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FORELAND VIEW BLK 3 LT 1
Foreland View Block 3 Lot 1 #017-401-49 (Rev 05/0211 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251267 PID Number: 017-401-49 Dwelling: X Single Family (SF) El with ADU El Duplex (D) El Two Single Family Project: n New FE -1 Upgrade Name Kathleen Moran A ORPTION FIELD Tr c rE01 De Trench El Wide Trench n Bed n Mound Site Address 8521 Spendlove Dr Othe Phone Number of Bedrooms Soil Rating Total depth from original grade 13 /SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original de Gravel depth beneath pipe "I Ft. Subdivision Block Lot Foreland View 3 1 Fill added above original grade Gr I length Ft. Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Dist e between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between t chis From Tank Field Tank Line Ft2 Well >100' N/A N/A N/A >25 TANK [] Septic F!] S.T.E.P. E] Holding [] Other Manufacturer Anchorage Tank Capacity 1500 Gal. Surface Water >1oo- N/A N/A N/A Material Epoxy coated steel Number of compartments 2 NA Lot Line >5, N/A N/A N/A Foundation >1o, N/A N/A N/A ttFT-,STATION Manufacturer —�.. Capacity Remarks Deep -burial tank Gal. Alarm location i Electric ailed by PIPE MATERIAL House to tank D3034 drainfie[dTankto D3034 Installer A+ Home Services Drainfield D3034 CO/MT D3034 Inspector Jared Earls BENCH MARK (Assumed elevation) 100 ft ection 1m 9/25/25 Inspdates: Location and description 2 Bottom of siding by deck SW corner aro 4th ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp FA Conditional Approval: Date low, 49 k Benjaq'n Schiller CE 12592 Se Septic Syst �t Approved Dat 10/7/25 0 ��ei ... 4 �� PROFESS0 — e: this approval does not include well permit require ents. (Rev 05/0211 CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FD - FLOW DIVERTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND PERMIT # OSP251267 PID # 017-401-49 1"=40' FORELAND VIEW, BLOCK 3 LOT 1 FEET 0 40 80Benjamin Schiller CE 12592 R E GISTEREDPROFE S S I O N A L E N G INEER 10/8/25 SEPTIC AS-BUILT 3-BDRM HOME EXISTING TRENCHES TO REMAIN IN SERVICE EXISTING WELL UNDEVELOPED 1500-GAL STEP TANK 10' UTILITY EASEMENT A B 2CO 15.0 MH1 15.9 MH2 19.3 31.2 33.0 39.2 A B 2CO MH1MH2 PROFILE AS-BUILT (NO SCALE) MH PERMIT # OSP251267 PID # 017-401-49 FORELAND VIEW, BLOCK 3 LOT 1 2C O Benjamin Schiller CE 12592 R E GISTEREDPROFE S S I O N A L E N GINEER 10/7/25 1500 GAL STEP TANK93.6 89.0 94.3 98.2 MH 2" INSULATION 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: OSP251267 Work Type: SepticTank Upgrade Tax Code Number: 01740149000 Site Legal Address: FORELAND VIEW BLK 3 LT 1 G:2841 Site Mailing Address: 8521 SPENDLOVE DR, Anchorage Owner: MORAN KATHLEEN Design Engineer: FORGE ENGINEERING This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 8/18/2025 8/18/2026 76063 ❑ 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 Receiv( Issued I Date: 8/18/2025 Date: 3 MUNICIPALITY ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section ON-SITE SEPTICIWELL PERMIT APPLICATION Parcel I.D. 017-401-49 Property owner(s) Kathleen Moran Day phone 907-240-2248 Mailing address 8521 Spendlove Dr, Anchorage, AK 99516 Site address 8521 Spendlove Dr, Anchorage, AK 99516 Legal description Foreland View Block 3 Lot 1 Number of Bedrooms 3 Engineering Firm Forge Engineering Building Permit Number Not Applicable R APPLICATION IS FOR: APPLICATION IS AN: (® all that apply) Absorption Field ❑ Initial ❑ Septic Tank Upgrade Holding Tank ❑ Renewal ❑ Privy ❑ Well ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Tank to foundation (6.0, 8.4) Tank to Deck support (2.5') Distance: Varies Permit/Rush Fees: P2 j Waiver Fees: Date of Payment: 7/36/1f Date of Payment: t/ Permit No. 9 22 % Waiver No. August 13, 2025 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Foreland View Block 3 Lot 1 – 8521 Spendlove Dr. Septic system design Dear On-Site Services Engineer: The owner of the above lot has a 3-bedroom home on the property with a 33-year-old tank, we are submitting this permit application for the installation of a new tank. The attached site plan identifies the location of the home as well as the proposed tank location. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. Our current plan is to install a 1000-gallon tank in the location of the original tank. However, we are not yet sure if we can meet the exception requirements for the distance to the foundation. As a precaution, we have also prepared a plan that incorporates a 1250-gallon STEP tank, which we can use if we are unable to meet the exception at the time of installation. Please refer to the attached plan for the tank replacement design. We believe that if this design is followed, there will be no adverse impacts on adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251267, Ben Cogger, 08/18/25 CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FD - FLOW DIVERTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND 1"=40' FORELAND VIEW, BLOCK 3 LOT 1 FEET 0 40 80Benjamin Schiller CE 12592REGISTEREDPROFESSIONA L E N GINEER 8/13/25 SEPTIC PLAN 3-BDRM HOME EXISTING TRENCHES TO REMAIN IN SERVICE EXISTING WELL UNDEVELOPED 1250-GAL STEP TANK ENSURE 10' SEPARATION TO FOUNDATION AND 5' TO TRENCHES CONFIRM FCO OR ADD 2CO BEFORE TANK Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251267, Ben Cogger, 08/18/25 a. HOUSE DETAIL Scale: 1" = 30' Lot 1 \ 74'03 5g lV 129.96' \ SPEND o E \ ACCESS EASEMENT DRIVE '\\ a=1 Q �' • a C4O�4000 M n � OQ: q o• a I I rn OP N: Q � Y �� t��o a p Su : : aE�`oo Z m 0000�� U O O m O m a c m E LL Q Q O % Em mom o me I1(0m -.crn - a m Ne m Y t o T > Q 0 , N i OLcn,, N C Om�cc m nnO mOmp O OO O ON C N OOC I °)°oML0 °aa°Em m NI c� O O m 0 O L Z o 1 m C I m m Lot 1 1 c`Fa00Cc I m` �i i mSE�F ZNm mr =I� sZ+0-mL me cL 30ccv c O— � L m 0. I O 7 t 0 0 0 L m p• o La q`v T m a C.)m m N C tin ��om— N c m 0 3 m I O U COO I C •_ 0 W N C Tm a I Ca X1 U L>2 a C X O 3pL J m O inJ >gocaOT o ; Wt o _ m m o�N m I a Q Lm�mrmol > a m= c s m �I x .« m OMC r0�-0 'I � CO «le O mL O m 0 N TU 0 p_ C+ m C L .r O m m m C m Oa ` Vl tm0 OECD w m0 ^l m O m m m 0 t m L D- �r J O 0-E 3 00 C «mmeo E2E0Lmm3=:E- a c`°Cm am z°n 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: SW 9/ 03/f PID Number: D/%—#O/ �Af Name: L Wastewater System: XNew ❑ Upgrade Address: ;ZO4 016kZZ.41V,0 A - O/ 41V(_# ABSORPTION FIELD Phone: ,L /- 11 No. of Bedrooms: ❑ Deep Trench XShallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: D. Total Depth from original grade: G GPD/S . Ft. L� U Lot: Block: Subdivision: 0A1'E1_4AIP Depth to pipe bottom from original grade: Gravel depth beneath pipe W /'0 Ft. 3 d Ft, Township: Range: Section: FIII added above original grade: Gravel length: , c2•5 -Ft. 7r "A Ft. WELL: XNew ❑ Upgrade Gravel dept},' W,, Number of lines: Dis encs between lines: Classification (Private,A,B,C): Total Depth: Cased To: 7107 Ft 140 FL Total absorption area: I O Ft. Pipe material: Ft. %fid SG. Ft. 317.314 /16 7M Driller: Date rilled: Static Water Level: 41 P//k/6 Law(o 9 14 5 Ft. Install r:/ M� Ja Date installs : / Yield:0ev Pump Set at: Casing Height Above Ground: GPMOAlkhOW Ft. Z Ft. TANK SEPARATION DISTANCES Xseptic ❑Holding ❑S.T.E.P. To Septic Absorption Lift Holding cul WPrivate Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines L,vc�.-= T -Nr fDOO Well /D6 13v a///] �S Material: S+e Number of Co partments: Surface Water N/� JU A NIA q J1J%A LIFT STATION Lot Line 6a2 ' /0 14 I ,{ / ,4 /'� j'/0 / Size In gallons: Manufacturer: Foundation IN14 /t7 ,r /�{^'/A/APumpae f� "Pump on" level at: m evel at: High water alarm at: Curtain Drain 11An' /7 /`r A A & Electrical Inspections performed by: Remarks: BENCH MARK rZ r MOU110ED L! D Location antl Description: -Z 35 P51 ORIAL FOs3 Nt 01/6,e_ rr Assumed Elevation: A510149 ENGINEER'S SEAL r V. n Inspections performed b : Dates: lst//A /9/ feeee.ao 2nd Z/ZQ0/ aacn Department of HealM and Human Services approval Tg selams .4. Rut®ra t.%' 1 CE -673a �f® Reviewed and approved by: Date: Permit No. SW 910347 94.4' Page Z of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report uescription: rucciana view. Lot L. block PID No.At7_401_49 S 0°03'58" E 100.00 (NOT TO TANK 12-013 A(2/91)MOA 25 FIELD SCALE 1' = 60' UI U ASSUMED ELEV - 100.00' FILL y 91 q2 8].67.6i1"f LEACHFIELD ENGINEER'S SEAL-.. i, WATER SOL aSfZ (TH p2) ( ba x0 x SWING TIES A -C 27' B -C 14' A -D 60' B -D 18' A-E 59' B-E "G'4'— 21 - TEST HOL •- - MONITOR o - SEWER C 4 - WELL ,TT.i,T.Tr. - PROPOSE = 180.00' - - - - EASEMENT. = 34.33' ASSUMED ELEV - 100.00' FILL y 91 q2 8].67.6i1"f LEACHFIELD ENGINEER'S SEAL-.. i, WATER SOL aSfZ (TH p2) ( ba x0 x JUN -17-1.31.2 WED S : 09 A - P . 04 . -. STATE OF ALASKA STATIC WATER LSVOL: 41S ft. Date material type ana Color DZPA.RTMENT OF NATURAL. RESOURCES .. METHOD OF DRILLING: fesair rotary ©cable tool other: ._.._.__ DIVISION OS GEOLOGICAL AND GEOPHYSICAL SURVEYS ` WATER WELL RECORD LOCATION OF WELL USE OF WELL:j3domestio Dirrigatioll []monitor ❑ public supply []other: BOROUGH iUUDIVISION LOT BLOCK SECTION QTRS TOWNSHIP RANGEAN MERIDI �0 `g I-1 �y.,-y�- ��•.r4d2xD._,�"• /"" IS �L� .P I WELL OWNER:..T._ MEASURING POINT: /atop of caning © graumt surface other. BOREHOLE DATA: Depth WELL DEPTH:ft Depth of hole: Depth of Caging:'11ft DATE OF COMPLETION / STATIC WATER LSVOL: 41S ft. Date material type ana Color From I To .. METHOD OF DRILLING: fesair rotary ©cable tool other: ._.._.__ .,..14 USE OF WELL:j3domestio Dirrigatioll []monitor ❑ public supply []other: CASING: Stiok-up ==.-w t: DSam: in WELL INTAKE: Aa open end Q :screened El perforated amen hole Depths of openings: to ft �0 `g �y.,-y�- ��•.r4d2xD._,�"• /"" !SO SCREEN`,YPE; Diem: in Slat/Me ahllzes,.r�Length _eft Set Between and `'ft- r GRAVEL PA PE: _ Volume used: Depth t0 .top:--.r.�..,. .. GROUT TYEVolume:._....... Depth: fxom t,toft DEVELOPMENT METPIOD:�� �- Duration R E C E 1 E REMARKS. JUL 91992 Munlcipallty of Anchorage Dept Health & Human Services CONTRACTOR INFO t TIONf — _ w j �� i A A I — PUMPING LEVEL ANA IELD: -� �--ft after hra pumping-Ypm PUMP INTAKE DEPTH .-£t HOxgepower:`� Date Pump Installed �- WATER CHEMISTRY SAMPLE TAKEN? Q yds an .. .. . , . . . . .. 0 Date PLEASE MARL WHITE COPY OF 1,06 WITHIN .45 DAYS TO: DGGS PO BOX'77-2116 EAGLE RI'V'ER, AX. 99577 PERMIT NUMBER:SW910347 DATE ISSUED:10/28/91 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES EXPIRATION DATE:10/28/92 OWNER NAME:SINES MARK OWNER ADDRESS:P.O.BOX 112876 ANCHORAGE, AK 99511 PARCEL ID:01740149 LEGAL DESCRIPTION: FORELAND VIEW BLK 3 LT 1 LOT SIZE: 76063 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY ISSUED BY: DATE: zezo I/ 9/ DATE: PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE s� i usp� roc DEPARTMENT OF HEALTH AND P.O. BOX 196650, 825 "L" HUMAN SERVICES STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW910347 DATE ISSUED:10/28/91 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES EXPIRATION DATE:10/28/92 OWNER NAME:SINES MARK OWNER ADDRESS:P.O.BOX 112876 ANCHORAGE, AK 99511 PARCEL ID:01740149 LEGAL DESCRIPTION: FORELAND VIEW BLK 3 LT 1 LOT SIZE: 76063 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY ISSUED BY: DATE: zezo I/ 9/ DATE: Male RAT(ti' ��1�Il�QQpIl�1� 3QpA710M Louis Butera, P.E. Registered Civil Engineer R E C E I V E October 23, 1991 John Smith, P.E. Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Foreland View, Lot 1, Block 3 Narrative Dear Mr. Smith, OGT 2 3 1991 PPiunicipallty of Anchorage Depi. Health & Hurnan Services The proposed septic upgrade will have very limited impact on adjacent properties for the following reasons: 1. The area has large lots allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance if installed. 3. Reserve space is adequate. Well is sited appropriately. 4. Drainage will not be effected and is not a major consideration in our design. 5. The installation of the leachfield will require the leachfield be installed on a 33 % slope. This will require a variance from the MOA 25 %- limit. The soil has an adequate percolation rate to prevent effluent seepage from the hillside and there is sufficient separation to the road grade break. Neighboring septic leachfields are installed on this slope, and there are no alternatives for this lot. The system is designed 7' off suspected bedrock layer. Bedrock depth is conservative at 12'; we have a test hole at 30' distance showing bedrock at 14' depth. System is also conservatively designed at 0.6 GPD/ft2 based on worst of three test holes. This will allow greater effluent dispersal. Over 85.5' of trench or a maximum of 5.3 gallons per foot per day. A distribution box will be utilized to maintain equal distribution, an effluent pumping system would be prohibitively expensive. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. P.O. Box 773294 • Eagle River, Alaska 99577 • Telephone (907) 694-5195 • Fax (907) 694-3297 SPECIFICATIONS FOR ON-STTE SEPTIC SYSTEM Revised 10/23/91 LEGAL: LOT 1, BLOCK 3, FORELAND VIEW A. GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified or modified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. B. DRAINFIELD 1. The drainfield is to follow the natural land contour to maintain uniform total depth of the drainfield bottom. 2. The bottom of the drainfield shall be level, plus or minus 1.5". 3. The total depth of the drainfield excavation is not to exceed 4' at any point. 4. The drainfield gravel is to be covered with typar fabric material. 5. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield. 6. The area over the drainfield is to be finish graded to prevent ponding of surface water runoff. 7. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 4' GRAVEL DEPTH = 3.0' DRAINFIELD LENGTH = 85.5' DRAINFIELD WIDTH = 5' SOIL RATING = 0.6 GPD/ftz BEDROOM CAPACITY = 3 SEPTIC TANK SIZE = 1,000 gallons (minimum) NOTE: 2' mounded soil cover 2" 35 PSI burial foam over trench, tank and all flow lines Install level tee fitting to distribute effluent evenly to each trench. Twenty-four (24) hours notice required for all inspections. EAGLE RIVER ENGINEERING SERVICES P. 0. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694.5195 3 JOB L-O'r/ dl"Il 3 �o"�.7mro� (//B�✓ SHEET OF CALCULATED BY L '-ff DATE /"/1 3/11 CHECKED PRIVATE WELL AND SEPTIC + 100' NO COMMUNITY WELL _ F--10' I _ _ _ — 10' TELE. ESMT. — — — — — — — — — — — — — — — I I q I� I w JG NI w I w u NO DEVELOPMENT �- �t y W VELL\SEPTIC I o W I = /- I VEPJ a( z ! w o. LOT 1 I I BLOCK 3 PWEOSLO 3 OMN00 I I ' 0�1 I !` M v 100' R 2 j ! 160 .X, TANK 0* REPL. 0 4 a ! AREA 2 j �/ �33 y /! Dor t. ti O DEVELOPMENT 'li3Y, W / h R = 30' AV L = 34.33' 34. I ® — TEST HOLE • — MONITOR TUBE SCALE 1' = 60' 0 — SEWER CLEANOUT + — WELL — PROPOSED LEACHFIELD NO KNOWN CURTAIN DRAINS - — - - EASEMENT WELL AND LEGAL: FORELAND VIEW OWNER: MARK SINES CONTRACTOR: HAGMEIER JOB # 91 -1421 DATE: SEPTIC PLAN LOT 1, BLOCK 3 10/22/91 SCALE 1" = 60' EAGLE RIVER ENGINEERING P.O. Box 773294 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) SER VICES 694-3297 4%1- OF A4s10 * :49TH* I c LOUIS A. BUTERA CE -6736 OCT -11-91 F= P- 1 1 2: 32 A �, "•�' �� j 'Munlcipbllly'at,AAehor�ge , ' DEPARTMENT OF HEALTH A HUMAN `68RVIC&S'' , A25:"L" Street, ApchoragevAlaska 99502-oeSo =0 LOG ,,: P'EpOOLATION TEST ' _ P _ 0 1. y�.,(�IvQiweEq•59 •}�• . e; r ^�.,� 04 PERFORMED DATE PERFORMED I 'J "'•V . LEGAL OF.$CAIPTION• L-,1 $ Townshlp, gange, 5oction: ocPTii AjRI LAua5 V I6KJ sLOPs SITE PLAN _..._ IFEtrI 3 p a elZl.y Cwt fte:D 3N4 6 , OOMMENIS WAE6F OVNQ WATa . y Ft 'IFY98. AT WHAT NTH? PBACOLIjT10N RAT! ' B • 8 VENOM=' to 11 �.rO _ 12 13 14 is ,18 " q t8 19 Zd OOMMENIS WAE6F OVNQ WATa . y Ft 'IFY98. AT WHAT NTH? PBACOLIjT10N RAT! ' VENOM=' �.rO no A0 HQLZ DIA6)1ITER TEST ALIN BETWEEN ... PT AND FT k. Q Arm.-. Ate" I eA 4" ✓ 9P 1% D AAAA PERFORMED BY; K U: 'Kat3r:= r=M 1 0-1-016 TH, AT 1'HISMST .WhAI PERFORMED IN J OCORDANCE WITH ALL STATE AND MUNICIPAL OUIDECINES IN EFFEOT ON THI$ OATS, DATE; -- ,12•004 IR4v.4"951 G a: 4o �03 0t4g-- kat a oo �• ^ '• ranrt faX transmittal memo 7871 P E � ,. JOB Lo t / /f/tf 3 /—ore 1A . of EAGLE RIVER SHEET NO. / OF ENGINEERING SERVICES P.O. Box 773294 CALCULATED BY L'� DATE EAGLE RIVER, AK 99577 694.5195 CHECKED BY DATE Kai BH Ism a.ml msi lrnew� ®. n�: sam w.. m n i. to s�a� BWM rou rsB immmm 1 L SOILS LOG MUNICIPALITY OF ANCHORAGE Jk rI/rlo +.r DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: ���-+� 49 �'+-�e/ B DATE PERFORMED:w/�/`J/ LEGAL DESCRIPTION: �i'� / /-'thy-7 fie. /4.. a( (/ieN Tf/ -I- -r/4 Od I-T«Oa SPT SLOPE SITE PLAN E /v/n ta/ L+lye s- 1 2- 3- 4- 5d3 45 t O 12 13 66 m) c,.�t Ro�ir /,�rev✓r✓ o ry 14 Date Gross Time Net Time 15 Net Drop 16 3'-� his` 1 i6 17 18 PnCFF= 19- TS3\ 20 COMMENTS rH WAS GROUND WATER S ENCOUNTERED? tiV LO 3a P IF YES, AT WHAT E DEPTH? 7 c(. yr Reading Date Gross Time Net Time Depth to Water Net Drop 3'-� his` 1 i6 PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN 3 FT AND ' FT Eagle River Engineering Services PERFORMED BY: P. n. Rnr 773P94 CERTIFIED BY: �DATE: Eagle River, AK 99577 6945195 72-008 (6/79) 1 SOILS LOG 'r MUNICIPALITY OF ANCHORAGE g PERCOLATION 1 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION resr 925 L. Street, Anchorage, Alaska 99501 284-0720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: -TVA /74 P',,'e"C— DATE PERFORMED: LEGAL DESCRIPTION: ��'� / /�/L!3 f e/ vi//e`- Ty #/ SLOPE SITE PLAN EPT 1 Toru/ / L +•ye i 2 G ' 3- 4 6 5 U 6- CG m) ,S/%f4) 6+�r�� Gra•+-f. 9 /3ru.✓../ O+J A, fir. r WAS 13- Date Gross Time Net Time Depth to Water Net Drop 4- /•/is-�5I t "r" a.13 ti 15 T Via^ 3r'i'iE:F ,A 16 '�' 3 8 VDy9v¢am'gonv 17 �V � q. Louis .n. Fulcra 8 T CE -6736 so De• 0 8 18- 2: 3q 3, g FI/6 3 �6 19- 19 20 WAS GROUND WATER ENCOUNTERED? No zil■ IF YES, AT WHAT DEPTH? Tor ;N rAP n Reading Date Gross Time Net Time Depth to Water Net Drop SOq /•/is-�5I /It3��try6w T 3 /. �; • Y 3 8 3 7%c 3 2: 3q 3, g FI/6 3 �6 3 . F./6 PERCOLATION RATE E-' 3 (minutes/inch) TEST RUN BETWEEN 3 FT AND y FT PERFORMED 8V: Eagle River Engineering Services CERTIFIED BY: DATE: /o d "t5 Eagle River, AK 99577 6945195 72009 (6/79) Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251465 Parcel ID 017 -401-49 Expiration Date: Legal description FORELAND VIEW BLK 3 LT 1 Site address 8521 SPENDLOVE DR Current property owner(s) FORGE ENGINEERING X The On-site system(s) is/are approved for 3 bedrooms e 7/17/2026 Conditional approval for bedrooms, with the following stipulations: Comments or conditions: No comments Original Certificate Date: 10/28/2025 Th s Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject Otem(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE Development Services Department e: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Darn 1 I n 017-401-49 Complete legal description Foreland View, Block 3 Lot 1 Location (site address) 8521 Spendlove Dr Current property owner(s) Kathleen Morgan Day phone 2. ON-SITE SYSTEMS SIZED FOR BEDROOMS 3. TYPE OF WATER SUPPLY: RE Private Well serving #1 dwelling units 0 Other Non-public well as regulated by MOA 0 Water Storage F Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: � Private Septic F Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 6. SEPTIC TANK: Fk Steel F-1 Plastic ❑ Concrete R Fiberglass Age New - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: [] AWWTS ❑ Bed ❑ Deep Trench Fm� Wide Trench 7 Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $_ 5-5-b— Waiver Fee $ Date of Payment COSA # Date of Payment Waiver # COSA Application—Apr2025.doc COSA Checklist Legal Description: Foreland View, Block 3 Lot 1 Parcel ID: 017-401-49 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA ❑■ Well log is filed with Onsite (or attached) Date drilled 116192 Total depth 208 ft Cased to 16 ft ❑■ Sanitary seal is functioning correctly ❑■ Wires are properly protected Casing height (above ground) 20 in. Date of flow test for COSA 7/17/25 Static water level at beginning of test 145 ft. Comments Well production at time of test 6.6 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑■ No ❑■ Coliform bacteria is Negative Nitrate 2.60 mg/L E]Nitrate less than MRL (ND) Arsenic ug/L ❑■ Arsenic less than MRL (ND) Collected by Forge Engineering Date 7/17/25 B. TANK DATA C. LIFT STATION Measured operating fluid level in septic tank New ❑ Required maintenance completed Date of pumping Age of lift station New years ❑ Required maintenance completed, if AWWTS Lift station material Comments: D. DISPOSAL FIELD DATA Which system tested (date installed) 1991 FE -1 ALL standpipes present per record drawing Total measured depth from grade 5.8/5.1 ft (max) Measured depth to pipe invert from grade 2.8/7.1 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 372' ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced NSA gallons N/A date Any rejuvenation treatment (past 12 months) N/A If yes, enter date Comments: Adequacy test date 7/17/25 Results II Pass Fluid depth prior to test 0/29* in Water added 643 gal New fluid depth 1'5/29 in Elapsed time 73 min Final fluid depth 0/29 in Absorption rate '450 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 36 in Effective depth used 0/36 in Effective depth remaining 36/0 in Comments/Deficiencies: *Trenches labeled north/south. North trench had broken/blocked lateral visible in cleanout, south trench was receiving most effluent and was full. North trench absorbed all req'd water for testing. Lateral fixed at construction. COSA Checklist_May2025.docx E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100' ❑E Yes if No ft Neighboring Tank > 100' ❑� Yes if No ft Disposal Field on Lot > 100' ❑■ Yes if No ft Neighboring Disposal Fields > 100' R Yes if No ft Sewer Line/Main > 100' R Yes if No ft Sewer Manhole/Cleanout > 100' ❑� Yes if No Sewer Service/Septic Line > 25'[E Yes if No Holding Tank > 100' Yes if No Animal Containment > 50' Yes if No Manure/Animal Excreta Storage > 100' ❑■ Yes if No ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10' 0 Yes if No ft Surface Water > 100' 9 Yes if No Field to Foundation > 10' ❑■ Yes if No Tank to Property Line > 5' R Yes if No Field to Property Line > 10' ❑� Yes if No Water Main/Service Line > 10' ❑E Yes if No F. ENGINEER'S COMMENTS ft Wells on Adjacent Lots: ft Wells > 100' ❑� Yes if No _ ft Community Wells > 200' ❑� Yes if No _ ft If tank or field is under driveway comment below ft ft ft ft ft ft ft ft G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name ofFirm Forge Engineering Engineer's Printed Name Benjamin Schiller, P.E. COSA Checklist_May2025.docx Phone (907) 522-7773 Date 10/8/25 .' SOF A�q�ll �* •'qg TH .. .. .. ... ........ J� '. • Benja. ' . chiller ����F�;l , CE 12592 • .������ 1 tl`F�pROFESSI4N�t.� � 3 0. / / / / I I I 0 rt NOTES: GROUND LEVEL IMPROVEMENTS SHOWN ARE APPROXIMATE. DATE OF SURVEY: 06 OCTOBER 2025 PLOT PLAN AS BUILT X SCALE --!L= 40' GRID SW 2841 Project No. J25 -293/A1 P.O. Box 20005 Lang & Associates, inc. Ancho age, Alaska 99521-0005 �/6 00 �R Z10215— (907) 522-6476 0 OF , A Professional Land Surveyors surveyClangsurvey.com I hereby certify that I have surveyed the following described property: LOT 1, BLOCK 3, FORELAND VIEW SUBDIVISION (PLAT No. 83-203) Anchorage Recording District, Alaska, and That the Improvements situated thereon are "' "•'' within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed �'�o "1•JONA ... . LANG : .. premises and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. _ Dated this The ^ Da of �L"TOI��� ��� 40 Fa•'••LS-9944.'• C3 Day at Anchorage, Alaaka p4 °qo �l`P QO FESSIONA\• 00 It is the responsibility of the owner to determine the existence of any easements, 0pO0p000 covenants, or restrictions which do not appear on the recorded subdivision plat. MUNICIPALITY OF ANCHORAGE Development Services Department �`= Phone: 907-343-7904 On -Site Water & Wastewater Section `'- Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 017-401-49 1. GENERAL INFORMATION Expiration Date: 2- - Z 02 Q Complete legal description Foreland View, Block 3, Lot 1 Location (site address) 8521 Spendlove Drive Anchorage, AK Current property owner(s) Mailing address Real estate agent Raymond Kaufman Day phone 907-349-3821 8521 Spendlove Drive, Anchorage; AK 99516 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: _ Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Q Private Septic` Water Storage ❑ Holding Tank I ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer i ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: I' COSA Fee $ 556- Waiver Fee $ Date of Payment 3"1 Q -&I amts Date of Payment Receipt Number Receipt Number COSA # USC 0-6 D Waiver # COVID-19 257o DISCOUNT APPLIED 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 5/24/2020 6. DSD SIGNATURE �/ /` System #1 Approved for 3_ bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: '-11J/[I)))dol. By.,_� Original Certificate; Date: �-0--20Zb 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. i` 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Adviso Well Flow Advisory Other0WV'ke COSA Checklist blue sheet Legal Description: Foreland View, Block 3, Lot 1 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA OR Well log is filed with Onsite (or attached) Date drilled 1/6/92 Total depth 208 ft Cased to 10 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) '18 in. Date of flow test for COSA 5/15/19 Static water level at beginning of test 130 ft. Comments B. TANK DATA Age of tank(s) 28 years Tank type/material Septic/Steel Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping 5/16/20 - A Plus Home Services D. ABSORPTION FIELD DATA 5' Wide Shallow Trench Which system tested (date installed) 11/7/91 ❑ ALL standpipes present per record drawing Total measured depth from grade 5.8 ft (max) Measured depth to pipe invert from grade 2.8 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced NA gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 017-401-49 Structure served by this system Well production at time of test 4.4 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate 1.53 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 5/7/20-,-- C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: N/A Adequacy test date 5/15/19 Results ❑✓ Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 801 gal New depth 0 in Elapsed time 0 min Final fluid depth 0 in Absorption rate '600 gpd Any rejuvenation treatment (past 12 months) NA If yes, enter date 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' P/ Yes Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft [ Yes if No ft Neighboring Tank > 100' E✓ Yes if No ft Private Sewer/Septic Line > 25' 7 Yes if No ft Absorption Field on Lot > 100' ❑v Yes if No ft Holding Tank > 100' Q✓ Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10' Animal Containment > 50' Yes if No ft 0✓ Yes if No ft F✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' Yes if No ft M Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' P/ Yes if No ft Surface Water > 100' Q✓ Yes if No ft Property Line > 5' 0✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ED Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' ✓Q Yes if No ft Community Wells > 200' F✓ 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' 21 Yes if No ft If absorption field is under driveway comment below Property Line > 10' F71 Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓® Yes if No ft Private Wells > 100' ®✓ Yes if No ft Water Service Line > 10' Fv Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100'✓� Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I 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 5/26/20 'ORO F F1,1; P® �� Septic 'Tank Advisory Certificate of On -Site Systems Approval #OSC201210 Subdivision: Foreland View Block 3 lot 1 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 28 years old. Typical replacement costs range from $8,000 to $11,000. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. Mailing Address P O Box 196650 * Ancliorage,jAlas�Ca 99519 6650 *www MuhEiorg Municipality of Anchorage ° Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING n Parcel I.D. 017-401-49 HAA# 14 A o fy// D 1. GENERAL INFORMATION Expiration Date: tri —Z 9-O f Complete legal description FORELAND VIEW SUBDIVISION; LOT 1, BLOCK 3 Location (site address or directions) 8521 SPENDLOVE DRIVE * ANCHORAGE AK 99516 Current Property owner(s) MARK SINES Day phone 345-1931 ® Individual On-site Mailing address 8521 SPENDLOVE DRIVE * ANCHORAGE, AK 99516 Lending agency Mailing address Real Estate Agent Mailing address Day phone BONNIE MEHNER w/ JACK WHITE Day phone 563-5500 3201 "C° STREET SUITE 200 * ANCHORAGE AK 99503 Unless otherwise requested, HAA will be hold by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (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. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $9,000.00 at or prior to closing for the engineering services provided. 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 Health AuthorityApproval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system islare) safe, functional and adequate for the number of bedrooms and We of structure indicated herein. I further verify that based on the information obtained from the Municipalily of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system !slate) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD, SUITE 26 * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do theyguarantse that there are no hidden defects or encroachments. AWWC, Inc, can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor w111 it confer any legal right whatsoever. 5. DSD SIGNATURE ✓ Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the filowing Attachments: HAA Checklist r/ Septic System Advisory Well Flow Advisory Date 337-6179 v 01 Manitenance Agreements Supplemental Engineer's Reort Other a "uAll e � ON-SITE WATER AND WASTEWATER PROGRAM e A By:— i �, D�_ Original Certificate Date: (Rev. 11100) Municipality of Anchorage R, Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: FORELAND VIEW S/D LOT 1 BLOCK 3 Parcel ID: 017-401-49 A. WELL DATA *PER 1991 INSPECTION REPORT Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed *1/06/92 Sanitary seal (YIN) YES Total depth *208 ft. Cased to *16 ft. FROM WELL LOG Date of test *1/6/92 Static water level * 145 ft. Well production *115 g.p.m. WATER SAMPLE RESULTS Coliform 0 colonies/100 ml. Nitrate 0.6 mg./L. Date of sample: 3/9/01 Collected by: B. SEPTIC/HOLDING TANK DATA Well Log (Y/N) sp i6S Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 3/9/01 154 ft. 5.0+ — 9 -p.m -Other bacteria 0 colonies/100 ml. AWWC. INC. Tank Type/Material STEEL Date installed 11/07/91 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 4/28/2001 Pumper C. ABSORPTION FIELD DATA "BELOW FINAL GRADE " CALCULATED Date installed 11/08/91 Soil rating 6p.d./ orft2/bdrm) 0_6 HOME SERVICES MT1/MT2 System type TRENCH Length 85.5 ft. Width 5 ft. Gravel below pipe 3 ft. Total depth*6 5 - 9 75 ft. Eff. absorption area ***?37 fe Monitoring tube YES Depression over field NO Date of adequacy test 3/9/01 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test0�'in. Water added 983 gal. New depth4"/5 1n. Elapsed Time: 30 min. Final fluid depth07fin. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed "Pump on" level atin. E. SEPARATION DISTANCES Size in gallons High water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5' Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line P 10'+ Building foundation 10,+ Water main N/A Water service line 10'+ Surface water 1001+ Driveway, parking/vehicle storage 50'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION i certify that I have determined through field inspections and Q -. review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. QO • • • .. , .... • • . of r y A. —7953 Gorness: JEFFREY A. GARNESS Q P .•:� Engineer's Printed Name dos '•. .• 4�fPrP .........•• `hod Date '? Z�f7f 4O dP"f essio"ON HAA Fee $ 3 SOO • Oc-�, Date of Payment C) Receipt Number 3 (Rev. 12100) Waiver Fee $ Date of Payment Receipt Number Gat -21-98 04:31P Bonnie Mehner• &. Associate. (907)762-1858 P.02 "L Mol it r4; 12;33 Ivn.c!;3 rut �L�-ANU vjtw )UODIVISION .oT I , BLOCK 3 r .soa 03' s-s"r 10$ 5' `7p.0' S 4Sn ,�6 O'47° wCL 1. V !' 6YI%T" b 0, bbPc,blk5 � x'P fr ti 4t e ya t{d v as brr 4 v a� P P i d" gyp' AS "UILT a hereby certify that � s tho pj'�rty depicted ahpvAnd rth9�P wlA[1)I LAtYD ,SURt7TNC no entc:oac/mnenta exist axcppt a5 iPidi- at! A. Gaatald[,�, cat,Cd. It 720 T'"t 88t}, Atie. S® tlsa ras�ioeaRibilit.y of kha Pcwrage, Alaska 99501 eee er ko det�smi�g vhhee exl�tehce of an! (P f I.M PI^1 .( a OF At%4h� �' ddTM 1.47 a. �/2-31�Z i f3� y T f I.M PI^1 .( a OF At%4h� �' ddTM 1.47 a. �/2-31�Z MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES M e Division of Environmental Services M} 1 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. It 017-401-49 HAA # 1. GENERAL INFORMATION Complete legal description Foreland View, Lot 1, Block 3 Location (site address or directions) 8521 Jeanne Drive, Anchorage, AK cr,Dj.2 Suer, � Property owner Re - Ha Day phone 248-6789 Mailing address 2204 Cleveland #201, Anchorage, AKK 99517 Lending agency NSA Day phone Mailing address Agent NSA Day phone Address Unless otherwise requested, NAA will be held for pickup. F 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well X 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 x Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA 421 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm yaglP Riyer Eng;nPer;ng Se=ices Phone 694-5195 Address P.O. Box 773294, Eagle River, Ak 99577 Engineers signature / Date 7 ,f S 6. ' DHHS SIGNATURE X Approved for Disapproved. 1n I Conditional approval for _ Additional Comments yFii �a oav as o�na�=aaea, o..e—�c-r> •S�?] `d c�' - Luuis lk8u!era bedrooms. bedrooms, with the following stipulations: By: Date 7— 20 -92 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025(Rev.1/91) Beck MOA#21 I Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST (A Legal Description: F-0r41A1Vp 11/ENJ Parcell.D. 01*7-4t0l-- 9 Lof /v &06k 3 A. WELL DATA Well type RX1447E If A, B, or C, attach ADEC letter. ADEC water system number IV/A Log present (Y/N) %/ Date completed U/10&19 2 Driller 4Lp/1V6 i Total depth 207 Cased to Casing height Sanitary seal (Y/N) YC5 Wires properly protected (Y/N) YE 5 Date of test Static water level Well flow Pump level FROM WELL LOG /O& /92 /# 5' /5 g.p.m. ONkNOWN SEPARATION DISTANCES FROM WELL TO: AT INSPECTION i 5 i� 3 R7 c r- z rn ; N m g.p.m. rn CO m N N o N_ O Z Septic/hakfizzqtank on lot /0& ; On adjacent lots _J_/0,0 Absorption field on lot 130 ; On adjacent lots f / 00 Public sewer main N% Public sewer manhole/cleanout NIA Sewer service line f /00 i Petroleum tank MW6 ARPAi2C'1yT WATER SAMPLE RESULTS: Coliform Nitrate 0 79 Other bacteria Date of sample: Ol��/1/92 Collected by: <N6/N !Q B. SEPTIC/HGL9tNG TANK DATA Date installed ZZ 16 Z9 / Tank size 2000 Compartments Z Cleanouts (Y/N) yE5 Foundation cleanout (Y/N) Y65 Depression (Y/N) NO High water alarm (Y/N) NSA Alarm tested (Y/N) /V 1A Date of pumping Pumper N /,4 SEPARATION DISTANCES FROM SEPTIC/1 lei E)I dG TANK TO: Well(s)onlot lob—on adjacent lots f //00J Foundation 6/ To property line CD2 Absorptionfield 0 r Watermatin/service line f/DD� Surface water/drainage 4i LA 72-026 (Rev. 7/91) Front - CONTINUED ON BACK PAGE 0 C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level Meets MOA electrical SEPARATION Al Well o t "Pump on" level FROM LIFT STATION TO: D. ABSORPTION FIELD DATA On adjacent lots •/Access (Y/N) "Pump off" level at Cycles tested Surface water _ Date installed ��D �9 / Soil rating 0,10 68011F7 Z System type A Length gs' S v Width 5 y Gravel thickness 3 v Total depth T4ENC' l! Total absorption area 75D lie Cleanouts present (Y/N) 1165 Depression over field (Y/N) NO Date of adequacy test IIIA " NEG1J r Results(pass/fail) %SASS for bedrooms Peroxide treatment (past 12 months) (Y/N) If yes, give date N�A SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /301 On adjacent lots 71_/00 � Property line To building foundation To existing or abandoned system on lot 6e 1A On adjacent lots 71 -sol, Cutbank NIA WaterwA+F'service line f X 61 v Surface water - N/A Driveway, parking/vehicle storage area 70 v Curtain drain E. ENGINEER'S CERTIFICATION I certify that t have checked, verified, or conformed to all MOA and HAA guidelines in effect on the'date of this inspection. Signature Engineer's Name Date Z.l6 i HAA Fee $ / 70 t1rL19 Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number