Public eswer manhols/desneut Holding tank N/A Pn~e~ line lO'+ Water esMce line 1 o'+ Curteln drain NONE KNOWN F. COMMENTS SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:. Bulidlng foundation 5'+ Properly line 5% Water main N/A Water esrvlce line 10'+ Wells o~ adjacent Iota 100'+ SEPARATION DISTANCE FROM ABSORPTION REM) ON LOT T~. Buliding foundation 1 o'+ Surface water 100'+ Wells on adjacent Ints, 10o'+ At~orp~on ~ld. 5'+ Surface water. 100'+ WEtel' mall1 N,/A Driveway. I~addngNehlcte ~omge 15'+ G. ENGINEER'S CERTIFICATION I cerfffy that I have determined through f/eld Inspections end review of Municipal rece~ls that the above systems em In conformance ~ MOA HAA guidelines In e~ect on this date. Englnesr'$ Printed ~ame JEFFREY A. GARNESS Date Date of Payment~ Recelpt Number 9'.~' ~'~' Waiver Fee $ Date of Payment Recelpt Number 09/04/01 12:23 FAX 9072737362 BRIAN-BROD£RICK ! ]43~ Hyder ~$]0N$ WO~X. OI~,D~R: DAT~' BY' · BOOK: GRJDNO-' ' .' 09/03/01 14:14 TX/RI N0.0542 P.O01 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. # ~"~IL~- ~-I\~ ~C~ HAA# ~;~c~('~°~L~ 1. GENERAL INFORMATION Completelegaldescription Lot 9~'10~11, ~12; Block I~ For~t Vim HP.J.q/~s Location (site address or directions) 7348 Spruce Street Property owner Mailing address Lending agency Mailing address Agent Carol Epton Address Neal Schlee P.O. Box 111694 Day phone 322-6677 Anchorage, AK 99511 Day phone Day phone 244-8306 e Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 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. TYPE OF WASTEWATER DISPOSAL: individual on-site Holding tank Community on-site Public sewer NOTE: XXX 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 #21 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 inves~t~ation 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. NameofFirm ~'~ Phone /'~/-/ A..,'ess , . . . , . . . . , //'/ 17034 Eagle River Loop Road No. 2~/~/ Engineer's signat~r~e R:':c.', ~!='.~.' ?~.577 . ///'J'' ----"- ~'~' Date . HS SIGNATURE . Approved for '~ ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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 order to satisfy certain federal and state requirements. Employees of DH HS 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. 724325 (Rev 1/91) Back MOA #21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: /-.-,~T-s ~ /0/ // o/.. /~. Fo,,~E'~7'- yl£-C.J ~/~ A. Well Data Well type Log present (Y~D~ Total depth '~'//(~" Sanitary seal. N) ~---~ FROM WELL LOG Parcel I.D. If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~/?'~//'a~ [ ~'~ :ADriller ~,~X2~ /~L_~- A./&Cc-/-.),'~'I/J.-.IA'-~ Cased to ~D/'/- Casing height / Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Wires properly protected ,~(~N) ~4E..~ Septic/holding tank on lot /CZ__..) ~ Absorption field on lot /~-~ ~ Public sewer main /,.A /,,J /~'- fo~ Sewer service line ~--~"{?~'~ g.p.m. 2: AT INSPECTION ~u O --~ ~o->o 7, ¢ g.p.m, o ~ ; On adjacent lots Public sewer manhole/cleanout /../'o.~Jc~- Petroleum tank /L)J/,-/L_~ }~'AJ~ c.,J/,,..J WATER SAMPLE RESULTS: Coliform / Date of sample: lZ/Z'~/~/~ Nitrate (~,]0 /~/~ Other bacteria ~_.)///.-'O ,'~'~... __ Collected by: B. SEPTI~ TANK DATA Date installed ~ J I-~l "~ ~-~ Tank size /~'-(_~ L..~ Compartments ;::~' Cleanouts(~N) F~,-~ Foundation cleanoutl~N)--~ y_,~ .~' Depression (YI~ /,,J,.3 High water alarm (Y~. /CJc, Alarm tested (Y/N) Date of pumping 7/Zo/~:3 Pumper A/u~or~ PARATION DISTANCES FROM SEPTIC/H~TANK TO: Well(s) on lot /(~..~ C/~ On adjacent lots To property line ~© r-A~ Absorption field Surface water/drainage /CO (-¢~- Foundation _~_ ' ~ ~- ~ Water main/service line /© "/-- 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION HO~L~ Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots---, D. ABSORPTION FIELD DATA Date installed ~__.~,///-~ / ? Length ~'~~ Width ~' Total absorption area ~'~ c'~' ~' Cleanout present~N) Date of adequacy test ~/Z..~/~ Results ./~. fail) Water level in absorption field before test ~"~ Peroxide treatment (past 12 months) (Y/N) Manufacturer Manhole/Access (Y/N) "Pump off" Level at Soil rating (GPD/Ft2) ,/,~-~-//'/~'/'~-- System type ~-f'~//~ Gravel thickness~/~ ' ~ Total depth /~ ~ Depression over field (Y/~ ~ ~ for ~/~ ~ Bedrooms After test ~ ~" If yes, give date ~/~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /~_.~ To building foundation On adjacent lots Sudace water / Curtain drain On adjacent lots /" ¢--~ ~ / Property line To existing or abandoned system on lot Cutbank ~oFJE J~-dJu~-cF- Water main/service line E. ENGINEER'S CERTIFICATION Driveway, parking/vehicle storage area Signature/Certifythat/havechecked''a~'/ved' r conformed to all MOA and HAA guidelines in effect on the date of this inspection. Engineer's U a~rl/'e~, .,&..~E_ _N G! N_E.ERING , /u.;,4 ~.~o ~ Loo~ ~o.~ Date F.,a'gle River. Alasl~ 99577' / Date of Payment ] - --~ · ~ Receipt Number .~..-~(~/ ?/~)-~ Waiver Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back MujtI-Famity in ~f~c~s ~ ' TM ~rJ~,~c, ;r~Dhy ~th? ~. ~NSU~TION j. ~0~A~L~ I ~OMPA~BLE NO, 2 ~O~PA~BLE NO, $ ' ~om~= ' 1 bn +2, Soo · ..... 2RVDO 1-4- INDIteD V~UE BY I~Mi AP~OLCH '~ t.,~ :-~'c) E~"'~?to~ kt~'ket ~c~' $ -: - Th, lO ~.a'~s~ i~ "~¢ ~ 'e~ i¢ ~ ....... ~, .~-~,-.; :'torY, b'5 '~ - i},",r'~ - .TZ., ,, _ -%- v~ ~¢, S RA AA ' 6 ~ .. ~t t"~':~', ,~;~,'1: ~f:% ................... ~' / e. r~¢ ~* BKIIZ__ b /b?G J t8 AGI~R~T FOR CREATION OF EASEM]~f~ TO SHARE WELL AGREEMENT made this // day of ~-~4. , 1994, by and between NEAL W. SCHLEE (hereinafter Grantor) of 7348 Spruce Street, Anchorage, Alaska and NEAL W. SCHLEE (hereinafter Grantee) of 7348 Spruce Street, Anchorage, Alaska. RECITALS The parties hereto are owners of adjacent property and desire to enter into an agreement for the creation of an easement as follows: S~"~ION ONE CONVEYANCE OF EASMMENT Grantors of Lot 9 FOREST VIEW HEIGHTS SUBDIVISION hereby grant and convey, an easement to Grantee of Lot 12 FOREST VIEW HEIGHTS SUBDIVISION plat #63-44, recorded in the Anchorage Recording District, Third Judicial District, State of Alaska, for the use of the existing water well, together with water service line and/or plumbing system on property owned by Grantor. SECTION TWO "USE OF WA'£~a~ WELL" DEFIN~ "Use of water well" as used herein means residential and customary usage. SMCTION TH~Rm. EXP~qSES TO BE SHARED The parties agree to share equally the costs and expenses of and for the above-described water well system maintenance, including the following: a. the energy supply for the well pump; b. repairs, testing, inspection and disinfection: c. system component replacement due to wear, obsolescence, incrustation or corrosion; d. system improvement to increase the service life of a material or component, to restore well yield, or to provide necessary system protection; e. repair costs for system damage caused by persons other than a resident or guest at a property sharing the well; and f. costs for abandoning all or any part of the shared system so that contamination of ground water or other hazards will be avoided. for the period commencing on the date of the execution of this easement and ending as set forth in this agreement. S~CTION ~ ADDITIONAL PROVISIONS 1. This agreement permits well water sampling and testing by a responsible local authority at any time at the request of any party. 2. Corrective measures shall be implemented if testing reveals a significant water quality deficiency, but only with the consent of all parties. Page Two 3. This agreement provides for continuity of water service to "supplied" parties if the "supplying" party has no further need for the shared well system. 4. This agreement prohibits well water usage by any party for other than bona fide domestic purposes. 5. This agreement prohibits connection of any additional living unit to the shared well system without: a) the consent of all parties, b) appropriate amendment of the agreement, and c) compliance with the following 4 items: 1) The well must be capable of providing a continuing supply of water to involved dwelling units so that each existing property simultaneously will be assured at least three gallons per minute over a continuous four-hour period; 2) The well must provide safe and potable water; 3) There must be a valve on each dwelling service line as it leaves the well so that water may be shut off to each served dwelling without interrupting service to other properties; 4) The well may serve no more than four living units or properties. 6. The parties may amend this agreement to assure equable readjustment of shared costs when there may be significant changes in well pump energy rates or the occupancy or use of an involved property. 7. No party may locate or relocate any element of an individual sewage disposal system within one hundred (100) feet of the shared well. 8. The parties shall provide adequate access and necessary working space for system operation, maintenance, replacement, improvement, inspection, and testing. 9. No party may install landscaping or improvements that will impair use of the easements. 10. Any removal and replacement of preexisting site improvements necessary for system operation, maintenance, replacement, improvement, inspection or testing, will be at the cost of their owner, except that costs to remove and replace con,non boundary fencing or walls shall be shared equally between or among parties. 11. Any party may act to correct an emergency situation in the absence on-site of the other parties. An emergency situation shall be defined as failure of any shared portion of the system to deliver water upon demand. 12. This agreement requires the consent of all parties upon cost sharing, except in emergency situations, before actions are taken for system maintenance or repairs. 13. Any necessary replacement or improvement of a system element(s) will at least restore original system performance. s O2575e6980 Page Three 14. No party shall be responsible for unilaterally incurred shared well debts of another party, except for correction of emergency situations. Emergency situation correction costs shall be equally shared. 15. Each party shall be responsible for: a) prompt repair of any detected leak in his water service line or plumbing system; b) repair costs to correct system damage caused by a resident or guest at his property; and c) necessary repair or replacement of the service line connecting the system to his dwelling. 16. This agreement assures prompt collection from all parties and prompt payment of system operation, maintenance, replacement, or improvement costs. 17. This recorded agreement may not be amended during the term of a Federally insured or guaranteed mortgage on any property served, except as provided in items 5 and 6 above. 18. In the event of any dispute or impasse between parties with regard to the system or terms of this agreement, the parties agree to binding arbitration. Binding arbitration shall be through the American Arbitration Association or a similar body and may be initiated at any time by any party to this agreement. Arbitration costs shall be equally shared by parties to this agreement. SECTION FIVE OONSIDERATIONS For and in consideration of this Easement, Grantees agree to pay to Grantors the sum of $1.00 per month, to be regulated and fluctuate with the Municipality of Anchorage Water Utility rate. For and in consideration of this Easement, future owners of Lots 9 and 12 FOREST VIEW SUBDIVISION may add to or discontinue this agreement with the consent of both parties. SECTION SIX EAS~T~ RUN ~LAND This grant of easement shall run with the land and shall be binding on and shall inure to the benefit of the parties hereto, their heirs, successors, or assigns. S~CTION SEV~ ~:qTIRE This agreement constitutes the entire agreement between the parties pertaining to the subject matter contained in it and supersedes all prior agreements, representations and understandings of the parties, except for those documents expressly mentioned or referred to in this agreement. No supplement or modification to this agreement shall be binding unless it is executed in writing by all parties. Page Four IN WITNESS THEREOF, the parties have executed this agreement on the day and year set forth below. N~i'~/ ScfiIee- STATE OF ALASKA ) ) THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this~Q of j~/. , 1994, before me, the undersigned Notary Public duly cor~nissioned and sworn, personally appeared Ne&l W. Schlee, known to me and to me known to be the person named in and who executed the foregoing; and he acknowledged to me that he signed the same freely and voluntarily for the uses therein stated. WITNESS my hand and offical seal. · " %, .' .......· ~:2,'% .:- _~, j...; ! '. .~ ",,4 ~, '~ ;'. P U B ~~ ..:.~, ~ .,.;" ':?~.' ":' ..",~:t: ' :'"i;" ' S & S Engineering 17034 North Eagle River Loop, Ste. 204 Eagle River, Alaska 99577 ska My commission expires: 'g'l Jf ,"l 11 PP1 3 03 KF 2575PS982 D~CLARATION OF EAS~T FOR SEPTIC SYST~ WHEREAS, Neal W. Schlee (hereinafter Schlee), is the owner in fee of lots 9, 10, 11 and 12, Forest View Heights Subdivision, according to the official plat thereof, filed under Plat Number 63-44, Records of the Anchorage Recording District, Third Judicial District, State of Alaska --- commonly known as: 7348 Spruce Street, Anchorage, Alaska 99507: and WH]~LEAS, there exists partially on Lot 11 a septic system and related apparatus owned by Schlee, which presently serves Lot 12; and WI~9(EAS, Schlee desires to assure the continuity of septic service to Lot 12. NOW, TH~C~E, Schlee declares and covenants as follows: 1. There is hereby established and reserved, for the benefit of Lot 12, Forest View Heights Subdivision, according to Plat 63-44, Records of the Anchorage Recording District, State of Alaska, an easement for the use and maintenance of the presently existing septic system which is located partially on Lot 11 and which services the property on Lot 12. 2. Said Lot 12 septic system is located on Lot 11. The within established easement is intended to provide reasonable access in, to, and around the presently existing system, as well as any portion thereof, which is located on Lot 11 and is serving Lot 12. The purpose of said easement is for the use and maintenance of any said septic system. 3. The said easement shall run with the land and shall be binding upon the owners of Lot 11, for so long as the Lot 11 septic system, or any necessary replacement thereof, is needed for the habitation of Lot 12. Ne~ W./~Schlee STATE OF ALASKA ) ) THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY than on this //~(~ day offS., 1994, before me, the undersigned Notary Public duly commissioned and sworn, personally appeared Nell W. Schlee, known to me and to me known to be the person named in and who executed the foregoing; and he acknowledged to me that he signed the same freely and voluntarily for the uses therein stated. ...'~ .%..,' ~,.~' '..,.~: ;; ,.,.: ,~ 4 ~,'?..' '". ', .; " [:' i~'G.-' %'~AE]'Y~'.'..,,.t ',;',Ci{','i',[,,,d ',Qo_O,~' for Alaska ,. ~. :.~, : ',,% ,,',,.,, , , :% com~.is~ion~ expires: " ........... ;:" '~'I J,,i'l 11 PFI 3 03 Return to: S & S Engineering 17034 North Eagle River Loo~Ste. 204 Eagle River, Alaska 99577