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Home My WebLink AboutSPRING FOREST BLK 1 LT 4Spring Forest Block 1 Lot 4 #015-321-08 Only the 4 bedroom system may be tested for a COSA Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water & Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 141015 PID Number: 015-321-08 ❑ New ® Upgrade Name: MARY ROHLFING ABSORPTION FIELD ® Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address: 5830 WEST TREE DRIVE, ANCHORAGE, AK, 99516 ❑ Other Phone: No. of Bedrooms: Soil Rating: Total Depth from original grade: (907) 277-4444 4 1.2 GPD/Sq. Ft. 12.51 MAX Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade: SEE DWG. Ft, Gravel depth beneath pipe: 7.02 Ft. Subdivision: Block: Lot: SPRING FOREST 1 4 Fill added above original grade: Gravel length: SEE DWG. Ft. 38 Ft. Township: Range: Section: _ Gravel width: Beds Number of lines: Distance between lines: 3+ Ft. — — Ft. SEPARATION DISTANCES Total absorption area:Number 533.5 SD. Ft. of trenches: 1 Dist. between trenches: — Ft. To From Septic Tank Absorption Field Lift Station Holding Tank Public/Private Sewer Lines Well - - - - - TANK ❑ Septic ❑ S.T.E.P. ❑Holdinther Manufacturer: Capacity: Surface Water 100'+ 100'+ 100'+ — EXISTING Gal. Lot Line 5'+ 10'+ 5'+ - N/A Material: Number of compartments: Foundation 5'+ 10'+ 5'+ — LIFT STATION Curtain Draink___L NONE KNOWN Manufacturer. c 1: EXISTING Gal. Remarks: "Pump on' level at: j7ftmp�off" lev High water alarm at: TRENCH WAS EXCAVATED, RE—BUILT IN PLACE AND EXTENDED Pump Make & Electrical Inspections performed by: ONLY THE 2014 DRAINFIELD MAY BE TESTED FOR COSA APPROVAL. PIPE MATERIAL House to tank EXISTING Tank to D3034 drainfield Installer WILCO CONTRACTORS Drainfield D3034 CO/MT D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 Ft. Inspection Location and Description: Dates: 1 st 2/7/2014 2nd 2/7/2014 3rd — 4th — TOP OF LIFT STATION MANHOLE LID Community Development Department Approval ENGINEER'S S Conditional approval: Date: a U,. 4 QQ..� . y A.........ss.....� OQO�� f .Je/f CE 795 •mac O a61�� 1.2 Approved: Date: S�" v4edprafessia0 OVA PERMIT NUMBER: AS—BUILT DRAWING PARCEL ID NUMBER: OSP 141015 015-321-08 A A •V \ I B C \ �o BR 64.82 53.03 64.11 '.�; .. '. Fq FM�NgT F C01 80.70 69.72 84.76 \ •' MT1 81.23 ,+� \ 70.31 85.17 CO2 86.67 83.62 112.54 �' \ MT2 88.49 85.20 1113.43. a C, ALL SURROUNDING PROPERTIES SERVED BY COMMUNITY WATER. WATER LINE INLETS FROM NORTH ,n F SIDE OF PROPERTY. F 0 0 EXISTING 4 BEDROOM HOUSE Y A Y D3 Ic B DO O � N N N FT STATION ul w 0 2 Z CO'S 00 z a CO TANK a rn � CO 0 0 LER TIGHT VALVE vll COWAN, PE TESTHOLE F I IBERT C01rnCO2 MT2 REBUILT DRAINFIELD II N 10' FENCING & SCREEN/NG EASEMENT SCALE: 1" = 30' 10' TELE. & ELEC. ESM'T. OMALLEY ROAD aQo6o �O 4 GARNESS ENGINEERING GROUP, Ltd. p°* 4 0 DD CONSULTANTS & GENERAL CONTRACTORS - �"" • • .. • • • • • • • • ...... • • • • • 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-6179 • FAX (907)338-3246 • WEBSITE: w.gomeuangineering.com D ww a D PREPARED FOR: PHONE NUMBER: PAGE NUMBER: •••••• O MARY ROHLFING 907-277-4444 2 OF 3 �, Y G rness.. �,l� CE— 04 Cl LEGAL DESCRIPTION: DRAWN BY: cVQ SPRING FOREST S/D; BLOCK 1, LOT 4 A.J.G. ed�•).+.�..(.ir TYPE OF WORK: DATE: �Q �'rofessio'o� o �DOOoo�� AS BUILT DRAWING OF SEPTIC UPGRADE 2/14/2014 (Rev. 01/05) OSP NUMBER: AS—BUILT DRAWING PARCEL ID NUMBER: OSP 1410115 — 015-321-08 S&S TESTHOLE FINAL GRADE = 103.71-103.87 RELATIVE ELEVATION OF BOTTOM OF TESTHOLE = 82.21 (DRY) ORIGINAL GRADE = 103.21 FILTER FABRIC INVERT OF PIPE = 97.72 - BOTTOM OF TRENCH = 90.70 (Rev. 01/05) GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS& GENERAL CONTRACTORS �""" . ""' """" 3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-6179 • FAX (907)338-3246 • WEBSRE: www.gomessenginearing.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: • • • • • '. • • • • • • • • • • • • • • • • • • G MARY ROHLFING 907-277-4444 3 OF 3 Q e r y . rness.- LEGAL DESCRIPTION: DRAWN BY: A. J. EJ -7 a49� ^e C �� 3 �� \ j ' a SPRING FOREST S/D; BLOCK 1, LOT 4 e • • TYPE OF WORK: DATE: 4dpr QOOO�Op00fess-10P0� oma PROFILE AS BUILT DRAWING OF SEPTIC UPGRADE 2/14/2014 (Rev. 01/05) On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141015 Tax Code Number: 01532108000 Work Type: Septic Upgrade Permit Effective Dates: February 05, 2014 to February 05, 2015 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: SPRING FOREST Site Legal Address: SPRING FOREST BLK 1 LT 4 G:2538 Owner/Address: ROHLFING ROBERT R & MARY J 5830 WEST TREE DR ANCHORAGE AK 995160000 Site Mailing Address: 5830 WEST TREE DR, Anchorage This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy 2 -`?-/4 /:z0 2-7- r z(- -r o c Lot Size in Sq Ft: 40613 Total Bedrooms: N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: The Inspection Report is to state that only the new field is to be tested at COSA time. Received By: �C i r�- 21S MUNICIPALITY OF ANCHORAGE . E Community Development Department Phone: 907-343-7904 Development Services FcFBmlg'p On -Site Water &Wastewater Program ■ �_ /'�1 Mayor Dan Sullivan 5 JAN 2 S 2014 On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 015-321-08 Property owner(s) MARY ROHLFING Day phone Mailing address 5830 WEST TREE DRIVE *ANCHORAGE, AK Site address 5830 WEST TREE DRIVE *ANCHORAGE, AK Legal description (Sub'd, Block & Lot) SPRING FOREST; BLOCK 1, LOT 4 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms X y Gretchen StUller APPLICATION IS FOR: Waiver Fees: APPLICATION IS AN: TYPE OF DEWELLING: ( M all that apply) Absorption Field ® Initial ❑ Single Family (SF) Upgrade ® (w/wo ADU) Septic Tank ❑ ❑ Duplex (D) F-1Renewal Holding Tank ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: Distance: — I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: `$S -%g. Waiver Fees: Date of Payment: 4W1111 Date of Payment: Receipt Number: sic Receipt Number: Permit No. tg pi� is Waiver No. (Rev. 01/11) .rt e;0 +FARNESS ENGINEERING GROUP, Ltd. CONSULTA14TS & GENERAL CONTRACTORS January 31, 2014 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic Upgrade for Spring Forest; Block 1, Lot 4 To whom it may concern: The existing 4 bedroom house is served by a community well and a private septic system. The drainfield is in a state of failure and needs to be upgraded. We are proposing to rebuild the existing drainfield and re -utilize the existing HDPE septic tank and liftstation. The proposed re- built drainfield will be 3'+ feet wide (as necessary to remove contaminated material), 38 feet long with 7 feet of effective depth (2 feet deeper than the existing system). 1. SOILS & GROUNDWATER LEVELS: See the 2000 soil log (attached) which shows the soil classifications, groundwater monitoring, and the percolation test results. We are proposing to excavate 2 feet below the existing drainfield and add an additional 2 feet of effective. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: The proposed re -built drainfield will be installed greater then 100' from any surface waters. 4. TOPOGRAPHY: The average topography around the drainfield is relatively flat. In short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. A P.E., M.S. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com 1300 GALLON -HDPE TANK CO CO o CE EXISTINGtVE C a C' �5 H BULL RRE-B D EXIS,41DVROBE I I MT II II 10' FENCING & SCREENING EASEMENT 10' TELE. & ELEC. ESM'T. OMALLEY ROAD GALRNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 37D1 E. TUDOR ROOD, SUITE 101 • ANCHORAGE, m 99501 • PIp (W7)337-6178 • FM (801)336-3296 • WE65RE www.Ramsssmgln ing.eom PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MARY ROHLFING 907-277-4444 1 OF 1 LEGAL DESCRIPTION: DRAWN BY: SPRING FOREST S/D; BLOCK 1, LOT 4 A.J.G. TYPE OF WORK: DATE: DESIGN DRAWING OF PROPOSED SEPTIC UPGRADE 1/31/2014 (Rev. 01105) `� fomess: m CE -7953 m� v(S� DESIGN CRITERIA:GEc Ltd. HAS A 7 `A(it SFLCiIiCATION �o '" 4' CONTOURS NUMBER OF BEDROOMS: 4 • <.•, LETTER THAT PERTAINS TO THIS DESIGN. Eg5'F Rq�': GALLONS PER DAY (GPD): 600 TO OBTAIN A COPY OF THE LETTER PERCOLATION RATE/S: *3.1 MIN/IN r .• :•. CONTACT GEG. BY PROCEEDING FORWARD PROPOSED APPLICATION RATE: *1.2 GPD/FT' "' •4 - \ WITH THIS INSTALLATION, THE ENGINEER, MINIMUM DRAINFIELD SQ.FT.: 500 WELL DRILLER, CONTRACTOR AND *PER ROBERT COWAN, PE. PROPERTY OWNER AGREE THAT THEY TESTHOLE DATED 10/9/00 HAVE READ THESE SPECIFICATIONS AND .•,"tii�.`, AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. \ DRAINFIELD DESIGN: • \ MAXIMUM DEPTH OF EXCAVATION: .A-•• 'a:, '•, \ 2 FEET DEEPER THEN EXISTING SYSTEM \ (12 FEET DEEP) v WIDTH: AS NECESSARY TO REMOVE 'q'' • *::. ' CONTAMINATED MATERIAL ALL SURROUNDING LENGTH: 38 FEET PROPERTIES SERVED M.O.A. APPROVED SAND FILTER: N/A ' BY COMMUNITY WATER. WATER LINE CT 7 FEET - INLETS FROM NORTH RED REDUCTIOIO N FACTOR: SIDE OF PROPERN. ACTUAL SQ.Fi.: 532 EXISTING HOUS APPROXIMATE / LOCATION OF 6' RETAINING WALL EXISTING 80 GALLON LIFTSTATION TO BE RE -UTILIZED. 1300 GALLON -HDPE TANK CO CO o CE EXISTINGtVE C a C' �5 H BULL RRE-B D EXIS,41DVROBE I I MT II II 10' FENCING & SCREENING EASEMENT 10' TELE. & ELEC. ESM'T. OMALLEY ROAD GALRNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 37D1 E. TUDOR ROOD, SUITE 101 • ANCHORAGE, m 99501 • PIp (W7)337-6178 • FM (801)336-3296 • WE65RE www.Ramsssmgln ing.eom PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MARY ROHLFING 907-277-4444 1 OF 1 LEGAL DESCRIPTION: DRAWN BY: SPRING FOREST S/D; BLOCK 1, LOT 4 A.J.G. TYPE OF WORK: DATE: DESIGN DRAWING OF PROPOSED SEPTIC UPGRADE 1/31/2014 (Rev. 01105) `� fomess: m CE -7953 m� Municipality of Anchorage Development Services Department Building Safety Division +• - On -Site Water and Wastewater Program. 4700 S. Bragaw St P.O. Box 196650 Anchorage, AK 99519-6650 Page of 3 www.ci.anchorage.alLus (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number, w d+005 8 PID Number. 015-3'M-09 pS Name L•t t ri Wastewater System: ❑ New t9j Upgrade AddrS83D W ea Drive cloo a e 9951b DO ABSORPTION FIELD PWw//q _ NuniWrMa.dmarr' ".Deap T.Ih 0 Slulbr Trenrh 0 Bad Dalwm OOdwr LEGAL DESCRIPTION saR Ie T�DeoAean«9nv,ad.. I P m ebtlO Lce /' SuDdiviebrc • I 4 s /M FOf DeWh b Ppe bdl "M arvi we- .5 FL Gravel depth bewail pipe: FI To"41up: Rwp: a.abm FA added ad wa * rdl trade: O FI. Gr" WSW 38 FI. Well: ❑ New ❑ Upgra Dm+l wdm: 3 Ne of 1: Dielarcebsweendne. Ft. Ft CI/yaaratvn (Pmals. A a. c$ fl, TOW Dep dr Caead ex 71" abeorptan ersa 3W Flt FPO ma1snY: (,[ AA �0 F43 142 Fl. Ft J / Dnder Dale Dnlald. SWC Wats Level l J V e +lm DalebtaW. FI wee G4 xer, Twld: Fumy"K Cawq Hew9 rcor. Ormnd: TANK GPM F FL SEPARATION DISTANCES W Septic O Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding PublollrWat MaiYditlif°`. y.T Pre 0451 Ca ty 1160 From Tank Field Tank sewer Une ler e WN W% 1. ^Station �) �tW� .mss �l MNxW: / )Pli F� NwIWrMCMp+nneme: O^1 sudsewalw IM -11- I(0L-p. 01+ LIFT STATION Lot Lirw 65{/ % 3X +$.aa. �- g0 G�. M advs a `s Se. ;yes a 63% •6t0% a:� ` . .Ptxvpo• 013 .Pump a s: 9 Hpt•"terwarms: Far w 1` h b In. -1 rl None. kno to a dN Pumt Mo 1'N wily Ebcbnl wecouu m pWe ad Or. Q CurlNn Drm ✓ srdLi 1pu A • R.m : Lxrs.rtiL S'e'a 7 C_ 7 RNK BENCHMARK Lo "wDeamptwn: TO D uMFEO GRvSN� /tr0 of G NaurnW A6.4m0O/VC.0 nEiweuen IQ✓ FL p .> `. OF AL `f ` `•�••M �fi,,� S d 5 ENGINEERING �� ✓.,• Nobs. 17034 Eagle River Loop Road ��OI atV0916 ..«. Inspections performed by: KIVOT, •, n - ndz 5_� 0j J .^ �H� • ROCERT C. CLIA.NN Developme Servic s Dep ent Approval p �/� c; .� cE-Boot � R s/r� 2 D/_ eft �� Reviewed and approved by: Date: V ••... N . ;...-. (Rn. 1:/001 PERMIT NO. SWO 1 0058 PACE 2 OF 3 Municipalit of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Bax 196650 • Anchorage, Alaska 99519-6650 • Telephone; 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 4, BLOCK 1, SPRING FOREST S/D P.I.D. NO. 015-321-08 - _ lo' RAi - _ GCNAE CASEM'i- , EXISTING 3 BEDROOM HOUSE EXISTING RETAINING DECK WALL (APPROX. 6' HIGH) _ - ----------- CO3L DELI k DBL2 MH 0 T 5 NEW 1300 GALLON HDPE SEPTIC TANK TI MT °• ST2 OBl3 & DBL4 = DV (DIVERTER VALVE) i ATH W ~ NEW TRENCH CO1 CO2 Z MTI (jW1 x 10'x32' W r, -'ANCHOR I (EASEMENT -- -----------------------1 t--------------- 10' SCREENING EASEMENT I I -- ---------------------------------------- 10' UTILITY EASEMENT I I SCALE: 1' /0' 0 MALLEY ROAD >+ ROBERT C. COWAN 1�C fr l�'0�*l CE -88 j��• �r P .lLJil•1�'y``'am tit -_-_-_-_-_-_-_-_---_-_-_ PERMIT No. SW010058 PACE 3 OF 3 Municipalit 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 LECAL LOT 4, BLOCK 1, SPRING FOREST S/D P.I.D. NO. 015-321-08 S S 105.8' FINAL GRADE NEW 102.-7 1300 GALLON POLYETHYLENE 102.5' SEPTIC TANK A B ST1 53.5 56.0 ST2 56.5 57.0 C01=107.1' D8L1 32.0 52.5 CO2=107.4' 6BL2 33.0 52.5 6BL3 59.5 58.0 OBL4 60.5 58.5 DV 64.5 65.5 MH 38.0 51.5 FINAL GRADE O1 85.0 81.5 MT1 109.0 86.5 CO2 1 13.5 87.5 C01=102.1' CO3 1 36.0 52.0 SR CO2=102.2' N. T. S. i�v T -w b1T1=97.1, Y�� „.. . `�\//fes ..kilt 9 . NO WATER FOUND . G COWAN f C 8 6. 1B.O.H. ROBERT •'� CE - 8801 ��Zioaz`� Page 12 of 12 INSPECTION REPORT MUNICIPALITY OF ANCHORAGE - BUILDING SAFETY DIVISION 4700 SOUTII BRAGAW STREET, ANCIIORAGE. ALASKA INSPECHONS. Voice: (907) 343-8300 Far: (907) 249-7777 INFORMA770N. (907) 343-821 NAME: HEAVENLY LIGHTS ELECTRICAL CONTRACT'. PERMITNUMBER: 01-7812 ADDRESS: 5830 W. TREE DRIVE. DATE: 5/17/01 PlIONE aI: 232-8687 PnONE a2: LOT. 4 BLOCS: 1 SUBDIVISION. SPMG Ik)RREST COMAIEMS LIFT STATION/EARLY PM TYPE OF �— a/r az: .- -- 93: INSPF.C770N.• Electrical Rough No non-compliance observe . ❑ Do not conceal until re.inspecu . ❑ C.O. approved. �] Corrections essential as explain elow. ❑Will re-examine at next insp 'on. ❑ C.C.O. approved !'comments below). ❑ NPDES (Stormwater) COMMEMS: j 1 G, L--1 F -r S -r4 rl r-1 N A-1. 4&,PPRavF U, INSPECTOR: Reinspection? ❑ RauC*N-tN ljp DATE: 5 _ 1 -1 _ ❑ Stormwatertreatm6tplan/spec.onsite. ❑ Stormwater treatment implemented ❑ Sitc/offsitc drainage isnot being controlled ❑ InsWItCOrtect straw bales. ❑ InsWUcorteasilt fences. ❑ Other best management practices on ❑ See attached detailed notes/instructions. ❑ Failure to comply may result in fines. ❑ Take action now. ❑ Reinspection will be made on: Report given to: ❑ Redirect flow. Company: WHENCORREC770NSARE MADE, PLEASE CALL FOR IN.SPEC770N DO NOT REMOVE THIS NO77CE. 2571 MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade /:oo d-5:as Date Issued: Apr 09, 2001 Expiration Date: Apr 09, 2002 Permit Number: SWO10058 Parcel ID: 015-321-08 Legal Description: SPRING FOREST BLK 1 LT 4 Design Engineer: 0003 S & S Engineering Site Address: 005830 WEST TREE DR Owner Name: MARY ROHLFING Lot Size: 40613 SO. FT. Owner Address: 5830 W TREE DRIVE Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99516-6707 This permit is for the construction of: Q Disposal Field 0 Septic Tank E] Holding Tank [:] Privy ❑ Private Well E] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3_ The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: J-/—/0 — V/ Date: 7 " /O —O/ \ Municipality of Anchorage e Development Services Department Building Safety Division e On -Site Water and Wastewater Program , . , .. 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. O I S- 3)'1 - 0 9 Permit Number SWD/00.5 B Property owner(s) wl FIAY Ro H L FIN G Day phone Mailing address (1) '31 S 1 s' R4 ,— A.I c Na/i f es@ 9 CIS -0 � heili"Eg-address (2) 5830 WEST TIQEE DRIVE Zip Code 9Y3'l Legal description (Lot, Block & Sub'd.) Lo -f - Legal description (Section, Township &Range) Lot Size f sn Ft. Number of Bedrooms 40, 6 !3 THIS APPLICATION IS FOR: 3 Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. S 8 S ENGINEERING / 17034 601e River Loop Road No. 204 ��1 of AI L e (Signature of property owner or authorized agent) 0000000 Permit Fees: 3 3-0. Waiver Fees: Date of Payment: 3 / 3- Y/0 I Date of Payment: Receipt Number: 0 0 1 b y Receipt Number: (Rev. 12/00) ROBERT C. COWAN, P.E. CML ENGINEERS (907)694.2979 FAX(907)694-1211 March 22, 2001 NEALTHAnNOA!" APPROVALS MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 SEWERSWATER Anchorage, AK. 99519 MAINEMNSIONS • REFERENCE: Lot 4, Block 1, Spring Forest Subdivision SEWERS WATER INSPECTION It is requested that you issue a permit to upgrade the septic system serving the existing three bedroom dwelling on the referenced property. ENDFWPGrt163TlCIEs One test hole was excavated and a test was on 10/9/00. The ANDREPOTITS percolation performed C� r_ approximate location of the test hole is located on the attached site plan. Ground water was monitored and after seven days the hole was dry as shown on the attached soils logs. WEUE ION We do not anticipate any adverse effects on neighboring wells, septic systems, reserve LOWTEST areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. SITEPLANS If you require additional information, please contact us. ROADDESIGN Sincerely, 2. SOIL TEST RobertC. Cowan" , P.E. RCC/bjj PExaATION Enclosure TEST STRUCTURALS MECHANICAL 94PECTIM ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER. ALASKA 99577 z 0 N w 0 IAT 4, BLOCK 1 B.J.J. g DESIGN 3 8DRM =/ SOILS = T. 450/1.3/ 34 EAGLE RIVER LOOP ROAD >CLE 99577 HONEI# (907)694 7 2979 FAX/ (907)694-1211 / DRAINT'.f;LD,-C-RITERIA: 110.DEEP 15.0' EFFECTIVE 13.0'I WIDE X38' ALONG I I I I LOT 2 I I I � I I W I W I I i I I � I I 3 I SEPTIC C AREA ? I l C' ISI I I I I I C AREA � ALL PORTIONS OF SYSTEM WITH LESS TRAY 35' OF COVER REQUIRE ISSCIwTIOV_ _ R.C.C. !I ERIA: /GPD SPD/SQ.FT. 5 SOFT. REQ' SPRING FOREST S/D 3-22-01 3� L DRAIRIA_ �EASE4fNI_E. °M EXISTING 3 BEDROOM HOUSE EXI"]NO RETAINING MALL (APPROX. E' LOT 3 EXISTING 1750 GALLON SEPTIC ALL LOTS SERVED BY TANK PA. N.ro mo. r ArseAm COMMUNITY WATER �o FLAT1 PROPOSED 1 1000 GALLON y SEPTIC TANK -DOUBLE CLEANOUT FIAT* 10' SCREENING EASEMENT_ 10' UTILITY EASEMENT -------------------- O'MALLEY ROAD 1 OF 1 CONTRACTOR IS REQUIRED TO RTAIN UTILITY LOCATES PITT64TO ANY EXCAVATION WORK. n 1 ROBERT C. COLVASj !f r ....::, LOT 5 I I I I I I I O'x32' NCHOR—_------_--� ASEMENT r�, a..rsan .NR aso. n r re n0. r wf(Ss».. t0 a(P SR _ cl.n«as PERFORMED LEGAL Municipality of Anchorage - DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST (EET) 1 ?(kZ OAC -A IcS F I .-j G L4r-#-- / ,$r&.T- Wir H ,COM4, (,_vat AvCL $ A..00S ROBERT C. COWAN Q DATE PERFORM Section: WAS GROUND WATER N O ENCOUNTERED? S L 0 P E 3�/ del IF YES, AT WHAT _VA -v b DEPTH? _ Depth In Water Mier DRY Monitoring? )7Ay Dale: SITE PLAN Reading Date Gross Time 2 Net Drop RAS JqK 3 1 — S d h1 L 4 A.c f .... 5 0 3 'i " t, � •'• i 30 4i $'/y 6- 7/ 3 v r. •� Ti Sat 8 %.. 3 'IV 7 7 f ... 8 9- 1012 10- 12 3 13- 14- 141516 15- 16- 17- 17 18- 1s20 20 - 6.v.N. I*1 ,• COMMENTS F I .-j G L4r-#-- / ,$r&.T- Wir H ,COM4, (,_vat AvCL $ A..00S ROBERT C. COWAN Q DATE PERFORM Section: WAS GROUND WATER N O ENCOUNTERED? S L 0 P E 3�/ del IF YES, AT WHAT _VA -v b DEPTH? _ Depth In Water Mier DRY Monitoring? )7Ay Dale: SITE PLAN Reading Date Gross Time Net Depth to Time Water Net Drop RAS JqK /0 q O — S d A.c f .... S 7/y ' 0 3 'i " t, VY 30 4i $'/y 7/ 3 v r. •� Ti Sat 8 %.. 3 'IV 3 air " PERCOLATION RATE 3. 1 (mmutevmch) PERC HOLE DIAMETER G TEST RUN BETWEEN /0 FT AND // FT S & S ENGINEERING PERFORMED BY:1 1 4 c i1./7"— CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE Milli 401 MrA1V JX* 11ON1GIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: In 111(7/00 72-008 (Rev. 4/85) Municipality of Anchorage � t Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 January 9, 1989 z> J syy,Oe.l William E. �ougtet 5830 West Tree Drive Anchorage, Alaska 99516 Subject: Lot 4 Block 1 Spring Forest Subdivision Permit #880167, PID #015-j21-08 A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1988. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system, the original as -built inspection report (three-part form) must be sent to this office for review and approval, and for documentation. When applying for a new permit, the fees are: $90.00 for an on-site sewer permit; $50.00 for a well permit; $140.00 for a combined sewer and well permit. If there are any further questions, please call this office at 343-4744. S' cerely, j. 4 - Daniel J. Roth Acting Program Manager On-site Services Section DJR/ljw enc: Copy of Permit ` ' MUNlCIPALITY OF ANCHORASE Department a & Human Services 825 L Street, AnchorageAlaska 99501 343^4720 ON�SITE SEWER PERMIT Permit Number: 880167 Upgrade Date Issued: 08/23/88 Engineer Designed Owner Name: W[LLIAM E" BOU8UET Day Phone: OMner Address: 5B30 WEST TREE DRIVE 346~3894 ANCHORAGE, AK 99516 Parcel Id: 015-321~08 Lot Leqal: Subdivision: GPRINGFORE�T SUBD" Lot: 4 Block: 1 Section: 14 Township: 12N Range: 3W Lot Size 42840 <sq"ft" or acres) Max Bedrooms: This Permit: 1 Total Capacity: 4 SEPTIC TANK: Minimum total septic tank capacity: 1,250 gallons" Each septic tank must have at least 2 �o�part�eDts" Depth to top of septic tank(s) (eet requires insulation over tank(s)" INFORM D"H`H.S^ PRIOR TO 1ST & 21\11) INSPECTIONG BY ENGINEER; IF AFTER OFFICE HOURS, CALL 343^4681 AND LEAVE AMESSAGE" CON3THi1CT PER ATTACHED APPROVED DESIGN. PERMIT EXPIRES 12/31/88, VALID FOR SINGLE FAMILY RESIDENCE ONLY" MONITOR WATER TO 20 FEET BENEATH GROUND SURFACE FOR SEVEN DAYS AND SU8MIT RESULTS WITH AS,BUILT. I CERTIFY THAT: :1. I am �amiliar with t�� reqUiPRmeDt� �oP oD-sit� s�weP5 �Od wells as set (orth by the Municipality o{ Anc�Dr�g2 <MOA) aOd the of 2" I will install the system in accordance with all MOA codes and regul�tionsv and in compliance with the design criteria of this permit" 3. I will adhere to all MOA and State of A1aska req(�.kiremeIrl ts �or the set back distances {rom any existing we1,19 wastewater dispossa1 system or public sewerage system on this or any adjacent or nearby lot. 4" I understand that this 1--)er0it iS Valid f cir a maximj0 of' 1 b�drooms" [ also understand that the c�pacity of the total system is 4 bedrooms and any �nlarge t` il1 i d it" Signed: TE: ~^, . 0100 (Owner> BOUGUET /� Issued By: -----�--��~-��~�-~~~-�-^~~-~~—� DATE: .} .��_�.��~ 1, ,a �.. o h M� ,yo WEST TREE 69 DR. ENGINEER SERVICES — 1 rn OR41 AGE _ES- 00 In „ ze 8 to N V 6 FOOTINGS 10 N ONLY 16 O 30 m O U') 75 Co N _`�M `lit 0 A4,1 s e•�4 I •'�ik i J000.66 .e..... e..... / t . f. •..tae ON 606 feet too a.j` In REID, JR. -2251 l$ -00 0 W b `•a�.YYYYprolessioaa y'� 0 (] T 1�^9�aie O g 10x32 ....:rt r I ANCHOR ESMT x_oD i `10' SCREENING ESMT— .10' -UTILITY 173MT 152.75 S 89056'.00" W 5/8" REBAR TYP 75 0' MALL E Y ENGINEER I.O. ecIO.WSERV,1CkS . 911 wr.w a..rwwew Ne loblily F. 700 LS - 5464.i` t •.e• .e^•:i oo ��.wao•� �0 ai Oram by Dote Iowa 1 "= 50' Grid 2538 Plot - Plop _ As -Built 1 hereby certify the following described property. LOT 4 OLK d SPRING FOREST SUED XWel—wato .'tacording rec nct.as s surreymo— or at may direction, and that the 1plprovommnts situactad thereon are within the property lines and do not overlap or encroach on the property lying Wacent thereto encroach on the promises 1 ir"stion and that there are no roadways, transmission lines, or other visible eastawmts on said property, except as Indicated heron. It is the responsibility of the owner or builder prior to construction, to verify proposed building trade relative to finished grade and utility conections and to detemline the existence of any easments covenants or restrictions which do not appear on the recorded subdivision plot. yi( D z2 7 1 ^� �= c l 40, it Ih s/��%83 f Co N _`�M `lit 0 A4,1 s e•�4 I •'�ik i J000.66 .e..... e..... / t . f. •..tae ON 606 feet too a.j` In REID, JR. -2251 l$ -00 0 W b `•a�.YYYYprolessioaa y'� 0 (] T 1�^9�aie O g 10x32 ....:rt r I ANCHOR ESMT x_oD i `10' SCREENING ESMT— .10' -UTILITY 173MT 152.75 S 89056'.00" W 5/8" REBAR TYP 75 0' MALL E Y ENGINEER I.O. ecIO.WSERV,1CkS . 911 wr.w a..rwwew Ne loblily F. 700 LS - 5464.i` t •.e• .e^•:i oo ��.wao•� �0 ai Oram by Dote Iowa 1 "= 50' Grid 2538 Plot - Plop _ As -Built 1 hereby certify the following described property. LOT 4 OLK d SPRING FOREST SUED XWel—wato .'tacording rec nct.as s surreymo— or at may direction, and that the 1plprovommnts situactad thereon are within the property lines and do not overlap or encroach on the property lying Wacent thereto encroach on the promises 1 ir"stion and that there are no roadways, transmission lines, or other visible eastawmts on said property, except as Indicated heron. It is the responsibility of the owner or builder prior to construction, to verify proposed building trade relative to finished grade and utility conections and to detemline the existence of any easments covenants or restrictions which do not appear on the recorded subdivision plot. ALASKA ENVIRONMENTAL JOB 1 �/ l �pf �y =o s 7 S��• CONTROL SERVICES, INC. SHEET NC. / OF 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 CALCULATED BY d DATE 8 1 — (907) 561.5040 CHECKED BY DATE--- SCALE ATE_ -SCALE MUNICIPALITY OF ANCHORAGE �'' • +.r' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 11K PERCOLATION 825 L. Street, Anchorage, Alaska 99501 264-4720 TEST �--' SOILS LOG -- PERCOLATION TEST PERFORMED FOR: JA1k`tAr—SCS DATE PERFORMED:_ � T� LEGAL DESCRIPTION: �>Pr 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 K Ml. Mbis* Ve.-y 1;tt1e Gv-c-,vg1 M\ ^ vec'I 1;�c SGntit or czmvg, SM ori 5? f• ��a N M WAS GROUND WATER S ENCOUNTERED? _ N L O P IF YES, AT WHAT E DEPTH? 1 i1 n-) %tl i n Vvt r -E s✓ ■■ Date Gross Time ■ ■■ IN ■■ St31-?3t149 ,.iq ■ ■■�■ IN 1 t: y0 3C► 1qj 1� ■ M1■■■�I� FF, ��.'1�� RiAl POE ■ N 0 Reading Date Gross Time Net Time Depth to Water Net Drop t H zO St31-?3t149 ,.iq 10 t.oi • 42 1 t: y0 3C► 1qj 20 ..,. PERCOLATION RATE md ' 4 / 'lrNI)Ltes/inch) r V�`.ter �tr��'', '• ,f ,r ry TEST RUN QED WEEN k ` Fr AND T COMMENTS UiSUA1 ELA�FA� lhG p. PERFORMED BY:kAm*C- CcAACj^ CERTIFIED 13Y. '4' ,.�rtil'),i� j DATE: S -T ply 72.008 (6/79) ' ''%''� ✓ Ll Asn MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ANEW 1J _ ❑UPGRADE MAILING ADDRESS t �_ � — , LEGAL D_T SCRIPTION LD -r)4 h I' /l1 U a� LOCATION NO. F PEDROOMS Uy DISTANCE TO: Well �d % Absorption a ea ,�( Dwelling PERMIT NO. � ("j[j 7l WQ Manufacturer /'t n e_'C s iG Materia �� L No. of c,Qmpartments n • Liq. cap city in � Ions ll IF HOMEMADE : Inside length Width Liquid depth C1 JAZ DISTANCE T0: Well Dwelling PERMIT NO. 02 4 Manufacturer Material Liquid capacity in gallons 0 ws DISTANCE TO: Well �j0//Y2k" Found 'on Nearest I t liV GJ/ PER 'N O. c 63- °j a z ?waJ No. of lines Length of ach�fine Total le thojAines Q Trenrj wi th J aches Distan e t een lines ;. ..' r To of tile to fJii.nrrish rade p Material beneath tile Total effective alt's tion area -- 0 cc 6. f inches `7`'v a / Length Width Depth PERMIT NO. w � /U H F Type of crib Crib diameter Crib depth Total effective absorption area i fll�' W a t Au W Well Building foundation Nearest lot line l `� DISTANCE TO: - ,�t� Class Depth Driller Distance to lot line PERMIT NO. J w DISTANCE TO: Building foundation Sewer line Septic tank Absorption areals) OTHER PIPE MATRIALS / SOI L T ST RATI G/l INSTALLER REMARKST/ R6 14. C 41 14, CQ f'Sow, .S' f r M oa APPROVED DATE LEGAL to 72-013 1RV.. 3/78) MUNICIPALITY OF ANCHORAGE / e DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME �cJ�ii PHONE NEW Ol/6t/j'' ❑ UPGRADE MAILING ADDRESS ,/ c2"W_51r' R /* //V tee LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS ®DISTANCE Uy TO: Well / % Absorption area Dwelling f Z,J, PERMIT NO. — F- Manufacturer Material No. of compartments Q w H. %L N Liq. rapacity in gallons IF HOMEMADE: Inside length Width Liquid depth / C7 z DISTANCE TO: Well Dwelling PERMIT NO. 02< Manufacturer Material Liquid capacity in gallons O wy DISTANCE TO: Well 4knoi%� Foundation Nearest lot line PERMIT NO. FL z No. of lines Length of each line Total length of lines Trench width Distance between lines Z W /' '' `d ' (p inches Top finish Material beneath rile Total effective absorption area of rile to grade 0 �� inches Length Width Depth PERMIT NO. W U a h Type of crib Crib diameter Crib depth Total effective absorption area W° WWell to Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT N0. J W Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS SOI I_ TEST RATING X45 INSTALLER REMARKS Fes""' Al 49T .* d. NFIILD f OL BOVD JAVROWr A as 5'4Cfa St ♦j f.ffa toff• CVS. f • LEGAL APPROVED DATE 72-013 (Rev. 3/78) __ :ii L_ -C 4 WII L. 0 '11 J_H-1 "IT, `-r` C_-, -, - 0 1 __:1-' -4 F�- _ 0_,- Li =_ i_Yj -Ii 131 E P I-" I R -H, I E FIE: FILTH AkID Et` -V-/ I P,: C N I "I Eki _f A L ANIDHORAGE.. Ak:'. I -IT E C"T .10 1"4 9 _921) jCI _"rREE'f'., 26,1 0 IIA S, I -o'" EE. U,11 -"-N U F�... PERIIII'F I%10. I" FIPPL 1: C1-ii",11" E. L-MUSL-10JE]" 44;21 E OFF1 L.CjCFFf'IWA --. _.� S Lf. - IT 4 BLI,.. J. FORES]" SUL'i LFIJ* SIZE 9,_-,:1999' '..QUARE Fll-7E*;I- -f'R. E 1,.,l C [A .Vk1.1 F,E OF' SOIL ABSORF111- -1 S',i`'TEff1 1%IUMBEF" Or," Bf:.:DRCII__'HS 'i"HE R.E.G.11-11RIE11 OF' THE :", 71 .1 -4 J' --n E_-_ P"1- 9-1 ic�u OZ? F -h FEE Ca E-_ IFF IJAIE L.ENG'FI-I DIMENSION I'S. 'F[lf,-' LDIGTH IN F['..*E`T) OF' THE TRENCH OF' F)RAINIFIELL1. FP:E .R I 'TF -IE: DI' BEI'WED.-I -I'FIE -5-URFACE OF THF.'. I HE ClEP-1+1 OF' I "1 0 i. J *ROUPAD -IE B("T'V011 OF' 11-11E EXI-FikiATIOPA F'EE 'I"HEFf" IS hil".1 kilDfl-I FOP` 'THE' GP.W.-'EL DEPTH 1�_:; 1-FIL'.' PIPATHLIN ClEP'TH CiF GRAVFL BETI..1EEhI rFIL':' OILYTFALL. PIFIE AVA) "I'FIE BC) "f "FOH OF' 'TIdE E'.::CA,NI'TIOkI 1..'IN F'EE'T). V-A Fz.-' I f F_ F L... L__ PEFAII'T API-JLIC.AhIT HAS "I"HE RI:'..';PIDI%ISI BI L I T It' 'TO INFOP-11 `FHIS DEPF1f'_r0IEhFT THE -P-115 PF'..'CIPERW Fil"41) THE I'A.'7S'T LA"TION II'A'_;FEC'I'IC)NS OF- ANY [,I[.- LA -5, A DJ I'AUMBER OF 1"HE WELL WILL SER' -,-'E. :wE C.. EL' ' UN J: E . ... .. . .... .. IL P-4 9::' S CIF MA'r' H 1,11"TH(DUl' FINFit II'-J1=PEC.TIUN F:IhID APPROVAL BY F1EPF1R'f'[lEhI*T 1,11L.L. F:O:E "..I_IBJEC"f' 'TID ' "I' E I 1�-PO.'.".;AL IS 1-5 -3 [cilkIINUIrl DISTANCE BE*TI..-IE1.:.N F1 kIELL. AhID Ahl'-F' 01 SITE SEI -di- FOR A PRT1v1A'IE kiELL J.FMi 'TO 2"C10 FEE'T FROM A PUBLIC 1.,iEL.L DEEEN[P-M UPOhl 'THE Tlill::'E C.IF FlU13LIC IdEL.L. IIII11HUM FROM A I.-IELL 'VO A F'RIVFITE SEWER LIhIE E". 2�- FEEI' ANE., 'rCI SEWER L.IhIE IS '-('5 1=[=.L-. i . C I F'' C A`F Ii -I IN S A [A I' C C I,-,IS"I'R Ll C I'l 0 hl D I A G R A I'l S ARE:. O`TFIr.."_*P: F, E I'"! U IP'E H E -JA I'S FIPPL.Y. F1 F1 I I ... FIBI E 'TO IP,ISLJRE PROF -ER R"I" 1: Pr' Ti -IFI -i" .1 WELLS F -IS SE`F -IN API Ff"IMILIFIR WITH fl --IE REW.U.'REMEr.-ITS FOP' C — I'TE SEIAIER`_�; AN[ FORTH B`r' THE i'1ILII',II C:f PFLI P-,' OF APAC-140F.'FICiE. 2: 1 IdILL IS'FIFIL THE ':.11"-r'S'f'EPJ PA FICI-:I_DFf:,FiPACE Id) P -I 1 -HE UNDfER'S.-I"AhID TFIA'F THE 0N--_F•IJ*E SEI)IF'R Fif-l'i-I REiDUIRE Et,11LARGEPID.4"r IF "['FIL' R.ESIDE-hICE IS REMODELED TC) 1I,AF:LIJDE I'll -IRE 1"H -1N 3 BE1.)RCICIMS. 1. Gl',IED: F P P L'( -.'::11-1 T E. 1:-: CI Q Li E J' k --N 11.� 4. 01� !SSIJED E C R SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 625 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR:i� l`?C.(iAC�l'tl __DATE PERFORMED: LEGAL DESCRIPTION: _ SLOPE 81TE PL� Vis) P}: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Ml_ Vts� y \ tw Sci.r,t), cs.. GrLhv A SM nlic-A COMM c(\a 0 0 -r VJ Ir_ WAS GROUNDWATER _N S ENCOUNTERED? 1�_J L 0 P IF YES, AT WHAT E DEPTH? (,l'/-7" a to ,N) n 4 �.✓ W Reading v Date Gross Time Net Time Depth to Water Net Drop f!f -40 3=>31 S3 1\ zq c71 11:140 30 PERCOLATION RATEC 6�_ _(minutes/inch) TEST RUN BETWEEN , 7 ----., Fl AND _21,2-•. FT PERFORMED BY:\)i'M�,c—_ q, vt\ CERTIFIED BY: DATE: 65 5 3 k_..._ 72-006 (6/79) M MNOC P UTY OF ANCHORAGE Development Services Department Phone: 907-343-7904 �r On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-321-08 1. GENERAL INFORMATION Expiration Date: &—J5'20Z 2 - Complete Complete legal description Spring Forest, Block 1, Lot 4 Location (Site address) 5830 West Tree Drive Anchorage, AK Current property owner(s)- -- O- -,e- rt _ -. - _ ary Rohifing Day phone Mailing address ---5830 West -Tree Drive Anchorage, AK 99516 Real estate agent Shannon Ingram 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone (907) 748-7861 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic F Water Storage ❑ Holding Tank ❑ Community Well Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 1'1 12.50 co U I O Date of Payment 9 Af 17-0 Receipt Number 6 7075D COSA # O S C 201 1-I Q � Waiver Fee $ Date of Payment Receipt Number 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone 522-7773 Address 1399 W. 34th Avenue, Ste. 100 Anchorage, AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 9/3/2020 a= 49th 6. DSD SIGNATURE e System -#1 Approved -for-_ --_.bedrooms---_._ _ __ �A MICHAEL E. ANDERSON t., System #2 Approved for bedrooms °Q®�� ... No. CE -4381. ,N ;P. A �, 9/3/2020 ,,o C�� y Disapproved �Qr3 PRoFESS\��A®p'�� Conditional approval for bedrooms, with the following stipulations: Of ONhl S R N, By: Original Certificate Date: -( —3C) ^ Zd The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Spring Forest, Block 1, Lot 4 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA Property is served by a Community Well. ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments COMMUNITY WELL PWSID 210605 B. TANK DATA Age of tank(s) 19 years Tank type/material SEPTIC/PLASTIC Measured operating fluid level in septic tank 11 FOR Standpipes/foundation cleanout per record drawing Date of pumping 4/23/20 - ONE STOP PUMPING All Vent Pipes shown on the Record Drawing were found. D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) 2014 ❑ ALL standpipes present per record drawing Total measured depth from grade 12.6 ft (max) Measured depth to pipe invert from grade 5.9 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 6.76 Parcel ID: 015-321-08 Structure served by this system Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station 19 years Lift station material Fiberglass Comments: Lift Station located prior to Septic Tank. Adequacy test date 6/15/20 Results El Pass For 4 bedrooms Fluid depth prior to test 75 in Water added 603 gal New depth 79 in Elapsed time 1440 min ❑ Code -required soil cover over field Final fluid depth 56 in ❑ System presoaked Absorption rate >600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) None date of test) Gallons introduced 1000* gallons If yes, enter date Comments/Deficiencies: All Pipes were found and are present per record drawings. Tank vents and double cleanouts are missing from survey. *Effluent depth prior to presoak 42". 1,000 gallons of water to raise level to distribution pipe. COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) - Community Water System. Septic Tank/Lift Station on Lot > 100' ❑✓ Yes Community Sewer Manhole/Cleanout > 100' ft ❑ 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' ❑ Yes if No ft Holding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ❑ Yes if No ft ❑ Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' 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 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ 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' Q 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'✓❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓❑ Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Line > 10'✓❑ 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 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet ♦♦�>>aaa�4i 49th MICHAEL E. ANDERSON • Sm.' No. CE -4381 o .J 9/11/20 ••'• . p F; ♦f 14,,oF Ess 0"' ♦• e�. 849ON TRF F 7(900 �pRi�F M 9�7CD ^c� Q ' GjM 20' p Ease ent 9e 20 Oraina9e EF., 2. 00 1.2)H =rent t SCALE: 1 "= 50' o za.o Lot 3 ? Lot 5 22.0 a dk 0 2 Story Frame 10 N House �16.o a5 6.4 36.4 44.0 Su M 2.0 OH deck room 00 N CD ReL wall _ ®O®®0 a V ! c 2.0 OH `® Manhole LOT 4 0 �Q'•` •S,� • • o�? C) o z42_ 49 th s I .. . 9 .... -,o.0 0 o Septicven[(typ)� ,� �,'. Elizabeth L. WalatkaCD . s O o ••�� AW 8036 - LSMW 10' x 32' Anchor Easement [ 1 •°OCJ.W , ARoFesstortaL `A®® ---------------- I �®�ao�� — — 10' Screening Easement 10' Utility Easement S89056'00"W 152.75 AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection in accordance with ASPLS Standards of the following described property: LOT 4, BLOCK 1, LO LO SPRING FOREST SUBDIVISION r` ~ Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines OWALLEY ROAD and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and — — — that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska EASEMENTS OF RECORD, OTHER THAN this 31st day of JULY 2020. THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. FRED A ASSOCIATES, L.L.C. UNLESS OTHERWISE NOTED FB 20-3, pg 5, 61-63 BE Engineeersrs and nd Survv eyors 907-248-1666 This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The Information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Waiatka is a violation of Federal Copyright law. Unless gross negligence Is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. Ecklund, Timothy J From: Office Forge Civil <office@forgecivil.com> Sent: Wednesday, September 30, 2020 9:01 AM To: Ecklund, Timothy J MUNICIPALITY :OF ANCHORAGE +3.7 Department 904 artment Phone: 907-3 Development Senrires p �_= .� Fax: 907-3+i3-7997 On -Site Water & Wastewater Section Lift StationlP ump Vault Maintenance Log StreetAddress_- t Sia L.e. al Desc._. —PID_ Phone -1'•x.8—._.1__- 9 -Sludge Ie inches -Pumping' required yes no -pumping completed } t s -Pump basket cleaned y.Q_s no •Effluent filter leaned yp-a—no -Control floats cleanedro-C-11 Proper float settings confirmed 5•Operation satisfactory Blarm Svstesn� Dedicated electrical alarm circuit a --no -Audible^, and visual alarm inside dwelling y_F;, � -Alarm system operation $aiLt'� not.at!sf@.CtQ_rC Manh�1� Riser_ -G=,ound water intrusion at riser to tank connection y ' 9 •{3roisr=d wafer intt�csion around wipe re:aet•*°tions }+ec nn •tAlPeD hole functional •rr •- nn 9)—ng insulated e��s 1n� Property Secured Q •lv�anhole lid: Functional �/ �JJ -All manufacturer required inspections and maintenance completed es sMm C�.niIILerit� . ?...... -��.....1�5?>5.�'� Z �'.......br.... �� .......� ............................... tia-.:.,�Qnance Pr vo ider: 'sechnician FSG C W_ Date of maintenence�_5_42 b Signature Date1 'S �{� 1 MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services -- On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # �1� - �j�j (?P) HAA # �A 1. GENERAL INFORMATION Complete legal description�4 i> Y "'^'V Location (site address or directions) Property owner �'� Day phone�� Mailing address Lending agency Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: I 3. TYPE OF WATER SUPPLY: Individual well Community well�— Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site — 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(Ftev. 1/91) Front MOA 021 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Y n-C�/c/,-I# cctiCLL��ct�� Phone Address J-0 3 LV t J Engineer's signature %L � Date Z s Y 6. DHHS SIGNATURE J Approved for 3 bedrooms. - Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments -255 ri 7ACt—t M (✓ /VtC.; By: - C% �-Nq Date I - The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA 421 Date: 3/5/92 To: All Parties Concerned From: John Smith, Re: Health Authority Approval for Lot 4, Block 1, Spring Forest All parties concerned are advised that the subject house has historically functioned as a five bedroom house. Because the on-site wastewater system was only designed for a three bedroom house, two of the bedrooms were converted to a den and a sitting area. Any conversion of these rooms back to bedrooms will void this Health Authority Approval 675111.0IOND8LVD. ANCHORAGE, ALASKA YY502~JY04 (907) 240-5095 Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 Subject: Retest of Septic system Lot 4, Block 1 Spring Forest February 28, 1992 This septic system was treated with Hydrogen Peroxide in November and a conditional HAA was issued at that time. Three months have now ch has been retested" On Feb. 27, 1992 660 gallons of water was added to the trench. Prior to adding water no water was observed in the trench moni� tor. The house has been occupied since mid November. The following readings were taken: GALLONS WATERDEPTH 170 8" 340 110 540 14.5" 660 17n � 20 hours later 10 These readings indicates that the system is working properly for a three bedroom residence. Please issue an unconditional HAA. T. Spurkland P.E. ��/��K�y�K� ��1�� FEB 2 87Q92 DO»xunioip�y m��ofAnohur& MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 362- 1 —o L HAA # GENERAL INFORMATION Complete legal description s t y I QlL l S i��' 1N C7 Fc) 02, t�f� S 1 Location (site address or directions) v Property owner Day phone Mailing address /f�� f a I Id IW�GIi" I �io-r'� a y Lending agency ��a �- A 4 Day phone � '� � -7 � Mailing address °'t^ d t 6,%4 r'°'``t//D Agent T MaAi Day phone Address — Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well 9 Public water NOTE: if community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: if community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 2 til ' D v Y % 1A vLD/ P F Phone —�-7 q Address Engineer's signature Date t t t 2? I Q J, 7 �i of 0, 00 -- � yi o U v 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for _3 bedrooms, with the following stipulations: 5EE5 6, rgerfep he-17c_o OF CoNor pobS --- -Y/s 0CI1,/D1770hlit'L /}P&QL/A- _ WtC I— $ems L120 uo 77iaFN Additional Comments By: �IOH N �� t�T�{ Date IL o ci 411TIC The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA 021 Date: 12/10/91 To: All Parties Concerned From: John Smith, P.E. JC✓v�iiE't Re: Health Authority Approval for Lot 4, Block 1, Spring Forest All parties concerned are advised that HA910574 is being issued conditionally. The on-site wastewater disposal system was treated with hydrogen peroxide as a means of remediating an inadequate system. The system must be retested after 90 days of use and occupancy by the new owners. Sufficient monies must be escrowed to construct a new system should the retest not be successful. All parties concerned are advised that this house has historically functioned as a five bedroom house. Because the on-site wastewater system was only designed for a three bedroom house, two of the bedrooms were converted to a den and a sitting area. Any conversion of these rooms back to bedrooms will void this Health Authority Approval Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: �d� �� I Spr +k� << Parcel I.D. O I5 — 3ai , o e A. WELL DATA Well type AV If A, B, or C, attach ADEC letter Log present(Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level Date completed Cased to FROM WELL LOG SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot — Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Nitrate ADEC water system number a to (00_6 Driller Casing height Wires properly protected (Y/N) ENVIRONMENTAL SERVICES DIVISION AT INSPECTION 9 -p.m On adjacent lots ; On adjacent lots Public sewer manhole/cleanout etroleum tank Collected by: Other bacteria NQV 2 7 1991 'RECEIVED Date installed 8 ! Tank size — I.2 `ry 0 Compartments _ Cleanouts (Y/N) —Foundation cleanout (Y/N) t _ Depression (Y/N) lam_ High water alarm (Y/N) Alarm tested (Y/N) IqA % Date of pumping �� 9 f ( Pumper A14 6. S SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Wel I(S)onlot —On adjacent lots '� Foundation— To oundation To property line. >—r' o Absorption field t Water main/service line > �5 0 _ Surface water/drainage t & 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level _ "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off' level at Cycles tested Surface water _ Date installed f " r Soil rating System type 7-6-44-1614 Length 100 Width / Gravel thickness 4V(6 Total depth Total absorption area / Cleanouts present (Y/N) %� Depression over field (Y/N) Date of adequacy test Results (pass/fail) for bedrooms Peroxide treatment (past 12 months) (Y/N) �7 If yes, give date + t I I Q SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot_ t`/A On adjacent lots w/A Property line a To building foundation// �66 To existing or abandoned system on lot MIA On adjacent lots K/ Cutbank yzA Water main/service line �> 1 () Surface water ��P Driveway, parking/vehicle storage area a S— C) Curtain drain E. ENGINEER'S CERTIFICATION l certify that l have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signa Engin Date HAA Fee $ Z 0, D6 Waiver Fee: $ — Date of Payment _L1-21- %/ Date of Payment Receipt Number 3 ��`� % �%/ Receipt Number 72-026 (Rev. 3/91) Back MOA 21 - APPLIC AT FILLS OUT UPPER IAP ONLY Property Owner(, 414(�y--- Phone . r Mailing Ad�ress - -- �- _ - ' _ << Zip Code -- Buyer Address - - Zip Code Lending Institution - Phone Address - --- ; "' Zip Code Date Really Co. & Agent Phone Address - Zip Code Inspector Legal Description Inspector Inspectpr) Street Location Type of Residence Q�"Single Family Field Notes: MUNICIPAI TY Or ANCHORAGE i \l��lr r r °I gal ll - H r �NVIR®'::NTPRAL PRO(EGTION, 1��✓� ❑ Multiple Family No. of Bedrooms ❑ Other ( ) APPROVED BEDROOMS Water Supply ( ) DISAPPROVED ❑-Intffvidual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑'Com-munity BY: e For wells drilled prior to that date, give well depth (attach log if available). --❑ Public Utility ate Sewer Installed Well To Absorption Area Sewer Disposal _ ❑ Individual YearIndividualInstalled:—' ❑ Public Utility When Connected to Public Utility: F.l .Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 0. I Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspectpr) i �' lh Field Notes: MUNICIPAI TY Or ANCHORAGE i \l��lr r r °I gal ll - H r �NVIR®'::NTPRAL PRO(EGTION, 1��✓� �fya I I r ( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITION PPROVAL- DATE BY: e Soils�Rating, ate Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size 72023 (3182)