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PERMIT NUMBER:
OSP241122 RECORD D R OWI G PARCEL ID NUMBER:
017-342-04
LA F
ORIENTATION AND LOCATION
OF DRAINFIELD IS UNKNOWN
APPROXIMATE LC
SEPTIC VENT ON A[
i
EXISTING
3 -BEDROOM
HOUSE
-APPROXIMATE LOCATION OF EXISTING DRAINFIELD
ALL DRAINFIELD C/O'S AND BOTH MTS WERE JETTED
—NEW INFILTRATOR IM -1060
PLASTIC SEPTIC TANK
ITALLED DOUBLE
CLEANOUTS
(DBL1 R DBL2)
Av
GARNESS ENGINEERING GROUP, Ltd .4 -
ENGINEERING SALES CONSULTING �r
3701 EAST TUDOR ROAD SUITE 101 'ANCHORAGE. ALASKA' PHONE (907) 337-6179WEBSITE: m}w.gam sseronasring.c l•. ..• ••• ,
PREPARED FOR' PHONE NUMBER: PAGE NUMBER: * f� •• _ • . rey A.SSrtZf
DAVIS BALES 907-317-7743 2 OF 3 ''• C 795 " Z
PROJECT/LEGAL DESCRIPTION: DRAWN BY: ®�`� �� (`q®
LA FORET; LOT 4 J.L.M. }®®� p..........
FESS �®
TYPE OF WORK: DATE: LICENSE it FE � \
RECORD DRAWING OF SEPTIC TANK UPGRADE 8/20/2024 # LICENSE
A B C
17.5 17.2 -
51.2 34.7 66.0
57.7 40.4 70.8
E
58.7 42.2 72.8
58.7 42.8 73.6
NOTE: PIPE LOCATIONS ARE
SHOWN PER GEG SHOTS
TAKEN WITH LEICA DISTO
S910 LASER DISTANCE
f'
METER. SWING -TIES TO
ff
HOUSE CORNERS WERE
' I
GENERATED IN AUTOCAD.
5' LOT LINE
WAIVER
GRANTED
i�r
LA F
ORIENTATION AND LOCATION
OF DRAINFIELD IS UNKNOWN
APPROXIMATE LC
SEPTIC VENT ON A[
i
EXISTING
3 -BEDROOM
HOUSE
-APPROXIMATE LOCATION OF EXISTING DRAINFIELD
ALL DRAINFIELD C/O'S AND BOTH MTS WERE JETTED
—NEW INFILTRATOR IM -1060
PLASTIC SEPTIC TANK
ITALLED DOUBLE
CLEANOUTS
(DBL1 R DBL2)
Av
GARNESS ENGINEERING GROUP, Ltd .4 -
ENGINEERING SALES CONSULTING �r
3701 EAST TUDOR ROAD SUITE 101 'ANCHORAGE. ALASKA' PHONE (907) 337-6179WEBSITE: m}w.gam sseronasring.c l•. ..• ••• ,
PREPARED FOR' PHONE NUMBER: PAGE NUMBER: * f� •• _ • . rey A.SSrtZf
DAVIS BALES 907-317-7743 2 OF 3 ''• C 795 " Z
PROJECT/LEGAL DESCRIPTION: DRAWN BY: ®�`� �� (`q®
LA FORET; LOT 4 J.L.M. }®®� p..........
FESS �®
TYPE OF WORK: DATE: LICENSE it FE � \
RECORD DRAWING OF SEPTIC TANK UPGRADE 8/20/2024 # LICENSE
PERMIT NUMBER: PARCEL ID NUMBER:
OSP2411=22RECORD DRAWING 017-342-04
TOP OF MANHOLE
LID = 98.94
FINAL GRADE
= 97.96-98.59
ST1
TOP OF TANK @ PER CONTRACTOR,
INLET = 95.50 --\2" OF INSULATION OPO TANK @i
INSTALLED OVER TANK
�I
INVERT OF PIPE @
INLET = 94.90
1060 2 -COMPARTMENT INVERT OF PIPE @
INFILTRATOR SEPTIC TANK T OUTLET = 94.65
no
,.
4 #
GARNESS ENGINEERING GROUP, Ltd f
.......1 .. ...0
ENGINEERING SALES CONSULTING— ,�
3701 EAST TUDOR ROAD SUITE 101 'ANCHORAGE, ALASKA' PHONE (907) 337-6173' WEBSITE: wmw.games,arr0inaering.com ••• ••• {. ....:^r.E..................
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ♦ tom'- ( rey A. Garness Zb
DAVIS BALES 907-317-7743 3 OF 3 ®,P -� Cr -7153
PROJECT/LEGAL DESCRIPTION: DRAWN BY: II• (2
. a\
LA FORET; LOT 4 , ��•'' ..
J.L.M.. �� Fp p••�•.�....,•t•��
TYPE OF WORK: DATE: dii `pIUrETA lk�SSM�
RECORD DRAWING OF SEPTIC TANK UPGRADE 8/20/2024 �EcC68 IN III,
Sonja Blewett
From: Admin <info@aplusak.com>
Sent: Thursday, August 22, 2024 12:46 PM
To: Sonja Blewett
Cc: Jeff Garness
Subject: Re: Follow up on 13350 Ginpole Circle
Yes ma'am! I just double checked with my crew and he said they were jetted.
Best Regards,
Natalie Chisum
Manager
A+ Home Services
907-345-1890
www.apLusak.com
From: Sonja Blewett <Sonja@garnessengineering.com>
Sent: Thursday, August 22, 2024 12:11 PM
To: Admin <info@aplusak.com>
Cc: Jeff Garness <Jeff@garnessengineering.com>
Subject: RE: Follow up on 13350 Ginpole Circle
Were the lines jet cleaned? That is what we required. Thanks!
Sonja
From: Admin <info@aplusak.com>
Sent: Thursday, August 22, 2024 10:37 AM
To: Sonja Blewett <Sonja@garnessengineering.com>
Cc: Jeff Garness <Jeff@garnessenginee ring.com>
Subject: Re: Follow up on 13350 Ginpole Circle
Good morning,
Yes, the Co3 was repaired and debris was cleaned from the MT's.
Best Regards,
Natalie Chisum
Manager
A+ Home Services
907-345-1890
www.aptusak.com
I
From: Sonja Blewett <Sonja@garnessengineering.com>
Sent: Wednesday, August 21, 2024 2:46 PM
To: Admin <info@aplusak.com>
Cc: Jeff Garness <Jeff@garnessenginee ring.com>
Subject: Follow up on 13350 Ginpole Circle
Hello, per the permit, we need confirmation that Co3 was repaired and all lines/Mt's were jetted/cleaned. Thanks!
Sincerely,
Sonja Blewett
Corporate Secretary/Treasurer
Garness Engineering Group, Ltd.
3701 E. Tudor Road, Suite 101
Anchorage, Alaska 99507
Phone: (907) 337-6179
Fax: (907) 338-3246
Website: www.gamessengineering.com
GARNESS ENGINEERING GROUP, Ltd
ENGINEERIPM- SALES -CONSULTING - - - - - - - -
•®
delta xERxESO A .-.ma rnvtnw 5s�s.tmr i
reatment systems CORPORATION
Authoraed AW*a De tWot a
by INFILTRATOR
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road �.
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
hftp://www.muni.org/onsite
i)c-ps rtrtte��tt
On -Site Wastewater Disposal System Permit
Permit Number: OSP241122 Effective Date: 6/12/2024
Work Type: SepticTank Upgrade Expiration Date: 6/12/2025
Tax Code Number: 01734204000
Site Legal Address: LA FORET LT 4 G:2937
Site Mailing Address: 13350 GINPOLE CIR, Anchorage
Owner: BALES-OLSON REVOCABLE LIVING Lot Size in Sq Ft: 50760
Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 3
This permit is for the construction of:
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall 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 shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received By: ( 55 ' G, C_ - Date:
k
Issued By: t - Date: U (� �
r
ON -SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 017-342-04
Property owner(s) DAVIS BALES
Mailing address 13350 GINPOLE CIRCLE *ANCHORAGE, AK
Site address
Day phone 907-317-7743
Legal description (Sub'd., Block & Lot) LA FORET; LOT 4
Legal description (Township, Range & Section)
Lot Size - Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
Absorption Field Fj Initial El
Single Family (SF) Fx_j
Septic Tank Upgrade nx
(w/wo ADU)
Holding Tank ❑ Renewal ❑
Duplex (D) ❑
Privy El
Multiple Dwellings El
(SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
DRAINFIELD TO LOT LINE; AMENDMENT TO EXISTING WELL TO SEPTIC Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: Waiver Fees: 2
Date of Payment: 3 /20K Date of Payment:
Receipt Number: Receipt Number:
V
Permit No. U Waiver No.
11, -
GADevelopment ServicesTuilding Safety\On Site Water and Wastewatefforms\Client FormsTermit Application.doc
Municipality of Anchorage
P.O. Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 (907) 343-7904 Fax (907) 343-7997
Development Services Division
On -Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSV241020
PID#: 017-342-04
Legal Description: La Foret Lot 4
Engineer: Garness Engineering
Permit#: OSP241122
In 1985, the Department granted a waiver to 93.5' for the well on lot 4 to the septic system on lot 3.
Your request for a waiver of the required 100' horizontal separation from the absorption field to the
well has been approved. The amended separation distance is 90 feet. Water sample results from
May 2024 show that nitrates are non -detect and bacteria is negative in the water from the well on
lot 4.
Your request for a waiver of the required 10' horizontal separation from the absorption field to the
lot line has been approved. The approved separation distance is 5'. This waiver approval applies to
the existing absorption field. Any future upgrade to the on -site wastewater disposal system will
require all separation distances be met or another approval from this department.
Waiver is Granted: X
Date:
Waiver is not Granted:
Approved by:
Name of Reviewer
**** VARIANCEIWAIVER REVIEW ****
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241122, Curtis Townsend, 06/12/24
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241122, Curtis Townsend, 06/12/24
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241122, Curtis Townsend, 06/12/24
(SECLUDED HILLS
SUBDIVISION)
(BLANCO SUBDIVISION)
LOT
C G
J=7rltpj=h Inc
ORDERED BY: DAVIS BALES
GRAPHIC SCALE
1 25 50
1 " = 50'
250 H Street
Anchorage, Alaska 99501
Survey Department
Phone 562-5291
Mainline
Phone 243-8985
AECC 668
S89° 59' 54"E 330.50'
(SWENSON SUBDIVISION)
TRACT B
LEGAL DESCRIPTION:
LOT 4
LA FO RET LEGEND:
GINPOLE
�o
001
CIRCLE
TRACT A
AS -BUILT
DRAWN DATE: 05/17/2024
' WORK ORDER: 24016
CLEAN OUT
WATER WELL
POWER POLE
o
C
DRAVi N BY: ADS PLAT: 77- 1
CHECKED BY: GMG GRID: SW2937
UTILITY PEDISTAL
FENCE X
SCALE: 1 " = 50' FB/PG: 826/27-29
Concrete y
Brick
1Vood Deck
i
c� 0.4
a, • -
,.
Z.we
20. € ` 12.8
�<
I � EX�S iI�C HOUSE �'
�` '•
8.0
32.4` =�
SHED -
"RETAINING WALL
J�
HOUSE DETAIL
lit = 30'
NOTE:
1) THIS MORTGAGE LOCATION SURVEY (AS -BUILT) WAS PREPARED
FOR DAVIS BALES. IT SHOULD ONLY BE USED FOR A SINGLE
PROPERTY TR,-%NSACTION. RE -USE OF THIS DRAWING BY THE
ORIGINAL CLIENT OR BY OTHERS FOR ADDITIONAL USES LATER
WITHOUT THE EXPRESS WRITTEN CONSENT OF LCG LANTECH,
INC. IS A VIOLATION OF FEDERAL COPYRIGHT LAW. -
2) THE LIABILITY EXTENT OF LCG LANTECH, INC. SHALL BE
LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES
IN PREPARATION FOR THIS PRODUCT, UNLESS GROSS
NEGLIGENCE IS DISCOVERED.
3) THIS MORTGAGE LOCATION SURVEY (AS -BUILT) IS A
REPRESENTATION OF THE CONDITIONS THAT WERE FOUND AT
THE TIME THIS SURVEY WAS PERFORMED. THIS AS -BUILT DOES
NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO
ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY
MAY DISCLOSE.
4) THE INFORMATION CONTAINED ON THIS DRAWING SHOULD
NOT BE USED IN SUPPORT OF ANY NEW CONSTRUCTION.
5) THIS AS -BUILT ONLY SHOWS EASEMENTS THAT WERE ON THE
ORIGINAL PLAT. IT IS THE PROPERTY OWNER'S RESPONSIBILITY
TO DETERMINE IF THERE ARE OTHER EASEMENTS, COVENANTS,
RESTRICTIONS, OR RIGHT OF WAY TAKINGS OF RECORD NOT
SHOWN ON THE ORIGINAL PLAT. (D
ADDRESS: 13350 GINPOLE CIRCLE PARCEL #: 017-342-04-000
Received Date/Time 05/22/2024 13:30
05/22/2024 12:45Collected Date/Time
1242281001
Matrix
SGS Ref.#
Client Sample ID La Foret; Lot 4
Client Name
Project Name/#
Printed Date/Time 05/31/2024 17:05Garness Engineering Group, Ltd (GEG)
Technical Director Stephen C. Ede
La Foret; Lot 4
Drinking Water
Sample Remarks:
Parameter Results LOQ Units Method
Allowable
Limits
Prep
Date
Analysis
Date InitContainer ID
Metals by ICP/MS
ACF05/30/24EP200.8ug/LArsenic 05/28/24ND5.00 (<10)B
Waters Department
AJP05/24/24SM21 4500NO3-Fmg/LTotal Nitrate/Nitrite-N ND 0.200 (<10)C
Microbiology Laboratory
HGS05/22/24SM21 9223B100mLE. Coli Negative 1 A
HGS05/22/24SM21 9223B100mLTotal Coliform Negative 1 A
2 of 3
MUNICIPALITY OF ANCHORAGE
DE ,TMENT OF HEALTH AND HUMAN SER
Environmental Health Division () / -7 '~
825 "L" Street. Anchorage. Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Daois
Address
Phone~} Perm~[ No lNG Gl Bedrooms
LEGAL DESCRIPTION
"T' I ~ Al/
TANKS
DISTANCES
SEPTIC ABSORPTION
TANK EIELB WELL
WELL t o ~l / ROI
LOT LIN[! I ~ ~
FOUNDATION
/8
i_./30
AS-BUILT DIAGRAM ~Snow locatlor, Gl well, septic system, p¢operty hne$, Ioundahon.
~,~ SEPTIC
HOLDING
TYPE OF SYSTEM
[~] TRENCH ~'] BED ~ W. DRAIN ~ OTHER
Depth [o p~pe boROm irom ~ Total depth Irom original grade
original grade I ~, ~ FT ~ I ~.~ FT
FT ~, ~ FT
~'~i;~ Gravel WI(Rh
WELLS
[] PRIVATE [] OTHER (Identifv)
~$1~ll~l~lOf~ (A,B.C;j 7[ 7oral Depth Caseo to
FT FT
Instalh.,, LD~ITe ~;d
REMARKS:
Scale:
Inspections Performed by:
Cate
¢ //$/~' 7
,_ . ..~..~,,~,.~ ~,_ ~ __ ceriily that Ihis inscectio, was ,erl0rmad according to all
Municipal and Slate §ui[lelilles in ellecl on Ihis dale: _ ~/ /...e / ,¢' ~
Health Department Approval:
72 013 (3/85)
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
[] SOILS LOG
OF
ANCHORAGE
MUNICIPALITY OF ANCH(~i~I~LITY
'~r~T, OF HEALTH &
DEPARTMENT OF HEALTH AND ENVI RONMI~i~I~k~[~',,~I~T/~C~I:~I~STION~
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG -PERCOLATION TES~'~U~ ~ 6 1987
RECEIVED
DATE PERFORMED:
PERCOLATION
TEST
SLOPE SITE PLAN
MI.., DC, rt..ce C,-m)/ 5ilt
...c ? /.K ~ 5o.,-cF ,¢m~ g, It7
10
11
12
13
14
15
.16
17
18
I
WAS GROUND WATER S
ENCOUNTERED? N L
O
IF YES, AT WHAT g~ ~ E
DEPTH?
Net
Gross Net Dopth to Drop
Reading Date Time Time (f'tin) Water
~o to:o~ ~3 vt
19
20 '¢~,"~°°o CE- 3589 .-".~.~
~¢¢ %. .' ~COLATION RATE ~ (minutes/inch)
~ ~ ~ ~[0[e~ig~~ TEST RUN BETWEEN ~ FT AND ~ FT
COMMENTS
.ER~ORM.DBV: ¢[~f ~C4~;~.¢eCA~ C~T~DBV: ~ ~ ~ DAT~: ~/~/~7
72-008 (6/79)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
5
6
7
SLOPE
DATE PERFORMED:
SITE PLAN
10
11
12
13
14
15
16
17
18
19 'o THEODORE F, MOORE
CE - 3589
20 ",.......
COMMENTS
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT ~]~0
DEPTH?
PERFORMED BY:
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
(minutes/inch)
VT AND __ FT
TEST RUN BETWEEN
DATE:
72-008 (6/79)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
PERFORMED FOR:
DATE PERFORMED: ~'/' /~ /'~'7
LEGAL DESCRIPTION:
?~.
2
SLOPE
SITE PLAN
lO
11
12
13
14
15
16
17
18
19-
20 -
COMMENTS
WAS GROUND WATER S
ENCOUNTERED? ~ L
O
IF YES, AT WHAT E
Gross Net Depth to Net
Reading Date
Time Time Water Drop
F. AL "
~ .. c~-o58¢ · *
· ;~.... .¢(.~ATION RATE (minutes/inch)
~ ~t~;~, ~ ~ RUN BETWEEN AND FT
72-008 (6/79)
t.~lat. -: T~chMc6I Ss~vic~s
./
S IT~- PL.A N
MUNICIPALITY OF ANCHORAGE
Depadment of Health & Human Services
On-Site Sewer/Well Permit Application __-
NOTE: ApphcahO .... I be filled out completely SINGLE FAMILY DWELLING
Property Owner Name i~/L..J , J-"~A~J 1 ~, ~A C~S
Mailing Address J ~ ~ ~0 ~ I ~ P O ~ ~ ~(~ '
Legal Description ~ LA ¢O¢.~_n
Lot Block -- ' . ~ bdivi~
Lot Size ~ ~ ~'Sa Ft Inspections will be conducted by: . .,~0~ ~ O %~%~
Number of Bedrooms: ~ _ _~ Approved Engineering F,rm ,~ _ ~V
Does your house contain any of the following: Hot Tu~ ~ n%U~il~;~:r~¢;~%~;;;~t~' or Waler Sohener Unit? _ If yes. which one? /
This application is for: Sewer Only Sewer and Well Sewer Upgrade . Well Only.
I cedi~ that the above information is correct. I fudher cedify t~at this app~tion is being made for a Single Family Dwelling
and in accordance with applicable Municipal codes. //~/ ~/,,~ '~ /~
~e~ Owner/well Drille
Receipt~ ~' ~ ~/~ ¢~ ~ermit¢
Day Phone
W. Davis Bales
13350 Ginpole Circle
Anctlorage, Alaska 99516-3031
Re: Investigation of Sanitary Sewage On-Site Disposal System
Dear Mr. Bales
Per your request, I have investigated your 3 bedroom private residence on-site
sanitary sewage disposal system. This investigation included test hole
excavations and a soil percolation test.
Your existing system consists of a 1000 gallon septic tank and approximately
37 linear feet of perforated pipe drain field. The septic tank is adequate
but your drain field, constructed in 1981, does not function properly. At the
time of my investigation, August 16 & 17, 1986, the water level in the
observation tube at the terminus of the perforated pipe was 2 feet below
ground level. The pipe flow line is approximately 4 feet below ground level.
You have stated this situation commonly exists. Your existing field was
woefully inadequate for the existing site conditions, according to my
investigation, and you have resorted to frequent pump and haul away of you
septic tank effluent.
The most feasible location for a new subsurface disposal field is in the
southwest corner of your property. This area is lower elevation than your
present drain field, is fairly flat, and construction activity in this area
will minimize any impact on the vegetation surrounding you house.
On August 16, 1986, we dug a test p~t (TP1 With a backhoe to 12' depth.
Twenty feet away we dug a second hole (TP2 to a 5' depth. 'Except for the top
2' organic root mat, the soil was light brown sandy silt and silty sand. The
soil was very tightly compacted, but dry and there was no evidence of a water
table. In the second hole at 6' depth, a percolation test was performed in
accordance with standard practice methods described in the U.S.· E.P.A. Design
Manual, On-Site Wastewater Treatment and Disposal Systems, 1980. The hole was
kept well soaked overnight and measurements the next day consistently were 30
minutes per inch. This is what I would have expected for this type of soil,
and equates to a soil test rating of 287 square feet per bedroom (Municipality
of Anchorage Ordinance AO 1~o. 86-21, as amended, May 20, 1986).
I recommend you construct a new on-site subsurface disposal system in the
southwest corner of your property. Your property is well drained, and there
are no water wells within 100' of the proposed site. You should install 290
linear feet of 4" diameter perforated pipe as shown on 'the attached sketch.
This design provides 870 square feet of absorption area.
If you have any questions or need any additional information, feel free to
contact me.
Sincerely,
Ronald D. Rhodehamel, P.E.
3850 ~/estminster Way
Anchorage, Alaska
Attachments
Sketch, Soil Absorption System,
W. Davis Bales, 13350 Ginpole Circle,
Lot 4, La Forest Subdivision
Z
d
W
PERFORMED FOR:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
: Ronald D ~hodeh~mel,**
° ' 46 "*
l.&,.. ,.
DATE PER FORMED: A'~C/~"~"~¢' f E) 8 O
LEGAL DESCRIPTION:
Township, Range, Section:
SLOPE
SITE/ PLAN
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
PERFORMED BY:
¢__..o ,~ PACT)
,<:~U I T^ 8
.)
WAS GROUND WATER
ENCOUNTERED?
$
IF YES, AT WHAT
DEPTH? ~ /,/~ P 0
E
Deplh to W3Jer ABer
Monilorino? NJ //~ Bale:
Gross Net Depth to Net
Reading Date Time Time Water Drop
I" 30 P ~o ,~.t,,,,), I ~
PERCOLATION RATE -~ ~ tm~nules. ~nch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FT AND '~ F7
~,~:~ ~L~,. /~ CERIIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE
72-008 (Rev 4/85)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 LStreet-Anchora§e, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAl,. SYSTEM AND/OR WELl INSPECTION REPORT
lAbsorption area
PGRADE
NAME
MAILING ADDRESS
LEGAL DESCRIPIION
- W¢'I
DISTANCE TO' //(.~ ~.~ /
Manufacturer ~ ~
ciq. c~)acit~ in ~allons ~ ,~ _
O~ O ~ .... MEMADE'
DISTANCE TO:I~11
DISTANCE TO- Well ~
N° -Z ILeng'" /_0¢'
of each line !
Top of tile to fi-n~si'¢~}ade ~ '~-'
I Dwellinfl !
Ma t e r ial~'--~ __
Inside length J Width
NO. OF BEDROOMS
PERMIT NO.
Dwelling
Length
No. of compartme~.~
Liquid depth
PERMIT NO.
I
Width
]Material
Foundation -- I Nearest lot line
~ ' / / ,nc%-~i,K~th
Material beneath tile -
inches
Depth
Liquid capacity in gallons
PERMIT NO.
Total effective absorption area
PERMIT NO.
Type of crib Crib diarneter Crib depth Total effective absorption area
Well Building foundation Nearest lot line
DISTANCE TO:
Depth Driller Distance to lot line
DISTANCE TO: Building foundation Sewer line Septic tank
LEGAL
OTHER
SOIL TEST RATING
REMARKS
bsoH)tion area(s)
PERMIT NO,
FI F' F' L. I IT.:I::t N T
L CI C I:1T :[ 0 N
tbq lEE Ii ....
G!NPOL. E C
I..OT 4 I...FI FORET' :.3UE:[:,I',,,'~:F.;ZON LCd- SIZE .?~JO00 'Z.C-.fljF-IRE F:EET
'T'¢F'E CIF: ':20ZL. PE,::,-[ F fi .N .::,~.:,IEH I'E; "-;" ....
I'"IFI::'::ZMUH I'.,II.JHE:ER OF' BE[:,ROOHEi; =: ]:
SO:IL RF1TING ':'.'..:7,'2! FT,.."E:R)=
THE RE(;¢.JIR[E[:, SIZE ,::iF THE SO ZI... RE:L:;ORF'TION S"r'%TEM IE; '
THE L.E:NGTH [:,INE:NSION IS THE LENGTH ,:.' IN I'--EET::, OF ]'PIE TRENC:H L")R [:,F.:FIiNF'IEL[:'.
TIdE DEF:'TH OF F:l TF'.ENC:FI OR F:'].'T :[E; THE [::,ISTFqNCEE BETHEEN THE E',I...IRFFtC:E OF:' TlaE
I]i~'.OI.Ji"',lfJ) FINE:' THE: BE)TTOH OF THE: E,s::CR"/FaTION (IN FEET).
THERE IE; J~'llJEJ SET I,qI[:,T;4 FOR ]"RENC:HES.
THIE GRFI'v'EI... [)EF']'H ]::5 THE HI IqIMUH DEF'TH OF GRR',/EL DE"f'HEEN THE OUTF'FtLL F.'.f. PE
laN[:, THE E:OTTOM OF:' ]"HE EXE:R'v'FIT l' ON ,.': I N FEET .".,.
F'EFff'tZ T FIF'F'L:I:C:FtNT HRS THE RE:.3F'EINS]:DI L ! T"r' "FO i NFOF::M TH I S E:,EF'FIRI'HEHT DURING THE:
:[NS;TFILLFYI"ZON :[NE;PECTZOI",tE; CI::' fiN"/ HELLS RI}JFtCENT TO THIS F'F.:.I'-EF.q~ FINE:, THE
NLIHE',ER OF RE:'SIDENCE:L'3 'I"HF4T ]'HE HELl... 14:ILL ::,Ef.,E.
E:RC I':::F'Z L..L ]' NG ()F FIN"r' .::, r.::, T E.I I [,.I I THCII.JT F Z NFIL.. ]: NE F'E E ]"l '"iN FIND F:IF'PI;.':O'v'I::II_ B'¢ "tH 15
[:,EF'F:IF:rTI'"tEI',!T I.,.I ILL.. BE: '51,JE 3'ECT '['0 F'F' :' 'SE ::I...tT l
t"lI N l MI.jM E:,]: S"f'I::tNCE 8Eq"HE:EN f::t I.,iIELL_ FliNE:, l::ll",t"r' ']N'"S I'rE :~;EI.,.IFIGE D I :E;F'OSFIL S'¢STE:M I
:'L:~IEI FEET For4: ~ PRIIv'FtTE HELL. CIR :ZSO 'T'O 200 FEET FROM FI PI_lEft_Il::: HELL. [:,EPENE:,ING
I_IF:'IEI[.~ THE: T'¢PE OF F'UE:I....iC I.,i!E[LL.
P'IZNZMUH E:,ZST'FtNCE F'ROH R F'R]:'v'RTE HEL. I... TO R F'RZ'v'FtTE SEHER LZI",tE Z:E; 25 FEET RNE)
TO Ft COMMUNITh" :5EI.,.IER L. ZNE IS '75 FEE:T.
HELL I..OG:5 FIRE RE(;iI..ItRED FIt",IE:' MI E;T DE RETURNED TO THE E. EFPEfHEN] t4Z-I"HIN '20 E:'FI'¢:E;
EF' THE HELL.. ":OMF'I_ET]3N.
'ETHER f;;:E:I]:!I..IZFi'.[~:f'IEi",I"I"~; MFl"r' FIF'PI .... E;F'ECZFtCR'I'ZON2~ Flf',lE:' ECf'.'ETRI.IETZ]Iq E:,ZF!GRRh'IE; FIRE
F:I'v'RILFtBLE TO IN':2;L.tRE PROP[ER ZNS'f'FIL. LF1TZON.
~ CERTIF'r' THFIT
~.: ): F!H F't::IMZL. IFIR N~TH THE REQLIIREMENT:5 F'3R ON-S]]-E ::J;EI.,JER:~; FINE:' I.,JEL..LS RE; SIET
FORTH EJ"r' THE MI_INZC:[F'F~LIT'¢ OF RNCHORFIGE.
'":" ]: HIL. L ]NE;-t"FILL THE .:,t:,.,tE~l :[1",1 RI]:COF~:[:'FINCE HITH THE
]:' I I..HE:,EEg]"F4NI} 'T'FII~T THE Oh,I'"'S]TE SEHER .:,r:,TEfl t"llg'r' REQUZRE ENL. RRGEMENT IF 'THE
"'- :: I E; ..... ,.,
I .E....,:[DEt"~CE REMO[:'E:I...ED TO INCL. IJDE MORE THRN ]: EE'['R"'fi]M'::
FIF'F'L. :[ C:FINT H. [:'R',,,' ]: S E:FILEE; O- ~'~'~
MUNICIPALITY OF ANCHORAGE
[ Health and Environmental
L
Department 'rotection
825 Street, Anchorage, AK. 99501
264-4720
* * * HANDWRITTEN PERMIT * * *
WELL AND/OR ON-SITE SEWER PERMIT
Applicant: L~,~r~~ [?~(j~<~_ Mailing Address:
Location: ~/'~, C~ Phone Numar: ~
Legal Description: C--: /n::~:: ~::' LOt ~lze:
Type of Soil ~sorption'System ~s:
Trench: l_~rainfield: Seepage Bed: Holding Tank:
~aximum Number of Bedrooms: ~ Soil Rating(sq.ft/br)
The Required Size of the Soil Dsorp~ion System Is:
LENGTH . ~ GRAVEL DEPTH ~/~IDTH
DEPTH
~he length dimension is the length(i~ feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minima depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE TM /~2~ GALLONS *
Permit applicant has the responsibility to inform this ~epartment during the
i~stall~tion inspections of ~ny wells ~dj~cent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this department
will be subjec~ to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31j 1 9
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is~emodeled to include more that~Tbed~ooms.
Signed: ~/ .~///~:~ Y~ . Issued by: ~~
Ap plican5 ' Date: U.~ //9~/~/
SWP/024(1/81)
~v~UNIClPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-650, Anc~orage, AlaC~a 99502 276-2221
SOILS LOG - PERCOLATION TEST
SLOPE SITE PL,~ .... : "=: ,': ':' '
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19
20 .'J . . ~ " :.
'' ':, ' . PERCOLATION ,,ATE Z minutes/inch ~:2~¢ ~)~: : ~:'~:
~'¢~'. , . ~:[::-',
.......... : 7' "--:::Z:':'7: -:':: -: ~
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COSA Checklist
Legal Description: LA FORET; LOT 4
Parcel ID: 017-342-04
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _
A. WELL DATA
A Well log is filed with Onsite (or attached)
Date drilled 5/29/1981 Total depth 354 ft
Cased to UNK ft
F■ Sanitary seal is functioning correctly
N Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 5/22/2024
Static water level at beginning of test 207 ft.
Comments
B. TANK DATA
Measured operating fluid level in septic tank NEW
Date of pumping NEW
❑ Required maintenance completed, if AWWTS
Comments: NEW SEPTIC TANK
D. ABSORPTION FIELD DATA
Which system tested (date installed) i 7
X ALL standpipes present per record drawing
Total measured depth from grade 10.1 ft (max)
Measured depth to pipe invert from grade 8.8 ft (min)
❑ N/A — pressurized field.
❑ Per record drawings, field is insulated.
❑� Monitor tubes go to bottom of effective.
If not, state depth into effective *
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced N/A gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date N/A
Well production at time of test 2.5+ gpm
Water storage tank volume N/A gallons
Well disinfected for coliform test? ❑ Yes ® No
MR Coliform bacteria is Negative
Nitrate mg/L R Nitrate less than MRL (ND)
Arsenic ug/L W Arsenic less than MRL (ND)
Collected by _
Date 5/22/2024
C. LIFT STATION
❑ Required maintenance c ted
Age of lift station years
Lift stati erial
ments:
Adequacy test date 5/22/2024
Results Q Pass
Fluid depth prior to test 4 in
Water added 460 gal
New fluid depth 7 in
Elapsed time 1314 min
Final fluid depth 4 in
Absorption rate "450+ gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 6 in
Effective depth used 4 in
Effective depth remaining 2 in
Comments/Deficiencies: *MT EXTENDS APPROXIMATLEY 6.5" BELOW THE INVERT OF THE LOWEST CLEANOUT
IE— Per owner, home was occupied FOR 2 WEEKS PRIOR TO ADEQUACY TEST. THE HOME otherwise had been Vacant since November 2023.
-SEE ATTACHED LETTER REGARDING THE SEPTIC ADEQUACY TEST
COSA Checklist June 2022
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100'
Q Yes
if No
Community Sewer Manhole/Cleanout > 100'
[EYes
if No
ft
FE Yes
if No ft
Neighboring Tank > 100' ❑■ Yes
if No
ft
Private Sewer/Septic Line > 25' Q Yes
if No ft
Absorption Field on Lot > 100' 0 Yes
if No
ft
Holding Tank > 100' WYes
if No ft
Neighboring Absorption Fields > 100'Animal
if No
*90'+
Containment > 50' 0 Yes
if No ft
E] Yes
if No
ft
ft
If tank or field is under driveway comment below
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ❑■ Yes
if No
ft
0 Yes
if No ft
❑ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
Q Yes
if No
ft
Surface Water > 100'
n Yes if No ft
Tank to Property Line > 5'
Q Yes
if No
ft
Wells on Adjacent Lots:
� C11)4 TH
Field to Property Line > 10'
❑ Yes
if No
*51+ ft
Private Wells > 100'
Yes if No ft
Water Main > 10'
0 Yes
if No
ft
Community Wells > 200'
Yes if No ft
Water Service Line > 10'
[9 Yes
if No
ft
If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
*AND** OSV241020
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Gamess Engineerinq Group, LTD. (GEG) Phone 907-337-6179
Engineer's Printed Name Jeffrey A. 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 industry
�SooO
practices. The reported results describe the condition of the systems on the date/s of the evaluation.
identifiable features. Hidden defects
�o�
�F
Separation distances were measured to readily or encroachments may
that identified during the The life and septic systems depend
o
exist were not evaluation. operational of all wells
including limited to) levels (that may fluctuate
O Q
upon a variety of variables, (but not soil conditions, groundwater
during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing
� C11)4 TH
the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not
0...... .... • • . • .. • • • .. • • . • • -
juarantee future performance of the systems; therefore, GEG makes no warranty (express or implied) regarding
the future performance of the well or septic system. GEG makes no representation whether an alternative well
... ..:.. . ....... ....
or septic system can be installed on the property in the event either of the current systems fail to perform
= r A. Gorn s:
d4
adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG
E— 53
Q�'se'
to perform the evaluation. Reliance upon the information provided in this report by any other person or party
it legal
"�'i•� 2'i: o
(including subsequent property purchasers) is not authorized, nor will confer any right whatsoever.
COSA Checklist June 2022
LtCENSEprofesslo��
cceen
August 23, 2024
Municipality of Anchorage
Development Service Department *: 9
On -Site Water & Wastewater Program ,,.,
4700 Elmore Road r... y'.......:�
Anchorage, AK 99507 cE-79�;
Ref: Letter regarding adequacy test for La Foret; Lot 4
4
To whom it may concern: ie,' z3 I z4
Per the owner, the house was vacated in November 2023 and reoccupied approximately two
weeks prior to us performing the drainfield adequacy test.
Prior to the start of the test, the liquid level in MT1 (see attached sketch for location) was
approximately 4 inches and MT2 was dry. Elevations were taken (H.l = 100.00) and the bottom
of the monitoring tubes were found to be at/near the same elevation (6.5 inches below the
lowest cleanout (CO4)). The elevations of the cleanouts were also shot (see attached sketch).
After the introduction of 460 gallons, the liquid level in MT1 rose to 7 inches with no rise in liquid
in MT2. After the adequacy test, a small amount of water was added directly into MT2, it
immediately rose to 8 inches and remained elevated for about 10 min. It should also be noted
that at the end of the adequacy test, the liquid level had risen in CO4 to about 0.5 inches above
the invert.
Based upon this data, it is believed that MT2 was non-functional at the time of the test. We
required that the drainfield be jetted, as well as both the MT's (during the tank installation).
Chemical rejuvenation (with Hydrogen Peroxide) may enhance lateral migration of the effluent
and extend the life of the drainfield.
If you have any questions, please contact us at 337-6179. Thank you for your assistance.
3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
L_a / L -L4
51-zz 24
q -j
ter- C .
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IV
CCS
DIAGRAM OF SYSTEM - OVERVIEW/SKETCH OF LAYOUT WITH
LABELED PIPED.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 * Ph: (907) 337-6179 * Fax: (907) 338-3246 * garnessengincering.com
(v-
160
fo�
r
------- ---------- --
'-14L
IV
CCS
DIAGRAM OF SYSTEM - OVERVIEW/SKETCH OF LAYOUT WITH
LABELED PIPED.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 * Ph: (907) 337-6179 * Fax: (907) 338-3246 * garnessengincering.com
'SEu_UDED HILLS
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LEGAL DESCRIPTION:
(SWE SON SUBDIVISION)
LOT 4
LA EGRET
D RAS, N DA
08/5/12024
\NO RK ORDER: 2/4,016
DRAWN BY:
........
IaDS
.. ......- ------
PIAT: 77-1
CHECKED BY:
GMG
= GRID: SW2937
SCALE;
111-50'
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MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PI:IOTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
I_ocation (address or directions)
(b) Applicant Name __~_~_%~.L&_
Applicant Address
(c) Applicant is (check one): Lending Institution []; Owner/buildet~"'; Buyer []; Other [] (explain);
(d) Lending Institution %_,'~:_.
Address
(e) Real Estate Company and Agent
___ -relephone
Address
Telephone
(f)
Mail the HAA to the following address:
..... Lb r~ ·
TYPE OF RESIDENCE
Single-Family~.~,... Multi-Family [] Other
Number of Bedrooms ___:~_ .............
WATER SUPPI..Y
Individual Well~ Community [] Public ~
Note: If community well system, must have written confirmation from the State Departmont of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite~, Public I~] Community D Holding Tank []
Note: If corn munity well system, must have written corffirmation from the State Department of Environmental Conservation
attesting to the Iogality and status.
Page 1 of 2 72-025
ENGINEERING FIRIVi PROVIDING INSPECTIONS, TEST:'3, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto aed as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that [he on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicatec herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from rny investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and re§ulations in effect on
the date of this inspection.
Name of Firm ,.~ LOc' 6~ Telephone ~"
Address /.z(.~ ~, l,-J .)~¢ '~/ ,,1,~/-, /'~/< 5~ ~,, .~ ~c~ ~
Date
DHEP APPROVAL
Approved for '?~/'~'~:*~:'- bedrooms by~
Disappcd?d
Terms of Conditional Approval ~:¢,~Z¢¢1~::c~,~
CAUTION
The Muncipality of Anchorage Depadment of Health and Environmental Protection (DHFP) issues Health Authority
Approval certificates based solel~ upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
WELL DATA
MUNICIPALI'rY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKI.IST - FEBRUARY 1984
264-4720
MUNICIPALITY OF ANCHOI~AG~.
DEPT, OF HEALTH &
ENVIRONMENTAL PROfECTIoN
Legal Description:
Well Classification
Well Log Present f!~N)
Total Depth ,35 q-
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit
Separation Distances from Well:
To Septic/Holding Tank on Let __
Cased to. CS ~'¢' _
If A, B, C, D.E.C. Approved (Y/N)
Date Completed ~'1¢,~/ :~'i' ! 5'8 ! Yield
Depth of Grouting --
Pump Set At --
__ Sanitary Seal on Casing ~)/N)
____ Depression Around Wellhead (Y/~
; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot _/,~! 7zo c,¢,; On Adjoining Lots
To Nearest Public Sewer Line /,,",'~ To Nearest Public Sewer
Cleanout/Manhole /pA To Nearest Sewer Service Line on Lot
Water Sample Collected by ~¢ ¢-'"~ ; Date
Water Sample Test Results
Comments
SEPTIC/HOLDING TANK DATA
Date Installed v/v~¢
Standpipes CN) __ Air-tight Caps ~/N)
Depression over Tank (Y/¢
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N) /'V~
Separation Distances from Septic/Holding Tank:
To Water-Supply Well /
To Property Line _
To Water Main/Service Line /,O .+
Size /ooo
No. of Compartments
Foundation Cleanout
Date Last Pumped ~/3/~-----
; for
Temporary Holding Tank Permit (Y/N)
To Building Foundation -/,5' '
Course
To Disposal Field
To Stream, Pond, Lake. or Major Drainage
Page 1 of 2
72-026(11184)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata /Oo /2 ~/,,~--
Date Installed
Width of Field ~ 6"
Square Feet of Absorption Area
Depression over Field (Y/~.)
Results of Last Adequacy Test
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present ~¢Y~N)
Date of Last Adequacy Testat
/v A
Separation Distance from Absorption Field:
To Water-Supply Well /5-
TO Building Foundation
Lot /v-
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments ~
To Property Line ~-gd'
To Existing or Abandoned System on
; On Adjoining Lots 30'
To Cutbank (if present)
D, LIFT STATION
D'""~'~a st ailed Dimensions /
"PumpO: evel t Off"L v l t _
High Water Alarm Level at '-~-~ Vent (Y/N)
Tested for ~ ~~mping Cycles during Adequacy Test. Meets MOA
' Comments
** Check Permitted Bedroom Rating Against HAA Request ** ~~~
I certify that I I/i~ve checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed ~~~' Date ~ ~t %'-0 Y-
Company /~' /-e-c.,(' MOA No. ~'7- ~- ~?o"~~'
Receipt No. '~ .c.~
Date of Payment
Amount: $
Page 2 of 2
72~026 (1U84)
Seal
P.O. BOX 6650
ANCHORAGE, ALASKA 99502-0650
(90'7) 264-4111
TONY KNOWL£$.
~'¢A YOI~
DEPARTMENT OF HEAL'fH & HUMAN SERVICES
August 23, 1985
Darcy Bevans
Alaska Environmental Control
Services,
1200 West 33 Avenue, Suite B
Anchorage, Alaska 99503
Subject: Lot 4 La Foret Subdivision
Dear Ms. Bevans:
This Department hereby grants a waiver to 93.5 feet for the well
on Lot 4 to the septic system on Lot 3. Please note that the
attached health authority approval is conditional upon the installation
of a foundation clean-out prior to June 15, 1986.
Sincerely,
Stephen S. Morris
Civil Engineer
On-site Services
SSM/ljw
// 6?'/
ALASKA Ci dlF OnFfl TAL CONTROL
~aqJl'leerJncI ~- ~nuiroam~maI ~ludi~s
August 12, 1985
Department of Health & Human Services
825 L. Street
Anchorage, Alaska 99501
Attn: Susan Oswalt
Dear Susan:
This is in regards to La Foret Subdivision, Lot 4. The well on this lot
is only 93.5 feet from~IeJn"~u~representing the end of the septic
system on Lot 3 to the north. This well was drilled in May of 1981.
The septic system on Lot 3 was installed in September of 1980, and hence
was there at the time the well was drilled.
Ground level at the well of Lot 4 in roughly 5 feet higher than ground
level at the septic system of Lot 3. There does not appear to be any
contamination of the well, as is shown by the water sample taken on
August 7, 1985 which is satisfactory. The well is 354 feet deep and
goes through several clay layers as the well log shows.
Consequently we are asking that the horizontal separation distance
between the well of Lot 4 La Foret and the septic system of Lot 3 La
Foret be waived down to 93.5 feet.
If you have any further questions or if I can be of further assistance
to you please call.
Sincerely,
Darc~/~ev ens
Engfneering Geologist
, PE
1200 UJesl 33rJ Aucnae, 5uiJ¢ B ~, Aachoraqc, Alaska 99503 ~ (907) 561-50zj0
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