HomeMy WebLinkAboutSPENDLOVE VIEW HEIGHTS #2 BLK 4 LT 5pendlove View
Heights #2
Block 4
Lot 5
#017-401-30
f n
D H '9J
Municipality of Anchorage Page I of 2
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • AnCiorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: S LfI a00 17 8 PID Number: 017 - y01 - 3r2
(r,�f H aff
Wastewailer System: ❑ New. ❑ U
Y Upgrade
FAddress:
G.3n>< 1!2176/}nch f}4 995-1/
ABSORPTION FIELD
66 o6
N,,. of Bedrooms:
y
® Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
d- 6 GPD/Sq. . Ft.
12. El
Lot: Block: Subdivision: iZ,
S
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
y S Cno(10✓e //i Ga.. H,j'
2. Z Ft.
10.6 Ft.
Township:
Range:
Section:
Fill added above original grade:
Gravel length:
1.0 Ft.
58.5' Ft.
WELL: CXrSr ❑ New ❑ Upgrade
Gravel width:
Z.s
Numberoflines:
Distance between lines:
Ft.
Classification (Private, A, B,C):
Total Depth:
Cased To:
Total absorption area:
Pipe material: F_&rte rver,Z
Ft.
Ft.
(I ZO So. Ft.
C) -.?o?,/
Driller:
Date Drilled
Static Water Level:
Ft.
Installer:
Cu,rl.t ExGct
Date installed:
Z,/ cit
YieldPump
Set at
Casing Height Above Ground:
TANK
GPM
FL
Ft.
SEPARATION
DISTANCES
XSeptic ❑Holding ❑S.T.E.P.
M an u fact u�re/rr: Capacity in gallons:
To
From
Septic
Absorption
Lift
holding
PUbIIC/PIIVa,,e
Tank
Field
Stalion
Tank
Sewer Lines
�'#*je_ roP e TL!/7%{' 12.5-'0
W211 -
r
I f o
( & t
1
`-
_6 r
Material:
S! e t/
Number of Compartments:
2
Surface
Water
> !ems•
>!en•
_
-
_
LIFT STATION
Lot
Line
2 5'
2
Size in gallons:
Manufacturer:
Foundation
•
1(i ,
—
_
"Pump on" level at:
.'Pump off' level at:
High water alarm at:
Curtain
Drain
'—
—
—
—
_
Pump Make &Model
Electrical Inspections performed by:
Remarks: pac logy ,,, S /ac-Jonk
BENCH MARK
c
*ll -1 4n& 2�/T �1 /' . r'(3 • •.
Location and Desk"ription: ./
�O �Tpwr 6� s[ G(In,� �1w ,�. fOd'nG�
wo/t Qn� o,Y �"rtne/7 L.e,f• . /r.rx e.,arc:
o,� �i ••e�(olrn � (-,We Oj .*)
Assumed Elevation: -
15Jutai liL"PicR 74* lc 1.0• 100,E Ft
v ENGINEER'S SEAL
m � ling 6ul1 titin•' /J([✓<r%Cr rIa (tib rli.rfu//�cC �b
et((uw :l;-4A.Lrtl rero.Onac /tun {6 ori rnc./ ire^CA ar o(exir«!
Inspections performed by: F(affco Tec/+ S' -e- Dates: 1st 6/ 27/ao 9 ' r
—
Pg gGp
2nd 6'/ -2-8/0o
V 3 gCq �4C
Department of Health an Human Services approval ,t
Reviewed and approved by: Dater'
12-013 (Rev. 9/91) M0A 25 -
PERMIT NO: SW000178
SCALE: AS NOTED
14530 ECHO STREET
DRAWN BY TFM
SWING TIES:
OCTOBER, 2000
FROM: COR. "A" COR. "B" COR. "C"
TO:FDN.
PID NO: 017-401-30
"D"
C.O. 42'
S.T. C.O."E" 15'
37'
S.T. C.O. "F" 8.5'
45'
i
DBL. C.O. "G" 8'
47'
VALVE "V" 8'
49'
DRIVE
TR. C.O. "H" 19'
52.5'
"I" 36' 12'
NEW 58.5' LONG
7R. C.O 38'
SOIL ABS. TRENCH
W. 10.0' GRAVE
i4t
BOT. T.H. #1 M.T.
ELEV. 76.45'
(DRY 6/27/00)
INS. + 2'
INV._
INV. 94.2'
BOTTOM TRENCH
ELEV. 82.5'
CROSS-SECTION
NOT TO SCALE
INV.
PAGE 2OF2
WELL
LOT 5, BLK. 4, SPENDLOVE VIEW HTS. #2
SEPTIC SYSTEM UPGRADE
AS -BUILT INSPECTION REPORT
FLATTOP TECHNICAL SERVICES
SCALE: AS NOTED
14530 ECHO STREET
DRAWN BY TFM
ANCHORAGE, ALASKA 99516
OCTOBER, 2000
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW000178
Legal Description: SPENDLOVE VIEW HEIGHTS #2 BLK 4 LT 5
Design Engineer: 0019 Flattop Technical Services
Owner Name: Cliff Hyatt
Owner Address: PO Box 112176
Anchorage , AK 99511-2176
Date Issued: Jun 19, 2000
Expiration Date: Jun 19, 2001
Parcel ID: 017-401-30
Site Address: 013035 JEANNE RD
Lot Size: 53773 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
E Disposal Field D Septic Tank ❑ Holding Tank E] Privy
All construction must be in accordance with:
1. The attached approved design.
❑ Private Well ❑ Water Storage
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.
Received By:
Issued By:
Date: 4> l FIGO
Date:
T Municipality of Anchoragc } �
Department of Health and Human Services
825 "L" Street
Rick Mystrom. P.O. Box 196650 Anchorage. Alaska 99519-6650
Mavor
h1tp:/1www.ci.anchorage.ak.us
June 19, 2000
Ted Moore
14530 Echo St.
Anchorage, AK 99516
Subject: Waiver Request for Spendlove View Heights #2, Block 4, Lot 5
Waiver Request #WR000036
Parcel ID 9017-401-30
SW000178
Dear Mr. Moore:
Your request for a waiver of the required 10 feet horizontal separation from the
on-site wastewater disposal system to property line has been approved. The approved
separation distance is 1.0 foot.
This waiver approval applies to the existing on-site wastewater disposal system to
property line separation only. Any future upgrade to the on-site wastewater disposal
system will require all separation distances be met or another approval from this
department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-4744.
Sincerely,}—
.
LzvtL l
Daniel J. Roth
Civil Engineer
On -Site Water Quality Program
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
On -Site Services
Waiver Review Worksheet
WR#: WR000036 PID#: 017-401.30 HAM Permit#: 5-W000176
Date Received: June 7, 2000
Legal Description: Spendlove View Heights #2, Block 4, Lot 5
Engineer: Flattop Technical Services
14530 Echo St., Anchorage, AK 99516
Applicant: Cliff Hyatt
**********
Waiver Requested: Lot -line waiver
Criteria: 1. Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
2. Special Conditions:
3. Other:
}}kk}k}}kk
Waiver is Granted: X Waiver is not Granted:
List Conditions or Reasons for above: S E F_ /9 114 CH F2
Date: 6 " I9 -a(% By: [SAN
Name of Reviewer
**********
Rao#: 06794 Amount: $115.00 Date Paid: 6-7-00
CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS
THEODORE F. MOORE, P.E.
PH: (907) 345.1355
June 6, 2000
M.O.A. DHHS
P.O. Box 19-6650
Anchorage, AK 99519
Dear Sirs:
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
The purpose of this letter is to provide the required design narrative in support of our application for
a permit to upgrade the wastewater disposal facilities on Lot 5, Block 4, Spendlove View Heights, Unit
#2, located at 13035 Jeanne Road. The existing trench is no longer able to accept the wastewater load
emanating from the residence. Soils logs, perc test results, a site plan, design drawings and
specifications are enclosed for your review.
Because of the extremely limited area available for construction of the proposed trench, a lot line
waiver is needed allowing the system to be constructed within 1 foot of the west lot line common with
Lot 1, Block 2 of Foreland View S/D. Issuance of the requested waiver will not have any significant
impact on the ability to construct future wastewater disposal facilities on the adjoining lot. There is a
10 -foot utility easement running along the west side of the lot line, and then the proximity of a cut -bank
for Jeannie Road makes this an unsuitable location for septic system construction on that lot. Ample
other sites are available on that lot.
The proposed system will be constructed in the vicinity of test hole # 1. As can be seen from the soil
log, the native material below 3.25' is a sandy silty gravel with a measured perc rate of 12 minutes per
inch. Using the slightly conservative soil application rate of 0.6 gallons per day per bedroom, this 4
bedroom residence requires a total absorption area of (4 x 150)/0.6 = 1000 square feet. The proposed
56 -foot long trench design with an effective gravel depth of 9.0 feet has a total absorption area of 1008
square feet. Because of the limited area available, approval is also requested to allow the new trench to
be dug within 10 feet of the original trench. During construction we will verify the absence of
contaminated soil in that area.
The topography of the lot in the area of proposed construction slopes downward towards the
southwest at approximately 20 - 25%. The configuration of the trench will parallel natural contours.
The proposed project will have no significant impact on present or future water supply and
wastewater disposal systems serving adjacent properties, nor will it have any significant impact on
reserved space -surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have
any questions on this submittal.
Sincerely,
Ted Moore, P.E.
LOT 1, BLOCK 2,
FORELAND VIEW SID
CONSTRUCT
56' LONG SOIL
ABS. TRENCH
W.9'GRAVEL
� � F
ii
T.H.
#1
STEMP
2 CIRCLE
C, Z
10,
---- _
R 100,
' I
1�
� I
1
1 I
1
R 100'
I
ll
II I
WELL
ll
I I
I N
-. an nnJo�sls e�/®JLu..m�m c,]a �m%eeso ae: mcw�
'...4 o•so- •aaiaa•amaaeba H•
ADO F Ar70RE !�
JJJ% AV
LOT 4,BLOCK 5
SPENDLOVE VIEW HTS. #2
(VACANT)
NOTE: ACTUAL CONFIGURATION
OF TRENCH ALIGNMENT WILL VARY
AND IS DEPENDANT ON TOPOGRAPHY
CONSTRUCT 56' LONG SOIL
ABSORPTION TRENCH WITH
9.0' GVL BELOW DIST. PIPE
4" DIA. F-810 PERF PI
N
N
N
40
PLAN VIEW
SCALE: 1" = 10'
an
SECTION "A - All
SCALE: 1" = 5'
►L��i*iF�.'fiZ�T_1�
CLEANOUT
TUBE
MOUND BACKFILL 12"
SLOPE @ 3:1
GROUND
FILTER FABRIC
4" DIA. F-810 PERF. DIST. PIPE
/2" - 2 1/2" SEWER GRAVEL
BOTTOM OF EXCAVATION
WASTE LINE
FROM HOUSE
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
TEST HOLE # 1 SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION: Lot 5 Block 4, Spendlove View Heights #2
DATE PERFORMED: May 23 2000
PERFORMED FOR: Cliff Hyatt
DEPTH SLOPE
(feet) WN
Pt. II
GM fill
Pt. original ground surface
GM Sandy silty gravel
more sand above 5.5 feet
more silt and cobbles
between 5.5 and 7.5 feet
F".
r
. ... .. iy Yee O Y+i+IO+>
+sa + • >� se++�+es
"li 70 'DORED•
6j
k.A 4
SITE PLAN
Depth to Groundwater
Date
No groundwater
5/23/00
Monitor tube dr
5/30/00
27 1/2
Start
3:58
23 3/8
J_.. _. 20% _.
Date Reading
Clock
Time
Net Time
(minutes)
Percometer
Reading
Net Drop
(inches)
/23 12" Presoak
27 1/2
Start
3:58
23 3/8
#1
4:28
30
20314
25/8
Add water
4:28:30
21 5/8
#2
4:58:30
30
21
25/8
Add water
4:59
23 5/8
#3
5:29
30
21 1/8
1/2
LV a PERCOLATION RATE 12 (minutes/inch) PERC HOLE DIAMETER 6"
TEST RUN BETWEEN 9.0 FTAND 9.5 FT
COMMENTS: Recommend sizing trench on basis of 0.6 gpd/sq. ft. applicable to stratum between 3.25' and 18.25'
PERFORMED BY FLATTOP TECHNICAL SERVICES. I«t CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: /G /�dG
GRE. . L:R ANCHORAGE AREA BOR )GH
Department of Environmental Quality
-'` 3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSA
NAME EF'� _ MAILING ADDRESS.C)��`��/
P)1`7 /
LOCATION - LEGAL DESCRIPTION
SEPTIC TANK:
SYSTEM
PHONE 7V- /,/ 5
DISTANCE�/,����
NUMBER OF
FROM WELL1�-
MANUFACTURER �1-
—MATERIAL —
— COMPARTMENTS
r
J
INSIDE LENGTH_
NSIDE WIDTH
LIQUID DEPTH
LIQUID CAPACITY�C)GALLONS.
TILE DRAIN FIELD:
TOTAL LENGTH
s� /
DISTANCE FROM WELL/e' LL FOUNDATIONNEARESTLOT LINE_ /P. OF LINES
NUMBER OF LINES / DISTANCE BETWEEN LINES TRENCH WIDTH — IN. TOTAL EFFECTIVE
ABSORPTION AREA ��" `- SQ. FT. LENGTH OF EACH LINE
t DEPTH OF FILTER J
DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE_ OIp. ABOVE TILE IN.
WELL:
TYPE�i '�y CONSTRUCTION ��/ DEPTH 1 DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE- , SEWER LINE , TANK , SYSTEM
CESSPOOL , OTHER SOURCES
APPROVED G DISAPPROVED REMARKS
DISTANCES:
INSTALLED BY:✓ l_�
SEWER LINE DEPTH: 4
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form EQ -032
DIAGRAM OF SYSTEM
DATE��_=�/ o'_k'APPROVED
G.A.A.B. \ I
I OF AN[) EPATIRC)NMEN PROTECTJON
f-ldr."s 3 P -A S:- T.
r.-.' N. r U-', I:.... r,
[<.OD 11 -JCI -1
1-1,10 Al, 1. Ohl TL,AI-,lNFRD
kL, - rC�.t-A s N f".) I.- f.')'ieE MT. F- W -_;I:;
8 2
OF ."'ML. I" RPT.1.' ON SYSTEl1I._._ . TRENCIH
4 s 1L. RATING'.. -.1.40
i 1
ILENG' H- 2
JF , f,Hf`1:_ I-SXNEPTH= 16
1"HE" V11611.4-11 11-1 I'll IJ"TI I 0F BIET14F.P.4 THE' OI.J1"FAI_l PIPE AND THL' EX(;:AVA4JON 130"I'TOM
_THERF,.: 1S - NO SF.7 FOR F=OR DP'n I NF b.11 I)TH :C'_ :F -'f:
'I'FIE [`..,TFj"fH C.,11"' TRF1.,I('1,H OR PTA 'T'HE: ANL) THr"
OF' _TFIF`
TIA-: ,L..r.,113TH 1'THF-- I-ENG"FIA OF` FlIf-M Sl'r,',E' F'OR A SEEPARL.' PIT OR THE
I._EJ4j.'iTH OF' T'f-IE- OR
TFIFE FT.,l TANI< I ('3ALLON-1
jq T
0F' FIl,.l y C.M.31 [,.I I THOI.Yr ri r -i A L I t.,l S P 1::,. ID' T I t 4 -B •
T-' "I"HI-S.'-f-EPART EN —WILL
tel f.r.jUlUl"I U11SIT)WE FF 011 I-AEL.L. T(11 - FIN`r' SEPT 1: PLANT OR -.S�.'O I L -ABSORM" I o(A
T.". F-I- Pk'.')`-,-ATEWEl. L ANI) ;'2'00 F -l' I"-f..'.IR A FlUBLIf." IAELL.
REAT.IWALD To fill DEPARTTIPA,r- w i "I'll I P -.l OF THE-WEL.L.
("1 0 1`111 p L. T-( 0 N.
F"T i oris- w.,iri c TON D 1FIG3RAMS AR.E: AVA 1LABLE TO N`A WeE -PROPER
I U'RTIP-r' THIll' I FIN Ffill)*LfAk.' 1.41114 TWE' (1N--S).'TE SEWER'S. AND I.-.lELL1,,'
F"I s 1:7-l" F 11. 11-1 B F-FIF: MUNT I PFILT'l ",` OF- ANCHORA(AE'. AND WILL INSTALL- IN AGCORDANGF
fl+7:
1' h;rar
I& - -
.. ......(.. ............ I ..............
U F, 1) E3,11.1 Ok_ GLF y t
Lo
04
BL'Ci. L0`P'
H. Spenuiove
p '/, I► U Drilled by C.H. SELF
Completed Dec. 27,
7T/a 3 w, S n�
Total depth of well 11,11
Nq7-o6
Gallons per minute ....... .41 19 Y 3o717
Static level .............. 10.feet.
C.si" used.... .........73 feet 8 inches.
/
, E L LO''
BWCK� LOT
Omer H. Spendlove
Drilled by C.H. SELF
Completed Dec. 27, 1.975.
Total dep ih of rrell. I') fe, t,
Gallons per mi.nute...... A04,
Static level..............10 feet.
Casin.- uscd............... 73 feet 8 inches.
0-3 feet,.,topsoil.
3-17 feet... sand and gravel.
17--23 fee t.. send and gravel.
?_ 5-->0 .fc(-. t..rocks )nd gravel.
3i)-35 f.eeL,.gravel.
35-8 feet..pea gravel.
38--70 feet rocks and. gravel.
70-71 feet... sand.
71 feet... ..bedrock.
7w feet -101 ..bedrock.
��'t-e o`er /0,30 e -U6
OW Le�.�r�i /101 y
�QulAICJPALLTY ,
5.-LEG/ALL DESCRIPTION
( MOF I ALTH & —
MUNICIPALITY OF ANCHORAGE
ENVIRON .FNTAL 1 1ECTION
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
/Lle D / -
825 L Street - Anchorage, Alaska 99501
0*
6. TYPE RESIDENCE
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264.4720
RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTYOWNER
❑ MULTIPLE FAMILY
PHONE
K &/V/9 Seca fn
S l 9 5 9 3
MAILING ADDRESS
A 60V q 7a , 19/Vc� or�5 e
❑ COMMUNITY
PROPERTY RESIDENT (If different from above)
❑ PUBLIC UTILITY
PHONE
8. SEWAGE DISPOSAL SYSTEM
3 yy-s-s
2. BUYER
PHONE
If system is over two (2) years old an adequacy test is required
PUBLIC UTI LITY
MAILING ADDRESS
I❑
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
-
:S -/e /71 e , 191C 9 I
3, LENDING INSTITUTION
PHONE
T -/Y3/ yFe We v -5'09V) All S i. �O A'{J
MAILING ADDRESS
AYG /- i ` C a" GU L /5
4. REALTOR/AGENT
/�
- L� C o n7
MAILING ADDRESS
y /� /
- G " "" r/i ✓/NLG/C, ✓ti f
5.-LEG/ALL DESCRIPTION
ZI
47
STREET LOCATION
7 G✓n/ /e
/Lle D / -
�J
' 1B v [l f/' Pf rRa ✓-N r - �`"% i(o ✓S <" GN %-/
6. TYPE RESIDENCE
NUMBER OF BEDROOMS
®SINGLE FAMILY
❑ One ❑—Four ❑ Other__
❑ Two ❑ Five
❑ MULTIPLE FAMILY
❑ Three ❑ Six
7. WATER SUPPLY
n— INDIVIDUAL*
"ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to t te, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE**
**If individual/on-site, give installation date
If system is over two (2) years old an adequacy test is required
PUBLIC UTI LITY
by this Department.
I❑
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
-
24-
THIS SIDE FOR OFFICIAL USE ONLY
INSPECTION APPOINTMENTS
DATE RECEIVED
TIME
TIME
TIME
DATE
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
.Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
INSTALLER
❑Septic Tank or ❑ Holding Tank
Size: If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
PPROVEDFOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
BY (Title)
LEGAL DESCRIPTION
iz-L)iu Ircev. sl /to
A
C G GEOLOGICAL LABORATOI OF ALASKA, INC.
4649 BUSINESS PARK BLVD.
P.O. Box 4-1275 ANCHORAGE, ALASKA 99509
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
PUBLIC WATER SYSTEM:
[Rol,
City
SAMPLE DATE: Q''-1 LD 1 u 1
Mo. Day Year
SAMPLE TYPE:
❑ Routine
❑ Check Sample (for routine sample
with lab ref. 11 Treated Water
) [IUntreated Water
❑ Special Purposee
SAMPLE
NO. LOCATION
2 -
3
4 I .l
5
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Form No. 18.310 (3-78)
Time Collected
Collected By
06-1220 (b)
Rev. 1978
Date Collected
TELEPHONE
(907) 2794014
TO BE COMPLETED BY LABORATORY
LABORATORY:
DDRESS
CITY 7
Date Received
Time Received
Analytical Method:
❑ Fermentation Tube
,"embrane Filter
Lab Ref. No. Result' Analyst
I I m
D
m
L I 0
� No. of colonies 1100 ml. or No. of Positive porlions.
BACTERIOLOGICAL WATER ANALYSIS RECORD
Source
a, M.
ru.,o oa�el�nn n.m. I ah. No.
Multiple Tube Report:
Membrane Filter: Direct Count
Verification: LTB
Final Membrane Filter Results.
Reported By
Broth 24 hours: —Broth 48 hours:
10ml Tubes Positive/Total 10ml Portions
Coliform/100mi
_BGB—
– ?Ilform/100ml
Date '/..
_- Time: _ / a. M.
p.m.
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GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received February 5, 1976
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OFA•
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Conv.
1. Approval requested by: Security Nationa Bank
Mailing Address: Pouch 7-777 Phone:
2. Property Owner: Rodney Spendlove Phone:
Mailing Address:
3. Legal Description: Lot 5 Block 4 Spendlove View Heights Addition #2
4. Location: NHN Jeanne Road, off of Upper De Armoun Road
5. Type of facility to be inspected Single FAmily No. of bedrooms 2
6. Well Data: Individual
A. Type _ B. Depth
C. Construction D. Bacterial Analysis
7. Sewage Disposal System: on—si'u.e system
A. Installed 1--76 B. Installer
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank Absorption area Sewer Lines ,
Nearest lot line Other contamination
B. Foundation to septic tank Absorption area
C. Absorption area to nearest lot line
278-1541
EQ -034 (1/74) Page 1 of two pages
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" Street, Anchorage, Alaska 99503 — 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: CMRO VA FHA
2. Property Owner: Rodney Spen&ove
Mailing Address:
Unknown
3. Name of Buyer: Mane D. 9 Mancha P. Stem
Day Phone
t,AtjN:u. a.i.rrY c� ANCHORAOL
DEPA�:iA4LA OI: W"ILiH &
INvr:oN�^n� finl. �!:os-..-crloN
[(r
CONV XXXX
Unknown
Mailing Address: 4024 E"t 4th Avenue, No. 2 Day Phone 274-3602
4. Name of Lending Institution: Security Nat ona"2 Bank
Mailing Address: Pouch 7-777 Phone 278-1541
5. Name of Realtor or Agent: Jon C. Dawson - Jack White Reat ty
Mailing Address: Ca,2a-ins U{{ice Centa Phone 277-1553
3201 "C" StAeet
Anchorage, A.-aska 99503
6. Legal Description: _ _ Lot 5, Btoek 4, Snendtove View Heights A&Uti.on No. 2
Location: _ NHN Jeanne Road U„( o 1A Uppeh DeAnmoun Road
Anchottme, Ata,5ka 99502
7. Type of Facility to be inspected: Singte Aam,i.tU dweUi.na No. Bdrms. 2
8. Water Supply
Type of Supply: Public Utility Individual Weft
If Individual, number of dwellings presently served
If Individual, depth of well Unknown
9. Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation _ Janucucy, 1976
EQ -037 (1/74)
Individual (on-site) Septic
06-1220!a) Rev. 1973 ALA DEPARTMENT OF HEALTH AND SOCIAL St. 'ES
DIVISION OF PUBLIC HEALTH
INDIVIDUAL AND SEMI-PUBLIC
DATE - BACTERIOLOGICAL WATER ANALYSIS
INDIVIDUAL ❑ SEMI-PUBLIC ❑ CHLORINE RESIDUAL PPM
REPORT RESULTS TO
INAME
(ADDRESS
CITY
ADDRESS
OF SOURCE
I _
ZIP CODE
Lab No,
OFFICE
-Analysis shows this Water SAMPLE to be:
❑ Satisfactory
❑ Unsatisfactory
❑ Questionable
❑ Sample too long in transit; sample- should not be over 48
hours old at examination to indicate reliable results. Please
send new sample.
❑ Bottle broken in transit, please send new sample.
SANITARIAN'S REMARKS
COMPLETE THIS SECTION
ONLY IF WATER IS AN INDIVIDUAL SUPPLY
SAMPLE COLLECTED BY
DATE COLLECTED TIME COLLECTED
Sample Collected From ❑ Kitchen Tap ❑ Bathroom Tap ❑ Basement Tap
❑ Other (List)
Well - ❑ Dug ❑ Driven ❑ Drilled ❑ Bored --- --
SOURCE; ❑ Spring ❑ Cislern ❑ Other----------
Dug
ther-- _--_Dug Well or Cistern Construction: -
Walls —❑ Wood ❑ Concrete ❑ Metal I] Tile Brick or -
Top — E] Wood El Concrete F]Metal ❑ Open Top ❑ Concrete
LOCATION:
❑ In Basement [I Basement Offset El Under House - -
[]In Yard ❑ Other _
Building Sewer Septic
DISTANCE TO: or Other Drainage Pipe __-Feel, Tank —Feet
Tile Seepage Cess -
Field Feet. Pit Feet. Pool —_ Feel, Privy ---Feel.
Other Possible
Sources of Contamination - - -
MATERIAL: Building Sewer- ❑ Cast Iron ❑ Wood E] Tile ❑ Fibre ❑ Asbestos
❑ Plastic Joint Material - Type Cement
GENERAL: Does Water Become Muddy or Discolored? ❑ Yes ❑ No _
When?
Diameter of Well Depth Feet.
Well Casing
Material Diameter — - Depth
Length of Water Depth
Drop Pipe From Bottom Feet.
Offset in In Utility
PUMP LOCATION: ❑ In Well ❑ Basement ❑ In Basement ❑ Room
On Top
❑ Of Well ❑ Other
PURPOSE OF EXAMINATION: Illness Suspected? ❑ Yes ❑ No - -
New Source of Supply? ❑ Yes ❑ No Repairs to System? ❑Yes ❑ No Signature -
06 -1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD
Rev, 1973
READ INSTRUCTIONS am
Dale Received Time Received ______pm Lab. No. —_
ON
REVERSE SIDE
COLLECTING SAMPLE
Lactose Broth
IOcc
locc IOcc locc IOcc l.Occ I.Occ
24 Hours
40 Hours
- -
--- - '- - -- - -
Brilliant Green -
24 Hours
4B Hours
EMB
Lactose Broth, 24 hrs.
Coliform Density
MF Results
Reported by
This analysis indicates Coliform Organisms to be:
AGAR —
48 hrs.
Date
Absent
Present
Gram's stain
— (Most probable No, per 100cc)
a.m.
MUMUPAUTYOF "HCH0PR GE
,�( `qtr'
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 017-401-30-000
Expiration Date:
Legal description SPENDLOVE VIEW HEIGHTS #2 BILK 4 LT 5
Site address 13035 JEANNE RD Anchorage AK 99516
9/21/2023
Current property owner(s) HYATT & JORGENSEN JOINT REVOCTRUS
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Original Certificate Date: 6/21/2023
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory X
Tank Age Advisory X Arsenic Advisory
Other
COSA ApprovaUune 2022
Development Services Department �- �.7 Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 017-401-30
Complete legal description SPENDLOVE VIEW & HEIGHTS #2; BLOCK 4, LOT 5
Location (site address) 13035 JEANNA ROAD *ANCHORAGE, AK
Current property owner(s) AUDREY JORGENSEN
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
Day phone 907-230-2970
3. TYPE OF WATER SUPPLY: 0 Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ❑® Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 23 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed 0 Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ _550
Date of Payment 5�z3
COSA # 0S G
Waiver Fee $
Date of Payment
Waiver #
COSAApplication_June 2022
COSA Checklist
Legal Description: SPENDLOVE VIEW & HEIGHTS #2; BLOCK 4, LOT 5 parcel ID: 017-401-30
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system
A. WELL DATA
❑■ Well log is filed with Onsite (or attached)
Date drilled 12/27/1975 Total depth 101 ft
Cased to 73 ft
AN Sanitary seal is functioning correctly
❑■ Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 5/18/2023
Static water level at beginning of test 46.4 ft.
Comments
B. TANK DATA
Measured operating fluid level in septic tank 49.5
Date of pumping 10/05/2022
❑ Required maintenance completed, if AWWTS
Comments:
Well production at time of test 4.0+ gpm
Water storage tank volume N/A gallons
Well disinfected for coliform test? ❑ Yes 0 No
FM Coliform bacteria is Negative
Nitrate 5.47 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L R Arsenic less than MRL (ND)
Collected by GEG
Date 5/3/2023
C. LIFT STATION
❑ Required maintenance c
Age of lift station years
Lift statio erial
D. ABSORPTION FIELD DATA CONDITION OF 1976 TRENCH WAS NOT EVALUATED
Which system tested (date installed) 6/2000
AN ALL standpipes present per record drawing
Total measured depth from grade 12.6 ft (max)
Measured depth to pipe invert from grade 3.2 ft (min)
❑ N/A — pressurized field.
M Per record drawings, field is insulated.
0 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 gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date
Adequacy test date 5/18/2023
Results Q Pass
Fluid depth prior to test 50
Water added 786 gal
New fluid depth 66 in
Elapsed time 194 min
Final fluid depth 60 in
in
Absorption rate 600+ gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 120 in
Effective depth used 60 in
Effective depth remaining 60 in
4
N
®o
2
0
M
Comments/Deficiencies: ON 5/3/2023 (HOUSE NOT OCCUPIED) GEG NOTED THAT THE 2000 TRENCH WAS DRY AND THERE
WAS 29.5 INCHES IN THE 1976 TRENCH SUMP. ON 5/18/2023 (HOUSE WAS OCCUPIED) THERE WAS 50" IN THE 2000 TRENCH
AND LIQUID LEVEL IN 1976 TRENCH HAD ROSE 47.5". PER TED MOORE, PE TESTHOLE IN 2000, THERE WAS NO GROUNDAWTER TO 18'
DEEP. IT IS PLAUSIBLE THAT THE FLOW DIVERTER IS DIVERTING WATER TO BOTH TRENCHES
COSA Checklist June 2022
s
co
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'
❑ Yes
if No
Community Sewer Manhole/Cleanout > 100'
❑o Yes
if No
ft
Fn -1 Yes
if No ft
Neighboring Tank > 100' R Yes
if No
ft
Private Sewer/Septic Line > 25' ❑� Yes
if No ft
Absorption Field on Lot > 100' E Yes
if No
ft
Holding Tank > 100' FE Yes
if No ft
Neighboring Absorption Fields > 100'
if No
ft
Animal Containment > 50' Q Yes
if No ft
Yes
if No
ft
ft
If tank or field is under driveway comment below
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' M Yes
if No
ft
Fil 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'
❑ Yes
if No
* ft
Surface Water > 100'
❑■ Yes if No ft
Tank to Property Line > 5'
Yes
if No
ft
Wells on Adjacent Lots:
Field to Property Line > 10'
❑ Yes
if No
ft
Private Wells > 100'
Yes if No ft
Water Main > 10'
Yes
if No
ft
Community Wells > 200'
M Yes if No ft
Water Service Line > 10'
Yes
if No
ft
If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
*51+ CODE AT TIME OF INSTALLATION **1'+ WR#000036
TANK CENTERLINE IS APPROXIMATELY 60" FROM DECK PILE (2ND STORY DECK). THE TOTAL DEPTH OF
THE PILE IS UNKNOWN. THE EXACT ORIENTATION OF THE DRAINFIELD IS UNKNOWN C01 IS APPROXIMATELY 56" TO DECK PILE
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 Garness Engineering 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
practices. The reported results describe the condition of the system/s on the date/s of the evaluation.
Separation distances were measured to readily identifiable features. Hidden defects or encroachments may
exist that were not identified during the evaluation. The operational life of all wells and septic systems depend
upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate
during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing
the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not
guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) 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
adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG
to perform the evaluation. Reliance upon the information provided in this report by any other person or party
(including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever.
COSA Checklist June 2022
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M UN CIP U V OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
On -Site Water and Wastewater Section
www.muni.org/onsite
Septic Tank Advisory
Certificate of On -Site Systems Approval # OSC231201
Subdivision: Spendlove View & Heights #2 Block:4, Lot: 5
907-343-7904
Fax: 343-7997
The septic tank for this property is 23 years old. The average life of an asphalt
coated steel septic tank is 20 years. Typical replacement costs are $10,000 or more,
not including engineering, surveying or MOA permitting fees.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
This is an example of what the metal of a 30 year old steel tank MAY look like.
T®Titrate Advisory
Certificate of On -Site Systems Approval # OSC231201
Subdivision: Spendlove View & Heights #2, Block: 4, Lot: 5
A water sample revealed a nitrate concentration of 5.47 milligrams per liter (mg/Q.
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Since nitrates are known to slowly increase, we recommend
you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for
important information regarding nitrate.
This advisory 'must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
'Mailing Address P tJ Box 296650 *Anchorage, Alaska 99519 6650 *www mum org r