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HomeMy WebLinkAboutGREENBROOK BLK 4 LT 6Greenbrook Block 4 Lot 6 #017-431-11 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water 8 Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 Page 1 or 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SWO80125 PID Number. 017-431-11 Nome:VICTORFLINT Wastewater System: ❑ New ■ Upgrade Address: 12621 VON SCHEBEN DR. "ANCHORAGE, AK 99516 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 441-1597 3 ODeep Trench OShallow Trench tBed OMound OOl LEGAL DESCRIPTION See Rem`7 TOW acth fan 7 R GPD/S4. R Block: Lot: Subdivision: Dsplh is pale kelt" fn n odgl d 9n : Gre.N espth pips: 4 6 GREENBROOK R Township: Range: Section: rN sed" aes.e enW"el rodki:w\ Nrglk PL Grww www- \� ` N« of Ense: Distance b9~ erwe: WELL: ❑ New ❑ Upgrade R R Cksxfswlion pd k AMC); Tac P p1n: Coese ro� Tela aesorylion POO mslsdak R 5a. R a.ldMr REY CONSTRUCTION Dela 11,aloMe: 8/20/2008 W: SIo4c Wal« ariNr. S�� Leval: E R YWW: Puny eel w Geeing Ilei0i AtWve Grano: TANK GPMR FL SEPARATION DISTANCES ■Septic 0Holding 0S.T.E.P. 0Other* To Septic Absorption Lift Holding ac/Prw to ranwacty .. ANCHORAGE TANK Dep«b N 9 r: 1000 From Tank Field Station Tank sew« Lines Well N/A N/A — — 25'+ STEEL Nana., oft 2 Surface water 100'+ 100'+ — — — LIFT STATION Lot Line 5'+ 10'+ — — — Ws M ppspns: YenWoclwer. on Wvsl el: amp ell W.+I el: s « aWrm a: Foundation 5'+ 10'+ — — — Pemp Yoke ! v¢al k.sp«Gons PwfennW ky. Curtain Drain NONE KNOWN Remarks: OLD TANK WAS PUMPED, CRUSHED, AND BENCH MARK lope ami aespr". COMPLETELY ABANDONED PER UPC. BOTTOM OF SIDING ® FCO Asa,mee E".ewn' 100.00 R ENGINEERS SEAL Inspections performed by: GEG, Ltd. Dates: 1st 8/20/08 00� op0 0 3rd Development Services Department Approval 0 4 yTM..D Conditional approval: Date: ...••••••••.. G P •. Gar ess.� E-79 3 :p ���� ie ••.B.�z6 oB�Aoo Review ed and approved by: Date: -a-0 �OO00000060 I PERMffNUMBER: BUILT DRAWING PARCEL ID NUMBER: SWO AS -BUILT 017-431-11 c spy FeF� PUBLIC WATER PUBLIC GARNLSS ENGINEERING GROUP, Ltd. p*? •4 fir` -- -•-,• ==mss—.- CONSULTANTS& GENERAL CONTRACTOR - 1 L TOW OtiD. OI A[ 101 . MKIMKL M M'At - F (W1),WI 1" . r" ("7) l 1M . �091C �w.pn.rylv�Yp.—n IEPAREO FOR: PHONE NUMBER: PAGE NUMBER: VICTOR FLINT 441-15_97 2 OF 3 CAL DESCRIPTION: DRAWN BY: GREENBROOK; BLOCK 4. LOT 6 1 P.N.B OF WORK: ASBUILT DRAWING (Ra AI*5) 8/22/08 f A. orness: CE— 317 .•' �Fa e_ A B ST1 1,35.72 1 11.14 ST2 1 39.711 16.94 DBL1 141.461 19.51 DSI -2 42.34 20.60 FD 42.95 21.37 C01 50.55 31.13 CO2 81.19 52.09 MT2 79.97 51.19 spy FeF� PUBLIC WATER PUBLIC GARNLSS ENGINEERING GROUP, Ltd. p*? •4 fir` -- -•-,• ==mss—.- CONSULTANTS& GENERAL CONTRACTOR - 1 L TOW OtiD. OI A[ 101 . MKIMKL M M'At - F (W1),WI 1" . r" ("7) l 1M . �091C �w.pn.rylv�Yp.—n IEPAREO FOR: PHONE NUMBER: PAGE NUMBER: VICTOR FLINT 441-15_97 2 OF 3 CAL DESCRIPTION: DRAWN BY: GREENBROOK; BLOCK 4. LOT 6 1 P.N.B OF WORK: ASBUILT DRAWING (Ra AI*5) 8/22/08 f A. orness: CE— 317 .•' �Fa e_ PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SW080125 017-431-11 TOP OF TANK AT INLET = 94.78 INVERT OF BUNG AT INLET = 94.05 FINAL GRADE = 99.01-99.03 ST1 / ST2 NEW 1000 GALLON SEPTIC TANK - TOP OF TANK AT OUTLET = 94.76 INVERT OF BUNG AT OUTLET = 93.84 GARNESS ENGINEERING GROUP, Ltd. ....... .-- .- --.. CONSULTANTS d GENERAL CONTRACTORS gni c F" (907) " • sosm: �. ww O . ! PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 1 VICTOR FLINT 441-1597 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: GREENBROOK; BLOCK 4. LOT 6 P.N.B TYPE OF WORK: DATE' PROFILE DRAWING 8/26/08 (R". 01N5) ®ao:.rmommo>a I �trof sss, MUNICIPALITY OF ANCHORAGE UV Development Services Department I cI On -Site Water & Wastewater Program 4700 South Bragaw Street d P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jul 15, 2008 Expiration Date: Jul 15, 2009 Permit Number: SW080125 Parcel ID: 017-431-11 Legal Description: GREENBROOK BLK 4 LT 6 Design Engineer: 0855 GARNESS ENGINEERING GROUF Site Address: 012621 VON SCHEBEN DR Owner Name: VICTOR FLINT Lot Size: 49000 SO. FT. Owner Address: 12621 VON SCHEBEN DR Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE, AK 99516 - This permit is for the construction of: ❑ Disposal Field ❑� Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued Date: Date: /< Municipality of Anchorage --1 Development Services Department \ Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. D/q - 431 - Property owner(s) VICTOR FLINT Day phone 441-1597 Mailing address 12621 VON SCHEBEN DRIVE *ANCHORAGE, AK Site address Legal description (Township, Section 8 Range) N/A Lot Size�bd� Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field ❑ Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Zip Code 99577 70197:4112111111111411t• Number of Bedrooms 3 THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. Permit/Rush Fees: ID (4 G o . U 0 Date of Payment: -71 (1 l (-) q Receipt Number: (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number: GARNESS ENGINEERING GROUP, Ltd. --- + CONSULTANTS & GENERAL CONTRACTORS , July 9, 2008 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: SepitcTank Upgrade for Lot 6, Block 4, Greenbrook Subdivision To whom it may concern: A documented 1000 -gallon septic tank currently serves the existing 3 -bedroom house. We exposed the tank to verify the integrity, and confirmed it had holes. We are proposing that the existing 1000 -gallon septic tank be replaced, and a new 1000 -gallon septic tank in accordance with the Municipal standards. There are no surface waters within 100 feet of the proposed upgrade. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your I.S. NOTE: Attached is a site plan drawing, a design draining, one soil log, which are all part of the design package for this septic systcin. (Contact G.E.G. Ltd. for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: www.gamesscnginccring.com BLOCK8//,4. LOT 9 `�-P� ' CREENc ROOK; COMMUNITY BLOCLOT 10 WATER GREENBROOK; / C� BLOCK 4,LOT 11 / GREENBROOK; \\\ BLOCK 4, \\� /COMMUNITY v / / LOT 7 / WATER EXISTING J I I BEDROOM � HOUSE CREENBROOK; BLOCK 4, LOT 4 COMMUNITY WATER AGREENBROOK; PBLOCK 4, \ LOT 3 GREENBROOK; ` \ BLOCK 2, LOT K GREENBROOK: / BLOCK 2, GREENBROOK; LOT 10 BLOCK 2. LOT 9 GARNESS ENGINEERING GROUP, Ltd. - - - CONSULTANTS 6 GENERAL CONTRACTORS w���-- -- PREPARED FOR: PHONE 'u4'1— U LIBER: VICTOR FLINT 441-1597 LEGAL DESCRIPTION: GREENBROOK; BLOCK 4, LOT 6 TYPE OF WORK: SITE PLAN (Rmr, Ou05) 1 OF 2 DRAWN BY: P. DATE: 7/9/08 ....... 1 .. . ..... .......... i J A. rness.: Oe C -795 \ It n G �VOMdp�o f eaafo�°oma \ \ GEG. Ltd. HAS A 7 PAGE SPECIFICATION PUBLIC LETTER THAT PERTAINS TO THIS DESIGN. \ WATER TO OBTAIN A COPY OF THE LETTER CONTACT CEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION. THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY \ \ HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDRIONS OUTLINED. \ EXISTING SEPTIC SYSTEM Spy FeF� MLLN\VVIi OLD TANK TO BE REPLACED W/ NEW 1000 GALLON TANK GARNL:SS LNGINL:LRING GROUP, Ltd. • . • •• •- CONSULTANTS 3 GENERAL CONTRACTORS --,—, --•— ••_- ]101 L llppl 051& M 101 • MIU1gU0L NI M ? • F (F0r),W1 in . FM (*07)=-W" • 1PDLIL ....pnrgYrYgmm PREPARED FOR: PHONE NUMBER: PAGE NUMBER: VICTOR FLINT 1 441-1597 1 2 OF 2 GREENBROOK; BLOCK 4, LOT 6 OF WORK: PROPOSED UPGRADE FOR TANK (R. 0105) P.N.B 7/9/08 PUBLIC WATER l� 3 r U L Municipality of Anchorage Page 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: ?'L PID Number: 017 - 3 /Y/ Name: Wastewater System: ❑ New I Upgrade Address:tZ�2f ABSORPTION FIELD Phone: 34.5 - 422b No. of Bedrooms: 3 p Deep Trench E]Shallow Trench V.Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: r Total Depth from original grade: Vfj�t'`"* u `i GPO/Sq. FL Lot; p Block:6 Sum ^�' SCj 'c-C..c i` Depth to pipe bottom from original grade: V fj mow N Ft. Gravel depth beneath pipe • �� t. Township: Af (� Range: i4 Section: 14 Fill added abov original grade: %4 Ft. Gravel len the l Ft. la� El New ❑ Upgrade Gravel depth: I D Number of lines: 3' Distance between lines: Ft. • FI Classification ( e, A,B,C): Total Depth: seed To: Total absorption area: �oC�O Pipe material: D3034 - F S 60 Ft. SC. Ft. Driller: to Drilled: Static Water Level: Installer. ,(L -Date installed: Yleld: Pump Set at: Ca eight Above Ground: TANK) GPM Ft. Ft. SEPARATION -DISTANCES ❑ Septic olding J1�TE.P. To Septic Absorption Lift Holding ' Private Manufactures a aoit gallons: From Tank Field Station Tank Sewer Lines -`--. Well Y N �A ��� Material: - Number of Compartments: Surface 144 lot, �(�' LIFT STATION Water Lot IF / ��� N�A Size in gallons: Man urer: Line Foundation i "Pump on" level at: "Pum a l­aL High water alarm at: Curtain. t I� N �� N 1� r Pump Make el Electrical Inspections performed by: Drain f { BENCH MARK Remarks: Location and Description: o �� IGK IiSSUMC� i TA C-61�� COV FAL/— Ls —' t'�i— i.l I. l✓I .� I,�CTS Assumed Elevation: Sp0• o0 ENG[k ''4, JEEAL OF A4 3. Inspections performed by: (L rSS Dates: 1 st `t a w va.•ve aev ... .• 2nd s 3 Jr rey A. G- rn • CE -7953 ���yF Department of Healt Hu a • ervices ap vat �— DateZ ` `.•••,.•..••,'•���� pROFESS��N��' FES. Reviewed and approved by- 72.013 (1191) MOA 25 I 9 I C/ 0 •4 • d o q o ' ,e• �1bNITo�,1NEs TUB;=. 4°c� pQp.irJ PIPe w rrN- PrJz-�oW>-i IorJS ww ToT"n,L. ?.B502PTIOr1 f•2EA = (000' IFTZ- i � d d A � o , • 9 ` d d a r cu 4 o U NOTE % D2AIn3 PZOGK SEAL PF a %z -ro 2�/z r Sc 2EF�1✓D R6 K Tn> o . N �ro .b .� a C/o (--N4>) T j NtEnl17DP—It, - TUBE. PE�Fo�rEO I/J 6PAvE BACKFILL wlTl4 Nt��1V>= Z \ SOIL t OUND A 41 sa I "ORA, P`K OA lL"1�� FAg1Z1 C' �- INSITt.i ^ 'OF — � PSE•,,..... C qS LpT Bk4 G2Brzro �° �� �! p�D p�T�IL '7�S-3�t1t-1 SID ..:.•: ... ... • ..... j �<zE�APED R�� i S v io FowUEEER dyes .........; J r yA.Gar n•s k CE -7953 ,•���� PP�PrkR�D By �AIAsKA VHA-rFP. �NAST�wAT��.—Efi�IC�S °l��F �� •� A r 4�a0aE�SO'� :GNe® 70 Alaska Water 8c Wastewater Services "Preserving the Last Frontier" August 18, 1993 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System Inspection Report for Lot 6, Block 4, Greenbrook Subdivision. To whom it may concern: Attached is the inspection report and plan/profile drawings for the subject system. Additional comments are as follows: 1. Old Trench was Abandoned: The homeowner chose to abandon the existing trench rather than fill in the low areas on the adjacent property which -had standing surface water, 2. Absence of Surface Waters: Dua to the unseasonably drj?, s�}r i nyYr�surrr�rrc r it is possible t ha t there a r e areas eas uvh c h kvould normally have standing cvatar' .if? them but are c;•urr•entlyy ctryy. The drainage ditch which parallels the north side of Von Scheben Drive is completely dry, and the ditch which parallels the north property line is dry. In addition, low areas on Lot 7, Block 4, Greenbrook S/D which appeared to be "swampy looking" were dry upon closer examination, except For, on& area Im"ar t"f'tE: sout'hwe5t cor'n<3r of the subject p rope rt % The homeowner filled this low spot with soil to eliminate the presence of standing water so that the separation distance to the existing septic tank and the now `aed is greater than 100 feet. 3. Incorrect Pipe Used for Clean -outs and Standpipes: The installation of this system was done by the homeowner which used x'81.0 HDPE pipe for both the drainpipes, monitoring tube, and the clean --out pipe. Per discussion with Dan Roth, can 8/18/93, all vertical solid pipe was excavated down to a depth of 12 inches and replaced with D3034. 4. Septic Tank was not Physically Inspected: When the homeowner picked up his permit he was incorrectly given a permit for another system in the same subdivision= This permit did not have any special provisions. i4fter• the Telephone - Fax 338-3246 0 8471 Brookridge Drive 0 Anchorage, Alaska 99504 ,vysrrsvrr was �rrs�aZlGr, it became apparent to the homeowner that he was not given the correct permit. After obtaining the correct permit he noted that there was a requirement Por verification of the septic tank structural integrity. At this point the equipment was off site and there was no way to expose the tank, consequently, we are requesting that this requirement be waived. I am unaware of any impacts that this installation would impose on adjacent wells (neighborhood is on community water), or septic systems. If you have any question, please call me a 337-6179. f incere].y, w7eff . y A. ess, P.E., M.S. ow) /Consultant QAC/Jag fowlers. WP's PAGE 1 OF 1 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 (UPGRADE) PERMIT PERMIT NUMBER:SW930265 DATE ISSUED: 8/02/93 DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES EXPIRATION DATE: 8/02/94 OWNER NAME:FOWLER STEVEN R & OWNER ADDRESS:12621 VON SCHEBEN DR ANCHORAGE, AK 99516 PARCEL ID:01743111 LEGAL DESCRIPTION: GREENBROOK BLK 4 LT 6 LOT SIZE: 49000 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 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 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: (INTEGRITY OF EXISTING :THE PROPOSED DIVERTER EXISTING TRENCH'FOR A RECEIVED BY: ISSUED BY: SEPTIQ.TANK SHALL BE ,FIELD VERIFIED. VALVE SHALL SHUT OFF FLOW TO THE NI UM OF ONE YEAR: DATE: <-8-)/Il DATE. B Alaska Water k Wastewater Services "Preserving the Last Frontier" July 23, 1993 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services (:)n -,Site Services Section P.Q. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System Replacement for Lot 6, Block 4, Oreenbrook Subdivision. To whom it may concern: Attached is the application, site plan, and design drawings for the subject septic system replacement. Comment<.,> regarding the proposed system are as follows: 1. BED DESIGN: As can be seen from reviewing the attached percolation test results, the soil "perked" at 3.33 minutes/inch at the location proposed for the system. For a bed system, this corresponds to an application rate of .8 gpd/ft2. Since the existing home has 3 bedrooms, the total design flow is 450 gpd. Based upon this, the minimum amount of absorption area is 563 ft2. The proposed bed is 15 feet wide by 40 feet long, providing an absorption area of 600 ft2. 2. LOCATION OF CLEAN -OUTS: The clean -outs normally required immediately downstream from the septic tank have not been provided, since they would not be functional for this design. Instead, I have placed clean --outs so that Jetting can be done back to the septic tank from the bed, 3. TOPOGRAPHY: The subject bed will be installed on a slope which has an approximate grade of 6%. 4. Ditch Parallels Back Property Line: The subject ditch appears to be for drainage, however, it was completely dry on my 7/1.4/93 site visit. Regardless, I have specified that the new bed be located 100 feet from the ditch. Telephone - Fax 338-3246 0 8471 Brookridge Drive 0 Anchorage, Alaska 99504 5. High Groundwater?: Attached is a excerpt from a report I found on file for Lot 4, Block 4., Greenbrook Subdivision. This report was prepared in April, 1951 by Alaska Test Lab. In this report it addresses a sails test done on Lot 6, Block 4, Greenbrook S/D in which they encountered groundwater at depth of 5.1 feet. 777e location of the test' hole is unknown to /rte aiO was not s to tecv on the rallor t . The soils test performed by AECS (5/26/82) for the existing septic system indicated that groundwater was not encountered. The system installed in 1982 lasted for almost 1.1 years. I did not encounter groundwater in the test hole performed for this design, however, it is possible that the absence of groundwater was due to the unseasonably dry spring/summer. Since the existing system lasted for 11, years, and due to the fact that the bottom of the new bed is approximately 3 feet higher in elevation than the bottom of the existing trench, it is reasonable to assume that the proposed design will be adequate. 6. Absence of Surface Waters= Due to the unseasonably, dry, spring"Isummer it is possible that there are areas which woul('� normally have standing water, in them but are currently airy. The drainage ditch which parallels the north side of Von Scheben Drive is completely dry, and the ditch which parallels the north property line is dry. In addition, low areas on Lot 7, Black 4, Greenbrook S/D which appeared to be "swampy ].coking" were dry upon closer examination, excevt for, erre area near the southwest corner, of the subject property. 7'his water, was only 85 I -eat away from the existingy sal,,tic tank. The homeowner is going to fill this law spot with soil to eliminate the presence of standing water. I will verify that there is no standing water within 100 feet of the existing trench, or the proposed bed, during the installation inspection. I am unaware of any impacts that this installation would impose on adjacent wells (neighborhood is on community water), or septic systems. If you have any question, please gall me a 337--6179. Sincerely, JAG/jag fowl.er2.WP S M. S. Lo -r Q�o�K 4- SVA H T�� % SFS gf D 9(7 -,AIL FJ2 IOUi'TO^� OF C/o moNj-ro2wC7 "KBEs. Lp� � - C(o 6i+cK7D A�TF_2.va�AG NEw BED gl p(X 4 vA WE —� 15' H mss£ ,o 'T'EST 1E pF BEf> O raw o�`rF�rM iNEr Wows= NEij WO 4-0 DEC gAck- �ExI -s-n VON 5��3� D2iv� Pj2Ovl0(i Alm-F�N� i J6 VaLvl� su -��- — �---� OIVER'►ED Tn EX STI .1 Gr Dg S PT1C UPC�i2R Dom. � c7T 6) W-4 � CSR-�BtzoolL <(D _Qp.EPP1�,D FOR: S`i�vE �owl�ElZ- TPfLEP���D B� ; ALA SkA WATER. � WkSIMWA MEP SEZVICE S `i -o' WT- Q Lock �- R 1 •�e9 0 10• sm• • .• e re A. Garn ,•�4�i, •e• E-7953 0 ROFEssokn N 2'-6 I _ s'o 'I 1 C/ 0 d o'G .p o , KI b N I -7M l c-3 j UBE �°c� pRAlr1 PIPS wrrt-l- PF1�FoWi-i low GbW N NOTE . DP IN 2ocK SU4(-L &E %y° -ro 2'/� n sceEEjJ&D Roy --K ToT�L ASSOQPT1Cr1 G00 PrZ �PE�Fo IKJ EL A• TEO 6P-/ 95• o� 77 • o _Z \ Sol!_ h-tO�ND 4 'pP.AI�J QOGI{ ' / o s o e I D d ' a 4 o C ^ OF q��1I F�> T g�IG SILT LCL ISoIL� �Zr`�- • qs ► o�P.•''• AW -of �. BED DETAIL SFPiIG UPC 7E WT �� BK4 6r��ND 5/D 00 ...•.. ......... ... . o lf y . Go rnes �e 7953 ° PP�PA4Z�D �y ALASKA WA -FE -P,/ �N57—C-WAT ' i�IICES n • ,��<� ►k0�o0a���®t�� �PE�Fo IKJ EL TEO 6P-/ 95• o� 77 Z .gpCk>7ILL wITA NAM' JE:_. _Z \ Sol!_ h-tO�ND 'pP.AI�J QOGI{ ' / ^ OF q��1I F�> T g�IG SILT LCL ISoIL� �Zr`�- • qs ► o�P.•''• AW -of �. BED DETAIL SFPiIG UPC 7E WT �� BK4 6r��ND 5/D 00 ...•.. ......... ... . lf y . Go rnes �e 7953 PP�PA4Z�D �y ALASKA WA -FE -P,/ �N57—C-WAT ' i�IICES n • ,��<� ►k0�o0a���®t�� ba-1-� : '7/235'3 D�zavrN : G��t;ss scA��.E.: rt-rs Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 " ` "" •';'Q SOILS LOG — PERCOLATION TEST tit"�i� r yA. 53rn �a I_ .n. CE -7953 PERFORMED FOR: ST>=v how t'DATE PERFORMED: Ln-t-6� 3K 4 RIPT'nra• i or_t=.t0.n�oK sto Township, Range, Section: /�/4 LEGAL DE SC URC�IG -� t — '0 0 2 3 !� o 4- 6- 7 6 7 8 e a7 -Q H 14 15 16 17 18 19 SLOPE SITE PLAN 0 WAS GROUND WATER O ENCOUNTERED? s Gross Time Net Time Depth to Water IF YES, AT WHAT L O DEPTH? P { 7 r5' o Ib r Y 3,5 Z E Depth to Water Alter 2/ 93 Monitoring? N A Dale: 3 o Reading Date Gross Time Net Time Depth to Water Net Drop { 7 r5' 10 Ib nlA 3,5 Z 20 O 3 o 3 4 20 ' IL— JI PERCOLATION RATE 3"33 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 89' S FT AND qO. D FT �x 'OMMENTS <_ S Foy? --Ont — S I -ry--- S -r= P 1 / G E `/ :` r7E M . Y is Nor wES� Cart-- Z OF DE< -"V I/q FRar•ri \jAp : 7kSSvME)1 E t_(cep . 00 PERFORMED BY: 3fff�- 6A.Z'�lle-S5>7 I d L=Ll1!5-06-51�' CERTIFY -THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: / ��3,/ 93 72.008 (Rev. 4/85) f • .j second and Fourth Anchorage Limited Partnership April 17, 1981 Page Four seasonal high water. Lot 4, Block 4 vr-� Urj0J� UO -1 I+_)gK. The measured water level in the test hole at this site remained fairly constant and high. Saturated conditions were encountered at 12 -feet while drilling on March 14. The water table.elevatio was found at 6.8 feet on March 23, at 6.8 feet on April 9,'aAd'=:a 8.3 feet on March 16. The measured percolation rata was 40tyr= minutes/inch. Because of the high ground water, a shaliow.mound disposal system should be used. $Lot.0 - Lot 6, Block 4 The high water level'at this site necessitates a highly mounded`` system; or using insulation to provide frost protection while=+;: maintaining the necessary separation between the disposal system and the seasonal high water. While drilling, saturated conditio .were encountered at 13 feet. On April 18,'the water level was measured at 5.4.feet, then at 5.1 feet on April 23, the water ;level had lowered to seven feet by•April.9, and then to 7.54eet on'April 15. however, much of this water is probably from-aurfa _-'water,and melting seasonal frost.. The measured percolation'rate =:.was'3.8 minutes/inch, however, we recommend a more conservative''&, <`design -;value of 10.0 minutes/inch. Lot 120 Block 4 s:Again;':the disposal system should be placed as high as possible;' at this site. Tris-wa er level in the test hole remained fairly` --� constant at gait fee The water level was measured at 28'£ee on March 8, Dut. a appeared that this high level was caused -by 'infiltration of surface water, and was not the true water:.level ;at the time. The measured percolation rate on March 17 was: >3.4' .`'minutes/inch, but it is recommended the more conservative value,_ ' of 10.0 minutes/inch be used,.because of the high silt content'o; the.upper soils.' t Lot 13, Block 4 The test hole was drilled near the center of the lot on April and no water was observed. Again on April 91 no water was de on April 15, the measured percolation was 9.0 minutes/inch.;,'•;'' recommend the disposal system be placed between 5 and,11..lebt avoid the surface silts.' Lot 14, Plock 4 No water wa:.encountered whilr drillin(i, on April 7, or � M� r -797-7X W -7-" t -1 � r pLA50 PIPIN4 w*s rMa p Top Nevi FOR GCM REFi�ct� Aeftby Fat RES Ceu Vcs. A FML gzftftswww Aw. 6xc mv**n w WAS RetuRMM (CSZMI"6 TO OCcVR oµ =MORS OAy 8 -a6 -q3. Steven R. Fowler 12621 Von Scheben Drive Anchorage, Alaska 99516 907/345-4226 August 2, 1993 Municipality of Anchorage Department of Health and Human Services On Site Services - Room 50 P.O. Box 196650 Anchorage, AK 99519-6650 Re: Septic System Permit for Lot 6, Block 4, Greenbrook Subdivision To Whom It May Concern: The purpose of this letter is to respond to a request by your department for information regarding my qualifications for installation of a new septic system on my residential property. This installation will be performed under the direction and watchful eye of Mr. Jeff Garness of Alaska Water and Wastewater Services. Although I am not presently engaged in the business of constructing underground utility systems, I have many years experience in this field. I was the general partner in Lockerbie Construction Company and constructed 44 homes in the Anchorage bowl during the early 1980's. A number of these properties required the installation of septic systems. In the 1970's I was part owner of Western Investments, F.F. Green Construction and Universal Construction Company. These three firms were engaged in underground utility construction. Our primary source of revenue was as agent for the former Central Alaska Utilities. Our companies performed the main line installation of almost every mile of CAU's water system during the 1970's and early 80's. During that period we participated in the development of dozens of subdivisions in the Greater Anchorage Area Borough. Our experience in these developments involved clearing, excavation, utility installation, road construction and paving. Some of the efforts were usually sub -contracted out (ie. paving); however, excavation, main line construction and service installation and connections were always performed by our company. Our various endeavors in these areas never involved failure to receive bonding and insurance, revocation of our bonding or judicial defeat in any lawsuit. The reputation our firms enjoyed provided the opportunity for our longstanding, positive and profitable relationships with CAU, engineering firms and many other Anchorage area companies. My experience includes the operation of all equipment normally used in the course of the construction projects noted herein. Furthermore, I will be operating the equipment used in the installation of the system currently undergoing design review. I will also perform the installation of the screened gravel bed, piping and all other necessary components, and the final backfill. Should you have any questions, please contact me at the number above. //// `I S�I� `(fid Sincerely, /J&' � PX' 9 7110 MUNICIPALITY OF ANCHORAGE o DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION r% 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 V ,en e F o W 1 e j 266 —8601 ❑ UPGRADE MAILING ADDRESS 2137 Fa;r eth % LEGAL DESCRIPTION Lot 6 %3 ock 4 Greer► h rook SL,Ia LOCATION NO. OF BEDROOMS 0 P rr,oaii eh 1/0',Ae rv) Well Absorption areae Dwelling�^ ® PERMIT NO. ��T1 ��jj Uy DISTANCE TO: co h, Hl h ©20 9 `�/J Y 0 F- zManufacturer W � Gr eer Material Stec/ No. of compartments U Liq. capacity in gallons IF HOMEMADE: Inside length �- Width -_-- Liquid depth -- `f 0 O y Jaz DISTANCE TO: Well Dwelling PERMIT NO. U Z Q Manufacturer Material Liquid capacity in gallons ❑ w= DISTANCE TO: Well �� �pKnm H n Foundation 7 Nearest lot line vy r o — `}� �- PERMIT NO.82041-40 L ee LL z No. of lines Length of each line /1i Total length of lines �J Trench width ry 4 Distance between lines Z w V 70 inches ~ Top the to finish Material beneath tile Total effective absorption area f❑.. of grade, > > t0 3 inches 20 fl3 ❑ Length Width Depth PERMIT NO. w U 1 F- Type of crib Crib diameter Crib depth Total effective absorption area CL w m Well Building foundation Nearest lot line DISTANCE TO: J Class Depth Driller Distance to lot line PERMIT NO. J W Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS �� l SOI L TEST RATING Z -+ 7 ✓i o INSTALLER%� PI, Ve'r P �U �r 4P 6` REMARKS S APPROVED DATE LEGAL -L E32 Lot 6 131ock 4 &-i-ePhbrook5'ak 72-013 (Rev. 3/78) DEPARTMENT '�,- HEALTH AND ENVIRONMENTAL' OTECTION 825 �L' STREET, ANCHORAGE, AK. 99501 264-4720 0"—* I -T E= :-=. FE W a FR F:=o a F--" M I -r- PERM I T FPERMIT NO. 820948 APPLICANT GENE FOWLER 2137 FAIRBANKS ST 99503 268-8843 LOCATION LE13AL L684 GREENBROOK LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (50 FT.,'BR)= 100 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: E -a E-= Fza -F " = .0 - � L F::"r-.i F-3 -r "1 :2- xZ. 173 F -Pm F1-11%0 E:A ED- F:::F='-r Fi -- 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). F.0 1= 1:;:! t-1 I F..'I= CA :-7. E: F=' -r 11 IZ- 7- n r -.l Vr. _�� I � F:"_ ::L I -El C3 cz-:u RD n L_ PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. -rL4C -- - F=l FR' *1= '1= i < Z=:,, Q U I F=_EC:" OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A I -JELL 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 I -JELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SE14ER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F='r=- F --'M I -IF F= X [:=' I lzl E=_ E" E'-)- HE f--- F= M E. 1= FZ =-_ _- -1 S�:E:;ao I CERTIFY THAT 1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: 1 UNDERSTAND THftT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS R�WEJLEGA TO INCLUDE MOPE 'THAN 3 BEDROOMS. SIGNED:- �'­&:HT4T 13E FOWLER HZ 5F- - L_YI r If -i E r�. ISSUED BY------ ----- D A T E ----- V4. 0 71 ---------- ❑ 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 rr E ��— DATE PERFORMED: PERFORMED FOR: P�� LEGAL DESCRIPTION: L.0 -r W Bue' ' ' `''� r— So- DEPTSLOPE H C� 2 3 04LI 5I/*1 F�rs77C, 4 �'/A 41516 14- 15- 16 17 18- 19- 20- COMMENTS 81920 COMMENTS CP WAS GROUND WATER Mo S ENCOUNTERED? �evvyy L O P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop 2 PERCOLATION RATE TEST. RUN BETWEEN PERFORMED BY: ijs l't CERTIFIED BY: 72-008 (6/79) (minutes/inch) FT AND ..-7—- FT N X� Parcel I.D. 017-431-11 Certificate of On -Site Systems Approval Expiration Date: 4/29/2025 Legal description GREENBROOK BLK 4 LT 6 Site address 12621 VON SCHEBEN DR Anchorage AK Current property owner(s) CLARK X The On -site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: The property has been using the bed, trench has been dormant. Diverter valve will be switched to the trench. Original Certificate Date: 9/25/2024 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcell.D. 017-431-1#� Complete legal description Greenbrook Block 4 Lot 6 Location (site address) 12621 Von Scheben Drive, Anchorage, AK Current property owner(s) Skylar & Amber Clark Day phone (907) 308-0195 2. ON -SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: R Private Well R Private Well serving 2 dwelling units F1 Private Well serving 3+ dwelling units RN Community Well or Public F] Water Storage 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic E] Private Septic serving 2 dwelling units R Holding Tank F] Community Septic or Public Sewer 5. SEPTIC TANK: F01 Steel [:] Plastic Fj Concrete Fj Fiberglass Age 16 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: F-1 AWWTS r_1 Bed 9 Deep Trench F-1 Wide Trench F-1 Seepage Pit Waiver request for: Expedited review requested: Fj Distance: By applying for this entitlement, this property is subject to inspection by municipal On -site staff to verify the accuracy of the information provided. COSA Fee $ 5 50 Date of Payment qhl g-1 COSA# Waiver Fee $ Date of Payment Waiver # COSA ApplicationJune2022 N/A Benjamin Schiller, P.E. (907) 522-7773 ® Municipality of Anchorage ° On -Site Water and Wastewater Program (907) 343-7904 5 T Y Certificate of On -Site Systems Approval Parcel I.D. 017-431-11 1. GENERAL INFORMATION: Expiration Date:. --Z2 _Z �Z3 Complete legal description GREENBROOK; BLOCK 4, LOT 6 Location (site address) 12621 Von Scheben. *A Current Property owner(s) Jack & Josie Hickel Day phone 244-3291 Mailing address Real Estate Agent 2. TYPE OF DWELLING: X❑ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class A Well ® Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 55 D Date of Payment & Receipt Number b7 3 0 1 G COSA # O S C a 11 3 1 3 Date: Waiver Fee $ Date of Payment Receipt Number Waiver # Cr" J 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. Name of Firm: Garness Engineering Group Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road Suite 101- Anchorage Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: ( �J In conducting this evaluation, GEG provided an engineering evaluation. of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for p r Vs��� CJTI, Yf_ t� %% ........... ! .....9........ .. y.-r.e_s..:... Jef� A. _ s: E—�7L9f 3 c G G��F'�ofessi00000 #AECC884 NLITY pF 0A1 -s17_, y bedrooms, with the following sili �tla ' I4� 11 - =_ � Original 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist Legal Description: GREENBROOK; BLOCK 4, LOT 6 Parcel ID: 017-431-11 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA a , .• ❑ Well log is filed with Onsite (or attached) Well production at time of test Date drilled Water storage tank volume ? gallons, Total depth ft Well disinfected or c"ol fi orm test? ❑ Yes o Cased to ft ❑ JAorm is Negative ❑ Sanitary seal is functioning correctly Nitrate mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) In. Collected by Date of flow test for C Date of Sample Static Ovate at beginning of test ft. ments CLASS "A" WELL PWSID# 210346 B. TANK DATA C. LIFT STATION Age of tank(s) 13 years ❑ Required maintenance completed Tank type/material SEPTC.9TEE Age of lift station years Measured operating fluid level in septic tank 4 Lift station material © Standpipes/foundation cleanout per record drawing Comments: N/A Date of pumping 11/20/20 D. ABSORPTION FIELD DATA DATA IS FOR 1982 TRENCH Which system tested (date installed) 1982 Adequacy test date 5122/21 ® ALL standpipes present per record drawing Results ❑Pass For 3 bedrooms Total measured depth from grade 6.25 ft (max) Fluid depth prior to test 23 in Measured depth to pipe invert from grade *2.83 ft (min) Water added 606 gat ❑ N/A — pressurized field 31 New depth in 0 Monitor tubes go to bottom of effective. If not, state 120 depth into effective Elapsed time min ❑ Code -required soil cover over field Final fluid depth 26 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of test) Gallons introduced N/A gallons If yes, enter date N/A Comments/Deficiencies: SEE EMAIL FROM OWNER REGARDING FREEZING 1993 BED WAS DRY UPON ARRIVAL & MONITORING TUBE EXTENDS 8' BELOW INVERT 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' ❑ Yes if No Community Sewer Manhole/Cleanout > 100' Surface Water> 100' ❑ Yes if No ft ❑ Yes if No _—ft Neighboring Tank > 100' 1771 Yes if No ft j�.�.,c Private Sewer/Septic Line ?� 25 - des if No ft Absorption Field on Lot > 100' ❑ Yes if No ftolding'T"ank > 100' ❑ Yes if No ft F71 Yes if No ft Water Service Line > 10' 121 Yes if No ft Neighboring Absorption Fields >100' "" Animal Containment > 50' [-71Yesif No ft - es if No ft Manure/Animal Excreta Storage > 100' (p t y Sewer Main > 75' ❑ Yes if No ft ❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water> 100' R✓ Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Wells on Adjacent Lots: Absorption Field > 5' P/ Yes if No ft Private Wells > 100' ✓0 Yes if No ft Water Main > 10' ❑✓ Yes if No ft Community Wells > 200' F71 Yes if No ft Water Service Line > 10' 121 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' 121 Yes if No ft If absorption field is under driveway comment below Property Line > 10' f7l Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓0 Yes if No ft Private Wells > 100' n✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' 0 Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *SURFACE WATER LOCATED TO THE WEST AND SOUTH. GIVEN THE DATE OF INSPECTION, WE ASSUME THAT THIS IS SEASONAL. **MET CODE AT TIME OF INSTALL G. ENGINEER'S CERTIFICATION l certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet #AECC884 Im M r MNIM11 110 1111111 Ill lulllll l Hu 10. DUE 'I BID 2 III DID ill mmil iiipuml Ill I IIW in I lifillilifloffloll \ Municipality of Anchorage -tel Development Services Department Building Safety Division �- On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL ^ .i FOR A SINGLE FAMILY DWELLING 6n�J(rl Parcel 1. D. � i-' 9 3�- %� COSA# n(LI/✓'f O� �t 1. GENERAL INFORMATION Expiration Date: J 0 I Complete legal description GREENBROOK: BLOCK 4, LOT 6 Location (site address) 12621 VON SCHEBEN *ANCHORAGE, AK Current Property owner(s) VICTOR FLINT Day phone 441-1597 Mailing address Lending agency Mailing address Real Estate Agent Mailing address 12621 VON SCHEBEN *ANCHORAGE, AK Day phone GORDON SLONE W/ REMAX Day phone 276-2761 110 W. 38TH SUITE 100 *ANCHORAGE, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site E Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well 5a' Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date e Z G/013 Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, ooOF OpO4 conscientious engineering analysis of the system in accordance with ADEC and MOA Po q p4 DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may Q• • • • . • • • • • • • • • • • • • fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test .. . . ............:... results do not guarantee future performance of the system, nor do they guarantee that Q 9 ey Garn .. there are no hidden defects or encroachments. GEG, LTD.. can therefore not provide Q4°p. ' C —79 any warranty or future estimate of how long the system will continue to meet the re bi operational requirements of the ADEC or MOA DSD. The content of this report is for �Oedpr° tessl°^ the sole benefit of the owner listed above. Any reliance upon or use of this report by any DD��D�opo� other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the flowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory L/ Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Nitrate Advisory Other By. Gti (Rev. 1110 ) Original Certificate Date: / 0 —'?, — 40.g \ Municipality of Anchorage C•(� �l Development Services Department ° Building Safety Division On -Site Water & Wastewater Program ` 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST t1 Legal Description: GREENBROOK; BLOCK 4, LOT 6 Parcel ID:017 —7 31'11 A. WELL DATA COMMUNITY WATER Well type A_ If A, B, or C provide PWSID# 210,346 Well Log (Y/N) Date completed Total depth ft. Date of test Sanitary seal (Y/N)_ Wires properly protected Cased to ft. Casing height FROM WELL LOG AT Static water level ft. Well production g.p.m. WATER SAMPLE RESU Coliform colonies/100 ml. Nitrate —mg./L. nic: ug./L. Date of sample: _ B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1000 gal. Number of Compartments 2 in. Other bacteria—colonies/100 ml. Collected by: Date installed _ Cleanouts (Y!N) Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping NEW Pumper N/A ` C. ABSORPTION FIELD DATA Be ow EXISTING CRAoe 8/4/19930.8 BED Date Installed 11/5/1982 Soil rating .p.d./f or /bd 100 System type TRENCH 40 15 0.75 Length 40 ft. Width 3.5 ft. Gravel below pipe 4 ft. •7.33/8.08 600 Total depth •6.5 ft. Eff. absorption area 320 ft' Monitoring tube YES Depression over field NO Date of adequacy test "7/8/08 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test DRY In. Water added 600 gal. New depth 19 in. Elapsed Time: 270 min. Final fluid depth DRY in. Absorption rate >= 450+ g.p,d, Any rejuvenation treatment (past 12 me.) (YIN & type) NONE KNOWN If yes, give date — *•1982 TRENCH TESTED %a93 Q,6.D D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN "Pump on" level at in. "Pump oft" level High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line areas COMMUNITY WATER On adjacent On adjacent lots manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water service line Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Buildingfoundation 10'+ Water main N/A Water service line 10'+ Surface water • 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200+ F. COMMENTS *WATER FOUND IN ROAD DITCH 65' AWAY 1Nlczcz H �T - G. ENGINEER'S CERTIFICATION p� �........ .... 500 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date cOl 17/0 S COSA Fee q 39� Date of Payment -v9 Receipt Number to (Rev. 11/05) Waiver Fee Date of Payment Receipt Number Ae I Prepared by SURvEY '+�rrrrr, .PSE of °4.,' Robert E. Johns, Jr. &Assoc. 'v1.oTran A, �� professional Land Surveyors Professional I •.+r ...1, wr I A... /,.Iw•K.wM•• Y1 Y M M ...�. -1•y . noo BRINK DR. ANOIORACE, ALASKA 09504 •.� .•w. �Ir.w� Rsa Lot S.F. Rea M1Ot f%e No. 50' FOINDATON AS -BUILT I AAwa.r ww..wA.Pw.Tw +wrr Oat- SNr rAl 7 �j�7 Drown Dy. E CheCktC DK .r-rw.r �rwr•w.w+wt.w. ♦ ... ... ......•• . ..•...... I, Ooto Old": GK:e: 2839 W.O. a.•w wA.w.W ROB NS. L•9d oox 1ptlem FWAL STRUCTURE AS -SLILY I •. .•: SJ• w '•Al l •�. t aw.A i. •.wY...•K M ............. plaI a •' of 6 Block 4 re Grecribrook :.......... D LOT AnEY SURVEY TYPE r=3 S✓wr wea.s SYM— ASPHALT ❑ MMATICII AS-V..FLT • SET REBAR Moloo. DRAINAGE �: �:•`:•. CONCRETE O .w.At tlwUctNAC Aa-ww.T O FOUND REBM � WOOD FENCE ❑ PLOT PLAN ... AS -MLT ... LOT ILWn ... ToroCRAew' w Op A$$IIML'D ELEV. *—X--* META FENCE w _ PEYSLOT PLJLNS k LOT SURVNOTE. IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER. PRIOR TO ONLY MDSE IMPROVEMrNTS ABOVE GROUND ANO VISIBLE WALL BE WELLS. SEPTIC CLEANOUTS. SIDEWALKS. DRIVEWAYS. CONSTRUCTION. TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES. TO FINISHED GRADE AND UYRJTY CONNECT104S AND TO DETLRVINE ETC.. APE KNOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW MAY PREVENT SOME IMPROVEMENTS PROM BONO SEEN AND LOCATED. ME EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS CDROMIVIJb41 PLAT e N e n .- e.• IC. O Q7 AP N TH UNDER No CIRCUMSTANCES SHOULD AN AS-L^JR.T BE USED FCR CONSTRJCTION OR FCR ESTABLISHING BOUNDARY OR FENCE LINES ASSUMES FINANCDAL LIAB'LITY ONLY FOR THE COST OF THE SURVEY. THE yTNVEyOR TAKES RESPON5BNTY FOR THE INITIAL TRANSACTION OVLY AND LISTED DISTANCES PREVAIL OVER SCALNG. REFPCDUr'nON MAY CAUSE UKRORS IN SCALE. 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. # 0th - 4131 - /I HAA # 1. GENERAL INFORMATION Complete legal description LOT 6, Coax ZY S/a Location (site address or directions) /2- 6 -at Vo 7-i T WA,TDN Property owner +W_Q 6;wcz.N TDay phone Mailing address l2 C0 1 VON sc#ea-%6?y t Acv C!� to V_ Lending agency Day phone 2R -b — lt2 S® Mailing address Agent 'MS. CLE^2bt C-7MIMAS Dayphone -2rj --�163( Ad d ress Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 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. 1191) 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 forthe number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Fir Sye Phone Z^�21 Address'©oX Engineer's signatu .00 6. DHHS SIGNATURE X Approved for - bedrooms. Disapproved. Conditional approval for Additional Comments By: Date 3/c? Am A Steven R. Pannone ft,^, CE -8149 bedrooms, with the following stipulations: Date 3 — Z(-'79 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 theirlending 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-M (Rev. 1/91) Back MOA 1121 Municipality of Anchorage R M V I DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MAR 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) ;4744 h:,ch®rage Dept. H , y •Iuman Services Health Authority Approval Checklist Legal Description: LG 1'1� If Gr2Pwa'J � 12opK sj Parcel I.D.: ®1--7- — e-13 t — e A. WELL DATA Well type A If A, B, or C, attach ADEC letter. ADEC water system number 2 10 3 /-/6j og present (Y/N) Date completed Total dept Cased to Casing height (ab ground) Sanitary seal (Y/N) Wires prop protected (Y/N) FR WELL LOG AT INSPECTION Date of test Static water level Well production g.p.m. g.p.m. WATER SAMPLE R LTS: Coliform Nitrate Other bac 'a to of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed 1t �5 Tank size IOb n Number of Compartments 2-- Cleanouts (Y/N//) Foundation cleanout /(Y/N) Y Depression (Y/N) N High water alarm (Y/N) /Jl Date of Pumping 3fs��6 Pumper A -t' 90MF- G%C- C. ABSORPTION FIELD DATA Date installed g `5143 Soil rating (g.p.d./ft2 or ft2/bdrm) 0, System type T 90 Length q Width /67 Gravel thickness below pipe 0•4K Total depth vP -r-o Effective absorption area 6 co Monitoring Tube present (Y/N) Depression over field (Y/N) /0 Date of adequacy test 3 /V (IT 6 Results (Pass/Failss For Is bedrooms Fluid depth in absorption field before test (in.); "'Y I( Immediately afters gal. water added (in.): � Fluid depth '�(n (ins) Minutes later: / V40 Absorption rate = 4/-S'0 g.p.d. Peroxide treatment (past 12 months) (Y/N) N d If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm E. SEPARATION DISTANCES Size in gallo on" level at* *Datum "Pump off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: 14 1 N Septic/holding tank on lot Absorption field on lot Public sewer main service line On adjacent lots acent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation /b Property line 80 Absorption field yo + Water main/service line >/01 Surface water/drainage yvo Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line Building foundation y 4 e 1 O b Water main/service line �� t Surface water POt Driveway, parking/vehicle storage area ev a� Curtain drain ti` 6Q F. ENGINEER'S CERTIFICATION _ Wells on adjacent lots le)® + /certify that I have determined thru field inspections and review of Municipal recordX30NVJMt3-above,yg * 40ki in conformance withMOA HAA guidelines in effect on this date. r a;z ``"°•'""' 'r°. yam o ` 1HU•i..t f. Sst Signat� ,a i Steven R. Pannone a C- Engineers Name S I(-_'�hjP,o c� mn� , ./3 . * Y O&M,% CL -8149 x Date 3/T 4 !� . ti - HAA Fee $ ? ( I VA—) n Date of Payment n \ 11t Receipt Number�{n?bn 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number Steven R. Pannone, P.E. P.O. Box 142025 Consulting Engineer Anchorage, Alaska -99514 (907)272-8218 SEPTIC SYSTEM ADEQUACY TEST Legal: Lot 6 Block 4 Green Brook SID Owner: Mr. Frank Prewitt and Ms. Gwen Byington Residence: 12621 Von Scheben Drive Anchorage, AK 99516 Septic System: Tank Size: 1,000 gallons. Absorption System Type: Bed (from MOA records) Absorption System Size: 40'x 15'x 0.75' Absorption Area: 600 s.f. Installation Date: 8-15-93 Soil Rating: 85 gpd/sf Date of Pumping: 3/5/98 By: A+ Home Services Date of Test: 3/8/98 Test Procedure: System was inspected and measure. Tank was found with 4 Feet of cover. Liquid depth was measured to be 18 Inches. The drain field was found to have 5-7 Feet of cover and a total depth of 5.8 to 7.8 feet. There was 4 Inches of liquid measured in the field's monitor tube. Water was added to the system at a constant rate of 8.6 G.P.M. The water levels in the tank and drain -field monitor tube were monitored. A total of 472 Gallons of water was added. During the test the level rose two (2) Inches in the field. No rise was noted in the tank. The infiltration rate was monitored for 1440 minutes. During this period, a total of 472 Gallons were absorbed. By extending the observed infiltration rate, a total absorption rate 450 Gallons per day was arrived at. TESTS RESULTS: This system meets the code requirements of the Municipality of Anchorage. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system. 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 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 under different conditions, nor do they guarantee that there are no hidden defects or encroachments. We can therefore not give any estimate of how long the system will continue to meet the operational requirements of the Municipality and State. �� ®" p®� 0969000 iYlBOPB (� Ar W r0 00809 p006 ,9V\ /V) 0 60 M 49TH Steven R. Pannone.' a— b 2 (� 1149 1II1 �® OB`9899388099098000�\ (/�®� 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. # 01-74-3111 HAA # 1. GENERAL INFORMATION Complete legal description LOT %, 4- , GQ�� Y3r'-00� S/u Location (site address or directions) 12.(,2_) V6N Sc4QSE.,J DP-- bF-i:: D'= A2Tcon1 Property owner. S tyE i`2AC'I tO"N�� Day phone E45- 4ZZ(o Mailing address 2 X02 l V 07J jCwE 13/ice-1 • AK • Lending agency N (. Day phone IN /A Mailing address Agent N ! �. Day phone L4 Address. --/\4 )� Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 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 -�aorn s,aaaul6uo leuolssalwd all ul suolsslwo ao sione aol alglsuodsaa lou sl a6eaogouy to AllledlolunW aql •panssl sl aleoipliao a aaolaq elep azAleue ao suolloodsul lonpuoo lou op SHHa to saaAoldw3 -sluawaalnbe i elels pue leaapal uieliao (idles of iepio ul suollnlllsul bulpual alagl pue sawoq to saasegoand of (solinoo e se slyl saop SHHO aql ely to olelS agl ul paaalsibe i aaaul6ua leuolssaloid luopuadepul up Aq anoge g gdeibe.ied ul uanl6 suolleluasaidaa eql uodn Aluo paseq saleolpliao lenoaddy Al!aoglny glieaH sanssi (SHH(l) saolruaS uewnH Pup 4+IeaH to luawl.iedap a6eaoyouy to Al!IedlolunNl aql ;it= suollelndlls 6uimollol aql gl!M 'swooapaq //-3 ale(] sluawwoo leuolllppV aol lenoidde leuolllpuoo •panoiddesla •swooapaq aol panoaddV 3linIVNCJIS SHHO `;Q lz�6 1�lV ' lz-d 641o) -IES: auogd �g)lnTr3S —aqi"'°rr\ ainleu6ls s,aa9ul6u3 C:)UQ I L-jva ssaaPPV i ays v^� rnls�ald wilzi to aweN •uolloadsul slgl to alep eql uo loelle ul suolleln6ei pue 'saoueulpao 'sapoo alelS pup ledlolunw lie gl!M eouelldwoo ul sl welsAs lesodslp aalemalsem ao/pue Alddns aalem ails-uo aql 'uolloadsul pup u01le6llsanui /w woal pup salll a6eaogouV to AlllediolunN eql woal poulelgo uoilewaolui eql uo paseq leglAllaanaaglanl I 'ulaaag poleolpul ainlonils to adAl pup swooapaq to Aegwnu aql aol alenbape pup leuollounl 'ales sl walsfs lesodslp aalemalsem ao/pue Alddns aalem alls-uo aql legl smogs uolleoildde lenoiddV Al!aoglnV glleaH slgl to u01le6llsanul Aw legl Al!aan i 'molaq unnogs alep uolleP!len aql to se pup olaaag pamille leas Aw Aq pa!l!laao sy a33NIE)N3 AS N01103dSNl d0 LN3W31t/1S In .9 .5 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: WT � Qg 4 Parcel I.D. &f2se�-Jea-0c>K S p A. WELL DATA type COMM ' If A, B, or C, attach ADEC letter Log pres�it (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level Date completed Cased to OM WELL LOG SEPARATION DISTANCES FROM WELL Septic/holding tank on lot _ Absorption field on lot Public sewer main Sewer service line WATER SA E RESULTS: Colifo ate of sample: B. SEPTIC/HOLDING TANK DATA ADEC water system number Z10 3+(o Driller Casing height Wires properly protected (Y/N) AT INSPECTION On adjant lots Public sewer manhole/c anout Petroleum tank Nitrate Other bacteria Collected by: tl S $ Tank size f0(�O Compartments 2 Date installed I P Cleanouts.(Y/N) V Foundation cleanout (Y/N) cES Depression (Y/N) High water alarm (Y/N) Alarm tested (Y/N, Date of pumping f3A/93 Pumper M oZ�iyA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot A111+_ On adjacent lots � �� Foundation lD J To property line �d Absorption field Water main/service line 7/n / Surface water/drainage ADD 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE /n)SP�,z�J /teat�s�-�1 %G1912 m O Z Mv zr g•p n� _, r o M T Z rel w M = < m adjacent lots F, Z On adjant lots Public sewer manhole/c anout Petroleum tank Nitrate Other bacteria Collected by: tl S $ Tank size f0(�O Compartments 2 Date installed I P Cleanouts.(Y/N) V Foundation cleanout (Y/N) cES Depression (Y/N) High water alarm (Y/N) Alarm tested (Y/N, Date of pumping f3A/93 Pumper M oZ�iyA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot A111+_ On adjacent lots � �� Foundation lD J To property line �d Absorption field Water main/service line 7/n / Surface water/drainage ADD 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE /n)SP�,z�J /teat�s�-�1 %G1912 C. LIFT STATION Date i d Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) on" level at Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots "Pump off" level at Cycles tested Surface Ovate 1 D. ABSORPTION FIELD DATA C,PD Date installed3 Soil rating System type 4a Length Width l Gravel thickness / Total depth S. 54 Total absorption area �p Cleanouts present (Y/N) —'YF --S Depression over field (Y/N) Date of adequacy test Results (pass/fail) `�Jf::' 1 S�YS7^6'�i for _ bedrooms Peroxide treatment (past 12 months) (Y/N) 1 If yes, give date SEPARATION DIST NCE FROM ABSORPTION FIELD TO: Well on lot r� On adjacent lots A- Property line To building foundation On adjacent lots r S (O To existing or abandoned system on lot Cutbank IQ1.Water main/service line. I Surface water (�1 '+- Driveway, parking/vehicle storage area Curtain drain Civ E. ENGINEER'S CERTIFICATION 6b/ '> f0Of s (D i 6o DY2--r 1 certify that I have checked, verified, 0,4conformed to all MOA and HAA guidelines in effect on the date of this inspection. HAA Fee $ Rio `` d?) Waiver Fee: $ Date of Payment 0 – / e `� Date of Payment Receipt Number O� 1 tel% �� Receipt Number 72-026 (Rev. 3/91) Back MOA 21 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 Mr. & Mrs. Tracy Fowler 12621 Von Schoven Anchorage, Alaska 99516 WALTER J. HICKEL, GOVERNOR August 13, 1993 (907) 349-7755 SUBJECT: Lot 6, Block 4 (12621 VonSchoven Dr); Greenbrook Subdivision Class "A" Public Water System, PWSID 210346 Dear Mr. & Mrs. Fowler: I have completed a review of this office's files concerning the monitoring status of the above -referenced Class "A" Public Water System and found the following: The last satisfactory Total Coliform Bacteria Sample results was submitted to this Department on July 9, 1993. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. 2. The last inorganic Chemical Contaminants Sample results were submitted to this Department on November 10, 1992. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. 3. The last Radioactive Contaminants Sample results were submitted to the Department on December 11, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. 4. The last Organic Chemical Contaminants/Volatile Organic Chemical (VOC) were submitted to this Department on November 12, 1991. Based on analysis of the previous VOC samples results have been satisfactory. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. Issuance of this letter does not imply that the above -referenced Class "A" Public Water System is in compliance with other provisions of the State Drinking Regulations. Unless otherwise noted, this letter is valid for 30 days and is for the specified legal description noted above only. August 13, 1993 Page 2 If you have any questions on the above information, please do not hesitate to contact this office at 349-7755. Sincerely, A244 Michael Lu Environmental Eng. Asst. II ML/pf V s� MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date / 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) `" f (b) Applicant Name�3 oe Telephone: Home 2b Business (c) (d) Lendin Applicant Address 5��>I�� Applicant is (check one): Lehdirig Institution ❑ ; Owner/builder-; Buyer ❑ ; Other ❑ (explain); f ��t Telephone %F: (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: Lf 21-7-4 7,g,t.L i 2. TYPE OF RESID NCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY Individual Well ❑ Community/ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. , 4. SEWAGE DISPOSAL Onsite C/ Public ❑ Community ❑ Holding Tank ❑ Note: if community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11184) i ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Healtr Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address )ate W Date �C�(�fvtQu� OoaC��'Fio�c� t 15-Otr`I wey Telephone 54-�-/-5010 Seal ,'. 6. DHEP APPROVAL, Approved for /bedrooms by to Approved Disapproved®® Conditional Terms of Conditional Approva����3�46 t2 �� C •L L�R.s `��,� `�"`� 1 CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) MUNICIPALITY OF ANc4WAUH AUTHORITY APPROVAL (HAA) DEPT. CF HEALTH & rHECKLIST -FEBRUARY 1984 ENVIRON RENTAL PROTECTION 264-4720 JAN '2C 10R Legal Description: A. WELL DATA RECEIVED Well Classification r l u If A, B, C/, D. E. C. Approved (Y N) Well Log Present (Y/N)%lt ate Completed Yield f Total Depth —I JA Cased to :T Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground A/A Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) t6 Depression Around Wellhead (Y/N) Separation Distances from Well To Septic/Holding Tank on Lot AM ; On Adjoining Lots 1614 To Nearest Edge of Absorption Field on Lot &4 ; On Adjoining Lots dZ4 To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lott��/';� Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA ; Date ��// Date Installed y Size »0Q No. of Compartments lam' �–` Standpipes (Y N)Air-tight Cap (Y N) Foundation Cleanout (Yqv Depression over Tank61� Date Last Pumped Pumping/Maintenance Contract on File (Y/N) 41f� ; for A1114 - Holding Tank High -Water Alarm (Y/N)/moi Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: f t To Water -Supply Well (!-�;r To Building Foundation To Property Line K" T /0 To Disposal Field 1 To Water Main/Service Line 67 /© To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA � � CA 4( ef'fi6a-00'k Soils Rating in Absorption Strata 100 Type of System Design Date Installed ll -moi -`h2 Length of FieldG� Width of Field Square Feet of Absorption Area Depression over Fiel (Y ) Results of Last Adequacy Test Depth of Field / - Gravel Bed Thickness Standpipes Present(91N) Date of Last Adequacy Test /_ /�—fir Separation Distance from Absorption Field: r f l0' To Water -Supply Well � r r�� To Property Line � /� To Building Foundation /S To Existing or Abandoned System on Lot %i On Adjoining Lots (�Z % To Water Main/Service Line % (D To Cutbank (if present) Z To Stream/Pond/Lake/or Major Drainage Course r,T rOC f < To Driveway, Parking Arei Comments Njq;UO r.M My ttV d' nye fy 1 �u D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensio anhole ccess(Y/N) ump Off' Level at Vent(Y/N) ** Check Permitted Bedroom Rating Against HAA Request ** Pumping Cycles during Adequacy Test. Meets MOA I certify that I have chec5ed, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed -- Date Company= C Ci vi l MOA No.®9 A���® Receipt No. ��� Ll a-3 Date of Payment � — ate Amount: $ LoS .0>C) Page 2 of 2 72-026 (11/84) 1 V �oe � ees0 eeoBmW��`'� !® a e�� J�JC fcfoY Le y G. Reid Jr. .> �V4 2251.8 ALASKA 611UPOnMenTAL COnTnOL SeRUICOS, Inc. 6ngineerinq & 6nuironmental Studies 01/20/86 STEVE FOWLER SELLER—STEVE FOWLER STEVE FOWLER 2813 DAWSON STREET 2813 DAWSON STREET ANCHORAGE ALASKA ANCHORAGE ALASKA 99501 99501 60021 LEGAL:GREENBROOK SUBDIVISION BLOCK 4 LOT 6 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE -1/17/86 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 320 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 450 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON 1/17/86 . ADDITIONAL COMMENTS : THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER SUPPLY OR WASTEWATER SYSTEM. 1200 West 33rd Avenue, Suite 13 • Anchorage, Alaska 99503 • (907) 561-5040 BILL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION Telephone: (907) Address: ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 274-2533 ANCHORAGE, ALASKA 99501 DATE: January 9, 1986 PWS I.D.# 210346 To Whom it May Concern: According to records on file in this office the GREENBROOK SUBDIVISION Water System is in compliance with the State Drinking Water Regulations L Sincerely, / // Z�- Michael P.Lewis Environmental Engineer iihicipality of Anch6fiage MEMORANDUM DATE: January 19, 1983 TO: Laura Crow FROM: Sewer and Water Program SUBJECT: Request for Refund - Account #2460 Please make the necessary arrangements for the following refund. A private engineering firm has performed the inspections in lieu of this department. Thank you. Gene Fowler 2137 Fairbanks Street Anchorage, Alaska 99503 Lot 6 Block 4 Greenbrook Subdivision - 20.00 Lot 5 Block 4 Greenbrook Subdivision - 20.00 Total: $40.00 Receipt # 205966 Laura J. Ward Senior Office Assistant attachments t 91-010 (5/78)