HomeMy WebLinkAboutSPRING FOREST BLK 1 LT 5Spring Forest
Block 1
Lot 5
#015-321-09
n iii ,►d .,,,.,.
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP211124 PID Number: 015-321-09
Dwelling: Al Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade
Name
ABSORPTION FIELD
DAVID RABE
❑ Deep Trench ❑ Wide Trench ❑ Bedound
Site Address
5900 WEST TREE DRIVE *ANCHORAGE, AK
❑ Other
Phone
of Bedrooms
Soil Rating
Total depth original grade
7Numl—er
GPD/SF
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
Ft.
Gravel depth beneath pipe
Ft.
Subdivision Block Lot
SPRING FOREST; BLOCK 1, LOT 5
Fill added above original gr
Ft.
Gravel length
Ft.
Township Range Section
-
Gravel width
Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total orption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
Line
Ft2
Ft.
TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Well
_
ZI
Manufacturer
GREERTANK
Capacity
1500 Gal.
Surfacewater
100'+
Material
HDPE
Number of compartments
2
Lot Line
51+
NA
Foundation0'-}
LIFT STATION
Manufacturer
Capacity
Gal.
Remarks OLD TANK DECOMMISSIONED PER UPC
PER CONTRACTOR
Alarm location
Electrical installed by
PIPE MATERIAL House to tank D3034Tank to D3034
drainfield
Installer
A+ HOME SERVICES
Drainfield D3034/EXISTING CO/MTD3034
Inspector GEG
BENCH MARK (Assumed elevation) 100.46 ft
Inspection 1s' 5/5/2021 -
Location and description
dates: 2°'
TOP OF MH
3b _ 4" _
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval: Date
0oo600p�0
TH -v0�
�........ - .:...........�
Y, .�y A. Gayness:' DSO
��.. cE—a
�4p �
Septic System i�I�Ik�
Approved ��y Date �a 10�
pp
e� •�.�� coo
Note: this approval does not include well permit requirements.
4p°fessic) o�
X0000 0
#AECC884
(Rev 05/02/18)
PERMIT NUMBER:
OSP211124
A I B
FCO -„_...
6.9 ...._„18.7
31.3
16.9
ST1
35.5
18.1
TMT
35.4
19.9
DBL1
38.4
19.7
DBL2
39.1
19.8
FD
39.9
20.4
SWING TIES WERE OBTAINED FROM
AS -BUILT SURVEY (ATTACHED)
SPRING FOREST; BLOCK 1, LOT 4
PUBLIC WATER
RECORD DRAWING
BOX
WEST MAIN TREE DRIVE
EXISTING 5
BEDROOM HOUSE
.18� IT
SINED
PARCEL ID NUMBER:
015-321-09
*-WATER LINE WAS PROFESSIONALLY
LOCATED AND "PICKED UP” BY SURVEYOR
PUBLIC WATER
SPRING FOREST; BLOCK 1, LOT 6A
NEW 1500 GALLON HDPE GREER
TANK RATED FOR 10' BURIAL
N
SCALE:
!!Sm -
1"= 40' 1"=40'
♦♦♦OF
1 �!
.�E......♦♦♦
�•'• / GARNESS ENGINEERING
GROUPI-Lid� .....::.................. ....`.....
. �
�...u.... N_....2 .,._,... _ 1 ENGINEERINGSALES'.
3701E TUDOR ROAD SUITE 101 -ANCHORAGE, AK 99507 -PHONE (907)337ai79-FAX (907)3383246'WEBSITE: wxw gamessmgmearmg com /yyY..... .. L .••��.�•�....••••.•..
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: '0 �1 I Ey-A _GarnOSS 4! a
MIKE RABE 2 OF 3 ♦♦� %79 3 :'_�
LEGAL DESCRIPTION: DRAWN BY: ♦'��n•.i24.•'�
SPING FOREST; BLOCK 1, LOT 5 D.J.G. !! 4W
TYPE OF WORK: DATE: LICENSE♦1/ ESS`”'
SEPTIC TANK RECORD DRAWINGS 6/14/2021 #AECC884 ������'►�� i
=PERMITER: PARCEL ID NUMBER:
24 RECORD DRAWING 015-321-09
TOP OF MANHOLE = 100.46
FINAL GRADE = 99.98-100.04
MH1 I is
2" HIGH DENSITY INSULATION (PER CONTRACTOR)
TOP OF TANK AT INTLET = 96,81 TOP OF TANK AT OUTLET = 96.87
INVERT OF BUNG AT INLET = 96.17 INVERT OF BUNG AT OUTLET = 96.06
NEW 1500 GALLON
H.D.P.E. SEPTIC TANK
OF
.Ari �') ;.• `••. f#
777777
11 Tp0
n * '}
�....... ..� .. ..........
ENGINEERING - SALES CONSULTING
3701E TUDOR ROAD, SUITE 101 'ANCHORAGE, AK 99507' PHONE (907) 3376179' FAX (907) 336-3246 WEBSITE: k+w.V=es ngweenng <om �^,,,e.. area � . .....5 ...........r
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: '� !fit• fey }1,,,Gafness :' Q
MIKE RABE - 3 OF 3 �j�i'` CE -7 3 ' _w
LEGAL DESCRIPTION: DRAWN BY: �,Aw
��,`'• �l f 4 -1 V
5900 WEST TREE DRIVE *ANCHORAGE, AK D.J.G. �j� F0••p'"�",•..••.• `P�, 0
TYPE OF WORK: DATE: f ' RVFESS\� �W
SEPTIC TANK PROFILE 6/14/2021 #AECC884,ilt►sx;S*••
I
A&Wrol
1A
•
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
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP211124
Work Type: SepticTank Upgrade
Tax Code Number: 01532109000
Site Legal Address: SPRING FOREST BLK 1 LT 5 G:2538
Site Mailing Address: 5900 WEST TREE DR, Anchorage
Owner: RABE DAVID M & ANNA M
Design Engineer: GARNESS ENGINEERING GROUP LTD
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
0�111�nt S
r
v
1)eparumen t
5/3/2021
5/3/2022
41224
❑ 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
InTs "I
N
Special Provisions: The water line must be located prior to the installation of the septic tank. If the water line is
too close to any part of the septic system the MOA is to be contacted to determine further action.
Received By:
Issued By:
Date: oz—
Date: i/ VJI �----
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 015-321-09
Property owner(s) A+ HOME SERVICES (CLIENT) Day phone 907-242-0476
Mailing address 5900 WEST TREE DRIVE *ANCHORAGE, AK
Site address 5900 WEST TREE DRIVE *ANCHORAGE, AK
Legal description (Sub'd., Block & Lot) SPRING FOREST; BLOCK 1, LOT 5
Legal description (Township, Range & Section)
Lot Size
'Sq. Ft.
Number of Bedrooms 5
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(Z all that apply)
Absorption Field
Fj
Initial D
Single Family (SF) El
(w/wo ADU)
Septic Tank
M
Upgrade Fx_1
Duplex (D) D
Holding Tank
El
Renewal
Multiple Dwellings 0
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION
INCLUDES A WAIVER REQUEST FOR:
N/A
Distance: -
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: Waiver Fees:
Date of Payment: 5 ' 31 1 Date of Payment:
Receipt Number: OY(020 6 — Receipt Number:
Permit No. 0 sfl� /I / a.1 V Waiver No.
GMevelopment Services\Building Safety\On Site Water and Wastewatefforrns\Client FormsTermit Application.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211124, Deb Wockenfuss, 05/03/21
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211124, Deb Wockenfuss, 05/03/21
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211124, Deb Wockenfuss, 05/03/21
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 'U' Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name
.�
DISTANCES
/(i/ --- J';J./ Q
TO
SEPTIC
ABSORPTION
WELL
Address
FROM
TANK
FIELD
ISD
WELL
(
Phones) Permit o. No. of Bedrooms
`S—)I
LOT
I
LEGAL DESCRIPTION
LINE
Lot
BlockSubdivision
--�
FOUNDATION
(�I'
�s
Township, Range, Section
v
AS-BUILT DIAGRAM (Show location of well, septic system, property lines, foundation,
�-S
driveway, water bodies, etc.)
TANK_
,SEPTIC ❑ HOLDING
Manufacturer
Capacity In
((
/gallons
Material�
No. of Compartments
Ll
TYPE OF SYSTEM
❑ TRENCH <'�13 ED ❑ W. DRAIN ❑ OTHER
Depth to pipe bottom from Total depth from original grade
original grade
17 FT , OFT
Fill added above original grade Gravel depth beneath pipe
,OFT U,S FT
Gravel length Gravel width
�y
"10 FT FT
Total absorption area Distance between lines
C
p,
I D SQ FT (V FT
Number of lines Soil rating Pipe material G
1
r
SQ FT 1 VL
Insla Y
'r, Lt� Dale Ing
s
'
C
WELLS
.
❑ PRIVATE OTHER (Identifv)
Classification (A,B,C) + Total Depth Cased to
FT FT
Installer Date Installed:
v � 2 1
REMARKS:
MIT-
r
q'
SCE he: rj, _
£NGItJ E?E�Sf,�L
Inspections Performed by:
1:1
•+➢•1
_ I r�D�
Date: �n}
v'a5
L iTS
(�� 2
5 !It S ENGINEERING
', �y
eerij�y thyt�nspectien was performed according to all
9
,,-, ti
0.204
Munici0hj"te>lB 8tfiesih fi95 dale:
-
Health Department Approval: Date:
72-013 (3/85)
MUNIClPALITY DF ANCHORA8E
Uc--parLment of Health & Human Services
825 L Street, Anchorage, Alaska 99501 343-4720
UNlTE 1111WER
Pormit Number: 900224 Upgrade
Date Issued: 07/30/90 Engineer Designed
Owner Name: ROD KIRSCH
Owner Address: 1013 E DlMOND BLVD
ANCH, AK 99502
Parcel ld: 09
1 O Legal: Subdivision:
Section: 14
Lot S�ze 41224 (sq.{t.
Max Gedrooms: lhis Permit:
SPRlNG FOREST Lot: 5 8lock: 1
Township: 121Y Range: 3W
Cir acres)
5 Total Capacity: 5
Day Phone:
694~2979
SEPllC |ANK: Minimum tota1 septic tank capacity: 1v500 gallons" Each septic
tank must have at 1east 2 compartments, Depth to top of septic tank(s) < 4.0
feeT requires insulation over tank(s)"
THE EXISl[NG LEACHFIELD MUSl BE PRDPERLY ABANDQNED, THE UPGRADE
8ED MUST BE INS[ALLEU AS SHOWN ON lHE ENGlNEER'S DESIGN DATED
89, NOTIFY 0HGS 8EFORE ALL lNSPECTI)NI S, THIS PERMIT IS FOR
A 5 8EDROOM SINGLE FAMILY RES1NONE ONLYAMID EXPIRES IN
12/31/90.
1 CERTIFY THAT:
1. I am familiar with the requirements �or on�siie sewers and wells as set
forth by Lhe Municipality of Anchorage (MOA) and the State of Alaska,
2. l w 11 insta1l the system in accordance with all MOA codes and regu1ations;
and in compliance with the design criteria of this permit"
3" I will adheru to al MOA and State of Alaska requirements for the set back
distances from any existing well; wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot"
4. I understand t|iat thzs permit is valid For a maximum of 5 bedrooms. 1
also understand that the capacity of the total system is 5 bedrooms and
any en1argement will require an additiolial perm1t"
Signed:
(|Jwner RO
1ssued Dy DATE:
'
__ 3 A ,
O
AT
`F
T
,►
'14W, rJ, 4 to � r1sJ� o�►o�
ilAVU -- .
w phi gyp,
C -W%
► S`Ck> 40 Act'.
S�PnC-
cam' M L� o
0
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG - PERCOLATION TEST
( C+ 1 �
PERFORMED FOR: `�- r.� G^f DATE PERF
LEGAL DESCRIPTION: L5 .Y ��� 1 AJ fir'; Township, Range, Section:
aEPitb1- 7`-'O (a � r G SLOPE SITE PLAN
(RwEt?z) � ,Q- r" _ /C.
1 � l�
2
3
�t O
4
5 � O
6
kJtr
7
8
9
r�
10
11
12 ` r`
13
14-
15-
16-
17
4151617
18-
19-
20—
COMMENTS
81920COMMENTS —
S&S
:N - SM
5e e P e,rc.
d I I I' I I
WAS GROUND WATER
ENCOUNTERED?
#0IF DEPTH AT WHAT
DEPTH?
PERFORMEN110.e River, Alaska 99577
X")o
��S
o
P
E
Depthto Water Alter
Montt
Monitoring? _� Dale: ���''"""���
Reading Date Gross Net Depth to Net �I
Time Time I Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUID
72-008 (Rev. 4185)
(minutes/inch) PERC HOLE DIAMETER
T AND FT
� CERTIFY THAT THI'TTEST/WAS PERFORMED IN
T ON THIS DATE. DATE: 12,1
0
• Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
625 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR: ��t rL�-,rs� DATE
LEGAL DESCRIPTION: (+•&7 r.?
A" DEPT
,IEEE )
2-
4-
7 47
` •�M
9
♦rr d
10
11
12 V,
4Ct
13 t.6
14 r '
d%
15
d r
16
17
18-
19-
20-
COMMENTS
81920COMMENTS —
), Range, Section:
SLOPE
SITE PLAN
�0
WAS GROUND WATER
n ENCOUNTERED?
IF YES, AT WHAT
'i• DEPTH?
A'7 Depth to Water . �A�ftepr�
Monitoring7 . Date:
CSF
H
PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND ___q_ FT
PERFORMED BY: 17034 Eagle River Loop R®ad N0. 2Q¢
Eagle River, AM
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIN14
SCJ CERTIFY THAT THIS TEST WAS PERFORMED IN
ON THIS DATE. DATE:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
Le*) ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/013 WELL INSPECTION REPORT
NAME m
PHONE
NEW
ROD A. KIRSCH
349-6545
❑ ure,RaDE
MAILING ADDRESS
1013 E. Dimond Blvd. #340, Anchorage, Alaska 99502
LEGAL DESCRIPTION
L5 - B1 Spring Forest Subdivision
LOCATION
NO, OF BEDROOMS
5900 West Tree Drive, Anchorage, Alaska 99516
five
Well
Absorption areaDwelling
PERMIT NO.
DISTANCE TO:
feet
15,10feet
840445
1-2
Manufacturer
Material
No. of compartments
Lu p
GREER TANK CO. , ANCHORAGE
steel
two
rn �Liq.
capacity in gallons
Inside length
Width
Liquid depth
1500
IF HOMEMADE:
n/a
n/a/
n/aQ
DISTANCE TO:
Well
Dwelling
PERMIT N ,,
N A
N A
OS Z
Manufacturer
Material
Liquid capa/city in gallons
N/A
O
Well
Fou dation
Nearest lot line
PERMIT NO.
w y
DISTANCE TO:NIA
»
J LL z
No. of lines Length of each line
Total length of lines Trench width
Distance between lines
H ? an
`T E—
Top of the to finish grade
inches
Material beneath tile
/[�
Total effective absorption area
pn
n
108"-110" inches
918 sf
Length42
Width
Depth
PERrytff NO.
N/A
N/A
N/A
N/A
Q E°
Type b
y i�%A
Crib dia e r
%�
Crib depth
p N/A
Total effective absorption are
p �/A
wa
Well
Building foundation
Nearest lot line
DISTANCE TO:
Na -
N/A
- NIA m
Class
Depth
Driller
Distance to lot line
PERMIT NO.
mUr1J t-y—
Lu
w
�
Building foundation
Sewer line
Septic tank
Absorption area(s)
DISTANCE TO:
OTHER
4"
PV
r
se
w ca
PIPE MATERIALS
C.I. to tank, steel tank, C.I. to absorpt'
n lield,
SOILTEST RATING PVC lield p:Lpe
Per-G.Lest_aZtache-
IN ALL R�
OWNER
REMARKS
H
3 rj
Al
2
4r
CI
st
nd
ip
s
p
1
•'+
pr
p.
lire
j
�Y
OY,Y Y oo
-T
'1& Y YY Y YY a s ooai -
GE
e
} o CDWAR EJ MAO
G
,
I
APPROVED DATE -
/LEGAL
72-013 (Rev. 3178)
MUNICIPALITY OF FINCH. AGE
DEF'ARTI•lIEf-IT OF HEALTH AND ENVIRONMENTAL PROTECTION
E:25 L. STREET: ANCHORAGE: A1e:: 99501
264-4720
1 `Y r-.0 -- W= � "'i' E. 'r E -_•.1-•.a � fes' . �" � Imo'". Ih'�U � �i'
PERMIT r•JO: 840445
DATE ISSUED: 06111184,
APPLICANT: ROD A. KIRSCH
ADDRESS: 1613 E. DIh1OND
ANCHORAGE: At': 49502
CONTACT PHONE: 5'4212-1283
LEGAL. DESC:RIP: SI_IEL:IVISION: SPRING FOREST LOT: 5
SECTION: 14 TOWNSHIP: 12N RANGE: 31-1
LOTSIZE: 41224 (S-0. FT. OR ACRES)
MAX BEDROOMS: 5
QLOCK : 1
LISTED BELOW ARE THE OPTIONS AVAILABLE TO YOU IN DESIGNING YOUR SEPTIC
SYSTEM. CHOOSE THE OPTION THAT BEST . FITS YOUR SITE.
GRAVEL LEN13TH 75 FT. REQUIRES MULTIPLE PUP'S <NOT EXCEEDING 75 FT. EAc-H.*---
TANK MUST HAVE FIT LEAST TWO COMPARTMENTS
CERTIFY THAT: •
I. I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOA) AND THE STATE OF ALASKA.
2. I 14ILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOA CODE-'-'.--. AND REGULATION.113:
AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT.
_. .1 WILL ADHERE TO ALL MOA AND STATE OF ALASKA REQUIREMENTS FOR THE SET BACK'
DISTANCES FROM ANY EXISTI.NG WELL: WASTEWATER DISPOSAL SYSTEM OR PUBLIC.
SEWERAGE SYSTEM ON THIS OR ANY ADJACENT OR NEARBY LOT.
4. 1 UNDERSTAND THAT THIS PERMIT IS VALID FOR A MAXIMUM OF 5 BEDROOMS ANI"'I
ANY ENLARGEMENT WILL REQUIRE AN ADDITIONAL PERMIT.
IF A LIFT STATION IS INSTALLED IN AN AREA COS1ERED BY NOR BUILDING CODES,
THEN A*l) AN ELEC:TRIC:AL PERMIT AND INSPECTION HUS,T BE OBTAINED. (2) AS-BUILTS
14ILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; FIND C 3y THE
ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN.
SIGNED � ` G e DATE
_...__ .___--__.______�._-______ _.4A"R/_.
__
APPLICANT: ROD A. k:: CH
ISSUED C:Y DATE:
.E777-
`f F--. E: r -a w: N_`o
IE" EE r_
c -A FR* n x ria
DEPTH TO i PIPE BOTTOM ':FT.
4. 0
.4. 0
4. 0
GRAVEL DEPTH (FT.)
9 Q--
0. 5
3. 5
TOTAL. DEPTH (FT.)
13.10
4. 5-
7. 5
GRFIVE:L WIDTH (FT. y
E. 5
27• Cl
5. 0
GRAVEL LENGTH (FT.
47. 0
52. Fri
:102. 0
GRAVEL. 'VOLUME (CU. YDS.
41, 3•
53. O
75. 5
TANK SIZE (GAL)
1: 5C� 0. 0 :+: s:
1: 500. 0 4::+:
:L: 500. 0
SOIL RATING FT. .-'BP)
166'
i8s
188
GRAVEL LEN13TH 75 FT. REQUIRES MULTIPLE PUP'S <NOT EXCEEDING 75 FT. EAc-H.*---
TANK MUST HAVE FIT LEAST TWO COMPARTMENTS
CERTIFY THAT: •
I. I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOA) AND THE STATE OF ALASKA.
2. I 14ILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOA CODE-'-'.--. AND REGULATION.113:
AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT.
_. .1 WILL ADHERE TO ALL MOA AND STATE OF ALASKA REQUIREMENTS FOR THE SET BACK'
DISTANCES FROM ANY EXISTI.NG WELL: WASTEWATER DISPOSAL SYSTEM OR PUBLIC.
SEWERAGE SYSTEM ON THIS OR ANY ADJACENT OR NEARBY LOT.
4. 1 UNDERSTAND THAT THIS PERMIT IS VALID FOR A MAXIMUM OF 5 BEDROOMS ANI"'I
ANY ENLARGEMENT WILL REQUIRE AN ADDITIONAL PERMIT.
IF A LIFT STATION IS INSTALLED IN AN AREA COS1ERED BY NOR BUILDING CODES,
THEN A*l) AN ELEC:TRIC:AL PERMIT AND INSPECTION HUS,T BE OBTAINED. (2) AS-BUILTS
14ILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; FIND C 3y THE
ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN.
SIGNED � ` G e DATE
_...__ .___--__.______�._-______ _.4A"R/_.
__
APPLICANT: ROD A. k:: CH
ISSUED C:Y DATE:
.E777-
f�4 SOILS Lvu
MUI_.eIPALITY OF ANCHORAGE �c7( PERCOLATION
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST
825 L. Streat, Anchorage, Alaska 98501 26"720
SOILS LOG — PERCOLATION TEST
DATE PERFORMED: -'June 2—
FOR:
FOR:
r'nA.Fonst 6 1 L S s4 33rItN23W _M04 ST 93 Q -L -
gGAL DESCRIPTION: =ji: —P__ SLOPE SITE PLAN
T
4 I `o L) organ , t So; 1
t CS Ml S�I�'1 SA^d
2 ` 1
3
4
6
6
7
8
' r�c� Sa'l d•
10
72.006 (6/791
WAS GROUND WATERS
Nis—
S
0
,
11
�r.�c1 ENCOUNTERED?
P
Sand
E
12
IF YES, AT WHAT
DEPTH?
---
13
ML�
t
6" b�.• e.c 1e
A'� S,I�
Gross
Net
Depth to
Net
Drop
eding Date
Time
Time
Water
..14
A' OF 6�3
..•,;4,p�
X231
Icy
30
�, 26
so
15
.Tp-( 0""a*
16
0 * 491 /
114
I I I
0
00 *a: m °
I14�'
3 ?6
18
���rtc )aro C. n r.:0
�P •• o. 51 • C��
/ Z y
13 N
10
3.
-
006
9 N• aP• �,. r
�l1F�PROFE
10
1�6 I
. I J
__
19
S1�N+~
v
203
PERCOLATION RATE
I rY
(minutes/inch)
TEST RUN BETWEEN
Iy
FT AND —=---
FT
—
I rb
COMMENTS o; _ 4-c
e
1 CERTIFIED BY:
DATE:—
�--
PERFORMED BY:
72.006 (6/791
Municipality of Anchorage =...
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ek.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-321-09 HAA# -144 c�C7 / G�
1. GENERAL INFORMATION Expiration Date: ✓ (o O
Complete legal description SPRING FOREST SUBDIVISION: LOT 5, BLOCK 1,
Location (site address or directions) 5900 WEST TREE DRIVE • ANCHORAGE, AK
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
JANICE & DOUGLAS PARKER Day phone 346-4626
2405 HIALEAH DRNE " ANCHORAGE. AK 99517
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 5
Day phone
Day phone
3. TYPE OF WATER SUPPLY:
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 Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority
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.
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ at, or prior
to closing for the engineering services provided.
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 Health Authority 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. /further verify that based on the
information obtained from the Municipality of Anchorage riles 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone 337-6179
Address
6901 DEBARR ROAD, SUITE 2B ' ANCHORAGE, AK 99504
Engineers Printed Name JEFFREY A. GARNESS, P.E.
Engineers Comments:
in conducting this evaluation, AKWWC, Inc.. 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. AKWWC, Inc. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
lam• Approved for S bedrooms.
Disapproved.
Date 3
Conditional approval for bedrooms, with the flowing stipulations:
ttl�:I ni-fffrrr
J = ON-SITE •_V --
��" • rrnrrn e•rn • m
e
WASTEWATER
PROurvAM
o . A
Attachments: ��•. ,.• O ,��
HAA Checklist Manitenance Agreements ��ii! //;' Jlil1Z
Septic System Advisory Supplemental Engineers Reort
Well Flow Advisory Other
By: Original Certificate Date: �" (p' d 3
(Rev. 12101)
Municipality of Anchorage
Development Services Department
Building Safety Division
OnSfte Water& Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519.6650
www.cf.enchorageek.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: SPRING FOREST SUBDIVISION: LOT 5 BLOCK 1. Parcel ID: 015-321-09
A. WELL DATA
Well type CLAW •A, If A. B, orC provide
Date completed Sant
Cased to ft.
FROM WELL LOG
Date of test
Static water level ft
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform - colonies/100 ml. Nitrate - mgJL.
Wires properly protected (YIN)
Casing height (above ground) in.
AT INSPECTION
ft.
—
g -p.m -
Other bacteria - colonies/100 ml.
Arsenkx - mg./L. Date of sample: Collected by: -
S. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEEL Date installed 8/1984
Tank size 1500 gal. Number of Compartments 2 Cleanouts (YIN) YES
Foundation cleanout (YIN)YES Depression over tank (YM) NO High water alarm (YIN) N/A
Date of pumping 4/25/2003 Pumper A+ HOME SERVICES
C. ABSORPTION FIELD DATA 10BELOW EX=NG0 r'13"E-DI
8/14/1994 TRENCH/
Date installed 51/
8 1990 Soil rating (g.p.ddft'oVP'
125 System type BEgD
Length �ft. Width ft. Gravel below pipe N5 ft.
918
Total depth •4—; -3 ft. Eff. absorption•area g6D ft' Monitoring tube YES Depression over field NO
Date of adequacy test ••4/25/2003 Results (Pass/Fail) PAS For 5 bedrooms
Fluid depth In absorption field before test 0 in. Water added 1504ga1: New depths 1 gin.
Elapsed Time: 943 min. Final fluid depth 0-5/0 in. Absorption rate >= 750+ g,p.d,
Any rejuvenation treatment(past 12 mo.) (YIN & type) NONE KNOWN If yes, give date -
4* TESTED WED ONLY
i
D. LIFT STATION
Date installed Size in gallons Manhole/mss
"Pump on" level at in. "Pump oM Ievn in. High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?.
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO: COMMUNITY WATER
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
line
On adjacent lots
On
Public sewer manhole/cleanout
Holding tank
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main •10'+ Water service line •10'+ Surface water •'100'+
Wells on adjacent lots 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main •10'+
Water service line '10'+ Surface water 0*1000+ Driveway, parking/vehicie storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 200'+
F. COMMENTS
*PER S&S ENG. DESIGN (12/6/89) do ALL PREVIOUS D
"EXCEPT FOR SEASONAL WATER IN DRAINAGE EASEMENT.
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Munidpal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed ame JEFFREY A. GARNESS
Date 5�63
HAA Fee $ 515 • —
Date of Payment
Receipt Number 5s j!z 0 _
(Rev. 1201)
Waiver Fee $
Date of Payment
Receipt Number
V11
jamIRA 1
Ik
N 89056'00°E 1 50.001
1 HEREBY CERTIFY THAT I HAVE PERFORMED A
MORTGAGEE'S INSPECTION OF THE FOLLOWING
DESCRIBED PROPERTY.
LOT 8. BLOCK 1. SPRING FOREST SUB.
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT
EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL THEVISIBLE IMPROVEMENTS SITUATED THEREON ARE
STRUCTURES OR FENCELINES. WITHIN THE PROPERTY LINES AND THAT NO VISIBLE
EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. ENCROACHMENTS EXIST OTHER THAN NOTED.
NOTE'. ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELYANO ARE NOT TO BE USED TO DETERMINE PROPERTY LINO DATED AT ANCHORAGE. ALASKA THIS_STH_
DAY OF MAY 2003
OR LOCATE STRUCTURES. HOLT LAND SURVEYING 8963. FB10i86
ANY PAVING SHOWN MAY BE APPROXIMATE DUE TO SNOW CONDITIONS. TEL. 04'5-5313
-,.TREE—.
L = 1 58.90
I
I
I
ID
I
N
O
I
M
�
I
I
W
%
I a
I�
N
I t
!7
Ic
0
N
ly
Z
In
I
M
I`
N
0
❑
a
SINGLE T4MILY INAMC HOUBC
41.6
f I
QQDOQQOO4�4
❑
0
DECK �,. _ _
I
N
a OFsq � p
^ �0
Al
f CO. TH � p0
M
49 0
p ...:............................0
D
S�....�, f�
• �p
QQO0 •, SHALS
I
O
LS -6914 •
p0. '••.
I
°
o
.�'
�,p ..........• ^�
pra
°
I
I
Z
I
I
sl
u
ul — _ — — — — —
I
— — 4"
AS -BUILT SURVEY
II IO' SCREENING [BMY.
21 ———--——----- 10' TCL[. i CLEC. CBM'— — —
I
— — — — I —
SCALE: 1�• 401
N 89056'00°E 1 50.001
1 HEREBY CERTIFY THAT I HAVE PERFORMED A
MORTGAGEE'S INSPECTION OF THE FOLLOWING
DESCRIBED PROPERTY.
LOT 8. BLOCK 1. SPRING FOREST SUB.
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT
EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL THEVISIBLE IMPROVEMENTS SITUATED THEREON ARE
STRUCTURES OR FENCELINES. WITHIN THE PROPERTY LINES AND THAT NO VISIBLE
EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. ENCROACHMENTS EXIST OTHER THAN NOTED.
NOTE'. ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELYANO ARE NOT TO BE USED TO DETERMINE PROPERTY LINO DATED AT ANCHORAGE. ALASKA THIS_STH_
DAY OF MAY 2003
OR LOCATE STRUCTURES. HOLT LAND SURVEYING 8963. FB10i86
ANY PAVING SHOWN MAY BE APPROXIMATE DUE TO SNOW CONDITIONS. TEL. 04'5-5313
MUNICIPALITY OF ANCHORAGE
U*
DEPARTMENT OF HEALTH & HUMAN SERVICES
!\�
Division of Environmental Services 91
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. # O t S 3 ZI —09 HAA #
1. GENERAL INFORMATION
Complete legal description t�'i jeK/
Location (site address or directions)
Property owner ��(G fit„ r"a`ay phone
Mailing address
Lending agency Day phone Al /A—
Mailing address r'j
Agent Qn rgA'&- Day phone a'7�;-697J
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3.
.a
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: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOAA21
0
S. 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 furtherverify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of th' inspection.
Alaska Watrr &
Wasiewater services Phone
Name of Firm 33�— 7�
Address
Engineer's signature
6. Dr SIGNATURE 1
Dr
Approved for �G SJ bedrooms.
Disapproved.
Conditional approval for
Additional Comments
Date
J f ey A Garn'' w sd
CE 7553
bedrooms, with the following stipulations:
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 orderto satisfy certain federal and state requirements. Employees of DHHS 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.
72-025 (Rev. 1/91) Back MOA #21
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division (�� / ry
825"L" Street, Room 502 • Anchorage, Alaska 99501 • (90 344 V D
JUN 2 7 1996
Health Authority Approval Checklisb pe Anchorage Health&Hum
es
Legal Description: Lo—i-- & V 1 Parcel I.D.: (-"�) 1 5-- 32! —0 9i
A. WELL DATA
Well type (:!10"'Y"+ .
Lo escnt(Y/N) _
Total depth
Sanitary seal (YIN)
Date of test
Static water level
16 B, or C, attach ADEC letter. ADEC water system number � 13 -5-64'
Date completed
Cased to
LOG
Casing lieig *Tibove ground)
Wiresyp6perly protected (Y/N)
Well production1 v I f� g.p.m.
WATER SAMPL S
Coliform Nitrate
D c of sample: Collected by:
I:GIIIi:G�7�YL1►1
Other bacteria
B. SEPTICAIOLDI NG TANK DATA
Date installed $ 9Tank size Number of Compartments e—' Cleanouts (Y/N)--Y—
Foundation cleanout (Y/N) _ y_ Depression (Y/N) 1'430 High water alarm (Y/N) IJ IA
Date of Pumping _b2-7 9.b Pumper _ . f J59v-- S
C. ABSORPTION FIELD DATA
Date installed 8 Iii Soil rating (g.p.d./ftz or ft2/bdrm) �� System type ReD
Length _Width 24- Gravel thickness below pipe Toted depth 4 —ID +
Effective absorption area +60 Monitoring Tube present(Y/N)Y Depression over field (Y/N) 1*J0
Date of adequacy test -A &I Results (Pass/Fail) PA�6 For !G bedrooms
u
Fluid depth in absorption field before test (in.); �yP Immediately afterw76
_ gal. water added (in.): Ct q//6
Fluid depth 4-//8ii (ins.) Minutes later: 1495' Absorption rate= 7 %�� g.p.d.
P01 -1E
Peroxide treatment (past 12 months) (YIN) �+ouJr✓ If yes, give date h1/k
L°t7h�hl r '� �t-.i� rdCiF( J Ir1S'fi'GC:EJJ A—r- - Cge- VA-LVC—, 4,JD SwTCFL
—roc� cA S`s 5`I 1 7 67C /9b
D. LIFT
Date installed
Manliolc/Access (Y/N)
High water alarm level at*
Size in gallons
"Pump o "Pump off' level at*
*Datum
E. PARATION DISTANCES � )A-
SEPARATIO TANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer
/septic service litre
On adjaccnt
n adjacent lots
Public sewer manho e
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
PF2 191341asP. f2EPorrri
Building foundation 14-'51±- Property line Z 3 Absorption field 10
i I P
Water main/service line t0Surface water/drainage :>IC`Q Wells on adjacent lots >ZOO
me 5� s s.)6Q. baw-j iz1616y � Au-- Pr:VVrouS OocunF—r70—nw.
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
r
c�r J'ea 6/i190
Buildingfoundation 4�0 J t�SP o4POSrrf SrpES Qi^
guar Water main/service line '� I U oQ,,,�wA
Surface water '-,-too � � Driveway, parking/vehicle storage arca 2Z)
) � Pte, i9B4
Curtain drain NOrr� oL,JtJ Wells on adjacent lots N > 2oD Property line /0 * )�SP� tz�a
F. ENGINEER'S CERTIF'ICATION� EKLepf
v-
w.v���'6'tia
certify that! h de r)nined 1rC 'eld inspections and review of Municipal records jh��ibo sy are
I"
c017f0
r1)lan e wi h A Hi id Ines in effect on this date. sip'; •'°°m°��°'•°
m
m• �
Signature
®m c. °n � a4rmmina mmm m
sr a°a+e •r e
Engineer's Nameeeness
A. Garrners od�
DateCE-'/953 1 �
�O 2 me \ y
»------------------»-----------------------------------------------------------»» » »-� �J�J��..L`J�.�yy� »-----
HAA Fee $ 00-d e
Date of Payment6 �� 7
Receipt Number 1'77 % 0
Rev. 8/95 OSS: haa.wk.doc
Waiver Fee $
Date of Payment
Receipt Number
A\l<<alsk'a Wateir & Wastewater
8471 Brookridge Drive —Anchorage —Alaska gg57U4'
Phone (907) 337-6179 — Fax (907) 338-3246
Consulting Engineers
Ref. HAA for Lot 5, Block 1, Spring Forest S/D.
To whom it may concern:
The subject property has a 5 bedroom house which is served by a community well, and a private
septic system. The septic system was originally tested on 4/27/96, and it was determined that it
could only absorb 510 gallons/day (filled to a depth of 9.125 inches in west M.T.).
During the first week in May 1996, the bed was treated, by the property owner, with a drainfield
cleaner called "Septiclear". A copy of the product literature is attached. I retested the drainfield
on 6/11/96, filling it to a total depth of 6 inches (west M.T.), and determined it would only
absorbed 450 gallons in 24 hours.
The system was tested again on 6/16/96 (house was vacant in the week prior to the test, and tank
pumped), this time filling it to a total depth of 9.56 inches (west M.T). I monitored the septic
tank (visually & audibly) to ensure that water didn't backup into the tank. The recovery was
monitored for 24 hours, during which time it absorbed approximately 990 gallons. The data
,from this test is noted on the HAA paperwork. In short, when filled to the top of the drainpipe,
the bed will absorb greater than 750 gallons/day. Based upon this data, it was determined to be
adequate for a 5 bedroom house.
NOTE: The adequacy of a septic system is influenced by numerous factors, including, but not
limited to, seasonal surface water infiltration, groundwater variations, septic system
maintenance (frequency of septic tank pumping, usage of biological additives), condition of
drain pipe and pipe joints (which can be damaged by seismic activity and deteriorate with age),
°0"
June 21, 1996
��.Of •
i% I
' Va0
® ° 4
®r `S
... ..... ...•...e.�•
C
Municipality of Anchorage
rey A. Gorness
CE -7953 ° : '4
��Fq
Dept. Health & Human Services
••®> °`,F` o
Division of Environmental Services
On -Site Services Section
RO Box 196650
Anchorage, Alaska 99519-6650
Ref. HAA for Lot 5, Block 1, Spring Forest S/D.
To whom it may concern:
The subject property has a 5 bedroom house which is served by a community well, and a private
septic system. The septic system was originally tested on 4/27/96, and it was determined that it
could only absorb 510 gallons/day (filled to a depth of 9.125 inches in west M.T.).
During the first week in May 1996, the bed was treated, by the property owner, with a drainfield
cleaner called "Septiclear". A copy of the product literature is attached. I retested the drainfield
on 6/11/96, filling it to a total depth of 6 inches (west M.T.), and determined it would only
absorbed 450 gallons in 24 hours.
The system was tested again on 6/16/96 (house was vacant in the week prior to the test, and tank
pumped), this time filling it to a total depth of 9.56 inches (west M.T). I monitored the septic
tank (visually & audibly) to ensure that water didn't backup into the tank. The recovery was
monitored for 24 hours, during which time it absorbed approximately 990 gallons. The data
,from this test is noted on the HAA paperwork. In short, when filled to the top of the drainpipe,
the bed will absorb greater than 750 gallons/day. Based upon this data, it was determined to be
adequate for a 5 bedroom house.
NOTE: The adequacy of a septic system is influenced by numerous factors, including, but not
limited to, seasonal surface water infiltration, groundwater variations, septic system
maintenance (frequency of septic tank pumping, usage of biological additives), condition of
drain pipe and pipe joints (which can be damaged by seismic activity and deteriorate with age),
type of substances deposited in septic system (cigarette butts, sanitary napkins, misc. objects),
and the amount of water being introduced on a continual basis. Consequently, the results of this
adequacy test are only valid for the specific day of the test. Furthermore, because of the limited
nature of this investigation, it is possible that there are hidden defects which may not have been
detected. No warrantee is made regarding the future performance of this septic system
If you have any questions, please contact me at 337-6179, or on my digital pager at
1-800-481-1162. Tek you for your business.
Sincerely,
Jeffrey{ N. /Garnes`s, P.E., M. S.
c.c. Bob Baer, Totem Realty
Greg & Robin Navarre
Navarre3.wps
Figure 28. Typical Onsito Systeme
SEPTIC
III I YANK
ABSORPTION
FIELD
I
Ili�l�illo I'I 1
-NON PERFORATED til
TII.E w
TILE
'I
DRAINAGE
LINES
INLET
a" I
Figure 29. Distribution Boxes4
'LET
60'1
4°OUTLETS
INLET
4"
IN
INLE
TLETS
I �r
i�
4"OUTLETS
1 Cis —
.N
•. 7749659 Il.:d,'iz 774-9659
Figure 30.
Septic Tank4
cl!]St hHRN
1'09TLANa. ORh:(:0N 91101
S}IP19C TANK:
1, Root main line (to check for break or blockage)
2, put 4 Gal, Chemical Treatment into clean out, floor drain
or waning machine drain - not toilet
—�'
don't spill - wear rubber gloves
3, restrict water use for 48 hra. ( no laundry)
4, in 3 weeks put one package of Super Pack Bacteria dorm
x ' -
'V
Your toilet.
I
Note: outflow pipe can be blocked. To open blockage backrest
1
from-jlmcti 44UtAe
I
)RhIN FIP
VJ
1
d•
1, find junction / T / distribution box
,�'r
2, insert garden hose in weep line as far as it will go '
thru funnel pour I Gal, of Chem. Treatment per 50' lino
-
into hose as you slowly pull back on hose
-.
weep line is dry - add 2 Gal. nater
-
- J
• WIDE ME311
-
'�
1.1 I
CESSPOOL•
1. root main line (to check for break or blockage)
f.ToeDI"KR WX
2, thru clean out, floor drain or washing machine drain pour
«}'
tCTO D"--
I1.OW LINE
-
};4 •'
TL [T
rj
10 - 15 Yr, old pool 8 Gal. Chemical Treatment
'N
-`
- If
b �—
15 - 25 yr. old pool 10 Gal. Chemical Troatment
Chemical Treatment
c
. IeTO
„�•
S
25 .L older pool 12 Gal.
h�5
E
-'^-�:'
w L(7^�
If caustic soda has been used 16 Gal, Chemical Treatment
„
`
into pool, Don't spill - wear rubber gloves
3, restrict water use for 48 h-rs. (no laundry)
•.F
-
t+�
4, in three weeks put 1 box of Super Pack Bacteria down
your toilet.
r,
MAINTMANCE:
tip•
••� Y:
,f•r•"�:'.
ice; ..
v', �_.
Every 6 month I Gal. Chemical Treatment to be followed
-
3 weeks later by 1 box Super Pack Bacteri.
Y C V • U C 9 C H' k `d ii ^_ ,«°` c y � O �' g y0�� u
ao« E
O
&ge4E �a£ `£ n E& E3Ao 'F&SX �5zE F��898 P��•P .B X.«�5_ •a
UQ�RN ^ `u Ogi°C 03 xa Efir"y o'�o n OUqOE_ 6Y
vfi' °oV y.r,C v�g�q Oa°£ ua n 8a
L •S G1Y c—v � _ a � 03 FFSyQ fiw��' Q{N c
qL,°CvcuO.1 wn 1 b •
x iO$o R8
vuo° >¢
c•eCq_uUy LLz F.p2�5
R O
�•
B
y Ll y VJJ
�yk2'L„aa LLyca wsa
-89Ey' �'gkrifio`ad syn }�E y�,c-N u QGp'23� 2Z'yu p 'kb}'R=�E ja�.'Scj•� N
BQCE 3aO�c,�pxi9 yR<
V t3 nL R'y.�$xS
E
2 `� g'-„aa�Eem e&w�va f b SU�Ci �a °aa gC ¢ o
w 2.C`• UO' ya OFFr •mob O (j •Q ••• �� _a W
t S qr in
�
UzR Ed6E Bor�aR u�{ESmv E.j v N•..N 5"s�g �5 ao. •$wp hn'Eppb J3� ,HEi aN,tc Y S$E8, &,CM LI0p&<1
..
$
3 4� Eb b �g'� on�s�Sa i$8_Fdwg �gy�A
�Y yy
c 8 g
_•Zi� c �y u'g'
G w ..$n _T.^, mA yq �F Fg:E d"9y ce yFc
P '•`�'' y c
P C Zp %Y• N .6 .LG q CC C 9 �Op p yy O y N d 'P $F= gyp( is •i j{ Y y 4� T 'L
.-=dw QU Tin G uE O'SpiV •VuC OCCEC�=J�d °Cf�•1Fe 'p yy 'u "u
�v`�b°$ a°„=' w?�U^ gg•ii-�' ~b $ u
55 o Fn > '
i
Alaska Water & walstewalter
8471 Brookridge Drive — Anchorage — Alaska 99504
Phone (907) 337-6179 — Fax (907) 338-3246
Consulting Engineers
RECEIVED
July 30, 1996 AUG 1 1996
Municipality of r,-norage
Dept. Health & Human Services
Municipality of Anchorage
Dept. Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O Box 196650
Anchorage, Alaska 99519-6650
Ref: HAA for Lot 5, Block 1, Spring Forest SID.
To whom it may concern:
.Cd' - a104
�` a ee a stave e
• ea o e aeeeao aaeeae<.,•-
��e'a� e Y Baas ee sae uow .^
1� o
off reyA. Garness
®e� Tae
CE -7953
F aase e°°a•����
��IS�pROFESS\;�__
As directed by your department, in our meeting (Jim Cross, Dan Roth, Bob Baer, Jeff Garness) on
7/10/96, we have reconnected the old trench system (installed 8/15/84), and installed a valve so
that flow can be alternated between the bed and trench. I noted during my most recent site visit
that the monitoring tubes in the bed system were essentially dry (no standing water). This is a
marked improvement over the operating level noted in April of 1996. Perhaps the Septiclear
(sulfuric and phosphoric acid) reduced some of the biomat. In short, the bed visually appears to
be operating very well at this time. Comments regarding the connection are summarized as
follows:
OLD TRENCH SYSTEM WAS NOT ABANDONED IN PLACE: Per the inspection report,
dated 8/3/90, the old trench system was abandoned in placed. When the excavator tried to locate
it, beginning near the tank, he found broken drainpipe, and insulation in the upper soil layers.
Upon further investigation it became clear that the drainpipe to the old trench has been removed
along the entire length of the trench, and the solid pipe to the new bed was placed on top of the
drainrock. In short, the old system was not abandoned in place. We received verbal approval
from your office (Dan Roth ) to place new drainpipe in the trench, and install a monitoring tube.
As you can see from the attached photograph the drainrock had a considerable quantity of dirt in
it. The excavator, Monte Acheson, removed as much of the dirty drainrock as practical ,
installed new drainpipe, filled over it with clean drainrock, and placed filter fabric. In addition, he
installed a double c/o after the tank, an alternator valve (Bull Run) after the double c/o, a single
c/o at the end of the trench, and a monitoring tube.
When installing the monitoring tube, the excavator attempted to drive a perforated steel pipe into
the drainrock, but was unable to drive it any deeper than about 3 feet (According to the 1984
inspection report, dated 8/15/84, the trench has an effective depth of 9 feet). Amer that he dug
into the end of the trench, and installed the monitoring tube to a depth of 9 feet below the
drainpipe invert. He commented to me that he only encountered several feet of drainrock.
Perhaps he dug to close to the end of the trench, and the drainrock depth was shallower there?
Why he placed the monitoring tube below the gravel depth he encountered is unclear to me. In
short, the actual depth of the drainrock in the old trench is uncertain. Given the conditions
encountered, I think the excavator did the best he could, short of rebuilding the entire trench.
Although the performance of the trench will be somewhat diminished, it should still provide some
periodic relief for the bed system.
SOLID PIPE FROM SEPTIC TANK TO BED SYSTEM IS HALF FILLED WITH
SANDY DIRT: When the excavator removed a section of the solid pipe, to install the alternator
valve and double clean -outs, he noted that the solid pipe was about half full of black (sewage
contaminated) sand. The source of this sand, and the length of pipe which is filled is unknown.
The most practical way to remove the sand would be to install a clean-out on the solid line, just
where it enters the bed, and then jet clean the line from the new double clean-out, towards the
bed. The sand/dirt could be vacuumed out of the proposed clean-out, with a pump truck, as the
line is jet cleaned. The bed system appears to be operating adequately now, and according to the
homeowners, there have not been any problems. In the future, it may be necessary to install the
aforementioned clean-out, and jet clean the line. Again, the source of the dirt/sand is unknown.
CLOSING: If you have any questions, please contact me at 337-6179, or on my digital pager at
1-800-481-1162. Thank you for your assistance.
Sincerely,
Jeffre I . Garness, P.E., M.S.
Owner/Consultant
c.c. Bob Baer, Totem Realty
Greg & Robin Navarre
Navarre6. wps
MUNICIPALITY OF ANCHORAGE
• Department of Health & Human Services M !
DIVISION OF ENVIRONMENTAL SERVICES M�
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. # �- SQ Cal HAA #
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 5• Block 1 Spring Forest Subdivision
Location (address or directions)
5900 West Tree Anchorage Alaska
(b) Property owner Rod A, Kirsch Telephone : (home) Business
Mailing Address 1013 East Dimond BQuleyard, #340-, AnrhQrage, Alaska 99502
(c) Lending Institution
Mailing Address
Telephone
(d) Real Estate Company and Agent POR111NE 2R02 RTTFSZC aiBP11 i a RUSPhman
Address 3000 A Street, Suite 101, Anchorage, Alaska 99503
Telephone 346-2323
(e) Mail the HAA to the following address: (or check here IN, if hold for pick up.)
List contact person and day phone number below:
S & S ENGINEERING/694-2979
17034 Eagle River Loop Road Suite 204
Eagle River Alaska 99577
2. TYPE OF RESIDENCE
Single -Family M Number of bedrooms 5
3. WATER SUPPLY
Individual Well ❑ Community XX Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site IX Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-025 (Rev. 7788) Page 1 of 2
Z; to z abed
MOUO (99/L nad) SZO-EL
-�AoM s,aaeul6ua leuolsseload aql ui
suolsslwo ao saoaaa jol alglsuodsaa lou si a6eaogouy to Al!ledlolunW ayl -panssi si aleolllliao e aaoleq elep ez (leue ao
suolloadsui Ion puoo lou op SHH(] to saaAoIdw3 •sluawaainbei alels pue Iwo pal uieliao Alsiles ol.)apao ul suoilnjpsui
6ulpual iiayl pue sawoq to siesegoand of (salinoo e se slgl saop SHHO aql Te Isely to alelS aql ul paaalsibaa
aaaulbue leuolsseloid luapuedepui ue (q anoge 9 gdei6eied ul uanlb suoileluasaidaa aql uodn Aluo paseq paleoilliao
lenoaddy Allaoglny glleaH sanssi (SHH(]) saolAJOS uewnH pue glleaH to luawlieda(] abeaogouylo AllledlolunW aql
N011flt/O
lenoiddy leuolllpuoO to sw.)al
leuolllpuo(] panoiddesi4Y panoaddy
�(G �/� ele(] '_7' pV r (q swooapaq S �� /f aol panoaddy
A
.7-
IVAOUddb' SHHO '9
•gaodaa uotgoadsut pagoPgqP aag '686T 'aagwaoaQ
panss. TPAoaddV IgtaogqnV ggTPaH TPuotgtpuoo
aad sP papea6dn ueeq seq wagsAs otgdas aqs
ale(]
/ LLS66 e:lsnly'aaATIH o10e3
z'ON peo4 CIOOJ JOAIZJ 81693 PCOLI sseippy
auogdalal ONI MNION3 S T-1 5
` U wail to aweN
-uoiloadsui sigl to alep aql uo loalla ui suollelnbaj pus 'seoueuipio 'sapoo alelS
pue ledlolunW !le gllM eouelldwoo ui si welsAs lesodslp aalemelseM ao/pue Alcldns aaleM alls-uo aql 'uoiloadsui
pue uolle6llsanu1 AW woal pue sal!; a6eaogouy to AllledlolunW aql woal paulelgo uollewaolul eql uo paseq
legl AllaaA Aaglanl l •ulaaag paleolpul ainlonils to adAj pue swooapaq to aagwnu aql aol alenbape pue leuollounl
'ales sl wals (s lesodslp aaleMalseM ao/pue Alddns AaleM alls-uo agl leg! SMogs lenoiddy Llljoglny glleaH
slgl to u011e61lsanul Aw legl lllaaA I 'Molaq umogs elep uolleplleA aql to se pue olaaaq paxllle leas Aw Aq pallllaao sy
NOl1VVY80dNI ONV y.LV(3'HO8d3S 3l1d'S1S31'SNOLLOUSNl ONIOIAOad WHIJ ONIH33NION3 'S
MUNICIPALITY OF ANCHORAGE
T Department of Health & Human Services}t
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL_ OF
ON-SITE �SE�W,.E�R, AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. # C)�5_ �F/ 1- )V HAA # �N)�
'a3
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 5; Btock 1; Spni.ng Fone�•t
Location (address or directions)
5900 (Vest TLee
(b) Property owner
Rod A KiLAoh Telephone : (home) Business
Mailing Address 1013
D,rrnood B,Pvd U40 A)^cl^anagQa A alha 99502
(c) Lending Institution
Telephone
Mailing Address
(d) Real Estate Company and Agent FORTUNE PRt)PERT7F4 ATTN • Cn nc n n : „
Address 3000 A St)teetp suite 101 Anchan.a e Ak. 99503
Telephone
(e) Mail the HAA to the following address: (or check here DUif hold for pick up.)
List contact person and day phone number below:
S & 5 ENGINEERING _
17034 Eagle River Loo Road
Eagle River, Alaska 99577
2. TYPE OF RESIDENCE
Single -Family NX Number of bedrooms
3. WATER SUPPLY
Individual Well ❑ Community XI Public O
.Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEEWAGE DISPOSAL
On-site [NX Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
Page 1 of 2
72-025 (Rev. 7/88)
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by myseal affixed hereto and as of the validation date shown below, I verify that my investigation of this
Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe,
functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and
inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and
State codes, ordinances, and regulations in effect on the date of this inspection. /7
/�!�
Name of Firm Telephone �/
Address 17034 Eagle River Loop Road No. 204
age Kiver, Alaska 99577
Date
b-GLo�-t�t�� T TNS aT1��
Z
6. DHHS APPROVAL
Approved for bedrooms by Date 4 '
Approved __ —_Disapproved Conditional X
Terms of Conditional Approval
d�9
S14cc •fii-
:.i!af� .►�,us� .� /or,��er/y o6a�rJ�i7� a.�ai a i-��sr.�ino•� o.`ro•/o,liah dam/
s�Q�/�✓ ,.� ����d��u �4.1
11,14 74ie oW,5<s ope.,7v�d.�d 7%e
/ep/arzryvir/ sys, .r.,us,� �e ins�s/.(et✓ 4ne> i5otti �N.SCS o/°�'low/� no/ ia�-
✓i'wC /S /��b. <iu��uc.�� veal4wsl ,», us,< 'Ife- /a4ea/ is a. -I Gsc•-flus
covers- �� �os�s m 7�� ,/�er,,,�,,,� �rys�,
'�5A?o
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health AuthorityApprovaI
cerificated 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 DHHS 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.
72-025 (Rev. 7/88) Back Page 2 of 2
MUNICIPALITY OF ANCHORAGE (MOA)
• Wealth Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744
Legal Description:
A. WELL DATA
Well Classification
Well LogPreseot (Y/N)
Total Depth Ca
Static Water Level
Casing Height Above Ground
Date Completed
Electrical Wiring in Conduit (Y/N)
Depth of Grouting
SEPARATION DISTANCES FROM WELL:
If A, B, C, D.E.C. Approvedj�VN)
Yield
Pump Set At
Sanitary Seaham Ceasing (Y/N)
Depression Around Wellhe
I
To Septic/Holding Tank on Lot lzle� ; On Adjoining Lots
t
To Nearest Edge of Absorption Field on Lot — ; On Adjoining Lots
To Nearest Public Sewer Line
To Nearest Sewer Service Line on Lot
Water Sample Collected by
To Nearest Public Sewer Cleanout/Manhole
Water Sample TestResults
Comments f �'s• 1 f -->. Z �3�j �U,4�
B. SEPTIC/HOLDING TANK DATA
; Date
Date Installed 8—VG—e&Size 1 S ems® No. of Compartments
2--
Standpipeso N) —\/ Air -tight Caps(�RN) Foundation Cleanout 61N)
Depression over Tank (Y�l 1--i ate Last Pumped (S9
Pumping/Maintenance Contact on File (Y/N) ; for
Holding Tank High -Water Alarm (Y/N, A Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water -Supply Well ���� I To Building Foundation
I
To Property Liney To Disposal Field
I
To Water Main/Service Line
To Stream, Pond,, Lake or Major Drainage Course
Comments A` `rL"JS Me' S
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata l2a� Type of System Desig K_�A
Date Installed Length of Field S 1
Width of Field -2 • S Depth of Field
Gravel Bed Thickness �N 1 \ 0 4
Square Feet of Absortion Area t Statndpipes Presentq-WN) y
Depression over Field (Y/& Date of Last Adequacy Test
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water -Supply Well 1 k 1 To Property Line Tim
To Building Foundation, 2A� To Existing or Abandoned System on
Lot _ P ; On Adjoining Lots
To Water Main/Service Line cp 1� To Cutback (if present) P
To Stream, Pond, Lake, or Major Drainage Course 1 "�
To Driveway, Parking Area, or Vehicle Storage Area
CommentsX\�I,�GA
D. LIFT STATION
Dat stalled
Size in Gallon
"Pump On" Level at
High Water Alarm Level at
Tested for
c�G� Phis
Meets MOA Electrical Codes (Y/N)
Comments
L� v
J?
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent(Y/N)
Pumping Cycles during Adequacy Test.
"Check Permitted Bedroom Rating Against HAA Request"
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect
inspection.
Signed S & S ENGINEERIN(7
170 4 age KIM LOOP KOaCRIVo, �,Url
CompanyAlaska 9957
Date A
MOA No. —��
Receipt No. C2
Date of Payment
Amount: $ / 2 0
0
72-026 (Rev. 7/88) Back
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
v7
�e of this:;: ,
_N
r °o oto"
i°9Mkwatl %14J,74 4�
�.. ;i{trs/fei' ° S�J
Q r L n9r9oil -
+tl,L "Cu, �..i J. .;, Y
orSTEVE COWPER, GOVERNOR
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
3601 C STREET, SUITE 322
ANCHORAGE, ALASKA 99503
DATE: December 19, 1989
PWSID: 213564
To Whom It May Concern:
563-6775
According to the :records on file in this office, the SPRING FOREST
S D water system is in compliance with the State of Alaska Drinking
Water Regulations.
Sincerely,
VERA E. CRAIG
Environmental Field fficer
SCALE
xdelro �.
N ---
V
'�—�—tvr%►G g,a2��G�
G��
x
a
,�.• sLo
•. ��,�
o Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: �Q_ \/-•I DATE PERFO
LEGAL DESCRIPTION: 1-Jg f Township, Range, Section:
SLOPE SITE PLAN
2 .
3 •Q �,-
4 9,
5-7",
6 p'
` P
7C'SQ---
a
8 0!
h
9
11 �]J
12 6
13-
14
3 14 •�� °
15
d r
s
16
17
81920 18-
19-
20-4
COMMENTS
WAS GROUND WATER
ENCOUNTERED? V
S
IF YES, AT WHAT L
O
DEPTH? P
E
Depth to Water Alter
Monitoring? Date:
H
PERCOLATION RATE �� (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
SCJ G � E /J ll
PERFORMED BY: 17034 Eagle River Loop Road No. 204
Eagle River, Alaska
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINIi
72-008 (Rev. 4/85)
CERTIFY THAT THIS TEST WAS PERFORMED IN
ON THIS DATE. DATE: _
f=
�e�. ,-
.,.
f a � -_Jim
�'t-��' � ../
-_�� i��
cam/ � '"��
. � : ---- �
c_
-J
J
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343
FEDERAL TAX ID N 92.0040440
Lf.B OR/.TO RIES
ANALYSIS REPORT BY SAMPLE for Work Order # 18919
Date Report Printed: DEC 19 89 @ 17:28
Client Sample ID:LT 5 MELINDA Client Name S & S ENGR
PWSID :UA Client Acct SNSENGP
Collected DEC 18 89 @ 14:35 hrs. P.O.# NONE RECEIVED
Received DEC 18 89 @ 16:00 his. Req #
Presexved with :AS REQUIRED Ordered By : BOB SHAFER
Analysis Completed :DEC 19 89 Send Repoxts to:
Laboratory Supervisor :STEPHEN C. EDE 1)S & S ENGR
Released By : � %C, �%�
........................................................>..........................?..........................................._........
Special HOLD UPON COMPLETION FOR PICK-UP.
Instruct:
Chemlab Ref #: 8952. Lab Smpl ID: 5
Parameter Tested
------------------------------------------------
NITRATE-N
Matrix: WATER
Allowable
Result Units Method Limits
-------•--------------------------------------------------
ND(0.10) mg/l EPA 353.2 10
Sample ROUTINE SAMPLE. SAMPLE COLLECTED BY BOB SHAFER.
Remarks:
.................................................................................................
1 Tests Performed See Special Instructions Above UA -Unavailable
ND- None Detected See Sample Remarks Above
NA- Not Analyzed LT -Less Than, GT -Greater Than
t
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL iD G7l
OF ON-SITE SEWER AND WATER FACILITY
264-4744
Application Date 5/11/87
1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
L5 — B1 SPRING FOREST S.D., Sec. 14. Twn 12N. Rae 3P1
Location (address or directions)
5900 TREST TREE DRIVE, ANCHORAGE, ALASKA 99516
(b) Property Owner _ ROD A. KIRSCH Telephone: Home 346-3994 Business 349-5944
Mailing Address_ 5900 W -est Tree Drive$ Anchorage, Alaska 99516
(c) Lending Institution _ALASKA MUTUAL BANK Telephone 338-7890
Mailing Address Benson & Minnesota, Anchorage, Alaska
(d) Real Estate Company and Agent none
Address
Telephone
(e) Mail the HAA to the following address: or: Check here ®, if hold for pick up.
List contact person and day phone number below.
Rod A. Kirsch
349-5944
2. TYPE OF RESIDENCE
Single -Family 12
Number of Bedrooms 5 bedrooms
3. WATER SUPPLY
Individual Well ❑ Community M Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite 0 Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 n-ozs (RPv 8/86) Front
4308 (98/8 Aad) saO-ac Z jo Z abed
'>JOM s,Aaaw6ua
leuolssajojd a41 ui suoissiwo ao saoaJa aoj alglsuodsaa lou si a6eao4ouy jo Al!ledlolunW a41 -panssi si ajeoljljaao e aaojaq
elep azAleue ao suoiloodsut jonpuoo jou op SHHO jo saa (oldw3 sluawaiinbaa ajels pue leaapaj ulelAeo (lsiles of aapao
ui suollnjljsul bulpual aiaU1 pue sawoq jo siasegoand of Asalanoo a ss si41 saop SHHO a41 'e�sely 10 a1elS a41 ul paaalsl6aa
aaauibua leuolssajoid juapuadapui ue Aq anoge g 4dea6eaed ul uaAlb suopeluasaadaa a4j uodn Aluo paseq sajeoiplaao
lenoaddy (juogjny 4lleaH sanssi (SHHO) saolAaaS uewnH pue 41leaH jo juawliedaa a6ejogouy jo Al!ledlolunW a41
NOI1f1V0
leuoll!puo0
lenoiddy leuoljlpuo0 jo swial
panoaddesia panoaddy
L _ _ ale(I� Aq swooapeq aoj panoaddy
IVAOkiddV SHHO '9
4t�eueissado�d
® y"h 0769 - 30 �•.' o �Q
}4a lag -1 sewoNl Q
•dui•••.•.••••• ••.•..Jd
fig, �s •.• �H 1 t)
17 .' 0) o
Qvd
leas s,aaaul6u3
aje4
ssaappy
S_5 auo4dala1 0 OWEN
/uolloadsul s141 10 alep a41
uo joaga ui suolleln6ai pue 'seoueulpio 'sapoo ajejS pue ledlolunw Ile 4l!M aouelldwoo ui sl wals/s lesodslp aalemalsem
ao/pue (lddns aelem ajls-uo a4j 'uoljoadsui pue u01le61jsanu! tw woaj pue salt' a6eao4ouy jo Al!ledlolunlN aU1 wojj
paulelgo uopewaojui a4j uo paseq je4j (j!JOA aa41anj I -ulaaa4 pajewpul ainjonals jo adAl pue swoojpaq jo aagwnu a41 aoj
alenbape pue leuoljounj'ajes sl wals (s lesodslp jalemalseM jo/pue (lddns aalem alis-uo a41 le41 snno4s lenojddy Allaoglny
411e9H s14j jo u011e61lsanul !w 1e4j (jlaaA I 'Molaq UM04S ajep uolleplleA a4j jo se pue olaje4 paxige leas /w !q paljluao sy
NOIIVWHOdNI (INV V1V4 'HOHV3S 311d 'S1S31 'SNO1103dSNl ONIOIAONd VYHld ONId33NION3 '9
y �� P�GLOO\�loJ
N, N'O
A. WELL DAI&�
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4744
Legal Description: L5 – Ill SPRING FOREST S.D.
Sec. 14, Twn. 12N, Range 31d
Well Classification N/A If A, B, C, D.E.C. Approved (Y/N) N/A
Well Log Present (Y/N) _ — Date Completed
Total Depth Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments COMD4UNITY [JELL
B. SEPTIC/HOLDING TANK DATA
Depth of Grouting —
Pump Set At
Yield
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
On Adjoining Lots
On Adjoining Lots
— To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
Date
Date Installed 8/15/84 Size 1500 Gal. No. of Compartments
Standpipes (Y/N) YES Air -tight Caps (Y/N) YES Foundation Cleanout (Y/N) YES
Depression over Tank (Y/N) — NO Date Last Pumped 'A `'j ¢h -7X5'_!7_7-Z,.,-3
Pumping/Maintenance Contract on File (Y/N) NO ; for
Holding Tank High -Water Alarm (Y/N) NSA Temporary Holding Tank Permit (Y/N) N/A
Separation Distances from Septic/Holding Tank:
To Water -Supply Well N/A – no well _ To Building Foundation 15 feet
To Property Line _23 feet _ To Disposal Field 7 feet
To Water Main/Service Line 22 feet
Course
Comments
Page 1 of 2
72-026 (Rev 8/861 Front
To Stream, Pond, Lake, or Major Drainage
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata 166 sf/ bdrm. Type of System Design trench
Date Installed 8/14/85 Length of Field 51 feet
Width of Field 30 inches Depth of Field 13 feet
Gravel Bed Thickness
9 feet
Square Feet of Absorption Area 918 sf Standpipes Present (Y/N) ves
Depression over Field (Y/N) NO Date of Last Adequacy Test 5/9/87
Results of Last Adequacy Test}Ty.___25�b
Separation Distance from Absorption Field:
To Water -Supply Well N/A — no well on site To Property Line
To Building Foundation 24 feet
Lot
; On Adjoining Lots
21 feet
To Existing or Abandoned System on
To Water Main/Service Line 15 feet To Cutbank (if present)
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION
Date Installed nc)nP
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
none
15 feet
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
" Check Permitted Bedroom Rating Against HAA Request `°
Vent(Y/N)
none
Pumping Cycles during Adequacy Test. Meets MOA
I certify that I �haavv checked, verified, or
conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Sigr�L..a.—✓,��jf1 T,� i7�fy�G� Date �� _%
Company MOA No.
Receipt No. /6c) / 6
Date of Payment
Amount: $
Page 2 of 2
72-026 (Rev 8/861 Back
if 4
* •' 49r� � �
•�•�e_y•••e•e•se•eOeoi•a
Thomas L. Beckett �` p
CE - 5940 ly
DATE: March 20, 1987
PWS J.D.# 213564
To Whom it May Concern:
According to records on file in this office the SPRING FOREST
SUBDIVISION
Water Regulations
Water System is in compliance with the State Drinking
Sincerely,
.01
ames C. Allen, RS
Regional
9 1 S
0 r
egional Sanitarian Supervisor
STEVE COWPER, GOVERNOR
i IX i
DEPT. OF ENVIRONMENTAL CONSERVATION
Telephone: (907)
Address:
ANCHORAGENESTERN DISTRICT
OFFICE
437 "E" STREET, SUITE 303
274-2533
ANCHORAGE, ALASKA 99501
DATE: March 20, 1987
PWS J.D.# 213564
To Whom it May Concern:
According to records on file in this office the SPRING FOREST
SUBDIVISION
Water Regulations
Water System is in compliance with the State Drinking
Sincerely,
.01
ames C. Allen, RS
Regional
9 1 S
0 r
egional Sanitarian Supervisor
A�
CUSTOMER
♦ ♦.
=J�
*rd A FILL
HOME SiRRVIC
15900 Francesca Drive
Anchorage, Alaska 99516
345-1890 or 345-2444
$,Qd. Kirsch
5900 West Tree Drive
346-3994
Block L.ot
INVOICE # -167-1
DATE
DESCRIPTIOIV
AMOUNT
4•-16-87
Pump Septic
65
00
after 1:00
Birch 2nd on R.
c?J ty b k4V e_ e, yi1aILCL JAmr —6,v_! N_ e Lcl. LC
TOTAL
REM/A S
b'M 717-6 1e.e, y
A e% A) ;—h-4 Zc� 2u G/L
L ,
•4-/'7 me L4cte �o �r. Gemq�v 4/4 o?%,?ob Cjlqi.i J)4d1 o!Ra et SSZ,,Ji e 141
14 1,5-66 14 ej iCt J^u,v/VIA4 h,4! /�x/h A4,ule,
Gallons �' Septic Cesspool 6 Ja Time
_Standpipes
❑ PROBLEM AREA—CALL FOR MORE INFORMATION
❑ NEEDS TO BE DONE AGAIN IN 6 MONTHS
❑ Good Shape ❑ Sludge buildup on bottom ❑ Floater on top
❑ Jim cap missing or ❑ Cut standpipe to 1' above ground ❑ Needs Septictrine
needs replacing
-PLEASE PAY FROM THIS INVOICE-
30,
e
MUNICIPALITY OF ANCHORAGE
DIVISION Or, ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information
Application Date __EERRTIARV 19- 1QR5
(a) Legal Description (include lot, block, subdivision, section, township, range)
1,5 -- B1 Spring Forest S.D., Sec. 14, Twn 12N, Rge 3W
Location (address or directions)
KQhQ rtiTrS' =P� R ,fir nRTVE_, ANC;iTf�,RAC�_ AT.ASKA_ 995].6 _
(b) Applicants Name ROD A. KIRSCH Telephone - Home346-3994Business349-6545
Applicants Address 1013 E. Dimond Blvd. #340, Anchorage, Alaska
99502
(c) Applicant is (check one) Lending Institution ; Owner/builder ;
Buyer ; Other (explain);
(d) Lending Institution-Alaska_Mutual -_Ran�Telephone _338-7840
Address Benson & Minnesota, Anchorage
(e) Real Estate Co. & Agent-_Q„pe_
Address
Telephone
(f) Mail the HAA to the following address:
ROD A. KIRSCH
1013 E. Dimond Blvd.
0
2. Type of Residence
Single -Family Multi -Family
Number of Bedrooms 5
3. Water Supply
Other (describe)
Individual Wellies Community M� Public =
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. Sewage Disposal
Onsite ag Public Community = Holding Tank =
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 21
k
5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information
As certified by my seal affixed hereto and as of the validation date shown below, I
verify that my investigation of this Health Authority Approval shows that the on-site
water supply and/or wastewater disposal system is safe, functional and adequate for
the number of bedrooms and type of structure indicated herein. I further verify that,
based on the information obtained from the Municipality of Anchorage files and from my
investigation and inspection, the on-site water supply and/or wastewater disposal
system is in compliance with all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm !E�40 a e,- —n� �� � Telephone 410 "qO
Address P ® 'A
�
Dat;e eke,-, Co` 6 5 oa�®oma_ � f�%3� coa000000 V
CIO
•+. a ooeoaea o as 0 - ° oo tj, '
(ENGINEER SEAL),
6. DHEPA r�oval�
r 1"
Approved for _L - bedrooms
Approved x Disapproved
Terms of Conditional Approval_ -
. ooaooe0o 0000p000 U�uo (3�
COWAIM a MACAC °
Y L•�
CE -313ib o
c ° y
Y �
By
Conditional
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS 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 REQUIRE-
MENTS. 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.
(DHEP SEAL)
RR4/ej/D18
(Page 2 of 21 7-19-84
iv1UNICi PALI i L: , J`dCFli ;:AC
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA) AB 216 1985
CHECKLIST FEBRUARY 1984
A. WELL DATA Legal Description: L5 - B1 Suring Forest SSD.
Sec 14, Twn 12N, Range 3W
Well Classification _ If A, B, or C, D.E.C. Approved(Y )
Well Log Present (Y/N) Date Completed Yield
Total Depths Cased to Depth of Grouting
Static Water Level Pump Set At
Casing Height Above Ground Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y )
Separation Distances from Well:
To Septic/Holding Tank on Lot On Adjoining Lots
To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots
To Nearest Public Sewer Line To Nearest Public Sewer
Cleanout/Manhole
To Nearest Sewer Service Line on Lot
Water Sample Collected By ; Date
Water Sample Test Results
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed _ 8/15/84 Size _ 1500 Gallon No. of Compartments 2
Standpipes (Y/V) yes Air -tight Caps (Y/X) yes Foundation Cleanout (Y/N) yes
Depression over Tank IM)_ no Date Last Pumped N/A -• new installation
Pumping/MaintenanoB Contract on File M= N/A for NN/AA
Holding Tank High -Water Alarm (Y/N) N/A Temporary Holding Tank Permit (Y } N/A
Separation Distances from Septic/Holding Tank:
'
To Water-Supply1 _N/A - no well _ To Building Foundation 49 feet
To Property Lire _ s Meet _ To Disposal Field 7 feet
To Water Main/Service Line 22 feet To., Stream, Pond, Lake, or Major Drainage
Course
Comments - --�_
Receipt # '��T2-)CNq 49 _
Date Paid: Q -_ac,
Amount: 1-! 7 U$
(Page 1 of 21
2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata 166 sf/BR Type of System Design _ trench
Date Installed 8/14/84 Length of Field 51 feet
Width of Field 30 inches Depth of Field 13 feet
Gravel Bed Thickness 9 feet
Square Feet of Absorption Area 918 sf Standpipes Present (Y/V yes
Depression over Field (") no Date of Last Adequacy Test pert test 6/2/83
Results Of Last Adequacy Test new installation no adequacy test
{
Separation Distance from Absorption Field:
To Water -Supply LAJe11 no well on site To Property Line�..r
To Building Foundation feet To Existing or Abandoned System cn
Lot On Adjoining Lots N/A
To Water Main/Service Line 19 feet To Cutbank(if present) n nA
To Stream/Pond/Lake/or Major Drainage Course nnnP
To Driveway, Parking Area, or Vehicle Storage Area 15 feet
Comments
D. LIFT STATION
Date Installed none
Dimensions
Size in Gallons Manhole/Access (Y/N)
"Pump On" Level at "Pump Off" Level at
High Water Alarm Level at Vent (Y/N)
Tested for Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes(Y/N)
Cor rants
** Check Permitted Bedroan Rating Against HAA Request **
I certify that I ha checked, verified, or, conforred to all MOA HAA Guidelines in effect
on the e ofs pact'
Signed. Date
Company
KBl/d5/s
[Page 2 of 21
0
777 r e
,oe . •y o0 0
eowARn a MAcac o
CE -3816 0 A'a
�r�..y.. °otle9UUCUtl !�" V
i
2-15-84
DEPT. OF ENVIRONMENTAL (';ONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA 99501
DATE:'? zw�/? 'PS
PWS I.D.# 3
To Whom it May Concern:
BILL SHEFFIELD, GOVERNOR
Telephone: (907)
Address:
274-2533
-03A I3 36
1
961 �j� I avn
tq01j'D3108d 7VJN.9kvN0
80 %, hLIV314 2 . d1AN.3
7Vd1.)1fqr)kV
According to records on file in this office the c Fl�re-j
C/ with (S A- r� Water System is in compliance th)Stat'e Drinking
Water Regulations
Sincerely,
S