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SPRING FOREST BLK 2 LT 5
0 F t p rin 9 or s 0 U A( M 11 awVWVa Ilig e, L Soz /--10 a- v s L D Fz-& 0 /L-1 s F--C) P- is- IS � () '� C) .� J, Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: _OSP251053 PID Number: 015-321-25 Dwelling: RE Single Family (SF) El with ADU 171 Duplex (D) R Two Single Family Project: [I New X Upgrade Name DAVID & MARZIEH FINK ABSORPTION FIELD El Deep Trench El Wide Trench RE Bed R Mound Site Address 6001 WEST TREE DRIVE, ANCHORAGE, AK El Other Phone Number of Bedrooms Soil Rating depth from original grade 907-240-0308 5 0.3 GPD/SF JTotal SEE DWG. Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade SEE DWG. Ft. Gravel depth beneath pipe 0.50 Ft. Subdivision Block Lot SPRING FOREST 2 5 Fill added above original grade SEE DWG. Ft. Gravel length 50 Ft. Township Range Section Gravel width 50 Ft. Beds: Number of Lines 10 Distance between lines 5 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area 12500 Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well PUBLIC PUBLIC - - 25'+ TANK 9 Septic [I S.T.E.P. [3 Holding [I Other Manufacturer GREER TANK Capacity 1500 Gal. Surface Water 100'+ 100 1 + - - Material PLASTIC (DEEP BURIAL) Number of compartments 2 Lot Line 5'+ 10'+. - - NA Foundation 10'+ 10'+ - -A TION Manufacturer Capacity Gal. Remarks PER THE CONTRATOR, THE OLD TANKS WERE DECOMMISIONED AND DISPOSED OFFSITE. Alarm location Elec r i tailed by PIPE MATERIAL House to tank D3034d Tank to D3034 rainfield Installer ANDERSON CONTRACTING & ENVIROMENTAL SEPTIC (ACES) Drainfield D3034 CO/MT D3034 Inspector GARNESS ENGINEERING GROUP, LTD.- BENCH MARK (Assumed elevation) 100.00 ft Inspection 1st 4/9/2025 4114-22/25 Location and description dates: 2nd 31d 4/14-22/25 4h 4/14-22125 1 BOTTOM OF SIDING NEAR BACK HOSE BIBB ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date -.7 Oo�P H ... .............. y Septic System Approved Da CE—_7 is approval does not include well permit requirements.ofess'10'0\i� CC884 (Rev 05/02/1 PERMIT NUMBER: PARCEL ID NUMBER: OSP251053 RECORD DRAWING 015-321-25 1 NOTE: PER THE CONTRACTOR, GRAVITY FLOW COULD 1 i �7p UT1LtT NOT BE ACHIEVED TO TO THE 1983 DRAINFIELD. PER \ VFgSEM THE CONTRACTOR THE PIPE SLOPE FROM THE FCO TO ' THE SEPTIC TANK INLET WAS INSTALLED AT A 2% SLOPE. \ TREE EXISTING 4 -BEDROOM 1983 TRENCH. ABANDONED IN PLACE FOR POSSIBLE FUTURE U i oll LOCATION OF 1987 BRUCE CORWIN. P.E. TEST HOLE NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS / TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE GENERATED IN AUTOCAD, APPROXIMATE WATER LINE LOCATION-----� APPROXIMATE LOCATION OF 1983 A.E.C. SERVICES, INC. TEST HOLE NOTE: AFTER THE TANK WAS INSTALLED, NEW OWNERS HAD CONTRACTOR REMOVE DECK AS PART OF THIS PROJECT EXISTING 5 -BEDROOM HOUSE \-NEW 1500 -GALLON PLASTIC SEPTIC TANK !/ `-DOUBLE CLEANOUTS / (DBL1 & DBL2) ?/ / Z/ N .,,`1� 50' X 50' DRAINFIELD S ALE: 1"=30' . yA' 4 NOTE: PER THE CONTRACTOR, THE OLD SEPTIC TANKS WERE DECOMMISSIONED PER UPC AND DISPOSED OFFSITE I � i .r �T i •rrey •* fI OF E]"! RIT GA SS I � C , ....::....a.........6..::.....� -=� � r :.:, ENGINEERING - SALES �- CONSULTING �� � � .:�� �s _ r�,:�� 0 � 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, ALASKA' PHONE (907) 337.6179' WEBSITE. v .gamessenginaedng cont 0 •• .•. ...................,• 0 PREPARED FOR. PHONE NUMBER: PAGE NUMBER. ♦ :• IIJ Garness : Or DAVID FINK 907-240-0308 2 OF 3 ff J,'f C -7953 � PROJECT/LEGAL DESCRIPTION: DRAWN BY: fff� S�2 SPRING FOREST; BLOCK 2, LOT 5 J.L.M. fFp•••.........•((('''''���' TYPE OF WORK: DATE: LICEN �,+, r>S>•♦�►�r •` RECORD DRAWING OF SEPTIC SYSTEM UPGRADE 5/22/2025 tF ECC884 TERMIT NUMBER: PARCEL ID NUMBER: OSP251053 RECORD DRAWING 015-321-25 U.M. - M.. NOTE: PER THE CONTRACTOR, THE NEW OWNERS WILL BE ADDING TOPSOIL TO THE SEPTIC TANK AND DRAINFIELD AREA IN THE SUMMER OF 2025. NOTE: ALL CONTAMINATED MATERIAL (DRAINROCK, SEWER PIPE, SOIL, ETC.) FOR OLD BED DRAINFIELD WAS COMPLETELY REMOVED. =ECTIVE ISTRIBUTION 94.35 NOTE: BENCHMARK FOR PROJECT IS BOTTOM OF SIDING NEAR OUTSIDE HOSE BIB = 100.00. 00 v 0 cy) z U) 0 u- U. Li Lu a M 4;r 2 C*4 c1q 0 C-N, uj I. x D 2 LL D 0 >- M < < CL uj C) z z LLJ Cy) (y) U-) w a. X (L < CL y ilk` Ai F C� uj 05P rl CL XyR CL CN w Z100 W F Z �?0 55F w LL wo 01 0 gal -j Coln ff� C4 M (D Z (n w 00 CL oz cf) �o w cr- a Q U. ow ui CL fr a. w -j F- OF Aw Aw 0844*496 sees a gone 0 0 0 oasis ii� a Jlog go 4 0 oo r y farness i 45—w AV CE-795 e N< AV !w AV < '*rss ay # amasses$ so 44rAjjFES1S I LICENSE 4 0 #AECC884 it TA; i �i, 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: OSP251053 Work Type: Septic Upgrade Tax Code Number: 01532125000 Site Legal Address: SPRING FOREST BLK 2 LT 5 G:2538 Site Mailing Address: 6001 WEST TREE DR, Anchorage Owner: FINK DAVID & MARZIEH Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft: Total Bedrooms: A 4 f l_7c17arCtncnt 3/18/2025 3/18/2026 48052 Q Disposal Field Cl Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: I i1 �� C Date: Issued By: Date: r ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-321-25 Property owner(s) DAVID FINK Day phone 907-240-0308 Mailing address 6001 WEST TREE DRIVE, ANCHORAGE, AK Site address 6001 WEST TREE DRIVE, ANCHORAGE, AK Legal description SPRING FOREST; BLOCK 2, LOT 5 Number of Bedrooms 5 Engineering Firm GARNESS ENGINEERING GROUP, LTD. Building Permit Number Not Applicable Fol APPLICATION IS FOR: APPLICATION IS AN: (H all that apply) Absorption Field S Initial ❑ Septic Tank ❑ Upgrade ❑ Holding Tank ❑ Renewal ❑ Privy ❑ Well ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: Permit/Rush Fees: - $_9g Waiver Fees: Date of Payment: 3Z / Date of Payment: Permit No. Waiver No. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251053, Curtis Townsend, 03/18/25 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251053, Curtis Townsend, 03/18/25 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251053, Curtis Townsend, 03/18/25 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251053, Curtis Townsend, 03/18/25 ELE F TH CD 0�j SHANE A. HOLT � '� LS-6914� �.��� Is THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTI TUTIONS SPECIFICALL Y TO SHOW ANY CONFLICTS BETWEEN EXISTING ,STRUCTURESAND PLATTED LOT LINESAND IOR EA.,SE ENTS' AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, CAR FENCELINES. EASEMENTS OFRE'CORD, OTHER THAN THO.SEAPPEARING ON THERECORD PLAT, ARE NOT SHOWN HEREON (UNLESS IN©ICA TED) ,MOTE' FENCELINES THA T CIA YAPPEAR ON THIS DRA WING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANYPAVING5140WIVHEREON MAYBEAPPROXf ATE DUE TOEXCESSIVE SNOWAND/OR ICE. NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT S, BLOCK 21 SPRING FOREST ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LIME" AND NO 'VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS 27 TH LAY OF _JANUARY 2025 HOLTLANDSURVEYINO 309 GROVER DRIVE ANCHORAGE,AK 9950 128447 FB 165-11 240-21 223,8615 MUNICIPALITY OF ANCHORAGE �t DEF rMENT OF HEALTH AND HUMAN SERV S U Pgr-cje— Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name n I A Ian USk-e- DISTANCES Tp FROM SEPTIC TANK ABSORPTION FIELD WELL Address Phone(s) Perm— No. of Betlrooms 3q�-355rq Fmwoq I 5 WELL +0001 + DO LOT LINE �C) ( r �--- LEGAL DESCRIPTION Lot Block Subdivision rj J' ren Foresi Township, Range, Section f ! A ^ I /� I lJ� c 'j FOUNDATION 5 5' �' --- AS -BUILT DIAGRAM driveway. water bodies, tShow location of well, etc.) septic system. property lines, foundation, TANKS LeSEPTIC ❑ HOLDING ManUlaactwerl_ ht 6hora Capacity in gallons __500 R Material � No. of Compartments I TYPE OF SYSTEM E- ohm las-12 'Ji []TRENCH [i? BED ❑ W DRAIN ❑ OTHER Depth to pipe bottom from original grade S FT Total depth from original grade S', 5 FT Q lion 5o at n — tA .� Mir ,� ' { (L 5 Fill added above original grade nC s" FT Gravel depth beneath pipe d.s FT -- Gravel length 50 FT Gravel width ��(p FT _ Total absorption area / c�(t �' S SQ Number of Imes Soil rating 8 aqa SQ FT _ Distance between Imes FT Pipe material srM 303 PUC Installer L Dale Installed NuCQQP S-u.5�LalS IAL !4S7— WELLS ❑ PRIVATE ❑ OTHER (Identify) Classihca n (A,B,C) Total Depth=Galed FT Inslalle, Dale Installed: REMARKS: all rM 51,E �r'a r+ a � �� � U P✓' S00 q al to n /IIJJ ,�• � O (� Sf-/S`FLCYf [.l.1�C�n�.PC�GI3 Oan Scale: NTS Inspections Performed by: ENGINEER'S SEAL r i --_--�� pu t C ,$ / J /� /1 :3YCi U..S a _ _ _ Dale. 8 mm, 1g87 I llll1,-C 1C . C- 11 \/�� cerlily Ilial t s inspection was performed according to all Municipal and State guidelines in ellect on this date: `� ( Health Department Approval: - -� 'u(Z Date: Y7 72-013 (3/85) PERM)T NO: DATE ISSUED: APPLlCAN[: �DDRESS: CONTACT PHONE: LEGAL DESCRlP: LOlSIIE: �PHV����������^� �ILI, I �����; 1� 11:� -�� DEPARTMENT OF HEALMH AND £NVlRDNMENlAL PROTECTION 825 L STREE[� ANCHURAG�, �K 99501 264^'4720 W& Th 1 Q X H 870O�4 �PGRADE 04/29/87 ALAN LESKE 1001 ME 11 WE DRlVE ANCHORAGE� AK 99516 346-�554 SU8DIVISILIN! : SPRING FOREST SUBD" LOT: 5 BLOCK: 2 SECTTON: ]4 lOWNSHIP: 12141 RANGE: :0.4, 48052 (SQ.FT. OK ACRES) { certi�y that: 1. I am (ami|iar wzth the requirements Ior op and wells as seL forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. l will install the !system in accordance with all MOA codes and regulations, and in compliance with the design criteria o[ ihis permit. 3. I will ODA he|`e to all MOA and State of Alaska requirements Ior the set back distances �rom any existing well, wastewater disposal system or public sewerage sysiem on \his or any adjacent or nearby lot, lF A LlF[ STATION IS INSTALLED IN AN AREA (OVESD BY MOA BUILDING CODES� THEN (1) AN ELECTRlQW. PB<MlT AND 1NSPECT1ON MUST BE OBTAINED; (2) AS-8UILTS WILL NOT BE APPROVED WlTHOUT AN ELECTRICAL INSPECTION REPORT; AND (3> THE ELECTRIC�L WORK MUST 1011 DONE BY A LICENCED [LECTRlCI&N. ,o . . S[GNED DATE: ' ��x� ���.L/��i/. T~~^—`~--'`~~~-��D-----�~----`~- APPLICANT: A / lSSUEU BY u Municipality of Anchorage a DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: \)n( I✓\'1 I: 1I t II , 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 M L so 0(,1 1o1 ENCOUNT IF YES, A I DEPTH? O J Depth to Wale Monitoring? (ENGINEER'S SEAL) _ 9 11 , DATE PERFORMED: 1� I Township, Range, Section: UND WATER SITE PLAN ERED? IV S T WHAT 0 P — - — -- E rAAj;� Date: Reading Date Gross Time Net Time Depth to Water Net Drop Apr, 1 10'.75 'SO 10 3, f0rrin5 •13 03 ML a !o" ys r0a�''s s4 Dy ra•y5 / ■1■■■■®MINIM ! 11 04 .SD II'! 0 ERED? IV S T WHAT 0 P — - — -- E rAAj;� Date: Reading Date Gross Time Net Time Depth to Water Net Drop Apr, 1 10'.75 'SO 10 3, f0rrin5 •13 03 a !o" ys r0a�''s s4 Dy ra•y5 / ! 11 04 .SD II'! 0 PERCOLATION RATE �2� (minutes/inch) PERC HOLE DIAMETER I i TEST RUN BETWEEN J• FT AND �'' FT %�rC �OI71.W> ��S�J✓t; l"��� vh �XC��; PERFORMED BY: IAI�IL�i'U l/cT%t!r I ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINY 72-008 (Rev, 4/85) lr1 1 IOG "L 6t�r �f G A14 fid._ -CERTIFY THAT TH S TEST WAS PERFORMED IN IN THIS DATE. DATE: - l� o. C �'AraA �eno} 5� /" IZeServe Seu"Iage I 5�.t5ern = �}Io x��II ��fbndo°r \ +u�U Je U:>V 1•Tye �r�7o 'i'ar K her' w%C.�P-o.v�ov+ \ - % r1/ JOi P oro�or O IAdd one Ne�gi�1"or,•�q I ; � �SU'Jq�iicn' p I--- ,��,,c 1 / NttJ ins ollaicon bor Sbe�ito�M r `01 ,( A Q k i VIAI 'j1��11C-1 O J; S/ ER SYSTEM LOCATION PLAN LOT BLOCK SUBDIVISION !7 a Spr,r\q F�orc '+ NORTH Comin �� C C:-5::33 � ce :ACEI NOTES ' of I ; THE ACCURACY OF LOCATION OF EXISTING _ t0 PROPERTY CORNERS, WELLS, AND SEPTIC iAWN BY, SYSTEMS INDICATED IS NOT EXACT. L DIMENSIONS INDICATED HAVE BEEN DETERMINED BY USE OF CLOTH TAPE ARD NOT BY SURVEYINO TECHNIQUES. P PREPARED FOR, i n9 eert< --• DATES SHEET / OF I MUNICIPALITY OF ANCHORAGE 1A k ST- 83 �� 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 NAME PHONE KZl NEW .{,, �� f W; n te: vVi,�/� 3011 UU.PGRADE: El UPGRADE MAILING ADDRESS LEGAL DESCRIPTION prrns Z_ 1 S LOCATION NO. OF BEDROOMS Op 0,VVOIe • on 13 zl, - p" rrr,lit ``i' Well Absorption area Dwelling PERMIT NO. U Y DISTANCE TO:Ar> we c) In 8 :S 6 2.S — Ia Z Manufacturer Material No. of compartments w h �.'� rCtr 5 l 7. rn 'ILiq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth IZ �� �r0 DISTANCE TO: Well Dwelling PERMIT NO. O z Q S —F Manufacturer Material Liquid capacity in gallons Well Foundation Nearest lot li PERNO. w= DISTANCE TO: trPe11 Df` En AT J LL z No. of lines Length of eachline Total length of lines Trench width Distance between lines aZ ui 1 f> r 9 inches Top tile to finish Material beneath D(3 Total ccF of grade E tile p T onr effective abptiarea O W' t b inches Hog Length Width Depth PERMIT NO. IL C7 Q N Type of crib Crib diameter Crib depth Total effective absorption area wLLI N Well Building foundation Nearest lot line DISTANCE TO: J Class Depth Driller Distance to lot line PERMIT NO. r W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS ave. SOIL TEST RATING •,r r INSTALLER \rl v 1? REMARKS 7 rAi i- 'p - .5 7 .Vj = 5 . Re -4c i` nc 4 In 'eve s 75 �u _ 0 S /1 %' 7b /Z WeiS C/o/,?;71 / / 2h/l /Z)<S' S SIU— r! L3 Wui' C APPROVED DATE LEGAL i 5 /a/6 ?i s Pri fyj gores i 5'2- L 5 72-013 (Rev. 3/78) PIC r1� tris pc,ted 61 i3 e�re�s � �ell ��1 1 9:77'� lt�::� IL__ 1 f�� IF=' ���1 � , ���03 E_ [)EPART�E@T L HEHLTH FIND -OTECTION 8�5 /L/ STREET/ HNCHORHGE/ HK99501 C.64~4720 K�CE K." I -W ll:_E� F? r -,j I~F, P�RMIT NO ( 8]025] ) HPPLI�HNT WINTER WISE INC 7400 E 20TH 99504]]]-]811 LOCHTIO� LEGAL L5132 SPRING FOREST LOT SIZE 999999 SQUHRE FEET TYPE OF SOIL HBSORPTIop.,i SYSTEM DRHINFIELD 1-117lXlMUM kILIFIBER OF �EDI7n'OIDMS 4 SOIL �ATII%IG FT/BR)= 31 THE R[��UI�E� SIZE OF' THE SOIL. ABSORPTICIN SYSTEM IS: ��"Y' F -A �5 IL_ IFE #�.Il i -P == ��� KID L_ ������ � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFTELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND HND THE B017*0,1 OF THE EXCAVATION (IN FEET). �U ... I "ll ���C� 11-11 0.4 1 1 1.: � 51.C-9 C) 11211 IF__ FE F-7-11",' THE GRAVEL. DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). ���Y, 1 �1,-.§ 1-,., T E -Z �Iffu C-) ������� PERMIT HPPLICHNT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTHLLHTION INSPECTIONS OF ANY WELLS HDJHCENT TO THIS PROPERTY HND THE NUIE-CR OF RESIDU-ICES THAT THE WELL kIILL SERVE. �R-R, E-_ ��0 LJ 3E F-.-,, &_ CH BACKFILLING OF HNY SYSTEM WITHOUT FINAL INSPECTION RND HPPRO\,Ak BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTHNCE BETWEEN R WELL AND HNY ON-SITE SEWHGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET HND TO SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MWY APPLY. SPECIFICATIONS HND CONSTRUCTION [:lIHGRHM, ARE HVHILHBLE TO INSURE PROPER INSTHLLHTION � F- I ���Irl ��� I CERTIFY THHT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FORTH BY THE MUNICIPHLITY OF ANCHORAGE. 2: I WILL INSTHLL THE SYSTEM IN HCCORDHNCE WITH THE CbDES. ]: I UNDERSTAND THAT THE "N -SITE SEWER SYSTEM [FY REQUIRE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED AND WELLS HS SET ENLARGEMENT IF THE HPPLIC0NT WINTER WISE INC � ISSUE[':, - . � V40 f7ls -'L,' •_.#',lkEf: t'.. MA:,HtNRflQE, BK.. 99501 .:.�. _ _.. _ .. -. .1.-.`hz'+- _�E� __-C-i Yui.-Y._���.a�_r._Q>ay q•.l -S U'l 1 F T•{i9�i #fsaif# N►JMSEP OF 4 SO [L RA#'c NIS FT/0R):= u'-l.d! "--✓ � �?�Eii�E=�F e.�a:�. Fs�' ��-?F �S'�#.f Y4.`3��.33?.s �t��f •�`r"=T�t�# ��: 1-4 THE L E"rsT#i V. N £'elslm G It'1 FEETss OF FM TflFNJ#OH OR UtU?W an -o { f S TRE fL:�>~ 7',-tfhis: 2 �'?-i�' £�•#�sr'i !�;' �S s;�._3{r3'�t 43�;• �`� t �� ..3�I'�•;�tit� THE s1.}ws=3im 63= rFo� s;xrtsa?jai Ws T>;' F,�sTTs_`s # QF IHS s5 T##E mrt ", Nt ~EPTH *F }sRklV £. k:'ETMEEN T`r{f rj�.}TFR3- PtPEE sit#£s THE €?LST Ms's;# tsi TtRt~«ty#iTsst# s' 1N�i>. "t + .q f J_ tv:CE#> 1�__€ jl``' — :c t_ _f_# a--3 I. . its Cifi *I --t-- Cjr-4-"n PC R#'# I Ti i! 'f't I 'ji# #'� < s s y ? 3s'}_ 1i i IL `s 1 `T` TC -1 I N OP t TH E 1 € F -PAR 7P-101 i DUR f el THF ; � ,Tt3LL1 fI�7lt 24s�s� =Ft��iF' }Jr ; 73's' �lEt_L his#>�f#:Et#T Tt� MIS Pf?f3PO4rlgf WAD THE r4tipiflEre or- p9:z fKC- WELL t-KUl ':•tit's+E. r 1-4 z fs= si 3'w T-wzEa Fzi!u t x j4f> t:-,- OF :tOF AM' SYSTEP! WITMUT F IML 'q,``':PN;K-lv'9 BY THIS '+ #4Iu. PF a1J •3 e� isT t�f sJ'�stsilFlt]�i. t°#•1 :F#r€lF3c5 s's T# i#t. .I �TLiEC: J A #•��I_i qN0 ANY f:it#•= 1TE GI;LAGE LrIS;�=ti�1#'3 'Y'5TFit IS �i FRIWITF WELL tits -I Sit ill V3 fft=T F,r>;'.$);t R 1�i113LIr +•tF:ti I}s #'�tk�Iti►3 #1 jJ€d UHE i4EU_. sn3 #s££tEit4 £�I Ti cc:t F ti PRI ITE t, i_ f'O A P.Rf'VArf 'SaIEwR LINE is 25 ANIO T{ n Cot'ttlUNIT't' r`i1^t+ -I##P £3 7:( FEET. s-Tt?i fiR TO�t�# i3L'�t i';t}>? }i'jt�t' #�o°0sf) �Pt I4 3?�i3 1- NT 4 44 d az�-! IN-, s I : #f'a r „#L 1 s Y I s THE tF 3el s j33lfr���.� )R --j i ,��fr �'� lTtlC+ IIIELL J t�� Yff y f Eyi..Fy'� is 'w : SS ffi}I I rV 11,t- i t 3 f `.f'�w:_. ice%- �3t'�i �I �i'} I ? I t'N01� c0'5TI-IM DIT THE s.s#'4-SE 0-1 WISTizt'i ?'fuss PEtR(M i NL,19R'! iMEN.T Ii" T.I,tP TO�t�# i3L'�t i';t}>? }i'jt�t' #�o°0sf) �Pt I4 3?�i3 1- NT 4 44 d az�-! IN-, s ,0I SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATIONTEST \ 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: �\� �CL/v ��<i` kms, DATE PERFORMED: -6 : z /_ LEGAL DESCRIPTION: f (c_J J.1.<,J`���I�" J� <'�t—> V Z� I__� DART SLOPE SITE PLAN P E R I i (-T 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMEN Ikl(_ i3l(u PLASTIC 510— /n l_ SaJuv�crzay s�(._T (�L 5i uKjor GfLnueu_Y 5 t_T I' L- t', s WAS GROUND WATERS Y ENCOUNTERED? /`f o L O IF YES, AT WHAT _ DEPTH? M Reading Date Gross Time Net Time ntii �� Depth to Water FY Net Drop Fi 7 06 �s PERCOLATION RATE U (minutes/inch) TEST RUN BETWEEN `� — FT AND - FT PERFORMED BY: l;.oiy/JoiG�� 0 I JA,J CERTIFIED B 72-008 (6/79) tt DATE:0_ ALASKA RUIR011WITAL COCA ROL ROMP Inc. 6nymeerinq fi 6ironmental Studies PERCOLATION TEST DATA SHEET CLIENT DATE x`31- '3 ADDRESS ZIP CODE LEGAL LOCATION ::5 ((kA U TOTAL DEPTH OF HOLE —ft ZONE TESTED ft TO V7, ft READING # CLOCK TIME NET TIME DEPTH TO NET DROP RATE (min/in) DATUM 2- Y 7 el 14- 1-1 0 FINAL PERCOLATION RATE C-, n/in) PERFORMED BY oef-vA"x f2 e 2 -�Z— "- 1220 West 25th Auem,:,, AQAoraqe, Alash 99503& (qol'1 ) 276 1361 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251097 Parcel ID 015-321-25 Expiration Date: Legal description SPRING FOREST BLK 2 LT 5 Site address 6001 WEST TREE DR Current property owner(s) FINK DAVID & MARZIEH X The On-site system(s) is/are approved for 5 bedrooms W 4/22/2026 Conditional approval for bedrooms, with the following stipulations: Comments or conditions: Original Certificate Date: 6/5/2025 This Ce4ficate of On -Site Systems Approval (COSA) is intended to demonstrate the subject sysm(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other 1. GENERAL INFORMATION Parcel I.D. 015-321-25 Complete legal description Location (site address) SPRING FOREST; BLOCK 2, LOT 5 6001 WEST TREE DRIVE, ANCHORAGE, AK Current property owner(s) DAVID & MARZIEH FINK 2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS Day phone 907-240-0308 3. TYPE OF WATER SUPPLY: n Private Well serving #_ dwelling units E] Other Non-public well as regulated by MOA E] Water Storage OR Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: � Private Septic M Private Septic serving 2 dwelling units ED Holding Tank El Community Septic or Public Sewer 5. SEPTIC TANK: F] Steel RE Plastic R Concrete R Fiberglass Age NEW _ See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: n AWWTS nN Bed n Deep Trench n Wide Trench El Seepage Pit Waiver request for: Expedited review requested: R Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 06? '0 / Waiver Fee $ Date of Payment., 3 / "2 1/ Date of Payment COSA # 0 o ek �E 1-7 Waiver # ) COSA Appka6on_Ap2025.doc COSA Checklist Legal Description: SPRING FOREST; BLOCK 2, LOT 5 Parcel ID: 015-321-25 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 ELL DATA ivy ❑ Well log with Onsite (or attached) Date drilled 1 depth ft Cased to ft \ ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) Date of flow test for CO Static waterat beginning of test ft. B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NEW ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 4/9-22/2025 OR ALL standpipes present per record drawing Total measured depth from grade 6.1 ft (max) Measured depth to pipe invert from grade 4.5 ft (min) ❑ N/A - pressurized field. ❑ Per record drawings, field is insulated. M Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N/A If yes, enter date Well production at time of test-.-*"- *"- opm Water storage tan�me�gallons Well d' ' cted for coliform test? ❑Yes Q No Coliform bacteria is Negative 'ate mg/L ❑ Nitrate less than MRL (ND) enic ug/L ❑ Arsenic less than MRL (ND) Collected by Date STATION ❑ Required Age of lift station Lift station mater Adequacy test date NEW Results Q Pass Fluid depth prior to test NEW in Water added NEW gal New fluid depth NEW in Elapsed time NEW min Final fluid depth NEW in Absorption rate 750+ gpd FIELD STATUS - POST RECOVERY Effective depth (per record drawings) 6 in Effective depth used 0 in Effective depth remaining 6 in Comments/Deficiencies: NOTE: NEW TANK AND DRAINFIELD INSTALLED BETWEEN 4/9-22/2025. COSA Checklist June 2022 TION DISTANCES From Private Well oiT t;at�to: (Please enter distances if less than required or if community well on to Septic Tank/Lift Station on Lot > Community Sewe ole/Cleanout > 100' [� Yes I ft ❑ Yes if No ft Neighboring Tank > 100' Yes if No ft rivate Sewer/Septic Line > 25' [:]Yes if No ft Absorption Field on Lot > 100' ❑ Yes ft Holding > 100' ❑ Yes if No ft Neighboring Absorption F' _ 100' Animal Containment > []Yes if No ft [� Yes if No ft Manure/Animal Excreta Storage > 100 C nitySewer Main > 75' [:]Yes if No ft n Yes if No ft © N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' R Yes if No Tank to Property Line > 5' Field to Property Line > 10' Water Main > 10' Water Service Line > 10' F. ENGINEER'S COMMENTS Yes if No ft Yes if No ft M Yes if No ft n Yes if No ft Wells on Adjacent Lots: Private Wells > 100' M Yes if No _ Community Wells > 200' 0 Yes if No _ If tank or field is under driveway comment below ii ft ft G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Gamess Engineerinq Group, LTD. (GEG) Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Gamess Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systems; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. COSA Checklist—June 2022 NAECC884 9199*czz SE-Gtj lZ-0tZ Gt-S91 8_q 'tit8Z1 L0966 XV'39VZ 01401V ' 301HO/ONV1VlONS3AISS30X301317031VP/IXOHddV39.(VGVN03H314NMOHSONIAVd.(NV 3A/NOTJ3A0219 6066 S1N3V311OHddV17VN0IIlOOV N0111S0d HO S31V7.C1H3dOHd ©ppp�O 9NlA-7Ab(nSONV7170H - 3NWH31300103Sn36701ION 3JVON/MVNOSIHINOVV3ddV,(VW1VH1S3N1730N33:31ON o-� �¢uolssa�00 031V0IONI SS37NI7) NO3H3H a 440 _IVMOHS1ON3HV '1V7d OH003H3H1 NO ON/HV.3ddV3SOH1 NVH1 H3H10 'Ot1003Hd0 SIN31N3SV3 ��SQ Aa S Z OZ AVW S3NI730N33 HO "SIN3IN3AOHdP11 '13H1710nY19 7VNOI1100V ON/NOIIISOd HOd 03Sn 39 01 ION OOH 4169 Sl o �C Jo AVO Hl 8 SIH! VNSVIV`39VNOHONV 1V 031V0 SIONV.SIN3W3SV3H0/ONVS3 031 NI71071V7dONVS3Hn10nH1SON/1S/X3N33M139310173N00 i10H-V 3NdHS 0310N NVHl 2l3H10 1SIX3ANVMOHSOl.(77V0Id103dSSNO11n1I1SNIONION37303Sn3H1HO3S/NO3H3HNOIIVWHOdNI3H1 y� S1N3WH)VO0N3 3l8ISIA ON 0NV S3NIl AlM3dMid 3Hl NIHIIM 38V N03213H1 031vniIs S1N3W3AO'ddWI 318ISIA 3H1 1VH1 0NV `V)ISVIV `10IN1SI0 9NI0M003N 39V2OHAV Q '. Hl ans 1s3a0J 9NIddS `Z AXIS `s 10l �pyo AI213dOU 039DDS30 9NIM01103 3Hl 30 A3MnS V 03WM0313d 3AVH 11VHl A3I H) A8383H I 31VO SIH! AS S83NaOO ON L6"1317. M .,EZ ,97 68 N 21, 9 cl d cN 773 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251097 Parcel ID 015-321-25 Expiration Date: Legal description SPRING FOREST BLK 2 LT 5 Site address 6001 WEST TREE DR Current property owner(s) FINK DAVID & MARZIEH 5/15/2025 The On-site system(s) is/are approved for bedrooms X Conditional approval for 5 bedrooms, with the following stipulations: Comments or conditions: By: Original Certificate Date 3/27/2025 This rtificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject syr em(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-321-25 Complete legal description Spring Forest 132 L5 Location (site address) 6001 West Tree Drive *anchorage Current property owner(s) David Fink 2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS Day phone 907-240-0308 3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units 0 Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: 0 Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 38 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS O Bed 0 Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ , Waiver Fee $ _ Date of Payment 2 Z S Date of Payment COSA # ©S C- 2 (0-9 _� Waiver # COSA Application—June 2022 COSA Checklist Spring Forest 132 L5 Parcel ID: 015-321-25 If more than II and/or septic system on lot, provide separate checklist. Structure served by this system _ A. WELL DATA ❑ Well log is filed with Onsite (ora hec Date drilled Total depth Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments B. TANK DATA Measured operating fluid level in septic tank _ Date of pumping ❑ Required maintenance completed, if AWWTS Comments: Tank being upgraded D. ABSORPTION FIELD DATA Which system tested (date installed) 05/1987 X ALL standpipes present per record drawing Total measured depth from grade 7.2 ft (max) Measured depth to pipe invert from grade 5.5 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. N �, If not, state depth into effective Z� Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 1787 gallons 3/4/25 date Any rejuvenation treatment (past 12 months) no If yes, enter date Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ® No tJ,jQoliform bacteria is Negative Nitrate mg/L F] Nitrate less than MRL (ND) Arsenic u Arsenic less than MRL (ND) Collected by Date C�IWT STATION ❑ Requiredlrrai tenance completed Age of lift station ars Lift station material Comments: Adequacy test date 3/5/25 Results ❑ Pass Fluid depth prior to test 3.75/5 in Water added 953 gal New fluid depth 5.75/7 in Elapsed time 1410 min Final fluid depth 5.25'6.5 in Absorption rate <750 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 6 in Effective depth used in Effective depth remaining 0 in Comments/Deficiencies: House was vacant time of test. Data is for 1987 bed. 1983 trench was not tested, but was found to have a liquid depth 8.5" in MT that extends 122" below grade. COSA Checklist June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well ot) Septic Tank/Lift Station on Lot > 100' Community Se anhole/Cleanout > 100' Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft vate Sewer/Septic Line > 25' [:]Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' ❑ Yes if No ft G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Gamess Engineering Group, LTD. (GEG) Phone Engineer's Printed Name Jeffrey A. Garness Date _ In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an attemative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 907-337-6179 9��i :....!... .............. � V V profess<< COSA Checklist June 2022 #AECC8U Neighboring Absorption Fields > 100' Animal Containment > 50' ❑ Yes if No ft es if No ft Manure/Animal Excreta Storage > 100' Community Sewer n > 75' F1 Yes if No ft E] Yes if No ft N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑■ Yes if No ft Surface Water > 100' ❑■ Yes if No ft Tank to Property Line > 5' ❑■ Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' 0 Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' ❑Q Yes if No ft Water Service Line > 10' Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS Septic to be replaced in summer of 2025 `Existing tank under deck G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Gamess Engineering Group, LTD. (GEG) Phone Engineer's Printed Name Jeffrey A. Garness Date _ In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an attemative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 907-337-6179 9��i :....!... .............. � V V profess<< COSA Checklist June 2022 #AECC8U ENGINEERING SALES CONSULTING March 27, 2025 Municipality of Anchorage Development Services Department On -Site Water & Wastewater 4700 Elmore Road Anchorage, AK 99507 Subject: Request for Conditional Certificate of Onsite Systems Approval (COSA) for Property at 6001 West Tree Drive To whom it may concern: The subject property is currently vacant, and it has been conveyed to us that it will remain vacant until the new septic system is installed. • We are unaware of any unreasonable risks to the public regarding health, safety, and welfare associated with the existing septic system. During our site visit, no overflowing sewage was observed. • We are unaware of any code violations regarding the septic system that could unreasonably compromise public safety until the septic system is upgraded. • Given the vacant status of the property, there should be no adverse effects as a result of granting the Conditional COSA. Please feel freelto contact me should you require any further information or clarification. President s,`P.E. 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www,garnessengineering.com Municipality of Anchorage.`- ` _< On -Site Water & Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL`AA =f mir, Parcel I.D. - 015-321-25 Expiration Date: ! / 1. GENERAL INFORMATION Complete legal description SPRING FOREST S/D; BLOCK 2, LOT 5 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: 6001 WEST TREE DRIVE, ANCHORAGE, AK, 99507 PATRICK & TREECE HANLEY Day phone 227-7425 6001 WEST TREE DRIVE, ANCHORAGE, AK, 99507 MICHELLE NELSON W/ REMAX/DYNAMIC Day phone 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: 257-0466 TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well ■ Community On-site LJ Public Water System ❑ Public Sewer ❑ Waiver/Variance request Received by: COSA to be release requested by the engineer. COSA Fee $ 524.0 Date of Payment 311?tI5 Receipt Number 61+_ 6 (46 COSA # 015C157O q `g Date: Waiver Fee $ _ Date of Payment Receipt Number. Waiver # Distance: 5. 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. /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. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municlpalilyd'Anchorzg , and industrypraclices. The reported results describe the condition of the syslem/s on the datels of the evaluation. Separation distances were measured to readdyidentiffable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may lluchime during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the systemis. These conditions can vary, and are outside the control of GEG. Saffsfactory fest results do not guarantee future perfomance of the system/s, therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail. The content of this report is for the sale benefit of the persavaudy who retained GEG. Reliance upon the information provided in this round by any other person or party including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the person/party who paid for this report. 6. DSD SIGNATURE ' System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for A bedrooms. bedrooms, with the following Phone 337-6179 Date 3 itf 15�' —•���OF `1`€c'ilstnitra �ryO 'i ON-SITE 70-11, WATER AND S% WASTEWATER o Jr2` PROGRAt� Original Certificate Date: 3 _- ..;Z 3-45 The Muni, pafr`�r, nc ague Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represe etat' ns given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTCHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory (Rev. 10/12(12) Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: A. WELL DATA Well type COMMUNITY Date completed Total depth ft. Date of test Static water level Well production WATER SAMPLE RE; SPRING FOREST S/D; BLOCK 2, LOT 5 Parcel ID: 015-321-25 If A, B, or C provide PWSID# 213564 Well Log (Y/N) Sanitary seal (Y/N)— Cased to ft. FROM WELL LOG Coliform colonies/100 ml. Nitrate mg./L. enlc: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA SEPTIC/STEEL Tank Type/Material SEPTIC/STEEL 1250 2 Tank size 500 gal. Number of Compartments 1 Wires properly protected (Y/N Casing height Mw Collected by: 'SEE NOTE ON BACK REGARDING FCO ACCESS 5/17/1983 Date installed 5/8/1987 Cleanouts(Y/N) YES Foundation cleanout (Y/N) *YES Depression over tank (IY/N) NO High water alarm (Y/N) N/A Date of pumping `' Pumper / T C. ABSORPTION FIELD DATA BELOW EXISTING GRADE 5/17/1983 231 Date installed 5/8/1987 Soil rating (g.p.d./ft Or /bdrm 292 System type TRENCH/BED Length 69/50 ft. Width 3/46 ft. *11.8 1104 Total depth *4.3 ft. Eff. absorption area 2300 ft2 in. Gravel below pipe 8105 ft. Monitoring tube YES Depression over field NO Date of adequacy test **3/10/2015 Results (Pass/Fail) PASS Fluid depth in absorption field before test 69 in. Water added 600 gal. Elapsed Time: 120 min. Final fluid depth 84 in. Absorption rate >= For 4 bedrooms New depth 89 in. 600+ g,p,d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - **1983 TRENCH WAS ACTIVE AT TIME OF INSPECTION SO THE TRENCH WAS TESTED. THE 1987 BED WAS NOT IN USE AND DRY. 1983 BED SYSTEM WITH TWO TANKS IS SIZED FOR 5 BEDROOMS, TRENCH AND 1250 GALLON TANK ARE ONLY SUFFICIENT FOR 4 BEDROOMS. NOTE: SOME PORTIONS OF BED SYSTEM HAVE LESS THAN 36" OF SOIL COVER. D. LIFT STATION Date installed "Pump on" level at in E. SEPARATION DISTANCES [] Size in gallons Manhole/Access "Pump off' level at water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on Public sewer main Sewer /septic service areas COMMUNITY WELL On adjacent On adjacent lots manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 51+ Absorption field UNSPECIFIED Water main 10'+ Water service line 10'+ Surface water. Wells on adjacent lots 200'+ PUBLIC/100'+ PRIVATE SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ 100'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 104 Curtain drain NONE KNOWN Wells on adjacent lots 200'+ PUBLIC1100'+ PRIVATE F. COMMENTS NOTE: FOUNDATION CLEANOUT IS UNDERNEATH DECK. DURING INSPECTION, NO ACCESS HATCH WAS PRESENT FOR GEG TO ACCESS BUT FCO IS VISIBLE UNDER DECK. 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 3billr (Rev. 10/12/12) 4: 'f J A. ess 5 4 c%' C 7 53 ' ��♦,Oak FESSt :.•� z 4.Z " n `+i -. f ..,L 1✓3'a"; .- � ��51 B� oldr � ' °yC.p%✓C' y'L/�iTS rf o �- N a - `tA �M f y hl '� f 41 f ?s.s-0EJtv_rf— 1J,! 6a'l PLAiti 3-szjiLa -40—i ,^,j„a �'�i MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA# t\r�a�a�,l� Parcel l.D.# UI' _3AB 1. GENERAL INFORMATION S >�n Funeh Subdivision Lu.l 5; BZoch 2; p 9 Complete legal description 6001 Wut Tn.ee DiLive. ---- Location (site address or directions) Anchuna e, AK Hanvor� 9 Sancti We L Day phone_ 346-1454 11 - Property owner — t�------ Mailing address 6001 We.,St TiLe.e, Dkive. Anchuna e. AK 199516 Day phone Lending agency Mailing address 3091 766-6442 Agent State, FaiLm Re2oeaV.on - Banb Benedetti Day phone —( Address 2702 IiLe2and Gnove Road Btoomingtonp IZtLnoje 61709 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: r� — 3. TYPE OF WATER SUPPLY: Individual well Community well XXX Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: XXX Individual on-site Holding tank -- Community on-site Public sewer NOTE: if community wastewater system, provide written confirmation from State AD EC attesting to the legality and status of system. 72.025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INS, XTION 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 this inspection. Name of Firm S & S ENGINEERING Phone (' �� f i 17034 Eagle River Loop Road No. 204 Address P-MIARlvw_ A1..4. Carrs Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. -- �— bedrooms. Conditional approval for Additional Comments Date I�_/r3 lei s... 007G OF In RONERT C. COWAN 1,(0 4,x,'•, CE - 8801 ' I4W bedrooms, ,with the following stipulations: ne Ivlunicipainy of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of 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 N21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 0 Anchorage, Alaska 995010 (907) 343-4744 Legal Description: � O 7— Health Authority Approval Checklist B L K2- 5 f N 4 �",)� ( s sP reel I.D.: © I S -3 d — S A. WELL DATA � Well type `I If A, B, or C, attach ADEC letter. ADEC water system number D 13 Log present (Y/[) Cv m nu r? Y Total depth _ Sanitary seal (YIN) Date of test Static water level Well production WATER SAMPLE TS: Coliform to of sample: Date completed Cased to FROM WELL LOG Nitrate _ Casing height (), c grun ) t Wires pr By protected (1� Wires INSPECTI�,�.� g.p.m. Collected by: Other bacteria g.p.m. B. SEPTIC41OL-DING TANK DATA / 'k 117 h 3 c ),13-0Date installed5 447 ``7 S Tank size S'b o Number of Compartments Z Cleanouts 0Y N) y If S Foundation cleanout 6)IN) _ i S Depression (YO ay High water alarm (Y4 I '161 Date of Pumping It y./� S Pumper } N° �" 5ER 7.c� 5' j' S -vitf ratio E,:T C. ABSORPTION FIELD/ DATA a6-- Date installed 5 /� / 3 Soil rating (g.p.d./ftZ o ft`/bdri/ System type Length `I Width 3 Gravel thickness below pipe Total depth Effective absorption area t ° `� Monitoring Tube present&jj/N) YDS Depression over field (Y/6) ^/ c Date of adequacy test `ts 1 / Resultsas /Fail) JS For /� bedrooms Fluid depth in absorption field before test (in.); Immediately after y�gal. water added (in.): Fluid depth _ -?y / (ins.) Minutes later: ) S - y 6 Absorption rate = / q A y g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date _ / , / , J S` -?(- /i- � '� ,3- i- q 7- t £i , c /-1 0� i y n � �� �.2 r f..2 /i �� i< l N S i A � � g t3 A /3 t; 7- 1, CC �- � 7_�-/L' (wU S�P7, "r/7 j` /)NA C,J-P 7.eEN")I �i. coNNkc7 L1 rf j 7 zFo)- D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm levet E. SEPARATION DISTANCES Size ill level at* "Pump off' level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/liolding tank on lot Absorption field on lot Public sewer main Sewer /septic ice line adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTICINOUDWA3 TANK ON LOT TO: Building foundation S / Property line / D / Absorption field_ r r Water main/service line 16 a Surface water/drainage ) o ° Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation ) v t Water main/service line / Surface water J o o -)�- Driveway, parking/vehicle storage area Curtain drain z ° ^ f NoLv t Wells on adjacent lots to /AProperty line ° 1 - i A/ 1A a S� F. ENGINEER'S CERTIFICATION �ett I certify that I have determined thru field inspections and review ofNlunicipal reco C. eOahoq in conformance ivith IOA HAA guid 'nes in effect on this date. .� t� �A Signature ��� `, » •• Engineer's Name A 4Z le t in iR� ti' soil 47 Date 1 Jl3I95 I�IrF:+. r ��t*a HAA Fee $_� Waiver Fee $ Date of Payment 1 -? — 1 3' % Date of Payment Receipt Number Receipt Number Rev. 8/95 OSS: haa.40's 6 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services M 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. # )A 1-a) HAA # I�M_'�-moot 1. GENERAL INFORMATION Complete legal description Lost 5; Block 2; Sph,%ng FoneAt Subdivision Location (site address or directions) 6001 p1ut Tkez Dkive., Anchwtage Property owner Michaet 9 Pat 0loode_U Day phone 346-2995 Mailing address 6001 Went Ticee, Drive., Anchorage,, AK Lending agency Day phone Mailing address -- Agent Naome, Fuller/VISTA REAL ESTATE Address 3000 "C" Sticeet, Suite 101 _ Day phone 562-6464 Anchorage, AK Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 5 I 3. TYPE OF WATER SUPPLY: Individual well Community well XXX Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX 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 MOA #21 5. STATEMENT -OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my 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. 5 & 5 ENGINEERING Name of Firm n re. 204 Phone Address eagle River, Alaska 99577 Engineer's signature 6. DHHS SIGNATURE —62�. Approved for bedrooms. Disapproved. Conditional approval for Additional Comments Date bedrooms, with the following stipulations: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of 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 021 Municipality of Anchorage Department of Health & Human Services w+ HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L6_16- aU< Z F626ST Parcel I.D. 0 3ZL. `Z6/ A. WELL DATA Well type A If A, B, or C, attach ADEC letter. ADEC water system number Z 1 3S 6 4, Log present (Ya C'J 1" M JNI7Y Date completed Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level Cased to FROM WELL LOG SEPARATION DISTANCES FROM WELL TO: Septic/he g..tank on lot 7—y0 rL Absorption field on lot 000 rf Driller Casing height Wires properly protected (Y/N) AT INSPECTION On adjacent lots On adjacent lots G��'�yNITY Public sewer main G°^ M uw (TY Public sewer manhole/cleanout GCSV" A4 c)N I T`>' Sewer service line LUM �'t�� �`i' Petroleum tank Gc>M,(9U/ 9(iY WATER SAMPLE RESULTS: 1_6-(7en or'— vM�LIf}NGE �TI�1Gf(Ev Coliform Date of sample: B. SEPTIC/. 4N6 -TANK DATA Nitrate Collected by: Other bacteria Date installed 45191L +5r//i1?3 Tank size SoU `f- /ZSD Compartments Z °` Z- CleanoutsY N yGS Foundation cleanou (Y/ ) YCS Depression (Y& Nv —,11 High water alarm (Y&1 /"C Alarm tested (Yo - Date of pumping �Vz Z j q3 Pumper NovzwU4N/�) SEPARATION DISTANCES DISTANCES FROM SEPTICS TANK TO: r 2UUr� ✓ / Well(s) on lot t�� N On au,acent lots l ^/(��^" r I Foundation S f rz S / ZS To property line 20 'f' _Absorption ;field Water main/service line Surface water/drainage A101JE elzes'�_A_ �/ 72.026 (Rev. 7/91) Front CONTINUED ON BACK PAGE (.71 Ice ..c Ile g.p.m. ' z On adjacent lots On adjacent lots G��'�yNITY Public sewer main G°^ M uw (TY Public sewer manhole/cleanout GCSV" A4 c)N I T`>' Sewer service line LUM �'t�� �`i' Petroleum tank Gc>M,(9U/ 9(iY WATER SAMPLE RESULTS: 1_6-(7en or'— vM�LIf}NGE �TI�1Gf(Ev Coliform Date of sample: B. SEPTIC/. 4N6 -TANK DATA Nitrate Collected by: Other bacteria Date installed 45191L +5r//i1?3 Tank size SoU `f- /ZSD Compartments Z °` Z- CleanoutsY N yGS Foundation cleanou (Y/ ) YCS Depression (Y& Nv —,11 High water alarm (Y&1 /"C Alarm tested (Yo - Date of pumping �Vz Z j q3 Pumper NovzwU4N/�) SEPARATION DISTANCES DISTANCES FROM SEPTICS TANK TO: r 2UUr� ✓ / Well(s) on lot t�� N On au,acent lots l ^/(��^" r I Foundation S f rz S / ZS To property line 20 'f' _Absorption ;field Water main/service line Surface water/drainage A101JE elzes'�_A_ �/ 72.026 (Rev. 7/91) Front CONTINUED ON BACK PAGE LIFT STATION /V0/U6_ Dateinstalle Size in gallons Vent (Y/N) High water alarm level /5/2 E.lE uJ "Pump on" level at Meets MOA electrical codes (Y/N Manufacturer Manhole/Access (Y/N) SEPARATION_Q4& INCE FROM LIFT STATION TO: n lot D. ABSORPTION FIELD DATA On adjacent lots Cycles ump off" level at Surface water Date installed 5 z2ZO02 Soil rating Z Z type —System t Length Sd Width �U f 6.11 ?hickness Total depth S S Total absorption area Z Z Ds, Clean outs present &y N) tL f Depression over field (Y No It -J2 Date of adequacy test Results ass ail) _Sljsj for - Cr--1V6r) F bedrooms Peroxide treatment (past 12 months) (Y/N) If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 1'J 6_SeC (JTOn adjacent lots Zo'fi `d"144uN�Property line /O /' / A'�NhX>oNC� To building foundation (s f— To existing or abandoned system on lot 3d C<<wcH On adjacent lots Zo Cutbank �y�ti'c PrZ�fENTWater main/service line 2S �-& Surface water r Driveway, parking/vehicle storage area O ?' Curtain drain �i� /�✓��S�a1S� E. ENGINEER'S CERTIFICATION 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. or fig S FRJGINFF►21NC �. u°eamcaoaeaoao 17034 ragle River Loop Road No. 204 0 el Signaturee River, Alaska o e !P V e06`B ®8Y®a0p(�gp oS�OU N B Engineer's Name �111rf 1/ /� q�L e aoenaeroo uoo ew aQ Date110G R J. 'HAFER �d6J°e° No. 8'15 HAA Fee $ �`Waiver Fee: $ Date of Payment Date of Payment Receipt Number $ Receipt Number 72-026 (Rev. 3/91) Back MOA 21 WALTER J. HICKEL, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 March 31, 1993 Mr. Scott Swenor S & S Engineering SUBJECT: Spring Forest Subdivision Class "A" Public Water System, PWSID 213564 Dear Mr. Swenor: (907) 349-7755 I have completed a review of this office's files concerning the monitoring status of the above -referenced Class "A" Public Water System and found the following: 1. The last satisfactory Total Coliform Bacteria Sample results was submitted to this Department on March 12, 1993. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. 2. The last inorganic Chemical Contaminants Sample results were submitted to this Department on January 28, 1991. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. 3. The last Radioactive Contaminants Sample results were submitted to the Department on February 12, 1993. This does _meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. - 4. The last Organic Chemical Contaminants/Volatile Organic Chemical (VOC) were submitted to this Department on June 16, 1992. Based on analysis of the previous VOC samples results have been satisfactory. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations.' Issuance of this letter does not imply that the above -referenced Class "A" Public Water System is in compliance with other provisions of the State Drinking Regulations. Mr. Scott Swenor March 31, 1993 Page 2 If you have any questions on the above information, please do not hesitate to contact this office at 349-7755. Sincerely, Michael Lu Environmental Eng. Asst. II s ' MUNICIPALITY OF ANCHORAGE DEPARTME(. t OF HEALTH AND ENVIRONMENTAL PR, VECTION L) .� DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL _ 14 U — ct4 I q OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. " GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, rang� ) p G 5� 2, /7 fro SGI f%6f/l�/yrs! Location (address or directions) � acs / t✓2 r/' �2��1�© (b) Applicant Name ��� Telephone: Home Business Pe `/(LQ�IVs�i Applicant Address (c) ' Applicant is (check one): Lending Institution ❑ ; Owner/builders ; Buyer ❑,; Other ❑ _(explain);,.' �(d) Lending Institution ,]`t $ Telephone — — '' :Address (e} Real Estate Company and Agent �[ KI E. 1 Address Telephone (f) the HAA to the following address fg' ,Mail 41 r4 1 ra= iW 4(s�?ri tp Q10 '�+ 2.. TYPE`OF RESIDENCE • '—, rl tit 5 iuq% � Iti Ori . - �-t Single -Family Multi?Family ❑ Other ( �e 5 l ` `, Number of Bedrooms , -/ � 3.�'11 WATER SUPPLY / 1 ry` 1 , q4{(!N Axl{- :• (: �- r Individual Well ❑ Community Public ❑ a �, A // Note.;lf community well system, must have wntten confirmation from the State Department of Environmental Conservation attesting to the legality and status s 4 ' SEWAGE DISPOSAL Onsite Public El community ❑ Holding Tank 11 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. - - - - 72-025 Page 1 of 2 5. ENGINEERING FIRM PROVIDIf NSPECTIONS, TESTS, FILE SEARCH, D, 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 regulations in effect on the date of thisins ection. Name c. Firm � lkp0r Telephone D¢�—f�U Address ZLE20(ezllko� 44& / p / SSS Date `o G Q /1!a`�fl 7oe.�'� 9..e e�eee na � MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SLRVICES DIVISION AUG I 1198 % A. [U-- L( DJTA E D MUNICIPALITY OF ANCHORAGE (MOr.1 HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: Well Classification _ �iwift&6n 1*124 If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) _ Date C mpleted Yield Total Depth Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground — Sanitary Seal on Casi�/ ) Electrical Wiring in Conduit (Y/N) Depression Ar Wellhead (Y/N) 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 Collect y — ;Date Water Sample st Results Comme B. SEPTIC/HOLDING TANK DATA 5-�7--c�g Date Installed 5-6-4P7 Size No. of Compartments �f 5c.)04uPak K Standpipes (Y/N) — Air -tight Caps (Y/N) Foundation Cleanout (Y/N) A Nelms/ Depression over Tank (Y/N) — Last Pumped Pumping/Maintenance Contract on File (Y/N) /Date A / �" ; for -_ Xv, Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well 7�� To Building Foundation 3e.'> To Property Line To Disposal Field To Water Main/ServiceL'n))e//�� To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata .Type of System Design Date Installed �/ ���7 Length of Field 5 / Width of Field Depth of Field •, Gravel Bed Thickness �✓ r Square Feet of Absorption Area Boo Standpipes Present (Y/N) Depression over Field (Y/N) �J Date of Last Adequacy Test Results of Last Adequacy Test A24 Separation Distance from Absorption Field: To Water -Supply Well l!�b To Property Line f® / To Building Foundation; To Existing or Abandoned System on Lot �� / ; On Adjoining Lots �Vx+ To Water Main/Service Line �w ,{T/o`Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course �r To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N Comments ** Check Per tied Bedro I certify tha I ec Signed Company Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) — Dimensions Manhole ess (Y/N) "Pump Off' Level at Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA ng Against HAA Request ** or conformed to all_M A and HAA guidelines in effect on the date of this inspection. Date MOA No. 5- 767 -- OD l O 016 ld U $ F Y" oacoor� Engineer's Seal � - c i w 3 cw SBam0 �� ur C J. Cormn CE -5283 ,�'4 e STEVE COWPfR, GOVERNOR OF a s a DEPT. OF ENVIRONMENTAL CONSERVATION/ ANCHORAGE/WESTERN DISTRICT OFFICE 563-6775 3601 C STREET, SUITE 1334 ANCHORAGE, ALASKA 99503 DATE: _d//?/ -!PL-------•-------- PWSID: --------------- To Whom It May Concern: According to records on file in this office, the 5DRY21-11___—_— o2�1S Water System is in compliance with the State Drinking Water Regulations for monthly bacteriological sampling only.* Sincerely, 9 Ronal S. Klein Environmental Field Officer •NOTE: Alaska State Drink.''Ing Water Regulations require that sampling for primary inorganics be taken at prescribed intervals. Since this is a groundwater system, primary inorganics saipling is required every three (3) years, The last samr:-le was received _��"� -------- 4 Please submit a current sarnp1e in order to bring your system into compliance with the inorganics siimpling requirements. APPLK NT FILLS OUT UPPER HAI ONLY Property Owner - %>.// i / /„ / (' Phone Zi l%il Code li l l`/ Mailing Address p Buyer Time Address //CJ �.� /S -',-i; / �(:' - - %l/ // Zip Code Date Lending Institution Phone / ' Zip Code Address j:7,-/�r./ (-/!�"�'"!r� /J/!L/SfJ�- Inspector /`` Phone Realty Co. & Agent .. Inspector Zip Code Address Legal Description��r Street Location _//%lf Field Notes: Type of Residence Single Family jNo. Multiple Family of Bedrooms— ❑ Other _ Water Supplyo�q LOG. A log is required for all wells drilled since June 1975. 1:1Individual ,�✓ fj]: Community C— r� ATTACH WELL well For wells drilled prior to that date, give well depth (attach log For if avallable). ( ) DISAPPROVED ❑ Public Utility ( ) CONDITIONAL APPROVAL' Sewer Disposal �I� Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72029 (3182) /' C Time Ti ne Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: G (,SRC MUNICIPALITY OF ANCHORAGE LA DEPT. OF lic.LTH f: ENVIRO\f,t_NIAL PROTKT!ON 3fr , t IN TI -1) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' Soils Rating Date Sewer Installed Well To Absorption Area,WellLog Received ' 7 e Well to Tank `-- " Septic Tank Size / © 72029 (3182) /' C CONSTRUCTION AND OPERATION CERTIFICATE ALASKA DEPARTMENT" OF ENVIRONMENTAL CONSERVATION . PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT Plans for the construction of '��� r n� <-' rJ ( (_. C.i l.< r'' /( 1_ KZ I LLpublic water system located in ��//..t i C �, o i- c, <' <' �f Alaska, submitted in accordance with 18 AAC 80.100 by f� 1 G� t 1 1� ! t - / f > a C 1 C P c have been reviewed and are ,0. approved. !/ ❑ conditionally approved„(see attached conditions). TITLE CATE If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. APPROVED CHANGE ORDERS Change (contract order no. Approved by Date or descriptive reference) The "APPROVAL TO OPERATE” section must be completed before any water is made available to the public. APPROVAL TO OPERATE �... >7, The construction of the water system was completed on y �' (date). The system is hereby granted interim approval to operate for 90 days following the cpmpletion date. DATE As -built plans submitted during the interim approval period, or an inspection by the Department has confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate. , - ;j ref; '.-' '- _ �."'"•r..... ...e r F f , � .,? �_;x TITLE - DATE a R,w ALASKA CI dROnMenTAL COnTROL SHUNS, InC. 6ngineerinq & Enuironmental Studies October 31, 1983 Department of Health & Environmental Protection 825 L. Street Anchorage, Alaska 99501 Attn: Cory Willis Dear Mr. Willis: This letter is to offer my humble apologies for incorrectly writing up certain parts of the inspection report for Spring forest Block 2 Lot 5. I had previously stated that the material beneath the tile was 144 inches. In fact, it was only 96 inches, as the total effective absorption area indicates. I also failed to explain why I re—designed the trench from what the permit called for. I did so because the drill log implied that the strata encountered was a silt which changed properties at various layers. However, the excavator dug to a depth of 12 feet to show that actually the soils were the same. Being suspicious, I climbed down into the trench, imperiling my very life for the sake of an accurate soils log, and found that, indeed, it was the same formation all the way down, not siltier or more plastic with depth. I then explained that they would need to dig down to 16 feet to show that there was no water, and naturally they proceeded to do so. I regret that I did not explain this on the report and beg forgiveness. Sincerely, Darcy Sevens Engineering Geologist 1200 West 33rd Avenue, Suite B • Anchoraqe, Alaska 99503 • (907) 276-1361