Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
SPRING HILLS ESTATES BLK 1 LT 7
Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON -SITE WASTEWATER INSPECTION REPORT [Permit Number: OSP231323 PID Number: 015-051-45 Dwelling: ❑N Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name pg MAHEAR ABOU EID ABSORPTION FIELD Site Address 9501 SPRING HILL DRIVE *ANCHORAGE, AK ❑ Deep Trench ❑ Wide Trench ❑ Bed ound [Phone-350-6777 ❑Other Number of Bedrooms Soil Rating Total depth original grade 3 GPD/sF Ft LEGAL DESCRIPTION IDepth to pipe invert from original grad Gravel depth beneath pipe Subdivision Block Lot SPRING HILL ESTATES; BLOCK 1, LOT 7 Ft. Ft. Fill added above original gr Gravel length Township Range Section Ft. Ft. Gravel width Beds_ Number of Lines Distance between lines SEPARATION DISTANCES Ft. To Ft. Septic Absorption Lift St Tank Field Station Holding Sewer Total orption area Number of trenches Dist. between trenches From Tank Line Ft2 Ft. Well 100'+ G 5 + TANK ❑ Septic 9 S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water 100'+ ANCHORAGE TANK 1500 Gal. Material Number of compartments Lot Line 5'+ NA EPDXY STEEL 2 Foundation 10'+ LIFT STATION Manufacturer Capacity Remarks PER CONTRACTOR OLD TANK WAS HAULED OFFSITE ANCHORAGE TANK *500 Gal. *SECOND COMPARTMENT. PUMP, PANEL, FLOATS AND Alarm location Electrical installed by PUMP BASKET WERE RE -UTILIZED GARAGE. OWNER PIPE MATERIAL House to tank D3034 Tank to EXISTII Installer drainfield BC EXCAVATING Drain£eld EXISTING Co/MT D3034 Inspection BENCH MARK (Assumed elevation) 100.00 It dates: 1,' 11/4/2023 2"d - Location and description 3'd - 4� - BACK DOOR THRESHOLD ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp �a6opp o� OF q hook% londitionai Approval: Date o Septic System Approved Date Note: this approval does not include well permit requirements. (Rev 05/02/18) o , �............O rey A_ orness...= d C'99 3 : Ft • e �9- ! •' .\cam �4444apI�1?. 0\�00 rofessio0 o #AECC884 4���ndCSd NA.unicipality of Anchorage On -Site Water and Wastewater Program P.O. Box 196550 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite Review Comments Engineer: GARNESS ENGINEERING GROUP LTD Legal Description: SPRING HILLS ESTATES BLK 1 LT 7 pro Parcel ID: 01505145000 -14A Permit: OSP231323 SepticTank Report Type: As Built Review 9/10/2024 lop 6'je' Completed By: C.Townsend The applicatio"as-tfe—en reviewed and the following comments have been generated. These are to be satisfactorily addresse_"ribr to MOA approval: 1. survey shows two FCO. The engineering plan view shows 1. please coordinate _j - -'C'l 'f pu 2. STEP tank appears to have a gravity draining outlet. Is this correct? -40 0 tl,- 3. --Q�ou show B s on plan view drawing? show the M 1 n plane d r0a n �g— M so view air compressor s� s alarm con irme ? 0 OD tj c rm 4. Was the air compressor and is operation con i e ? 7 "j) to D PL (,-I L2r— , (.,, &Z- - W o r2- V- 1,4 1— PERMIT NUMBER: RECORD DRAWING I N G PARCEL ID NUMBER: OSP231323015-051-45 TOP OF MANHOLE = 97.59 TOP OF TANK AT INLET = 92.27 INVERT OF BUNG AT INLET = 91.53 MH1 FINAL GRADE = 97.22 MH2 NEW 1500 GALLON EPDXY COATED STEEL STEP TANK DURING THE TANK INSTALLATION, GROUNDWATER WAS ENCOUNTERED AT ABOUT THE MIDPOINT OF THE TANK JZ ENGINEERING -SALES W CONSULTING 3701 E. TUDOR ROAD, SUITE 101 ANCHORAGE, AK 99507 -PHONE (907) 337.6179' FAX (907) 338-32d5' WEBSITE: www.gamesunpheenn9 c.m PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MAHEAR ABOU EID 907-350-6777 3 OF 3 LEGAL DESCRIPTION: DRAWN BY SPRING HILL ESTATES; BLOCK 1, LOT 7 D.J.G. TYPE OF WORK: DATE: SEPTIC TANK PROFILE 1/5/2024 TOP OF TANK AT OUTLET = 92.26 TOP OF BUNG AT OUTLET = 91.50 .vim` ��P.• ,+� A ' 4 IH . _���.... '.... «�.. .E.......................... +, ... ......... .........:.....;..r I* o' f efeyA. arness -Q: ♦ J CE- 53 AV1#+♦+ �o Ppp���b Z � AV LICENSE LICENSE` #AECC884 O,�1% gg1L •® / PERMIT NUMBER: RECORD DRAWING V d 1 N G PARCEL ID NUMBER: OSP231323 015-051-45 i A 8 MH1 29.9 60.1 MH2 37.9 1 83.5 NOTE: PIPE LOCATIONS ARE SHOWN PER AS -BUILT SURVEY PROVIDED BY SHANE HOLT, PLS �.� DRIVEWAY Y •+•'• SPRING HILLS EST; BLOCK 1, LOT6 B Q I GENERAL LOCATION OF EXISTING IDSF I I ~ \ MH7 1 DECK A fool vV F( C RAO�VS I I I / goo I\N SS J ENGINEERING -� SALES = CONSULTING 3701 E. TUDOR ROAD. SUITE 101 'ANCHORAGE. AK 99507 ' PHONE (9071337-6179 -FAX (907) 336-3246' WEBSITE:-gamesseng ne g com PREPARED FOR: PHONE NUMBER: PAGE NUMBER. MAHEAR ABOU EID 907-350-6777 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: SPRING HILL ESTATES; BLOCK 1, LOT 7 D.J.G. TYPE OF WORK: DATE: (SEPTIC TANK RECORD DRAWINGS 1/8/2024 FI z w W (,j Ill U w U) Ill U ~ W I � J w 0 N JEW 1500 GALLON EPDXYCOATEDSTEEL STEP TANK I Q SCALE: AV ..�.. .......• 0....:...... . ......0 ............... _ ldeffrey+ . Garness ••, i � i t ' LICE NSE�4,%F,SS\ , e #AECC884 J `.P•�� OF AC�s��O �.. 49 TH .( p SHANE A. HOLT d0 o LS-6914 SJ�d Q�� jessfonal �Qo Z N 89 59' E 282.29 (ANDSCAPE YARDUGHT THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN HEREON ( UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. AS -BUILT SURVEY i" = 30' no coar�ns ssr nusnnr I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 7, BLOCK 1, SPRING HILLS ESTATES ( PLAT 83-382) ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE, ALASKA THIS 29TH DAY OF NOVEA4BER , 2023 VOLT LAND SURVEYING 9389 GROVER DRIVE ANCHORAGE,AK 99587 14563, FB 203 34 235-72 223.8615 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: OSP231323 Work Type: SepticTank Upgrade Tax Code Number: 01505145000 Site Legal Address: SPRING HILLS ESTATES BLK 1 LT 7 G:2436 Site Mailing Address: 9501 SPRING HILL DR, Anchorage Owner: ABOU EID MAHEAR & KATHRYN E Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date 1»cnt S n �1 s Department Lot Size in Sq Ft: Total Bedrooms: 9/27/2023 9/26/2024 50937 ❑ 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 3 Received By: Date: Issued By: Date: ✓ 2' 2-1-2-0 2-3 UNUP UT OF AN G' Development Services Department -3 Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-051-45 Property owner(s) MAHEAR ABOU EID Day phone 907-350-6777 Mailing address 9501 SPRING HILL DRIVE *ANCHORAGE, AK Site address 9501 SPRING HILL DRIVE *ANCHORAGE, AK Legal description (Sub'd., Block & Lot) SPRING HILL ESTATES; BLOCK 1, LOT 7 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: (® all that apply) TYPE OF DWELLING: Absorption Field ❑ Initial Single Family (SF) Q Septic Tank E Upgrade (w/wo AD U) Holding Tank El Renewal Renewal ❑ (D) ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A 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: 122 S5Waiver Fees: Date of Payment: _ G1A t /z3 Date of Payment: Receipt Number: /C 7 SZ Receipt Number: Permit No. Waiver No. GADevelopment Services\Building SafetyMn Site Water and WastewateAFormslClient FormsTermit Application.doc �� _j Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231323, Curtis Townsend, 09/27/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231323, Curtis Townsend, 09/27/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231323, Curtis Townsend, 09/27/23 '�N 89 59' E 28229 [= LAIVOSCAPE raga LIGHT THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINESAND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS S OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOW HEREON ( UNLESS INDICATED) DOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMf E PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW ANLL/UR ICE. SURVEY CORNERSNO I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY #F THE FOLLOWING DESCRIBED ERTY L O T 7, BL ©CK ? SPRI'VG HIL LS ESTA TES (PLAI T 83-.382) PROPERTYVISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE AND O VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE. ALASKA THIS 23 RD DAY OF 7,4563, FB 205-34 HOLT LAND SURVEYING 9309 GROVER DRIVE ANCIORAGE,AK 99507 345-5513 Municipality of Anchorage R co, Pa¢,e ----o, 4, DEPARTMENT OF HEALTH AND HUMAN SE,,~VJCES o 19'98 ENVIRONMENTAL SERVICES DIVISIO~/~I/~:.~.~ P.O. Box 196650 · Anchorage A aska 99519-6650 · Te ep~on6233~744 On-Site Wastewater D~sposal System and/or Well Inspection Report Permit Number: ~~ ~ PIDNumber:_ 01~-- o~l ~[~ ~ ~ b~o Wastewater System: ~ New ~ Upgrade ~5~ ~ 5e~ ~ ~. ABSORPTION FIELD +WW Uou U LEGAL DESCRIPTION So,,~n~: ~ ~s,.~. ~, O~'T~ ~.77' I"'"": po.o.> Fill added above originalgrade:'Gravellength: / ~ '~1 ~ ~* ~/ Ft. ~ Ft. WELL: D New ID Upgrade Gravelwidth:l~/ Numberofli~es: ~8ista,ce~lweeali,es: F~. ~ 30" ~ Ft, __..Driller: ~~ %~Drilled:~,_ Static Wale, Level:Ft. I nstaller:~ ~ ~, Date installed: Yield: /d ~~t. TANK SEPARATION DISI'ANCES ~ Septic U Holding ~S.T.E,P. FrO~ Tank Field Station Tank Sewer Lines ~' ~K-- 1 "Pump off" levee at: ~ ¢o..dation ~[~ ~ ~ ~ "Pump on" level at:~ Highwateralarmat: I Drain ~ ...... ~'- ~ C~ ~, O,~ Remarks: ~ ~xi~4~ S~G ~ BENCH MARK ~ ,,~;: ¢).- .~ ~'~ . Inspections pedormed by: ~,~ ~,~'¢S ~ _ Dates:,,~" ~ ~ ~'~,v...~ Depadment of Heallh ~nd Human Se~ices approval '~"~"" ~:~'7~ "'~'~ Reviewed and approved by: ~~' Date'. ~'Z~ ~ ~?'~O~ESS[~,~ 72-013 (Rev. 9/91) MOA 25 ~ EXISTINfi ~ AIR LINE ~ ~OUBLE c/o X S X I ~ TO STEP TANK FOR D~AINAGE, ~ Tn MT4 ~ L~NCH PVC (~3034) SLBPE~ NBTE: THE AIR COMPRESSOR I8 A THOMAS INDUSTIRES, MODEL 5070, AS SUPPLIED ~ITH ~/2 INCH FDAM PIPE ~RAP (R3 VALUE), INSIDE A 2 INCH SCH 40 ~ PREPARED FBR~ MR, ~ MRS, DIMINB ~¢~.?/I sienA. PREPAREB BY, ALASKA WATER & WASTE;lATER U~,.'....., ........ ..~¢~ r o f essiO¢~ OATE~ 3/~3/98 DRAWN~ GARNESS SCALE~ l' = 30' --iR' x 20' BOTTOMLESS ISF J NO LINER ON ~OTT[]M, INCH PVC .... ___~__/ PRESSURE PIPING DESIGNE]] HEADER, ----~ BY ORENCO, AND SLJPPLIED HOPE AIR LINE FROM ~ ~' ~ ~ ~ ~ ~Y ANCHORAGE TANK, STEP TANK --~ ~ ' 1,25 INCH PVC~ ~- ~--4 INCH DIA. MONITORING LINE FR~M THE ~ , , , TUBE AT EACH CORNER, STEP TANK, ~ ~ ' AIR LINE COIL ~ -, ~ FLUSHING VALVE SPACED AT APPPROX ~ // (TYP), 3URIED ~ITH -, REBAR MARKER, 2 FEET. OR~NC[] ~ / · ~ASTEFLD~ TYPE ~ · ANCHORAGE 'rANK, ~ ~3/4' PVC LATERALS , /2' MINIMUM ~FILTER FABRIC AIR LINE 18 BELD~ /I -'LDVER /~IqVF~ p TOP DF SAND --I ~ELEA r--ORIGINAL GRADE -2' INSULATION ~m 97,5 TB 98.2 ~ TD = 3,07 TO 3~-/ FEET, ~ ~2,1 FEET MIN, OF FILTER SAND, 6 ' LAYER OF 3/8' PEA GRAVEL ~ TdP OF SAND = 96.7 ~ITH THE PVC LATERALS BURIED MID~AY IN THE STRATUM,' INVERT = 96,92, DEPTH OF PEA GRAVEL BELOW PIPE = 2,6 INCHES AS 3UILT ISF DE'TAIL SEPTIC SYSTEM UPGRADE , LOT 7, BK l, SPRING HILL EST, PREPARED DATE~ 3/23/98 DRA~N~ GARNESS SCALE~ NTS AS- BtJIL. T DRA /ING CDVER = 4,0+ FEET SEPTIC AS-BUILT~ LOT 7, BK J, SPRING HILLS ESTATES PREPARED FOR~ MICHAEL AN]] ANN DIMIND ALASKA ~/ATER & ~/ASTE~/ATER DATE: 3/e3/98 I ]]V/N~ GARNESS I SCALE, NTS C .r,)~. IIIlul E:eL:iri¢- Chu.~laK ~ 907-688-1,540 ~fl~/~N96 03/24/98 TL~ 08:~8 FA% 907 343 8214 BUiLDIN~ SA~Y DIV · .~, 9.37 Arv~ , ,,,.., ~.*.,,, lQ., r,:~ ~001 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:SW980029 DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES OWNER NAME:DIMINO MICHAEL J & ANNE V OWNER ADDRESS:9501 SPRING HILL DR ANCHORAGE, ALASKA 99516 DATE ISSUED: 3/11/98 EXPIRATION DATE: 3/11/99 PARCEL ID:01505145 LEGAL DESCRIPTION: SPRING HILLS ESTATES BLK 1 LT 7 LOT SIZE: 50937 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK 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 (18YAC72) 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 REQUIRBD 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 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THIS PERMIT IS FOR THE CONSTRUCTION OF AN INTERMITTENT DOSING SAND FILTER. THIS IS AN ALTERNATIVE WASTEWATER SYSTEM AND THE ATTACHED PROPERTY OWNER MAINTENANCE AGREEMENT SHALL BE A PART OF THIS PERMIT PACKAGE. RECEIVED BY' ~ DATE: DATE:B"I7-?8 Alaska Water & Wastewatcr 7320 East Chester Heights Circle ~ Anchorage - Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Coasulting Engineecs February 23, 1998 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ret~ Sewer Upgrade for Lot 7, Bk 1, Spring Hills Estates S/D. To whom it may concern: The existing 3 bedroom house is served by an onsite septic system, and a private well. The drainfield will not pass an adequacy test, (and is encroaching groundwater) at this time, and must be upgraded prior to the sale of the house. Comments regarding the proposed upgrade m'e summarized as follows: I. GENERAL: There are a number of site restrictions which limit the available spots to put the new drainfield. These restrictions are summarized as follows: The protective well radius for the well located on the adjacent lot (lot 8, Bk 1, Spring Hills Est. S/D) to the south prevents utilizing the southeast portion of the lot. See the attached site plan. · During test hole excavation a buried brush pile was encountered just to the just south of the existing leachfeild, the limits of this bnried brush pile is unknown. · The existing septic system, and the protective well radius~ for the lot "consume" much of the remaining space oil the lot. · Groundwater was encountered at ,6.75 feet below grade on 2/11/98. This level will undoubtedly rise in the spring, diet~Jng that a shallow system be installed. Given these restrictions, it appears that the only suitable site for the septic upgrade is the location shown on the site plan (short of placing tile system along the north property line). Due to groundwater levels and limited space, we are proposing to install a bottomless, Intermittent Sand Filter ([SF), rather than a conventional mound system or shallow trenches. 2. SOILS: On Febmm3, 2, I998 a test hole was excavated and a percolation test was pe~Tormed at the area of the proposed septic site. See the attached log for soils classification and ground water levels. As can be seen fi'om the log, groundwater was encountered at 6.75 feet below ground surface. We anticipate that the groundwater levels will rise this spring, but to what extent it will rise is uncertain. Consequently, we are proposing a design depth (bottom of pea gravel) of one foot below the ground surface. This will allow for a 1.75 foot rise in the current water table, which is currently 6.75 feet below grade. 3. TRENCH DESIGN: Bottomless Intermittent Sand Filter (ISF) a. Percolation Rate: 5.3 migrates/inch b. Allowable Application Rate for ISF: 4 gallons/day/fi2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 112.5 ft2 £ Effective Depth: 2.5 inches g. Width: 18 feet h. Length: 20 feet. i. Effective absorption area = 360 ft2 (>112.5 fi2 OK) j. Air Supply: Thomas Industries, Model 5070, "Anchorage Tank". k. Air Supply Line: "Wasteflow" emitterline, i/2 inch I.D, "Anchorage Tank". 1. Sand Material: Central Paving Products "Winter Road Sand" m. Pea Gravel: 100% passing 3/8" sieve, less than 20% passing the 1/4" sieve, and less than 1% passing the #8 sieve. We are proposing to excavate clown to a maximum depth of 3 feet, place a minimum of 6 inches of sand, install the air supply line, and cover it with 1.5 feet of sand. On top of'the sand, we will place 6 inches of 3/8 inch pea gravel, with the pressure laterals midway in the layer. We will use a conventional lift station (Anchorage Tank), equipped with a programmable timer so that flow can be intermittently dosed to the 1SF. 4. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 5. TOPOGRAPHY: See the site plan for slope information. The slope is approximately level at the proposed site for the ISF. Just east of the proposed site for the [SF, the ground slopes upward at approximately 5% to the easement located along the east property line (see the l" - 30' site plan). To the south and to the west of the proposed ISF the slope is approximately 2%. Based upon our field measurements, it appears that the ISF will be at least 50 feet uphill from any slopes greater than 25% except for those slopes shown which are all uphill (to the north) fi'om the proposed ISF~ In short, there are no slope concerns. '~re/o~ 6. MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the construction practices will comply with DHHS' "Intermittent Sand Filter Design, Installation & Maintenance Manual". The contractor should read this document prior to construction. Copies are available at the Municipal Onsite Services office (Sth floor, 9th & L St.). ?. CLOSING: Given the site restriction, and the soil/groundwater conditions, I think the ISF is the most viable option for this lot. I am open to any suggestions fi'om your department, wbich would be an improvement to the proposed design. I am unaware of any adverse impacts this installation would have on adjacent wells (there are none within 100 feet) of the proposed septic system. If you have any questions, please contact me at 337-6179. Thank you for your assistance. S. Principal kJ c.c. Ann Dimino GENERAL LIDATIGN DF SEPTIC SYSTEM~~ LIT 6, D~< l, SPRING HILLS ESTATES '-'-- PRIVATE WELL AND SEPTIC SYSTEM PER M~D,h, RECORDS RESEARCH. 3DTTDMLESS ISF APPEARS TB 3E A LARGE UNDEVELBPE3 TRACT, NB WELLS WITHIN iOD FEET OF THE PRDPDSED SEPTIC SYSTEM UPGRADE. WELL WELL GENERAL LBEATION OF REPTIC SYSTEN LOT 8, ~]K l, SPRING H[L.LS ESTA' PRIVATE WELL AND SEPTIC PER N,O,A, RECDRDS RESEARCH, CBNTI:RAC 1-t31R NBTE NDTEI THIS IS NIT a SURVEY, THE LBCATION I]F AL[_ WELLS, SEPTIC SYSTEMS~ AND ~I'RUCTURES IS APPROXIMATE, THE C£1NTRACTBR SHALL VERIFY THE SEPARATIBN DISTANCE FRQN THE SEPTIC SYSTEM UPGRADE TB ALL WELLS BN ADJACENT LOTS, SEPTIC UPGRADE" LOT 7, 31< 1j SPRING HILL_ ESTATES PREPARED FOR: MIKE AND ANN ]DIMINO PREPARE]] ]3Y~ ALASKA WATER & ~/ASTE~/ATER DATE:~I/23/98 ! 1]RAWN: GARNESS ISCALE, 1' = 100' DF 1998, TOPSOIL, AND RESEEDING SHALL ~ ~E NEGDTIATED BETWEEN THE BUYER AND THE SELLER PRIOR TO ISSUING THE CONTRACT. THE CONTRACT[]R SHALL INCLUDE THESE ITEMS Ag A ~~ SEPARATE LINE ITEM ON THE BID, / ~ / EXISTING TANK TO BE k Xk / , > ~ ~ ~ ~ / - ~85 INCH HOPE LIN~ SLOPED MACK TD LIFT STA ION FOR ,mASE ~ N ~ ALLOW WATER TO OOLLECI'. ALL CONNECT- ..... ~ / ~ IDN~ SHALL BE STAINLESS gTD]L WITH NEW 1250 GALLON LIFT STATION, THE AIR CQMPRESSDR SHALL DE LOCATED IN THE GARAGE. ~ AT 114 INCH/FOOT MIN AT THE COMPRESSOR. NOTE A 30 PSI GAUGE WILl_ NOT WORK. ' THE CONTRBL PANEL FOR THE STEP TANK SHALL BE LOCATED PREPARED FOR: MR, ~ MRS, DIMINO ,~q .... PREPARED 3Y~ ALASKA WATER & ~ASTE~ATER -,,. ....' DATE~ 2/83/98 DRAWN~ GARNESS SCALE: 1" = 30' ~ .r... 1 INCH PVC / NO LINER ON BOTTOM, HEADER,--~ ..................... //-'- BYPRESSUREoRENC[],PIPINGAND SUPPLIEDDESIGNED PVC AIR LINE TO ~ ---f~> ~x, ~__~ BY ANCHORAGE[ TANK, t,25 ~NCH H~PE ~ X--' I .... ~-4 INCH DIA, MONIT[]RING LINE FROM THE STEP TANK,--~ ~ ~ .... TUBE AT EACH CORNER, ~ .... ! ..... ; "~ F'LUSHING VALVE AIR LINE CDIL I I~ (TYP), BURIED ~ITH SPACED AT APPPROX ~ t~ REBAR MARKER, ~ ' i 2 FEET, ORENCO / ~ASTEFLO~' TYPE e e PROVIDED BY ~ .... ~ %~ ~' , ANCHORAGE TANK,- ~-3/4~ PVC LATERALS *~o -'~ ~, *~*~,- /2' MINIMUM ~F~LTER FABRIC ~616~'~t~' s~ / F-cOVeR /ov~ ~ / /GRAVEL ~ BRIOINAL GRADE / ''~"'""'~T HIN UF FILTER SAND 6 . LAYER BF 3/8' PEA GRAVEL OTTE]MI_ESS ISF ETAIL PREPARE~ BY, ALASKA ~/AFER b ~ASTE~ATER DATE, 2/23/98 DRA~N, GARNESS SCALE, NTS - 7 8 9 10 11 12 Municipality ol Anchorage DEPARTMENT OF HEALTH & HUMAN: 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAl_ DESCRIPTION:_~['~.I I''~ (y 13 14 15 16 17 18 19 20- "DATEPERFORMED: ~[ILi.~//e? .'~! ~¢~[ownship, Range, Section: SLOPE WAS GROUND WATER /~ ENCOUNTERED? IF YES, AT WHAT ~ I DEPTH? t.~ ~' . pO E Oepth to Water Alter/-'Jr' / MenilerinD? _ ~,7'~ Dae: SITE PLAN Reading Date Gross Net Depth to Net 'rime Time Water Drop PERCOLATION RATE ~ '~ (mmutes/~nch) PERC HOLE DIAMETER TEST RUN BETWEEN LC _ FT AND _~(~ FT COMMENTS PERFORMED BY: ~ ~ ~ ~ ~: CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE ~'ALL STATE AND MUNICIPAL GUIDELIN~N EFFECT ON THIS DATE. DATE: 'eL " 72-008 (Rev. 4/85) MAR 12-1998 10:48 RE/MAX PROPERTIES INC. 90? 2?6 1504 P.OP PROPERTY OWNER AGREEMENT FOR 'DIE MAINTENANCE OF AN ON-SITE WASTEWATER DISPOSAL SYSTEM This agTeemc~t is made for the pm'pose of m~axahfi~g aa o;i-site wast~water disposal system on th~ subject property. The property owners agree tO ~e following: Submit to the Mmfieipaliry of Anchorage, on an atmual basis, an Laspoction and ol~mtiou statemeat ~om a reg~eted professional engi~e~. This impection a~d operafiou statement shall veri~ that ~e cngL~e~r has ~ected all effluent aud. pumps, timers, ~d alarms, and t~t auy deficiencies have been ~e.d and that the system is f~n~tio~ing ~ de$ig~d. ($ig~e) ($ilpature) (Printed Nacne) (Prh£ed Name) who i~ p~rsou~llY known co ma ~ ~ ~C~ ~ whose identity ~ prayed on ~he basl~ of (% ~(~ ,STATE OF ALA$1(A .J NOTARY ~UBLIC i] NAtALlf MICHliI,LI] TIERNEY J My comaission expires TOTAL P,02 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALYH & 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 MAILING ADDRESS LEGAL DESCRIPTION LOCATION Material II NO. OF BEDROOMS~.~. 5-~ee I Liquid capacity in gallons DISTANCE TO: / ~ 3 3 0 Tron~i~_ inches /~ inches Type of crib Crib diameter Well _l__. °2p'AN !i TO: TO: PERMIT NO,~ c/-0 ~/ Z Total effectiveabsolpti nar~a PERMIT NO. Crib deptl~ Total effective absorption area Ruildin9 foundation Sewer line ~_~1~ ¢ OTHER PIPE MATERIALS Septic tank APPROVED LEGAL 72 013 (Rev. 3/78) I:::'E!]:;;: H :1: T NO: 17:'F:ITE! F:IPI:::'I... ]: CF:IblT: I:::11::' E:' P. I!!i2:2; S: CONTRCT PHONE L E GI:::II... I..OT SIZE: I'"IFIX IE:tEDFi:OOH:5: I::liq C H O [';ff::l G [iL, f::ll< :Z:}i: 7'~"l.'-i;'F~!;!;:ii: F' IF;q: II~Z:: P.,,~ C:::: !1-..~1 liE: 'I:?.,I::i:I::'TH 'f'O F' ]: F'I!!: E',OTT'OI'I (f::'T.) 4. IZ~ 4. GRFIVEI.. DEF:'Ttl ':I:::'T'. ;:, 5. ~2) 'i"i]FFi:::ii_. DEF:'-FH ,::F:'T. ) E:L E) 4.. GRFF,,'EL. I...[EI",It;~TH (f:'T. ;:, ::~:8. E~ GF;'.I::rlVIE:L. 'v'O[...LIHE ,::CI...I. "r'C'2;. ::, :[.:~;L :Z: ;~::~.. TFII",Ik: S:[;;~IZ '::CJI::'IL.2;::, :1.., ~;]~'.~8. g~ ;.M.: i., EK~IEL :5Oll. [;;:l::l"l':l:l",li::i ':::~;6:L I:::"1'. ,."E:F;:) t2~'.~5 :1.2::[5 S0. S :1.25 :'['.+: TFINI.::: HI.Jr~;-I' III:::I',,,'E: FIT I..[ii]::r?l~ THO C:OMF'FII:;;:TI','IEN]":~; i THf:T'F': 1' I::]M F:f:IMIL. I i::iF4! [,.I]:"l'[I T;.IE I;~tE:IT.!UIP. IZI,KE:N]L'5 I::'OF:: ON-<E;ITIE ':'i.:,IEI.qE:I:;.:':'~ RNE:, I.qEL. L':_:; R:'~; SET F::'OFYl]..] 1!3"r' TI'IE MUNIC]:F'f::II...I]"¢ (IF: F:ff',ICHOI';:F:IC'iE ':;FIOFI) RI',IE) THIE !i;TFI]'E OF' I':'tL.I::I'.::;I::]::I. I I4iI.J... INL:i!;TFII.I. 1'HI'i: :ii;"r'STEM :[1",1 I::)CCOF~:[::,I:::ti",ICI:{ I.,.IITH FILL I"IOR I::ll",l[::, I1",1 CCIHF::'I_IFII',ICE: I'.I:I:"I'F'I THE E:,fii::i~;:[(2d',l E:RITEI;.:IFI OF THIS F:'EP.I~IZT. I I,.IIL. I.. FIC, H[ii:I:;~:IE TO f::ll...L. I'iOFI FIN[::, '.:.FTFIT['_:: O1::;' FILFI'.51-(FI REI.7!UI[;::[ZMEI'.,IT:5 F'OF~'. THE .':.:;ET BI:rICK E:'I:iT, Tf:INCE;'::J; I:::'F:OM f:tN"d EXI:~!;TING I'.IE;L.b HFIS"r'Eb. II::H"EI-(: DI'_:;PO'.SF:iL. ?.¢:!.FI"EM OR 'F'UBLIC :~;F.:I,.IIZf:~:FiGE :E;V:ii;'T'EI,I Oi~.,l T'HI:50lq: FIl",l"r' FII)J'F:iCENT OF;'. i",IEFIRE:',"¢ L. OT. I LII",II::)E{F;;'.'.E;TFIND THI:::IT TH]:S PIEI';;:HIT' I:~; ',,,~1::'11_I[) F'OF: FI MFIXIMUH OF 2:E~E[DROOM::5 FII",I[:, Fli',t'¢ ENL.FII:RC~EMENT I,.IIL. I.. I:;:Ei:g!l. JIf~tE FII",I F:I[:'[:'ITIONF'IL. PEP. MIT. IF' FI I..IFT :i;;'r'l:::Fl'lOI,.,I IS INSTFILI...[F:D II'-,I I:'IN FIFtlEf:I COVEI:REI) B'.r' MOF:I Ii~:UIL. DII'..IG COB, ES., THEN (:1.) FIIL. I.. NOT DE F:If:'F'f;;:O',,,'EI:)I.qlTl-IOt.Ff' I::11'.,[ E~L.EC'f'I:;:ICf:II.... II'.,tSF'EC:TIOI'.,I IREF'CiP. T.; Ri'.,ID C~:) T'HE F!!LEf:C'I"F~II]:F:IL~ I.,IOF:I< I'ILIE;'f' li~[E I?,Of',lE: E:'¢ I:::1 [...IC:E[",I21;ED E/LEJ]:TF2. ZCIFIN. .::, ]. I.~ f,ll::.[ .... ~ ' D FI'I"E~: -: ...... k:~ ........................................................................ :'F'I.. ): CFiI",tT: ): r,'l :[ Tra::, . SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMI:NT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchora§e, Alaska 99501 294-4720 SOILS LOG - PERCOLATION TEs'r PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION:__ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17, 18- 19- 20- SITE PLAN ENCOUNTERED? o P IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time 'rime Water Drop 0.53 PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN ..~--~, FT AND '~*~ ET 72-008 (6/79) tv1-w DRILLING, In¢, P.O. Box 10-378 * 10300 Old Seward Highway (907) 349-8535 ANCHORAGE, ALASKA 99511 84-256 DRILLING LOG Well Owner DESIGNS IN WOOD/SAM HIlL _Use of Well. Domestic Location (address of: Township, Range, Section, if known; or distance main road Lot 7 Block 1 Spring Hills Size of casing_ 6" Static water level Screen ( Describe screen or perforation None Well pumping test at 10 gallons per of drawdown from static level. Date of completior~_ gn~3mt 27, _1984 _ ~Depth of Hole_ 202 feet Cased to 201.30 feet 164 ft. ~,~) (below) land surface. Finish of well (check one) ); Perforated ( ). open end ( X ); (minute) for. i .hours with~ 100% WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 TI 2 Casing sticloap 2 T( 50 TC 65 T£ 70 _T£ 130 T£ 161_T£ 190 TO TO TO _TO _TO _TO __TO_ 50 65 70 130 161 190 202 Brown silty gravel Brown silty gravel - damp Silty water~ravel Gray siltw gravel Brown silt~Lg~av¢l_. Brown silty ~rave]._z damp Wa~erbe~r_iBg~graval_- Ttr~ad NWWA Certified Contractor C~_,,*mamte No'~. 814 & 9?3 1 -- CUSTOMER Municipality of Anchorage 'On-site Water and Wastewater Program (907) 343-790 : E Y Certificate: of On -Site Systems Approval Parcel I.D. 015-051-45 Expiration Date: 27 202 1.' GENERAL INFORMATION: Complete legal description SPRING HILL ESTATES; BLOCK: 1, LCT 7 Location (site address) 9501 Spring Hill Dr. *Anchorage, AK 99507 Current Property owner(s) Greg. & Sally Kessler Day phone 907-244-9961 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: Z Single Family (w/woADU) 17 Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 _ 4. TYPE of WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL Individual Well Individual Individual Water Storage ❑ , Holding Tank. ❑ Community Class Well ❑ Community Public Water System ❑ Public Sewer ❑ Waiver./Variance request for: - - instance: Received by Qate: COSA to be released to the engineer, unless otherwise requested by the engineers. COSA Fee $ FJJ� Ll 12.50 Waiver Fee Date of Payment u 1.994 90VLO Date of Payment. Receipt Number. Receipt Number. COSA 4 a o 11&0 waiver # 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: 4 �7_t /20 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 g000O�p� 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 o ��,.• SQOO encroachments may exist that were not identified during the evaluation. 'The operational life of all wells P. ' 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 9 TF1 workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and . •' • • • • • • I 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 systemJe '61r," S' orn "s. can be installed on the property in the event either of the current systems fail to perform adequately in OQ ° / r _ 9 3 44 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 �44 ( ti'7it party (including subsequent property purchasers) is not authorized, nor will it confer any legal right Q� Pt party a� whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved ```\��Q Conditional approval for bedrooms, with the �owir_@*��IT�tions.0 WATER AND m By: Original Certificate Date:_l �7Zv i The Municipality of Anchgy a Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representation 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: SPRING HILL ESTATES; BLOCK 1, LOT 7 Parcel ID: 015-051-45 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA Al Well log is filed with Onsite (or attached) Date drilled 8/27/84 Total depth 202 ft Cased to 201.3 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 2/7/20 Static water level at beginning of test 149.6 ft. B. TANK DATA Age of tank(s) 22 years In! S,,' Tank type/material Si EF+STEEL Measured operating fluid level in septic tank 49 ❑ Standpipes/foundation cleanout per record drawing Date of pumping L> D. ABSORPTION FIELD DATA Well production at time of test 4.2+ 9 p Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ No oliform bacteria is Negative Nitrate - I, i mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L rsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample C. LIFT STATION Required maintenance completed Age of lift station 22 years Lift station material STEEL Comments: Which system tested (date installed) 4/16/14 Adequacy test date 2/7/20 ❑ ALL standpipes present per record drawing Results Q Pass For 3 bedrooms Total measured depth from grade 4.0 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade ft (min) Water added 640 gal X N/A — pressurized field New depth 1 in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time 130 min depth into effective ❑ Code -required soil cover over field Final fluid depth 0 in Absorption rate 450+ gpd ❑ System presoaked NONE (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) N/A Gallons introduced gallons If yes, enter date Comments/Deficiencies: "BOTTOM ELEVATIONS OF ALL MONITORING TUBES ARE WITHIN 0.5 OF SAME ELEVATION 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 Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25'✓� Yes if No ft Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' ✓❑ Yes if No ft Neighboring Absorption Fields > 100' ❑✓ Yes if No ft Water Main > 10'✓❑ Animal Containment > 50' ✓❑ Yes if No ft ❑✓ Yes if No ft ✓❑ Yes if No ft Water Service Line > 10' ✓❑ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community 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' ❑✓ Yes if No ft Property Line > 5' ✓❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5'✓❑ if No Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Main > 10'✓❑ ft Yes if No ft Community Wells > 200' ✓❑ Yes if No ft Water Service Line > 10' ✓❑ 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' ✓❑ 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'✓❑ Yes if No ft Private Wells > 100' Yes if No 50'+ ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' ❑ Yes if No 50'+ ft F. ENGINEER'S COMMENTS 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 Rld % n 0 NCR ldatinic-; ance 1. r I ti Chvner - 'Add ri '3: f re�t Xci Legal I-Clesso, P D Septic Tank: -Shud-ae leveli f c he �s -PulmoilnI c�i corn�--Oef c Abs2rwfign Rick. fvel W -nches -Rushing valves, per approve design ru', 4 Ail, flushing vai, es operied, distribUtt" -n fifleS flUS.1he and IlLshir va Q Lift station, -Pump baske'l cleanad V r- 5, 0) -E-,4iotutwz e" uii:,ai t ft.,r deane"JI -Tar `ner flaait settinglin o h e, s �K�gh pp ffnat Sevi" es -Refe- J uunqg —I n C ervce oo;r, -Pu-- p on 60 's o n j S, P u r -i lo 'o ff minutes n u. -Aulative Iff-eti, ine cycles 'A 1;` -Cun'--iiative run lip'le io, r's -C)p ratlion s, sfactiory 1�io Aid System: .,A-r pump fifter ute--an.,s-d Wev no A;r p7essure P-- i -ruatea of lafte-s't ;-,nstaH or reblilic _S -A 5v -,A m ope ratJon -�ka-tjs;;Ctorvhl not sabisfactoi-v -De&cated electf-ical circui,t i"Q-ah, ing -Audible and visual af,'wrn inside dwelling wk -,:s) nok n M c s -7irrn -,v-,tI=rnq O_ri,,,,_ er3tjq c-for"A not `;"``'„P`;"``'„PrV e. Comments: A'S .......... Maintenance Provider: - I 't , Cornt.w� �er Q, i..._.. L r^ Dafte of maintlenance n A � e) -% -L-1144 —1-4 Parcel I.D. # 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 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent ~AC.~:- bo,,~7',~./'--~c~.-,--J Address Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: -~ ~ TYPE OF WATER SUPPLY: Individual well /% _ Community well Public water NO'f'E: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC a~testing to the legality and status of system. 72-025 (Rev. 1/91) Fronl MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As cer[ified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in com :liance with all Municipal and State codes, ordinances, and regulations in effect on the date of tt i~ inspection. ~r~ Alaska Water & Wast~w/a/,er Address ~rn~h~ra,~ /A~a~/995q 6. DHHS SIGNATURE ~ Approved for '~'~-~- bedrooms. Disapproved. 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 DH HS 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 engineers work. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502. Anchorage, Alaska 99501. (907) 34~/~ Health Authority Approval Checklist Legal Description: A, WELL DATA Well type Log present (Y/N) Total depth Z.~ Sanitary seal (Y/NJ if A, B, or C, attach ADEC letter. ADEC wamr~ system number Date completed /! Cased [o 'Z.~3 / Casing height (above ground) Wires properly erotected (Y/N) "[{"~.--'~ FROM WE~.L LOG Date of test ¢/ Static water level /~ ~ Wel eroduction /O WATER SAMPLE RESULTS: / Coliform .¢0 Date of sample: __ ~../'~ ~ · Nitrate AT INSPECTION, /~-/ g.p.m, do. l · 94-4- m~./~¢ Other bacteria Collected Dy: ~ I ~ 5 B. SEPTIC/HOLDING TANK DATA .~"~--~ Date installed ~/¢2 ~ Tank size / Foundation cleanout (Y/N) _ ~ __ Depressio~ ',Y/N) ~0 High water alarm (Y/N) Date of Pumping ~/~ Pumper C. ABSORPTION FIELD DATA Date inslalled ~ -~ 9oil rating (g,p.d./fF Length ~O Width f ~ Gravel thickness below pipe Effective ausorption area ~O Monitoring Tuba present (Y/N)_ Dat~~.st Results (Pass/Fail] Fluid depth in absorption field~~~ Immediately after Fluid dept~ (ins) Minutes later: Number of Comoartments 2 Cleanouts (Y/N)_Y' System type _ "/ _ Total depth h ~,"/ Depression over field (Y/N) /JO For bedrooms gal. water added (in.): Peroxide treatment (past 12 months) (Y/N) -"~-026 (Flev. 3/96)* ? Absb r'Tptfoa-mt~L~.~ g.p.d. If yes, give date D. LIFT STATION Date installed ~/~ Ma[~hole/Access (Y/N) High water alarm level at* Cycles tested Size in gallons "Pump on" level at* TI~-~ ~ *Datum "Pump off" level at* '~'-(~-----JP~ E, SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot /' ~0 ['~ Absorption field on lot / '70 / '~ Public sewer main /d/~-~ Sewer/septic service line <:~'O/'P On adjacent lots On adjacent lots I OL~/+ Public sewer manhole/cleanout Lift station {OO/ff.- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~'/+' Property line ~ ['¢- Absorption field ~' ~'¢' Water main/service line /0 [w Surface water/drainage /Of.) Wells on adjacent lots /00 /~' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 2 ~' '~- Surface water /069 Curtain drain Building foundation '7 % If_ Water main/service line Driveway, parking/vehicle storage area /OO/+' Wells on adjacent lots F. ENGINEER'S CERTIFICATION A I certify that I have de,~e/rmine~l,¢¢/u ~eld inspections and rev in conforman~h~¢//~%n effect on this date.. Signature k.~/,?/!?.J' ~ %~/ Engineer's Na~V ¢ d~ ~' ~; are HAA Fee St ~ ~ (:~" © 0 Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF I=NVlRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property owner J~Y~ u &/ ~o.~L ,~ L., Telephone: (home) Business Mailing Address (c) Lending Institution ~,/4_ -~,o.....~.~. ~ ~,~,,~ ~ t (' Telephone Mailing Address (d) Real Estate Company and Agent Address (e) Mail the HAA to the following address: (or check here ~,;~ if hold for pick up,) List contact person and day phone number below: 2. TYPE OF RESIDENCE ~ Number of bedrooms Single-Family 3. WATER SUPPLY Individual Well,~ Community [] Public [] Note If comrn'unity well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site~ Public [] Community [] Holding Tank [] Note: ff community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025(Rev. 7/88) Page 1 of 2 ~ J.o ~ e~d leAoJddV leUOR!puoo Jo su]Je/ ~ MUNICIPALITY OF ANCHORAGE (MOA) MUNICtPALII"~"~'~ORAe~NtSlO Health Authority Approval (HAA) ENVIRONMENTA~.~.~ DIV CHECKLIST - FEBRUARY 1984 APR 4 1989 RECEIVED A. WELL DATA Well Classification ~ ~ -% Well Log Present (Y/N)~ Date Completed Total Depth.~.~ Cased to ~ Depth of Grouting Static Water Level ___ J ~ 5 Casing Height Above Ground J L~ ~t Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FRoM WELL: To Septic/Holding Tank on Lot [,! ~ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line _ To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results ¢ Comments. 343-4744 Legal DescriptiOn: Lt~T 7 Jf A, B, C, D.E.C. Approved (Y/N) Yield Pump Set At "~ ¢'¢t¢'"~1 Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots J ~ "~ :5 ; On Adjoining Lots _ To Nearest Public Sewer Cleanout/Manhole B. SEPTIC/HOLDING TANK DATA Date nste,ed _No, o Compartments Standpipes (Y/N) ~--~UC~J~ _Air-tight Caps (Y/N) Y Foundation Cleanout (Y/N) Depression over Tank (Y/N) ~1~ Date Last Pumped _ ?'/:~ ¢/~ ~' Pumping/Maintenance Contact on File (Y/N) . I"I/A ;for Holding Tank High-Water Alarm (Y/N) ~//.~,.__ Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well J I J To Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course To Building Foundation To Disposal Field Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata I~., ~,~ Date Installed q/~ ~/ Width of Field I '7 Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well / ~ ~ To Property Line Type of System Design Length of Field Depth of Field Gravel Bed Thickness Statndpipes Present (Y/N) Date of Last Adequacy Test To Existing or Abandoned System on ; On Adjoining Lots ,~¢ ~ To Cutback (if present) 'J"//,~r! To Building Foundation ,"~ Lot To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area /-/¢ ¢ Comments D. LIFT STATION [ 0/k//_~_~ Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. _ _ /~ Signed '"'~ ~ Company ~ ~oJo/'e- v't ~).~O'¢''~ L ~ ~--'~ Date ~/~/~ ~ MOA No. Receipt No. Date of Payment Amount: Receipt No Waiver Fee: Engineer's Seal Date of Payment 72-026 (Rev 7/88) 8ack Page 2 of 2 A. WELL DATA MUNICIPALITY Ol: ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAl, PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 284.4,20 R E C E I V E D Legal Description: ~ 7-~-~ Well Classification If A, B, C, D.E.C. Approved Well Log Present (Y/N) _ Date Completed __~--- Yield Total Depth _~.(~.~._~ Cased tO ~ Depth of Grouting_ /2V'"/,-'~ Static Water Level .,/~2/7L' Pump Se, At Casing Height Above Ground Electrica Wiring in Conduit fY/N) Seearation Distances from Well: Sanitary Seal on Casing (Y/N) ____~( . Depression Around Wellhead (Y/N) _ On Adjoining LOtS ; On Adjoining Lots To Nearest Public Sewer To Septic/Holding Tank on LOI /~// To Nearest Edge of Absorption Field or Lot __/'~.~ To Nearest Public Sewer L ne. Cleanout/Manhole _~_____~_ To Nearest Sewer Service Line on Lot Water Semele Collected Dy ~.)! ~4./~,/~/l~z~o~L Date Water Sam p~e Test Results _~.4~t~.~,~' ° / Comments B. SEPTIC/HOLDING TANK DATA Date Installea -~ Standpipes '~,~/~/ Air-tight Caps (Y/N) (Y/N) Depression over Tankk '(y/N) Pump,ng/Maintenance Contract on File (Y/N) _/~///'J¢ Holding Tank High-Water Alarm [Y/N) Separation D slances from Septic/Holding Tank: To Water-Supply Well To Property Line ~'~/'"~-_ To Water Main/Service Line __ COL rse ~/ Comments Size //'~'"~ 6' . NO. of Compartments ~ Foundation Cleanout (Y/N) _ Date Last Pumpea _ I~/1~ _/~1~,, :,or Temporary Holding Tank Permil (Y/N) To Building Foundation To Disposal Field //___ To Stream. Pond, Lake, or Major Drainage Page 1 of 2 r2-026111/84 ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~ Width of Field Square Feet of Absorption Area Depression over Fieid (Y/N) Results of Last Adequacy Test Separation Distance from Absorption~Field: To Water-Supply Well To Building Foundation Lot /~//4 To Water Main/Service Line / Type of System Design / / Length of Field ,27' / Depth of Field Gravel Bed Thickness ~ ~'~ Standpipes Present (Y/N) Y . Date of Last Adequacy Test ./C~.~.~;','~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Properly Line To Existing or Abandoned System on ; On Adjoining Lots ,....z~"~(".'.2 ~ To Cutba,nk lif presentl Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that l have checked, ~verif.ie~r conformed to al~l~A a~nd HAA guidelines in effect on the date of this inspection, Signed '~.~ Date Company MOA No. Receipt No. _ _~'"'O) (~ ! Date of Payment Amount: $ Page 2 of 2 72-026 (lt/84) Engineer's Seal MUNICIPALITY OF ANCHORAGE 1 DEPARTMENI' 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 _-/O/1 GENERAl. INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name _~,~Lo'~'~';I~ Telephone: Home ~'~ "'1'~::~ Business Applicant Address ~ I ~]~ ~,'~] ~ ~ (c) Applicant is (check one): Lending Institution []; Owner/~,~der j~; Buyer []; Other (-] (explain); (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the lollowing address: TYPE OF RESIDENCE Number of Bedrooms Other WATER SUPPLY Individual Well [~ Community [] Public [] ' - Note: If community well system, must have written~donfirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE I:)ISPOSAL Onsit Public [] Community [~] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of I-=nvironmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) ENGINEERING FIRM PR()VIDII~,.~ INSPECTIONS, TESTS, FILE SEARCH, DA I'A AND INFORMATION " As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm .-~,-'~"-'~/~"~f-~-"~ Address/ Engineer's Seal DHEP APPROVAL Approved for v~,,.,.~' bedrooms by ~'~,A~ Approved l/~- Disapproved' = Con~al. 'Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and ,E,nyi[o, qmental Protection (DHEP) issues Healtb 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~gs a :courtesy to purchasers of homes and tbeir 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 72-025 (1 ~/84) CONSULIING ENGINEER TELEPHONE: (907) 279.39~ 6 WELL INSPECTION LEGAL: LOT 7, BLOCK ], SPRING HILL LOCATION: 950]. SPRING HILLS DRIVE OWNER JOHN HOLTON TYPE OF WELL: SINGLE FAMILY WELL LOG AVAILABLE: YES INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELL LOG: 10 GALLONS PER MINUTE PUMP YIELD: 5-6 GALLONS PER MINUTE DATE OF INSPECTION: OCTOBER 8, 1986 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OE 6.5 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. THE WELL WAS PUMPED TILL THE DRAWDOWN STABILIZED. STATIC WATER LVEL WAS FOUND AT 168 FEET BELOW TOP OF CASING. AFTER 15 MINUTES OF PUMPING THE WATER LEVEL STABILIZED AT 172 FEET AND REMAINED AT THAT LEVEL FOR THE DURATION OF THE TEST, ANOTHER 50 MINUTES. THE WELL RECOVERED 100 % WITHIN 5 MINUTES AFTER PUMP SHUT DOWN. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON OCTOBER 9, 1986. TEST WAS NEGATIVE. TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flew rate of the we].] may change due to subsurface conditions that may not be observed from the surface, and changes in land use and other factors that may impact t~he~conditions of the aquifer feeding the well. /il , .,.. , - - , ~>.',:, .,. ,. ANCHORAGE, ALASKA 99501 CONSULTING ENGINEER IELEPHONE: (907) 279-3916 S E P T I C S Y S T E M ~~ T E S T LEGAL: LOCATION: LOT 7, BLOCK 1, SPRING HILLS ESTATE 9501 SPRING HILLS DRIVE OWNER: JOHN I-IOL TON RESIDENCE: SINGLE FAMILY, THREE BEDROOMS WELL: PRIVATE, ON SITE SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: MAT-SU STEEL, TWO COMP. 1000 GAL. ABSORPTION SYSTEM: BED ABSORPTION AREA: 17X34= 578 SQ. FT. SOIL RATING: 125 INSTALLATION DATE: OCTOBER 1984 DATE OF PUMPING: ]DATE OF TEST: OCTOBER 10, 1986 ANCHORAGE CASSPOOL PUMPING OCTOBER 8, 1986 TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITB FOUR FEET OF COVER AND 52 INCHES OF LIQUID. THE TWO STANDPIPES IN THE BED HAD 2 AND 4 INCHES OF LIQUID. TOTAL DEPTH OF STANDPIPES WERE 60 AND 54 INCHES. CLEANOUT BETWEEN HOUSE AND TANK WAS DRY, CLEANOUT BETWEEN TANK AND BED HAD ONE INCN OF LIQUID. WHEN A TOILETT WAS FLUSHED WATER COULD BE HEARD FLOWING INTO THE TANK, INDICATING THAT THE INLET WAS NOT SURCHARGED. CLEAN WATER WAS ADDED TO THE SYSTEM AT A CONSTANT RATE OF 6 GALLONS PER MINUTE. THE WATER LEVELS IN THE TANK AND TIIE TWO STANDPIPES WERE MONITORED. THE ADDITION OF 380 GALLONS OF WATER CAUSED THE WATER LEVEL TO RISE TO 3.5 AND 6 IN THE BED AND 2.5 IN THE TANK. AFTER 98 MINUTES OF EXFILTRATION THE WATER LEVELS WERE 2.5, 4, AND 53 ]iNCHES RESPECTIVELY INDICATING THAT THE WATER WAS BEING ABSORBED BY THE SOIL. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF' TNE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year,...~a.m~'~-~t~~~..awater usage of the family being served b YSv,~,%l~%**~.~-~.v,~t*ons are outszde the control of ~he evaluat o*..:~S' se~,*ia':'~em. We can lsherefore not give any estimate ho~~_.~ ~q'%'°Oa ~e 'Bya.~m will continue to meet the-operationaa recui-i f~: · Jb,~a z.4 [97~ ,% .,~ 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) ~:~'~ //-~/'~ -- Telephone: Home (b) Applicant Name ~--~: '/¢/¢ , Business Applicant Address ._7.~' ~',~-~..-¢- /--~.A' ~'~ ,.-~,,~ --/~- (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [-I (explain); (d) Lending Institution __ Telephone Address (e) Real Estate Company a~d Agent Address Telephohe (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family/'/~ Multi-Family [] Number of Bedrooms Other WATER SUPPLY Individual Well.~ Community [] Public [] Note: If cornmunity well system, must have written confirm,ation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL. Onsite/~ Public [] Community [~] Holding Tank [] Note:lfco*nmun ywe system, ~ust l~ave writtea confirmatiOn from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 72-025 (~1/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and es of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein, I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of t_hi.j~i~spe_~ction. Name of Firm ~:-~_s~ .~.~ ~ ~ Date ~ '~ /~ -~ ~0/ Approved for'"~'~"~' ~.~::?oedrooms by Approved J D i S ~l~"O'v~ -~ ~-'~-~a ~)__ '~O~ Terms of Conditional Approval Engineer's Seal al CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based aolely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The [)HEP 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 72-025 n 1/84) r~cation: Client's Name: Address: BESSE, EPPS & iKYI~S 2220 EAST 88 AVt,INUE ANCHORAGE, AK 99507 (907) 349-6451 WA~ER ~ELL TES~ Initial Reading on Meter: ~/~ ~,~ .?-/ 7/ GALLONS GALLONS TIME GPM A VOLUME TOTAL VOLUME P~x]nct:i otl Ra t:e:/.jeff GPM 24--Hour Capaci NORTHERN TESTING LABORATORIES, IN(',, 600 UNIVERSITY PLAZA WEST, SUITE A FAIRDANKS, ALASKA 99701 907-479.3115 6957 OLD SEWARD RIGHWAY, SUITE 101 ANCHORAGE, ALASKA 99502 909-349-8623 D~'nking Water Analysis Report for Total Coliferm Bacteria TO BE COMPLETED BY CLIENT ~F~/PRIVATE JNATER SYSTEM NAME " ~ ' ' Mailin ddro~s Mo. Day Year Purchase Order No. SAMPLE DATE: SAMPLE TYPE: Routine [] Special Purpose [] Check Sample (for original contaminated sample with lab reference no. 2 [] Treated Water /~'Untreated Water Zip Code 6 7 8 9 10 FOR LABORATORY UaE ONLY O(rect Count TO SE COMPLETED BY LABORATORY Received at: I~--Anch. [] Fbks, Date Received c~_ I '~ "~ ~' Time Received / O ~ Next Sample Due ~ COMMENTS: SATISFACTORY ~ UNSATISFACTORY U RESAMPLE R OTHER BACTFRIA OB TOO NUMEROUS TNTC TO COUNT Date Tim~ WELL DATA MUNICIPALIiY u~ ~.,~'-,, ....... DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MO~4 HEAl. TH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 ENVIRONMENTAL pROTECTF~'~'[ Legal Description: .~,~ ~ ~,~,~'~' ' ~L~ ~ If A B. C. D.E.C. Approved (Y/N) Well Classification -~P/'~ ~,. Well Log Presen~N)_ Date Comp eted ~ - ~-- ~/ Yield Total Dedth ~,~¢.d,2: / Static Water Level Casing Hmght Above (~rouna Electrical Wiring in Condul¢~N) Separation Distances from Well: Deeth of Grouting ~--'~ Pump Set At -~' Sanitary Seal on Casing~N) Depression Around Wellhead (Y~ To Septic/Holding Tank on Lot /~/.// { ~' ; On Adjoining Lots To Nearest Eage of Absorption Field on ~ot /~ ~ ; On Adjoining Lots To Nearest Pubic Sewer Line .~ To Nearest Public Sewer Cleanout/Manhole ~/'. Tc Nearest Sewer Service Line on Lot .~/~ Water Sample Collected by ~~d/ ; Date Water Sample Test Results __ ~/~~,~ Comments SEPTIC/HOLDING TANK DA'rA Date Installed ,'? ".' -~ Size /// ~¢~'0 ~¢°-~1/-~-No. of Compartments ~ ' , Standpipes¢'N) . Air-tight Cap.iN) _ ____ Foundation Clea.~/ou~_E~N.) -- · Date Last Pumped ,/f/~'¢// Depression over Tank fY/~ '4'""/~ Pumping/Maintenance Contract on File (Y/N) , -- ; for ~'~ , Holding 'rank High-Water Alarm (Y/N) ~-"~.-~ Separation Distances from Seetic/Holding Tank: To Water-Supply We _ To Property Line / TO Water Main/Service Line /4- Course Temporary Holding Tank Permit (Y/N) _ / To Building Foundation / To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-02S 11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ..~'~=~/:~ /// Width of Field Gravel Bed Thickness Square Feet of Absorption Area -. Depression over Field (¥~:¢~.) Results of Last Adequacy~Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation / Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design -- Length of Field ,¢~-:'-~¢:~ Depth of Field '~'~4¢-'¢-4'~ / Standpipes Presert~N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots .-"'"¢2,~¢ To Cutbank (if present) ./,~/2 '/ 7' LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I h~o,,e'z)~ke~, verifie, d, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Company Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/841 / 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owne~ ,AL~ Mailing address ~:~l Day phone Lending agency Mailing address Day phone Agent Day phone Address (Jnless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL.: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72~25 (Rev, 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wasteWater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address EngineeCs signature ~ zr/-"~ I/'~7~F/~-~',--' --.. Phone ~_~_ c~ _ Date DHHS SIGNATURE · Y Approved for. *T"'/7//~:'~F'~c' bedrooms. Disapproved. 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 DH. HS 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 engineeds work. RECEIVED OCT 08 1999z Municipality of Anchorage ~ DEPARTMENT OF HEALTH & HUMAN ,SERVIGES~VtUNICi~EA~YL~;R$~NcC~ ....... ' bnwronmema ~erwces uivision ~ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description: ~-O-I- q ~Ft~. ~ <~pR,{~ ~J~u~- I~- Parcel I.D.:_~)I,~--~ A. WELL DATA Well type :~)¢-t~JC¢[~ If A, B, or C, attach ADEC letter ADEC water system number I'J-~_ _ Log present (Y/N) "~¢S Date complete~ ~ ..- ¢~.'7'~. ~z~.- Total depth "~-E~ i ~ ~ .3~¢ Cased to ;2-0 l Casing height (above ground) '~- Sanitary sea, (Y/NJ, ',~¢C-o Wires properly protected (Y/N) ~6~ FROM WELL LOG Date of test (~.~ ~;'7~>/-{'' Static water level {~¢z,[, We,. production l~ WATER SAMPLE RESULTS g,p.m, AT INSPECTION I¢~/ 'FC-~'T~-P ~p "// g,p,m, Coliform O Nitrate Date of sample: C~ -;;Z-"7~ 07 ~ ( ,'~'c~ Other bacteria Collected by: B, SEPTIC/HOLDINGTANK DATA Date installed ~2 '¢l¢-¢~' Tank size ~;)¢~:~ Number of Corr. oartments ~'- Cleanouts IY/N)_ Foundation cleanout (Y/N) ~r~-,~ Depression (Y/N) ~C~ High water alarm (Y/N). Date of Pumping Pumper C. ABSORPTION FIELD DATA Date installed ¢~I~--~ Length ~ Width Effective abserption area ¢ (~¢ Soil rating (g.p.d./fF o..¢~drrrO z4- l'~ / Gravel thickness below p~pe Monitoring Tube present (Y/N) "7,/ FD-ale'-o f 4 ~e.q~ m c._~ty t_e s t Results (Pass/Fail) leFlUid del,th in absorpt~io~'-before'YEtest~n.~ ~_~_~.~_~y-aftef--'-~-ga-~. wa~er a~de~ (in.)'. Fluid depth _~ (in~~ Abs~~ g.p.d. r~reatment (past 12 months) (Y/N) If yes, give date ~~ 72-026 (Rev, 3/96)* _ System type I, ¢,. ~-, ~2" _Total depth [, . Depression over field (Y/N) For LIFT STATION [(¢L¢/O ~--~,[~"L~, Date installed "~" Manhole/Access (Y/N) Size in gallons "Pump on" level at*'~r~ High water alarm level at* Cycles tested 4'7. E. SEPARATION DISTANCES Absorption field on lot Public sewer main Sewer/septic service line SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot I ~k¢~/q- ! On adjacent lots I~''~ On adjacent lots lOG f Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/blGC~tN6 TANK ON LOTTO: Foundation '~0~ Property line. ~'/''j~ Absorption field /-u-.~ ~[ Water main/service line l O/-t''~ Surface water/drainage ~-[~ Wells on adjacent lots l©q F. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line N ~_~ ! ¢~ Surface water ~/~ Curtain dr*n ENGINEER'S CERTIFICATION I certify that I h~Jetermin/¢~Jt~ru fi~l~e~ ~ections and Engineer's Name ~% HAA Fee $ Date of Payment Receipt Number Building foundation ~ ~ O Water main/service line. ! Driveway, parking/vehicle storage area Wells on adjacent lots review of Municipal ree~t~.'=~'~..,.e, ~/~c~vstems are ~,5,~.. ........ ~.~. ............ .: Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* 10/07/99 't'l~ t5:05 FAX 9073448770 IIIN'KO'S DI~OND BLVI) ~002 NORTHLAND PUMI:, N_G__ r-'~l 11301 WILLENE [)RIVE SOLD'ro: ' ..~/'~'"" ANCHORAGE, ALASKA 99~16 ~ PHONE: 344-7146 -- PROdEO'F No, PROJECT TITLE DESCRiPTIoN , L. ¢//'-,',,,? ./, ,','/ DATE UNIT PRICE TOTAL -- TERMs-NE'T'30 DAYS PLEASE PAY BY 11418 INVOICE CT&E Environmental Services Inc. 200 W. Potter Drive Drinking Water Analysis Report Total Coliform Bacteria Anchorage, AK 9951§-1605 Tel: (907) 562-2343 READ iNSTRUCtIONS ON. REV. E,.RSE SIDE BEFORE COLLECTING SAMPLE Fax: (907) 561-5301 MUST BE COMPLETED BY WATER. SUPPLIER. TO BE COMPLETED BY LABOID~TORY SAMPLE DATE: Month SAMPLE TYPE: [] Routine Repeat Sample (for routine sarspl~ with lab ref. no. ___~ ) //~ Speelal Purpose SAMPLE LO~ATION Duy 0 Treatmt Water ~ Untreated Water TIm~ Collec~d Coll~ By Analysis shows this Water SAMPLE to be: Satisfactory n Unsatisfactory Sample over 30 hours old, results may be unreliable Sample m) long in mmsit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. TIm~ Received [l/~ Antllysis lk'lon -- Annl~ticfd Melhod~ fl~._Membrane Filter MMO-MUG * Numbe~. of colonies/100 rsL ~ult* Dat~: Tin~: AnaLyst Fbk! Jun Faxed Client notified of unsaflnfactor~ result: Phomd Spol~wttb Faxed Date: , Time: BACTERIOLOGICAL WATER ANALYSIS RECOED MMO-M1JG~amd~ T~al Colffom Mersbmte ~ ~ COURt VeriflcaOom LTB ~ BGB Fecal Coliform Conflr~tion Final Membrane Filter Reported By .~~ . Colonle~/1O~ mi . COLIFINM_.. TIrse = Cellformtl00 nil ~ hfs ENVIRONMENTAL FACiLiTIES I~ ALAS~-~--ALIFORNIA, FLORIDA. ILLINOIS. MARYLAND, MIC''~IIGe'N. MISSOURi. NEW JERSEY. OHIO, WEST vIRGINIA ~w CT&E F-nvironmental Services Inc. CT&E Ref.// 995298001 Client Name Eaton, Brent Project Name/// 9501 Sp Hill Client Sample ID 9501 Sp Hill Matrix Drinking Water Ordered By PWSID Smnple Remarks: Client PO# Printed Date/Time 10/01/99 14:35 Collected Date/Time 09/27/99 19:05 Received Date/Time 09/28/99 14:30 Techlfical Director: Stephen C, Ede Parameter Results POL Units Method Allowable Prep Analysis Limits Date Date Init Nitrate-N Total Coliform 1.39 0.500 mg/L EPA 300.0 0 co[/lOOmL SM18 9222B 10 max 09/28/99 09/28/99 SCL 09/28/99 KAP M-UNIC.IPA.LITY OF ANCHORAGE ADVANCED WASTEWATER 'TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 2(c2 Day of NKF- i-1- of 20 by and between Ili(' -rt -la( -- .4 -,�tA (--z, 9? herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITlY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Otivner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as 115-0 Gn�W� 5.1. i - iv;� C'; --iv i�r��W QDSF located at (legal description) t i�1L 1 -fl LL5fu �; cif J P t_.o GL I LJ T � t� ��15 =cam 45 2. Maintenance. Repairs and Alterations. (Owner is required to read, understand and initial each section) its Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. % It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 /4 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. A4 Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. /* Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. 4 Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. /04— Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWbVTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Lay. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The Iaws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7, Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: (signature} Date: +r n -Y-- A-VIDuf ( 0 (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) _:A_ The foregoing instrument was acknowledged before me this)May of 20-& by v � NOTARY PUBLIC FOR ALASKA a> Q� : •' . ;�� so My Commission expires: i� oca �a N�:uoAUSLIG '•��j�•; RES..-* OF Al-P'Smm�`` NIUNICLpALITY: By (signature) Date: Z7 (print name) Title: (rev. 05/18/2018) Page 3 of 3 z /V 89 59' E 28229 o �C� 0 Alk S,v4o ��,vnscsvFrnNot�crrr cr.' 4�9 1H - THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TD SHOW ANY SHANE A. HOLT QO CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; A14D IS 11P LS -6914 5 NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. Q EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN 40��0jessi0na�Qo HEREON ( UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. AS -BUILT SURVEY 1" = 30' WJ Cq "'SETT: = I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY 1077 6C0G1 ? SPRING HLLS 15TATIS (PI/I 33-332) ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE, ALASKA THIS 13 RD DAY OF Aa RC,Y , 2626 14561 F3203-34 F+OLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 99507 345-5513