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Home My WebLink AboutSPRING FOREST BLK 2 LT 2pr ing Forest lock 2 Lot 2 015-321 -28 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL. INSPECTION REPORT ~ . . -- ABSORPTION ~r~ TANK FIELD Lot Subteen ~ Township, Ran e, SecUon ~ /~ '~ /~-- dnveway,~S'~UILT DIAGRA. (Show Iocatio~ el welh sepUc syslem, prope.y lines, IoundaUOn,water bodies, etc.} Manul~urer Ca?city m gallons ~ TYPE OF SYSTEM TRENCH ¢ BED D W. DRAIN 0 OTHER EXIS'7'~ Depth to p,pe bottom Ir~ Total depth Item original grade ~j ~ tJ ill added above oriel grade Gravel depth b~e?, pipe FT FT ~ - Gravel lengJh Grave~ w~dth ~ Installer (' ~/ O~ /% c~ ~ate Installed / y / _ WELLS , _ ~ ~ PRIVATE ~ OTHER ddentilv~ Classification (A,B, Total Deplh Cased to / ~ Inslaller Date Installed: REMARKS: S & S BGINEERING cedily that this~spedion was peflormed according to all Health Department Approval: ~ , . 72-013 (3/85) Eh,,~r'~(:::.l' ~:.'~('.:Ic:ll"(.:.:.!!i~!~':i F:',, II. BOX 5().;"9 ~::~ ]' C UX F'AL..L.!~;, S)] 57 :L :L Par' c~:, Sec: t :L c:,n: :l. 4 'l'c, vm sh :L p: :1. 2N F~an {1 e: 3W l,,.cH', S :i, ;:: (,.,.~ ).:.~ E,) CI I' I:.ar'ik rrJu.!::?L I-h'..VV~.:::' a'[- ].(:~asT.. ;?. c:!::)ml::~ar, tm~::)rlts,, D(:.,pth t(::) 'l:.op (:)F Sel]'t'..:i.c Lank ]: Iqf:'E]RH :1:) ,: I.l ,, I.J., !::i ,~ F:'R ]: I]1::;: "l"(:l I NSi::'E:CTT :1: (::)IxIS ):.,Iy I:i:l',l(:i) ]: I',ll:!:l:ii:l::i'. :~ :1: I':: AI:::"H:ii:F<'. :::::::::::::::::::::::::: !"l(::]L.II::;~!i~:, C:AI....I... 3zl3'"46i!!]:1. Al\It) L..E:AVE! A C!:)NS'IRLK:7'F I:;'li::[:il lii:i',JG:J:l",llii!:l!:l::~S A'T'TA[:;I'I[i::O AF'[::'I::~:CJVI:::D Dli!i:S1F'iN. IH :t::i!'.: I:::'l:!!:l::ff"l :I: I- I!!:: X F:' I I:N:i!:E~ :t :.~/::!:: :1.//!!P? AhlD VAL :1: D F:'(:tR h S :1: Iqi:':)l....E l::: AM :1: L..Y HOMEi: ,, i: (:::EI::,."T' :l: I:::'¥ 'I"HA'T: :1: am t am:i ]. :i.[~':,.r' ~,;:i.'E.i'l 'L I'] (:.'.) r,(.:.)c!u:i.r'(:,,m(.:)r'rl'.!:; ~'(:)t" (:)n....s:i.'f.(~.) ::et,,h.::.H"s and v,~e:!. :l.s ~'::::::: ~'.:iu..)'i:. [c:,l"Ll'l by th(::, MLu"l:i.c:i. pa:l. ity (::)t Ar'H:::l"ior'.~:~.Cle (MOb) and '~:.I"H:.:, S'L,'~.te (::~' ~;~'.,, :1: v.~i:l..L :i.r'~s'La:l.i 'l:.hc~ :~;ys'L~z)m ir'~ <'.:u:::ccn".danc(:.~ w:i.'Lh a:l.:t. HOA codes and a'::l"~(::l ~"~ .::Cmil::J:liar'~ce ~d:i,'[,.l"l t.h(,:a d~::,,~::i,{:,:ll'] ::p:i.'~.(:~,)r':i.a oF th:is per. m:i.t. ::~';,, :1 ~4:i:1.] adher'e 'tr.(::~ al:l. ME) A and Sta'l'..e (::)[' Alaska r'e(::lu:i.l~(.:.:tmer'its For' th(.? set C] :J,~:~'J'.,J'2d'][::(~:'<~:~ ~' r.c:)m any ~::~).( is'L :i. ng ~x~-~'.l. :1., ~h:~stev-~ater' d :i. sposal sys'Lem of i::,ub ! ic s(.:'.)w<.:mag~..'.) system (::,'~ 'Lh:i.s of any adjacent ~::)t" r~(::.)apb,/ ].ot,, the capa<::ity (:)~' the 't. crt. al sy:::tGm :i.::: ~] [:)(:.~(::lpo(::)0'~s at'"Jd : J. P (:CII.{ :]. i" (,::.) an add:i, ticlr'Ja:L 1:) A "1' I::::: SAV :J: N(:.:~E; :C~AI',II< September 7, 1989 ROBERT SHAFER, P.E. ROGER SHAFER CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELl_ INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Ms. Susan Oswalt State of Alaska DEPARTMENT OF ENVIRONMENTAL CONSERVATION 3601 C Street Suite 322 Anchorage, Alaska 99503 REFERENCE: Lot 2; Block 2; Sp~ng Forest 5831 West Tree, Anchorage Dear Ms. 0swalt, A permit was issued by your office for the upgrade of the on-site wastewater disposal system on the referenced property. This permit ~lowed the e~isting system to be upgraded from 3 bedrooms to 5 bedrooms. At the time the upgrade was performed, we inspected the system to insure its proper installation which included the following, with respect to the separation distance between the add-on 500 gallon septic tank and the absorption trench. I. A 5 ft. section of D3034 PVC pipe was used between the tank and a cleanout at the start of the trench. 2. Material placed underneath this section of pipe was non-frost susceptible (NFS). 3. Maxim~ compaction of NFS material was obtained, prior to final connection and backfill. It is our opinion that this installation is adequate to prevent settting or frost action that might d~turb the discharge end of the septic system or the cleanout at the beginning of the trench. If you require additional information, please contact as. Since.r~y, .,,' ' ,,/ ~...,/'/~ -~' 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 ? ? PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION 'rEST LEGAL DESCRIPTION: [,-'~'~' ~.,~'~' ~;~'i~t I~-~-~ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Depth Io Water Alter _ Monitorinl~? ~:::¥'~'~ Date: Gross Net Depth to Net Reading Date Time Time Water Drop -- ~..~ ~ ~ ~ ~ ~/~ ~ .... PERCOLA-FION RATE ~'L~' (minutes/tach) PERC ROLE DIAMETER TEST RUN BETWEEN ~'~'~ND ~- FT COMMENTS I'(~ '~/'/ '~/ '~' 72-008 (Rev. 4/05) NAME MAI LING A.J~DR ESS LEGAL DESCRIPTION LOCATION T BISTANCE TO: Manufacturer 7 0 IF HOMEMADE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT 1PHO~-~' I E~NEW I,_ '/ Absorption area.D/, Dwelling Material Inside length.~ W dt ] Well Dwelling DISTANCE TO: Manufacturer DISTANCE TO: No, of lines Top of tile to finish grade Length Length of each Width Material Foundation ~ I INearestlotline~// Total length of ~nes~__~,¢,, I[ Trench width! Material beneath tile~ Depth NO. OF BEDROOMS PI~FJM IT N~). No, of compartments Liquid depth PERMIT NO. Liquid capacity in gallons Total effective absorptio~.~ ~a PERMIT NO. ITotaJ effective absorption area Nearest lot line Type of crib Crib diameter Crib depth Well Building foundation DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Sept c tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING -qo" INSTALLER A,P' ' ,hq ,,doA APPROVED 72-013 (Rev. 3/78) DATE LE( ~L £c;'i' Z PERMIT NO. DEI::'RRTMENT C HEFILTH FIND ENVZRONMENTRL r..OTECTII]I"~ 8;2.5 '"L'" STREET., RNCHORRGE, IRK. 99501 264.,-'4720 ,:: 830268 ) RPPL. I CFINT LOCRT I CiN LEGFiL DRLE MIZER ?80± LIN[:,FI LRNE LOT 2 BI...KK2 SPRING FOREST SUB LOT SIZE TYPE OF SOIL RBSOF.'.F'TION S'T'S'I"EI"'I IS: TRENCH Z-':,I.,4.- ]..::528 999999 S6!URRE FEE'T' F'ERM:[T FIPF'L I C:FINT HRS THE RESF'ONSIE3IL:[T'¢ 'i"O INFORM THIS DEF'FIRTME},IT DI..IRIIqG THE INSTFILLRTION iNSPECTIONS OF FtN'¢ 14ELI_5; R[:,JFICENT "FO THIS F'ROPERT'¢ FII',I[:, THE NUMBER OF RESI[:,ENCES; THFI"I" 'THE HELL 14ILL SERVE. E:FICKFILLING (]F FIN'¢ S'.r'STEM I.,.IITHOU]" FINFtL. INSPECTION FllqD FIF'PRO',/FIL E:'¢ THIS [:,EF'FIRTMENT [,.IILL E:E ~UUBJEC]" "l"O F'ROSECI.JTIOIq. MINIMUM [:,ISTRI',ICE BETHEEN R HEL. L RND FIN"r' ON-SITE SEHRGE [:'ISPOSRL SYSTEM ::L00 FEET FOR FI F'RI'v'RTE HELL. I]R ±5C~ TO 200 FEET FROI'd R F'IJBLIC HELL [:,EPEI'.~E:,ING UF'ON THE'.' TYPE OF PUBLIC HELL MINIMUM [:,ISTRNCE FROM R F'RI',,,'RTE HELL TO R PRIVRTE SEHER LINE IS 25 FEET FIND TO FI COI"IMUNIT'¢ SEHER LINE IS ]'"'5 FEET. OTHEF:'. REL]!IJIF.:EI'tENTS i'"lR~r' RPPL'¢. SF'ECIFICRTIONS RI",IE:' C:ONSTRUC:TION DIFIGRRMS FIRE' Fq","RIL. RBLE ]"0 INSUF.:E PROPER INSTRLLFITION. I CEF.'.TIF'¢ THFFf' :.L: I AM FRMIL. IRR HITH THE F.'.EQUIREI"IENTL-q FOR ON-SITE SEIqERS Rhl[:' HELLS RS SET FOF.'.TH B'T' ]'FIE HLINICIF'RLIT'T' OF FINCFIORFIGE. 2: I P.IILL INSTFILL THE S'fSTE]'"I IN RCCOF.:[:'RNC:E HITH TIqE CODES. 3: I Ui',IE:'ERSTF:IN[:' THFrr THE:.' ON-SITE SEP.IER S'¢STEM I',11A'¢ REOLIIRE ENLRRGEMEI',IT Il:" THE F.:ESI[:,ENCE IS F.:EMODELE[:, 'TO INCLUDE MOF.:E THRN ~: E,'E[:,F..:OOMS. .-., ........................ .... I '" :,,, .' .- MFI',:.:;IMUM I',IUMBEF.' OF BE[:,RCE$'IS = ]: SOIl_ RRTING ,:.'SQ FF,-.'BR)= .S00 I"HE REL..!IJIRED ::,I4,E uF /]I-tE buIL HE:'-',URF'7.:~!;~.N/S'~S'F~M IS: -/ / "-."' ') : ,,,' _.. - THE L. ENGTH DII'"Ii~NSION IS THE [..EN[.~'~z~N FEET) OF THE TF..ENC:H" OR I.':,RRINFIELt":,. THE DEPTH OF la TRENCH OR PIT IS THE [)tSTFtNCE BETHEEN THE SURFFICE OF THE GROIJND RND THE BO'f'TOM OF 'THE EXCFI',/FITION ,.'.'IN FEEl"). TNERE IS NO SET NiDTH FOR TRENCHES. THE GRR',,,'E:L [.':,EPTI4 IS 'THE MINIMUM [:,EPTH OF 6F..'FIVEL 8ETHEEN THE OUTFRLI._ PIPE FINE:, THE BOTTOM OF' THE E:qCKt',,,'RTION (TN FEET;,. · ~l~/~~:~?yr- ~ 26a-.477~o /{ANDWR!'TTEN PERMIT App].icaatf~~ ~ g~.r ___ Mailing Address: 7 ~ O~ k~ ~ Z~, ~O; Legal Description: '-~-~' ~],_..O~J~ ~O~ ~C~ Lot Size: ~ Type of soil AbsOrption System ~Is: ' Trench: ~E~L Drainfield: Seepage Bed: Holding Tank: The Required Size of the Soil Absorption System Is: DEPTH .~JJ] LENGTH . ~/ .... ] GRAVEL DEPTH ~.,Z WIDTH _ ~he length ~imension is ~he le~gth(i~ ~ee~) o~ t~e ~enc~ o~ ~i~iel~. ~e the bottom o~ ~he excAvation(in ~eet). ~e~e is ~o se~ ~i~h ~o~ ~enc~es, T~e 9~Avel ~ept. h is ~e ~i~i~m ~epth o~ g~vel between ~e ouE~ll pipe the bo~to~ o~ ~he exc~vAtio~(i~ ~ee~), · * REQUIRED SEPTIC(HOLDING) TANK SIZE = ~ GALLONS * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. · * * TWO(2) INSPECTIONS ARE REQUIRED Back~J.l!ing o~ an~ system without ~inal inspection a~ app[oval by this depa~tme[ will be s~b~ect to p~osecutio~, Minimum ~istance between a ~ell and any on-site sewage disposal ssstem is lO0 ~o~ a p~ivate well o~ ~0 to 200 ~eet ~om ~ p~blic well ~epen~J.~g ~po~ the o~ ~ublic well, Minimum ~ista~ce ~om a ~ivate ~ell to ~ p~ivate se~e~ is 25 ~eet an~ to a co~nit~ sewe~ lise is 75 ~eet, ~e].1 logs a~e ~e~ired an~ must be ~etu~ned to this department within 30 ~a~s o~ the well completios, Othe~ ~e~i~ements may appl~, Speci[ications and construction ~J. ag~ams available to insure p~ope~ installation, · * * PERMIT EXPIRES DECEMBER 1 9 3 * * * (1) I ~ ~amilia~ with the ~e~i~ements ~o~ on-site sewers and wells as se~ ~o~th b~ the M~ieipAZit~ o~ (2) I will i~stall the system in accordance ~ith (3) I un~e~stan~ that the on-site se~e~ s~stem ma~ ~e~i~e enla~gement the~esi~e~ce is ~emo~eie~ to include mo~e that 3 bedrooms. Applican~ ~ ~ Date: [ ~" ~ ~ ~ % [] SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: DATE PERFORMED: SLOPE WAS GROUND WATER S ENCOUNTERED? ~'~l (~) L O P E IF YES, AT WHAT DEPTH? --1 '"" ('~"~'') SITE PLAN DEPTH {,F E. ET) 1 3 4 5 6 7 8 9 10 11 12 !~, 14 ~j~ ,~ 15 16 17 18 19 2O COMMENTS Gross Net Depth to Net Reading Date Time Time Water (, ~:~-'~ Drop PERCOLATION RATE TEST RUN BETWEEN ~) . FT AND (minutes/inch) (~ FT . ~: _~'t~ ~"i CERTIFIED BY: 72-008 (6/79) ,~--'~. DATE: ALASKA [lb, ,o m I TAL COI TROL IllC. PERCOLATION TEST DATA SHEET CLIENT_~YA ~.~ ADDRESS ZIP CODE LEGAL LOCATION TOTAL DEPTH OF HOLE ZONE TESTED k~ ,~- ft TO ft. ,o ft READING l/ CLOCK TIME NET TIME DEPTH TO NET DROP RATE (min/in) DATUM ~ ~ '. 3'~ '7. - q ~ o ~'(~ , 6 i, '7_ .~ ,. q,,q t b ~- . ':~ 1 C , 0 z~ ,-~ '7: ~ n z' q '5 6 ut '3'~ ~ .z.,,3<~ , 055- C). '] '~">~'~' tl ] 'z'~ FINAL PERCOLATION RATE PERFORMED BY C,' RCZt- (min/in) 1200 ~st 33rct Auer~e. qJun~o~e A~choroq~, Atosk~ 99503 · (907] 276-1361 MUNICIPALITY OF ANCHORAGE t DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 .~ ON-si'rE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION RFPORT · P,ONE "l t~NEw -'- MAILINGADDRESS 'Z'zS'~ ~o~ 'pA~K '~'~v~ _ LEGAL DESCRIPTION ~ ~ ~cocl<2 ~;PR/~e F'ot~65'T LOCATION NO, OF BEDROOMS OFF 81ECt4 '~oAb o~ WEST 'T~ee b~.~e _. ,. _ PERMIT 'Wet] ~l~Absorptionare~ O~ Dwelling ]~,0~ DISTANCE TO: ~ '~"~ ~ r i~E I · -- ~ ~ Materia~ No, of compartments ~ Manufacturer _ _ Li,, capacity in gallons IF HOMEMADE: Inside length W~ Width ~ Liquid depth ~ A ,.,! (P OD W~ll' Dwelling PERMIT NO. -- 9~ DISTANCE TO: ~ -- O < Manufacturer Material Liquid capaciW in gallons ~ -- - Well Pt¢IVA:F~ Foundatio ~, Nearest mot ~i.~ PERMIT - No. oflines ~ Lengthnfeachlin¢~.O ~ T°talle~h flin~so Trench~idth/j~- [~ Distance between iines ~,O~ ..... - Material beneath tile Total effectige absorption area ~ ~ Top of tile to finish grade ~,O~ Z.~t, ~ 6,~~ lO,O,i~s ~ ~ength Width Depth PERMIT NO. ~ ~ Type of crib Crib diameterA]A Crib depth Total effective absorption area /vr-i [u Well Building foundation Nearest lot line ¢ DISTANCE TO: . - ~ Cl~s Depth A / A Driller Distance to lot line PERMITN0. ~ ~uilding4o~d~io~ Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER i~ ,~ ~ ;~% PIPE MATERIALS ,. ~/ ,~ 4? EA~LO~ ~'r~ ~,~ 5UP~ 56~ ~ ~ ~°:~"~ [ ' OAR ~K cAv~"r/~- ~ 't ~.~ , - ~EMARKS ~'t ~ ~AE'T I~o~ Pr~E I:RO~ ScepTiC. ~ PIPE ~j.~guE~ ~ ~o~p'rr~ " 72-013 (Rev. 3/78 MUNICIPALITY OF ANCHORAGE ~ I ENVIRONMENTALENGINEERIN~V~ -~ --- ~ 825 L S~reet - Anchorage, Alaska OOS~V~-~-~ ~~-- ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR REPORT ,/o _ - %' / PHON~ / ~EW MAILINGADDEESS . ~ LEGAL DESCRIPTION LOCATION NO' OF BEDROOMS Wel~ ~ IVR~ Absorption area , Dwellin~ PERMIT NO ~ ~ ~ No. of compartments Material ~.~ ~ - ~tb Total ,en~ ~ ,i,,es, Trench *i~th .... ~ Top of tile to finish grade. 4' O' 2'~:~'t~''Materialbeneathtile~''U~ ~ O 'i~ Total effective absorption area ' Length Width Depth - PERMIT NO, ~ Total offectiue absorption area ~ ~ Type of crib Crib dia Crib depth ~u Well f ~ -' ' Building foundation Nearest lot line ~ DISTANCE TO: I PERMIT NO, ~ Class Depth ~ / ~ Driller. Distance to lot liaa m guildin~ fountain/ [ Savor line Septic tank Absorotion aroa{s) ~ DISTA~C[ TO: OTHER : ~ ~ PIPE MATERIALS t, L, [ ~ SOiL TEST RATING ~lt~B :)'d ~NSTALLE. ~ ~ ( ~ REMARKS / 72-013 (Rev. 3/78) [, ['{ PI:IF::T '" E N T O F H E FI L. T 1'4 I::11".1[:' Et",I"" T F..' T- N I'"IE i", T F L I::' F'?. 7 7' E 7;'¥ Z O I",t '::'": ..... L"' E;TI:;.'.EET., RI'.,ICHE~RFIEiE., f:tl< '_q.'Lq..~ '2:'Ei4.-~47'' '::::O · FIF4CHOF'.FIGE E.;94..-.;;-Z/I. 3::L : EFIGLE fi'. :[',/ER ,:Z, ~'-,~ ...... :~;2; :E -'i-" EE :LE; E.'E P.~ E I~:~: F~ E£ FE-:: ~'""i -~:: i-' F'E.:F:HIT NO. IFIS(:-11ZI;;~:-'5~ F'HONE: b,'~.:,,"~:,,"b,"u,,' RPPL]:E:FINT ' B:[L.L. BREDE%ON FI[:,E:,I:;.:ES5: F '3FG ¢:1i",1:15., FIt( 9 '.~'.~ '~ 1.. EGF~L. [:,E'.~.i;CF.". I F'T i 01"4 "- SUE [: .f. ',,' I S :[ O1",1: SPI:;.: i t",IG FOF.:REST E',LOC:K: 2 LOT: -f'OI4N:E:;H I P: fi..SN RFII",IEqE: Z.':I4 '5ECTI 3N: 23: HFIXIHIJH NUHE:EF.: OF EE[,R'-IFJHS = Z.': SOIL RRTING = ,4. O?' iSL.q. FT. ,.."BR::' L. iSTEEE:' BELEd4 RF-:E THE OF'TtOI"4S FI',,,'RiLFIE:I..E TO '¢t]1.t Ii",l DESIGNING '~.'CI. II;;: '.'E;EI='TIC :, .::,~E:.II. -FI"3SE THE qPTIL')N THRT BEST FITS '.r'n F.' SITE. -li'~ "..,-" F" Z C: ~ b. ET.:, EEE ~ :E ~ ~'.',~ '"iF' IFR: E.' ~'-,,tt EZ: IF-~ lEE:, EE '.'ES; ZE E'-G ~"..,,~ I.,.IIDTH = 2. 5 F'T. LENGTH = i2}.'::. 0 FT. TOTR[... [::,EF'TH = 9. 5 FT. GRFF,,'IEL [:,EF'TH = 5. O FT. F'r'''-', r:L ~"1 II1"i[:' = E;2. 15 CIj. TRNI< S]:;;~E: = ~L., Zu;(~O. O GRLi...OI"4E; ,'THO CC~t',tF'FtI~:THE{NT TFtI'4K) ~:_,0 F'T. I.,~ I [:,T H .... '"' '= LEi",IG]"H = ~0. 0 FT. "FOTI::iL.. [:,EPTH =: 5. ~ F'~'' '~ 2 r ~--- ,' O. F, FT. . R -I E L. [:,E F'T H ..... ]P.:h ,EL. "~:L JI"IE = 4. E,. ;E: C:IJ. TF:INI'( '5 :[ ZE = '1..., 000. 0 3FIL. L .~ Iq'5 ,:: THO 3OHPFIf;.:TI'tEI",IT "FRNI'( ::' H]:E:,TH =: 5. 0 I::'"f'. LIEI",IG TH = :L5~5. 0 TO'f'RI-. [:,EP]"H ..... ';'. F"~ F'T. . ...... '~' 5 F'"T. ~Ri'I,EL. DEPTH = ~:.-. ~I'~.H ,EL. '¥h31_.iJHE ,;:,~' 6; ":1..I. TFINK S I ZE = :.L., ;~iRO. 0 3FILLO ", ~; ("I"P-!O C:Cd"IF'FIF.:'['HENT TFIi",IK ::' IE:ERT ]: I::"d THFIT: % I FIH FFIH]:L. IRF-: I.,.l:t:'f'l-'l THEE REE-.!LIIF:EHENT'..'.:.; FAR ON-"..E;ITE SEI4ERS P'ff',l[:' I.,.IELL:E: R:i'~; F(3F::TH E~h" THE I',IlJI'.,IICZPFII..I'F'¢ O1::' Ri'.,tCHCIF.:F'IGE FIi",I[:' THE STFITE O1::' FII_FISI<FI. 2. i kt:I;LL~ iNS"f'FIL. I- TI-lIE Sh.'!.:.,TEH ]:t",1 FICCORDFtNCE HITH THE COf:,ES FII"~[:' HFI'v'E F.'.ECEZVE[:' I I" '" -" ' I::1 13 'Z l::' "r' OF THE CO[:'E =,~HI II'-I[~. FII",I[:' [:'IFIGRF~IH H I1-H .HI IEI',tt=, F!HICH IS F:'I:IF.:T AF THIS F'EF.'.HIT. "-"-'¢~"1 HFI't' REC.:!U]:F.':E ENLFIF'3EHENT ]:F:' TFIE 3:. :1: LIN[:,EF,::STFtI"4D THFIT THE Oi",I~S I TE SEI4[CR :,'r.:, ~:. F..:ES:[DEI",tC:E IS RE.;H('~DELE[:' TO Ii'-,ICLIJf':'E HORE THFIN 3 EE'EF."L301"I'.'5 PE:F:H I T F:iPF'I_ i CFINT HI:IS THE: RESF'Ed",I:::i; I E', I L I T'¢ TO Z NFOI:;d"'I F'EF.'::E;OI",II",IEL [)t. JF.'. ]~ I'.~l] THE Ii,.,iSTFiLL. I':I-I~]:C~N II'-4:E';F'ECTTCfl",!S OF FIN'T' !4EL. I...S F:II:::,J'FICENT 1'3 THIS FF~PEP-.F~ FIt",IE:, THE NI...tI'i[.:.~ER OF F.'.E:E;IE:,ENCES 'l"l"tFff' THE NELL. P.I]:L.L .:,Eli., E. S I GNED: F:IF'PL. Z C FII'.,IT ;[ S'.:~:;IJEE:' l?,"r' E: I L.L. EJl.'~:E[:,ESOI".I SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR'. SLOPE OL 1 2 SITE PLAN 16- 17 18 19 20 COMMENTS PERFORMED BY: 72-008 (6/79) WASGROU.OWATER No [ ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? -'-~z ~57~ .n (minutes/inch) PERCOLATION RATE TEST RUN BETWEEN .~'/2. FT AND ~ : ' ., eT CERTIFIEDBY:~~~ Gross Net Depth to Net Reading Date Time Time Water Drop io'.'z~ . ~ .0~ lo'. s~ ~0 ,n,~ . ~o'.~ lO , qn s T 95-OZq 7801 Mnda Lane Anchorage, Alaska 99502 (907) 344-3528 Jttly 18, 1983 Mr. Robby Robertson Dept. of Health Anchorage, Alaska Dear Mr, 'Robertson: I am writing in reference to the septic system that was incorrectly installed on Lot 2 Block 2 Spring Forest Subdivision. I hired GAR Excavating to do my excavation, water and sewer. I acquired a sewer permit from the municipality and the work was started, At the time of installing the septic system we were going to change the single 54' trench into (2) two 27' trenches. The excavator installed a 27' by 10' trench and SaS Engineers approved the system. This was incorrect and the municipality turned it down, GAR then proceeded to go to sas Engineers and have: them instruct how to build a system the was corrected. This was then done, an additional 27'trench~_10,' of gravel was installed, As it turns out this system waslnoorrectly designed and the total 54' length of trench was not adequate because of soil test results. Therefore it was unacceptable again. I now have a system that won't ~ork and am out of alot of extra money that was not needed had the system been designed and installed correctly. My lot has been torn up and I have been handed a large problem that I should not have to deal with, I would like the municipality to take whatever steps necessary to re--design and correctly install the septic system and take the problem off of my hands as I did non creane it. Sincerely. Dale R. Mizer / ~ZF_ZI, 6~ .= CERTIFICATE FoR A Municipality of AnchOrage Development Services Department Building Safety Division On-Site Water & Wastewater Program ~ _ 4700 Elmore Road ~'~...-~'-'~ P.O. Box 196650 ~ Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 OF ON-SITE SYSTEMS APPROVAL SINGLE FAHILY DWELLING Parcel I.D. 015-321-28 1. GENERAL INFORMATION COSA# 0 ~C ~//q L,~ Expiration Date: Complete legal description SPRING FOREST; BLOCK 2, LOT 2 Location (site address) 5851 WEST TREE DRIVE *ANCHORAGE, AI~ 99507 Current Property owner(s) BRADLEY & PAMELA WENDT Day phone C/O AGENT Mailing address 5851 WEST TREE DRIVE *ANCHORAGE, AK 99507 Lending agency Day phone Mailing address Real Estate Agent CHER HAMPTON W/ DYNAMIC Day phone 261-7590 Mailing address 3111 "C" STREET *ANCHORAGE, AK 99505 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3:;' TYPE OF WAtER'SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well .". [] Individual On-site [] I ndiVid~a'[Water Storage [] Individual Holding tank [] Community Class A Well [] Community On-site [] Public Water System [] Public Sewer , [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal fight whatsoever. DSD SIGNATURE ~ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulationS:.,~.~_..~ '. Attachments' COSA Checklist Septic System Advisory Arsenic Advisory Maintenance Agreements pROGRAM.:../ . .... . . ' Well Flow Advisory N it ra/~ Advisory//~,,," l.. / Supplemental Engineer's Report Other Original Certificate Date: /~l/I/I/ (Rev. 11/05) Municipality of Anchorage Development Se~ices Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519.6650 www.cl.anchorage.ak.us (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SPRING FOREST; BLOCK 2, LOT 2 Parcel ID: 015-321-28 A. WELL DATA Well type COMMUNITY IfA, B, or C provide PWSID# 213564 Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ___ ft. Casing heig~ in. FROM WELL LOG Date of test ~ ~-- . Static water level ~ ft. Well production _ g.p.m, g.p.m. WATER SAMPLE ~ Coliform .---'~colonies/lO0 mi. Nitrate mg./L. Collected by: ~ ug./L. Date of sample: SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL 1000 2 Tank size 500 gal. Number o~ Compartments 1 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 11/29/11 Pumper. 7/11/83 Date installed 8/30-31/89 Cleanouts (Y/N) YES High water alarm (Y/N) N/A MCDONALBS PUMPING C. ABSORPTION FIELD DATA Date installed *'7/11/83 Length 2 @ 27 = 54ft. [*BELOW EXISTING GRADEI Soil rating (g.p.d./ff2or~ 300 Width UNK ft. Total depth *7.77 ft. Eft. absorption area 1080 ft~ Monitoring tube****YES Date of adequacy-test **'11/29/11 Results (Pass/Fail) PASS Fluid depth in absorption field before test****18 in. Water added 13709al. Elapsed Time: 120 min. Final fluid depth 39 in. Any rejuvenatiOn treatment (past 12 mol) (Y/N & type) NONE **THERE ARE ALSO ADDITIONAL 1983 & 1989 TRENCHES. **'1983 DUAL TRENCHES TESTED ONLY AND WERE PRE-SOAKED WITH 2000 GALLONS ON 11/28/11. ****MT'S IN 1983 TRENCHES ONLY EXTEND APPROXIMATELY 7.75' BELOW INVERT. .System type DUAL TRENCHES Gravel below pipe ***'10 ft. Depression over field NO For 5 bedrooms New depth****41 in. Absorption rate >= 750+ g.p.d. KNOWN If yes, give date - OF WATER D. LIFT STATION Date installed "Pump on" level at in. E. SEPARATION DISTANCES Size in gallons Manhole/Access (Y/N__~) "Pump off" level~. High water alarm level at Cycles tested Meets alarm & circuit requirements? .in. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main COMMUNITY WELL On adjacent lots On adjacent lots ~anout Sewer/septic service line ~ Holding tank ~~aeflil~~~~ Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field Wa{er main 10'+ Water service line. 10'+ Surface water. Wells on adjacent lots 100'+PVT/200'+PUBLIC SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Water service line 10'+ Curtain drain NONE KNOWN COMMENTS 5'+ 100'+ 10'+ Building foundation. 10'+ Water main 10'+ Surface water 100'+ Driveway, parking/vehicle storage Wells on adjacent lots100'+PVT/200'+PUBLIC G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date COSA Fee $ (~t~ C) '" l_ c~-c~ ~ ~ Re~ipt Numbe~~ ~ ~ 0~ (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number ELEV. (ASSUMED) N89~ 59' 55"W 145.00' 20' UTIL ESMT COs o MH COs EXISTING HOUSE / / / / / / / / / / t 3 UNDER NO CIRCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRUCTION OR FOR ESTABUSHING BOUNDARY OR FENCE LINES. FHE SURVEYOR TAKES RESPONSIB~LITY FOR THE INITIAL TRANSACTIONONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. [] LOT SURVEy SURVEY TYPE [] FOUNDA1]ON AS-BUILT [] F~NAL STRUCTURE AS-BUIL'F [] PLOT PLAN . . . AB-BUILT... LOT SURVEY... TOF'OGR.,~PMY [] AS-BU~L?... NO CORNERS SFT [] RECF-'R1]FtCATION AS-BUiLT... NO CORNERS SET PLOT PLANS &: LOT SURVEYS IT tS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINtSHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. SURVEY CERT F CATION -~ll- ---- ~ll~??,~ ~ ~llI ~ Y h · · ,, ~.~ ;. ~., .. ~.~ ~,,~ ~,, e~ F~ '%. ..-' o~ ~ SYMBOLS * SET REBAR ~ ~i~°SmDRAiNAGE ~ ASPHALT o FOUND REBAR C C C WOOD FENCE ~ CONCRETE Q ASSUMED ELEV. X X X METAL FENCE ~ WOOD DECK NOTE: ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE SHOWN. FENCES, WC-LLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, ETC., ARE SHOWN IN THEIR A~PROXIMATE LOCATION, ONLY. SNOW MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTE:E). Prepared by Robert. E. Johns, Jr. & Professionol Lond Surveyors 1700 Brink Drive. ANCHORAGE, ALASKA 9950~ Assoc. Scale: 1" = 60' Re~. Lot S.F. Dote S,,veye~: 11/25/11 Drown ~ REJ oot. Dr°w.: 11/25/11 Grid: 2538 Legol Description: Rec. Plot File No. c~.~e~ ~,~MK w.o. 11-399 LOT 2 BLOCK 2 SPRING FOREST Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I,D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1, GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) LOT 2; BLOCK 2; SPRING FOREST Location(addressordirections) 5831 West Tree, Anchorage (b) Property owner Mailing Address (c) Lending Institution Mailing Address Sears Savings Bank Telephone: (home) P.O.Bo~ 5079 Sioux Fa~s. S.D. 57117-9854 Telephone Business (d) Real Estate Company and Agent ~ACK-W~TE n,~uv**,~/. ~-r-r,,. ~ .... ;. u~/. .... Telephone (e) Mail the HAA to the following address: (or check her~¢~ if hold for pick up.) List contact person and day phone number below: $ & $ ENGINI-'EEING 17034 Eagle Ri~er Loop Road No, 204 Eagle River~ A[~sk~c)95-77 2. TYPE OF RESIDENCE Single-FamilyJ~3( Number of bedrooms. 5 3. WATER SUPPLY ~ individual WeU~¢~'] Community~ 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 ,1~ 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. 7/88) Page 1 of 2 ~ jo ~ elSed ')IJOM s,Jeeu¢~ue leUOiSSejoJd eq~ u! SUO!SS!LUO JO S JO J J@ JOJ alq!suodseJ ~ou s! eSeJoqouv ¢o ,~l!led!o!untq aq/'pensq s! e),eoH!peo e eJojeq eiep ezXleUe ¢o suo!loedsu! lonpuoo ~ou op SHHQ jo see~OldLU3 'slueLueJ!nbeJ elm, s pub leJepej u!m, Jeo Xjs!),es o~ Jap Jo u! suogn),Rsu! bu!puel J!eql pUB SeLUOq JO sJaseqoJnd o~ ,~sepnoo e se s!q), seop SHHQ eq.l_ 'e~selV jo ele~S eq~ u! peJejs!beJ Jeeu¢Sue leuo!ssejoJd luepuedepu! ue ,~q e^oqe g qdeJ§eJed u! UeA!6 suo!~m, ueseJdeJ eq~ uodn ,~luo peseq pe~eo!j!Jeo leAOJddV ,~poqlnv q~,leeH senss! (SHHQ) sao!AJeS UeLUnH pUB qlleeH jo ~UeLUlJedec] ebeJoqouv jo/q!led!o!unlAI eq.L leUO!i!puoo leAoJddV leuoR!puoo JO suJje/ peAoJddes!O X peAoJddv /,q suJoo~peq~ot pe^o~ddv q~AOl~dd¥ SHHa '9 S¢/z./i ¢ euo,de,e, I~0~: 'ON peo~ d~l ~e^'l~ elS"=J t~8OZ!. sseJppv t.uJN jo euJeN 'uo!loedsu! s]q], jo m, ep eql uo loejje u? suoReln6e~ pub 'seoueu!p~o 'sepoo e~m,S pus led!o!un~ lie ql!M eoUelldLUoo u! s! uJe]S,~S leSOdS!p Jm, e~e),SeM ~o/pue/,iddns ~e],e~ e]!s-uo eq], 'uoRoedsu! pub uo!~eep, se^u! XLu LUOJJ pus seliJ @eeJoqouv jo /~!led!o!unR eq~ LUO~J peu!e~qo UO!]eLU~OJU! eq] uo peseq ~,eq~/,Jpe^ Jeq~,Jnj I 'u!e~eq pe),eo!pu! eJm, onqs jo ed,~], pu~ SLUOO~peq JO JequJnu eq], ~o¢ e~enbepe puu leuop, ounj 'ejes s! Lue~sXs leSOds!p ~e),eMelSeM ~o/pue Alddns ~e~e~ e),!s-uo eq], ~eq~ s~oqs le^o~ddV ,O,!Joq]nv q],leeH s!q] jo uoRel~!],se^u! ,~LU ],eql XJpe^ I '~oleq UMOqS m, ep uo!~ep!le^ eq], jo se pus o~eJeq pax!JJe Fees ,~uJ/,q pe!j!Peo sV NOIJ.'~INI:iO-INI aNY ~'.L~'a 'HOt:I~'=tS ~"11=1 'S.LS=I.L 'SNOIJ. O~IdSNI ~gNlalAOl:ld INI::II-I IDNII:I'~=INI!DN=I .g MUNICIPALITY OF ANCHORAGE (MOA) ,,.~.... H~I,tI~,Aq, thpdly,Approval (HAA) *: } ~.'J Legal Description:~ A. WELL DATA Well Classification Well Lo9 Present (Y/N) 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 To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments Date Completed Depth of Grouting Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ~. ~ c, ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ; Date B. SEPTIC/HOLDING TANK DATA ,,~,~')~) ~::-[4 /.. Date Installed'~r/~/~'/~2~ize /~00 ~;'"f~'gNo of Compartments ~ Standpipes/~')C'N)/y _Air-tightCaps(((((~/N) ,,,l,,/ FoundationCleanou((~N) ~/ Depression over TanK(Y/(N~ _~ ~ Date Last Pumped Pumping/Maintenance C(~'tact on File (Y/N) , /t///~ ;for Holding Tank High-Water Alarm (Y/N) /"///~ T~mporary Holding Tank Permit (Y/N~i SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well ~ To Property Line .,~ TO Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course To Building Foundation To Disposal Field /L? Comments 72-028 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ,-~/-/.~ ~/~.~ Type of System Design Datelnstalled ,'/'~'¢~,.. ~¢/~'~"~ /~ Length of Field Width of Field ~.'~'( ~/ / Depth of Field .//" ' , ., Gravel Bed Thickness 17' / Square Feet of Absortion A_rea ~ /¢~'~¢/¢~- Present (Y~.,N) Depression over Field (Y N~_ ¢/~ Statndpipes Da~.~of Last Adequacy Test R es u i ts o f Last Ad e q u acy Test ~_~-'~-~-f'/:~'.,,¢c'/¢ ';~)~? SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well ? To Building Foundation Lot ~ To Water Main/Service Line To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course /4J'~ ,¢,,.J ~"~ To Driveway, Parking Area, or Vehicle Storage Area. -'"-'m~--~O Comments ~Z..~//~,?~/ z~-.-~_-.c.f-z~--~Z~J -~'-~'>'"/~ ~:~-- / D ' ;la;: ISnTs t~:lleOdN ~ Dimensions ,S, ize in Gallons ~~ Manhole/Access (Y/N) , 'Pump On" Level at __~ High Water Alarm Level at ' ~..---"~ Vent-O'/~ Tested for ~ J Pumpi~q Adequacy Test. Meets MOA Electrical C,~ Comments **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effec inspection. Signed $ & S ENGINEERING 17034 Ea~ie Ri~er Loop Ro.~ No. 2~ Company ~gl. ~lvev. Alaska 99577 ReceiptNo. ~O,/~c:~ :~¢~/,/~Z_._~' Date of Payment ~" ~ Amount: $ / ~ · 0(~2 72-026 (Rev. 7~88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 ANCHORAGE/WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 563-6775 PWSID: 5t~~- Requested By: According to the records on file in this office, the ~9{~ ~~J Water System is in compliance with State of Alaska Drinking Water Regulations. the Sincerely, Cindy Thomas Environmental Engineer MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date NO v/ ~',,~%,,~, I I ¢ ~ GENERAL INFORMATION (MUST BE cOMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property Owner ~)~'-~- JL~J'O~-z"'v" Mailing Address (c) Lending Institution ~ ~/~C Mailing Address ~~ (d) Real Estate Company and Agent Telephone: Home '~ q(~ -2./~-~/ _ Business Telephone Address (e) Telephone ~['~ ~ Mail the HAA to the followina address: or: Check here ~ if hold for pick up. List contact person and day phone number below. 2. TYPE OF RESIDENCE Single-Family'~l~ Number of Bedrooms_ 3. WATER SUPPLY Individual Well'~ Community [] Public [] Note: If community/' well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite~j~ Public [] Community [] Holding Tank [] ' Note: If/"com munity well system, must have written confirmation from the State Department of Environmental Conservation · attesting to the legality and status. Page 1 of 2 72-025 fRev 8/861 Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixe'd hereto and as of the validation date shown be~ow, 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 flies 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. Name of Firm ~ Telephone ~L'~ ~ ,, ~ ~/~:~ Address '~ ~ ~ I~ l~-~-- ~ Date ~0 ~-/ ~ O; ~ ~ ~""7 DHHS APPROVAL Approved for ~ bedrooms by Approved ~ Disapproved Terms of Conditional Approval \ Conditional CAUTION The Municipality of Anchorage Department of Health and Human Services ('DHHS) issues H~alth Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of 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. Page 2 of 2 72-025 fRev 8/86) Back MUNICIPAi.iW OF ANCii,,~ 7 , ,. ENVIRONMENTAl $~Mi~NiCJ~",~'LtTY OF' ANCHORAGE (MOA) ' 'h'~'~f~'HORITY APPROVAL (HAA) /",JOV 2 ~ ]~8~HEOKI-IsT- FEB.UAnY 1.84 " 264-4744 RECEIVED Legal Description: ~*~, WELL DATA Well Classification Well Log Present (Y/N) 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 Ed9e of Absorption Field on Lot ~,P "' To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results If A, B, C, D.E.C. Approved (Y/N) Date Completed Y'ield Depth of Grouting Pump Set At 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 Comments B. SEPTIC/II~B~IIIII~ TANK DATA Date Installed '/'~ ~ Standpipes (Y/N) "T Depression over Tank (Y/N) Size . Air-tight Caps (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~ '~.o -ro Property Line ? To Water Main/Service Line No. of Compartments ~1~ O ~' Foundation Cleanout IY/N) Date Last Pumped ~/A ;for Temporary Holding Tank Permit (Y/N) TO Building Foundation To Disposal Field Course To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72~026 IRev 8/861 Front ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ! ~ ~'~ Width of Field -~ ~ Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ,~ ~,, To Building Foundation Lot ~"*¢ 0 I~ To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field '~ ¢ '/' ~.. Depth of Field ~ ~ Gravel Bed Thickness ~ ~ Standpipes Present (Y/N) Date of Last Adequacy Test. To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments Date of Payment Amount: $ Page 2 of 2 ** Check Permitted Bedroom Rating Against HAA Request ** I certify that ~_veF.hec ek,,c.d,.,~erifi .ed~r conformed to all MpA arid HAA guidelines in effect on the date of this inspection. Signed /¢' ~ Date II/lo/~7 ! Company MOA No. Receipt No. ~ _ ~ C-:) /~ O c~2r q"~ 72-026 fRev 8/86) Back DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAeE/WESTERN DISTRICT OFFTCE / 3601 "C" STREET, SUITE 1334 ANCHORAGE, ALASKA 99503 STEVE COWPER, GOVERNOR 563-6775 To Whom It MaY Concern: According to the records on file in this office, the ??/2x'5%~. _~:~/'_~sj/~'~ ............... Water System is in compliance uith the State of Alaska Drinking Water Regulations, Sincerely, Ronald S. Klein Environmental Field Officer CONSULTING ENGINEER 203 W. 15th AVE "C- SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 S ~ P T I C S Y S T E M A D E QU AC Y T E S T LEGAL: LOT 2, ]BLOCK 2, SPRING FOREST LOCATION: 5831 WEST TREE- OWNER: RESIDENCE: DALE MIZER SINGLE FAMILY, THREE BEDROOMS WELL: CLASS A WATER SYSTEM SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: GREER STEEL, TWO COMP. 1000 GAL. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 1221 SOIL RATING: 407 INSTALLATION DATE: OCT. & DEC. 1983 DATE OF PUMPING: NOVEMBER 4, 1987. MARX ENTERPRISES DATE OF TEST: NOVEMBER 4, 1987 TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH FOUR FEET OF COVER AND 50.5 INCHES OF LIQUID. THREE STANDPIPES WERE FOUND FOR THE DRAINFIELD. TWO SUMPS AND ONE CLEANOUT. CLEANOUT WAS SIX FEET DEEP AND HAD TWO INCHES OF LIQUID. SUMP FOR 83 FEET LONG TRENCH WAS 8.5 FEET DEEP AND HAD A LIQUID LEVEL OF 27.5 INCHES, SUMP AT END OF 27 LONG TRENCH WAS -15 FEET DEEP AND HAD 13 INCHES OF LIQUID. 1000 GALLONS OF CLEAN WATER WAS ADDED TO THE CLEANOUT AT A CONSTANT RATE OF 7.5 ,GALLONS PER MINUTE. THE WATER LEVELS IN THE SUMPS AND THE TANK WERE MONITORED. THE TANK LEVEL DID NOT CHANGE. THE FIRST 500 GALLONS CAUSED THE LEVEL IN THE DEEP SUMP TO RISE ONE INCH AND THE ~EVEL~IN THE SHALLOW SUMP 2.5 INCHES. THE NEXT 500 GALLONS CAUSED.NO FURTHER RISE IN THE SHALLOW .SUMP BUT 8. INCH RISE IN THE DEEP SUMP. AFTER FIVE HOURS THE LEVEL IN THE ~[,~S~M~P_~A~, STILL 22_,I~[~H_~E~S T~HE SHALLOW SUMP LEVEL WAS 6.25_~ THE NEXT MORNING THE DEEP SUMP WAS UNCHANGED THE SHALLOW SUMP._,H~D THESE MEASUREMENTS INDICATES THAT THE ORIGINAL ABSORPTION SYSTEM WAS INDEED INSTALLED IN. SOIL WITH VERY SLOW PERCOLATION RATE, AND THAT THE ADDITIONAL ABSORPTION FIELD DOES WORK. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE FOR A THREE BEDROOM HOUSE, The operational life of all septic systems depends on the local soil conditions, 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 this.septic system. We can therefore not give any estimate of how long the system will continue ao meet the operational requi- rements of the Municipality and State. APPLI¢ ~T FILLS OUT UPPER HA" 3NLY Property Owner Mailing Address Buyer '~:2, ')'! Address Zip Code · Phone Lending Institution )!!~ (:'i Address /:: t,i/ /:/;r ~ ,- Realty Co. & Agenl Address Zip Code Phone ~;.. Phone Legal Description Street Location,"~, , ,/~' Type of Residence E]-~lngle Family .: [] Multiple Family No. of Bedrooms [] Other Water Supply ~,A'l'ndlvldual ..... ~/~ ' ~ ~.~ ~ ~ . ATTACH WELL LOG. A well log is required for ell wells drilled since June 1975. FO/Community .(_~; t For wells drilled prior to that date, give well depth (attach log if available). O Public Utility Sewer Disposal ; [~l'ndividual Year Individual Installed: [] Public Utility When Connected to Public Utility: [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN Bi= INITIATED. 'rime Time Time Date Date Date Inspector Inspector Inspector Inspeclor Time Field Notes: _ ~--V~::.~''~--'- Y'."") I-~' I" ~ -'~"~?~"" (:' "", '':'>¥ ' .... 0 '. ~L.~ ~ RECEIVED ) CONDITIONAL APPROVAl..* MUFIICjFAL!7¥ OF ANCHORAGE ,~J'.4V l R C~; ;,VC: ,xlT/~. L PP, O (ECTION 'CONDITIONS OF APPROVAL .,ate Sewer Installed Well To Absorption, Area Well to Tank Well Log Received Septic Tank Size