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Home My WebLink AboutSPRING HILLS ESTATES BLK 1 LT 4'0 Spring Hills Estates Block 1 Lot 3 #015-051-41 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: OSP211405 Work Type: SepticTank Upgrade Tax Code Number: 01505141000 Site Legal Address: Site Mailing Address: Owner: BRANDNER MICHAEL D Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date: Expiration Date t�cnt: S Cp t � •. v llepartment Lot Size in Sq Ft: Total Bedrooms: 9/30/2021 9/30/2022 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Veronica Pope *i4 2021.09.30 Received By: G 13:40:05 -08'00' Date: Issued By: Date: R z0 5 MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-051-41 Property owner(s) Brandner, Michael & Sheila Day phone 310-748-9511 Mailing address PO BOX 240921, Anchorage, AK 99524 Site address 9401 Spring Hill Dr, Anchorage, AK 99507 Legal description (Sub'd., Block & Lot) Spring Hill Estates L3 Legal description (Township, Range & Section) Lot Size 51,051 Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) Q (w/wo AD U) Septic Tank Q Upgrade Q (D) ❑ Holding Tank ❑ RenewalDuplex ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 9 -z? - -q Waiver Fees: Date of Payment: C��-Z-IA Date of Payment: Receipt Number: d 137'/0 Receipt Number: Permit No. OSPZ (l C405 Waiver No. Permit App_::- : ,—..:c September 16, 2021 MOA Development Services Department On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Spring Hill Estates B1 L3 – 9401 Spring Hill Drive Septic Tank Replacement Dear On-Site Services Engineer: The septic tank on the subject lot has reached the end of its useful life. We are submitting this permit application for the placement of a new 1,500-gallon tank. The attached site plan identifies the location of the existing and proposed tank along with the existing home, well and absorption system. No conflicts exist between this proposed system and any other wells or septic systems, whether on this lot or adjacent lots. We are proposing to upgrade the septic system to serve a five-bedroom home. The two absorption trenches on the lot were each designed to accommodate a four-bedroom home. Both trenches will be placed on line through the use of a flow splitter valve. Upon completion the new septic system will have more than sufficient capacity to serve a five-bedroom home. We have also located and designed an alternate site using historical test hole data and a CAT III advanced treatment system. The new septic tank will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the absorption fields. Please refer to the attached plan for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211405, Deb Wockenfuss, 09/30/21 Michael E. Anderson 4831-ER EGISTEREDPROFES S I O N ALENGINEEREXISTING WELL 1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND TH 1995 SPRING HILLS ESTATES, BLOCK 1 LOT 3 9/28/21 FEET 0 50 100 NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. 4-BDRM HOME SPRI NG HI L L DRIV E 10' T&E EASEMENTS EXISTING WELL EXISTING TRENCHES TO BE TIED TOGETHER FOR 5-BEDROOM SYSTEM NEW 1500-GAL SEPTIC TANK W/ 20" MANWAY DECOMISSION EXISTING TANK PER UPC FS 2CO 2CO ALTERNATE SITE: CATIII SYSTEM APP RATE 6.0 20' LONG x 5' WIDE x 3' EFFECTIVE DEPTH EXISTING WELL PLACE CO AT BEGINNING OF TRENCH 2CO 2CO ≥10' 400 405 400 390 385 380 375 395 400 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211405, Deb Wockenfuss, 09/30/21 F® Municipality of Anchorage Page I Of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: �W Q�PID Number: 41 S o 5 1 y l Name: SAr-times �/�/, ^P�Tlc�tz��J Wastewater System: ❑ New X Y Upgrade Address: I A wC-F1oRAL�c, A k. Gynt S-RIh1C7 MILL --DR, 9151 o ABSORPTION FIELD Phone: q s No. of Bedrooms: � ❑Deep Trench KShallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: I • a GPD/S . Ft. lot Lot: Block: ` Subdivision: SpeI"(.Nfc.LS Depth to pipe bottom from original grade: Gravel depth beneath pipe 5i• (c .5' Ft. 3.5' Ft. Township: Range: Section: Fill added above original grade: I Gravel length:t 4- 0.51- 1•'5 Ft. 6(' Ft. WELL' ❑New ❑ Upgrade �xlsYI),j6 pJ Gravel width: t rJ Number of lines: I Distance between lines: -.- Ft. Ft. Classification (Private, A,B,C): Total Depth: Cased T Total absorption area: Pipe material: (A<,�Prm Ft. Ft. SO. Ft. �010/P303� Driller: ate Drilled: Static Water Level: Installer: Date installed: Ft. I W��.b I; xG. to - lot -,i6 Yield: Pump Sei at: Casing Height Above Ground: TANK GPM Fi. Ft. CXtS"(f N SEPARATION DISTANCES aSeptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: 1 a� From Tank Field Station Tank Sewer Lines �2��ti' Well I Iq f ISI, _ _ as - Material: STE_ML Number of Compartments: o2 Surface Water I IOo -1 lc�o -t- — — LIFT STATION Lotr S t 10 Size in gallons: Manufacturer: Line Foundation to r a,1 , ,_ � --� "Pump on" level at: "Pump o " vel at: High water alarm at: CurtainN ��10 �� Pump Mak el Electrical Inspections performed by: Drain Remarks: -per- tlbN 0-HAt.A6>1-?,j c- y -o BENCH MARK SL_OvC,I-Ito-t (o OF V-�1AT�R.IAI. — Location and Description: -TnP oc 6A2AGE s' C...46 1( 0.5`1 /lanl�� ro Zl, GrH ' D�7L re L. spa/a`, Assumed Elevation: 100.0 Ft E N C�f✓I�+QC�L .. ql.. h a �Sf 1104 �i,J. ` r A� � 5 S ENCINEERIING �' �' 9ttj• a Inspections performed bYP34 Eagle River Loop Road, No.208ates: 1st I o -tl -15 ' r , Eagle River, Alaska V9577d 2nd �S - • •.... t� ROBERT C. COWAN -�`� Department of Health -rd Human�Services approval ` 8801 ��" �` Reviewed and approved by�,*_, Date: �� i 72-013 (Rev. 9/91) MOA 25 WELL a Permit No. SW950329 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 o Anchorage, Alaska 99519-6650 o Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report LOT 3, BLOCK 1, SPRING HILLS ESTATES 01505141 Legal Description: PID No.: S 1 72-013 A (Rev. 9/91) MOA 25 \ 99.4' ST2 FINAL GRA )E MT1 CO3 99'5 FINAL GRADE 92.3' 1L :501:G:A 2 1' SR EPAN 8.0' ♦ 82.0' NO WATER FOUND 9-30-95 EXIS ING TRENCH ABANDON D SUCH THAT R DAY A B 6' -- FCO F� LOT 3 j (Mre ST1 10' 34' NEW ABSORPTION ST2 19 43 TREN H C01 21' 45' CO2 22' 46' C Ir\ I I J C04 CO3 32' . 51' I�� C04 73' 83' j 0O, 00a I i MT1 63' 69' CO �'` —�I Mr2 79' 103' � IL,T1 $TI EXI TIIPNTG 1250 1250 AL FCO A EIC (VERIFIED TANK INT Rf1Y B F2��OM �L! 0� p -:OA oROBERT C. COWAN r9A+• SCALE 1" = 40' c� •., CE - 8801 •,c= o eAr .. .; + l %t t............... ..,, 72-013 A (Rev. 9/91) MOA 25 \ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT NUMBER:SW950329 DESIGN ENGINEERS & S ENGINEERING OWNER NAME:PETTIGREW JAMES W OWNER ADDRESS:9401 SPRING HILL DR ANCHORAGE, AK 99516 PARCEL ID:01505141 LEGAL DESCRIPTION: SPRING HILLS ESTATES BLK 1 LT 3 LOT SIZE: 51051 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 1c) .'z'U C) - `\ - `i (UPGRADE) PERM�IT((�� - DATE ISSUED:10/07/95-� EXPIRATION DATE:10/07/96 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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING S. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY:" - ISSUED BY: DATE: I Q DATE: O S&S HEALTHAUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 1nq September 28, 1995 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 Lot 3, Block 1, Spring Hill Est. S/D ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX(907)694-1211 Request you issue a permit to upgrade the septic system serving the four bedroom house on the referenced property. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The approximate location of the test hole is located on the attached site plan. At the time of excavation no water was encountered in the test hole and after seven day ground water monitoring, the monitoring tube was found to be dry. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, Robert C. RCC/gk Enclosure Cowan, P.E. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 I NZ I o I z m x 10' ELEC. Fc TELECOM. ESMT. ------ --Z m "O A �i n> G% N v r !- F' Z P I" = 50' - SITE PIAN UPGRADE D SCALE C) rill Ll)7 ar r mz C •d xi N � 0 O �/ JON-pw"�U p0 -`,inm�`rbV)z V m ADu'o j i ;I *t omC'� ht,1�;Cly ' r;u -Oi ODDm��ln zomtlu)�U)=m Z�n�;� azo � O"m3O (A N _m O _ Z U) O -1 m�z'm -1 K a� O out. <mm 1 LI Z j;v T N oz { m N 0 Odd Z O n a mz Z rC-*7 ZD z � �r ► �O mmz�mmm r O � U] 20' r, mom �m0 O T u n -- �0--- ----- �z-----�>Z�+ x -71 �_ A� NZ I o I z m x 10' ELEC. Fc TELECOM. ESMT. ------ --Z m "O A �i n> G% N v r !- F' Z P or - OO F ca cn � z D N C) rill Ll)7 o r II j II mz C q N � 0 O � W p0 -`,inm�`rbV)z W p CA ®7 �rzOi�x®1 c O *t t�.�tW w -< mWC Z ht,1�;Cly ' At ` m N C) 0 / }•. mz C w ��.✓•'• Z < OZ;)O-' z2-NI vc -`,inm�`rbV)z W �rzOi�x®1 c Z D t�.�tW w -< mWC Z ht,1�;Cly ' r;u -Oi ODDm��ln zomtlu)�U)=m ••''.a�� O"m3O (A N < vl rn � --- ---1 r------ _ Z U) O -1 m�z'm -1 K out. <mm 1 LI �8 X j;v T N oz { m N 0 Odd Z O n a mz Z rC-*7 ZD z � �r ► �O mmz�mmm ` z r U] 20' r, mom �m0 O T u n -- �0--- ----- �z-----�>Z�+ x -71 �_ A� 'I -I= m --1 --1 K O—O• m Z Oz0 A-nir m 0 O 7u 0 O M D (Jl m > m M 00 I CA cn (A m O m g-0OO O 0�07O N 0 0 i }•. mz C w ��.✓•'• Z < o vc CO n Z D ht,1�;Cly ' ,,,.,;Ids ••''.a�� (ENGINEER'S SEAL) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG PERCOLATION TEST Pf 7-)G.Rt:w PERFORMED FOR: C_�'� L� DATE PERFORME y`r LEGAL DESCRIPTION: Ld i— 3 Oi,< SPAi,c- yri-b t Township, Range, Section: DEPTH SLOPE SITE PLAN �F `E l)2 i1 ��G.. E1Ni C- S 1 2 3 4 j M1 Si�T u/ /pjcc1 5 } I� Depth to Water 6 i� III 7 I I 8 b I 11 _ 12 At SL P __ 4 14- 15 15 16 17 r 19 WAS GROUND WATER 0 ENCOUNTERED? s IF YES, AT WHAT — L DEPTH? O P / E Oepth to fter Aller OA)/ w/3V17 -- Monitoring? Dale: k Reading Date Gross Net Time Time Depth to Water Net Drop to it Ft�lOAK b b , S --O 6 3/y 6 ' ,-/ At SL -7 34/"' 6'13 8 20 6 r. PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND / O FT COMMENTS IDU 6- 13 0 £ X . S & S ENGINEERING PERFORMED BY: I CERTIFY THAT THIS TEPT WAS PERFORMED IN ag a R(var Loop Road No. 304 W / 3 0 / 9 Y - ACCORDANCE w1T*0fI-RNT#70kPAWk"WAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72.-008 (Rev. 4/85) HEALTHAUTHORITY APPROVALS SEWERS WATER MAIN EXTENSIONS SEWERS WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN S&S\ 1tneeninG ONSITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 3, Block 1, Spring Hill Est. S/D September 26, 1995 GENERAL: ROBERT C. COWAN, P.E. ROBERTA. SHAFER, RE. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 1. The scope of this project includes the installation of a leachfield trench to serve the four bedroom residence located on the referenced property. The existing leachfield trench is to be abandoned such that it may be used in the future. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. IC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page Two Lot 3, Block 1, Spring Hill Est. S/D September 28, 1995 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINF'IELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruff -ed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over •the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final. grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Lot 3, Block 1, Spring Hill Est. S/D September 28, 1995 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Tvbe of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by -the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Lot 3, Block 1, Spring Hill Est. S/D September 28, 1995 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual. arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Lot 3, Block 1, Spring Hill Est. S/D September 28, 1995 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out •the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER 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 NAME PHONE NEW !� d U C, �. Imo+ S �t� �,. �V l' _I �� i� ❑ UPGRADE MAILING ADDRESS /2—gC)0 �T5 tJ l C' LEGAL DESCRIPTION LOCATION NO. OF BE ROOMS Well Absorption ares Dwelling PERMIT NO. U Y DISTANCE T0: �rs'r , "SR el-Y�IJ Ci. Za Manufacturer CREEK. Material No. of compartments. wH rn Liq. capacity in gallons 1ZSC) /IF HOMEMADE: Inside length Width Liquid depth DISTANCE TO: Well Dwelling PERMIT NO. Z Q m —'I— Manufacturer Material Liquid capacity in gallons e w DISTANCE TO: Well Foundation j Nearest lot line PERMIT NO, g 7Jb-t- 1 tiJo I' w Z No. of lines Length of each line Total length of lines Trench width Distance between lines 1= z w ✓2— 6(3/ & Q inches .._. aF- Top of tile to finish grade , Material beneath tie _ Total effective absorption are inches Length Width Depth PERMIT NO. w Q H Type of crib Crib diameter Crib depth Total effective absorption area Lu N Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. d w DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER CN T 12us5 V PIPE MATERIALS C'JAS`t- PIC, (T'ta_e btJ� 5' 9 SOIL TEST RA7TIING i V '{ I INSTALLER REMARKS \ 1J� 1 1 ' 5� 771 1 I �_..1 _ C -. O b ' APPROVED DATE LEGAL 72-013 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE Department Health and Environmenta' 'rotection 825 L Street, Anchorage, AK. V9501 264-4720 Permit # # # HANDWRITTEN PERMIT # # # WEND/,0 ON-SITE SEWER PERMIT rf�i0 Applicant:, Mailing Address: %0�eh� �i(� - a7 Location: Phone Number: �.� 2 -� J �S L�1 Legal Description: ` / �`a't��o � Lot Size: -- -- Type of Soil Absorption System Is: Trench: � Drainfield: _ Seepage Bed: Holding Tank: Maximum Number of Bedrooms: c--� Soil Rating (sq. ft/br) C/o The Required Size of the Soil Absorption System Is: DEPTH _LL2 _. LENGTH �_ GRAVEL DEPTH S WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). # REQUIRED SEPTIC(H0tBq-NG) TANK SIZE _ /aS GALLONS # # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number ofresidences that the well will serve. # # TWO(2) INSPECTIONS ARE REQUIRED # # # Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. # # PERMIT EXPIRES DECEMBER 31, 1 9 3 3 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the res'v]is remodeled to include more that � bedrooms. enc Signed: I Issued by: C—1yr A lic t �� 3 Date: E SWP/024 (1/81) F,, SOILS LOG MUNICIPALITY OF ANCHORAGE i DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION v TEST 825 L. Street, Anchorage, Alaska 99501 7.64-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: LO a'r) DATE PERFORMED: 0C j d LEGAL DESCRIPTION:S'r-\r' {�, I ��. ` CSic._�F- I I' -c 1- L.o� � C`1L SLOPE SITE PLAN Qyg 1 I 2 3 4 Date Gross G pIy 1 Net Time Time Water Drop ctH 1' n- 6 -, I • T<<t 7Y: I I i- -" 8 -.! I, I F 11 v 0- P 12 - 1 14 OF At 16 Ap 'p(��......... 17- :' N jog 60:60 aws"266 18 f, 19- Leroy C Raid, No. 2251 tFy•. 20 COMMENTS PERF013MED BY: �r /V 72-008 (6/79) WAS GROUND WATER_ I S ENCOUNTERED? e% L 0 _.., .—. IF YES, AT WHAT / E DEPTH? II -'11 "J_„ oelc NoIC Reading Date Gross Net Depth to Net Time Time Water Drop T<<t fJ< I F v 0- P I I WAS GROUND WATER_ I S ENCOUNTERED? e% L 0 _.., .—. IF YES, AT WHAT / E DEPTH? II -'11 "J_„ oelc NoIC Reading Date Gross Net Depth to Net Time Time Water Drop 6 IIA '-'q pROFESS0 q ! \�ZCoUaA;MCOLATION RATE (minuteslinch) TEST RUN BETWEEN `3 2- FT AND FT l ,� IGiYI CERTIFIED BY: _ DATE: t M -W DRILLING, Inc. P.O. Box 10-378 • 10300 Old Seward Highway (907) 349.8535 ANCHORAGE, ALASKA 99511 DRILLING LOG E4-109 Well Owner 1'0u' Malin Use of Well Domestic Location (address of: Township, Range, Section, if known; or distance main road Lot 3",lock 1 Sprina Hills Lstates Size of casinCe Depth of Ho e 242 feet Cased to 241.50 feet Static water ft. above) (below) land surface. Finish of well (check one) open end Screen erforated ( ). Describe screen or perforation Nona Well pumping test at 5 gallons per RM*) (minute) for 1 hours with 100% Pty - of drawdown from static level. Date of completion January 26, 1984 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 113 TO 170 2 TO 100 100 TO 110 110 lr, , 118 113 TO 170 170 TO 220 220 TO 235 3 5 TO 242 ___2 OTOTOOTOTOTO -TO- -TO- To- 0- To- To- -TO Casing stickup Brown sandy clay witli graval Brown clay & gravel Brown silt Brown silty gravel ( Brown silty gravel Brown silty gravel (damp) Waterbearing gravel NWG'PA Certified Contractor Certificate No's. 814 & 973 3—CONTRACTOR a . t 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 Parcel I.D. # o I�-- 05- 1 'i I 1. GENERAL INFORMATION Complete legal description HAA# W R)5Q!S 2L) Lot 3; Btock 1; Spking H.i,P,P.s Subdiv.i6ion _ 72-025(Rw.1/91) Front MOA#21 9401 Sp,%ing HiU Dh i.ve - Location (site addressor directions) ,._ - Anchonage, AK Property owner- Cara Petti.gaew Day phone 346-2395 _ Mailing address 3605 Arctic Btvd #498 Anchorage, AK 99503 Lending agency, Day phone `Mailing address Agent Day phone ;Address p. Unless otherwise requested, HAA will be for pickup. " ,+ NUMBER OF BEDROOMS. ' .; 4 3.' r:TYPE OF,WATER: SUPPLY4 4 "' Individual well . XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- /, Ing to the legality, and status of system. " 4. OF WASTEWATER DISPOSAL: _TYPE Individual on -sit a XXX t- 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(Rw.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 invest�qation 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. S & S ENGINEERING 6K `� - a °I Name of Firm 3791,4, P -• Phone Address Eagle River, Alaska Engineer's signature Date 1> /1 3 1 q J- 6. DHHS SIGNATURE ��, fF; :' �r ,•,` CAUTION Approved for '_ bedrooms. Disapproved. itionaI approval for ; `bedrooms, with the following stipulations 'on r e{ f L L!1 r .n tl r r Y. 1 ti': .-1.� 4 _ y 1 V F.✓,.1 ; l Additional Comments By:z Date i 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-M (Aft. 1/91) Beek MOA e21 " Vii: CAUTION 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-M (Aft. 1/91) Beek MOA e21 " Vii: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 o Anchorage, Alaska 995010 (907) 343-4744 Health Authority Approval Checklist Legal Description: Lor 3, ��OLK Spa �6Nius Csr. Parcel I.D.: �l�J�r✓ 1 z{ I — c A. WELL DATA rn T 4' Well type -p(2 wATa- If A, B, or C, attach ADEC letter. ADEC water system number 4;0 i� CD CJ, presenf) t N) lkeG Date completed I- a h - `a`{ � Total depth — a `i a Sanitary scat (�DN) VE5 Date of test Cased to FROM WELL LOG I-��-Ooq Static water level NOT S-rATf�-ID Well production 1�5 g.p.m. WATER SAMPLE RESULTS: Coliform _ Nitrate Date of sample: _ )1 / `� / 9 S- B. SEPTIC/HOLDING TANK DATA I _ Casing height (above ground) I .t - Wires properly protected 6 N) �% S AT INSPECTION ala' S . I g.p.ut. o- I Other bacteria O Collected by: S & S ENGINEERING oep Road No. 204 17034 Evale River L Eagle River, Alaska 99577 Date installed I - 8 - 3 Tank size I'a 5' Number of Compartments a Cleanouts (®N) '/8-5 Foundation cleanout t7M) YrS Depression (Yo IJo High water alarm (Ye Wy Date of Pumping - I 4 Pumper V+ HomtE S�Rv tC�S C. ABSORPTION FIELD DATA Date installed 10- (9-95, _ Soil rating (g.p.d./ft' or ft'/bdrm) (• of System type S+IALLOUJ-'RC^-404 Length (n(o ' Width Gravel thickness below pipe S. Total depth H.5 Effective absorption area (oil Monitoring Tube presenZM Y� Depression over field (Y® rJa Date of adequacy test QA sysr Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test (in.); — Immediately after —gal. water added (in.): Fluid depth (ins.) Minutes later: Absorption rate = 9-p.d. PCrONide treatment (past 12 months) (YM) If yes, give dat D. LIFT STATION Date installed Manhole/Access (YIN) High water alarm level at* Cycles E. SEPARATION DISTANCES Size in gallons "Pump on" level at* / "Pump off' level at* SEPARATION DISTANCES FROM WELL ON LOT TO: epti folding tank on lot ltd Absorption field on lot � 3 I Public sewer main 5 +- Sewer /septic service line a5 On adjacent lots wo On adjacent lots loco '� Public sewer manhole/cleanout loo .,- Lift station �-i / A SEPARATION DISTANCES FROM<§�OLDING TANK ON LOT TO: Building foundation to / Property line (5 Absorption field Water main/service line Surface water/drainage 1Q0 Wells on adjacent lots 100 4 - SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation P Water main/service line I v Surface water two -` Driveway, parking/vehicle storage area a3 Curtain drain NpNE: KNowt.l Wells on adjacent lots too I'+ Property line 10 ' F. ENGINEER'S CERTIFICATION I certify that I have determined thrtt field inspections and review oflllunicipal records twha ANn in confot•mance ivith MOA 1141 mdelin s in effect on this date. e.[.�Py 0r oY CSS ,f Signature irl✓M^— ;' , y.. ,,Lr C. Co t✓A�✓ Ell Engineer's Name {` m E2 TT �; "" r' 'e tt e•� Date 11 %1 �! – i� r,?� RU9iRr C. COWAN CG - 8301 HAA Fee $ 3n ©) d Date of Payment Receipt Number ` r CJ tp3 Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ Date of Payment Receipt Number WIN MUNICIPALITY OF ANCHORAGE ° DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services Ak On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING l Parcel I.D. # 11� - (��l - 1 HAA It it (91 2Y�� 1. GENERAL INFORMATION Complete legal description �l��k I2iNq�/s �SYs Location (site address or directions) r Property owner DeNNls Z714vy Day phone 346o )4(e( Mailing address Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS 3. TYPE OF WATER SUPPLY: Individual well Community well Public water "1 \4 Day phone Day phone PA -A -SE c4 -cc_ 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 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 1421 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 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 / o roti EAef1P. Phone Address / Q _ � o til ZVP1 Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. A 1 p ea G; fit. !'.'y or• l d4n ncutr.s D. Bader C. 1110 � • �� \W bedrooms. Date (o- 1(r -?3 Conditional approval for bedrooms, with the following stipulations: Additional Comments 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. 1191) Back MOA M Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Apt NQ lrlr�%S ES'�� Parcel I.D. `T T A. Well Data t617I a mko -n /� < D Well type T -1uA& If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) V Date completed / - Z6 - 84 Driller Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump levell Cased to Zq-1. i -U Casing height FROM WELL LOG 1-a- -844 146�- .��47 sb SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot /00* Absorption field on lot Ierz Public sewer main 14 Ar Wires properly protected (Y/N) AT INSPECTION ..S- Z3- 1 S UaAL A6a1nl 0 e� WAS po"PAJ g. p. m. A^>`A s slr�G 64 W r'r-d�ou7 ��e�urr� sr9Ns 6-1PrL',sss , On adjacent lots /6a+ On adjacent lots / QZ ?I - Public sewer manhole/cleanout 14A Sewer service line NA Petroleum tank WATER SAMPLE RESULTS: t-1 /� Coliform Nitrate Other bacteria ZA-T-rsF,aC_`7.0�_ Date of sample: 0 o-7- 93 Collected by: B. SEPTIC/HOLDING TANK DATA Date installed 0-8-83 Tank size rasa Compartments a Cleanouts (Y/N) _Foundation cleanout (Y/N) Depression (Y/N) High water alarm (Y/N) aA Alarm tested (Y/N) ll�/+ Date of pumping o C' - 4 Pumper T1 4'"t+A'�p2s SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I CiZ)f On adjacent lots / 6n+ Foundation /0 To property line >S/ Absorption field Water main/service line /114 Surface water/drainage 72-026(3/93)•Front CONTINUED ON BACK PAGE C. LIFT STATIO Date installed A Size in gallons Vent (Y/N) p on" level High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE F OM LIFT STATION Well on lot D. ABSORPTION FIELD DATA On adjacent lots Manhole/Access (Y/N) "Pump off" Level at Cycles tested Surface water Date installed //- 8 -83 Soil rating (GPD/Ft2) /90 System type %�2eNc1� Length (08 Width (0C Gravel thickness 7,- Total depth /0* Total absorption area Cleanout present (Y/N) Date of adequacy test - Results (pass/fail) PhSS Water level in absorption field before test c� 9 Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO Depression over field (Y/N) for test yes, give date Well on lot / On adjacent lots /6� Property line S/ To building foundation &7t To existing or abandoned system on lot 9A_ On adjacent lots 7 30 Cutbank 1-4 o+ Water main/service line tiGAk Surface water r -f A Driveway, parking/vehicle storage area /5 t Curtain drain AlA- E. ENGINEER'S CERTIFICATION Bedrooms /certify that I have checked, verified, or conformed to all MOA and HAA guidelines {I'1�'4�(�{ect on the date of this inspection. Q 9 1q4, `t J. . \VA Signature a Engineer's Name v �5,�t ., �— Lr \Yce Date — 11-43 J sri�) r , HAA Fee $ / 70 , U"U Date of Payment 4 a -- %3/ Receipt Number �-Y7 1 % 72-026 (3/93)* Back Waiver Fee $ Date of Payment Receipt Number v s ) \A/a11 10' SL.UPE (�til4lT, ESf-l7 9 C2 6 89°56' 5O" W 10' L5 C.. r -t,` E9r�r. LEGEND 0 0 0 0 rf ✓�VI 1 V M 1 1 IV 222 E 2220 E. 88th, AVE.. ANCHORAGE, ALASKA 99507 • ) /� DRAWN BY, C, f2, SCALE, I'' p ,r -p' C -C OWO. N0. �`- '/ !.� 1J .�j/�=.t CHK, SYS /�. Imo- DAT Eirp 'Z'y'��r FLO. IK - Li O LOT CORNERS �---- FOUNDATION - 4`klo�\\ ---�-- DRAINAGE ARROWS OFAZ�.s�l wi �Q;.'• '•.,�¢' (+ NOTES, w"' I. IT SHALL BE THE RESPONSIBILITY OF THE BUILDER OROWNERTO VERIFY THAT ... ....... f BUILDING LOCATION SHOWN MEETS ALL SUBDIVISION COVENANTS AND Z014ING ORDINANCES. 2. IT IS THE RESPONSIBILITY OF THE BUILDER TO VERIFY ALL ELEVATIONS WITH ��! '•' '"""'•"'�p� �`'�•�._ :"'.-fi$ iii RESPECT TO ALL UTILITIES. r'I P�.'I'4-•. d S. THIS PLAT REPRESENTS THE PARCEL OF PROPERTY DESCRIBED BELOW TAKEN FROM THE RECORDED PLAT PARCEL. INSTRUMENTS RECORDED f �Y '. . .�i:)i•I'J • 4�"y� Fi O DESCRIBING THAT PRIOR TO OR AFTER THE FILING OF THE RECORDED PLAT ARE NOT SHOWN ON 50 t^�•'• • �,.•5�, �O%fSS�D�•v. ��►�uI`��F THIS PLAT. 4. THE INFORMATION ON THIS PLAT IS FOR THE USE OF LENDING IHSTITU710NS M SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND ��n( PLATTED LOT LINES OR EASEMENTS , THE PLAT IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCES. Sf/4° SURVEYOR S CERTIFICATION A6- BWIL*r I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DESCRIBED ON THIS PLAT AND THE IMPROVEMENTS SITUATED THEREON ARE LOCATED AS SHOWN ON THIS PLAT. Lal �y L. d C. K � DATED THIS DAY OF 6F'F1IKiGI 1"i1t-L ESiATF� +L IID$-. ✓�VI 1 V M 1 1 IV 222 E 2220 E. 88th, AVE.. ANCHORAGE, ALASKA 99507 • ) /� DRAWN BY, C, f2, SCALE, I'' p ,r -p' C -C OWO. N0. �`- '/ !.� 1J .�j/�=.t CHK, SYS /�. Imo- DAT Eirp 'Z'y'��r FLO. IK - Li NORTHERN TESTING LABORATORIES, INC. h 0 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-3116 •FAX 456-3125 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 (907) 277-8378 • FAX 274-9645 DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORM BACTERIA Dennis Zilavy Public Water System I.D.# 9401 Sring Hill Anchorage Ak 99516 Date Received: 06/07/93 Time Received: 12:20 Date Analyzed: 06/07/93 Time Analyzed: 16:00 Date Reported: 06/10/93 Time Reported: 09:31 Next Sample Due: Comments: S = Satisfactory U = Unsatisfactory POS = Positive Test Result ND = None Detected Collected by: TB TNTC = Too Numerous To Count (>200 Colonies) Sample Type: CG = Confluent Growth Routine HSM = Heavy Sediment Masking, Results May Not Be Reliable SA = Sample Age >30 Hours But <48 Hours, Method of Analysis: Results May Not Be Reliable Membrane Filtration Old = Sample Age >48 Hours, Too Old For Analysis Comments: R = Resample Required NT = No Test Location 1 L3 B1 Spring Hill 1 Susan C.Tifental Microbiology Supervisor Sample Sample Date Time --------------- 06/06/93 19:00 * # Colonies/100 ml ** # Colonies/ml Total* Fecal* Other* HPC** Lab# Coliform Coliform Bacteria Result Comments ----------------------------------------------•------ AA13766 0 NT 0 NT S EW! NORTHERN TESTING LABORMORIES, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-3116 • FAX 456-3125 2505 FAIRBANKS S1REET ANCHORAGE, ALASKA 99503 (907) 277-8378 • FAX 274-9645 Dennis Zilauy 9401 Spring Hill Anchorage AK 99515 Attn: - Report Date: 06/10/93 Date Arrived: 06/07/93 Date Sampled: 06/06/93 Time Sampled: 1900 Collected By: JB 'L awl- C Reported By: Susan C. T fental Microbiology Supervisor * Definitions * B = Below Regulatory Min. H = Above Regulatory Max. Our Lab #: A123956 E = Estimated Value Location/Project: Spring Hill M = Matrix Interference Your Sample ID: L3, Bl D = Lost to Dilution Sample Matrix: Water MDL = Method Detection Limit Comments: Lab Date Date Number Method Parameter Units Result * MDL Prepared Analyzed --------------------------------------------------------------------------------------------•---- A123956 EPA 353.3 Nitrate -N mg/l <MDL 0.1 06/08/93 'L awl- C Reported By: Susan C. T fental Microbiology Supervisor n 6 16204 CUSTOMER'S ORDER NO. DEPARTMENT DAT NAME ADDRESS , CITY, STATE, ZIP SOLD BY CASH C.O.D. CHARGE ON ACCT. MDSE I PAIDOUT RETD QUAN.�Wf PRICE' AMOUNT 0 'i si SAM --r-r-466 X 09504 4 7 11 12 14 i 15 i 16 17 18 19 20 I __ r� RECEIVED BY KEEP THIS SLIP FOR REFERENCE Zaos i Dennis Zilavy 9401 Sring Hill Anchorage Ak 99516 Collected by: TB Sample Type: Routine NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907)456-3116•FAX 456-3125 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 (907) 277-8378 • FAX 274-9645 DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORM BACTERIA Method of Analysis: . Membrane Filtration Comments: Public Water System I.D.# Date Received: 06/07/93 Time Received: 12:20 Date Analyzed: 06/07/93 Time Analyzed: 16:00 Date Reported: 06/10/93 Time Reported: 09:31 Next Sample Due: Comments: Sample S = Satisfactory U = Unsatisfactory POS = Positive Test Result ND = None Detected TNTC = Too Numerous To Count (>200 Colonies) CG = Confluent Growth HSM = Heavy Sediment Masking, Results May 1 L3 B1 Spring Hill Not Be Reliable SA = Sample Age >30 Hours But <48 Hours, 0 Results May Not Be Reliable Old = Sample Age >48 Hours, Too Old For Analysis R = Resample Required NT = No Test * # Colonies/100 ml ** # Colonies/ml l ( , Susan C.Tifental Microbiology Supervisor Sample Sample Total* Fecal* Other* HPC** Location --------------------------------------------------------------------------------------------- Date Time Lab# Coliform Coliform Bacteria Result Comments 1 L3 B1 Spring Hill 06/06/93 19:00 AA13766 0 NT 0 NT S l ( , Susan C.Tifental Microbiology Supervisor NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (9071456-3116•FAX 456-3125 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 (907)277-8378 • FAX 274-9645 Dennis Zilauy 9401 Spring Hill Anchorage AK 99515 Attn: - Our Lab #: Location/Project: Your Sample ID: Sample Matrix: Comments: Lab Number Method A123956 EPA 353.3 A123956 Spring Hill L3, B1 Water Parameter Nitrate -N 4,Z [w� Reported By: Susan C. T fental Microbiology Supervisor Report Date: 06/10/93 Date Arrived: 06/07/93 Date Sampled: 06/06/93 Time Sampled: 1900 Collected By: JB * Definitions * B = Below Regulatory Min. H = Above Regulatory Max. E = Estimated Value M = Matrix Interference D = Lost to Dilution MDL = Method Detection Limit Date Date Units Result * MDL Prepared Analyzed ----------------------------------------------- mg/1 <MDL 0.1 06/08/93 16204 CUSTOMER'S ORDER NO. DEPARTMENT DAA 5 � NAME ADDRESS i CITY, STATE, ZIP SOLD BY G45H C.O.D. CHARGE ION ACCT. - REPAID OU TE7 QUANL 1 - u 3 FUNIM %w FRII Ab iOtJNI =- 2 a �sH� , ws . -rt 66 3 �n d --a AX 99504 ! � 4 5 6 7—: � W- 9 10 11 12 13 14 15 16 17 i 18 1 20 R€CEWEE)BY,- - 4 KEEP THIS SLIP FOR REFERENCE MUNICIPALIPY OF ANCHORAGE DIVISION OF US VIRONMENTAi, HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH W7.1-I0RITX A13PROVAL CERTIFICATE 1. Ge-mryal Information (a) legal Des cription (include lo/t, block, Location (4dciresw"or directions) Application Date vision, secti.cn, township, range) (b) Applicants Narre / Applicants Address,f�� (c) Applicant i7 (c'heIc-k ore) Lending Institution �j ; OOwner/builder Buyer F� Othc r � _ � (e3(�,lain) ; c (d) Lending Institution � - -- _ _ _ -- Telephone Address (e) Real Estate Co. & Agent.. Address Telephone 2. 7[yfa of 1�si.clen<_e Multi --Family Number of Bedroom 3. Watear Eugully_ Individual VJel1, { ry � Camun .ty I Other (describe Public Note: 5.f community r:� ll system, must have written confirmation from the state Department of Envi.ronriental. Conservation attesting to the legality and status. Is the well adequate for the number of bedrooms specified in this HAA /N) 4. Sely l Di.s� Onsite 1.rh.i.r_ Cmm�nanity� Holding Tank Is the wastewater disposal system adequate for the number of badroems (Page 1 of 2 2-15-84 I 5. En inaerinq Firra Providing Inspections, Tbsts, Data and Information U I certify that I have checked, verified, or conforimd to all MOA HAA Guidelines in effect on the date of this inspection. Signe j< % a7, �y,'1'.<::c. Date -6L Nara of Firm �e S IY�le hong <<c� Address.12-Lt �1.{; Sign - d by Date 6.DHEP Amroval Approved for Approved rr �l (ENGINEER SEAT,) bedrooms Disapproved r Torms of Conditional Approved U AQ oo f e �El J expp 900U 6e0e ed °i •i 0}180640 d• ° d+q •�iOsCPo�u�4.6aat at i��3 e �3� �. F•�hit3a Jig °° i ✓� 9°G °es y and By ..�� _��, u c -A e - , Date � .1 OP5C Conditional ILL 'Me Municipality of Anchorage FA,partrrent of Ik?alth and Envi.romental Protection does not guarantee tlxa continued satisfactory performance of the water supply and/or_ the wastewater disposal system. This approval indicates that, as of the validation date shorn above, Lased on the data and information furnished by an engineer registered in the State of Alaska, tho, water supply and wastewater disposal system is safe and func- tional for the number of bedmove, and type of structure indicated. ( MFT SEAT.,) 7. Mail the HAA to the following address: KB2/d5/s (Page 2 of 21 2-15-84 A. WELL RATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 idu1Ni1 ;IPP.I.1iY OF ANCH011AGL DFP'r. OF HEALTH & JiIjl! r) Legal Description: n Well Classification - If A, B. cr C. D.E.C. Approved(Y/N) Well Log Present /N) Date Completed /12 Yield,S_ Total Depth V-2 Cased to 5//. Depth of Groutingp Static Water Level Aktr) iy,�// / � Pump Set At,�/�/,,,2 6xi f/ Casing Height Above Ground Sanitary Snal on Casing Jf/_k L_ Electrical Wiring in Conduit Yj/N) Depression Around Wellhead (Y Separation Distances from Well: To Septic/Holding.Tank on Lot 0 ; On Adjoining Lots � /06 To Nearest Edge of Absorption Field on Lot 7 Wo ; On Adjoining Lots To Nearest Public Sewer Line �L To Nearest Public. Sewer Cleanout/Manhole_ AJ/q- To Nearest Sewer Service Line on I.ot N47t Water Sample Collected By Da a Water Sample Test Results 5� {5✓ E Comments B. SEPTIC/HOLDING TANK DATA Date Installed it/ 3 Size/ �S c� No. of Ccanpartments Y2 Standpipes Y ) Air -tight Caps Y ) Foundation Cleanout /N) 3( Depression over Tank . LyDate Last Purpped N% Pumping/Maintenance Contract on File (YIN) )4 ; for Holding Tank High -Water Alarm (Y/N) Nr//+ Temporary Holding 'Tank Permit (Y/N) N/�f Separation Distances from Septic/Holding Tank: To Water -Supply W� ll 71a'01 ✓ To Building Foundation To Property Line >6_1' To Disposal Field _ To Water_Maip/Service Lire VIA- To Stream, Pond, Lake, or Major Drainage s - Course' [Page 1 of 21, 2mi5-s4 r C, CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. �o TELEPHONE (907) 562.2343 ANCHORAGE INDUSTRIAL CENTER �A• ne ee 5633 B Street 6 s " Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY rnI WATER SYSTEM: I I I I_ (') See It on back I.O. NO. �-6 r t t^ Water ystem Name Phone No. 12 cl n t :i 3'3 Mailing Address JI-Alc/ _AL city I State 'Zip Code SAMPLE DATE: f� 4 Mo. Day Year u SAMPLE TYPE: ❑ Routine ❑ Check Sample (for routine sampie with lab ret. no. ----j ❑ Treated Water ❑ Special Purpose ❑ Untreated Water f i SAMPLE Time Collected NO. LOCATION Collected By C� ( i -I- s/,L-> i`r I :o �c t. 3 4 5 READ INSTRUCTIONS BEFORE COLLECTING SAMPLE A alysis shows this Water SAMPLE to be: SatiMactory ❑ Unsatisfactory ❑ Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. ,t Date Received) Time Received (� Analytical Method: ❑ Fermentation Tube P\Membrane Filter Lab Ref. No. Result' Analyst I J EE I I m I__—_— I EE •No. of colonies/100 ml or No of Positive portions Y X06 1220(b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1983 Membrane Filter: Direct Count Verification: LTB GB Colltormlt00ml Final Membrane Filter Results �] /Coillorml100m1 Reported By�`{S�ti__Date— Time: a.m. p.m. TNTC = Too Numerous To Count 1-4 f Am: HEMICAL & GEOLOGICAL LABORATORIES OFALASKA9 INC. TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIALCENTER 5633 B Street: : t Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER II TO BE COMPLETED BY LABORATORY WATER SYSTEM: I I (') See h on back E - LD. NO. L Water tystern Name Phone No. Mailing gess City tP Code SAMPLE DATE: ® Ft rC. 1 b 4 Mo. Day ' Year t SAMPLE TYPE: ❑ Routine ❑ Check Sample (for routine sample with lab ref. ❑Treated Water ❑ Special Purposee t ❑ Untreated Water f SAMPLE Time Collected NO. LOCATION I - Collected By I (1t rtS"n1W a Iity,1 L. 2 112; 6 1 kin 141 t_I < 3 I I 4 5 I I READ INSTRUCTIONS BEFORE ' A lysis shows this Water SAMPLE to be: Sal itfactory ❑ Unsatisfactory ❑ Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. 4 Date Received/ Y Time Received 1� Analytical Method: ❑ Fermentation Tube J9\Membrane Filter Lab fief. No. Results cAn�a-llyys\t f ® r1� m I m m I m .No. of colonies/ 100 rel or No. of Po94ve porcors. 1 1061221) lot BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1983 Membrane Filter. Direct Count Collform1100m1 Verification: LTB BGB l Final Membrane Filter Results U \� I /Coilform1100ml Reported By o Date (0—'?^ `/ Time: a.m. p.m. COLLECTING SAMPLE TNTC = Too Numerous To Count Spring Hill Estates' Block Lot 4 #015-051-42 Municipality of Anchorage Page of Z DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: 5w,PID Number: Name: BHN C. HA6MQrP, Wastewater System: X New ❑ Upgrade Address: N- Q L � C C+�/L�l?it �s L ABSORPTION FIELD Phone: 2�g No. of B drooms:Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: '• n^/ 0 Total Depth from original grade: / f/1 GPD/Sq. Ft. /Y Lot:/' Bloc Subdivision: Depth to pipe bottom from original grade: _ Gravel depth beneath pipe ' '7 5ploA HILLS £S 3 Ft. /� Ft. Township: Range: Section: FIII added above original grade: Gravel length: Ft. Ft. WELL: New Upgrade Gravel depflr. w,�r: 3 Number of lines: Distance tweenlines: A N Ft. �"I Ft. Classilic tion (Private, A,B,C): Total Depth: Cased TO: Total absorption area: Pipe material: /��/ l�/fT� J Ft. '7 3 Ft. / O D t9 SQ. Ft. Driller: Dale Drilled: Static Water Level: 7./0 Installer: /167MC 15 k_ Date installed: Ft. Yield:060 Pump Set at: Casing Height Above Ground: TANK GPM UNKNOWN Ft. �• Ft. _/� SEPARATION DISTANCES XSeptic ❑ Holding ❑ S.T.E.P. To Septic Absorption -, Lilt Holding Pnbaa'Privete Manufacturer: Canso.I in allons: From Tank Field Station Tank Sewer Lines �C/i T A/� / 150 Well /� % ' Material: Number of Compartments: wafer N 1 N%A LIFT STATION Lot 7-zSSS N/A N1,4 �0 Size in gallons: 9 Manufacturer: Imo) Line Foundation 10 a. y i A/ /,4 'A` "Pump on" level at: "Pum f�fevel et: High water alarm at: CurtainA I /� �J /A �A A'/`/� ^ A A Pump Make & Electrical Inspections performed by: Drain ,`! / Remarks: BENCH MARK Location and Description: 0 tl,,,^ o7'_ 110"J[ SiG/irVf 47' r'r4 I' l d 14 %/euJt Assumed Elevation: 400,00 ENGINEER'9;SEQ_L `I 7.' 1 Inspections performed by: CNG1lNL'ej12 Dates: 1st__)2 Oa o`Sti�kp y_.op ooa ,o,.rosn�� ' 2nd 191115 Department of Health=es a royal,Reviewed and approved by:Date: 72-013 (1/01) MOA 25 SW910350 2 2 Permit No. Page of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box '196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: Seri -ng Hills Est. Lot 4, Blk 1 PID No.: 015-051-42 SPRING HILA— ➢RIv no„ � � TELE• l0' SCALE 1"=50' BUILDING ea b l SWING TIES .1250 TANK A – C B – C = 57.3' = 52.1' o $c E 'C A – D = 70.0' rF1++ Do B – D = 26.6' h5.5' LEACHFIELD B – E = 16.8' O�, ® – TEST HOLE 3 • – MONITOR TUBE 50' o – SEWER CLEANOUT SETBACK – WELL -- — — — — -- -- _ __ __ __ +m+H-Ht – PROPOSED LEACHFIELD 10' TELE: & ELEC• ESMT. S 89°58'50° W — — – EASEMENT 194.71' ELEVATIONS (NOT T❑ SCALE) TOP OF SLOPE BREAK ®BOTTOM OF HOUSE SIDING ASSUMED ELEV = WHO' m FILL 9 = 96.6'6' ORIGINAL GROUND 3 7• LEVEL NO GWT ENCOUNTERED TK 92.5' 92.5' 93.3' AN93.1' 71'6 FIELD 72-013 A (2/91) MOA 25 ENGINEER'S. SEAL illy 5 a3 i 0: S .3 11 H— 1 7—'92 W EL 8: 08 A P _ 0 3 STATE Or ALASKA ¢ DEPARTMENT OF NATu:FfAL TtAS0=CE5 DIVISION OF GEOLOGICAL AND GEOCNYSICAL SURVEYS WATP:R WELL RECORD (WU-L'C�!)ul�iy iii fUii;h0�at� LOCATION OF W'ELL�� W >.; !t�1UR11111)Services _ 60ROUGH SUI3pIVISIq LOT BLOCK SECTION OTRS TOWNSHIP RANGE MFkZDIAN �ayt Ott J N N; P r S 54 DIRECTIONS: """ WELL OWMA: HIZASURING PoxRT:p to of casing WELL DEPTH, DATE UP' COMPLETION, Depth of hold: ft j"`jIJCOUhd suxiace other; .. _ -- Depth of casings Z -Yt BOREHOLE DAxA: -Dep h STATXC WATER LEVEL: %G7 ft, I) t� Material -type and co o� lir From To _ — r METHOD OF DRILLING. [dais rotary U 2- (]cable tool Cjother:_ .. _ US-E� OF WES.L: �domeatio Oirrigkitiun (monitor t,,,f public supply L] other a CASING: Stick-up„_ft. Diam: in �r>. =•tea'' WELL XNTAKE: open end 03Ccr:dned / perforated —] opc�n hole * Depths of openings:-© Yc. .iu A.�'Y.'' � ��.. wu•W•MY.MMYYYY•�• SCREEN TYPE: Diam: in Slot/Mesh Site; Length: �1Set Between and ft Z!Z3 sag GRAVEL PACK : TYPE:_ Volume used: Depth to top: GROUT TYPE: volume:- De*pth: from £t to DEVELOPMENT METHOD: Duration, REMARKS PUMPING LEVEL AND YIELD; 4, ft aftez hrs pumpingj:�" (jpm 4 t'y u-r"I � % µ v241.1 PUMP INTAKE DEPTH: ft Hoxsep,me_lr: Date Pump Installed CONTRACTOR INFORM TION: ,7 WATER CHE141STRY SAMPLE TAKEN? 1j yes Ono A N �/? // ) I � _ ) WrOl A4m4n0nntmA iinnn Ka.... rinn Buainess Name Signature of Authorized P/presentative Date PLEASE MAIL WRXXB COPY OF ],O. c; W.7TBX14 45 DAYS TO: rzoz BO BOX 77-2126 EAGLE AMA, AK. 99.577 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PAGE 1 OF 1 /cg -19-`)1 PERMIT NUMBER:SW910350 DATE ISSUED:10/29/91 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES EXPIRATION DATE:10/29/92 OWNER NAME:FEDER MARCUS & OWNER ADDRESS:9421 SPRING HILL DR ANCHORAGE, ALASKA 99516 PARCEL ID:01505142 LEGAL DESCRIPTION: SPRING HILLS ESTATES BLK 1 L T 4 LOT SIZE: 48418 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: DATE: /G_ � DATE:./4( -2 q �/ Louis Btaera, P.E. Registered Civil Engineer October 16, 1991 John Smith, P.E. Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Spring Hills Estates, Lot 4, Block 1 Narrative Dear Mr. Smith, The proposed septic upgrade will have very limited impact on adjacent properties for the following reasons: 1. The area has large lots allowing sufficient room for septic and well sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, due to absorption capacity and lot size. 4. Drainage will not be effected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. P.O. Box 773294 • Eagle River, Alaska 99577 • Telephone (907) 694-5195 • Fax (907) 694-3297 4WELL ➢R / O I , L 5 SP N SEPTIC AREA N❑ SURFACE WATER NO KNOWN CURTAIN DRAINS \10% K51 TANK ®TH1,�Q\, T H 255 ED �EPM N� A55 PGE RPRGP �� 50' ALO% SETBACK 10' TELE. & ELEC, ESHT. S 89°5850° W 194.71' TOP OF SLOPE BREAK \�o% \50% ® - TEST HOLE NO CONFLICTING WELLS 0 - MONITOR TUBE OR SEPTICS LOT 6 ° - SEWER CLEANOUT -¢ - WELL H+H++ H+ - PROPOSED LEACHEIELD - - - EASEMENT SEPTIC SITE PLAN LEGAL: Lot 4, Blk 1 , Spring Hills EstatesAV OWNER: Davis o CONTRACTOR: Hagmeier ; * .49TH * �/ /�.. / JOB # 91-1381 DATE: 10/21 /91 SCALE 1" = 50' �,�- - ��` 75 ... EAGLE RIVER ENGINEERING SERVICES ,�®�� '. LOUICEA6836ERA - 0 P.O. Box 773294+TF�� .� EAGLE RIVER, AK. 99577 ,�I�1AROFEssION��.4W~ (907) 694-5195 FAX.- (907) 694-3297 REV. EAGLE RIVER ENGINEERING SERVICES P. O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-5195 Spring Hills Estates, Lot 4, Blk 1 JOB 91-138 SHEET NO. ---- OF CALCULATED BY L B _ DATE 10/17/91 CHECKED BY DATE 4 Bedroom = 600 GPD Trench Soil Rate = 20 min/inch = 0.6 GPD/ft2 600; 1,000 Square Feet Area 06 Trench Gravel Depth 11' Trench Length 45.5' PAOCOa 2041Ees Inc, Croton, Man. 01471 �y PAOCOa 2041Ees Inc, Croton, Man. 01471 SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: LOT 4, BLOCK 1, SPRING HILLS ESTATES A. GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified or modified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. B. TRENCH 1. The trench is to follow the natural land contour to maintain uniform total depth of the trench bottom. 2. The bottom of the trench shall be level, plus or minus 1.5". 3. The total depth of the trench excavation is not to exceed 15' at any point. 4. The trench gravel is to covered with typar fabric material. 5. Soil or combination of soil and extruded board insulation to a depth of 4' or equivalent is to be placed over the leachfield. 6. The area over the trench is to be finish graded to prevent ponding of surface water runoff. 7. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 14' GRAVEL DEPTH = 11' TRENCH LENGTH = 45.5' TRENCH WIDTH = 3' SOIL RATING = 0.6 GPD/FT2 BEDROOM CAPACITY = 4 SEPTIC TANK SIZE = 1,250 GALLONS Twenty-four (24) hours notice required for all inspections. Ll SOILS LOG <_- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST 825 825 L. Street, Anchorage, Alaska 99501 2544720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: ///4�imE� r DATE PERFORMED: LEGAL DESCRIPTION: Lo 7` y ��%%� riwf �7�� f 7Cr TNt5 I # EPT71 SLOPE SITE PLAN i Ty I � T TpSO/�' aL�GN/L 2 Date Gross Time Net Time Depth to Water Net Drop 3 —. 4 5 0 .. Iq d 8 7 7 9 a- 10 rp� ct r d/ •a' GCG S{ Ci/yt/Jf+w1"WASGROUND WATER ` S J ENCOUNTERED? Ala L10/e !ho i ,rcd P IF YES, AT WHAT E DEPTH? 7da�r COMMENTS MEN ILI M\\��oom ONE ", X10 ■0�liffimoNow E 0� n1/OMEN ONO M loin NKO ■O0 Reading Date Gross Time Net Time Depth to Water Net Drop Saa y Iq 7 7 PERCOLATION RATE .•<o (minutes/inch) TEST RUN BETWEEN `� FT AND % FT Eagle River Enginoering SerVIC68 ;� PERFORMED BY: P () CERTIFIED BY: `% - DATE: /o�i>�9i Eagle Rlver, AK 99577 694.5195 72008 (6/79) SOILS LOG - MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST , \ 825 L. Street, Anchorage, Alaska 99501 264.4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR:`//4r DATE PERFORMED: Z7�57� LEGAL DESCRIPTION: G."r --el"u 'S A -1'r 171l11 6fA"ffr P SLOPE SITE PLAN 1 %/f7,ro)� — QrG GNIG 11 D.0 Gross Time 2 T Q a. Suq �0 12 3 N 13 r 4 4 W16 3 4 14- 15– 15 7- s ; of 3> ., .N 16 d ■■■■■■■MON 17 O OSl/f�- J4NKC GY4ve- 18 19 .d D �� 2011 � � lr7a1r7` as i 11 Date Gross Time Net Time Depth to Water Q a. Suq 12 N 13 Q 30 4 W16 3 4 14- 15– 15 7- s ; of 3> ., .N 16 d ■■■■■■■MON 17 O — 18 19 .d D �� 2011 � � ■1�■■■■■■1\■ at COMMENTS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? I S lya L O P 1NoNrirorpc( E Reading Date Gross Time Net Time Depth to Water Net Drop Suq N won 30 4 W16 3 3 s ; of 3> ., .N 9'-JA'i6v 3 7�s ■■■■■■■MON ■►■■■■■■OU■ ■1�■■■■■■1\■ ■i1 rw9■■rii■!! ■■■■■■■■■■ Reading Date Gross Time Net Time Depth to Water Net Drop Suq ' 30 4 W16 3 3 s ; of 3> ., .N 9'-JA'i6v 3 7�s PERCOLATION RATE Iminuteslinch) TEST RUN BETWEEN FT AND - - FT R Cagle River Engineering Services PERFORMED BY: nCERTIFIED BY: _DATE: �// Eagle River, AK 99577 694-5195 72.009 16/7 9) 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 (� Parcel I.D. 015-051-42 Expiration Date: I(/- q-f/ (' 1. GENERAL INFORMATION Complete legal description Spring Hills Estates B1 L4 Location (site address) 9421 Spring Hill Drive Current property owner(s) Arthur & Pamela Dorsey Day phone Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: Q Single Family(w/wo ADU) ❑ Duplex ❑ Multiple Dwellings(Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: ' TYPE OF WASTEWATER DISPOSAL: Private Well 0 • Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ S S 0-b' Waiver Fee $ Date of Payment —I ICI I a 611 Date of Payment Receipt Number O1`C(.Q O Receipt Number COSA# 03C/I 9 tai a Waiver# 41'1,0" 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. 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. In conducting an adequacy test, I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe 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 soil condition,ground water 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 system.All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance,nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. Date �'��••4 % 6. DSD SIGNATURE *:'9m -.* System#1 Approved for bedrooms ••$}e- -anros System #2 Approved for bedrooms 8149 .2. Disapproved J Conditional approval for bedrooms, with the following stip la cl t(((((((( SIN( OFA (rr/iii nN-SITE WATER AND "`�' �c 3 WASTEWATER ozz. PROGRAM - o );/ f/i T SERA�G \`v })1))))1111 By eOriginal Certificate Date: ( � { The Municipality of Anchorage Development Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only upon the representations 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. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other /' G 27 y COSA Checklist blue sheet l COSA Checklist Legal Description: Spring Hills Estates B1 L4 Parcel ID: 015-051-42 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA ED Well log is filed with Onsite (or attached) Well production at time of test 4.2 gpm Date drilled 0ti09/92 Water storage tank volume gallons Total depth 243 ft Well disinfected for coliform test? ❑Yes ❑No Cased to 243 ft ii Coliform bacteria is Negative El Sanitary seal is functioning correctly Nitrate mg/L Nitrate less than MRL(ND) ❑� Wires are properly protected Arsenic ug/L 0 Arsenic less than MRL(ND) Casing height(above ground) 36+ in. Collected by Pannone Date of flow test for COSA 7112!18 Date of Sample 5/28n9 Static water level at beginning of test 217.9 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 27 years ❑ Required maintenance completed Tank type/material Age of lift station years Measured operating fluid level in septic tank 50" Lift station material I•❑ Standpipes/foundation cleanout per record drawing Comments: Date of pumping 11/07/18 D. ABSORPTION FIELD DATA Which system tested(date installed) 0115'92 Adequacy test date 7h12/18 ❑ ALL standpipes present per record drawing Results E✓ Pass For 4 bedrooms Total measured depth from grade 128 14 ft(max) Fluid depth prior to test 27 in Measured depth to pipe invert from grade 3.3+ ft(min) Water added 600 gal ❑ N/A—pressurized field New depth 40 in 0 Monitor tubes go to bottom of effective. If not, state 1440 Elapsed time min depth into effective ❑ Code-required soil cover over field Final fluid depth 27 in ❑ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) No date of test) Gallons introduced 600 gallons If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' —El Yes if No ft El Yes if No ft Neighboring Tank > 100' E Yes if No ft Private Sewer/Septic Line >25' M Yes if No ft Absorption Field on Lot> 100' 0 Yes if No ft Holding Tank > 100' 0✓ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' CI Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage> 100' Community Sewer Main> 75' 0 Yes if No ft ✓0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations> 10' 0 Yes if No ft Surface Water> 100' 0 Yes if No ft Property Line> 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells> 200' 0✓ Yes if No ft Water Service Line > 10' 0 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft If absorption field is under driveway comment below Property Line> 10' ✓0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' 0 Yes if No ft Water Service Line> 10' 0 Yes if No ft Community Wells> 200' 0 Yes if No ft Surface Water> 100' 0 Yes if No ft F. ENGINEER'S COMMENTS ..„,` G. ENGINEER'S CERTIFICATION -':"*-3.° . .? 1 certify that l have determined through field inspections and review A° c0.• •77 T of Municipal records that the above systems are in conformance with *.' 4• Tfi MOA COSA guidelines in effect on this date. 4 ��``��. 0 / /y COSA Checklist yellow sheet MUNICIPALITY OF ANCHORAGE /�� DEVELOPMENT SERVICES DEPARTMENT i`• i r r 907-343-7904 On-Site Water and Wastewater Section `s Fax: 343-7997 www.muni.org/onsite �-- Septic Tank Advisory Certificate of On-Site Systems Approval #0SC191292 Subdivision: Spring Hill Estates B1 L4 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 27 years old. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. • `yo Mailing Address:P.O. Box 196650*Anchorage,Alaska 99519-6650*www.muni.org Municipality of Arichorage Development Semites 'Departmenf Building Safety Division , Onsite Water & Wastewater Program 4700 SouthS P.O. Box 196650 Anchorage, L AK 99519.6650 www chorage.ek.us (907)907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 015-051-42 HAA# 9_ QM9 1. GENERAL INFORMATION Expiration Date: C - 2 -0 -IS Complete legal description SPRING HILL ESTATES S/D: LOT 4, BLOCK 1 Individual On-site Individual Water Storage ❑ Location (site address or directions) 9421 SPRING HILL DRNE • ANCHORAGE. AK. 99507 Current Propertyowner(s) CREED AND JANETT MAMIKUNIAN Dayphone_(907) 346-1121 Mailing address Lending agency Mailing address Real Estate Agent Mailing address 9421 SPRING HILL DRNE * ANCHORAGE. AK. 99507 Day phone CHARLOETTE SCHLOSSTON r/ RELM PROPERTIES Day phone (907) 227-7400 110 WEST 38 , SUITE 100 • ANCHORAGE, AK. 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ■ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ e Municipality or Anchorage Lievelopment -Services Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues HAAS upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat affixed hereto and as of the validation date shown beloll ReA%that my Investigation, eased on procedures outlinein the Health AuthorityApproval Guideli dnes fll� tis application, shows that LhAbnsite water supply and/or wastewater disposal system is(are) safe, function 1id aadequate for thaaOn er of bedrooms and type of structure indicated herein. I further verify that based on Me lgijOnation obtained from the Municipality of Anchorage riles and from my investigation and inspection, the onsite 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 Finn GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE, AK 99507 Engineers Printed Name JEFFREY A GARNESS, P.E. Engineers 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 6 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 wefts and septic systems depend on the local softs condition, groundwater levels that may fluctuate during the year, and the water usage of the famfty 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 otherperson or party is not authorized, nor %I// it confer any legal right whatsoever. S. DSD SIGNATURE Approved for q- bedrooms. Disapproved. Phone 337-6179 Date Z O Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Agreements Supplemental Engineers Report Other ON-SITE : WASTEWATER -•---PR66RAM gY&Z Original Certificate Date: 3-3—OC (Rw. 17)01) Municipality of Anchorage e , Development Services Department Building Safety Dtvlebn OnSke Water b Wastewater Program 47W South Bragaw St. P.O. Box 195650 Anchorage, AK 9951&5650 www.ci.anefwrage.ek.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: _ SPRING HILLS ESTATES S/D: LOT 4. BLOCK 1 Parcel ID: 015-051-42 A. WELL DATA Well type SATE If A. B, or C provide PWSIDA N/A Date completed 1/9/1992 SanReryseal (Y/N) YES Total depth 243 ft. Cased to 243 ft. FROM WELL LOG Date of test 1/9/1992 Static; water level 210 ft, Well production 15 g,p,m, WATER SAMPLE RESULTS: Web Log (YIN) YES Wires properly protected (YIN) YES Casing height (above ground) 12+ in. AT INSPECTION 2/21/2005 175 ft. 6.03 g.p.m. C01"Orm )&_ cotonlW100 ml. Nitrate Q.D mgA. Other bacteria—colonles/100 ml. Arsenic: N/A mgA. Date of sample: 2/21/2005 Collected by: GEG. LtD. S. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Date it"led 12/29/91-1/15/92 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation deanout (YIN) YES Depression over tank (YIN) NO High water alarm (YM) N/A Date of pumping 2/23/2005 Pumper MC'DONALDS PUMPING C. ABSORPTION FIELD DATA Date Installed 1/15/02 Soil rating 6p.d ft%bdrm) 0_6 System type TRENCH Length 45.5 fL Width 3 ft. Gravel below pipe 11 ft. Total depth •12.7 ft. Eft. absorption area 11000 ft' Monitoring tube "YES Depression over field NO Date of adequacy test 2/12/2005 Results (Pass/Fed) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 1746ga1. New depth 41 in. Elapsed Time: 1117 min. Final fluid depth 12 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YM 6 type) NONE KNOWN If yes, give date – *OUT ONLY EXTENDS 9.7' INTO DRAINROCK. D. LIFT STATION Date installed Size in gallons 'Pump on' level at _in. E. SEPARATION DISTANCES High water alarm level at fn. Cycles tested Meets alarm 3 circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lI t station on lot 1000+ Absorption held on lot 100'+ Public sewer main N/A Sewer /septic service One 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhote/deanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption Held 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 106+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 1000+ Driveway. parking/vehide storage 5'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS O. ENGINEER'S CERTIFICATION I certify that I have determined through field inspecdons and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name JEFFREY A GARNESS Date 3/7, IoS HAA Fees Date of Payment 3 -2 -GS Receipt Number 0%$V. 12/01) Waiver Fee $ Date of Payment Receipt Number Feb 24 2005 7:50PM CHRRLOTTE SCHLOSSTEHM 307-337-7111 a5.3' 713°59'OC3 9� .LOK Y"H"rt• EA• +. � o ab' Ta Y 2 N ` N•w1} ..POLE ..YILV �Y �O. OCOK N E 0 • P.2 ror,P• •�° 4C; ...................* ____________ yz _ - - - - S��I � ICIEL.C.. ILCO.IUCYCYT SHANE A. HOLT: io N 09 58'50"E 194.71 Ei LB•e91E i AS-BUILTSURVEY f SCALE' T' E 47 f1 •''... ••'' • .Jl1 p 1 HERCSY CERTWY TWT I NAVE PERFORMED A MORTGAGEES INSPECTION OF THE.OLLOVMO DESCRIBED PROPERTY LOT 4. BLOCK i. SARING HE LS ESTATES THE NPOANATIONHEREON B FOR THE USE 6 L1040 ,TRVT4N, NECMT/LLV To 111 W NY COKUCTS![TVE EN ANCHORAGE RECORDING DISTRICT•ALASKA AND THAT lXgTND E1ALKTUII!E AIO PLAITED LOT ONES OR EAEEYEYIlAKO EMOT IO SL VS®POR Pp}TH)NND ADDffIpUl THE "MILE IMPROVEMENTS SITUATED THEREON ARE 6TRUDNRE4P, TEI,GlJNEI. "THIN THE PROPERTY LINES AND THAT NO VISML E EMENBITE Of RECORD. OTHER TRAM TMOW4NCMII ON THERECORDEO MT, ARE NOT SMON4 WRWII. ENCROACHMENTS EXIST OTHER THAN NOTED. KOM ANITEMCMIHEI SHORN AAE LOCATED APPROXNATELY AND An NOT TO BE uwzm Omw W PROPCRTYLENES DATEDATANCHONAOEALASHATHISE4TN— OR LOCATE STRUCTURES. DAY DF LAO AMIPAVIH LOM11WYSEM"OMWTEDVETOSWWCOMOM". MOLT LAAO SURYEYIN�043FB IIT -7B 7EL546.E313 MUNICIPALITY OF ANCHORAGE ° DEPARTMENT OF HEALTH & HUMAN SERVICES.tl 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 Parcel I.D. # I S — 05 1 — 4Z HAA # !A Q( --A 1. GENERAL INFORMATION Complete legal description Lo 4 �K s�'�'-lC� AAiUL Location (site address or directions) 94 Z j SP2(r lU hl ILL D2 r Property owner I Y Day phone t�l IQ Mailing address Lending agency N I a Day phone W /A Mailing address tJ (a Agent Fo2'Tv��E P2oP& 2-r F_ -� Day phone SGZ --7(6S3 Address N 1p, Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS:✓�'�- T F-0 (7, 3. TYPE OF WATER SUPPLY: TIL -VP (0— Individual well X 9 13-7 Community well SCS r 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 %< 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 421 4 5. C:1 STATEMENT OF INSPECTION BY" ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of t is inspection. Alaska VVDu r vNiaSIO."Naiei SEN.Ce Phone 337— /% �/' Name of Firm Q. - Address Engineer's signature DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments Date 9 E 0F..A� q .,. ..... :� F� eff e A. Garners t +��r� . E-7953 00 ; PROFESSO 4P bedrooms, with the following stipulations: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in 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 921 �0 Municipality of Anchorage <: F��(F DEPARTMENT OF HEALTH & HUMAN SERVICEJFK 9' • � odd__ Environmental Services DivisionF 825"L." Street, Room 502 o Anchorage, Alaska 99501 • (907) 343 s 61 bp Health Authority Approval Checklist Legal Description: Lo -r 4.1 PtzWCr (kt t.l.. Parcel I.D.: A. WELL DATA Well type P(ZNyA-, �& If A, B, or C, attach ADEC letter. ADEC water system number N Cl a Log present (Y/N) Date completed 1/9 �1 Z ri ofz Total depth 2.4 Cased to _26r 3 Casing height (above ground) 30 X S Sanitary seal (YIN) Date of test Static water level NES FROM WELL LOG 1 /9 C)I 7z 10 Wires properly protected (Y/N) AT INSPECTION 1"70 BZW Well production _ 15 g. P. In. 6,9+- 9-p•nt• - WATER SAMPLE RESULTS: Coliform _ Nitrate . M ,Q lJ D Other bacteria Date of sample: �/� /^7� Collected by: B. SEPTIC/HOLDING TANK DATA Date installed�15 9 Z Tank size lZ 50 Number of Compartments Z _ Clcanouts (Y/N)Y Foundation cleanout (Y/N) y Depression (YIN) N High water alarm (Y/N) A Date of Pumping 1 (��(� Pumper OLD M DO'kJA'LA s C. ABSORPTION MELD DATA Date installed ( l5 4) Soil rating (g.p.d./ft2 or ft2/bdrm) • b —System type `TfzaA104 Length 45-5 Width 3 Gravel thickness below pipe 11 Total depth 14 Effective absorption area 1 000 MonitoringTube present(YIN) Depression over field (Y" Na rho �c9 �w \�c , Date of adequacy test _I 13 9Z' Results (Pass/Fail) PASS For —4- bedrooms n Fluid depth in absorption field before test (in.); 7-0 Immediately aftert� ll gal. water added (in.): g4!18 Fluid depth ✓re 78 (ins.) Minutes later: 1010 Absorption rate = i X000 _g.p.d. tilon*i V.aowa Peroxide treatment (past 12 months) (Y/N) op _ If yes, give date ►.I �A D. LTATION tistlledDae na Manhole/Access (Y/N) Higli water alarm ley s tested E. SEPARATION DISTANCES Size in gallons *Datmn SEPARATION DISTANCES FROM WELL ON LOT TO: at* "Pump off' level at* Septic/holding tank on lot 11-7 ; On adjacent lots /cc) Absorption field on lot 133 : On adjacent lots +oc� Public sewer main to Public sewer manhole/cleanout /0 Z� Sewer /septic service line Lift station SEPARATION DISTANCES F((R'OMSEPTIC/HOLDING TANK ON LOT TO: J(0 Building foundation 1 d+C')Propertyline -7Z-k Absorption field / Water main/service line a I O 'r Surface water/drainage P,//X Wells on adjacent lots y 100 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: / 4 of oSj-nE Building foundation Z4' Water main/service line 10' 0>✓ t+v S� Surface water /J 1A Driveway, parking/vehicle storage area -> E5-0, Cortain drain Wells on adjacent lots /00 Property line 55 F. ENGINEER'S CERTIFICATION I certify that I have deterr ' ed thr re +r spections and review ofAfunicipal recor�r �i�r{A'i`ie bo s e Ali in conformance it HAA ui eine in effect on this date. �/, � ' • I 09 ••i• . .. •••u •••••., . Signature Engineer's Na/me Af?�1ESS �� i�ere;'�®� Date I J /�/9� o,�;q��. .•P�F��i �� PROFESSt�� ----------------------------------------------------------- -- - --- -- -- - - - - - - ---- - - -- HAA Fee $ 300 Waiver Fee $ Date of Payment Date of Payment Receipt Number b V Receipt Number Rev. 8/95 OSS: haa.wk.doc 0,51, I � t . MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES t Division of Environmental Services ft 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. # D 1'p -- y '� I -- L{ Z -y 1. GENERAL INFORMATION Complete legal description HAA # �A �c i-� C) ? O n S bI ^(9 Location (site address or directions) q Property owner T� WE S, Ll [,A vi y Day phone �'� � - �3 :� °� Mailing address q �� 2 �_ raw �� 1�,5yr; ✓� Lending agency Mnilinn arJ(1rPca Day phone Agent _ rr_�� Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: — I 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site �/ Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front 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 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 i o k �^ �� Y �� = Phone �� 3 CY b Address go , � �, ;ZZ -3 Engineer's signature 6. DHHS SIGNATURE _X Approved for bedrooms. Disapproved. Conditional approval for Additional Comments 0 11ITlr Date /2!-2/ q� bedrooms, with the following stipulations: Date 7-9-74 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-M (Rev. 1/91) Beck MDA #21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L i i JqParcel I.D. 4 z ,a A. Well Data Well type If A, B, or C, attach ADEC letter. ADEC water system number'. Log present (Y/N) ' Date completed j ' C l"f '2;. Driller Total depth €) t .1' Cased to Casing height ° Sanitary seal (Y/N) `.3 Wires properly protected (Y/N)� FROM WELL LOG AT INSPECTION Date of test 2j 1 E? s t •f o z O Static water level rf s"" ' r- E`i- i �� z D N r Well flow `= g.p.m. g,p-mr" �, m O Pump levell ,f < r r �" r„ t J n z pit20 SEPARATION DISTANCES FROM WELL TO: y + rn Septic/holding tank on lot f:3 ; On adjacent lots ' j 6 i Absorption field on lot I he,r ; On adjacent lots Public sewer main {tj h // Public sewer manhole/cleanout �t /A Sewer service line Petroleum tank V-1 f t `1 C. WATER SAMPLE RESULTS: Coliform Nitrate ��,�� I Other bacteria Date of sample: (a. i" F LL - ` ,? Collected by: f B. SEPTIC/HOLDING TANK DATA Date installed 1 t /`i ? Tank size 1 ? Fief Compartments Cleanouts (Y/N) `_ Foundation cleanout (Y/N) Depression (Y/N) High water alarm (Y/N) Alarm tested (Y/N) 4-� Date of pumping A t,t 0 t .r Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot f On adjacent lots =` Foundation _ r` To property line �10 Absorption field Water main/service line Surface water/drainage 72-026 (3193)' Front CONTINUED ON BACK PAGE C. LIFT STATION I Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Surface water Date installed f a `):_ .z— Soil rating (GPD/Ft2) System type j',.[f F t o Length Y ') , s Width ' , Gravel thickness Total depth Total absorption area t` Pc c' ? Cleanout present (Y/N) Depression over field (Y/N) g=� R re! Date of adequacy test 1n f f V., fY j Results (pass/fail) r for ''t° Bedrooms Water level in absorption field before test x ^,'„ _`4 After test ksF Peroxide treatment (past 12 months) (Y/N) 1`74 If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: t. Well on lot t` On adjacent lots y (`i ' Property line ," ,"k r' ' TTo building foundation T To existing or abandoned system on lot c" ` i ," . , On adjacent lots Cutbank C Water main/service line t Surface water , `°° Driveway, parking/vehicle storage area ,r Curtain drain` E. ENGINEER'S CERTIFICATION certify that l have checked, verified, or conformed to all MOA and HAA guidelines. in effect on the date of this inspection. a HAA Fee $ Waiver Fee $ Date of Payment Date of Payment Receipt Number //r� /-7Receipt Number 72-026 (3/93)' Back 0003'�/ 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 Parcel I.D. # 015-05.1-42 HAA # 0&c120 39'A 1. GENERAL INFORMATION Complete legal description Spring Hills Estates, Lot 4, Block 1 Location (site address or directions) 9421 Spring Hill Drive, Anchorage, AK Property owner John C. Hagmeier Day phone 248-6789 Mailing address 2204 Cleveland, Suite 201, Anchorage, AK 99517 Lending agency N/A Mailing address Agent N/A AAHraec Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well X Community well Public water Day phone Day phone — 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 X 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 MOA921 r 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 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 Eagle River Engineering Services Phone 694-5195 Address — P_0. Rnx 773294, Fag1P River, AK 995177 Engineer's signature Date�- 7 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments bedrooms. t.\ Or {;,19 a.fdv >o�..cos ern Louis?. ".00ra ' �•;, 1.o J bedrooms, with the following stipulations: Date — l The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA N21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Sa)J' J(g JJJW-S ESr Parcel I.D. 0/$ o 0j Gos 4 )&,*� 1 A. WELL DATA Well type 291MEL, TL, If A, B, or C, attach ADEC letter. ADEC water system number N/4 Log present (Y/N) YFS Date completed o�/Dy�9 Driller Total depth yJ Cased to ` Casing height Z Sanitary seal (Y/N) v6 5 Wires properly protected (Y/N) V65 Date of test Static water level Well flow Pump level FROM WELL LOG O/��/9 2 Z /0' /5g.p.m. UN 1,eN O1,L)AI SEPARATION DISTANCES FROM WELL TO: AT INSPECTION Nor .�.vsnyc%� New J � g.p.m. s Septic/hekWvg tank on lot 07 7 ; On adjacent lots Absorption field on lot 133 ; On adjacent lots It Public sewer main N 1 Public sewer manhole/cleanout m r') UZ) Sewer service line /e).- , _Petroleum tank A10AIC APP412CIV7 WATER SAMPLE RESULTS: A r Coliform— Nitrate Date of sample: 06P AP192 Collected by: B. SEPTIC/NQ DDG TANK DATA Other bacteria Date installed 0�Tank size 12lo Compartments Cleanouts (Y/N) E5 Foundation cleanout (Y/N) Y65 Depression (Y/N) High water alarm (Y/N) gL4 Alarm tested (Y/N) /VA Date of pumping %�� AACk% Pumper AIA SEPARATION DISTANCES FROM SEPTIC/HCL-E)+MG TANK TO: Well(s) on lot 7� P 7 ' On adjacent lots f /0/ Foundation �d 7 To property line 7o2 / —Absorption field Water rimservice line S74/ Surface water/drainage N lA NO 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y Manufacturer Manhole/Access SEPARATION DISTANCE FROM LIFT STATION TO: of On adjacent lots D. ABSORPTION FIELD DATA "Pump off" level at Cycles tested Surface water _ Date installed� %% 5 J 9 2 Soil rating e9, 6' ' System type Length Width Total absorption area Depression over field (Y/N) Results (pass/fail) 3' raN_- 4 Gravel thickness /y Total depth y 'V Dy v Sr Cleanouts present (Y/N) X/CS NO Date of adequacy test —I Lli NEh� for Peroxide treatment (Past 12 months) (Y/N) N/A If yes, give date AM SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Property line i ,'`� To existing or abandoned system on lot A11-4 On adjacent lots -1.30' Cutbank N /ti Water ma+ /service line �O Surface water AIA Driveway, parking/vehicle storage area -�'/O Curtain drain DVLA E. ENGINEER'S CERTIFICATION bedrooms I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. � a Signature��— e ' b s „ Engineer's Name ��'��✓ `�`''``'"� � ` =� +'J.xo�'�i, Date -{l ,. Louis n. r,.aerc HAA Fee $ % 70 ` Waiver Fee: $ Date of Payment �A `Z 13 — 9/Z, Date of Payment Receipt Number '2-3 d 0,72-7 Receipt Number 72-026 (Rev. 3/91) Back MOA 21 JUII 22 192 08:17 HORTHERH TESTII•IG, ANCHORAGE P.1/2 NORTHERN TESTING LABORATORIES, INC. 3350 INDUSTRIAL AVF.NUF 2°05 FAIRBANKS STREET Eagle River Engineering P.O. Bax 773294 Eagle River AR 99577 Attn: Louis autera Our I.ab #: Location/Project: Your Sample TD: Sample Matrix: Comments: A118201 Spring Hill L4 B1 Water Method Parameter ------------------------ EPA 353.3 Nitrate -N FAIRBANKS, ALASKA 99701 (907) 4563116 . FAX 466-3125 ANCHORAGE, ALASKA 59503 (907) 277.8x78 • FAX 274.96451 Report Date: 06/19/92 Date Arrived: 06/%7/92 Date Sampled: 06/16/92 Time Sampled: 1636 Collected By: MP . MDL = Method Detection Limit Flag Definitions B z Below Regulatory Min. H z Above Regulatory Max. F = Below Detection Limit Estimated value Date Units Result Flag MDL Analyzed -- ------------------------------------- m 1 0.6 0.1 06/18/92 raivw Reported By: Susan C. T cental Microbiology Supervisor