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HomeMy WebLinkAboutPOLLOCK HOMESTEAD BLK 2 LT 3BPollock Homestead Block 2 Lot 3 B #017-113-18 2/12/21 PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) February 12, 2021 M.O.A. Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Subject: Pollock Homestead, Block 2, Lot 3B – 5221 Rabbit Creek Road Septic System Design Dear On-Site Services Engineer: The absorption trench on the subject lot has failed and must be replaced. The owner requested the new trench be upsized to meet the requirements of a six-bedroom home. We are therefore requesting a permit be issued for the construction of a new absorption trench to accommodate the home. The existing 2,000-gallon S.T.E.P. will remain in use. It was originally placed in 2003 and is in good condition. The attached Site Plan and backup documentation identify the location and configuration of the proposed septic system along with the existing site. Also identified on the plans are the existing well on the lot and existing wells and septic systems on surrounding lots. No conflicts exist between the proposed septic system or septic systems and wells on adjacent lots. The ground surface on the lot in the area of the septic system slopes to the west at grades of 10% to 15%. Ground surface contours are shown on the Site Plan. Storm water drainage will not affect the proposed septic system. Please refer to the attached test hole log and plan and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211024, Rebecca Carroll, 02/12/21 EXISTING WELL 1"=50' NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND THB THA POLLOCK HOMESTEAD, BLOCK 2 LOT 3B 2/3/21 FEET 0 50 100 RABBIT CREEK ROAD 5-BDRM HOME 10' LANDSCAPE EASEMENT 5' DRAINAGE EASEMENT 5' DRAINAGE EASEMENT 10' T&E EASEMENT EXISTING CLASS "C" WELL 5055105155202-75' LONG x 5' WIDE x .5' EFFECTIVE DEPTH ABSORPTION TRENCHES. EXISTING ABSORPTION TRENCH. EXISTING 2,000 GALLON S.T.E.P. TANK. MT MT MTMT BALL VALVES TO CONTROL FLOW TO TRENCHES. TOE OF 3:1 SLOPE. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211024, Rebecca Carroll, 02/12/21 POLLOCK HOMESTEAD, BLOCK 2, LOT 3B DESIGN FACTORS:SYSTEM REQUIREMENTS: 900 GPD PEAK FLOW PERK RATE: 1-5 MIN/IN APPLICATION RATE: 1.2 GPD/SF 5' WIDE TRENCH SYSTEM EXISTING 2,000-GAL SEPTIC TANK TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY BOTTOM OF TRENCH: 0.00' BELOW GRADE FLOW LINE ELEVATION: 0.5' ABOVE GRADE TOP OF TRENCH: 3.0' ABOVE GRADE 900 GPD / 1.2 GPD/SF /5' WIDE * 1.0 (RED. FACTOR) = 150 LF TRENCH REQUIRED (150 LF SPECIFIED) 2/3/21 DRAINFIELD ROCK 6" 2'0" 6" 15-3/16" DIAMETER HOLES PER LATERAL @ 5.0' SPACING 1.25" PERFORATED PVC (HOLES DOWN) 2" DIRECT BURY INSULATION 4" TOPSOIL & SEED 3:1 SLOPE 4" TOPSOIL & SEED 3:1 SLOPE OG OG 5' 1'0" REMOVE ORGANIC MATERIAL & REPLACE WITH MOA APPROVED SAND Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211024, Rebecca Carroll, 02/12/21 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE B SLOPE SLOPE SITE PLAN DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) Pollock Homestead, block 2 lot 3b 1/26/2021 J. MILLETTE DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH?6' 2.5 6 3 4 017-113-18 Chris Reynolds 11:01 1/26 1 2 3 4 0 16 / 8 4 16 11:12 11:23 1' OB Professional Engineers Stamp: 2/12/21 10 YES 6' 2/2/21 GM (SILTY SANDY GRAVEL) SEEPS @ 6' 4 4 16 10 10 4 5 6 11:34 11:46 11:58 10 10 10 4 0 16 / 8 2 16 4 2 16 4 0 16 / 8 0 16 4 0 16 4 0 16 / 8 0 16 4 0 16 4 0 16 / 8 0 16 4 0 16 4 0 16 / 8 0 16 4 0 16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211024, Rebecca Carroll, 02/12/21 Municipality of Anchorage •••� �- Development Services Department , Building Safety Division +. .,. On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page / of Z www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: Stu 020 't)4 2 PID Number: --;L —jig__—Aj*tR Name: 0 1r 4—j� (3,0 7 (3 014 ha' 1, Wastewater System: ;E2-New ❑ Upgrade Address{�•I�Fi. 4- ls'r, Std / I2 ABSORPTION FIELD Prong: Wat¢erdBuns' 3N �'-1 aS • re S— Cthe D Deep Trench D Sh ovt Trench D Bed P( ,,,d O r. LEGAL DESCRIPTION Soil Paling 12, Taal Depth from original grade: `(Z GPD/Ft' Fl. etodt Lot Subdivision: Z— p0 I u ? Deplh to pipe bosom ban originalgrade: %r-, Ft. Gravel depth beneath pipe: Ft Township: Range: Seeicm Fill added above original grade, 7--97 Gravel Lengdt /'Z S Fl. Ft. Well: EP New ❑ Upgrade Gravel width S. 0 Numbero(rner. / Dlstancebetweenrwes: Ft. FL C:assru;atiion(Pnvate, A,rS. q: P f s V e. A G'.� Total Dep:N •"f o 0 Ft. Cased to: 0 FL Total absorption area: ) Fe Pipe Material: 1031`4 Cnller. e-uall Date D led: �O$ StaftWater levet -2-1'L FL hstatler. . SPrt"tf4 vrLra• 5 Date lnsWaeq 575V?•U 3 Yield:/ Pump Set at Casino 116011 Grand no 116011 0 TANK GPM UV- A FL 7, FL SEPARATION DISTANCES Septic 1] Holding .T.E.P. ❑ Other. To Septic Absorption Uft Holding PutGtlPrivat Mamdacbaer A I-, capaaty From Tank Field Station Tank Sewerllne f, ?t7l� cal. Wel /pp r,� /00 f� / r7J � �/ I� �, / �VO,r� Material: S.t V, Number ar ccmpnen:ertr Z, Surface Water /0,)4- ran t't LIFT STATION Lot Ure /d( V Sae. 20 DO Gal. atamdac:urer �4V.,C�•nIt- Foundation /O V, 'aiJr /Os 'Pump on' level at 314. < h 'Pump otr level at: 30"5-- in High water alarm at .414,0 in. Curtain Drain PS}.urrp kne �d Mioedetl l EleVcl . spsec�bcFns. per'crmerdwb.y N(7`/03—vtery2 Remark': BENCH MARK Loealtm and Desrnpbcn:'A\ ,s / ASOk.T-�J �7/� 11Q rk Yml i G /UsuMed E.eva= /go .O'FL - En njnj^Cssi. � TH�1'�V ••••• �� , ...... 4'Foe. 1st 12:00 Inspections performed by: Dates: 1 g-w3 s Zed 3 �� ,HV,,,,�. e Develop ment S rvices Department Approval L "94r.9esscN", �t ci.�Mlcrv+fl�lim Reviewed and approved by: Date: Ir � +i±rF,gF •7.' •'�?`°� of J,X V -Permit No. SW020392 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT 3, BLOCK 2 POLLOCK S/D PID No.: 017-112—NIS MARK A B CRND. PIPE ELEV. ELEV. / CO1 29.1' 16.6' 98.2 94.0 II / CO2 33.2' 14.0' 98.3 93.46 I COj , 11.5' 98.2 ! II I ,38.0' Cn CO 49.8' 14.0' 98.3 II AiH'LfD" 52.0'' 15.0' 98.3 1 OT I \ �0IMT � �\ N I I � II I TEST HOLE RADIUS I 77.3' I \ 1 1/4. A / I HOUSE C01 I 2000 GALLON STEP 2 H .. -,- .. L % I ; ; EXISTING CLASS 'C WELL Ay� �� _ . RESERVE SYSTEM \ ! SEPTIC ! ASBUILT I / NEW WELL v— i SCALE: 1"=40' / // B 8 1 T C R E K R 0 A D - Y�, w+ wt rwi root ... n ..,. o r z • °" ' 49TH �;"• :. '� L4 SP 0 �'~L •� urr s � • MICHAEL N. PNDEF.;CIJ ' -6.0 • �•, CE- 469 • '�� SEPTIC N.TSS.CTION ``[Is`a.� `'•••' 77.3' 120.3 104.5 Certfficb Dn'tting log by Doc co. aw SULLIVAN WATER WELLS P.O. BOX 670272, CHLIGIAK, ALASKA 99567 • TELEPHONE 688-2750 OWNER OF LAND:?raw I o -'t4 f < <' /�� S C tfGi< BORE HOLE DATA DEPTH ADDRESS: F,.,,., T.. LEGAL DESCRIPTION: Pot.t-<<-� t,TcK Q I -or .3 R DATE:Y PERMIT NUMBER: �.� u .j7')Date of Issue LV TAX IDENTIFICATION NUMBER: 014-1hz - 31 Is well located at approved permit location? U-> '.j No Method of Drilling: 4rglorrotary j cable tool Depth of well: 1400 Casing Type S %f? C- Z- Wall Thickness - JTZ inches Diameter -6) 1 inches, depth qO feet Liner Type: iti O �IE Casing Stickup Above Ground: �" feet Static Water Level: .21A. feet Recover Rate: - S gpm Method of Testing: '414 Well Intake Opening Type: U open end U open hole j Screened; Start feet Stopped feet .J Perforations Start feetStopped feet Grout Type: k i ctoi'T� ` Volume Depth: from L feet, to .,2t t- feet Well Disinfected Upon Completion? tomes J No Method of Disinfection: C dot A: t•�JL 5-0 6 -n Comments: G/<'LL /J J J �"✓rv�l S S C d' ijrQ,FJL�C �Kt.t.�: Driller's Name i21 -A -A ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. MUNICIPALITY OF ANCHORAGE Building Safety Division L 5 A [ T T MEMORANDUM DATE: December 19, 2003 TO: File FROM: Joe Goodall Engineer II, On -Site Water Wastewater Program SUBJ: Pollock S/D Block 2 Lot 3 Please reference memo to file dated 10/8/03 from dan roth. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519 -6650 - Op PM (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SW020392 Legal Description: POLLOCK BLK 2 LT 3 Design Engineer: 0070 KND Engineering Owner Name: Patricia & Sid Bouschor Owner Address: 5201 RABBIT CK RD ANCHORAGE, AK 99516-0000 Date Issued: Oct 08, 2002 Expiration Date: Oct 08, 2003 Parcel ID: 017-112-34 Site Address: 005201 RABBIT CREEK RD Lot Size: 54500 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ❑✓ Private Well ❑ Water Storage 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. 15. *"The foiiowing special provisions. , AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL PERFORM AN ADDITIONAL ;;SOILSBEDROCK)GROUND WATER TEST IN THE AREA OF THE PROPOSED UPGRADE SITE. 3-11/03 SPIE NF.w 5AiG/n.F6)? �S (/�I/LK�¢EG N ANdFieSov) REnES/6-iv TK 1r►9- S T u.� 7'F� Si STEM Pope TA(15' 1°1?0pE)e T r D.N r-ev 4 /2 4la-7 or Received By: Issued By: Date: %v Date: 42 C. MUNICIPALITY OF ANCHORAGE Building Safety Division , sw ctr MEMORANDUM DATE: October 8, 2002 TO: File FROM: Dan Roth Engineer Site Water Wastewater Program SUBJ: Pollock Block 2 Lot 3 AFTER A FIELD TRIP WITH PROGRAM MANAGER (JIM CROSS) I HAVE BEEN AUTHORIZED TO ISSUE A PERMIT AND ASK FOR A SOILS TEST TO BE CONSTRUCTED FOR THE RESERVE SITE AT THE TIME OF CONSTRUCTION. AUTHORIZATION ALSO GIVEN TO ME TO ASSUME THAT GROUND WATER MONITORING IN TEST HOLE 99-2 IN APRIL 26, 1999 IS HIGH WATER FOR DESIGN PURPOSES. w <\$ �Ea §�§ Q,<= 2§=G LL O -ca kUL IoW c E Dcn �a ZCLC D0 & $ k I| ! mk y a£ LL\ . ! % ; < 2 _ / p . E k §�\ / n 6_ 2 _ ^ § _§\ , -j ! f � / } § mk y a£ LL\ k§ % < f _ _§\ c w :3 �o � S ® `\ O 3 k g j 5 / \ -Cc) { L `\ � )S , $ f m .} £� \ 0 / a \ m m f � / } § E_ LL\ k§ % c / _ § w �o / \ -Cc) ƒ )S E < / » £� § o a \ 3&/ � LL. ] mo / A §§§ * I cn . § c '_ - »E� >- E G k ° & )k§ % � q§ \ % cn \t - \ > _/ CL Cl. \ U. CL� /9 \ / k / - ' f � / } § Michael N. Anderson, P.E. Civil/Structural Engineering 4640 Shoshoni Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 April 24, 2003 Municipality of Anchorage Department of health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Re: Lot 3 Block 2 Pollock Subd. :REVISED PERMIT: SW 020392 To Whom It May Concern: This is a request for a revised septic system permit. The owner needs a 5 bedroom system for the relocated house currently being remodeled on the above referenced lot. Three new test holes were excavated along the east property line and found varying soils. The test holes were excavated in early February of 2003. Water was found as high as 4.5 feet below grade during excavation, however after monitoring the 3 test holes for the past 3 months the water has gone down each month since then. Currently the water is below 5 feet or dry in all of the monitoring tubes. The soils in test hole 2 and 3 were the same with 4 to 5 feet of clean sandy gravel (SP) then silty sandy (SM) material below that to the water table. The third test hole was silty sandy (SM) material for the full depth. The revised design is a 5 wide by 125' shallow trench system with 6" of rock excavated just below the surface setting on the good sands SP. The secondary system is a 2000 square foot bed system which is more than enough for a five bed system even using the slowest application of 0.4 GPD/SQFT. The 2000 gallon S.T.E.P. tank has been installed already under the old permit. The only changes done to this old permit is the leach field redesign. A waiver has also been requested with this permit to keep the system 5 feet off the east property line for use of the clean soils. Currently a 5 foot utility easement exists at the east property line. This new design layout will not impact any of the neighboring lots or shadow out any of their useable space because they have existing systems also along the property line. The slope of the lot is very gentle at about 2 to 5 percent to the west. No surface water was found within 100' of the new leach field design. If you have any question please call me at 345-3377 Sincerely Michael %N. Anderson, P.E. DESIGN CRITERIA: 5 BDRM X 150 = 750 GPD SOILS = 750/1.2 = 625 SO FT REO'D 625/5 = 125' 5' TRENCH SYSTEM 0.5' DEEP 0.5' EFFECTIVE -5.0' 5.0' WIDE -6.0' 125' LONG r) SP NEW 5.0' X 125' SHED OT Nom\ • \ CARPORT 84.8' HOUSE WITH APARTMENTS CLASS 'C' W /RI50.0000 179. I I Cpl DGE GRAVEL _ I 1250 S.T WO 3 B] PROPOSEW dI --LO I / NEW 30' BED FO f • TH #99 2 a/ 5.0' 0 OVER �l �-1/2' OF DRAIN ROCK #3 (2-27-03) 1 i♦ Y /♦ EP PROPOSED 5.0' X 125.0' TRENCH H #2 (2-8-03) .,5-1n% 2000 GALLON STEP TANK HAS BEEN INSTALLED ,. .. EXISTING SEPTIC SY3TEM x x N Septic Design Prepared For PATRICIA & SID BOUSCHOR Zsc•OF At LOT 3, BLOCK 2 * ' V-•'' •'r�-tl POLLOCK SUBDIVISION40 *rl� Prepared By 49TH* ,000, MICHAEL N. ANDERSON, P.E. r-M[CeHAEL f• 4640 SHOSHONI DRIVE N. ANDERSON(907) 345-3377 /FAX (907) 345-1391E96yAPRIL 30, 2003�l�tnOFESSlO`���" Municipality of Anchorage . / �;• •� f DEPARTMENT OF HEALTH & HUMAN SERVICES / 49TH �* 825 "L" Street, Anchorage, Alaska 99502-0650 x / SOILS LOG — PERCOLATION TEST X. "" �r MICHAEL N. ANDERSON :� f PERFORMED FOR: C k per DATE PERFOF l�0 'CZ•f ���10� LEGAL DESCRIPTION: l.e% 7 bik. Z Pe cpm cc Township, Range, Section: or EPTH7 SLOPE SITE PLAN (FEET) 2 s*TIM L. Loe 4e'/ 3- 4 5 6 81 I woi-<P s�_P. 9 WAS GROUND WATER L 10 ENCOUNTERED? Y e S tJ ��O vV! L 11 IF YES, AT WHAT r DEPTH? �'� P 12 E Depth to Water Alter 13-1Monitoring? (D.O Date: 6 14 15 16 17 18 19 20 -{ L uPERCOLATION RATE y� (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN — FT AND �FT COMMENTS ^�� �LrL V7rttir! Mt��Irt� 4je �te11 PERFORMED BY. m,4 A I CERTIFY THAT TF IS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4185) +.� Municipality of Anchorage . DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Jr l- V ' DATE LEGAL DESCRIPTION: t / I7 'L `0 `(a 2 "— Township, Range, Section: 1 2 3 4 . ztv-,h SP SeAdy rr0 b 'r- 6- 8- 9 6 8 9 10 11 12 13 14 15 16 17 18 19 SLOPE GROUNDWAS ■■■■.■■■■■ ■■■■■■■■■■ ■■■.■.■■■■ �1%kkkIkEJR - S SEAL) v OF A, h P• •'•;.9�f� k' 490 .* ? . %• 6 9606660./ •, CE 9 ��I��PRnErcciott�_ ��~ IF YES, AT WHAT DEPTH? Depth to Wrier Alter r Monitoring? Dore: -Q©AMIFZM � - ��r��11��lf�� 20 t__j PERCOLATION RATE (minutesiinch) PERC HOLE DIAMETER TEST RUN BETWEEN Z FT AND 3 FT COMMENTS 00 c� 4_ PERFORMED BY: Ml e a (AJ%t K 50 I CERTIFY THAT /THj� TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �/s/o 3 72.008 (Rev. 4/85) Municipality of Anchorage . DEPARTMENT OF HEALTH & HUMAN SERVICES 00 J10.1 825 "L" Street, Anchorage, Alaska 99502-0650 P• SOILS LOG — PERCOLATION TESTX. 1' (ENGINEER'S SEAL) _����• OF it' `'•'• QS �1 49TH •'� • -- • ANuUt RSCN ; "r / PERFORMED FOR: 41 � � • DATE PER�bf��D• R, tp�� t�t� �'as� � ,P��•�, o, LEGAL DESCRIPTION: L / � 2' ` 0 ��0 Township, Range, Section: SLOPE SITE PLAN DEPTH mrCTTFEnTrj �„fC$� E_M 4-I I + � &'y� 5 9 10 WAS GROUND WATER `' L ENCOUNTERED? r T S 11 IF YES, AT WHAT LO DEPTH? 6 O p 12 E Depth to Water Alter 13 Monitoring? SV Date 3 7 3 14 15 16 17 18 19 Reading Date Gross Net Depth Net Time Time Water Drop ?7 O u Ptr e u ,O 6.5 r e r .O r 20 Il.�l PERCOLATION RATE _L� (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN Z FT AND '3—FT COMMENTS 14 it t � of w0.'F "rr PERFORMED BY: M r K 0 7 I' 2194 4-e/Se/ir I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Z�`2 7[ 03 72-008 (Rev. 4/85) KN D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 June 17, 1999 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: New Well & Sewer Permit - Pollack Homestead S/D, Lot 3, Block Gentlemen: At the request of the owners, on April 9, 1999, we excavated two testholes for the subject property for subdividing 1 lot into 2 and to install a new septic for the proposed lot. Of the two testholes one was abandoned when ground water encroached close to the surface. We installed a monitoring tube and monitored water in both testholes. The results of these tests and water monitoring are attached. We propose to install a 5' wide shallow trench. The testhole registered no water during excavation and water was found at 6.0' from the bottom of the monitoring tube after monitoring on April 26'. Due to the fast percolation rate a 2' sand filter will be installed prior to placement of the gravel. Additional fill will be provided over the system as required. This lot is relatively flat and slopes to the east to west away from the existing field and the house at approximately 5-10%. There are presently two class "C" wells on this property however a new individual well will be drilled for the proposed lot. There are no other public or private wells within 100' of our proposed system location except as noted. There is neither surface water within 100' nor any known curtain drains within 50'. We do not expect that there will be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, IIS11 D Engineering e M. Duffus, P.E. attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test IWELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE POLLACK HOMESTEAD S/D, LOT 3, BLOCK 2 e _ PROPOSED WELL e ' (SECONDARY SITE) i g I N d I 2 j KA ------ i0 K t KD NO PUBLIC WELLS WITHIN 200' or PROPOSED SYSTEM. NO PRIVATE WELLS WITHIN 200' Of PROPOSED SYSTEM EXCEPT AS NOTED. NO SEPTIC SYSTEMS WITMIN 200. Or PROPOSED WELL EXCEPT AS NOTED. i:ens P I PLANI DESIGN DETAILS 3 BDRM X 150 GPD = 450 GPD 450 GPD/1.2 GPD PER SO. FT. (<1 MIN/IN.)= 375 SO. FT (375/5'(W)) X 0.70(RF) (2' GRAVEL) = 52.5 FT. TRENCH USE 1 TRENCH - 52.5'(L) X 5' (W) X 2'(D) Total depth of system is 3' from original grade. Total depth of gravel below distribution pipe is 1.0' . NOTES: 1. USE 1000 GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM. 3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK. 4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT \ WELLS is SEPTICS. AV �� OF ALgs � PREPA A' - D -R-- pr�� �' ' PAT E j`. JSCHOR /CQ 9 `y 5201 E r, F 'O C c: -EK RAOD * T * A O ' ' ,� 99516 0 )34 "^tn KENNETH M. DUFFUS FIELD BOOT S _ -Y COMPUTED: �¢ CE -7118 �4 BMMo"Rr. TNH an"""( KM '�T���2i STARING: TNH CHECKED: KMO ASDUaT: TNH DATE: 6/2/9 '%OPEssloo' Aw OWQ FLE: GR,D: 3137 "C"D TXF` 99025.DWG 'CD "" 99025 Scale: 1'= 100' PAGE 1 OF 1 lb\�bV .WJ ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 B-6111/FAX (907)696-8111 1� NO PUBLIC WELLS WITHIN 200' or PROPOSED SYSTEM. NO PRIVATE WELLS WITHIN 200' Of PROPOSED SYSTEM EXCEPT AS NOTED. NO SEPTIC SYSTEMS WITMIN 200. Or PROPOSED WELL EXCEPT AS NOTED. i:ens P I PLANI DESIGN DETAILS 3 BDRM X 150 GPD = 450 GPD 450 GPD/1.2 GPD PER SO. FT. (<1 MIN/IN.)= 375 SO. FT (375/5'(W)) X 0.70(RF) (2' GRAVEL) = 52.5 FT. TRENCH USE 1 TRENCH - 52.5'(L) X 5' (W) X 2'(D) Total depth of system is 3' from original grade. Total depth of gravel below distribution pipe is 1.0' . NOTES: 1. USE 1000 GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM. 3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK. 4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT \ WELLS is SEPTICS. AV �� OF ALgs � PREPA A' - D -R-- pr�� �' ' PAT E j`. JSCHOR /CQ 9 `y 5201 E r, F 'O C c: -EK RAOD * T * A O ' ' ,� 99516 0 )34 "^tn KENNETH M. DUFFUS FIELD BOOT S _ -Y COMPUTED: �¢ CE -7118 �4 BMMo"Rr. TNH an"""( KM '�T���2i STARING: TNH CHECKED: KMO ASDUaT: TNH DATE: 6/2/9 '%OPEssloo' Aw OWQ FLE: GR,D: 3137 "C"D TXF` 99025.DWG 'CD "" 99025 Scale: 1'= 100' PAGE 1 OF 1 lb\�bV .WJ ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 B-6111/FAX (907)696-8111 WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN POLLACK HOMESTEAD S/D, LOT 3, BLOCK 2 LOT 9 p r tfj SEPTIC � ------ in x 37 x.urt - a LOT 2 a LOT 10 b NWS( NTN -� IT9.1' APMNENTS DJ + I a o wus R_,nx D®CLASS •C' WELL ma x "tors SEPTIC LOT 11 ^ x x t PROPOSED VELL '"�°• ,' —t_,nz x 329.77' _—__—_ 86'36'00• E •o� tno OF — — .......... Rpgg CREEK RO PRESSURIZED DISTRIBUTI❑N SYSTEM HOLE SPACING DESIGN 1. RESIDUAL HEAD - 5' 2. HOLE SIZE - 3/16' - 1.00 GAL. PER HOLE E 30 PSI 3. 30 GALS (PUMP DELIVERY)/1.00 GALS./HOLE - 30 HOLES 4. 52.5 LF LATERAL/30 HOLES - 1.75' SPACING PER HOLE 5. ALL HOLES SHALL HAVE CAPS INSTALLED PER MANUFACTURES SPECS. 6. HOLES AT END OF LATERAL SHALL BE CONST. W/O CAPS AND PLACED DOWN. 7. CONTRACTOR SHALL USE 1 1/4• PVC FROM TANK TO FIELD AND IN FIELD. DESIGN DETAILS 3 BDRM X 150 GPD = 450 GPD 450 GPD/1.2 GPD PER SO. FT. (<1 MIN/IN.)= 375 SO. FT (375/5'(W)) X 0.70(RF) (2' GRAVEL) = 52.5 FT. TRENCH NO PUBLIC WELLS WITHIN 200' DF USE 1 TRENCH - 52.5'(L) X 5' (W) X 2'(D) PROPOSED SYSTEM. Total depth of system is 3' from orlgglnal grade. NO WELLSOF PROPD EDTSYSTEM E CEPTNASONOTTED, Total depth of gravel below distrlbutlon pipe Is 1.0' ND SEPTIC SYSTEMS WITHIN 200' Or INSTALL 2' SAND FILTER BELOW SEWER ROCK. PROPOSED WELL EXCEPT AS NOTED. NOTES: 1. USE 1250 GALLON S.T.E.P. TANK. INSULATE TANK IF <4' COVER. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM. 3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK. 4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT OF, ` WELLS & SEPTICS. j `' PREPARED FOR: PAT & SID BOUSCHOR 4-.9 TH 5201 RABBIT CREEK RAOD $(0.121 1'= 100' ANCHORAGE, AK 99516 (907)345-1506 PAGE 1 ❑F 1 Ll. US / FIELD BOOKS COMPUTED: �nlENGINEERING _ry BOUNDARY- TNH ORANN: KM l1J / STAKING, TNH CHECKED: KMD 20441 PTARMIGAN BLVD. ASGUILT: TNH DATE: 6/17/99 EAGLE RIVER, AK 99577-8736 \ '/bFESS10ti,' DWG. FILE: CRID: 3137 _ ........ ACAD FILE:JOB No: 990252.DW, 990252 (907)696-6111/FAX (907)696-8111 WASTEWATER DISPOSAL SYSTEM DETAILS P❑LLACK HOMESTEAD S/D, LOT t 3, BLOCK ?I I ! I � I I9NDI i IC 1 .5-10� l� I vVo IC I t 1250 S.�.E.P TANK I 1 1/4" Pv C I I I I I I I I RE�ERV I I MT I 329.77' DITCH -------- _ _ _ _ - _. OF AZ 4s .4 9TH *� KENNETH M. US W i .f/r�i AESS10N1 -dw PREPARED FOR: PAT & SID BOUSCHOR 5201 RABBIT CREEK RAOD ANCHORAGE, AK 99516 (907)345-1506 FIELD BOOKS COMPUTED: BOUNDARY; TNH DRAW KM STAKING: TNH CHECKED: KMD ASBILT; TNH DATE: 6/17/9 DWG. FILE: GRID: 3137 ACRD FILE: 990252.DW , IDB "' 990252 Scale: 1'= 20' PAGE 2 OF 2 LLXA\�] I U) ENGINEERING 20441 PTARNIIGAN BLVD. EAGLE RIVER, AK 99577—£3736 (907)696-6111/FAX (907)696-8111 t OF A�pDO. 'K' D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 SOILS PERCOLATION TEST Performed for: Pat Bouschor Date Performed: 4/9/93�'�' Project: Lot 3 Blk 2 Pollock Subd TEST HOLE # 99-2 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - SEE ATTACHED SITE PLAN GM- Org FOR HOLE LOCATION GP/GM- loose Cobbles to 8" Bottom X mixed w/sand B.O.H. Was Ground water encountered? NO What depth? NA Depth to water after monitoring? '7 Date? glzL►S Reading Date Gross Time Net Time Depth to Water Net Dro 1 4/9/99 3.05 - 7" - 2 3.07 2 min 2" 5" 3 108 - 7" - 4 3:10 2 min 2" 5" 5 3:12 - 7" - 6 3:14 2 min 1 3/4" 5 1/4" 7 3:16 - 7" - 8 3:18 2 min 2" 5" 9 3:20 - 7" - 10 3:22 2 min 2" 5" • Water Added Percolation Rate <1 (min/ in) Perc Hole Diameter 6" Test Run Between 2 feet and 3 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. Project: Lot 3 Blk 2 Pollock Subd TEST HOLE It 99-1 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - GM - Fill, loose GP- loose ML GM/GP- Damp Loose/med dense B.OJL SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Ground water encountered? NO What depth? NA Depth to water after monitoring? . r yl / Dep g / S Date? 9G Reading F % Otoo `'�s'��1 1v� �yT� Ji�AV`1 LTJ ENGINEERING •A .�y�• ;� • •••?y 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 �0 : 49TH . 0 1 I rte•.. „ • .• 2..05 �I �% CF 7116 SOILS PERCOLATION TEST 11.0 9a •71� .••��<<�.;`� Performed for: Pat Bouschor i'"A'%. 1a Date Performed: 4/9/99 Project: Lot 3 Blk 2 Pollock Subd TEST HOLE It 99-1 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - GM - Fill, loose GP- loose ML GM/GP- Damp Loose/med dense B.OJL SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Ground water encountered? NO What depth? NA Depth to water after monitoring? . r yl / Dep g / S Date? 9G Reading Date Gross Time Net Time Depth to Water Net Drop 1 4/9/99 2..05 - 7" - 2 2:07 2 min 2 3/8" 4 5/8" 3 2:08 - 7" - 4 2:10 2 min 2" 5" 5 2:12 - 7" - 6 2:14 2min 13/4" 51/4" 7 ' 2:16 - 7" - 8 2:18 2 min 1 3/8" 5 5/8" 9 ' 2:20 - 7" - 10 2:22 2min 13/4" 51/4" 11 2:24 - 7" - 12 2:26 2 min 1 3/4" 5 1/4" ' Water Added Percolation Rate_ (min/in) Perc Hole Diameter 6" Test Run Between 2 feet and 3 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. r OF kL aS9k TONY KNOWLES, GOVERNOR Q DEPT. OF ENVIRONMENTAL CONSERVATION DIVISION OF ENVIRONMENTAL HEALTH DRINKING WATER and WASTEWATER PROGRAM 555 CORDOVA STREET Telephone: (907) 269-7696 ANCHORAGE, AK 99501 Fax: (907) 269-7650 http://ivww.state.ak.us/dec&omelbtm May 31, 2001 Mr. Kenneth M. Duffus, P.E. KND Engineering 20441 Ptarmigan Blvd. Eagle River, Alaska 99577-8736 Subject: Lot 3, Block 2, Pollock Homestead Subdivision, Holding Tank, Separation Distance Waiver, and Class C Public Water System, ADEC Project Number 586; Plan Review pt pa 01? It Z 3 61 Dear Mr. Duffus: This is in response to your submittal received in this office on April 19, 2001 in which you addressed the concerns noted in my February 27, 2001 letter. Based on my review, the concerns noted in my February 27, 2001 letter covering the proposed holding tank, a separation distance waiver between source well number 2 and the existing lift station, and issuance of approval for the Class C Public Water System have been addressed. As a result, I have the following comments: Wastewater Holding Tank It appears that the proposed holding tank (4,000 gallon) was designed to meet the demand of the existing facility. The submitted soils and ground water information does verify that the use of a holding tank is the only solution for this facility. Therefore, in accordance with State Wastewater Disposal Regulations, construction approval is granted. A Construction and Operation Certificate with the construction portion of the certificate signed, constituting this approval, is enclosed. To obtain final operation approval for the proposed wastewater holding tank, the following items will need to be submitted for review and approval by this office: 1. Verification that the installation of the holding tank was completed under the supervision of a Professional Engineer (P.E.). 2. Record drawings will need to be submitted under the stamp of a Professional Engineer. The record drawings will need to verify ground water elevation, tank placement, and concrete weight placement. 3. The record drawings will also need to show that the holding tank is equipped with a high water alarm that will alert the facility owner that pumping is required. Kenneth M. Duffus Page 2 05/31/01 4. The enclosed forms will need to be completed and submitted with the record drawings. This approval does not imply the granting of additional authorizations, nor obligate any federal, state, or local regulatory body to grant required authorizations. Separation Distance Waiver With the relocation of the lift station within the foundation of the building, the separation distance waiver between the existing source well number 2 and the lift station is no longer required. Public Water System I have a found a Class C public water system registration form in the file along with test results for total coliform bacteria and nitrates (as nitrogen). The test results are within the maximum concentration levels found in the State Drinking Water Regulations. Once verification that lift station has been placed inside the foundation and existing source well number 1 has been properly decommissioned, I will use the submitted Class C public water system registration form to issue the approval for the existing Class C public water system. Thank you for your cooperation and coordination with this Department. If you have any questions, please do not hesitate to contact me. i ely, 1 "CA'L'L.0 K Kleweno, P.E. Environmental Engineer Enclosures: As Stated Cc: James Cross, P.E., MOA/Building Safety Division, w/o Enc. I? STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION CONSTRUCTION AND OPERATION CERTIFICATE FOR DOMESTIC WASTEWATER DISPOSAL SYSTEMS A. APPROVAL TO CONSTRUCT Plans for the construction or modification of located in by domestic wastewater disposal system , Alaska, submitted in accordance with 18 AAC 72.210 have been reviewed and are approved. conditionally a oved (see attached conditions). SPC M ��� 3J •�O % I �j�eA PPn �a BY TITLE DATE If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. B. APPROVED CHANGE ORDERS Change (contract order number or descriptive reference) Approved by • Date C. APPROVAL TO OPERATE The "APPROVAL TO OPERATE" section must be completed and signed by the Department before this system is made available for use. The construction of the domestic wastewater disposal system was completed on (date). The system is hereby granted interim approval to operate for 90 days following the completion date. BY TITLE DATE As-built/record drawings, submitted to the Department, or an inspection by the Department, has confirmed that the domestic wastewater disposal system was constructed insubstantial conformance with the approved plans. The system is hereby granted final approval to operate. BY TITLE Distribution: 1. Retain original for project file 2. Make copies for distribution DATE syayE or � L � sRa TONY KNOWLES, GOVERNOR DEPT. OF -ENVIRONMENTAL CONSERVATION _ DIVISION OF ENVIRONMENTAL HEALTH DRINKING WATER and WASTEWATER PROGRAM Telephone: (907) 269-7696 555 CORDOVA STREET F ANCHORAGE, AK 99501 ax: (907) 269-7650 http://�,*-,vw.state.ak.us/dec/home/htm February 27, 2001 Mr. Kenneth M. Duffus, P.E. KND Engineering 20441 Ptarmigan Blvd. Eagle River, Alaska 99577-8736 Subject: Ut 3,$16ckl' Pollock•Homestead Subdivision; Holding Tank, Separation stance Waiver, and Class C Public Water System, ADEC Project Number 586; Plan Review Dear Mr. Duffus: "• This is in response to December 11, 2000 submittal in which you requested construction approval for a proposed holding tank, a separation distance waiver between source well number 2 and the existing lift station, and issuance of approval for the Class C Public Water System. I have completed my review of the submitted information and have the following comments: Wastewater Holding Tank Although it is stated in your submittal that the reasoning for the holding tank is the encroachment of the groundwater to the existing soil absorption system, there is no cross section drawing or monitoring data to confirm this information. After attending meetings during which your client noted several times that there is not a groundwater problem, I have no choice but to request that documentation as required by the State Wastewater Regulations be submitted to document the groundwater issue. In addition, a profile view of how the proposed holding tank will be installed will also need to be provided. Separation Distance Waiver A separation distance waiver between the existing source well number 2 and the existing lift station was requested in your submittal. However, no information on the condition of the lift station nor the distance you are requesting the Department to waive was submitted. Based on the lack of information, I can not continue my review of the waiver request until the minimum required information is provided to the Department. To assist you in putting together a separation distance waiver request, I have enclosed a copy of the Department's publication entitled: "Plan Approval Checklists for Engineering Plans, Wastewater Treatment and Disposal". Kenneth M. Duffus Page 2 02/27/01 State Wastewater Disposal Regulations now require that a fee be paid all separation distance waiver requests. The fee required for the separation distance is $230. Public Water System I have a found a Class C public water system registration form in the file along with test results for total coliform bacteria and nitrates (as nitrogen). The test results are within the maximum concentration levels found in the State Drinking Water Regulations. If the requested separation distance waiver can be issued, I will use the submitted Class C public water system registration form to issue the approval for the existing Class C public water system. Turning to source well number 1, please provide information on the method and time schedule in which it will be properly decommissioned. Thank you for your cooperation and coordination with this Department. If you have any questions, please do not hesitate to contact me. ;Keven i erelti K Kleweno, P.E. Environmental Engineer Enclosure: As Stated Cc: James Cross, P.E., MOA/Building Safety Division, w/o Enc. I \'lunicipalit), of Anchorage °., Development Services Department /� Building Safety Division y 2 On -Site Water and Wastewater Program S. I,- 4700 ,.4700 South Br2gaw Sl. P P.O. Box 196650 Anchorage, AK 99519-6650 ,) www.ci.anchorage.ak.us �•�' (907)343-7904 CERTIFICATE OF HEALT H AUT HORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. (9(,� —11 HAA # Expiration Date: 2 — Z ' O 5 1. GENERAL INFORMATION Complete legal description Jae 1'(w r ice% r 5 eq� 'BLIP IST 3 13 Location (site addressor directions) Current Property owner(s) LfLkn ( gcoSeC6r Dayphone TWT—foto Mailing address - -a-IL vr Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address< Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ Individual Holding lank ❑ 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 anoval are required tforofessional a transfer it engineer registered in the State of Alaska. es sCertervedbya singth le -family wastewater disposal and/or water title (except between spouses) for p op Approval are supply system. DSD also issues HAAs upon request to homeowners. orf Class C well land maybe reissued with valid for 90 days from the date of issue for properties served by a p new water sample results. (Certificates may bs reissued dfor by Class A or period of Bto one or r with valid waters samples.) Municipality Certificates are valid for one year for properties P P.lumcip2lity 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 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 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.. j)jj ricer/ AjAn �_�i�,7h 33� Address �(aND 7iir/4/Dn,( Atli �V,vti/ `15Sft: ���- VW1 Engineer's Printed Name /'�/(r f v.� i /1��r1 Y� t pyf Date r-1/01;— OF /o1;— 5. DSD SIGNATURE Approved for S7 bedrooms. Conditional approval for Additional Comments OF A(Q'k11 *:49TH .,1•. . ........� ICNAEL N. ANDERSON CE- 46 Disapproved.FIS bedrooms, with the following stipulations: WATCH Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory - Other By1� /.y • ���1. Original Certificate Date:_' Jt (R" 0M) Municipality of Anchorage �• \` Development Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ak.us (907)343-7904 nHEIALTH AUTHORITY APPROVAL CHECKLIST Legal Description: WO ` e f k" ArA I *' (j 2 L. 3B Parcel ID: 7 -1l3^ S A. WELL DATA Well type It A, B, or C provide PWSID # _ Well Log (YIN) y Date completed -510410 Sanitary seal (YIN) V Wires properly protected (YIN) Y Total depth Hb ft. Cased to 11-9—ft. Casing height (above ground) n. FROM WELL LOG AT INSPECTION Date of test S' p jz 0 0 Static water level 7, ft. Z/ D ft. Well production 1 `5- 9 p•m• / g p'm' WATER SAMPLE RESULTS: Coliform (f colonies/100 ml. Nitrate -0-- mg.11. Other bacteria 41—L colonies1100 ml. A f--4 Arsenic: „� mg.11. Date of sample: b_-l'-si Os Collected by: h71 I B. SEPTICIHOLDING TANK DATA % Tank TypelMaterial Date installed 3� Tank size z ov u gal. Number of Compartments Cleanouls (YIN) Y Foundation cleanout (YIN) -y— Depression over tank (YIN) High water alarm (YIN) Date of pumping "4/y5- —'Pumper -X even 4 1-1•er to e. 0( C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./f' or ft'Ibdrm) -11-� System type S w, Length r Q < ft. Width S-. O ft. f Gravel below pipe ��L ft. Frye •J%slA* Total depth lft.4t14 ff."absorption area L��f•? Monitoring tube �_ Depression over field Date of adequacy test i 04 Results (Pass/Fail) P �t5_ For ;jc- bedrooms Ir Fluid depth in absorption field before test' in. Water added gal. New depth in. � Elapsed Time &� 44rmin. Final fluid deptigin. Absorption rate >= ASO 0 E g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed 256/0 Size in gallons _ 'Lou rn Manhole/Access (Y/N) "Pump on" level at � ifi, "Pump off level at �1 In. High water alarm level at Cie in. Datum di /f, ,, ,r 1`42A� Cycles tested =i Meets alarm 8 circuit requirements? Y E. SEPARATION DISTANCES T SEPARATION DISTANCES FROM WELL ON LOT TO. Septic tank/lift station on lot /do 1,� On adjacent lots /pri 4 Absorption field on lot /ryo 14 On adjacent lots too t-tc- Public sewer main h /�j� Public sewer manhole/cleanout V Sewer /septic service line r oo 14 Holding tank SEPARATION DISTANCES FROM SEPTIC/F=q; RG TANK ON LOT TO: Building foundationry /,F Property line 'lam y� Absorption field jp y -L Water main /✓ Water service line SO 14 Surface water / o rl /.- Wells on adjacent lots ruy I� SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line _ to r Building foundation 41 o f f Water main Y✓I4 Water Service line lo44 l44Surface water inn r #- Driveway, parking/vehicle storage S o Curtain drain _//1' Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's /Printed Name M r kar (A(,4e"«, .-1 Date y� 24 /a J:7-- HAA Fee S 7L30 Date of Payment C] —.2 Receipt Number_ '7 -3 7 (Rev. 12101) Waiver Fee S P. • �s,Fy�l k:•49*M*• • *�/ Date of Payment Receipt Number HAEL N. ANDERSON : CE 9 9 '� 02-25-05;Sc:02 . ;K7 531 5301 is 1: 1 SGS Rat. M 1055465 Clle-ItName: Mike Arderson, PE Prcjoc! Name: Pollock Homestead, L3B, E2 Clie'1t Sample ID: Pollock Homestead, L3B, E2 Matrix: Drinking Wale• P1NSlD Sample Remarks: SGS Environmental Services Inc 200 W. Potter Drive Anchorage. AK 99518 Tel: (907) 562-2343 Fax: (907)561-5301 All dates/Umes are Alaska Standard Time Printed Datertlme: 08•'26.C5 15:30 Colteded Datrllmc: 08124.'05 11:00 Recelved DateMme: 08,124!05 1 44 Teernicat Director. BSepher EOa Releasad Alowable Prep Analysls Parameter Results POL Units Method Llmlts Dale Date IN: Bacteria 0.00 92228 08.24105 09/24/05 It Nit -ate N.D. C.10 mg/kg EPA3010 10.00 0814105 08/24105 mx CVJ0,44 44 0 9 91. m10Q. :N p J96-L6Z M 649-V420.00 A -41 I-IL o �N 0 O. n ---__—_—_— _--- D G = 0I1d3S u0 70 Cl I I I I W w I CD N 1N3W3SV3 '3331 28 '10313 ,OL ° v v I En e� �;'" O 0 i S Ln //�'{�� V/ I I� I , Ito 0a J I LO w n rzi $ I LO 0 � I I tO Do a vod°�"�`o a E LLJ i A�,��gLq� Pti I tW pots ~ N 2,900 b m V3 4 V o u q 0 a . q Y o A O w, ff w „51V480.00 fFF ou Lvp+Aw 0.tub I w Q wQ p: wtw apo lsys3 O YPa YVQ �wwc p 3�b���0 f U ' I � ,A�a p�YUQ^ A.+OY N o eaa O o O j uJ Nn. O.w..px OJq wob0. pNoev',wu•A-, L�w0 pu wpL Y qq yy `�►yo ggS,�'V �Irwpr m p w N P.OeY^da o 0 0 Y� 0 0" y G Yy�y G9 a= 0=..qq e'O tl q J LOV dq v ►■ 00 o aa�sa g v aA cep t:v w Y^,u►,�i.,�pLl�Jp .�qqawauwow9oa0 sw.p�, 9ww 0 Yq AG No 0. j�iw0 0 exuw V'00 oti Y q u 90,63o MYL �• �A p0 qp'i L 0C 1 J96-L6Z M 649-V420.00 N o n ---__—_—_— _--- I 0I1d3S ------ — — — — — — 011d3S ------ — — — — — ---r I I I I W w I N 1N3W3SV3 '3331 28 '10313 ,OL ° I rn I l i"w a O 0 Ln //�'{�� V/ I I� I , ♦PI YO p; J I LO a' o n rzi $ I LO 0 � I I tO Do 1 a E LLJ i I 2,900 ------------------- M N - --T W I J „51V480.00 I Q liI lsys3 3�b���0 f U ' I J z g 1