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SPENDLOVE VIEW HEIGHTS BLK 2 LT 5
Spendlove View Heights Block 2 Lot 5 #021-021-28 Municipality of Anchorage Development Services Department • �2 a Building Safety Division s.... On -Site Water and Wastewater Program, 4700 S, Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page / of 2 www,danchorage.ak.us (907) 343-7904 ON-SITE WASTEIVATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: S k/ 0 2 U 3 a l PID Number: Name: 70'An 7uc6cey Wastewater System: New El Upgrade Address: / 3 SSt Spenellctwv On 919 S, 06r ABSORPTION FIELD Phone: Number of Bedrooms: Deep Trench ❑Shallow Trench Bed ❑Mound ❑Other. 3 y9_ 9 8 Y t Sod Rating: Total Depth from original grade: LEGAL DESCRIPTION 0' GPOIFF !0.2 Ft. Block: LotSubdivision Depth to pipe bottom from original grade: Gravel depth beneath pipe: 2 S_ S/pead lin ve Vle-w *e7( Aft Ai' J Ft. 6% / Ft. Township: Range: Section ✓ Fid added above original grade: Gravel Length 0• S Ft. S2 Ft. Gravel width Number of lines: Distance between lines: Well: New Upgrade 2. S Ft, I I — Ft. Classification (Private, A, B. C): Total Depth: cased to: Total absorption area: Pipe Material: r — B f O Per F Pr r u a, ft K -7 Ft. S Y FL 6 3 V Ftp D - 3ca3 Y nrOA. Pt''F Driller. Date Drilled: StaficWaterlevet Installer. Date Installed: f4lpmc &/,To/02 2Y FL Owner !o/16102 Yield:I Pump Set at ( Casing Height Above Ground: 20 GPM FL 2 FIL TANK SEPARATION DISTANCES N Septic [I Holding ❑ S.T.E.P, ❑ Other: To Septic Absorption Lift Holding PublirlPrivate Manufacturer. Capacity. From Tank Field Station Tank Sewer Line Tee! 1000 Gal. ��jj Material: 1 Number of Compartments: Well i,72f 102, � — `i a PERMIT NO: SW020301 PID NO: 021-021-28 52 -FOOT LONG "F" .,C„ SOIL ABS. TRENCH a "D" w. 6.1' EFF. GRAVEL SITE FOR SIMILAR ..G.. aaa T.H. REPL. TRENCH a„ #1 , as a a "H., a , SWING TIES: COR. "A" COR. "B" FROM: TO: S.T. C.O. "C" 40' S.T. C.O. "D" 45' DBL. C.O. "E" 48' TR. C.O. "F" 62.5' TR. M.T. "G" 53' TR. C.O. "H" 43' 3'+ SOIL COVER r,; INV.---!�� 52 -FOOT LONG SOIL ABS. TR. —/ w. 6.1' EFF. GVL. BOT. TR. ELEV. 80.0 BOTTOM T.H. #1 ELEV. 737 MON. TUBE DRY 10/16/02 50' 57' 60' 70' 67' 67' INV 87.5 PAGE 2OF2 1000 -GALLON SEPTIC TANK TBM 3-6011tM HOUSE UNDER CONST. LOT 5 ■ `� BLOCK 2 T.H. \\ #2 \\ 1 1 R 100' PLAN VIEW SCALE: 1" = 30' 4'+ SOIL COVER M ✓} Pi y f m©'f fA000ry > K' 'f"t q tl @®iG mm and®ma mfB . momoaoo®:aoe THEODOPP. MDORE m ;r LOT 5, BLOCK 2, SPENDLOVE VIEW HEIGHTS SEPTIC SYSTEM INSTALLATION AS -BUILT INSPECTION REPORT CROSS-SECTION FLATTOP TECHNICAL SERVICES SCALE: AS SHOWN 14530 ECHO STREET DRAWN BY TFM NOT TO SCALE ANCHORAGE, ALASKA 99516 NOVEMBER, 2002 vJ Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Rick MyStrom http:Nwww.ci.anchorage.ak.us Mayor Permit Number: #SW 020301 Date of Issue: 6-16-02 Parcel Identification Number: 021-021-28 Date Started: 8-25-02 Date Completed: 8-30-02 is well located at approved permit location? ® Yes ❑ No Legal Description: Spendlove View i cghts Blk 2 Lt 5 Property Owner Name & Address: John Tuckey 13551 Spendlove Drive Anchorage, Alaska 99516 Borehole Data: Depth (ft) Method of Drilling ® air rotary ❑ cable tool Soil Type, Thickness &Water Strata From To Casing type: steel. stick-up 0 2 Wall Thickness:.2 0 inches gravelly silt 2 35 Diameter: 6 inches Depth: 54 feet sandy gravelly silt wet 35 42 Liner Type: silty gravelly sand H2O 42 47 Diameter: inches Depth: feet Casing stickup above ground: 2 feet gravelly sandy silt wet 47 52 Static water level (from ground level): 24 feet Bedrock 52 6T Pumping level: 60 feet after 2 hours pumping 20 gpm Recovery Rate: 20 gpm Method of Testing: air Well Intake Opening Type: ❑ Open End ❑ Open Hole ❑ Screened Start feet Stopped feet ® Perforations Start 42'bp feet Stopped 46 by feet Grout Type: bentonite # 8 Volume: 1 bQs Depth: Start 0 feet Stopped feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes [] No Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage Alaska 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property .1. 11.1.•11 1.11 '1 ....111. 4. J. T.. -r11..141 011-... 11. ... .•-.. .... L/...'A.1... r.- 1" 4) G F)IC '�>EPT- -'�) -2-o-D--2 -17E -5 G=�� CN -Z- f),SPr -I Pt /D MUNICIPALITY OF ANCHORAGE Development Services Department I P M 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 I WATER SUPPLY PERMIT Initial Date Issued: Aug 16, 2002 Expiration Date: Aug 16, 2003 Permit Number: SW020301 Parcel ID: 021-021-28 Legal Description: SPENDLOVE VIEW HEIGHTS BLK 2 LT 5 Design Engineer: 0019 Flattop Technical Services Site Address: Owner Name: John Tuckey Owner Address: 13551 Spendlove Dr. Anchorage , AK 99516 - Lot Size: 50774 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: Disposal Field Z✓ 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 By: Issued By: f Date: Date: allal©?. Municipality of Anchorage O -r Development Services Department r''eE B <, Building Safety Division _ On -Site Water and Wastewater Program S A P E T T a 4700 South Bragaw St. /� P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. p24 `cz 1 --zb Permit Number SW02030/ Property owner(s) ,jm lin %uct�-.�r Day phone 3y.S — 96 yl Mailing.address (1) 17S-5-1 1 fle_ (lace Dr,,. -e_ Mailing address (2) bn chomp , Ak' Zip Code 9,9_ -g -/g,,' Legal description (Lot, Block & Sub'd.) (/ 4.0t_90 r3 !k 2 S�oena! �vun �/, w 14e7h17 Legal description (Section, Township & Range) Lot Size 57'7 7 Acres/Sq.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well 5d 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. (Signature of property owner or authorized agent) Permit Fees: 145-S-0 Waiver Fees: Date of Payment: 8 / 12 I O Z Date of Payment: Receipt Number: &loon �eceipt Number: (Rev. 12/00) CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. PH: (907) 345-1355 August 11, 2002 M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: 14530 ECHO ST. ANCHORAGE, ALASKA 99516 The purpose of this letter is to provide the required design narrative in support of our application for a permit to construct wastewater disposal facilities on Lot 5, Block 2, Spendlove View Heights S/D, located on Spendlove Drive. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed for your review. The proposed system will be constructed in the vicinity of test hole # 1. As can be seen from the soil log, the native material below 4 feet is a very gravelly silty sand with a measured perc rate of less than 1 minute per inch. The majority silt and sand fraction of the soil should provide excellent filtration of wastewater, eliminating the need for additional filter and. Using a somewhat conservative soil application rate of 0.8 gpd/sq. ft. this proposed 3 -bedroom residence requires a total absorption area of (3 x 150)/0.8 = 563 square feet. The proposed 50 -foot long trench design with an effective gravel depth of 6 feet has a total absorption area of 600 square feet. The topography of the lot in the area of proposed construction slopes down towards the west southwest at 22%. A short section of steeper (28%) slope downhill of the proposed trench will not cause, a 25% sloping line originating at the bottom of the distribution pipe to intersect daylight. The proposed project will have no significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space -surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. LOT 3 BLOCK 2 I ITO SEPTIC AREA SEPTIC AREA a ----------------"- ------------------- LOT BLOCK 2 r SURFACE CURTAIN DRAIN FLOW OUT 100' �N i INSTALL SITE FOR SIMILAR REPL. ABS. TRENCH i 22% , T. CONSTRUCT ° °° 5b� 50 -FOOT LONG ° SOIL ABS. TRENCH W. 6.0' EFF GRAVEL ° BETW. 4'& 10' B.G.L. LOT 4 BLOCK 2 (VACANT) LOT 5 BLOCK 2 1000 -GALLON SEPTIC TANK 100' \\ � r I � � LOT 2, BLOCK 3 WELL \ 0964090 � 1 491-H P-'� , '�arnoo®s9°000000eomo9 co 9; :,` o tl %tl00.9b9p YB06P9Y99R nd ,sy 34 �u 3 ® SEPTIC AREA T.H. LOT 6 #2 BLOCK 2 , PROP. WELL I SITE 100' SPENDLOVE DRIVE WELL LOT 3, -BLOCK 3 1 I I i I LOT 5, BLOCK 2, SPENDLOVE VIEW HEIGHTS PROPOSED WELL AND SEPTIC SYSTEM SITE PLAN FLATTOP TECHNICAL SERVICES 1 INCH = 50 FEET 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, AK 99516 AUGUST, 2002 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. CONSTRUCT 50 -FOOT LONG SOIL ABSORPTION TRENCH "A" —► 4" DIA. F-810 PERF. PIPE w. 6.0' EFF. GRAVEL BETW. 4.0'& 10.0' B.G.L. I. 50 MONITOR TUBE X C.O. C.O. „ 'r � 4" DIA. ASTM D-3034 PIPE --4(A DBL. C.O. 0 1000 -GALLON M SEPTIC TANK PLAN VIEW SCALE: 1" = 10' D-3034 WASTE LINE FROM HOUSE MONITOR TUBE a'a k ma ,ate ? CLEANOUT l.[/ „wua®®mm®amosmoo®o®ms000w.,r� �y'.: 6*$�me o®4 a®m d05s®s s66Cgm m PFGECEDORE F. AdOORE RIGINAL GROUND a a FILTER FABRIC 'c 10 � � 4" DIA. F-810 PERF. PIPE 112" - 2112" SEWER GRAVEL 6.5 6 r. BOTTOM OF EXCAVATION LOT 5, BLOCK 2, SPENDLOVE VIEW HEIGHTS CROSS-SECTION "A - All PROPOSED SEPTIC SYSTEM SCALE: 1" = 5' PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES SCALE: AS SHOWN 14530 ECHO STREET DRAWN BY: TFM ANCHORAGE, AK, 99516 AUGUST, 2002 FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # 1 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: Lot 5, Block 2, Spendlove View Heights S/D DATE PERFORMED: October 2, 2001 PERFORMED FOR: John Tuckey DEPTH SLOPE (feet) Pt. SM Reddish sandy loam 2— with huge boulders 3 / ML Light gray gravelly silt 4 20% ........................ 5 SM/GM Dark gray, very gravelly silty sand 6— Scattered lenses of ML 7 - 30% 8 9- 10 Depth to Groundwater 11— No groundwater Monitor tube dry 12� 13 i 14-- �„ V +g T 3 �. p�-)y000®WOmmmeW9m OPo d'W dy a F. A100RB o SITE PLAN LOT 5 BLOCK 2 Date 1012/01 m 2007—`— o 1019/01 0_ co Clock Date Reading 15— 10/2 12" Presoak (minutes) 12" Resoak _ Add water & start 16— B H Add water 17— #2 233/8 Add water 5 #3 18- 19- 1:15 20 — 171/2 Clock Net Time Percometer Time (minutes) Reading 273/8 27 1:04:05 233/8 1:09:05 5 171/4 1:10 23 318 1:15 5 171/2 1:15:40 23318 1:20:40 5 179/16 Net Drop (inches) 61/8 57/8 513/16 PERCOLATION RATE <1 (minutes/inch) PERC HOLE DIAMETER 6" TEST RUN BETWEEN 6,5 FTAND 7.0 FT COMMENTS: Despite rapid measured perc rate sand filter should not be necessary due to high silt and sand fraction, Recommend basing design on 0.8 qpd/sq. ft. to compensate for possible lenses of siltier material. PERFORMED BY FLATTOP TECHNICAL SERVICES. I �.�..e� 2hfi` - CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: /U / 9 / O/ FLATTOP TECHNICAL SERVICES 14530 ECHO ST, ANCHORAGE, ALASKA 99516 TEST HOLE # 2 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: Lot 5, Black 2, Spendlove View Heights S/D DATE PERFORMED: October 2, 2001 PERFORMED FOR: John Tuckey DEPTH Pt. (feet) 1 SM Reddish sandy loam 16- 17— is- 19- 20— ML 6- 17- 1s- 19-20 ML Gray gravelly silt Pockets of cleaner material SM/GM Gravelly silty sand Similar to T.H. #1, but cleaner Cleanest material betw. 8.0' & 12.0' Harder digging below 12.0'& dense SLOPE Depth to Groundwater Date No qroundwater 10/2/01 Monitor tube dry 10/9/01 Date Reading B. H. 1012 12" Presoak 12" Resoak Add water & start #1 Add water #2 Add water #3 LOT 5 BLOCK2 �u. e 0. f as 2 sC i `^k ®ri..9 7 a am/oaa 9reeoarrrrrrre•u.a. +r+;� a o�irrrre rr � T'riyi7i iP:=:t t. �i.CJc�RE o° / CL -3553 a". yea r � A, SITE PLAN a 20% O J W Clock Net Time Percometer Time (minutes) Reading 27 318 271/2 2:15:40 23 318 2:20:40 5 16 112 (dry) 2:21:40 233/8 2:26:40 5 161/2 2:27:25 233/8 2:32:25 5 161/2 Net Drop (inches) PERCOLATION RATE -c1 (minutes/inch) PERC HOLE DIAMETER 5.1 TEST RUN BETWEEN 6.0 FTAND 6.5 FT COMMENTS: The excavator (Carl Elsenbast) reported that the material above 12' in this test hole was easier digging than in T.H. #1. 67/8 6 718 6 718 PERFORMED BY FLATTOP TECHNICAL SERVICES. I -5r, 0, A-e....t CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: /G d" 9 / O/ Flattop 2'echnica(Services 14530 Echo Street, Anchorage,,TX 99516 Phone (907) 345-1355 Lot 5, Block 2, Spendlove View Heights Spendlove Drive Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of installation of a 1000 -gallon septic tank that discharges into a 50 -foot long soil absorption trench containing a total of 6.5 feet of sewer gravel. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform to Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The new 1000 -gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.2 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4"' per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed 1 - 4 feet from the building foundation, and a double cleanout shall be installed within 5 feet downstream of the septic tank. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating a 50 -foot long trench to a depth of 10 feet below ground level in the vicinity of test hole # 1. The long axis of the excavation shall parallel an existing contour 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. Sand for leveling or serving as filter material shall comply with Municipal specifications. 3.3 A total of 6.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 6.0 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in addition to the filter fabric. 3.6 The top surface of the cover material shall be raised a minimum of 6 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A total of 4 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. Municipality of Anchorage a • e Development Services Department`'� Building Safety Division _ On -Site Water and Wastewater Program * _ 4700 South Bragaw St. s "� P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. a Zf — 07-1 — Z& HAA 9 Expiration Date: 1. GENERAL INFORMATION Complete legal description i o f S, Oloc t; 2, S/lend IO r -t 1/ e w H9 Location (site address or directions) met tpve D,^I C.,e Current Property owner(s) 7o4 n %'u c GctY Day phone _ 345- 96y/ Mailing address Lending agency Ma+mg-- ddress Real Estate Agent Mailing Address 13as'f SaeI7 toc e Dt'cty, _ +neG,., /},rc Day phone r. /gone Day phone 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 R 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 sample results. (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. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify 111at 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 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 FlerHo -redia i rest Phone 311S'-13s"S Address Engineer's Printed Name 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for harms Date 1J-a/y22,, 200- Ewnumes • + e'lT%9i rp DJEODORE F. MOORE J•w'n �z'�yy?_'••• CE -3589 �'�:�r�:•.aiyL�,stY bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineers Report Well Flow Advisory Other By: Original Certificate Date:_ 7' a q --D3 (Rev 01102) r..... _ .............. Municipality of Anchorage ' Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Le i- ry M&C id ?r S� d�atx 04 e lib. Parcel ID: D Z! -O Z(^ 2t9 A. WELL DATA Well type Pv } If A, B, or C provide PWSID Date completed 49170/, 2 Sanitary seal (YM) r Total depth 67 fL Cased to 3l --ft. FROM WELL LOG Date of test B / 3u /© 2 Static water level zr ft Well production 20 9— p.m- WATER SAMPLE RESULTS: Coliform O colonies/100 ml. ... Arsenic: — mg./I. B. SEPTICIHOLDING TANK DATA Well Log (YIN) Y Wires property protected (Y/N) i Casing height (above ground) 3 G in. AT INSPECTION M, A. C Nrw� ft. g. p. m. Nitrate t,92 mg./l. Other bacteria 57 colonies/100 ml. Date of sample: �Y/03 Collected by: 1=1eft&4 Itch S4c Tank Type/Material _.5gQ Hr- / St*rf Date installed 1-0116102 Tank size 10 00 gal. Number of Compartments 2 Cleanouts (Y/N) i Foundation cleanout (Y/N) r Depression over tank (Y/N) High water alarm (Y/N) ".A. Date of pumping AAA• i n ~a Pumper M A C. ABSORPTION FIELD DATA Date installed 10/4 O 2 Soil rating (g.p.d./flz or felbdrm) 01 8 Ff = System type 7- efCA Length 5z ft. Width 2. S ft. Gravel below pipe 45.1 ft. Total depth Wel ft. Eff. absorption area jS ftp Monitoring tube _Y Depression over field Al Date of adequacy test (Nn"-') Results (Pass(Fail) Portr For 3 bedrooms Fluid depth in absorption field before test 0 in. Water addedQ gal. New depth -.0 in. Elapsed Time: Q min. Final fluid depth 0 in. Absorption rate >= ot� ,, g.p.d Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date N. #4 D. LIFT STATION jV• A. Date installed Size in gallons Manhole/Access (Y/N) _ "Pump on" level at_ in. "Pump of o level at_ in. High water alarm level at Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 13 Z' Absorption field on lot 1 0 2# Public sewer main N A. Sewer /septic service line ZY' Meets alarm & circuit requirements? On adjacent lots ? 100 ' On adjacent lots 7 i00 ' Public sewer manhole/cleanout V. A- Holding tank V. A in. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation :99, Property line _ Absorption field &I Water main P. A. Water service line 7 10' Surface water 7 100 ' Wells on adjacent lots > 100 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line eS9' Building foundation '346' Water main N• /�• Water Service line > 10' Surface water 7 100 ` Driveway, parking/vehicle storage 2' Curtain drain w /i • Wells on adjacent lots - F. COMMENTS•'�� r ,. ,...... t ...' go G. ENGINEER'S CERTIFICATION r °"�°�•���go ��to....0 I certify that I have determined through field inspections and : TN: CDCae F. KOCRE ; !f ':,`, `,'.," I- = 'P review of Municipal records that the above systems are in .: C, - 4 conformance with MOA HAA guidelines in effect on this date. ,°�',,,.••'c�`.t Engineer's Printed Name —rA toelo ✓z° F. P tc�cy� ,.: `• . Date Tu f 2 Z I CO3 HAA Fee $ 37S Waiver Fee $ Date of Payment��+'Z�1 ("1� 3 Date of Payment Receipt Number 3 �f a Z c Receipt Number (Rev. 12M I) rov 04 02 02:57P FrantzHildonen 2748688 /OQ (1T/L. IZO.CG' ESMT `s6T Loi �•�g. 50,775 S.F. . , SFJ�T/C S Rg +� P.1 0 1 1 °• 1 z9� ' Lor Or 0• N _ WEST Q �..% SPENDLOVE DRIVE %I J Lot 5 , Block Z '•,�9 �1 S,oend/ova 1/iew f.,%�hfs.. .............� 101-1 Anchorage Recording District, Alaska Eonmente of record other than those show n/ ; R. L. Button �` o the plot of record ore not shorn Norton unless s�•e• 151192 ; I LOT SURVEY CERTIFICATION "clod.�QFQ eejte-wee e•••••O i MEND LEGEND �1 pRDpESSIaNNO� AW 1 Mrooy certlly that Ihove sarveytd the property shown and deecribod Qj Bross or Aluminum capped monument recove hereon, and that the improvtmente situated thereon ort within the poo- orty lines one do naw overlap or encroach on adjacent property and that O Iron pipe and/or rebor recovered O 2 x2 hub 6 tack recovered no improvements on odlocont property overlap or encroach on the premleee in eveetlan and that more ore no roadways, utility lines, Of other visible 0 5/8a x 30a tabor set this survey eASIs OF VERT/CAL 04TUM easemenn on said property ..Coot as Indicated herson. — 1927 N.G-S. - /972 ACUU5T- Scale /11,r /a Date © �- ' OZ Prepared by: R. L. BUTTO/'✓ Regislerd'd Lorlo' SurvByor (907/279-6200 5191tf 6i 17hl Ave. Anchorage Alaska 99501 Ref. F.B. No. Property of:• BARBARA A 1",5'71?GWG �O "S4 JOHN 7LC/<EY -»J ics Ret# I034179003 _lient Name Flattop Technical Srv. Project Name/# Various -^Iient Sample Ill L 5, B 2, Spendlove View $Iatric Drinking Water , ;ample Retturks: ;VO7 y616sg1 + »i 7 All Dates/Times are Alaska Standard Time Printed DatelTime 07/18/2003 16:41 Collected Date/Pime 07/14/2003 13:40 Received DateMme 07/14/2003 16:50 Technical Director St!osnC.Ede Released Parameter Qualifiers Results PQL Units 1-feaw Container 10 Allowable prep Limits Date Analysis Date Init datery Department Nitrate -N 4.60 0.100 rng/L F.PA300.0 B ("10) 07/15/03 1S 4icrobiology Laboratory Total Coliform 5 OB, No Coli col/IOOmL SM18 9222B A (t=]) 07/15/03 is