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HomeMy WebLinkAboutFISCHER BLK 1 LT 3B4Fischer
Block 1
Lot 3B4
#015-292-22
•
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: OSP181204 PID Number: 015-292-22 ❑ New •Upgrade
Name:
PARIS COCHRAN ABSORPTION FIELD
Address: 0 Deep Trench El Shallow Trench 0 Bed 0 Mound
5100 SPRUCE CREEK CIRCLE*ANCHORAGE,AK 0 Other
Phone: No.of Bedrooms: Soil Rating: Total Depth from existing grade
(907) 230-9815 3 1.2 GPO/Sq.Ft. 10.74 Ft.
Depth to pipe invert from original grade: Gravel depth beneath pipe:
LEGAL DESCRIPTION
SEE DWG. Ft 4.02 Ft.
Subdivision: Block: Lot: Fill added above original grade: Gravel length:
FISCHER 1 3B4 SEE DWG. R. 40 Ft.
I ownshlp: Range: section: Gravel width: Beds Number of lines: Distance between lines:
5.0 -Ft. - Ft.
SEPARATIONDISTANCES absorption area Number of trenches: Dist.between trenches
t
To
Septic Absorption Lift Holding Public/Private1 -
From Tank Field Station Tank Sewer Lines 400 SQ.Ft. Ft.
Well *8o'+ #90'+ - - 25'+ TANK • Septic 0 S.T.E.P. OHolding 0 Other
Manufacturer Capacity:
Surface Water 100'+ 100'+ - - ANCHORAGE TANK 1000 Gal.
Material: 'Number of compartments
:2
Lot Line 5'+ *1i+ - - N/A
_ STEEL 1
Foundation 10'+ 10'+ _ -
LIFT STATION
Curtain Drain Manufacturer: C
- NONE KNOWN -
Gal.
Remarks: 'WAIVER#0SV181047;BOTTOM OF TRENCH INSPECTED BY Pump on level at Pump ort level at: High water alarm at
MOA ONSITE EMPLOYEE TIM ECKLUND AS REQUIRED BY A
Pump Make&Model' Electrical Inspections performed by:
SPECIAL PROVISION ON THE PERMIT;PER CONTRACTOR SEPTIC
TANK WAS HAULED OFF SITE AND DECOMMISSIONED AS REQUIRED -
BYMOA ONSITE EMPLOYEE TIM EKCLUND DURING CONSTRUCTION. PIPE MATERIAL
House to tank EXISTING/D3034 Tank to D3034
drainfield
Installer
A+ HOME SERVICES, LLC. Drainfield D3034 CO/MT D3034
Inspector GEG, Ltd. BENCH MARK (Assumed elevation)
99.94 Ft.
Inspection Location and Descnption:
Dates: 1st 7/20/2018 2nd 7/20/2018
3rd 7/23/2018 4th BOTTOM OF TRIM AT NORTHEAST CORNER
ENGINEE SEAL
Community Development Department Approval o0 opo
Conditional approval: Date: • •••.1--
'(/).* Al • -...)'‘ VA
001 9 f y •. • ess
. CE-795• ..• �1
kit e
41
Approved: a66(1-A / Date: 7/2 7 l ^°ap • o`•11247 IV-�
LICENSE 4o r0feSSiOnO�
k#AECC884 O00000�.' ''
Inspection Report_1-1-12 doe
PERMIT NUMBER: PARCEL ID NUMBER: `
OSP181204 RECORD DRAWING 015-292-22
I 1 1 I
I I 1
A BJ
1 I I
ST1 18.1 21.2DURING THE EXCAVATION OF THE TRENCH MOA ONSITE
ST2 23.1 25.5I EMPLOYEE TIM ECKLUND WAS PRESENT AS REQUIRED BY A
DBL1 24.6 27.11 SPECIAL PROVISION ON THE PERMIT.DURING THE
DBL2 26.2 27.4EXCAVATION,IT WAS NOTED THAT MINIMAL DRAINROCK WAS
CO1 30.2 39.5PRESENT(ABOUT 1-2 FEET PER CONTRACTOR).DUE TO THIS
MT1 29.1 38.5 \ FACT,NO SAND WAS USED AS THE TRENCH DID NOT HAVE TO
BE OVER EXCAVATED TO REMOVE CONTAMINATED MATERIAL
CO2 49.6 33.7 \MT2 47.9 \1.7 \ /\ \ FIS;,LOT BLOCK / ,LOT 3B6\\
\ \ /
\ I \ / /
FENCE
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I SHED
NEW DRAINFIELD;INSULATED 4"
UNDER DRIVEWAY
/ / � � � — � � \ \ ,: 02
MT
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FISCHER;BLOCK 1, V / / / \\\ NEW 1000 GALLON STEEL SEPTIC
TANK W1TH DOUBLE CLEANOUTS
LOT 4C-2 / •\ . IVAY .:•.,lir TANK
AFTER TANK
// �j��• / .,,d \ SPRUCE CREEK CIRLCE
/ woive
/ / 'oo ¢ `// \MT1 \.,
/ / 90, �! w EXISTING
HOUSE \ \IF1'+WR#OSV181047
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3701 E TUDOR ROAD.SUITE 101•ANCHORAGE,AK 99507'PHONE(907(3378179'FAX(907)338-3246'NEBSiTE-www.pamassanpineennp.com ; • 1 . r' •
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 11 : I - r/ey '.Gam- s : &v a
PARIS COCHRAN 907-230-9815 2 OF 3 0�G'i�• 7-77
LEGAL DESCRIPTION: DRAWN BY: .♦ • a,a ... � ri `
FISCHER; BLOCK 1, LOT 3B4 D.J.G. . �'• '� .t
TYPE OF WORK: DATE: LICENSE* PROFESS
SEPTIC SYSTEM RECORD DRAWINGS 7/26/2018 #AECC884 ,illlliIMS��� J
PERMIT NUMBER: PARCEL ID NUMBER:
OSP181204 RECORD DRAWING 015-292-22
FINAL GRADE=99.99-100.23
2"INSULATION PER CONTRACTOR
TOP OF TANK _1 g2
AT INLET=95.85 TOP OF TANK
AT OUTLET=95.81
11111
INVERT OF BUNG./ NEW 1000 GALLON N
AT INLET=95.31 SEPTIC TANK INVERT OF BUNG
AT OUTLET=95.15
J "I
MT CO FINAL GRADE=99.4.4-102.17
_
B EXISTING GRADE @
HIGHEST POINT=100.30
•
4"INSULATION UNDER DRIVEWAY
FILTER FABRIC
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:::::. :::::::.:.:.:•;.,.:
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4.02' INVERT OF PIPE=93.58
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BOTTOM OF TRENCH=89.56
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`RELATIVE ELEVATION OF BOTTOM OF T.H.=83.30
(TH#1 DRY ON 7/20/2018)
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3701 E.TUDOR ROAD.SUITE 101'ANCHORAGE.AK 99507•PHONE(9%)337bt79'FAX(907)77&33E6'NEBS�TE xww pameasm¢rw.1hp.com •
•
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: (f1 a /ey , ess : i-
PARIS COCHRAN 907-230-9815 3 OF 3 ••0 •
C 79 i 'Z�;
LEGAL DESCRIPTION: DRAWN BY: .* F• 7�• ' 1 c-
FISCHER; BLOCK 1, LOT 3B4 D.J.G. •♦-re"•••,�� ''''''�,,�'�'•�,�i
TYPE OF WORK: DATE: LICENS�,44,;�;;;;..�•
SEPTIC SYSTEM PROFILE 7/26/2018 #AECC884
"`r MUNICIPALITY OF ANCHORAGE
On-Site Water&Wastewater Program S
PO Box 196650 4700 Elmore Road
; Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax (907)343-7997•
' http://www.muni.org/onsite
fir y
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On-Site Wastewater Disposal System Permit
Permit Number: OSP181204 Effective Date: 7/19/2018
Work Type: Septic Upgrade Expiration Date: 7/19/2019
Tax Code Number: 01529222000
Site Legal Address: FISCHER BLK 1 LT 3B4 G:2537
Site Mailing Address: 5100 SPRUCE CREEK CIR, Anchorage
Owner: COCHRAN PARIS K 50% & Lot Size in Sq Ft: 11570
Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 3
This permit is for the construction of:
D Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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
Special Provisions: In lieu of sieve analysis to confirm insitu is sand, On-site shall be present at drainfield
bottom of hole inspection to confirm insitu is consistent with submitted sample.
,�Received By: � /� Date:
I
Issued By: �S 7� Date: T I f'
Municipality of Anchorage r'
~ i i rr
plI
P.O. Box 196650 0 4700 Elmore Road
Anchorage, Alaska 99519-6650 0 (907) 343-7904 • Fax (907) 343-7997
http:/lwww.muni.orq/Onsite
Development Services Department
On-Site Water and Wastewater Section
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSV181047 COSA#: Permit#: OSP181204
PID#: 015-292-22
Legal Description: Fischer Block 1 Lot 3B4
Engineer: Garness Engineering Group
Applicant: Paris Cochran
Your request for a waiver of the required 100 feet horizontal separation from the septic tank and
drainfield to the private well has been approved. The approved separation distances are 80.0 feet
and 90.0 feet, respectively. In addition, your request for a waiver of the required 10.0 feet
separation from the drainfield to a lot line has been approved. The approved separation distance
is 1.0 foot to the lot line bordering Spruce Creek Circle only. In addition, your request to locate
a portion of the drainfield under the driveway has been approved. See engineer's waiver request
letter for justifications for granting these waivers.
This waiver approval applies to the proposed septic tank and drainfield only. Any future upgrade
to the on-site wastewater disposal system will require all separation distances be met or another
approval from this department.
Waiver is Granted: X Waiver is not Granted:
Date: 1/19/lir Approved by: �k�ll l�t���1 0A,LJ-0
Name of Reviewer
**** VARIANCE/WAIVER REVIEW ****
3656 789
MUNICIPALITY OF ANCHORAr' - pt°*
i
Community Development Department �
Phone.V►7-343-7904
Development Services Fax: •t a 43-7997 C'A,N
On-Site Water & Wastewater Program 6 8 L 9 9'1
Mayor Dan Sullivan
On-Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I.D. 015-292-22
Property owner(s) PARIS COCHRAN Day phone 907-230-9815
Mailing address 5100 SPRUCE CREEK CIRCLE *ANCHORAGE,AK 99516
Site address 5100 SPRUCE CREEK CIRCLE*ANCHORAGE,AK 99516
Legal description (Sub'd, Block & Lot) FISCHER; BLOCK 1, LOT 3B4
Legal description (Township, Section & Range)
Lot Size Sq.Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING:
(®all that apply) Initial ❑ Single Family (SF)
Absorption Field ® Upgrade - (w/wo ADU)
Septic Tank ® Duplex (D) ❑
Renewal ❑
Holding Tank ❑ Multiple Dwellings n
111 (SF and/or D)
Privy
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: \
SEPTIC TANK TO WELL; DRAINFIELD TO WELL; DRAINFIELD TO
LOT LINE: DRAINFIELD TO DRIVEWAY: NO SIEVE ANALYSIS Distance: 80 FEET;/FEET;90 FEET: 0 FEET
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: 'JC' q -r Waiver Fees: 11 2ff
Date of Payment: -7 — t1--1 Y Date of Payment: -]-17--lr
Receipt Number: DaAr[6 Receipt Number: j' lct-taA
Permit No. 0SP'K I ib ` Waiver No. 05V i i c` 11
(Rev.01/11)
t __ uanics
GARNESS ENGINEERING GROUP, Ltd Aci.,,nc b T.' tm tv�,tC.m
ENGINEERING SALES CONSULTING Dealer
July 19th, 2018
Municipality of Anchorage
Development Service Department
On-Site Water&Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: Proposed Septic System Upgrade for Fischer; Block 1, Lot 3B4
To whom it may concern:
The existing 3-bedroom house is served by a private well and septic system. The 28-year-old steel septic
tank is at the end of its useful life and the drainfield is approaching the end of its useful life. We are
proposing to decommission the existing septic tank per UPC and install a new 1000-gallon steel septic
tank. We are also proposing to excavate out all contaminated material, import MOA sand as needed to
rebuild the existing drainfield to a depth of 11 feet below existing grade and construct a 5-wide type
drainfield over the existing drainfield that is extended approximately 8 feet (40 feet total). One testhole
was excavated on the property, additional information regarding soil profiles on adjacent lots are also
attached. As can be seen on the GEG soil log, and the soil logs for the adjacent lots, there is a sand and
gravel layer prevalent throughout the area. In short, although the existing drainfield is designed around a
testhole that was visually rated, it is reasonable to believe that the soil profile for the trench has a
percolation rating of less than 1 min/inch. Additionally. a soil sample was submitted with this design for
your review. A sieve was not submitted as we feel it is not necessary as the submitted soil sample is
clearly sand. In short, we feel as though a sieve should not be required and the drainfield should be
allowed to be rebuilt. Comments regarding the design are summarized as follows:
1. SOILS: See attached 2018 soil log by GEG which shows soil classification, groundwater monitoring,
and percolation test data. As stated previously, several soil logs are attached showing a consistent sand
and gravel layer throughout the area. In short, although we are outside the 30 foot radius for the proposed
re-build, we feel it is reasonable to assume a <1 min/inch percolation rating. Additionally, a soil sample
was submitted with the design to waive the requirement of a sand filter without a sieve analysis.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface water concerns.
4. TOPOGRAPHY: There are no slopes >25% within 50 feet of the proposed trench and the are of the
proposed drainfield is flat.
5. WAIVERS: A waiver was granted on 2/16/1990 for the existing septic tank to the well on property to be
reduced to 90 feet. We are requesting that your department issue a variance of 80 feet from septic tank to
well. Additionally, there is an existing waiver from drainfield to lot line from 10 feet down to 5 feet. We ask
that this variance be re-issued, although the existing septic system is approximately 10 feet from the lot
line. In short, we want to avoid having to request a waiver during construction if encroachment upon the
lot line becomes necessary. We also request that your department waive the requirement for a sieve
analysis and allow for the drainfield to be installed under a driveway. The requested waivers are
summarized as follows:
• Septic tank to well: 80 feet
3701 East Tudor Road, Suite 101 *Anchorage,Alaska 99507-1259
Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com
Page 2 of 2
• Drainfield to lot line: 1 feet
• Drainfield to well: 90 feet
• Drainfield to driveway/parking areas: 0 feet
• No sieve analysis
Justification for granting these waiver as as follows:
• Per the inspection report in MOA records, the existing drainfield is 100' from the existing well. Per
the record drawings, it is immediately adjacent to the 100' well radius. Based upon this fact, we
are requesting a 90 foot waiver as the drainfield will be widened and it is unknown if the initial
measurement was completed by a professional land surveyor.
• The drainfield is being extended an additional 8 feet. There is a seepage pit located to the west of
the proposed drainfield and its exact location is unknown. For this reason, we are proposing to
extend the drainfield south, rather than west. In short, the 90' well waiver is needed in order to
avoid over excavating (maximum depth of 11 feet) and avoid a potential encroachment during
construction.
• The house is located between the well and drainfield, if effluent were to overflow it would not flow
directly towards the well head.
• Water samples were pulled on 5/13/2018, the results are as follows:
Arsenic: Non-detectable (<5 ug/L)
Total Nitrate/Nitrite-N: 2.51 mg/L
E.Coli/Total Coliform: Negative
• The area between the well head and proposed septic tank and drainfield is vegetated
• Per the well log there is a "wet silt" to "fine gravel" layer from 215-296 feet
• The home is located between the well head and the proposed septic tank and drainfield
• It is an improvement from the existing 28-year-old steel septic tank
• A 100 scale is attached which shows the nitrate levels of all adjacent properties. Based upon this
data, it indicated that the nitrate levels are due to the aquifer, and not necessarily an indication of
the failing septic tank on property.
• The submitted soil sample show the insitu soil is clearly sand
• The existing drainield has been located under the driveway for approximately 28 years. The new
drainfield will be insulated with 4" of blue board insulation.
We are unaware of any adverse impacts this installation and/or waivers would have on adjacent wells or
septic systems. /It you have any questions, please contact us at 337-6179. Thank you for your
assistance.
rely,
- r- a ess, P. ., M.S.
Pres': t
3701 East Tudor Road, Suite 101 *Anchorage,Alaska 99507-1259
Phone: (907)337-6179*Fax: (907)338-3246*Website:www.garnessengineering.com
1 4A2
3A5 3A6 3A7
4A1 �—
3A4 SELDON Cir
4B-1 4B-2 — --(84-213)
(84-213) (84-213) /--' \X \�\ e� `�\
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PER OWNER;SEE NOTE S-, �� ��---_ - ��___-_,.
ON 40 SCALE -
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4C1 4C2/''� �* .i` SPRUCE CREEK Cir
100' _-- /_
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GARNESS ENGINEERING GROUP, Ltd I,; '911 .. ''' ' �_ ••
- . ENGINEERING SALES CONSULTING - - - - llr03701 E.TUDOR ROAD,SUITE 101'ANCHORAGE,AK 99507'PHONE(907)337-6179'FAX(907)338-3246'WEBSITE.www.garnessengineenngcon . ••• •• fPREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 J- - am-7. : Lz.,•
PARIS COCHRAN 907-230-9815 1 OF 2 ��J,'•;.. -7.15) '._
PROJECT/LEGAL DESCRIPTION: DRAWN BY: .. 4 •.• •• . 3 I,, (`,40
FISCHER; BLOCK 1, LOT 3B4 D.J.G. lir ♦ „,_••• (`'*.„ .�
TYPE OF WORK: DATE: LICENSE 44
, 1 ESS` ..••
SEPTIC SYSTEM DESIGN UPGRADE 7/3/2018 #AECC884 �����
1
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DESIGN CRITERIA: — GEG.Ltd.HAS A 8 PAGE SPECIFICATION I 1
NUMBER OF BEDROOMS:3 LETTER THAT PERTAINS TO THIS DESIGN.TO NOTE:THE CONTRACTOR SHALL HAVE
GALLONS PER DAY(GPD):450 OBTAIN A COPY OF THE LETTER CONTACT THE NORTH LOT LINE,AND ALL
PERCOLATION RATE/S:'<1 MIN/INCHGEG.BY PROCEEDING FORWARD WITH THIS
INSTALLATION,THE ENGINEER,WELL DRILLER, PERTINENT WELL RADAII FLAGGED BY A
PROPOSED APPLICATION RATE: 1.2 GPD/FT° CONTRACTOR AND PROPERTY OWNER AGREE REGISTERED LAND SURVEYOR PRIOR TO
MINIMUM DRAINFIELD SQ.FT.:375 Fr THAT THEY HAVE READ THESE CONSTRUCTION.
•SEE DESIGN LETTER REGARDING SAND FILTER AND SPECIFICATIONS AND AGREE TO ACCEPT THE
PREVIOUS PERCOLATION TESTSTERMS AND CONDITIONS OUTLINED.
DRAINFIELD DESIGN: \ \
MAXIMUM DEPTH:LIMITED TO REMOVAL \ / \
OF CONTAMINATED MATERIAL
MOA APPROVED SAND:AS NEEDED TO REBUILD THE DRAINFIELD TO BE INSULATED UNDER DRIVEWAY
EXISTING DRAJNFIELD NO GREATER THAN 11 FEETWITH A MINIMUM OF 4"HIGH DENSITY INSULATION
BELOW EXISTING GRADE
WIDTH:5 FEET OVER THE ENTIRE WIDTH OF THE TRENCH
LENGTH:40 FEET \ /
EFFECTIVE:4 FEET FISCHER;BLOCK
REDUCTION FACTOR:0.50 FEET 1,LOT 3B6
ACTUAL SQ.FT.:400 FT' N / FISCHER;BLOCK
/ 1,LOT 3B5 /
PER CONVERSATIONS WITH OWNER ON
6/26/2018 THERE IS NO WELL ON -
PROPERTY AND IS SERVED BY A WELL I --- _ —
SHARED WITH LOT 4G1 =I \
1 \0-5% ,5% 10'+
FISCHER;BLOCK 1,
LOT 4C-2 APPROXIMATE LOCATION C•. APPROXIMATE LOCATION OF
OF GEG TESTHOLE T.H.BY BRUCE COWAN.P.E.
ALL CONTAMINATED MATERIAL IS TO BE EXCAVATED
OUT;THE EXISTING TRENCH WILL BE WIDENED AND + — --- ligird.,.- k SPRUCE CREEK CIRCLE
EXTENDED;SAND WILL BE IMPORTED AS NEEDED tu CAR
PORT 1.7.71+1 / EXISTING SEPTIC TANK TO BE —____
AN EXCAVATED AND FILLED WITH PIT
/ // ¢ \ __N RUN GRAVEL
w - • PROPOSED DRAINFIELD
/ EXISTING 3 1'+WAIVER REQUEST
/ j BEDROOM 1000 GALLON STEEL TANK;DO
HOME \ NOT INSTALL UNDER DRIVEWAY;INSTALL
b
/ 9p.11,4
/1, DOUBLE CLEANOUTS AFTER TANK
ONFIRM
/ / ,,ri.Rk-QUFST — — 1 INTEGRITY CONTRACTOR FCO;INSTALL i NEW FCO IF NEEDED
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GARNESS ENGINEERING GROUP, Ltd0
3701 E.TUDOR ROAD.SUITE 101•ANCHORAGE.AK 99507•PHONE(907)337.8179'FAX(907)338-3248'WEBSITE:www.ym•sserpneering.ean , • .. ' .•
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: is = A. Gam: •
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PARIS COCHRAN 907-230-9815 2 OF 2 • i., . C 9 3•
PROJECT/LEGAL DESCRIPTION: DRAWN BY: I� •• .� �!t /.t'''. �
FISCHER; BLOCK 1, LOT 3B4 D.J.G. • p�•p��U,I� p\- .40
TYPE OF WORK: DATE: ,, �"`,��••
SEPTIC SYSTEM DESIGN UPGRADE 7/19/2018 #AECC884 11� *�
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3101 E TUDOR ROAD,SUITE 101•ANCHORAGE.AK 99507'PRONE(907,3376,79'FAX(907)336(3256,A,EOSITE x+vn 0,KF55K,9wec(r.)c_m ,�e .•�0 • �/
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SOIL LOG - PERCOLATION TEST '•,•,pF I . CE-7953 •;S�_i
LEGAL DESCRIPTION: FISCHER: BLOCK 1,LOT 3B4 A♦r 4O.,, •*/::4
PERFORMED FOR: PARIS COCHRAN DATE: 6/28/2018 (11 PROFESS\���4
LICENSE 1litIt"`ivS8
DEPTH ..7_:_-_,-:::::^ #AECC884
(feet) ^ ORG TEST HOLE #1
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6 •• . • . *0. k.p SC et• • • • ,`Q.
7 i• . DEPTH GROUNDWATER
DATE �P�
. • . 5�
8 DRY 6/28/18 ',0
• • • 4,4
DRY �8 7SCALE
9 1 =100'
• • • •
10
• • ' •
• • CLOCK NET TIME WATER LEVEL NET DROP
11 • ' DA I f READING TIME (MINUTES) READING (INCHES)
• • • •
• • • SM W/SOME GRAVEL 6/29/2018 ABSORBED 5 GALLONS<1 MIN 2 TIMES
12 ' a POCKETS OF SP
• • • •
• • •
13
• • •
• • • •
14
• • • •
• • • •
15
• • • •
• • • r
16
• • • •
• •
17 B.O.I1.
18
PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 ; N..
19
TEST RUN BETWEEN 6 FT. AND 7 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: D YES • N;)
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: ERIK WIDGER
COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH.
PERFORMED BY GEG, Ltd. I. JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PEFOFMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: -J /t.,//
J
I PROPOSED FINISHED FLOOR
0.EV.(ASSUMED)
$E BUnCIRD CORNER
°E°R0V.(9 ) '`‘; 3B5
ZONING DISTRICT
FRONT BUILDING SETBACK
9DE BULDNO SETBACK r2]Sp,
MILLING DG SETBAO( VV•-
SS9.
2S-
SN � 'o.
'< >'
b
cr H C.O.s`� o`
t` d
up
Lu CAR
PORT GRAVEL DRIVE X SPRUCE CREEK
a
J � C.C.S ..
L �
•
CIRCLE
RC L ENO
• 27.5 EXISTING
S N. HOUSE
cg0
W •
ELL X23
36
3B3
UNDER NO CIRCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE UNES.
THE SURVEYOR TAKES RESPONSIBIUTY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL UABIUTY ONLY FOR THE COST OF THE SURVEY.
LISTED DISTANCES PREVAIL OVER SCAUNG. REPRODUCTION MAY CAUSE ERRORS IN SCALE.
❑ LOT SURVEY SURVEY TYPE SYMBOLS
❑ FWNQAl10N AS-BUILT • DRAINAGE
SET REBAR 1:-.-:.:::::-.:::-:1 ASPHALT
❑ FINAL STRUCTURE AS-BUILT 0 FOUND REBAR O 0 0- WOOD FENCE t .:.o..a CONCRETE
O PLOT PLAN . . AS-BUILT. . .LOT SURVEY. . . TOPOGRAPHY /:=3) ASSUMED ELEV. X k X METAL FENCE IIJfifI WOOD DECK
El A$-BUILT . • . No CORNER$SET 0 RECERTIFlCAT oti AS-BUILT. . . NO CORNERS SET
PLOT PLANS Sc LOT SURVEYS NOTE:
IT IS THE RESPONSIBIUTY OF THE BUILDER OR OWNER, PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE
CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS,
TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW
THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED.
WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED.
SURVEY CERI1FICA11ONPrepared by
�� wwwr*�!
PLOT PLAN
.**,77:110 f •ate Robert E. Johns, Jr. & Assoc.
I hereby bray nwt I hots WtyHodtys lsd •♦,`p:,, •.,•.(.j Professional Land Surveyors
the Tot&eon old deedlb.d hence,red that I �♦C., •' ,.s(I.;.
1700 Brink Drive.
hors tared or.etabBahee al of the lot comers `C/
a WON n the Wan and to the beet of my / 1-I• ! . ANCHORAGE, ALASKA 99504
ICtordWoe nod ab&lle&at dlnen.toos ho.s been I N: `
eoa.rW true end correct Y 9 \ Rec. Lot S.F. Rec. Plot File No.
/ # J f Scale: 1„ = 301
FOUNDATION AS-BUILT 1 `�'�"r.;Ir " f
I,Robert C Jahno,Jr.,hereby only that I ., `7 0 Dote Surveyed: Drawn b Checked b
how I» •d n A.-Boat-,»r at the .. - "�` 01/15/13 Y RE ,FMK
toandatlen dl Mil lot and that all the /� •
awnrrton and Information as Wore hereon . RO RT HNS,
s;a.nat :"°°°`" ""'n""�' # . _.. o M Date Drawn: 01/16/13 Grid: 2537 WD 13-14
• P, ,• 4121— ••
FINAL STRUCTURE AS—BUILT •.d• 'N J �t AP Legal Description:
I,Robert E John.i.,hereby orgy that I .d',' 'N
•, i . C2
;fitctu�oa Nte an and
that
�e the .•Go,`jr••,••, .....�o,sa♦.• Lot 3 B4 BLOCK 1
aen.n.loaa and Ia,am,adv as Woe.hereon +1,,,a,O S SIO na,�♦♦ F I SC H E R
aro.t o nhe teee.encroachments erdtt urns;
aylimiw .
,
•
----11 -\:)4, SEED 1i. - 1r-
eJ\'T� 1
II N
II
�-r i Flsc CS/D - ''..'• /� '�
/ I I LOT X4( 1 FSCHER S/D \ S E:
/ FISCHER BI/0 LOT 3A1, BK 1 1
// I // \ LOT 3A2, eIZ�\ ,.. Ir1/\\ 1" - 100'
/ \\ I / \ ILL]
I I 4 -- -----4-i-- `'t:. ,
L I ' A --- t 1 I
I T' �� . .r 1 1 IL—J
1
' ' � FISCHER D
�� � LOT 386, K 1/ I7
0,,, ISCHER S/D / /
A' \ I t,OT 3B5, BK 1 \ FISCHER S/D H
`} J / LOT 3B7, BK 1 /
lv �� I � c AREA / NC.' N
(All \ �I- — "� �C AaeA, P?iC --!
-,.. ARS
— I ���
FISCHER S/6 I FISCHER S/
LOT 4C�/BK 1 I LOT 384,...61‹\ S R ImoUC CREEK C i r
" �// `
N.
\ I FISC ER\S .
LOT 81,
/ 1 I LOFISCHER
383, B D 1\/r HOU u \
/ I h'HEO[I 1
• , I . 1 ` I 1
__------_------- j ---- --/ 1, ----------•
\ \104T &VENUE
0 = a:R-$ N =a4W-)
ril3v113
ail►?Iry
LOUDERMILK 5/0
LOT 7,
_..__- '..__.......... .__.........,..r_._.:....................... .._� �t1 r_ r.-J ,...:..........:R.m:c_r3L."::::�_:u.::c�.. ..... • •
IS
I' �.
GARNESS ENGINEERING GROUP, Ltd • `
:-� •.
:, ,::a:CIVIL&ENVIRONMENTAL ENGINEERS- ........ .__::_:.: . :...- .. ::_s:._ . i
3701 E.71.100R ROAD.SURE 101 •ANCHORAGE.AX 99307•PHONE(907)337-0179•FAX(907)330-3241•wFBSIrE:....yams ung wwp . . . . .. - 0
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: j
. SG$
SGS Ref.# 1182185001
Client Name Garness Engineering Group, Ltd Printed Date/Time 05/22/2018 12:30
Project Name/# Fischer;B1,L3B4 Collected Date/Time 05/15/2018 15:50
Client Sample ID Fischer;B1,L3B4 Received Date/Time 05/15/2018 16:11
Matrix Drinking Water Technical Director Stephen C.Ede
Sample Remarks:
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits Date Date lint
Metals by ICP/MS
Arsenic ND 5.00 ug/L EP200.8 C (<10) 05/18/18 05/18/18 ACF
Waters Department
Total Nitrate/Nitrite-N 2.51 0.100 mg/L SM21 4500NO3-F B (<10) 05/16/18 AYC
Microbiology Laboratory
E.Coli Negative 1 100mL SM21 9223B A 05/15/18 K.W
Total Coliform Negative 1 100mL SM21 9223B A 05/15/18 K.W
MUNICIPALITY OF ANCHORAGE
` DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage. Alaska 99502• Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Ne^e
DISTANCES O/S— 9A _ x
TB
ABSFIELDIBN
WELL
" hasa
FAOM
TANK
PO F;ox 101040
pn;>ne(al Perma No. No. of Beorooms
WELL
W
01
OO 1
,f —1311 1 9MO 3LOT
LINE
/31
si
2
uau oascal TION
Lot
Bleck
$uDdwsron
3
FOUNDATION
231
30%
.3-71
Township, Range, Section
AS-BUILT DIAGRAM (Snow touuon of well, aepuo system. D,opety Ins0. tounaeion.
anreway, wale, Doles. CC) k1r, 11C S•
TANKS
► 1NI
SEPTIC ❑ HOLDING
lh,37
p
%h D 53'
TE 5
Manutecture,Qpauy
m gals
• ��
Metane
Na. a compartments
TYPE OF SYSTEM
TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER
14C U 11
oC
Depth to Pipe WIGM I,OM
ToW eepth hom onginal gia le
agmal glace 1 FT
17-' FT
Fm thweo above aig." g.aoa
Greel Ilepth beneath pope
Q FT
FT
Gravel length
Ware wieth
z t FT
3011 FT
—
jv5i IAYJ
Total aWorpeoneea
Distance between Ines
51Z SO FT
N FT
humps, of Imes
Sal rating
Fps maleNl
I
/SO SOFT
Sr 1
;A
ILLIaIIM o y $ y
Dale Ineaile0
S
3 3 o
3
Al- TR K nD l
WELLS
*PRIVATE ❑ OTHER (lden8fv)
�
Oleswbubon (AB.GI \
Total DepthQsaa
to
FT
FT
Imtaile /.
Dale lnstNleO.
TA
( t
REMARKS:
X/ST. ceiAtjovAjeo f C SPccS
ME-LI TAT 14 y 01—D
GL'usF�En F/GEED' F0�eQ&14ATeD
Scala: T
t .elwleteeAa
nOFol T P)
Ins ions Perform y:
il•� R '>i.
Dats.
y
N
•.
I rVy dist Inlpadlon waa Worsted arseding to all
d , . • i . �
Municipal and &ae guidelines In glad an W9 "t ��
.: IV,,
H@Mh Department Approval: ' Date:
72-0T3 (3/85) 0 0 x L
t
Pm
• 3-,�-9v
M U N I C I P A L I T Y O F A N C H 0 R A G E C�(�
Department of Health & Human Services —
02-5 L Street, Anchorage, Alaska 99501 343-4720
0 N- S I T E' S E W E R P E R M I T
Permit Number: 900036 Upgrade 51 1 �1L�C�L�ZC0
Date Issued: 02/20/90 Engineer Designed
Owner Name:
ALASKA HOUSING FINANCE
CORPORATION
Day Phone:
Owner Address:
P.O. BOX 101020
522-1311
ANCHORAGE, AR, 99510
Parcel Id:
015-922
Lot Legal:
Subdivision: FISCHER SUBDIVISION
Lot: 3B4
Block: 1
Section: 15 Township:
12N Range: 3W
Lot Size
11570 (sq.ft. or acres)
Max Bedrooms:
This Permit: 3 Total
Capacity: 3
SEPTIC TAME•:: Minimum total septic tank: capacity: 1,000 gallons. Each septic
tank must have at least 2 compartments. Depth to top of septic tan(.(s) < 4.0
feet renuires insulation over tank(s).
INFORM D.H.H.S. PRIOR TO INSPECTIONS BY ENGINEER, IF AFIT-H
HOIJkS, CALL 343-4601 AND LEAVE A MESSAGE.
CONSTRUCT PER' ENGINEERS ATTACHED DESIGN.
THIS PERMIT EXPIRES,12/31/90 AND VALID FOR A SINGLE FAMILY HOME.
I CER 17
1. I am familiar with the requ:remen s tur on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
�. I will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
4. I understand that this permit is valid for a maximum of 3 bedrooms. I
also understand that the capacity of the total system is 3 bedrooms and
any enlarg e t will requir an additional permit.
Signed: ( DATE, �20�
(Owner) A aSR:A HOUSING I ANCE CORPORATION
Issued By:DATE: - .20-190
J------------
-----------------------------------
�" i': �-'1'r:�`YiU:y.��t- .:Y.�1-YAfivCC-i SJY'•-_nau((� o�,o/nwv y�: �: rJT^.jvrs •err .✓.�.r-.-; ""1'Pir a�' .' .j,'+.�i'..�i�`.""
r4`ii 1-:].7V�a'.s�'+>-s��F�l�!�t�f�.."F�f�r�Y STiml.:alLS)�2Mws�.-TAl'4'15.5�1�'✓JtYiw`c.,?�u1�4`t� .. ... _ r.r.f ..
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
TomP.O. Box 196650 Anchorage. Alaska 99519-6650
Mayoror
343-4744
March 13, 1990
Bruce Corwin, P.E.
Corwin and Associates
PO Box 230608
Anchorage, Alaska 99523-0608
Subject: Waiver Request for Lot 3B4 Block 1 Fischer Subdivision
Waiver Request #WR900003, PID #015-292-22
Dear Mr. Corwin:
Your request for waiver of the required 10 foot separation
between a septic system and a lot line has been approved. The
waived distance is 5 feet.
This approval applies to the existing septic system lot line
separation only. Any future upgrade to the septic system will
require all separations be met or another approval from this
department.
Sincerely,
- �-1W
Daniel J. Roth
Civil Engineer
On-site Services
ljw#7
Concur:
I
YohnSmith, P.E.
Program Manager
On-site Services
Municipality of Anchorage �� 1
Department of Health and Human Services
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
February 16, 1990
Bruce Corwin, P.E.
Corwin and Associates
1000 East Dimond Boulevard
Suite 205
Anchorage, Alaska 99515
Subject: Waiver Request
Subdivision
Waiver Request
Dear Mr. Corwin:
for Lot 3B4 Block 1 Fischer
#WR890064, PID #015-292-22
The subject waiver has been amended as requested in your
January 19, 1990 letter. The prior approval issued on
November 1, 1989 waived the required 100 foot separation
distances of Lot 3B4 Block 1 septic tank to well, 80 feet;
Lot 3B4 Block 1 leachfield to well, 88 feet; Lot 3B4 Block
well to Lot 3B3 Block 1 septic tank 80 feet; Lot 3B4 Block
well to Lot 3B3 Block 1 leachfield, 90 feet. The amended
approved waiver is for the proposed new septic tank
separation distance to be installed 90 feet rather than 80
feet from the well on Lot 3B4 Block 1.
This waiver approval applies to the proposed septic tank to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this office.
If there are any further questions, please call this office
at 343-4744.
Sincerely,
"� y; , �'W
Daniel J. Roth
Civil Engineer
On-site Services
DJR/ljm:06
Co ur ence,
J nS�myith, P.E.
Program Manager
On-site Services
MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
Corw0in JAN 19 1930
& associates,inc. RECEIVED
Consulting Engineers
1000 E. Dimond Blvd.. Suite 205. Anchorage, Alaska 99515.(907) 522.1311
January 19, 1990
Mr. Dan Roth
Municipality of Anchorage
Department of Health & Human Services
825 L Street
Anchorage, Alaska 99503
SUBJECT: IAT 3 B4, BLOCK 1 FISCHER SUBDIVISION
Dear Mr. Roth:
We request that the Waiver for Well to Septic Tank Separation
Distance of 80 feet issued by you on November 1, 1989, be
amended to allow us to upgrade the septic system on the above
referenced lot. Our intent is to install a new trench system
100 feet from the well, and a new septic tank 90 feet from the
well.
We are also seeking a septic system to lot line waiver of five
feet. The $70.00 fee for this waiver is included.
If you have any questions, please contact our office.
Very truly yours,
CORWIN� && �AS�SOOC�IATES, INC.
Gerard Kress
Engineering Technician
enclosure
GK/lb
FLY. LL:i e naAS 46b
0 cQu Pd�K no P-Ali3i ajo
1..uP9Uc Z)a-5
65 =
(ENGINEER'S SEAL)
Municipality of Anchorage
(;tY� DEPARTt.1E-NT OF HEALTH E HUMAN SERV. 3 '
625 "L' Strect, Anchorage. Alaska 99502-0Gt � y
SOILS LOG — PERCOLATION TE
PERFORMEO
LEGAL DESCRIPTION: L.-,oT 394 91 K Township. Range- Section: Ti Z Kt f?—'Yu s / S
SLOPE SITE PLAN
HSGHEE SUaD.
2 SP -SM
- .. Sana w/trace o -C S;1+y 4AJ
3-
4-
6 46 ...
11 I I o
12 l0 w
75
ML
16
EAID
17
18
19
20
COMMENTS A1i1SL
MMUM ■oomm- IMMMM
riclAir-Mll C
IFYES.ATWHAT L
O
DEPTH? P
E
-H+
Otxh to we" RPxr
Kanitvirrl Oe,l ort 1
Readuv! Oate Gros Mt Depth to N<[
Time Time Water OZ
PERCOLATION RATE (m6v Il /:nrhl PMC HOLE DIAMETER
TEST RUN f1ETV/I;EN FT AND FT
pERFORMEO 8Y: PP � KCE4Z • ( 1AVtLGV' (L-VN.'IF r-ERTIFY THAT/T)HIcS�T/EEA��WAS PERFORMED IN
ti ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIOELINES IN EFFECT ON THIS DATE. DATE: _LL z2do
o
.-� 12-008 (Rev. 4/851 / '
. III
I L__
f
I � UE LL
EXIST. CRIB
TO eE MAUD,
\ I ' EX IST. TALI K
v TO BE AVAIM
DROP. TKCLCH
'U.r' LOSIG
,TEST HOLE.
SPPLr-E CEEEIC,
LIEU
61
W
J
J
e<
PROPOSED SYSTEM: TRENCH
(3 Bdrm)(150 soil)= 450 sq
Construct Trench
8' sewer rock x'28.5' deep
=456 sq ft.
Abandone Existing Crib S
Tank.
Install new 1000 gal sep
tank M.O.A. Approved
Insulate tank if cover
is less than 4'
Insulate trench with 4"
styrofoam insulation
where it crosses the
driveway.
Install clean -outs between
tank and trench, and at
both ends of trench.
Install monitor pipe in
trench.
A 500 Gallon M.O.T. Approv
Lift Station May Need To
Be Installed, if adequat
grade fron house to
proposed trench can not
be obtained.
INSTALL 4" STYPOFOAH 4 = Gov[K FILL
INSULATION OVEE GEO i O GEoFAgEt:
FASEIC AT DEMPAY J-4" PEZ.F PIPE
C FOSS I UG
s• SEWM
rmK
NOTE:
All Dimensions And Locations Must Be
y'�1
Field Verified Prior To Construction
SEWER
SYSTEM
LOCATION
PLAN
»--x^• NORTH
J. Conin
/ CE 2n
ISCHE
r Z&t zaw
00NOTE-
The Aceurfey er yLoc.tlonCorner Of all.ltlnd Ma
/reposed rrorertr Corners, act. .M sioptic
sLoas
LKEESS dUs"eis Mot Er.et. O senalons .Ipc and/ r My Yren Detecords, A Yse M Clotn
Sara l,L" T Ma.lelp.l Moeord.. And Mot 0y
A i Survaylny r«nnldaas
SYSTEM S
DATE- 111'71(70 1 SHEET ' OF 2
VERIFY TALL DIMENSIONS PRIOR TO CONSTRUCTION
GRAIL! LINK FENCE
PROPOSED TtEUCH ES.5' LOUD
5' PeOM P90PEE-Ty LINE C7
SE EKD OF TEEMCH
EETY LINE
1
iAf
.lti
EXIST. CQIB-\\`^ 1' n s -i- ,e•
..
>ro TEST HOLE ►..CBS:
♦' p
ral
1 rV 0044
CAE ET pelVEuAr\ - 1� I + SPEUCE. CEEEK C32CLE`
EXIST
•tnu K Z
27.3'
NO�yE \ I�PEOP05ED NEW 1000 GAL
SEPTIC TANK 90'* FEOM
WELL
a \ \ \ INSTALL 300,,99�E LIFT STATIot,I
30 2 IF NECESSZV
SHEET 2 OF 2
terfitt, lhel�a etcorole surrey of the
pr I
described perly-
/ ros nods on and Ilhe
Anprovsmenls a/lua �d thereon are r!!.0 hs
property /Ales cord do nQI ores/op or entroo
SEWER SYSTEM LOCATION PLAIN on oproperry /y�rD o srI Ihero% thof no
lnpro nenlaon'Oroparlyfy adjacent lhonro
L EC EN encroae rhe prem/sea In r/an and Thal
PrAnoy m
on
l;Cz woo !hare are roodroya, fronsm/ssI /Ines n other
\lt rts/D/s aosem s ae sold proper coal os
• /r Pe and eDoi re salad ArdJrnled hors
O fj�8 X a /sDor so h snrro Daf d of Anchorage, /onto, lhls d%,
198— .
PREPARED FOR: Ls Na
C#?W BY., Ili DATE: SCALE: 1 =soy SN£ETNO. of PREPARED BY
CHCKD BY: wa Ho. F.B. No. cam CORW/N & ASSOCI=ES
1000 E DIMOND BLVD.
SUITE 205
LC7"T 3B¢/ BG.0 ! ANCHORAGE, ALASKA 99515
96 10 (907) 522-1311
Municipality of Anchorage
Department of Health and Human Services
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
November 1, 1989
Bruce Corwin, P.E.
Corwin and Associates
1000 East Dimond Boulevard
Suite 205
Anchorage, Alaska 99515
Subject: Waiver Request for Lot 3B4 Block 1 Fischer S/D
Waiver Request #WR890064, PID #015-292-22
Dear Mr. Corwin:
A
Your request for waiver of the required 100 foot separation of
a septic system to a private well has been approved. The
approved separation distance is Lot 3B4 septic tank to well
80 feet; Lot 3B4 well to leachfield 88 feet; Lot 3B4 well
to Lot 3B3 septic tank 80 feet; Lot 3B4 well to Lot 3B3
leachfield 90 feet.
This waiver approval applies to the existing septic system to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this department.
Since'8ely,
Robert Y7. 'Robinson -
Civil Engineer
On-site Services
RWR/ljm
Municipality of Anchorage
Department of Health and Human Services
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
January 8, 1990
Alaska Housing and Finance Corporation
Box 101020
Anchorage, Alaska 99510-1020
Subject: Lot 3B4 Block 1 Fischer S/D
Permit #890257, PID #015-292-22
The subject permit, issued by this office for a single family
well and/or on-site wastewater system has expired as of December
31, 1989.
Permits are issued on a calendar year basis by authority of the
Municipal Code of Regulations. A new permit must be obtained
from this office for an well and/or on-site wastewater system
noh installed by the expiration date.
If you have drilled the well, a well log needs to be sent to
this office for documentation of the installation and to close
the permit.
If a private engineer inspected the installation of the on-site
wastewater system, the original as -built inspection report
(three-part form) must be sent to this office for review,
approval and documentation.
When applying for a new permit, the fees are: $90.00 for an
on-site wastewater permit; $50.00 for a well permit; $140.00 for
a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
Sincerely,
John Smith, P.E.
Program Manager
On-site Services
JW/ljm:200
enc: Copy of Permit
"Kids Are Our Future"
M U N I C I P A L I T Y O F A N C H O R A G E
Department of Health & Human Services
825 L Street, Anchorage, Alaska 99501 343-4720
O N- S I T E W E L L P E R M I T
Permit Number: 890257 Upgrade
Date Issued: 11/01/89
Owner Name: ALASKA HOUSING & FIN
Owner Address: BOX 101020
ANCH, AK 99510-1020
Parcel Id: 015-292-22
Lot Legal: Subdivision:[FISCHER, Lot: 3B4 Block: 1
Section: 15 Township: 12N Range: 3W
Lot Size 11570 (sq.ft.. or acres)
Max Bedrooms: This Permit: 0 Total Capacity: 5
Day Phone:
522-1511
WELL: Log must be submitted to Municipality of Anchorage Department of Health
and Human Services within 30 days of well completion.
WR89064 DA1ED 11/1/89 GRANTS SETBACK WAIVERS AS FOLLOWS; LOT 3D4
WELL TO SEPTIC TANK 80' AND WELL TO DRAINFIELD 88' : LOT" 3B3
WELL TO SEPTIC TANK 80' AND WELL TO DRAINFIELD 901.
I CERTIFY THAT:
1. I am familiar with the requirements for on-site sewers and wells as 'set
forth by the Municipality of Anchorage.(MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
3. I will adhere to all MOA and State of Alaska requirements for the set back
distances fr m any existing well, wastewater disposal system or public
sewerage syem on thi, or any adjacent or nearby lot.
4. I understa that thi permit is valid for a maximum of 0 bedrooms. I
also under t nd that the capacity of the total system is 5 bedrooms and
any enlarre wil rc•auire an additional permit.
Signed: ---------- DATE:
(Owner) ,aL iSK iNG " FIN
Issued By:DATE:
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
Tom Fink,
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
November 1, 1989
Bruce Corwin, P.E.
Corwin and Associates
1000 East Dimond Boulevard
Suite 205
Anchorage, Alaska 99515
Subject: Waiver Request for Lot 3134 Block 1 Fischer S/D
Waiver Request #WR890064, PID #015-292-22
Dear Mr. Corwin:
Your request for waiver of the required 100 foot separation of
a septic system to a private well has been approved. The
approved separation distance is Lot 3B4 septic tank to well
80 feet; Lot 3B4 well to leachfield 88 feet; Lot 3B4 well
to Lot 3B3 septic tank 80 feet; Lot 3B4 well to Lot 3B3
leachfield 90 feet. .
This waiver approval applies to the existing septic system to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this department.
Sincergely,
Robert W. Robinson
Civil Engineer
On-site Services
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Corwin
& associates,inc.
R� Consulting Engineers
1000 E. Dimond Blvd. - Suite 205 - Anchorage, Alaska 99515 - (907) 522.1311
October 26, 1989
Mr. Dan Roth
Municipality of Anchorage
Department of Health & Human Services
825 L. Street, Fifth Floor
Anchorage, Alaska 99501
SUBJECT: REQUEST FOR WAIVER OF WELL TO SEWER SYSTEM LOT 3B41
BLOCK 11 FISCHER SUBDIVISION
Dear Mr. Roth:
We are requesting a permit to drill a new well on the above
referenced lot as displayed on the enclosed drawing. The
existing well is located within an easement and, it is our
understanding that, an agreement with the utility companies
cannot be obtained to allow the well in the easement. The
owner would like to drill a new well, but there is no place
available on the lot to do so. The only place we can find to
place a new well is in the area shown and this will not provide
adequate separation to septic systems either on this lot or on
Lot 3B3 next door. The proposed well location will provide a
separation distance tto the"'sewer cleanout"on"Lot^31B4 of_88-ft
and' o the -septic tank on Lot -3B4 -of approximately_F80'-f t. The
distance from the proposed well to the sewer system standpipe
on hot'3B3 will'be,approximately_-90•ft. and to the septic 'tank
bn::Lot':3B3,will'.be.approximately 80*ft.
There is a slight grade from the sewer systems to the proposed
well location. Even so, we measured the wells in the area and
find that the static water levels in the surrounding wells is
as follows:
L3B1
- 245
ft.
L3B2
- 247
ft.
L3B3
- 230
ft.
L3B4
- 240
ft.
L3B6
- 246
ft.
L3B7
- 250
ft.
We could not access Lot 3B5 due to a large dog on the
property.
A well log for the well on Lot 3B3 indicates that the soils are
silty gravel and sand down to 224 ft. with a hardpan layer at
224 to 248 ft. deep. We do,not-believe there is any way that
contaminants could travel through this deep strata and the
hardpan to get to the aquifer.
Mr. Dan Roth
October 26, 1989
Page Two
We believe that drilling of a new well is an appropriate
solution and the separation distances provided will provide
adequate protection against contamination. We urge your
approval of the requested waiver and issuance of a permit to
drill a new well.
Should you have any questions, please let us know.
G1CT—•16-89
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GRFA"7R ANCHORAGE AREA BO'" JGH -
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME 6MY %7E-11EiPSnA/ etwsT MAILING ADDRESS 1M f• 5 PHONE 344 -8631'
LOCATION Sfwiter 00-k-01�1/011vj�p LEGAL DESCRIPTION 16T-384. Rlrw,k ( r1Vtk', S/D
SEPTIC TANK:
DISTANCE �;cpcuDNUMBER OF
FROM WELL IC61 MANUFACTURER f'fPG MATERIAL S}r-r>✓ u,tl 11094.Q COMPARTMENTS_
INSIDE LENGTH INSIDE WIDTH — LIQUID DEPTH r I IQUID CAPACITY 0t)GALLONS.
SEEPAGE PIT:
I i �
NUMBER OF PITS DIAMETER OR WIDTH -14
LENGTH!(--, DEPTH
s -/�
LINING MATERIAL 0CMkr71'rtX)CR1B SIZE: DIAMETERQ DEPTH q DISTANCE FROM: WELL /cc 4,
r r TOTAL EFFECTIVE
BUILDING FOUNDATION aV , NEAREST LOT LINE_. ABSORPTION AREA (WALL AREA) qOO SQ. FT.
ADDITIONAL ABSORPTION
WELL: %1'6MQ1 lt> rrleeT 6"B lsrnruee ke�wicemenrs
TYPE SXD/y CONST
BUILDING NEAREST
FOUNDATION LOT LINE
CESSPOOL , OTHER SOURCES
APPROVED DISAPPROVED
DISTANCES: As SNOWN
DEPTH
NEAREST SEPTIC
SEWER LINE , TANK.
X
i o
INSTALLED BY: h >�I y{� Pr,
C14
PIPE
PIPE MATERIAL: All LIE- iflif
LOT SLOPE:
REMARKS: PIT' Sir'rb
� An,i n i�cr1�/7rnwa 6Y,r4.1,•P( ,
Form No. EQ -031
REMARKS
DIAGRAM OF SYSTEM
DISTANCE FROM:
SEEPAGE
SYSTEM _
3 3�a
Porn Sr{�•ac G x /�
�'11*I.a s" �h:n xur �'n ed �G.ut, 0.•u�VCt .et �atJp ,
Tdnk /
J � N
DATE
APPROVED
G.A.A.B.
NAME OF APPLICANT
INSTALLATION LOCATION
LEGAL DESCRIPTION
GREATER ANCHORAGE AREA BOROUGH /9//7
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMITNO. /
3330 '•C•• STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274.4561
SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT
M
MAILING ADDRESS /'f'p/ E •Sj RO PHONE
/ C,/ S
a �
INSTALLATION OF: SEPTIC TANK ✓ SEEPAGE PIT / ^RAI( r� elcLn) a' OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED .80,ey J/AILS Gam' Yf%�Y•
FINANCED THROUGH TO BE INSTALLED BY -Lie— d!e�c-,W,
SOIL TEST RESULTS d'� Z 6 NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST,
COMPLETION DATE ANTICIPATED S44t-19!L
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE TYPE SEEPAGE AREA SIZE TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK 5-' SEEPAGE PIT
TO NEAREST LOT LINE.
DRAIN FIELD /0 /
DRAIN FIELD /
N/q-( ✓CZ
/
WELL TO SEPTICTANK SEEPAQE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, /", SEEPAGE PIT DRAIN FIELD /Py/
TO RIVER, LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION S FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G.A.A.B.
OR
LICENSED DESIGNER
DIAGRAM OF SYSTEM
1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
. DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ///� ,//�.�"`�.�•�I
APPLICANT'S SIGNATURE / �h��K�--�J'• �' /� /;�•�`^
FORM NO. CO-014��
y)'Mb Yp
/� GREATER ANCHORAGE AREA BOROUG'�
( Department of Environmental Qu, :y
i 3330 "C" Street
Anchorage, Alaska 99503
SOILS LOC - PEROLATION TEST
Performed for Glacier Excavating Date Performed 9/28/74
Legal Description: Lot 3B4, block_ is er u v sion
This form reports: Soils log es Percolation test
Depth
Feet
n--• --- ----
2 _ Sandy Gravel (6W - 6P)
3
4-
5-
6 _ Sandy Silt, ML
See enclosed gradation
7 -
ME
S/ope
14 -
16' Bottom of Hole
Was ground water encountered? No _ If yes, at what depth?
Reading Date Gross Time Net Time Depth to Water Net Drop
Percolation rate minute.
-Proposed installation: Seepage Pit Yes Drain Field—__—______�
Depth of Inlet Deptlitol,ottom of pit or trench
CUhUIENTS; 25U3quare oot drainLage area required_ p,r_sA=QM__ f_grave1
layer -3-s usable l-riseepage pit system. No bedrock or water table
to -161.__ _
Performed Cy:_ a:nes D. Mack Certified Dy :Co n.gjMuQ,tian_Teat_Uate:10/2/.71
Lab
EQ -040 (6/74)
1
• . � ��D . � n! '1�f� w�lo� �Z
P � Onikucllon E7esE fa_ -
���' L "One test is worth a thousand or7n70ns"
11028 TUDOR ROAD. ANCHORAGE. ALASKA 00507 a TtLePmons 522.0472
Eldon Pedderson
Performed For Date Performed 4-11-74
Leca1 Deserintion: Lot 81oc1: isi
Subdivon rIsiarr
This Form,Renorts Soils Lop yes Percolation Test _
Peoth
Coot
Snit rhArarfOrittirt
1�
Silt Overburden ,
10grse
Gravel, graded
GW -GP
Al
/
7 [1
:.'•
1.
77
Silt;
grAded ML
Bottom
of 'Pest Hole
minus 11'
i'�
Was ground Water Encountered? No
If Yes, At what Depth?
Reading Date Gross Time Net Time Depth to H2O Net Drop'
i
vercoiation Kate nlnute
Proposed Inst- ation: Seenace Pit Yes Drain Field
Deoth of Islet Denth i— o-9ottom Of Pit Or rench
Cr-R1NEXT5:lt. drainage area required per bedroom from minus 2 ft.
to minus 8 ft. No bedrock or water table to minus 12 ft.
Test Performed:By-jim Mack Data Certified By: Construction Testl
Lah Manager Date:4-1.1_711
MUNICMAUTY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 015-292-22 Expiration Date: ,;21 .';� (9 ©Z f
1. GENERAL INFORMATION
Complete legal description FISCHER BLOCK 1, LOT 3134
Location (site address) 5100 SPRUCE CREEK CIRCLE, ANCHORAGE, AK 99507
Current property owner(s) DANIEL & SERINE REEVES
Mailing address
Real estate agent
Day phone
5100 SPRUCE CREEK CIRCLE, ANCHORAGE, AK 99507
Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Private Well
Water Storage
Community Well
Public Water Sv,
Waiver request for:
Received by:
3
COSA to be released to the engineer, unless otherwise requested by the engineer.
Date:
COSA Fee $ 9 IZ J50 COU 1 0 Waiver Fee $
Date of Payment 1,� ,�0,20 Date of Payment
Receipt Number. I Receipt Number
COSA # OCG 20 I ZD Waiver #
TYPE OF WASTEWATER DISPOSAL:
®
Private Septic
❑
Holding Tank
❑
❑
Community
❑
❑
Public Sewer
❑
Distance:
COSA to be released to the engineer, unless otherwise requested by the engineer.
Date:
COSA Fee $ 9 IZ J50 COU 1 0 Waiver Fee $
Date of Payment 1,� ,�0,20 Date of Payment
Receipt Number. I Receipt Number
COSA # OCG 20 I ZD 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 FIRST WATER CONSULTING Phone 907-350-9566
Address 13030 SUES WAY, ANCHORAGE, AK 99516
Engineer's Printed Name CURTIS HUFFMAN, PE Date 11/10/2020
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting & Fks
6. DSD SIGNATURE
4 System #1 Approved for 3
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
bedrooms
g'Q,
49 TH
• Curtis Huffman
��c/•• CE 128991 .,•��`��/�
s�F�•41/1,0/2Q20•�f
iliF,PROFESSO
bedrooms, with the following stipulations:
��v\N( OF
SERV \�������
Original Certificate Date: I -za -zo
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
nKi_SITE
WATER AND
�
q WAST_V,
p r) AA/i
1
J, p o G`
Ira -
\
\C1
SERV \�������
Original Certificate Date: I -za -zo
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
Legal Description: FISCHER BLOCK 1 LOT 3B4 Parcel ID: 015-292-22
If more than 1 septic system on lot: COSA Checklist # —of,— Structure served by this system _
A. WELL DATA
® Well log is filed with Onsite (or attached)
Date drilled 12/21/1989
Total depth 299 ft
Cased to 299 ft
® Sanitary seal is functioning correctly
® Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 11/10/2020
Static water level at beginning of test 229 ft.
Well production at time of test 3.1 gpm
Comments
B. TANK DATA
Age of tank(s) 2 years
Tank type/material SEPTIC / STEEL
Measured operating fluid level in septic tank 48"
® Standpipes/foundation cleanout per record drawing
Date of pumping 11/10120
D. ABSORPTION FIELD DATA
Water storage tank volume NA gallons
Well disinfected for coliform test? ❑ Yes ® No
® Coliform bacteria is Negative
Nitrate 3.12 mg/L F-1Nitrate less than MRL (ND)
Arsenic ug/L ® Arsenic less than MRL (ND)
Collected by
FW`ES
Date of Sample 11/10/2020
C. LIFT STATION
❑ Required maintenance completed
Age of lift station _ years
Lift station material
Comments:
Which system tested (date installed) 7/20/2018 Adequacy test date 11/10/2020
® ALL standpipes presentResults r erecord drawingesulM PaFor 3 ss obedrooms
__
_P _ _.___
..._ _.-_._ , .._
Total measured depth from grade 10 ft (max) Fluid depth prior to test 0 in
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
® Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Comments/Deficiencies:
Water added 450 gal
New depth 13 in
Elapsed time 1320 min
Final fluid depth 0 in
Absorption rate 450 gpd
Any rejuvenation treatment (past 12 months) N
If yes, enter date
NES
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
® Yes
if No
Community Sewer Manhole/Cleanout > 100'
❑ Yes
if No *80+
ft
® Yes
if No ft
Neighboring Tank > 100' ❑ Yes
if No *80+
ft
Private Sewer/Septic Line > 25' ® Yes
if No ft
Absorption Field on Lot > 100' ❑ Yes
if No *90+
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 *87
ft
ft
If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if
less than required)
Manure/Animal Excreta Storage > 100'
® Yes
Community Sewer Main > 75' ® Yes
if No
ft
® Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
® Yes
if No
ft
Surface Water > 100'
® Yes if No ft
Property Line > 5'
® Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
® Yes
if No
ft
Private Wells > 100'
® Yes if No ft
Water Main > 10'
® Yes
if No
ft
Community Wells > 200'
® Yes if No ft
Water Service Line > 10'
® Yes
if No
ft
If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if
less than required)
Building Foundation > 10'
® Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
❑ Yes
if No *1+
ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells > 100'
® Yes if No —ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200'
® Yes if No
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
---- __...._.__._.1tMOAWAIVE RS: .._____ _.... m _.__.- ---------- ,------
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.
Aw
:• TH
• •� ��
. ..
..... ....t......
Curtis Huffman
f �FG'�� •. CE 128991��,®�
•
Municipality of Anchorage
o,�nib tiii ail <
On-Site Water&Wastewater Program `phiiro6 .i+iumi�n,
mtiJ!gitgi
(907)343-7904 ��
CERTIFICATE OF ON—SITE SYSTEMS APPROVAL
Parcel I.D. 015-292-22 Expiration Date: 1 ,Z7-1,g
1. GENERAL INFORMATION
Complete legal description FISCHER;BLOCK 1,LOT 3B4
Location (site address) 5100 SPRUCE CREEK CIRCLE*ANCHORAGE,AK 99507
Current Property owner(s) PARIS COCHRAN Day phone 907-230-9815
Mailing address 5100 SPRUCE CREEK CIRCLE'ANCHORAGE,AK 99507
Real Estate Agent RICK JARVIS Day phone 907-244-3590
2. TYPE OF DWELLING:
I. Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well U Individual On-site
Individual Water Storage ❑ Individual Holding tank ❑
Community Class Well ❑ Community On-site ❑
Public Water System ❑ Public Sewer ❑
WaiverNariancerequest for N/A
Distance: -
Received by: —glee Date: -1-2-x/08
COSA to be release•to the engineer,unless otherwise requested by the engineer.
OAS�t
SitIO ,t
COSA Fee$ ) `C . t [ Waiver Fee$
Date of Payment '7 I ;:›s# C ! (0°° Date of Payment
Receipt Number o c)r,,,,1 U Receipt Number
COSA# OG(N— t3‘65 Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is(are)safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are)in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP,Ltd. Phone 337-6179
Address 3701 E.TUDOR ROAD,SUITE 101 *ANCHORAGE,AK,99507
Engineer's Printed Name JEFFREY A.GARNESS,P.E. Date i/24 /
Engineer's Comments:
In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system in accordance with the .����S IL44;7
guidelines and regulations established by the MunidpafityofAnchorage and industry practices.The reported results descnbe the ,, C_condition of the systems on the dates of the evaluation.Separation d stances were measured to readily identifiable features. � �Hidden defects or encroachments may exist that were not identified during the evaluaran.The operational life of all wells and septic i r ♦♦systems depend on a variety of variables including,but not limited to,soil conditions,groundwater levels(that may fluctuate during 4� , ♦♦
the year).quality of construction(materials and workmanship),and the water usage of the family utilizing the systems.These * I 1 j\—�.-*�
conditions can vary,and are outside the control of GEG.Satisfactory test results do not guarantee future pedonnance of the • 9 ,: •,`
systems;therefore,GEG makes no warranty(express or implied)regarding the future performance of the well or septic system. 1
GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the 0 ,_,• ) ( ,.t .it
current systems fail.The content of this report is for the sole benefit of the person/party who retained GEG.Reliance upon the �'--: J ff ? , c rnes c =
information provided in this report by any other person or party,including but not limited to subsequent pmperly purchasers,is not / _
authorized.In short,GEG disavows any legal duty to anyone other than the person/party who paid for this report ♦ Aw
♦f' E-79`33
6. DSD SIGNATURE ♦♦ PRp \C� ��
LICENSE ,4Illa�„`io,*
iC
System#1 Approved for bedrooms. #AEccesa
System#2 Approved for bedrooms.
Disapproved. . - -Ni, OF Aik.
Conditional approval for bedrooms,with the following stipt. #ons:ON_SITE ,
•• WATER AND
o WASTE-WINTER o
cii PKpGRnP z
/,.l tic.
By: Original Certificate Date: 7^2 7"7
The Municipality or Anchorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only
upon the represenatations 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. ATTCHMENTS: , , '
COSA Checklist 1� .Nitrate Advisory , •
Septic System Advisory _ Arsenic Advisory • •
Well Flow Advisory Other
(Rev.10/12/12) . •
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: FISCHER: BLOCK 1, LOT 3B4 Parcel ID: 015-292-22
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 12/21/1989 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 299 ft. Cased to 299(?) ft. Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Date of test 12/21/1989 5/15/2018
Static water level 237 ft. 235 ft.
Well production 15 g.p.m. 2.9+ g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 ml. Nitrate 2.51 mg./L. Collected by: GEG. Ltd.
Arsenic: <5 ug./L. Date of sample: 5/15/2018
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 7/23/2018
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 NEW Pumper -
C. ABSORPTION FIELD DATA BELOW FINAL GRADE
Date installed 7/20/2018 Soil rating 6�.p.d./ 'or ft2/bdrm) 1.2 System type 5-WIDE TRENCH
Length 40 ft. Width 5 ft. Gravel below pipe 4.02 ft.
Total depth "9.9+ ft. Eff. absorption area 400 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test - in. Water added - gal. New depth - in.
Elapsed Time: - min. Final fluid depth - in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N &type) N/A If yes, give date -
D. LIFT STATION
Date installed Size in gallons Manhole/Access(Y/N)
"Pump on" level at in. "Pump off'level at '• .. a er alarm level at in.
- .• Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot X80+ On adjacent lots "80'+
Absorption field on lot *90'+ On adjacent lots ..
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 75+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 104- Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line '1'+ Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage '0'
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
"WAIVER#0SV181047;**WAIVER#890064-PROPOSED TO AMEND EXISTING WAIVER OF 90 FEET FROM WELL TO DRAINFIELD
FROM 90 FEET DOWN TO 87 FEET(PHYSICALLY MEASURED 89 FEET FROM EDGE OF WELL TO EDGE OF DRAINFIELD PIPE)
SON)-Q6 Fj .)-CSe. Gb.Aole 40 a - -F co wv`:(AA Ace- ,.c5�
G. ENGINEER'S CERTIFICATION �P� ........... • 44o.��•,
i .' �) , .1
I certify that I have determined through field inspections and : 1 4'IH, j
review of Municipal records that the above systems are in •• •
conformance with MOA COSA guidelines in effect on this
date. ♦c^ '. e. r-y A. Ga ness; =
Engineer's Printed Name JEFFREY A.GARNESS ••'P ••% CE-79 3
g •...Fo.•...1.12c4
c.
Date ']/2L�!$ .� OFESS\Mr' 4.
1/11 LICENSE �•\sli"s��
#AECC8B4
(Rev.10/12/12)
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CARPORT DRIVEWAY ::. A50.00'
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/ DECK i/, , „-' \` D57°17'40"
..../ r
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UTILITY I ,, s'• LS• -1'837 •'• tea`"_
POLE - / • .
Irrl�i�°FESS IION`;,,,,.o
I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING
DESCRIBED PROPERTY:
LOT 3B4,BLOCK 1,FISCHER SUBDIVISION
EASEMENTS OF RECORD,OTHER THAN THOSE SHOWN ON THE
RECORDED SUBDIVISION PLAT(70-170)ARE NOT SHOWN ANCHORAGE RECORDING DISTRICT,ALASKA AND THAT THE
HEREON. VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE
PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST
THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEY EXCEPT AS INDICATED.
AND IS SUBJECT TO ANY INACCURACIES THAT SUBSEQUENT
BOUNDARY SURVEY MAY DISCLOSE. DATED THIS 25th DAY OF JULY,2018,AT ANCHORAGE,ALASKA.
UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA
HEREON BE USED FOR CONSTRUCTION OF FENCES,
IMPROVEMENTS,OR FOR ESTABLISHING PROPERTY
BOUNDARIES. FIXED HEIGHT, LLC
Land Surveying Services 907.290.8949
AS-BUILT NO CORNERS SET THIS DATE SCALE 1"=30' WWW.FIXEDHEIGHT.COM
JOB 018091
PSE, �s
• Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
Certificate of On -Site Systems Approval
Parcel I.D. 015-292-22
1. GENERAL INFORMATION
Complete legal description
Expiration Date:
Fischer S/D, Block 1, Lot 3B4
Location (site address) 5100 Spruce Creek Circle, Anchorage, Alaska
Current Property owner(s) Richard Bullock Day phone
Mailing address
Real Estate Agent Janis Tolbert, Prudential Jack White Vista
2. TYPE OF DWELLING:
I] Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone 273-7206
3. NUMBER OF BEDROOMS:
3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Q
Individual
0
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNarianoe request for:,
Received by: ,<< f� Date:^I—
COSA to be released to the�ngineer, unless otherwise requested by the engineer. O'< 4n'I�ca.Q�-1r jaJr�;Ce.
Pe", Freoi.
COSA Fee $ 45k) . Waiver Fee $
Date of Payment / 11 1 �J f Date of Payment
Receipt Number Receipt Number
COSA# 05c131o13 Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, ) verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Douglas T. Kenley P.E. Phone (907) 746-1073
Address 9806 Northstar Circle, Palmer, Alaska 99645
Engineer's Printed Name Douglas T. Kenley
6. DSD SIGNATURE
V System #1 Approved for 3 bedrooms
System #2 Approved for _ bedrooms
Disapproved
Conditional approval for
bedrooms, with the following
By:4 )r�, /�� �41 ®`?Original Certificate Date: 1— jr' 13
The unicipity An a 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 blue sheet[ , e
If more than 1 septic system Is on the lot:
COSA Checklist # _of _
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description:
Fischer S/D, Block 1, Lot 3B4
A. WELL DATA
Well type Private
Date completed 12/22/89
Total depth 299 ft.
If A, B, or C provide PWSID #
Sanitary seal (Y/N) Y
Cased to 237 ft.
FROM WELL LOG
Date of test 12/21/89
Static water level 237.2
ft.
Well production 15 9 -
p.m -
WATER SAMPLE RESULTS:
Coliform Negative colonies/100 mL Nitrate 1.47 mg/L
Arsenic ND ug/L Dateofsampte: 1/07/13
B. SEPTICIHOLDING TANK DATA
Tank Type/Material Septic/Steel
Tank size 1000 gal. Number of Compartments 2
Foundation Geanout(Y/N) Y
Date of pumping 1/15/13
C. ABSORPTION FIELD DATA
Parcel ID: 015-292-22
Well Log (Y/N) Y
Wires properly protected (Y/N) Y
Casing height (above ground) 20 in.
AT INSPECTION
1/08/13
233.1 ft
3.5 g.p.m.
Collected by: F. Kenley
Date installed 3/13/90
Cleanouts (Y/N) Y
Depression over tank (YIN) N High water alarm (Y/N) N/A
Pumper One Stop Pumping
Date installed 3/13/90 Soil rating (g.p.d./ft2 or l /bdrm) 150 System type Trench
Length 32 ft. Width 2.5 ft. Gravel below pipe 8 ft.
Total depth 12 ft. Eff. absorption area 512 fe Monitoring tube Y Depression over field N
Date of adequacy test 1/08/13 Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test 21-1/2 in. Water added
621 gal. New depth 63-114 in.
Elapsed Time: 127 min. Final fluid depth 59 in. Absorption rate >= 450 g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date ----
D. LIFT STATION
Size in gallons
"Pump on level at
Cycles tested
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/fift station on lot *90 ft.
Absorption field on lot 100 ft.
Public sewer main N/A
Sewer /septic service line VrW+ ft.
Animal containment areas 50+ ft
Manhole/Access (YIN) _
g water slarmievel at
Meets alarm & circuit reaum
in.
On adjacent lots 80 -A -
On adjacent lots .109 -ft. q D r t")
Public sewer manhole/cleanout NIA
Holding tank N/A
Manure/animal excrete storage areas 100+ ft.
SEPTIC/HOLDING TANK ON LOT TO: As Ll PJilfi
Building foundation 5+ ft. Property line
Water main 10+ ft. Water service line 10+ ft.
Wells on adjacent lots 100+ ft.
ABSORPTION FIELD ON LOT TO:
Property fine **5 ft. Building foundation 5+ ft.
Water Service line 10+ ft. Surface water 100+ ft.
Curtain drain None Known Wells on adjacent lots 100+ ft.
F. COMMENTS
* *'* Waivers on file at the MOA.
G. ENGINEER'S CERTIFICATION
l certify that I have detemrined through ffeid inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
engineers Printed Name Douglas T. Kenley, P.E.
Date
COSA brown sheeL10-10-12.doc
Absorption field_
Surface water _
5+ ft.
100+ ft.
Water main N/A
Driveway, parkingivehide storage Baa c ay
N, ,�-,
&A
1Lhaw9 NEY
CE Bird ,;t
%ICPa4D FlNI41m fLMR
nEv. (Assuum)
365
�PPOPOSFDAS m)No COWIm
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I 723S0
fRCNT BNLLDNa 4 AQK
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J I PRT GRAVEL DRIVE SPRUCE CREEK
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27.5' EXISTING j
a
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ca
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I j
I yon
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�5g
36
(WELL 12g.
3133
UNDER NO CIRCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES.
THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LABILITY ONLY FOR THE COST OF THE SURVEY.
LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE.
LOT SURVEY SURVEY TYPE
SYMBOLS
❑ FOUNDATON AS-BUILT
El FINAL STRUCTURE AS-BUILT
• SET REBAR° 0 ASPHALT
DRAINAGE
❑ PLOT PLAN ... AS-BUILT ... LOT SURVEY ... TOPOGRAPHY
'S"°'6
o FOUND REBAR 9 e 0 WOOD FENCE CONCRETE
AS-BUILT ... NO CORNERS SET RECERTIFl
00 ASSUMED ELEV. METAL FENCE ® WOOD DECK
PLOT PLANS & LOT SURVEYS
NOTE:
IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO
ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE
CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE
SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS,
TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE
ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY, SNOW
THE EXISTENCE OF ANY EASEMENTS. COVENANTS OR RESTRICTIONS
MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED.
WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT.
ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED.
SURVEY CERTIFICATION,,
�.• OF q/ e
Prepared by
Robert E. Johns, Jr. & Assoc.
PLOT PLAN
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ae bt N°.n mE EuveM M1saen. aNE a°t I
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Professional Land Surveyors
1700 Brink Drive.
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ANCHORAGE, ALASKA 99504
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FOUNDATION AS-BUILT
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Lot S.F.
Rec. Plot File No.
Date Surveys . 01 /15/1 3
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01/16/13
2537
13-14
FINAL STRUCTURE AS-BUILT
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Legal Description:
I, Ra E .Mn4 &. M1a by awMy Mat
°»pa=Nmd t.-GNt.a»M.
aI. bt Mat Me
•• . :' ��i./
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FISCHER
MUNICIPALITY OF ANCHORAGE
O Department of Health & Human Services y
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel l.D.# QIP- `.1452- Aa HAA# 0A01 CY�°I%
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
SPW-F GPFFr, GIPCLE AK
(b) Property owner A N Fi Telephone: (home)i-�—Business HA—_
Mailing Address PG EU 101040 A AIC• H A K
(c) Lending Institution UI/A Telephone
Mailing Address N/A
(d) Real Estate Company and Agent KI, /A
Address NIA
Telephone
(e) Mail the HAA to the following address: (or check here h -if hold for pick up.)
List contact person and day phone number below:
2. TYPE OF RESIDENCE
Single -Family Number of bedrooms
3. WATER SUPPLY
Individual Well )d Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72-025 (RH. 71N)
Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, l verify that my investigation of this
Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe,
functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and
inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and
State codes, ordinances, and regulations in effect on the date of this inspection.
Name of Firm i I �_, Al Y_ Telephone z7`1' ! r
Addre
Date
6. DHHS APPROVAL
�S
Approved for �""46a3 edrooms by
L� &la-4-4-Lt�
%
Approved Y' Disapproved Conditional
Terms of Conditional Approval
CAUTION
Engineer's Seal
Date �� O
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated 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. Employeesof DHHSdo notconduct inspections
oranalyzedata before a certificate is issued. The Municipalityof Anchorage is not responsible for errors oromissions
in the professional engineer's work.
72-025(RM.?IN) BaCk Page 2 of 2
'Z
1 s MUNICIPALITY OF ANCHORAGE (MOA)
r r4'� • O Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744
Legal Description:
F/Sr- 14F2 Sven
A. WELL DATA
Well Classification PP I VAT -'E If A. B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N)Date Completed 1 rg� Yield S G ►'M
Total Depth ZIV Cased to Z77, Depth of Grouting h JA
Static Water Level 2-31 Pump Set At
Casing Height Above Ground Z 7 + Sanitary Seal on Casing (Y/N) �7
Electrical Wiring In Conduit (Y/N) Y Depression Around Wellhead (Y/N)
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot 90( ; On Adjoining Lots 80) _X
To Nearest Edge of Absorption Field on Lot 100' On Adjoining Lots 90 t
To Nearest Public Sewer Line N 1A To Nearest Public Sewer Cleanout/Manhole
To Nearest Sewer Service Line on Lot 2`4S7
Water Sample Collected by A jnt nr Drill""'. ; Date 12,P la. -1 3&7/70
Water Sample Test Results SA -W FA<GTrar $/
Comment tt"tuv[- to File- Dr7TtFn 2hckr) u[tCS9onrq
B. SEPTIC/HOLDING TANK DATA
Date Installed 3h -2; 7o Size 4 QQu No. of Compartments �
Standpipes (Y/N) VAir-tight Caps (Y/N) Foundation Cleanout (YIN)
Depression over Tank (Y/N) Date Last Pumped MEL) TRAI r
Pumping/Maintenance Contact on File (Y/N) ��A ; for W /A
Holding Tank High -Water Alarm (Y/N) AIJA Temporary Holding Tank Permit (Y/N) XI JA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water -Supply Well 90 To Building Foundation Zo ±
To Property Line /0' To Disposal Field '� t
To Water Main/Service Line 4S t +
To Stream, Pond, Lake or Major
Comments Prom 061
Course lel 1A
n-M(A". 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata ISD 5 1+ IAJr^• Type of System Design Tr FAIc
Date Installed�(�/9n
Length of Field .3Z
Width of Field fin``
Depth of Field /Z
i
Gravel Bed Thickness
Square Feet of Absortion Area SQL
Statndpipes Present (Y/N) Y
Depression over Field (Y/N)
Date of Last Adequacy Test k1Qk%
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water -Supply Well 100'
To Property Line S�
To Building Foundation �`
To Existing or Abandoned System on
Lot >1?6' ;On Adjoining Lots ;, 30
To Water Main/Service Line -4S
To Cutback (if present) U, X_
To Stream, Pond, Lake, or Major Drainage Course —IL
f f
To Driveway, Parking Area, or Vehicle Storage Area Drr✓e4t;✓
CmSPef % �e
Comments' tJ0fIle.,- trl F7,'% !. Ir— ft
(90000
D. LIFT STAT
I N =-
Date Instalie
Size in Gallons
"Pump On" Level
High Water Alarm
Tested for
Meets MOA Electrical Codes
Comments
"Check
Signed
Date —
MOA No.
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Rating Against HAA Request"
( verified, or conformed to all MOA F
J
Receipt No. — V / i I
Date of Payment l9 —4 b
Amount:$ cc)
72-M (R". 7/98) Beck
Vent(Y/N)
Pumping Cycles during Adequacy Test.
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
f this
Seal
Municipality of Anchorage
Department of Health and Human Services
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
March 13, 1990
Bruce Corwin, P.E.
Corwin and Associates
PO Box 230608
Anchorage, Alaska 99523-0608
Subject: Waiver Request for Lot 3B4 Block 1 Fischer Subdivision
Waiver Request #WR900003, PID #015-292-22
Dear Mr. Corwin:
Your request for waiver of the required 10 foot separation
between a septic system and a lot line has been approved. The
waived distance is 5 feet.
This approval applies to the existing septic system lot line
separation only. Any future upgrade to the septic system will
require all separations be met or another approval from this
department.
Sincerely,
Daniel J. Roth
Civil Engineer
On-site Services
ljw#7
Concur:
4,,4
y,
ohn Smith, P.E.
Program Manager
On-site Services
Municipality of Anchorage
Department of Health and Human Services
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
February 16, 1990
Bruce Corwin, P.E.
Corwin and Associates
1000 East Dimond Boulevard
Suite 205
Anchorage, Alaska 99515
Subject: waiver Request
Subdivision
waiver Request
Dear Mr. Corwin:
for Lot 3B4 Block 1 Fischer
#WR890064, PID #015-292-22
The subject waiver has been amended as requested in your
January 19, 1990 letter. The prior approval issued on
November 1, 1989 waived the required 100 foot separation
distances of Lot 3B4 Block 1 septic tank to well, 80 feet;
Lot 3B4 Block 1 leachfield to well, 88 feet; Lot 3B4 Block 1
well to Lot 3B3 Block 1 septic tank 80 feet; Lot 3B4 Block 1
well to Lot 3B3 Block 1 leachfield, 90 feet. The amended
approved waiver is for the proposed new septic tank
separation distance to be installed 90 feet rather than 80
feet from the well on Lot 3B4 Block 1.
This waiver approval applies to the proposed septic tank to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this office.
If there are any further questions, please call this office
at 343-4744.
Sincerely,
(I r; . W
Daniel J. Roth
Civil Engineer
on-site Services
DJR/1jm:06
CIn ur ante,
J Smith, P.E.
Program Manager
On-site Services
LOCATION OF WELL/DD at•M se Yela/Idr / tw or It.)
n. borough Subdivision LaIt�T,al�e�ata��N�ib'la'1�1/o.tra,
�sha,r • .f_.f_af
It. OISTANC! AND DIRECTION FROM 10A0 INTERSECTION!
(ice.Creed
Street Address and Also of will LeeauN
S. WELL LOO Fe
' t
Material Troe ,..
%ds wATZP
.,may fel
7.
Addeo
Blamed
Fore OR -WIN
terAM
um
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of 6401001eol a'GeOphyaftolSurrey$
17
F.
Drilling Permit No.
A.D.L. No.
54400A•1•fo. Township ND Range !❑ MHidlen
ap W❑
a. OWNER OF WELLS
1
AddnedtFvrt.�nc • rpac.A, s Inc.
Below ,a. WELL DC►TNI (flaol) 0.'DAT9 OF COMPLETION .
Belo
6attaat fl, •����
G. Q,Cable 1001 -' story QDAaN C)boo
Q' e•ar ' darted' Coated . ❑ oih.r t ~ '
T.Y1111SI •Domealle OPublic Supply 0Industry. •'
1 //❑ IrrlbeNN • Q Raaharga ❑ commando,
Vol le
Q7oa1Wall OIMr: I
a.CASINSi Q Thnoled elded
'1
4100. IN. lot, apth walgkl ,/ ;7 IDS./lit.
�T— • I
X100 dlom. Ih, le ft. Depth StltkYe 49j;ft.
S, FINISH OF WELLS
?Joel OlsnteNrt
QRAnF slat Leglh
& Set bglw*, 'II. OM
,••Satllfllllna °' •*ravel peak
'
40. STATIC WATZR LEVELS� t d:�T• r
... 4 } t.�,,� Aiow;? or c,.� I:N]aW rrrt:ti�:+�'; • 1D.f. �
' U.WVMPINO LEVEL Sslew'IeN war}•$ and TIlLD '
^7nC'TT7 ditef r -'ora. DYOGIAa ♦ i.e,....
_ . ._ _, _
�.�nvYnm, w.0 wreYree: :..0 Te IJQ wa � •.
Wetarlal: NNr CeepM(:)other:'
•
•;` ••A-: .•..••i._r: �. :.,•'. _
^
33. pump: dlt wrallUle).••XP
'.?•�tiLaapM wfDroi ?!j:' ..1 t. dpaatty.. .... 7me
•• w%.•.- {:a": '..;,•
.f••:.
�:1 �datfl}SNI r,� Other
'• •""' :r:
.w._
?�.YYbal.Jti i�,+ldt. •U
: •K !.. . r.: •;... :ti.4
r't•'... r:y. •.
,.Or.i�'
.F••.• . ♦TJ�'.(I ��.,..I,1.`w): ,'Y� �J., 5.� �I,i' iJ
�.
LSt.BREMaRNNe.}
,11R; ,. .
,.'V �� •JhJ'(.: ;, !�• •� ��r.•1:.''••'�
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1�4�.���:1iLS.i".1i1.4�:'I:MI•�.�i;f f�.iltYi N..;. .r -r... - .' ..1.
�.. ♦ {y.'.+,.� yi: .r:=..r• t%:.. r -.
,,
t)• ••''`•'•.
mingtONTAACTORS ACERTd FICATION'S ♦
.^; •.r NyT `':•::,'•.,.rJ'.n.t -d`•♦: •'•,
i1.' ••+, t• .:.A:.t .) 4i I.AI TAJ1 �. SAY` fr J f •JID.dtef' Z1111pentYn• •,�•��., ♦ ftt,�•r :. L': n. t1 -
7[•ti1'� i •� tdra Jri7 r
IKOS.a'I
a• iP.1; i, s11;;
,
oa r lea }'MN /Yfiied irtd Iola IePerlde arN aeRM Le��<I'w�r
, . " . •... ...�.Y.�.;1.. ,...... ..
!►ae.aya -C•
daei.ile/} r r • :.. ...w �•. t' C..Y. r. �:,
B
•'•
e alelela Sse Ne\ ligate �Y snit ICS ee Number
I$trlblltlon: WHITL•110e011108, ►INN•Orlllar, 0AHARY•CY/Io1f,
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Servlces
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcell.D.# �1S 79� 22-' gm— (wr)
HAA t�
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Gc7 3B9 amtK i fisc 77z.AJ ,e3;J i66 /S
Location (address or directions)
Sorg 5ir,'irc� ��K 2D ,
(b) Property owner /fAz' /sS�+�4 Telephone: (home) Business
Mailing Address
(c) Lending Institution
Telephone
Mailing Address
(d) Real Estate Company and Agent
ts'Pr14-
��° r
All 71-4
Address
Telephone
(e) Mail the HAA to the following address: (or check here if hold for pick up.)
List contact person and day phone number below:
jilt- Plee u)1
2. TYPE OF RESIDENCE
Single -Family Number of bedrooms
3. WATER SUPPLY
Individual Well Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site[ Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-x5 (Rm.7/U) Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this
Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe,
functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and
inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and
State codes, ordinances, and regulations in effect on the date of this inspection.
Name of Firm`s Telephone 7_79"s3Si
Address ell z- IJ 5 O
Date
'4IVA ssia:'
6. DHHS APPROVAL
Approved for 3 bedrooms by -oyDate '7 - 8g
Approvedng� Disapproved Conditional
Terms of Conditional Approval
I CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph 5 above byan 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. Employeesof DHHS do not conduct inspections
oranalyze data before certificate isissued.The Municipalityof Anchorage isnot responsible for errors or omissions
in the professional engineer's work.
7223 (Rm,.71W) Buk - Page 2 of 2
G.'�a
dp
0� V'
` AN- MUNICIPALITY OF ANCHORAGE (MOA) a
�Qu� Health Authority Approval (HAA)
CHECKLIST -FEBRUARY 1984
343-4744 /
Legal Description: Lerjgy
ZI.J ia_ /S
A. WELL DATA
Well Classification If A, B. C. D.E.C. Approved (Y/N)
Well Log Present (Y© Date Completed u'fCJO"/ / Yield AD
Total Dept Cased fo Z�Z Depth of Grouting ''��p
Static Water Level Z�o Pump Set At
r
Casing Height Above Ground Sanitary Seal on Casing)
Electrical Wiring in Conduit 6N) Depression Around Wellhead ( /N
SEPARATION DISTANCES FROM WELL:
Y 3Ti1iJDPi�i
To Septic/Holding Tank on Lot - /� ;On Adjoining Lots 92 Tc C[.EAW^+T
To Nearest Edge of Absorption Field ',
on Lot �/3 To $*rIWIP" ;On Adjoining Lots Ob r'/
/
To Nearest Public Sewer Line � To Nearest Public Sewer Cleanout/Manhole
i
To Nearest Sewer Service Line on Lot ZS t
Water Sample Collected by %j'EGS A' and ; Date
Water Sample Test Results ahC T
Comments 60 WE[L 6md 7257- /0-/V-575'-
4
O/ySb:s4 sCL,- hff&trA 1zlco25 Wlk7-,
A117,,e,4-TeS
B. SEPTIC/HOLDING TANK DATA
Date Installed /6-/_7"% Size /"0 No. of Compartments
StandpipesY N) Air -tight Caps(y)N) Foundation Cleanout)
Depression over Tank (Y6 Date Last Pumped D /6' 24y%4e3'
Pumping/Maintenance Contact on File (Y/N) 4)1,4 ;tor
Holding Tank High. Wate�larm (Y/N) Temporary Holding Tank Permit (Y/N)
SEPARATI . DIANCES;PjiOM SEPTIC/HOLDING TANK:
To Water-Suppl PT! ....... lre"l '40L_To Building Foundation
r �
To Proper(y.Line , T,S �` To Disposal Field 7,6
a,!.!I..) r�:7
To Water Majn/Servicetine•' • ,
To Stream, `Pond, Lake6r-Major Drainage Course
72 -VM (Aw.7/BB) Front Page 1 of 2
1333 P Flf4kr
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
ZSO Type of System Design
Date Installed
Length of Field 2114'
Width of Field
Depth of Field /,X
i
Gravel Bed Thickness
Square Feet of Absortion Area
�%M Statndplpes Present)
Depression over Field (Y&I
Date of Last Adequacy Test
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD: \� , e .
To Water -Supply Well 113 /RI-4fr1tK)h?i," To Property Line �KYZ
To Building Foundation Lo To Existing or Abandoned System on
; On Adjoining Lot' Id -1-y`-
/
To Water Main/Service Line /0 1 To Cutback (if present)
To Stream, Pond, Lake, or Major Drainage Course /Cy'0 t
To Driveway, Parkin9;Area, or Vehicle Storage Area ,�/e,/L" °yam Syl741,l
Comments -
Lot
D. LIFT STATION
Size In Gallon
"Pump On" Level at
High Water Alarm Level at
_ Dimensions —
Manhole/Access (Y/N)
"Pump Off" Levet at
Tested for Pumping Cycles during Adequacy Test.
Meets MOA Electrical Codes (Y/N)
Comments
"Check Permitted Bedroom Rating Against HAA Request"
T
certify that I have checked, verified, or conformed to all MOA and HAA guidelinesjr+yFff�S Qn the date of this
Inspection. ): ,�G q ,
Signed
Company
p ,¢SGS
Com
�� ,••••• ••••' "' ler's Seal
Date
MOA N ..... *.REI ,JR. ••r
No. el Z_ � Y C. REID, JR.
�•% CE.2251
to ••.......•• ��..
/ 3 %/� 1��Protesslaro� :+-
Receipt No. '2 6 7 " Receipt No.
Date of Payment /0—.26
Waiver Fee: $
O�
Amount: $ %y d Date of Payment -- —",e) S- 4-P
72-0m (A". ?/N) 8"k Page 2 of 2
Municipality of Anchorage
Department of Health and Human Services
825 '' Street
Tom Fink,
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
November 3, 1988
Lee Reid, P.E.
Alaska Environmental
Control Services, Inc.
1412 West 33 Avenue
Anchorage, Alaska 99503
Subject: Waiver Request for Lot 3B4 Block 1 Fischer S/D
Waiver -Request fWR88-068, H88-0477
Dear Mr. Reid:
Your request for waiver of the required 100 foot separation of
a septic system to a private well has been approved. The
approved separation distance is 92 feet between well on Lot
3B4 Block 1 to septic tank cleanout on Lot 3B3 Block 1.
This waiver approval applies to the existing septic system to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this department.
rely,
Daniell J. Roth V
Civil Engineer
On-site Services
DJR/ljw$6
A
Alpine Drilling & Enterprises* INVOICt
Domestic — Commercial N2 2 2
Pump & Water Systems
P.O Box 110496 Nana a
Anchorage, Alaska 99511
(901) 345-0202 F ub
PHONE v
DATE to '
Thank You
SIGNATURE
Q Hereby Acknowledge the Satisfactory Convielm of the Above Descroed Work.)
TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE.
SERVICE CHARGE AT RATE OF 1.S% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. I
1
DESCRIPTION
Iff -1
-
Thank You
SIGNATURE
Q Hereby Acknowledge the Satisfactory Convielm of the Above Descroed Work.)
TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE.
SERVICE CHARGE AT RATE OF 1.S% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. I
1
ALASKA enunonmCf1TAL COnTROL SCRUICCS, IRC.
Engineerinq & Enuironmenial Studies
October 20, 1988
Municipality of Anchorage
Department of Health 8 Human Services
825 L Street
Anchorage, AK 99501
ATTN: Dan Roth
RE: Lot 3B4, Block 1, Fischer Subdivision
From the Health Authority inspection, we find the separation distance from
subject well to lot 3B3 septic tank cleanout to be 92 feet. The depth of this
well is 272 feet and cased to the bottom. On October 14, 1988, a flow test was
performed showing a static level of 240 feet with a yield of 4.7 GPM. The house
on lot 383 is between the well and tank. Terrain is fairly level in this area.
Water samples taken October 19, 1988, are satisfactory.
With such a deep static level, I do not think there is a threat of contamination
to this well. I request that you grant a waiver of 92 feet from subject well to
lot 3B3 tank.
If you have any questions, please call.
Sincerely,
Alan C. Wien
Engineering Technician
ACW/sr * : 4
OY C. REID, JR.
CE•2251
• .• etZ'�
1200 West 33rd Auenue. Suite B • Anchorage, Alaska 99503 • (907) 276-1361
ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561.5040
JOB Z -3N 13/ rmak g
SHEET NO.—
CALCULATED BY
CHECKED BY—
SCALE
OF
DATE
DATE
er.
-
-------------
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7
7 T
7yy
T
T
. . . . . . . .. .
--7
----------
--
er.
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-------------
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----------
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—7
--4
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. '4 -
r '
r" 1
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICN
1. General Information
(a) Legal Description (include lot,
Location (address or
Application Date 5- 1 -Fiji
section, tewrship, range)
(b) Applicants Name Lilom-im Aofii Nb Telephone3N:i-71 55_
Applicants Address Swot, Creek C , cc �P
(c) Applicant is (check one) Lending Institution Owrer/builder ;
Buyer [� ; Other f� (explain);
(d) Lending Institution Telephone
Address
(e) Real Estate Co. s Agent
Address
Telephone
2. Tyce of Fbsidenee
Single -Family JE:j Multi -Family
Number of Bedroom "i
3. water Supply
Individual Db11 LE1 Community
Other (describe)
Public
Note: If ccmcurity well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
Is the well adequate for the number of bedrooms specified in this FAA 6�1)
4. Sewage Disposal
Onsite = Public f:::l Co runity C=j Holding Tarlo
Is the wastewater disposal system adequate for the cumber of bedrooms (YVN)
[Page 1 of 21
2-15-84
n
5. Engineering Firm Providing Irspectionsr 'Tests, Data and Information
I certify that I have checked, verified, or conformed to all MDA HAA Guidelines in
effect on the date of this inspection.
S
Name of Firm
Address 171")C) 'A' �3ae An�lrrnar. ��
Signed by
Date
(ENGINEER SEAL)
qg�dlm • .. .
Approved for bedrocns
Approved C" 4 Disapproved
Terms of Conditional Approval
Date ; %I AApr;j j q(c I
Te leohcne 5/„ 1
0�1<C
OF At tj
.
r
%9 LeC.C. Reid, Jr. , l✓r
0+8�L1�''•;FES S*�.�"'�` .
By Date s kl
Conditional
The Municipality of Anchorage Department of Health and Environmental Protection does
not guarantee the continued satisfactory performance cf the water supply and/Cr the
wastewater. disposal system. This approval indicates that, as of the validation date
shown above, based on the data and information furnished, by an engineer registered in
the State of Alaska, the water supply and wastewater disposal system is safe and func-
tional for the nJmber of bedrecns and type of structure indicated.
(DHEP SEAL)
7. Mail the HAA to the following address:
' k.k -a-a
(xlyr (—,,.0 c. ,�
t r -3F r •,, A c rk r,�L i
KB2/d5/s
(Page 2 of 21
2-15-84
MUNICIPALITY OF ANCHORAGE (MOA) Q 3 A 13 J 3 S
HEALTH AUTHORITY APPROVAL (HAA)% �dri
CHECKLIST - FEBRUARY 1984 NOUDUOUTYINANNOnUW3
Legal Description:
A. WELL DATA
Well Classification If A, B, or C, D.E.C. Approved(YM)
Well Log Present (Y Date Completed /977 Yield
Total Depth Cased to Depth of Grouting
Static Water Level -30' Pump Set At 46
Casing Height Above Ground �' Sanitary Seal or. Casing (Y )c
Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y )
Separation Distances from Well:
To Septic/Holding Tank on Lot 161 ; On Adjoining Lots •100
To Nearest Edge of Absorption Field on Lot I►y' ; On Adjoining Lots +100'
To Nearest Public Sewer Line �! A To Nearest Public Sewer
Cleanout/Manhole AIA To Nearest Sewer Service Line on Lot
Water Sample Collected By
Water Sample Test Results
Caments
B. SEPTIC/HOLDING TANK DATA
Date Installed m0 -M --►y SizeIFCy-) Sol No. of Compartments Z
Standpipes (XM). Air -tight Caps (Y� Foundation. Cleanout (Y )
Depression over Ta (Y/N) Date Last—Pummmpe ��/I �F(�/ ✓
Pumping/Maintenance Contract on File (YIN) J1A ; for
Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (YM) -
Separation Distances from Septic/Holding Tank:
To Water -Supply Wall 101' To Building Foundation LI&
To Property Line '10' To Disposal Field 590
To Water Mair,/Service Line WA _ To Stream, Pond, Lake, or Major Drainage
Course
Comment
[Page 1 of 21
.,L -o -f- 3,811
r�.reNcx S%
2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata g5 Type of System Design
Date Installed /D I74 Length of Field
Width of Field o2 yDepth of Field _ 42-
C � Gravel Bed Thickness
Square Feet of Absorption Area 0 0 �' Standpipes Present ) s
Depression over Field (Y& Date of Last Adequacy Test Z
Results of Last Adequacy Test _a
Separation Distance from Absorption ld:
To Water -Supply Wall jig, To Property Line 10 �
To Building Foundation .101 To Existing or Abandoned System on
Lot 11A ; On Adjoining Lots 1321
To Water Main/Service Line _ To Cutbank(if present) rJ A
To Stream/Pond/Lake/or Major Drainage Course +/oo'
To Driveway, Parking Area, or Vehicle Storage Area 351
Comments JE 12L1 blp A- \..s fer iie.1 gww\
D. LIFT STATION
Date Installed Dimensions
Size in Gallons Manhole/Access (YM)
"Pump On" Level at "Pump Off" Level at
High Water Alarm Level at
Tested for
Vent _(_YM)
Pumping Cycles dying Adequacy Test. Meets MOA
Electrical Codes(Y/N)
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MDA HAA Guidelines in effect
on the date of this inspection.
.:
Signed _ Yaj,(n Cc4' Date J (Q ' JI,i.••••••-4/.,1%%J 1
Cenpanyr ) 1 i'eao-(r ':9 0
tvr.�MOA NO. ryr .,
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e Y C. Reid,
�, Nf� ;e.• No. 2251E • Vim'
[Page 2 of 2] 1 9F .••......•.••��?�
2-15-84
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ALASKA EI idIROIl nTAL COnTROL SCRUICCS, InC.
Engineering 6 Enuironmental Studies
APRIL 26 1984
LUELLA GUILLAND
5200 SPRUCE CREEK CIRCLE
ANCHORAGE AK 99516
SELLER — LUELLA GUILLAND BUYER —
SUBDIVISION — FISCHER BLOCK — 4B1 LOT — 3
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A CRIB WITH AN AREA OF 900 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 675 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 675 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
(f3)BEDROOM HOME.✓
THE SEPTIC TANK WAS PUMPED ON 3/14/84. ✓
FLOW TEST ON WELL
THE WELL FLOW RATE WAS(6 GPM FOR 2 HOURS.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1000)IS ADEQUATE FOR
THIS 3 BEDROOM HOUSE.
OF q
.............
C. Reid, Jr. ,
22J1 -E
?ROFES510��
1200 West 33rd Auenuc, Suite 6 o Anchoragc, Alaska 99503 o (907) 276.1361
5. LEGAL DESCRIPTION
,
„
$ '
STREET LOCATION
C
MUNICIPALITY OF ANCHORA E7FACILi
�1DEPARTMENT
NUMBER F BEDROOMS
OF HEALTH& ENVIRONMENTA`
1525
SINGLE FAMILY
L Sten • Andllornea, AM" 59501aENVIRONMENTAL
❑ MULTIPLE FAMILY
❑ Three ❑ Six
ENGINEERING DIVISION5Telephone
X INDIVIDUAL'
2644720.REQUEST
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
FOR APPROVAL OF INDIVIDUAL WATER AND S3S
DIRECTIONS: Complete ail parts on papa 1. Ineomplaw requan will not be Processed. Plegia allow ten (10) days for procassinp.
1. PROPERTY OWNER
PHONE
❑ PUBLIC UTILITY
t4'
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,
MAILING ADDRESS
PROP TY RESIDENTIlf different from above)
PHONE
3
7 3
2, BUYER
PHONE
(LING AQFDRESS
yq n
3. LEN91P G INSTITUTIO
PHONE
F
MA IN AD R
i hJ!
A R LTO AGE T
PHONE
MAILING AODR
/
.--
/ a/ F
Lp
5. LEGAL DESCRIPTION
,
„
$ '
STREET LOCATION
C
0. TY►E OFR IDENCE
NUMBER F BEDROOMS
❑ One ❑ Four ❑ Other
SINGLE FAMILY
TWO ❑ Five
❑ MULTIPLE FAMILY
❑ Three ❑ Six
7. WATER SUPPLY
X INDIVIDUAL'
' ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
S. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE"
..Ifirldividual/on•sits,give installation date�. i
If system is over two (2) years old an adequacy test is required
❑ PUBLIC UTILITY
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,
7201013178)
CRFFKc'/ktLE
esu P= (3'7ry� Y3„
4.-/000=C51ro" ) 70
T11?S
i1
i'LOLd
1
House is '/ellow —
a n Cr deY-
af oG l -de -Lac.
1�
J THIS SIDE FOR OFFICIAL USE ONLY^?, _
INSPECTION APPOINTMENTS
DATE RECEIVED
TIME
IME
TIME
DATE
DATE
DAT
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE
ED- SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE Li—THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
INDIVIDUAL
❑ COMMUNITY
❑ PUBLICUTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3 SEWAGE DISPOSAL SYSTEM
YNOIVIDUAL/ON -SITE
❑PUBLIC+JTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED � /
- , cl, -,x `,Lt-�
k
INSTALLER
SOILS RATING
R;;3eptic Tank or ❑ Holding Tank
size: 00If Tank is homemade
give dimensions:
TYPE OF TAJfII(
MANUFACTUfiy�,F{)
/4,�"^/
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL TO:
Saptic Holding Tank
Absorption Area
Se~ Line
Nearest Lot Lim
Absorption Ara to ine
S. COMMEWS
d .
❑ APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
BV (Tltle)
LEGAL DESCRIPTION
..+.v 1r.ay. or ror
r
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received-z���7�
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
q FOR
1. Approval requested by:�
Mailing Address:
1'r,0i c S3' '3 Phone: 3 uu- 6G 3 J
2. Property Owner: A - _s ,.. c_ Phone:
Mailing Address: Zr,.fl 736,- /7,
3. Legal Description: 3 ,6 41
4. Location:
5. Type of facility to be inspectedNo. of bedrooms
6. Well Data:
A. Type B. Depth
C. Construction C"Ooa�gr2jewey D. Bacterial Analysis
7. Sewage Disposal System:
A. Installed 1o%7,171/ B. Installer frR rA �-
U
C. Septic Tank:
D. Seepage Pit:
E. Disposal Field:
8. Distances:
1. Size 10 o 0 r zF'. 2. Manufacturer �nr�
1. Absorption Area 00 2. Material Crncz� hu ,p
U
Total length of lines N /cam
A. Well to: Septic tank ie o c , Absorption area /00 /a Sewer Lines io,�
Nearest lot line /0 Other contamination
B. Foundation to septic tank /ifs , Absorption area
C. Absorption area to nearest lot line 411 /
120 '
EQ -034 (1/74) Page 1 of two pages
P-4ge 2 of •two pages''.- r"3t'�for Approval of Individual S r & Water Facilities
Lego' bescription.
Comments
Approved & 0 t a.<r Disapproved Date
Approval,Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
1 1.01411 WIPU I.". .... v......-.-.. --..--...-- ... _..._ - -
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ -034 (1/74)