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HomeMy WebLinkAboutSPRING BROOK VISTA #1 BLK 3 LT 4Spring Brook Vista #1 Block 3 Lot 4 #050-091-05 Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW020008 PID Number. 050-091-05 Name: c/o MARGARET GOCGE w/ DYNAMIC PROP. Wastewater System: ❑ New ■ Upgrade padre3111 "C" STREET * ANCHORAGE, AK 99503 ABSORPTION FIELD Phone; No. of Bedrooms: (907) 351-4551/261-7670 3 O Deep Trench O Shallow Trench ■ Bed O Mound OOlher LEGAL DESCRIPTION "`un 0.7 vane. Ft Tao, *SEE REMARKS n Block Lot: Subdivision: Dwth m P" beam h^m wrl-1 910dw *SEE Geer dwe, berseln Dip« 0.60 3 4 SPRING BROOK VISTA S/D #11 REMARKS e< rt Township: Range: — Section: — — n• ode'^ , wig' ral Ped" *SEE REMARKS Ga longe,: 44 r< n Growl wwee NvnLwr of erw« l)1 sawn sneer 5 WELL: ❑ New ❑ Upgrade 15 R 3 n ca.ewa prtao. ae.a TaralR cre.e T° ToW abo pUm area 660 Pk" D 3034/ F-810 R so. rt DdMn Dob ONed: 51atls war Lw.wl: ewbe«: CCC CONSTRUCTION Dae 2/14-16/2002 P�gJO FL P` sm A& a'*' " 'm m' Gam: •*EXISTING TANK cpu n R• SEPARATION DISTANCES ■Septic ClHolding 0S.T.e.v. 0Other To Tobe on Uft Holding leonur A ANCHORAGE TANK �« 1000 From Tank Field Station sear urn.. Well 3,00'+ 3,000+ — — 25'+ �`` STEEL« a womo 2 Surface water 100'+ 1000+ — — — LIFT STATION Lot Une 5'+ 10'+ — — — sy In qwb rbwrwcNr. on wwN a: a: awrm a Foundation 50+ 10'+ — — — [Waura ►urV Iwb Elw bW Yrprda sMr"»d er. Curtain DrainNONE KNOW BENCH MARK Remarks: *THE EXCAVATION WAS LIMITED TO THE REMOVAL OF THE BOTTOM OF THE EXISTING SAND tnoeeon and V""" a TOP OF GARAGE SLAB NEAR POINT "A" FILTER. ELEVATIONS SHOWN ON AS—BUILT DRAWINGS WHERE FOUND TO BE INACCURATE. THE DRAINFIELD� 100.00 n ENWNEE" 81u WAS REBUILT TO THE SAME ELEVATION AS THE EXISTING SEWER DRAINROCK. coo FSO **THE TANK INTERGRITY WAS FOUND TO BE GOON 2/18/2002. Inspections performed by: AWWC, INC. Dates: 1st 2/14/2002 2nd 2/15/2002 3rd 2/16/2002 J re A. ame m, d0 Development Services Departmen Approval `Date:� 7953 '. Q`Fp 4400"Prot Reviewed and approved by: 22 sslo0o' �0000� (ew.. 12n1) SW020008 AS -BUILT DRAWING PARCEL 09NUMBER: O0' KEY BOX,,,- ASSUMED LOCAT i WATER LINE OF \�G :.... THJ1 ;J C,'pp�' REBUILT DRAINFIELD EJ0F,0 JSF. B EGO, \\ R� / •y �,O C ti R� LOCATION OF WATER UNE IN EXISTING 1000 GALLON SEPTIC TANK. INTEGRITY VERIFIED ON 2/18/2002. 000 ®oma moo■®tl�l / 1 2/19/20( DRAWN BY: ALASKA R'ATRR & )NISTCWATER SCALE: J.Lm. CONSULTANTS, INC. 1 = 30• 6001 DFRARR ROAn. St TF 79 • AWRORAGF. AK OOS" • F F (0071537-0170 • FAX (00))116-57 6 REPARED FOR: PHONE NUMBER: PAGE NUMBER: c/o MARAGARET GOCHE w/ DYNAMIC 351-4551/261-7612 2 OF 3 EGAL OESCRIPnON: LOT 4. BLOCK 3; SPRING BROOK VISTA SUBDIVISION X11 rPE OF WORK: AS—BUILT OF SEPTIC SYSTEM UPGRADE A. rness: —7953 •'�o4g PERMITNUMBER: AS -BUILT DRAWING PARCEL NUMBER: SW0 SW020008 050-091-05 FINAL CRADE - 99.45+ TOP OF 1 INLET - NOTE: THE INTEGRITY OF THE TANK WAS FOUND TO BE GOOD ON 2/18/2002. INVERT OF BUNG - AT INLET - 95.05 BOTTOM OF TANK AT INLET - 90.76 FILTER FABRIC EXISTING 1000 GALLON SEPTIC TANK OF TANK AT ET - 95.70 "INVERT OF BUNG AT OUTLET - 94.87 -BOTTOM OF TANK AT OUTLET - 90.74 - FINAL GRADE - 98.94-99.73 INVERT OF DISTRIBUTION LINES - 92.11 (AVG.) BOTTOM OF SEWER ROCK / TOP OF SAND FILTER LIMITS OF EXCAVATION - 91.51 (AVG.) - 89.32 (AVG.) + �4 2/19/2002 0G 01 A 4 DRAWN BY: 'il ALASKA WATER & WASTEWATER SLE: CONSULTANTS, INC. 1 " = 30• 6001 DFRARR ROAD. SUITF 7R • ANCHORAGF. AK 00504 - PNONF (007)5774170 - PAX (007)356-3766 ... .. . ..... ... ... REPARED FOR: PHONE NUMBER: PAGE NUMBER e/D MARAGARET GOCHE w/ DYNAMIC 351-4551/261-7612 3 OF 3 of OQ4 p� ••• ey C . Go ess: 7953 EGAL DESCRIPTION: LOT 4, BLOCK 3; SPRING BROOK VISTA SUBDIVISION #1 �� ��e .•, ��4�0 40� pro esioo°� �ppppoo� TIRE OF WORK: PROFILE AS—BUILT OF SEPTIC SYSTEM UPGRADE ALASKA WATER & WASTEWATER CONSULTANTS. INC. IJVIL LVb — rrr%LyLm IIyIl lwli LEGAL DESCRIPTION: LOT 4 BLOCK 3• SPRING BROOK VISTA SID #1 PERFORMED FOR: c/o MARCAREr COCHE w/ DYNAMIC PROPERTIES DATE: 1/24/2002 DEM (feet) =_== ORGANICS EST HOLE Jill SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: N/A COMMENTS: PERFORMED BY A.W.W.C.. INC. 1. JEFFREY A GARNESS. CERTIFY THAT THIS rAS ERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2 I Z2 0 SIFICATIONS 2— SOIL CLASSIFICATIONS ORG GW GP ML 3 GM CIL: 4:. r-.. ; GC OL SW MH i SID CH 5 1 2.31L SM : OH .;: GP wi SC s i. ,�;: SOME SILT ExlrnNc 7 DEPTH TO DATE ExIsnND SEPnc 3 BEDROOM SYSTEM ++ GROUNDWATER HOUSE J g ;Z rev sem_ DRY 1/24/2002 % J DRY 2/1414 /2002 9 L -r.^ \.! :-. SITE PLAN ✓/ � 1'.100'to— ;,,•: iZ1. •; J CLOCK NET TIME WATER LEVEL NET DROP 1t DATE READING TIME (MINUTES) READING (INCHES) 12 :, :' ` GP W/ SOME SILT & LENSES OF CL 3 13- 14— 14NO N)PERCOLATI N TEST PER, ORMED 15- 5161718 16- 17- 18 PERCOLATION RATE - (MIN./INCH) PERC. HOLE DIA. - (INCHES) 19 TEST RUN BETWEEN - FT. AND - FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: N/A COMMENTS: PERFORMED BY A.W.W.C.. INC. 1. JEFFREY A GARNESS. CERTIFY THAT THIS rAS ERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2 I Z2 0 men o•'°�..•`1' Coon / m.r aanNT '•aA.AarIC �,.� "0=00 tn.al r E 1 0- ur�t. -7— of Of CE � 1'Rir'•5� N . �- CAX /� • �' e•'- '3 IB. N6 Z 1. ;fid 5 - c 0 / L -S � N / o / 40' �� a / fsr�r, n 5' V.• , Z 5.1 � b 09.5 UNDER NO CIRCUMSTANCES SHOULD AN AS—BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY DR fFNCE ONES. THE SURVEYOR TAKES RESPON98E7TY FOR THE "TIAL TRANSACTION ONLY AND ASSUMES FINANCIAL UAKM ONLY FOR THE COST Or THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING. REPRODUC110N MAY CAUSE ERRORS N SCALE tOT S T SURVEY TYPE SYMBOLS r0.NDATXN AS-IJLT :.. Rrkaar STWJCrJK AswT ... SET RF9M RA...O rum �• ;w DRAINAGE .:.::::i•. AV -HALT R RESARmay, WOW FENCE ..:; CONCRETE ® A6SU MED a" METAL FENCE ® WOOD DECK PLOT PLANS h LOT SURVEYS N IT IS THE RESPONSBIUTY OF THE BUILDER OR OWNER, PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE TO FINISHED RTO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES, WELL; SEPTIC CIEANOUTS, SIDEWALKS. DRIVEWAYS, TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE [TTL, ARE BROWN IN THEIR APPROXIMATE WCARON, ONLY. SNOW THE EJ(IDO NONCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY FARE SH WNI THEIR PPR FROM LOC0NO SEEN AND LOCATED, WHICH DO NOT APPEAR ON SHE RECORDED SUBDIVISION PUT. ALL DISTANCES ARE RECORD UNLESS OTHERVASE NOTED. SURVEY CERTIFICATION ..•,�r,Tlaa, Preparedby PLAN • (F OF •�,•. Robert E Johns Jr.PLOTr �r'rllb,r ,•rwr•„gy �� \`�M,••"•,•_- `Iy� E. F 8E Assoc. T•�^-�r------r-rl •�//�P••" �� Professional Land Surveyors w r«irrnrrrrr w.. I J•••' 812E 12 AVE I rte. «wear ••..r.. •.w rAV tj 5'., ANCHORAGE. ALASKA 90601 S Soal•: i0.MDATIGN AS-OVLT jig ... 1• _ R•a. lot R SJi. K Rat M Ns .. 1 40 • r+rw....., rr••• rr 1'F:DKU(1RY 20 '2002Green �t Chocked by ^ ........r.. ..�.... JOHN D1LJ •���; •t ��MARY 20, 2002 'NW 252 "022017 rWAL STRUCrAE AS -BOLT 121 4A•� •... t •r•.0. r.r, ..rr w I �. �•^ •.,• ••• •N•d•''�1 ice• tbn: "' ..... LOT 4, BLOCK. 3 , SPRUCE BROOK VISTA 1•••I0^a��� SUBDIVISION UNIT #1 aaaann� Permit Number: SW020008 2- MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Date Issued: Jan 22, 2002 Expiration Date: Jan 22, 2003 Parcel ID: 050-091-05 E Legal Description: SPRING BROOK VISTA #1 BLK 3 LT 4 Design Engineer: 0041 AK Water & Wastewater Consultan• Site Address: 012311 PRINCE OF PEACE DR E Owner Name: Craig & Cheryl Johnston Lot Size: 24188 SO. FT. Owner Address: 12311 E PRINCE OF PEACE Total Bedrooms: 3 Permit Bedrooms: 3 EAGLE RIVER. AK 99577-7544 This permit is for the construction of: ❑✓ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: A7.1]AX.GROUND ?EOTIOMREPORT, y' _ • _ Date: L62 Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program < 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.cf.enchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.O. - &5-d— bg ( — I)S— Permit Number SWOzo0o8 Property •wner(s) CRAIG AND • i • • \ 7 • \ Day phone 696-6336 Mailing .•• :7 PRINCE OF •ill RIVER, :• Mailing address (2) Legal description (Section, Township & Range) - Lot Size _ '�2LJI 19)6 Acr Sq.Ft. THIS APPLICATION IS FOR: Zip Code 99577 Number of Bedrooms 3 Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER do WASTEWATER CONSULTANTS, INC. Permit Fees: t t7 t+nn .,no Date of Payment: Receipt Number: O/ y5 �0 Cl Waiver Fees, Date of Payment: Receipt Number. ALASKA WATER F� WASTEWATER CONSULTANTS, INC. January 14, 2002 Municipality of Anchorage Development Services Department On -Site Water R Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, Ak 99519-6650 Ref Septic System Upgrade for Lot 4, Block 3; Spring Brook Vista Subdivision #1 To whom it may concern: The existing 3 bedroom house is served by public water and a private septic system. The septic system consists of a 1000 gallon septic tank and a gravity flow bed type dminfield that were both installed in May of 1992. The bed is 15 feet wide by 44 feet long and has an effective depth of 0.5 feet. There is also 2 feet of sand filter below the effective depth. During our site visit, the drainfield was found to be completely surcharged. The homeowner would like the bed to be rebuilt. We are proposing that the bed be excavated and all contaminated material removed. The total depth is to be limited to removal of the contaminated material. We than are proposing that new sand filter material be installed to the same elevation or higher as the existing sand filter. Than we proposed that new sewer drainrock be installed. All piping, filter fabric, insulation, etc., shall be new material and the piping configuration is to be the same as previously installed bed. The septic tank is to be excavated to verify the integrity. If the tank integrity is found to be poor, than a new 1000 gallon tank is to be installed in the same location and the existing tank will be completely abandoned. Attached is a copy of the inspection report and design package for the original installation. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your M.S. 6901 Debarr Road, Suite 2B • Anchorage, AK 99504 Ph: (907) 337-6179' Fax: (907) 338-3246 • Website: akwwc.com Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW 9Zc'o3g' PID Number: 05o09105 Name: ZObeY4 Kaiser Wastewater System: 9New ElUpgrade _ Address: )-445_9 Ck,) \e a+ C --a l�t�lve,� ABSORPTION FIELD Phone: No. of Bedrooms: 9�6� 3 ❑Deep Trench ❑Shallow Trench $i Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: M 1 11Jlr1 PSC Total Depth from original grade: SNND CI�TLW JSZV� GPD/Sq. Ft. Com° Lot: Block: Subdivisio 4 � � Depth to pipe bottom from original grade: c Gravel depth beneath pipe $ Yin V_001< 3�� 3 Ft. 0 Ft. Township: f g N Range: 21� Section: ( Fill added above original grade: 3-. Gravel length: -44 Ft. Ft. WELL: ❑ New ❑ Upgrade G ravc,44eWW I PTij Number of lines: Distance between lines: 1 15 Ft. 3 5 Ft. Classification (Private, A,B,C): Total De Cased To: Total absorption//area: Pipe material: _ Ft. Driller.: \ Date Drilled: Ft. Static Water Level: So. FL Installer: '�'So34�C•T, Date installed: Ft. Wal C,,^ 4v t' MA` 1 14 Sl,99Z Yield: Pump Set at: Casing Height Above Ground: TAN GPM Ft. Ft. SEPARATION DISTANCES ;W Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines '1� f5tY16\0 Ye%� % 0010 Well Material: Number of Compartments: Surface Water -+toc f lir NA N A 4-100, LIFT STATION Lot /�' 13r O✓ NA 15 r Size in gallons: Manufacturer: Line 7v' Foundation l LIS N AIA -10' "Pump on" level at: "Pu 'level at: High water alarm at: _ Curtain UA NA /lfi NA Pump Make el Electrical Inspections performed by: Drain lyP Remarks: News1�1. tf`s11ed Ma., 997- BENCH MARK //,� 1 Sand, 1�114ei, -5o0s- Vem4Ih.i» 41 Location and Description: Gai,—�Q.SIZlj M1! GA rv�ewo7 LouSG <2,++ Prl1.L�10Y11v, <-C�ioy C Q/y F1(1d 40Yv,\ (_ tib JSe, Q_XGZUa -66-, 6-, Assumed Elevation: O TOO ® ENGINEER'S SEAL i1t• 1� V � ��.�, 06 Inspections performed by: _- Dates: 1stL� J4, 00 2nd M� , ..� e . .> d.a.o..,.m..,y, 3311:1M aa�� t S , 1992 NG. 173a•t? �® �� ;{Cgap Department of Healthy and Human Services approval Jung 22, 19116. by: oNti� Sc� (� Date: 6 8 m �`0. Reviewed and approved -� — 72-013 (1/01) MOA 25 Permit No. 5W 9Za03. Page 1 of Z Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: 1.,4 133 ivinc�brook 1�,-<+a # 1 PID N N TS � o >r c v v� 94 t 1 FrLpI$%otea— NO 1 MPOKTCD SAND ?G -q - 1S-. 65 660 t sore -o n. oa TEsr 1-jpLL Cut\/ 79C ELev IW' 2g e- SIZ�9 cA0 (WP) i '- p U1 N w,. G'KAoe' 1 ANK I"verT 11rPfq k4 fsi.a✓ 940 PZbre% -TANK. 1000 a i'X}M,l -1- 72-013 A (2/91) MOA 25 N`3 zI A•vrc,� 1. �E,AL A toe®armsay w i JUI W 4A, 1 4 Yeti 3 {-jl 'n .ops• Am'. IQpan { acs '® A •�'S ���/S�a ���iA i 10 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW920034 DATE ISSUED: 3/19/92 DESIGN ENGINEER:CONSTRUCTING ENGINEERS, INC. EXPIRATION DATE: 3/19/93 OWNER NAME:KAISER ROBERT J & KATHLEEN F OWNER ADDRESS:17739 CHILKAT EAGLE RIVER, AK 99577 PARCEL ID:05009105 LEGAL DESCRIPTION: SPRING BROOK VISTA #1 B 3 L 4 SEC 1, T14N, R2W, SM LOT SIZE: 24188 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: MAINTAIN 50' SETBACK TO SLOPES >25%. C.O.'S ARE REQUIRED AT THE BEGINNING AND END UNLESS LATERALS ARE CONNECTED IN A LOOP, THEN C.O.'S MAY BE INSTALLED ON OPPOSING CORNERS 7 RECEIVED BY: DATE: ISSUED BY :���DATE: fy) ABSORPTION SYSTEM DESIGN 1 � Q�ix � PRev65�D b����U,ke- AeSoe3,Pnav FiaLfl i � Q(��a ?Koao 3-i3E M r7''M H6 1S /L7 / / � m nf1� 1/\ \V \ r .s, 4? '?p - \ LoT ARCA Z4,1 X �i \ 540po '7 7.5 IS�100 S� r-REA AoAILr,4LE Fofi S�vtyc.• $YST1:-M 510818 s SITE PLAN DETAILS --PROPOSED ABSORPTION SYSTEM LOT 41 BLOCK 3 SPRINGBROOK VISTA #1 SUB SWC/4 S1 T14N R2W PREPARED FOR: BOB KAISER 694-9663 17739 CHILKAT EAGLE RIVER, AK, 99577 SCALE 1" = 100' DRAWN BY CAL CONSTRUCTING ENGINEERS 346-2000 9601 BUDDY WERNER DR 694-9098 ANCHORAGE, AK, 99516 DRAWING 9 92-S1-03-01 I 41 N N ABSORPTION SYSTEM DESIGN ro �15 y 4 Socio tp �loovg -dank H00Tr PPA 9 " ? L,Rk P mr �a.rYXtiAL DIST Mr 141 14' n, TY PF4R 51(.TCR VAI SRn 0 o u I' rn.n SEwEC ctoU< t.TpZ MATE 2114 PURR SQI:'G ABSORPTION AREA CALCULATIONS: 3 Bedrooms x 150gpd/bedroom = 450 gpd 1�`/? Soils percolation rate < 1 min/inch. Require use of sand filter Filter material soils rating 0.7 gpd/sf for Bed design 450gpd / 0.7 gpd/sf = 643 sf area minimum - Minimum Bed size 15' x 43' = 645 sfL' IMPACT ON ADJACENT LOTS: This lot is served by a public water system. The proposed absorption system is located such that there is no adverse impact to any adjacent lot. SITE PLAN DETAILS --PROPOSED ABSORPTION SYSTEM LOT 4, BLOCK 3 SPRINGBROOK VISTA #1 SUB SW /4 S1 T14N R2W PREPARED FOR NOT TO SCALE BOB KAISER 17739 CHILKAT EAGLE RIVER, AK, CONSTRUCTING ENGINEERS 346-2000 9601 BUDDY WERNER DR 694-9098 ANCHORAGE, AK, 99516 694-9663 99577 DRAWN BY CAL DRAWING H 92-S2-03-01 7.JA Z s r �loovg -dank H00Tr PPA 9 " ? L,Rk P mr �a.rYXtiAL DIST Mr 141 14' n, TY PF4R 51(.TCR VAI SRn 0 o u I' rn.n SEwEC ctoU< t.TpZ MATE 2114 PURR SQI:'G ABSORPTION AREA CALCULATIONS: 3 Bedrooms x 150gpd/bedroom = 450 gpd 1�`/? Soils percolation rate < 1 min/inch. Require use of sand filter Filter material soils rating 0.7 gpd/sf for Bed design 450gpd / 0.7 gpd/sf = 643 sf area minimum - Minimum Bed size 15' x 43' = 645 sfL' IMPACT ON ADJACENT LOTS: This lot is served by a public water system. The proposed absorption system is located such that there is no adverse impact to any adjacent lot. SITE PLAN DETAILS --PROPOSED ABSORPTION SYSTEM LOT 4, BLOCK 3 SPRINGBROOK VISTA #1 SUB SW /4 S1 T14N R2W PREPARED FOR NOT TO SCALE BOB KAISER 17739 CHILKAT EAGLE RIVER, AK, CONSTRUCTING ENGINEERS 346-2000 9601 BUDDY WERNER DR 694-9098 ANCHORAGE, AK, 99516 694-9663 99577 DRAWN BY CAL DRAWING H 92-S2-03-01 rGAiPin dl to6-b>`�i.9la r'"';�ou�,o •'7' 9 s5ttr t3c Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES " 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOC, — PERCOLATION PEST c� 17az•v two b Ka `` PERFORMED FOR: t _ �Y,/ DATE PERFORMED: LEGAL DESCRIPTION: ��•'�� �P 'Imbrook l&S Z* Township, Range, Section: 5 W I/,rf 51 714w 2.zW DEPTH SLOPE STEPLAN (FEET) O�'C}aY1tL.) b\)erbvrden.\ -� ^� T.QtFrr.1�,R_.,_, 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 �f pt?Rc. E.t` j WAS GROUND WATER ENCOUNTERED? N6 IF YES, AT WHAT DEPTFI? N A M 1 Depth to Waler Aller Monitoring? Date: S L D a �e P E Reading Date Gross Time Net Time Depth to Water Net Drop IsA 1 ¢ WAS GROUND WATER ENCOUNTERED? N6 IF YES, AT WHAT DEPTFI? N A M 1 Depth to Waler Aller Monitoring? Date: S L D a �e P E Reading Date Gross Time Net Time Depth to Water Net Drop 8,j �I r+�r PERCOLATION RATE 3 (minutes/inch) PERC HOLE DIAMETER ILS1 RUN BETWEEN _� FT AND � FT COMMENTS /vt,in1,��� y�"6u\>z..L`j Sh�17 �1L•�}=Y� �7D g�'�(�1�.Si/i'lL JSIs �1i1Frf�7 ,, p I PERFORMED BY: ConSruGd-1A`1�1tXj I L_I/il--TG�.,d_Q,yS CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: - - �/161,9 2 72-008 (Rev. 4/85) 5vD Aw ,1Lo 0* �:� Municipality of Anchorage R DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: _�90 lje,y' -----DATE PERFORM LEGAL DESCRIPTION: �--9"*3 S ✓,rte ..��k Y S Z21+�OWnshlp, Range, Section: 5u-))�,4 rEPTH 1� SLOPEjj�������S I—yEEET) 0y5aJ y'v�ClOV w U t1Y b en � �I I I ICG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 P ;I2 -e- TS ,1$T" 6 -L - t_:\1 WAS GROUND WATER Ua L.NCOUNTERED? s IF YES, AT WHAT L DEPTH? 0 P E Depth Io Water Alter A1L Monitoring? Date: T'14N it ?- \A-) Reading Date Gross Time Net Time Depth to Water Net Drop -9z. -- _ 0" _ I� �h 41 9+n WAS GROUND WATER Ua L.NCOUNTERED? s IF YES, AT WHAT L DEPTH? 0 P E Depth Io Water Alter A1L Monitoring? Date: T'14N it ?- \A-) Reading Date Gross Time Net Time Depth to Water Net Drop -9z. -- _ 0" _ �h 41 9+n I I PERCOLATION RATE l� (minutes/inch) PERC HOLE DIAMETER LLLII 6 I LSI RUN nET WEEN FT ANU �� Fl COMMENTS ?i:�-�•.oI-AMnN `�A•l� 1/� MIN 3EIWE TAN ----[-2�I�St9- L•�.'Cb U S i;1 6j C7% I� �S i E-rrJ PERFORMED BY: �n's•� �`T���S intim_ _5�� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: _ 3 k0 / 9Z' 72-008 (Rev. 4/85) Nzb Municipality of Anchorage On -Site Water and Wastewater Program f (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. 050-091-05 1. GENERAL INFORMATION Expiration Date: S—_ 14 Complete legal description SPRING BROOK VISTA #1; BLOCK 3, LOT 4 Location (site address) 12311 E. PRINCE OF PEACE *EAGLE RIVER, AK 99577 Current Property owner(s) SONYA SMITH Day phone 854-0475 Mailing address 12311 E. PRINCE OF PEACE *EAGLE RIVER, AK 99577 Real Estate Agent FSBO Day phone N/A 2. TYPE OF DWELLING: ® 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 ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class _ Well ❑ Community ❑ Public Water System © Public Sewer ❑ WaiverNariance request for: N/A Distance: - Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee Date of Payment Receipt Number COSA# (343el6la09 Waiver Fee $ Date of Payment Receipt Number Waiver # S ENT 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 (907) 337-6179 Address 3701 E. Tudor Rd., Suite 101, Anchorage AK. 99507-3246 Engineer's Printed Name Jeffrey A. Gayness Date 9 � i'.6" In conducting this evaluation, GEG orovided an engineering evaluation of the well and/or seotic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and seotic systems deoend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the systems. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future conformance of the systems; therefore, GEG makes no warranty (express orimplied) regarding the ftuture oerformance of the well or septic system. GEG makes no representation whether an alternative well or sentic system can be installed on the property in the event either of the current systems fail. The content of this report is for the sole benefit of the Berson/party who retained GEG. Reliance upon the information provided in this moort by any other person or party, including but not limited to subsequent oroperty ourchasSm, is not authorized. In short GEG disavows any legal duty to anyone other than the oersoMoarty who paid for this report YWATER `��i`�Y OFq�yZ;,yr, 6. DSD SIGNATURE System #1 Approved for bedrooms ON-SITE System #2 Approved for bedrooms AND Disapproved "0 WASTEWATER PROGRAM Conditional approval for bedrooms, with the following stipulatiorf p < �FlVT SERNG� 'h By: Original Certificate Date: S ! �� Thenicipa y of n ge Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 9.1-12A.. 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: SPRING BOOK VISTA #1, LOT 4, BLOCK 3 Parcel ID: 050-091-05 A. WELL DATA AWWU WATER Well type If A, B, or C provide PWSID# T Date completed Sanitary seal (YIN_ 1 JAta�epm ft. Cased to ft. FROM WELL LOG Date of test Static water level ft. Well productiong,r WATER SAMPLE RESULTS: COliform colonies/100 ml. Nitrate _r -Date sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1000 gal. Number of Compartments E Foundation cleanout (YIN) YES Depression over tank (Y/N) NO Well Log (YIN) protected (YIN) Casing height (above ground) in. AT INSPECTION ft. g.p.m. Date installed 5/13-18/1992 Cleanouts (YIN) YES High water alarm (Y/N) N[A _ Date of pumping 5/6/2015 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA Dake installed 2Z14-16Z2002 Soil rating .p.d. or ft'/bdrm)OT7 System type BED Length 44 ft, Width 15 ft. Gravel below pipe 0.6 ft. , Total depth *8.55 ft. Eff. absorption area 660 ft' Monitoring tube YES Depression over field NO Date of adequacy test 5/4/15 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 680 gal. New depth 0 in. Elapsed Time: Q min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date — ALL FOUR(4) DRAINFIELD MT PIPES WERE DRY THROUGHOUT THE TEST D. LIFT STATION Date installed Size in gallons Manhoie/Ac cess (YM "Pump on" level at in. "Pump ofi" level High water alarm level at in. Cycles tested Meets alsrrn & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on Public sewer main Sewer /septic service line Animal AWWU WATER On adjacent On adjacent lots Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Properly line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ PVT & 200'+ PUBLIC SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line 101+ Building foundation 10'+ Water main 10'+ Water service line *10,+ Surface water 100'+ Driveway,n g parid gNehide storage 5'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ PVT & 200'+ PUBLIC F. COMMENTS *ASSUMED: SEE 2002 INSPECTION REPORT. IN 2015 WE RECONFIRMED THE LOCATION WHERE THE H2O SERVICE LINE ENTERS THE HOUSE. ENGINEER WHO INSPECTED INITIAL BED INSTALL IN 1992 NOTED 10'+ ON 1992 HAA G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date s%i rS (Rev. 11/05) Municipality of Anchorage .. � ., Development Services Department / Building Safety Division `+ Onsite Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050 — ME O5 COSAu _�'�Lpq� 1. GENERAL INFORMATION Expiration Date: 3 — O i; Complete legal description SPRING BROOK VISTA it, LOT 4 BLOCK 3 Location (site address) 12311 E. PRINCE OF PEACE DRIVE • EAGLE RNE AK 99577 Current Property owner(s) THOMAS CROWE Day phone 696-4420 Mailing address 12311 E. PRINCE OF PEACE DRNE ' EAGLE RIVE AK 99577 Lending agency Day phone Mailing address Real Estate Agent _ERIC BUSHNELL w/PRUDENTIAL VISTA Day phone 686-6518 Mailing address 16635 CENTERnELD DRIVE • EAGLE RIVE, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ■ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of tide (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat 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 Finn GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 ° ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GEG, UD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines B Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTO. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will It confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Phone 337-6179 Date 14 Ila h>:it k J f A.Qz_qp(ess: I 0EE-79/53..'�•�t!?LG�acavG Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory L/ Arsenic Advisory Maintenance Agreements Supplemental Engineers Reort Other ON-SITE WATER AND ; WASTEWATER PROGRAM By; Original Certificate Date:' 3 ' 07 (Rev. 11,05) Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 Bragaw Street P.O. Box 190650 `Andwrage. AK 995198650 www.muni.ayonaite 9074 CERTIFICATE OF� ON-SIITE�790 YSTEMS APPROVAL CHECKLIST Legal Description: SPRING BROOK VISTA f i, LOT 4 BLOCK 3 Parcel ID: A. WELL DATA Well type Date completed Date of test Static water level Well production PUBLIC WATER If A. B, or C provide PWSIDN Cased to ft. FROM WELL LOG WATER SAMPLE RESULTS: Coliform colonies/100 mi. B. SEPTICIHOLDING TANK DATA ft. 9— p.m- Nitrate mg./L. Wires property protected (YM) Casing height (above ground) in. AT INSPECTION Collected by: ft. — g—p.m—sample:— Tank Type/Material STEEL Date installed 5/1992 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 7/18/2006 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA Date installed 2/14-16/2002 Soil rating (g.p.d./feorj�EEO 0_7 System type BED Length 44 ft. Width 15 ft. Gravel below pipe 0.60 ft, Total depth 6.9-8.8 ft. ER. absorption area 660 ft' Monitoring tube YES Depression over field NO Date of adequacy test 4/6/2007 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test DRY in. Water added 454 gal. New depth DRY in, Elapsed Time: 0 min. Final fluid depth DRY in. Absorption rate >= 450+ g.p,d, Any rejuvenation treatment (past 12 mo.) (YM & type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN "Pump on" level at _in. "Pump T Hlgh water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankRift station on lot Absorption field on lot Public sewer main Sewer /septic service areas On adjacent On adjacent lots sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water service line 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 5'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 1410104 COSA Fee TL 1 Date of Payment Receipt Number 'a C)n (Rev. 1 V05) Waiver Fee $ Data of Payment Receipt Number Municipality of Anchorage • •� Dz/ZZ�o z evelopment Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.cf.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-091-05 HAA# A/ Q o o S 1. GENERAL INFORMATION Expiration Date: a — 2 2— O 3 Complete legal description r LOT 4. BLOCK 3: SPRING BROOK VISTA S/D #1 ❑ Individual Holding tank ❑ Community Class Well Location (site address or directions) 12311 EAST PRINCE OF PEACE DRrVE • EAGLE RIVER AK Current Property owner(s) Mailing address Lending agency Mailing address CRAIG AND CHERYL JOHNSTON Dayphone 261-7612 C/o MARGARET GOCHE w/ DYNAMIC PROPERTIES Day phone Real Estate Agent MARGARET GOCHE w/ DYNAMIC PROP. Day phone 261-7612 Mailing address 3111 "C" STREET * ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ■ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shalt be paid $2,425.00 at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, SURE 28 * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, A W WC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identif able features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Phone 337-6179 Date Conditional approval for bedrooms, with the ftlowing stipulations: Jz: ON-SITE rG, moiWnTGR &mn Ti WASTEWATER PRAGPM Attachments: HAA Checklist Manitenance Agreements Septic System Advisory Supplemental Engineers Reort Well Flow Advisory Other By: l%, GGA. ��—� Original Certificate Date: _�2 '2— (R". (Rw. 12101) i Municipality of Anchorage Development Services Department q; Building Safety Division T OnSke Water 6 Wastewater Program 4700 South Brogew St. P.O. Box 198650 Anchorage, AK 995196850 www.ci.anchorage.ak.us (907) 3437904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT 4. BLOCK 3: SPRING BROOK VISTA S/D /1 Parcel ID: 050-091-05 A. WELL DATA Wen type Date completed PUBLIC WATER If A, B. or C provide PWSID# Cased to ft. FROM WELL LOG Date of test Static water level ft. Well production g,p,m. WATER SAMPLE RESULTS: Coliform - oolonies/100 ml. Arsenic: - mg./L. S. SEPTIWHOLDING TANK DATA Nitrate - mgA-. Wen Lo Wires properly protected (Y/N) Casing height (above ground) in. AT INSPECTION ft. g.p.m. Other bacteria - oolonies/100 ml. Date of sample: - Collected by: Tank Type/Matenal STEEL Data krata led 5/1992 Tank size 1000 gal. Number of Compartments 2 Cieanouts (Y/N) YES Foundation deanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 2/20/2002 Pumper JR's PUMPING C. ABSORPTION FIELD DATA *BELOW FINAL GRADE, 2.19 of SAND FlLTEi BELOW TOTAL DEPTH. Date Instated 2/14-16/2002 Soil rating tj.p.d ftlbdrn) 0_7 System type BED Length 44 ft. Wkfth 15 ft. Gravel below pipe 0.60 ft, Total depth '7.4-6.2 ft. Elf. absorption area 660 fe Monitoring tube YES Depresses over field NO Date of adequacy test NEW Results (Pass/Fail) - For 3 bedrooms Fluid depth in absorption fleld before test = in. Water added =gal. New depth =in. Elapsed Time: = min. Final fluid depth = in. Absorption rate >= - g.p.d. Any raluvenatkm treatment (past 12 mo.) (Y/N 3 type) - If yes, give date - D. LIFT STATION Date installed Size in gallons "Pump on" level at _in. E. SEPARATION DISTANCES High water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAtft station on lot Absorption field on lot Public sewer main line On adjacent Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10, Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 5'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I cetHy that I have determined through field inspectlons and Co review of Municipal records that the above systems are in conformance with MOA HAA guideUnes in effect on this date. } Gamess.-' Engineer's Print Na a JEFFREY A. GARNESS •, —7953 ` rs�• 6 Date % aZProf HAA Fee E 3 r/.-6 pO f ��� oo Rush k Waiver Fee $ Date of Payment a - as - 0,2 Date of Payment Receipt Number 0/60-319 Receipt Number Iwv.1aJo1> Parcel I.D. # GENERAL INFORMATION Complete legal description MUNICIPALITY OF ANCHORAGE, • DEPARTMENT OF HEALTH & HUMAN SERVICES M}� Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING OSoOgIOS HAA# -4 Q 9 . L4-53 5pY a.5 brook Vi!*2 #-I Location (site address or directions) Property owner �'�' K�l'sei Day phone 694V663 Mailing address}39 Ch`�k�k �a����Je✓ Lending agency _ Mailing address— Ar nn# AAA Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well — Community well Public water Pe Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 021 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Cc',s4uc�- ine¢� Phone 346" 699-909$ Address X01 Pvc�cl(_1 W Engineer's signature 6. DHHS SIGNATURE Approved for -3 bedrooms. Disapproved. Conditional approval for Additional Comments ('" r "AR e_ Date S—Z J' ->r Z_ 140.1732-E June 29, 1968 a ��i�fOf:i1,l. •rG bedrooms, with the following stipulations: By: .�Ot-H l`! SM lTH Date 8 Z auTIC The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA 421 Municipality of Anchorage Department of Health & Human Services+ HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L4 -F>3 SPY'^�br°okylS' z_ #1 50091 OarceI.D.DlS P A. WELL DATA Well type Log present(Y/N)_ Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level If A, B, or C, attach ADEC letter. ADEC water system number Date completed — Driller_ Cased to Casing height — Wires properly protected (Y/N) Z FROM WELL LOG SEPARATION DISTANCES FROM W� v� Septic/holding tank on lot — Absorption field on lot — Public sewer main Sewer service line WATER S E RESULTS: Nitrate of sample: B. SEPTIC/HOLDING TANK DATA INSP2CTION -C jV *allay of /anchorage Dept, (•lealth & Hurnan Services ; On adjacent lots _ On adjacent lots —. Public sewer manhole/cleanout Petroleum tank Collected by: Other bacteria Date installed M ;1 1992 Tank size 100 O Compartments Cleanouts (Y/N) V Foundation cleanout (Y/N) Y Depression (Y/N) N _ High water alarm (Y/N) N t, -Y Alarm tested (Y/N) N A Date of pumping N Pumper N SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot � A (Nvowc-us)On adjacent lots +1001 Foundation To property line Absorption field_ 1�1 Water main service—Iinl Surface water/drainage 4 -loo' 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) "Pump on" level at Manufacturer Manhole/Access (Y/N) High water alarm level ' Meets MOA electrical codes (Y/N) SEPARATION D CE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA Date installed Length IS Total absorption area /Cy -Py ump off' level at Cycles tested Surface water _ � � 9,9 Z SPavo F) � IN$'TV3Ll.Cb BSD Soil rating so)c EEIkc < I MN/" System type %6 ° Tb 5ANo 171 crerC pta>1 Width �}4 Gravel thickness I Total depth9_� - 660 5.� Cleanouts r t Y/N Y Depression over field (Y/N) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) V esen ( ) . Date of adequacy test for SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot QA On adjacent lots -r 100 To building foundation _ On adjacent lots + IS Surface water Curtain drain IS' Cutbank If yes, give date NA Propertyline 131 To existing or abandoned system on lot + SOS Water main/service line. Driveway, parking/vehicle storage area ISI 2a bedrooms E. ENGINEER'S CERTIFICATION 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on tka,,#ete� s inspection. .X fto, k''e wq x�N°eee�e 6J� g � e Signature r�/'-�-� �'T��- � .E''�f� ♦p�� i�wee Engineer's Name Com' z� A to s e w od'M`Ke�aw ee ay" Date Q ' June 29, 1968 �. $4by�a"ccs vd e�naxa glib Uj HAA Fee $ Waiver Fee: $ Date of Payment �� /i� i Date of Payment Receipt Number J 230 Receipt Number 72-026 (Rev. 3/91) Back MOA 21