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Home My WebLink AboutMAXWELL LT 1Maxwell Lot 1 #018-281-25 Municipality of Anchorage I - Development Services Department \, Building Safety Division - On-Site Water and Wastewater Program, 4700 S. Bragaw St. �L P.O. Boz 196650 Anchorage, AK 995196650 Page' M3 www.d.onchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO50362 PID Number. 018-281-25 No" Candice Goard Bryant Wastewater system: ❑ New Q Upgrade Afteu, 14801 Loc Loman, Anchorage ABSORPTION FIELD P� Nw of eamm,na 4 p owao rtwldt t] maria, T ww, l] BW ❑Mound ❑om LEGAL DESCRIPTION ° 0.8 ra.I Dapd tmna12. paa 12.0 GI>cvFP F,. 61 c Lw SLedmum — 1 Maxwell 0"Ib to P" Gman ewn onpnal ansa Gravy OaWl bor pve 4,0 Ft. 8.0 Ft Taa,alp Ranaa soma, Fa added aeow wpiml anon Grawl Lwgw 0.6 Ft. 50.0 Ft. Well: ❑ New ❑ Upgrade G awn 2,5H i u». FL Ft t:bada rynaa. A, e, q: Tani DeanGena b Taal atwwgwn caw Pp Matwol Ft. Ft 800 Flt ASTM D3034/F810 DnM Den onb sl O Weer Lwa it lw Data I,Weed Ft A+ Home Services 10/14/05 Yn Pwry saw Dna HoW4 Aiwa GmW TANK GPM Ft.aw FL SEPARATION DISTANCES ElSeptic ❑Holding ❑S.T.E.P. ❑Other. To Septic Absorption LIR Holding lublidPrIvato From Tank Field Station Tank sawerLino Anchorage Tank 1250 Ga w"105* 129' NIA N/A 96' M.wwl Steel HanWwdDanprvwb s,o—mw 100'+ 100'+ N/A N/A LIFT STATION LdLM 37' 17' N/A N/A a NA oal n xW.w 'Pw on" Irval at 'Poop dr lora at H9h vwar *4 n FdarMaEm 14' 106' N/A N/A M H in cancan oro N/A I N/A I N/A N/A ° ° "" ' a MadN s wbcY Inrpaaeom Fe tinned W R0r1wM1a Diverter Valve installed to retain old field. Old BENCH MARK tank removed. LowWn wa Deeanplon garage floor slab Waeon 103.14 FL Engineer's Stamp 49k"_ Inspections performed by: Cindy W. Ellis, P.E.Dates: 1'r 10/12/05 *:' 10/14/05 -� .. m /% 2nd .-,_•��(/••-V_{ Development Services Department Approval Reviewed and approved by: Date: 0.. CI hdy W. Ellis! CE. tosn (Rev tuo> SSIO'LA=O -------------TWILIGHT---------------------- LANE CO2\\ AH \ Col MTI Line under driveway Is Insulated w/4" rigid foam MAXWELL S/D LOT 1 r � I , I I I\ I L nea C04 Old DrainSeld is being retained - i I LOT 1 \� I r _100'Radius � �W�B I / / I / I Gravel Driveway CO3i I - � I I � I Deck i c I �\ 4 BR 1 HOUSE I �a 1 I COS Shed New 1250gallon Steel Sepbc Tank BASED ON A SURVEY BY FRED WALATKA 3255-S Oct 26, 2005 AS -BUILT Maxwell Lot 1 Record Drawing of Septic Upgrade00000000 Candice Goard Bryant OF•,AZ 14 Watkins Engineering, Inc ��' ..1, Parcel ID: 018-281-25 9 9� � �e ' Permit Number. SW050362 $ 0-'.49 THy Op Cindy W. Ellis, P.E. CIND w t¢l us ; 'v January 18, 2006 P.O. Box 110443 00" c - 10577 ;• ,00 Scale 1 Inch 43 - 40ft Phone: (Anchora907) 349-1851, Faxe� Alaska 4( 07) 349-1934 0• '%...... ....�e °G 0��•_ _ A B C FCO 21.6 21.4 _ STI 22.5 34.9 _ ST2 27.3 42.3 _ DCO 30.2 46.1 _ DV 31.6 47.8 _ CO3 70.0 45.7 61.7 C01 133.5 106.2 18.6 CO2 182.4 156.4 53.8 MT1 133.8 106.9 17.3 MT2 182.0 155.7 53.7 C04 57.8 52.1 _ MT3 51.7 49.4 _ C05 31.7 64.0 - r � I , I I I\ I L nea C04 Old DrainSeld is being retained - i I LOT 1 \� I r _100'Radius � �W�B I / / I / I Gravel Driveway CO3i I - � I I � I Deck i c I �\ 4 BR 1 HOUSE I �a 1 I COS Shed New 1250gallon Steel Sepbc Tank BASED ON A SURVEY BY FRED WALATKA 3255-S Oct 26, 2005 AS -BUILT Maxwell Lot 1 Record Drawing of Septic Upgrade00000000 Candice Goard Bryant OF•,AZ 14 Watkins Engineering, Inc ��' ..1, Parcel ID: 018-281-25 9 9� � �e ' Permit Number. SW050362 $ 0-'.49 THy Op Cindy W. Ellis, P.E. CIND w t¢l us ; 'v January 18, 2006 P.O. Box 110443 00" c - 10577 ;• ,00 Scale 1 Inch 43 - 40ft Phone: (Anchora907) 349-1851, Faxe� Alaska 4( 07) 349-1934 0• '%...... ....�e °G 0��•_ _ FCO 99.22 8.560 NOTE: RELATIVE DEPTH OF TEST HOLE = 79.60 NO NATER I,ITI C01 STI FINAL GRADE = ST2 1250 GALLON STEEL SEPTIC TANK N.T.S. FINAL GRADE = 97.67 - 98.25 4"0 PIPE FILTER F SEWER ROCK 50.0' TRENCH N.T.S. DCO DV To Old Drainfield MT2 CO2 ��FE07 NOTE: II ORIGINAL GRADE _ 98.18 - 97.60 AS -BUILT Maxwell S/D, Lot 1 0000�pp a pFq �4p Record Drawing of Septic Upgrade oo�P� ••.•"••".....J P po Candice Goard Bryant Watkins Engineering, inc. 9 9, p�,O, TH y OD 49 Parcel ID: 018-281-25 Permit No.: SWO50362 D•.... F.... O • •, CIN W. ELLIS 10577 , o �Op• ' • :'oma ' Cindy W. Ellis, P.E.P.O. Box 110443 January112006 , Anchorage, Alaska 99511-0443 4p•.; d ��000v��oQ4 No Scale Phone: (907) 349-1851, Fax: (907) 349-1934 01/24/2006 15:25 3491934 WATKINS ENGR PAGE 02 Watkins Engineering, Inc. P.0 Box 110443, Anchorage, AK 99511 (907)3494851 cwellis®gci.net January 24, 2005 Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Maxwell SID, Lot 1 Septic System Upgrade Permit No. SWO50362 Attention: Jeff Poet The orientation of the trench on the subject septic system upgrade was changed from the original design. On the original design, the trench was oriented northeast -southwest, and the trench was installed from northwest to southeast. I believe that this change will not adversely affect performance of the drainfield and will not cause harm to human health or the environment. The trench was Installed in a relatively flat area, although the area generally slopes down to the northwest, as shown on the design. The difference in original grade between the ends of the trench was 1.4 ft, over a length of 50 ft, which reflects a slope of only 2.8%. The absorption layer in the drainfield occurred from 4 ft to 12 ft below original grade. As shown on the soil log, the soil quality was consistent from 0.5 ft (directly below the organics) all the way to the bottom at 18 ft. Therefore, there was no change In soil quality in the trench, even with a 1.4 ft original grade difference. For this reason, I believe that the performance of the drainfield will be similar to performance if the trench was oriented differently. The reason for the change of orientation was to allow the piping straight into the end of the trench, and to minimize destruction of trees. If you have any questions or need further Information, please tail me at 349-1851. Yours truly, %� 6&4' Uv M� Cindy W. ills, P. E. President 01/24/2006 15:25 3491934 WATKINS ENGR PAGE 03 01/24/2006 15:25 3491934 WATKINS ENGR PAGE 01 Watkins Enox 110443 gineering, Inc. 907-349-1851 fax Anchorrage, AK 99511-0443 Email: cwellisaaci net Fax o: Jeff Poet / MOA Onsite rom; Cindy W. Ellis, P.E. �= 3-7997 ages: 3_including cover hone: 3-7905 te: =4=06 e: JM21xwell Lot 1 COSH C: O Urgent O For Review O Prose Comment ❑ Please Reply ❑ Please Recyde e Message: Attached is a tetter of explanation about the orientation of the trench. I also drew a schematic trying to Illustrate what I was attempting to explain to you on the phone. This schematic Is not Intended to be Included with the Maxwell paperwork, but to illustrate how installing a trench on a slope can be a problem. If I had known this was an issue, I would have called you during the installation. I wasn't trying to circumvent youl Please tet me know if you have any questions or need anything further. Thank you, Cindy Ellis MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SWO50362 Legal Description: MAXWELL LT 1 Date Issued: Sep 21, 2005 Expiration Date: Sep 21, 2006 Parcel ID: 018-281-25 Design Engineer: 0844 Watkins Engineering, Inc Site Address: 014801 LOC LOMAN LN Owner Name: CANDICE GOARD BRYANT Lot Size: 42405 SO. FT. Owner Address: 14801 LOC LOMAN LANE Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 995164030 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 specked 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: Date: v Issued Byr Date: A z! o- Municipality of Anchorage Development Services Department Building Safety Division / On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonshe (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 016-261-25 Permit Number SW Property owner(s) Candice Goard Bryant Day phone Mailing address (1) 14801 Loc Loman Lane Mailing address (2) Anchorage, AK Zip Code 99516 Legal description (Lot, Block & Sub'd.) Maxwell SID, Lot 1 Legal description (Section, Township & Range) Lot Size 42,405 AMOSED THIS APPLICATION IS FOR: Number of Bedrooms 4 Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade i] THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. 1 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 Permit Fees: Date of Payment: Receipt Number. (Rev. 12100) 16. agent) Oct Waiver Fees: Date of Payment: Receipt Number. Watkins Engineering, Inc. P.0 Box 110443, Anchorage, AK 99511 (907)349-1851 cwellis@gci.net September 14, 2005 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Maxwell SID, Lot 1 Septic System Upgrade To Whom It May Concern: Attached please find the application and supporting documentation to upgrade the septic system for the referenced 4 bedroom house. The existing septic system was installed in 1983 and the drainfield is now surcharged. It is proposed to retain the drainfield for future use and install a new 1250 gallon steel septic tank. Three test holes were dug on September 7, 2005, with the first two encountering shallow ground water. The proposed design is based upon Test Hole #3. The hole was dug to 18 ft with no water encountered. After a 7 day monitoring period, no water was detected. The proposed drainfield will be installed in a sand and gravel layer between 3.5 ft and 12 ft. A percolation test conducted between 6.5 ft and 7.0 ft resulted in a rate of 6.6 minutes per inch. An application rate of 0.8 gpd/ft' is used in the design. The soil log is attached. Proposed Soil Absorption System: 4 Bedrooms x 150 GPD/BR = 600 GPD System Type: Deep trench Application rate: 0.8 gpd/ ft' 600 GPD / 0.8 gpd/ft2 = 750 fe required Maximum Depth: 12 ft Effective Depth: 8.0 ft Proposed Length: 50 ft Absorption Area: 600 if Sewer Upgrade Permit Application for Maxwell S/D, Lot f Watkins Engineering, Inc.; September 14, 2005; page 2 There are no surface waters or private wells within 100 ft of the proposed septic system. I am not aware of any adverse effect that this upgrade would have on any adjacent properties' water and wastewater treatment needs. Thank you for consideration of this permit application. If you have any questions or need further information, please call me at 349-1851. Yours truly, Cind�llis, P.E. President 124B I5 Approx Well Location I �'3 124A T12N R3W Proposed New \ Drainfield - E -4t -\E ---�-- Undeveloped ec 33 I watt I I �T11-13; / I I2 33 Well–J00Jadius— H1 1 2 Maxwell Lot 1 Proposed Septic Upgrade - Site Plan Candice Goard Bryant Parcel ID: 018-281-25 Cindy W. Ellis, P.E. Sep 14, 2005 Scale 1' - 100' \ Wetl LOT 1 / SepOc MAXWELL SID LOT 2 Watkins Engineering, Inc. P.O. Box 110443 Anchorage, AK 99511-0443 Phone: (907) 349-1851 Fax: (907) 349-1934 126A Note: This well serves Lot 126 126B tegan SID \-\------I I/ 1 / Septic Area 131A i/ T12NR3t Existing Septic System 131B 33 OF q�''�p. d?' 49 RI o. '•,. C.. IY W. ELLIS E - 10577 •e G Line Proposed Trench: 50 ft long 8.0 ft effective DESIGN DETAILS 4 BR, 600 GPD 0.8 gpd/ft2 Requires 750 ft2 Deep Trench 8.0 ft effective 50 ft long Max 12 ft deep Test Hole #3 g/7/2005 SMI GP No Water BOH U1e.0 CO&MT R min. -' Property Line Line under driveway to be Insulated w/4" rigid foam. Proposed Trench 4" perf pipe 12.0 OCA GA04NOyG �O Maxwell S/D, Lot 1 Proposed Septic Upgrade Candice Goard Bryant Parcel ID: 018-281-25 Cindy W. Ellis, RE September 20, 2005 Scale 1 Inch - 30 ft CO & MT DCO every 50' of pipe run DCO to be — retained. TFU1 WT Gravel Driveway Diverter Valve Property Line Watkins Engineering, Inc. P.O. Box 110443 Anchorage, Alaska 99511-0443 Phone: (907) 349-1851, Fax (907) 349-1934 deck Existing 4BR House Exist �pinetic tank - to be abandoned Shea it place. Proposed new 1250 gal septic tank w/DCO- to be insulated if less than 4 ft of cover. Line 50 ft long 8.0 ft effective DESIGN DETAILS 4 BR, 600 GPD 0.8 gpd/ft2 Requires 750 ft2 Deep Trench 8.0 It effective 50 ft long Max 12 ft deep Test Hole #3 917/2005 SMI GP No Water BOH LJ 18.0 CO & MT 10 ft min. Property Line Line under driveway to be insulated w/4" rigid foam. Proposed 4" pert pipe 12.0 O� GANO�G �O Maxwell S/D, Lot 1 Proposed Septic Upgrade Candice Goard Bryant Parcel ID: 018-281-25 Cindy W. Ellis, P.E. September 14, 2005 Scale 1 Inch - 30 ft CO&MT to be — retained. Tot r MT Gravel Driveway Diverter Valve Property Line Watkins Engineering, Inc P.O. Box 110443 Anchorage, Alaska 99511-0443 Phone: (907) 349-1851, Fax (907) 349-1934 deck F�cisting BR House 'n l=xi sUeptic tank - to be abandoned s'�ey in place. Proposed new 1250 gal septic tank w/DCO- to be insulated if less than 4 ft of cover. OFA �4 Qco. 49 TH' c DY W. ELLIS i O• CE - 7057 0' .............'�G Municipality of Anchorage t,JENGINEERSEAIJ Development Services DepartmentTH Building Safety Division * 49 ;— y,t Ort -Site Water and Wastewater Program 4700 South Bragaw St .. P.O. Boz 196650 Anchorage, AK 99519-6650 �X'..0 www.muni.org/onsite in W.EIIIS(907) 343.7904CE - t 9577 Soils Log - Percolation Test �ssy Performed For. Candice Goard Bryant Date Performed: September 7, 2005 Legal Description: Maxwell SID, Lot 1 Township, Range, Section: Slope Site Plan 11 WAS GROUND WATER ENCOUNTERED? YES a IF YES. AT WHAT DEPTH? 3.0 L Depth to Water Agar D Monitoring? NA E Date: PERCOLATION RATE () PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS No n ftodng tube set 6 m peroolation test performed. PERFORMED BY: Rocky Trainor/Cindy Ellis I (IL` /CVJ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIti S IN EFFECT ON THIS DATE. DATE: q,14 -OS Depth f9gn -$iCS P -40t t 0417 t t 2- ri1 i_ fa rty 3.0 4- iw y poebtio OP SP 5- SP W;b Watwr. 6- 7- 8- 9- 9.0 11 WAS GROUND WATER ENCOUNTERED? YES a IF YES. AT WHAT DEPTH? 3.0 L Depth to Water Agar D Monitoring? NA E Date: PERCOLATION RATE () PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS No n ftodng tube set 6 m peroolation test performed. PERFORMED BY: Rocky Trainor/Cindy Ellis I (IL` /CVJ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIti S IN EFFECT ON THIS DATE. DATE: q,14 -OS Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw SL P.O. Boz 196650 Andmorage, AK 995196650 www.muni.org/onsite (907) 3437904 Soils Log - Percolation Test I Performed For. Candice Goard Bryant Date Performed: September 7. 2005 Legal Description: Maxwell SID, Lot 1 Township, Range, Section: Slope Site Plan Depth (Feet) 0 r9 an ic3 0.75 W 1wro rA L 2.7 E36 �� Strew of 5 P },tach saw 11- w(,Lh water. 9- WAS GROUND WATER 9 a ENCOUNTERED? YES 8 10- E36 IF YES, AT WHAT DEPTH? 5.0 L After Depth to Water Ar O P 11- Monitoring? NA E 12- Date: 13- 1 17 PERCOLATION RATE (1 PERC HOLE DIAMETER TEST RUN BETWEEN FT AND Fr COMMENTS No perootation tea( pertorrned. PERFORMED BY: Rooky Trainor/Cindy Ellis I JW 1 � CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELI S IN EFFECT ON THIS DATE. DATE: 9,14,05 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907) 343-7904 Soils Log - Percolation Test Performed For. Candice Goard Bryant Date Performed: September 7, 2005 Legal Description: Maxwell Lot 1 Township, Range, Section: Depth - (Feet) Ofj& dS 1- 0.5 2- 3- 4- 5- SM 6- e 7C 15- 16- 17- 18 BoH Is.0 19- 20 - COMMENTS Presoak riortotest. Reading Date WAS GROUND WATER 9- Depth to Water ENCOUNTERED? No 1 9/8/05 6 10- 6-1.25 IF YES, AT WHAT DEPTH? — L O 2 918/05 Depth to Water After P 11- 6-1.5 Monitoring? Dry E 12- 918/05 Date: 9114105 15- 16- 17- 18 BoH Is.0 19- 20 - COMMENTS Presoak riortotest. Reading Date Gross Time Net Time Depth to Water Net Drop 1 9/8/05 10:39-11:09 30 6-1.25 4.75" 2 918/05 11:11-11:41 30 6-1.5 4.5" 3 918/05 11:44-12:14 30 6-1.5 4.5" PERCOLATIONRATE e.9 lmmne I r�^..�..."^"""" -- TESTRUN BETWEEN 6.5 FT AND 7 FT PERFORMED BY: Rocky Trainor/Cindy Ellis I W CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELI S IN EFFECT ON THIS DATE. DATE: 9/14105 Municipality of Anchorage Development Services Department e Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: WATKINS ENGINEERING Legal description: MAXWELL LOT 1 The attached paperwork has been reviewed and Is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. ❑ Additional soils information needed. ❑ Water monitoring results inadequate. ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. ❑ Incomplete; missing _ ❑ Incomplete; missing ❑ Additional adequacy test information needed. _ ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. _ ❑ Locations of all soils, percolation and water monitoring tests not shown. _ ❑ Proposed system too deep for soils information submitted. ❑ Well log required. ❑ Omission in narrative. ❑ Insufficient fill over tank or field._ ® Other. WHAT IS THE SOIL TYPE PERCED FOR TESTHOLE #3? NEED TO ADD CLEANOUTS ON HORIZONTAL RUN FROM TANK TO TRENCH. Name of reviewer: JOE GOODALL Date: 9/19/2005 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION II ENVIRONMENTAL ENGINEERING DIVISION 825 L Street • Anchorage, Alaska 99501 Telephone 264A720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME Sit' M Lt 1 PHONE ONEW ❑ UPGRADE MAILING ADDRESS /7 _A LEGAL DESCRIPTION LOf LOCATION NO.OF BEDROOMS 3 O DISTANCE ell Absorption area Owelfin PER IT NO. ;I Y WQ Manufacturer j Material No. ofcompartments to F Liq. capacity in gallons 00 IF HO EMADE: Inside length Width Liquid depth d Y DISTANCE TO: Well Dwelling PERMIT NO. _10Z 0 YQ- Manufacturer Material Liquid capacity in gallons TO: Oit dation tcjNo. Nearest lot Itne PERMIT NDISTANCE su of lines Length o each line Total le gth of lin s Trench width inches we trines Distance bet�,JC) rDFo Top of tile to finish grade 7 �3 Material beneath file / inchesLength Total effective abson) area Width Depth PERMIT NO. Type of crib Cribdiameter Crib depth Total effective absorption area W DISTANCETO: Well Building foundation Nearest lot line J Cla U Depth Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foundation I Sewer line Septic tank Absorption steals) OTHER PIPE MATERIALS all SOIL TEST RATING INSTALLER REMARKS V ^ e ! a� �t t>.A� tO AP-K Il ro L ` ,� �. o Z)NO3AJIL — APPROVED DATE LEGAL til 4-a.,fe, 8'/3�� 3 List-1 72413 (Rev. 3/78) if U MUtJ I C I -i L_ I TY OF Fit -A F-i"'RnC3E�U DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION `7-"'7 S53 +1 825 'L' STREET. ANCHORAGE, AY.. 99501 M 264-4720 LJELL-. ANL7 4FJ—nSITE 1 SELJER F}ERt•1 I T PERMIT NO. C 830016 APPLICANT SAMUELL MAXWELL BOX 1785 SRA 99507 344-177 m LOCATION LEGAL L1 MAXWELL SUBDIVISION LOT SIZE 42405 SQUAP.FE— TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER. OF BEDROOMS = 3 SOIL RATING CSQ FTZBR)= 125 ADM. THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [7EF}TH= 12 LEtJGTH= 24 13Rn%-REL_ I7EF}TH= S THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. r THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). RELLU I RED SEPTIC TANK SIZE= 1 0O0 GALLONS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. -- TLJO C 2 ] I tJSF}EGT I ONS ARE ' REQU I RE[J --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY -THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. i MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO.THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERMIT EXP' I RES E>E(-,Et1EsER 311 1S}03 I CERTIFY THAT 1: I AM FAMILIAR. WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IPJ ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED: -__ CL.a�-f-'1 ---------- APPLICANT MUELL VAX14ELL p ISSUED BY__� _ — �2� V4. 0 n — SOILS LOG MUNICIPALITY OF ANCHORAGE . • a, r � TION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TES? 825 L Street. Anchorage. Masks 99501 260720 SOILS LOG — PERCOLATION T t 3 -Rel)RpOPAiS AEST PERFORMED FOR: SA PF•N� LL. - _ DATE PERFORMED: TION: TION: LoT ' 1-42. LEGAL DESCRIP`SL1R � �><W ! L •SVSDIV ISIe)n/ SLOPE SITE PLAN (FEET) - 1 'o`•0 0 ' 4.5' GRAVELLY SAND - o••aoe WINVINEROVS COBBLES,LIFTLE 2 • e;•P :o: TO NO FfN6S, FAIRLY Witt.'. e Ds r GRADE9,NON-GoNES)uc, SuBRND,DRY 3 b ..e. �osu6M�( GP ied4'e MDtST 4 es•�_e 5 -J,$'-12.0' 5ANDY TILT- $ILT 6 • Wl S°ME SANDoTRACE TO SOsNc GRAVEL, POOR --Y GRADED.-IN05rLY 7 FtNcs < ccAitses, DRY fa 5uGHrLy ►1101 STI N0A7-1ONESrvE, NON-FLASrIC 8 5M 9 ° .e 10 •_ ° it e 12 e TRE rlcH 13 DEPTH 14- 15 16 PSE OF k4 17 d✓J�� 9 : JOHN L SWANSON : ,a ( 18 ��l ••••• 1834E•• • .' .�' ') 19 `� OfROFESSIONp��II WAS GROUND WATER L ENCOUNTERED? C Net Drop P 2 E IF YES, AT WHAT -� DEPTH? wNwarhOMMEN 114 Reading Pete Gross Net Time Time Depth to Water Net Drop / 2 O 0 5" b :00 3.0• o` „. IL . U 20 RtiGCOMENO ADJVSMb PERCOLATION RATE /;2.3c (minutes/inch) Z'06 .46 OR .OR TEST RUN BETWEENS. O FT AND FT COMMENTS PRE11100 PERG TEST loot' +e +fl• Nwr THrS PERI S.40, NoRrtr of by D C PLACE I SfiPrm TAArlcr 2f)d _ P[R� Cc91G/V'APPROVEA BY 4YN Li VEszAkd ; /+ PERFORMED BY: Cats i, S S Eqq, fFeu CERTIFIEO BY: "` DATE 72-00e (6/79) n r, a ' � ) SOILS LOG ` MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 2644720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: SAM M A X W ELL DATE PERFORMED: 4 -30 -59 - LEGAL _30'52 LEGAL 1- 2- 3- 4- 5 •3•4-5 6- 7 8 10 11 '12 13 14 15 16 17 18 19 20 ®N PERFORMED 72.008 (6/79) overbvirJen SITE PLAN _A .P. LDtS ed L',jr- C0bb\e6 ,zs�C 'A86 ...� ITH 2248-E d s......eof. , WAS GROUND WATER e� 1 Q L ENCOUNTERED? Iv O P OF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop • e „p d r PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT FIED BY: DATE: . r-. 1� .\ �ti`J 1\a �'J �.��.1 (n� 'v�R..f ►l.•. �:YVc(.ACD Ir J V 1.._e v 1 h- IZ N D W •el � u-�`'`'� s w Flu 'T r 1 I �3 x ctE mJ rt n —1 3 G G 19 FF W I i 1•+ F% F FH F•F w W w W w u F� a c s i cd i H: • U i i i 0):\: a a• : p: i of- s t i i i cd i �'c i tcE O O G C C lxwcgwg cd id W s W O W G4 n u F� a c cd H: F; �i U i i Hi ai 0):\: a a• : p: ai of- �g �: W cd i �'c i tcE t ❑ .�. i Y : M: cd id 1 W L6 L6 r•l i O 1 '< � � •• rli N i Ni N rii H : rt H i i O a O I.O. F0 � t iHi tOi,iN t L6 i H: H: i H i ❑ O O O O O W L wW L6 W s W O W Municipality of Anchorage • Development Services Department - Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.ak.us (907) 343-7904 S' e�� CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 018-281-25 cow QSC421.112LI 1. GENERAL INFORMATION Expiration Date: vs Complete legal description MAXWELL LOT 1 Location (site address) 14801 LOC LOMAN LANE *ANCHORAGE AK 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address SKIP & ELLEN PENNEBAKER Day phone 350-6890 14801 LOC LOMAN LANE *ANCHORAGE, AK 99516 Day phone BETH SIMPSON W/ KELLER WILLIAMS Day phone Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: ❑ Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ 865-6556 TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 .Individual Holding tank ❑ Community On-site ❑ 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 title (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 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 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. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSO Guidelines & Regulations. The reported results described the performance of the system unde, 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, LTD. 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 tight whatsoever. 5. DSD SIGNATURE Approved for t bedrooms. Disapproved. Conditional approval for bedrooms, with the following Attachments: COSA Checklist Septic System Advisory Well Elow Advisory_ 11/051 337-6179 Date q I 3o IZ- Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report ON-SITE WATER AND Other Original Certificate Date:_ Municipality of Anchorage _ • Development Services Department 1°= Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: MAXWELL LOT 1 Parcel ID: 018-281-25 *PER SURROUNDING WELL LOGS A. WELL DATA **WELL DEEPENED IN 1986 PER 2006 COSA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 10/1/83 Sanitary seal (Y/N) YES Total depth **180 ft. Cased to *40+ ft. FROM WELL LOG Date of test 10/1 /83 Static water level 115 ft. Well production 4.5 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate0a(—,3 mg./L. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 4/13/12 126 ft. 2.26 g.p.m. Collected by: GEG Ltd. Arsenic: N 0 ug./L. Date of sample: 4/16 /12 B. SEPTICIHOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 10/12-14/05 Tank size 1250 gal. Number of Compartments 2 Cleanout6 (Y/N) YES Foundation cleanout (Y/N) J__ Depression over tank (Y/N)No High water alarm (Y/N) N/A Date of pumping 10/21/11 Pumper NORTHLAND PUMPING C. ABSORPTION FIELD DATA BELOW EXISTING GRADE 8/3/83 008 Date installed 10/12-14/05 Soil rating (g.p.d./Wo !bd 61 2.5 Length 50 ft. Width 2.5 ft. System type TRENCH TRENCH 8 Gravel below pipe 8 ft. 14 976 YES NO Total depth *12.33 ft. Eff. absorption area 800 ft2 Monitoring tube YES Depression over field NO Date of adequacy test **4/13/12 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 62 in. Water added 600 gal. New depth 69 in. Elapsed Time: 280 min. Final fluid depth 64 in. Absorption rate >= 600+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date **TESTED 2005 TRENCH ONLY D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off' level High water alarm level at in. Cycles tested Meets alar & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 100'+ On adjacent lot,, Absorption field on lot 100'+ On adjacent lots Public sewer main Sewer /septic service line 25'+ 100'+ 100'+ Public sewer manhole/cleanout N Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main 5'+ Wells on adjacent lots 100'+ Property line 5'+ Absorption field 5'+ Water service line 10'+ Surface water 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 101+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS c I e& -n ux. s cA. 4.iA-6 erect o � { (ne ole. o1rut,�ialtl- G. ENGINEER'S CERTIFICATION SOM& I Qa;G. o I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSH guidelines in effect on this date. Engineers Printed Name JEFFREY A. GARNESS Q ps 9 / Date ?o J7_ 4� COSA Fee $ 4 qbi u' Date of Payment 5/111a Receipt Number a q ag 1-a (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number V ....................... ey Gar ess; CE -795 •' a 6` lL Municipality of Anchorage • Development Services Department j Building Safety Division On -Site Water and 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. 018-281-25 1. GENERAL INFORMATION Complete legal description Maxwell Lot 1 COSA# 01(o MA Expiration Date: J4 — a.47-- 0 Location (site address) 14801 Loc Loman Lane Current Property owner(s) Candice Goard Bryant Day phone Mailing address same Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding Tank ❑ Community On-site ❑ 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 title (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 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 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 verity 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 Watkins Engineering, Inc. Phone 349-1851 Address P.O. Box 110443. Anchorage, AK 99511 Engineer's Printed Name Cindy W. Ellis Date id 5. DSD SIGNATURE kc�`., Cindy W. Ellis ✓ Approved for bedrooms. CE-iosn ,. Disapproved. �ssxx+�cc� Conditional approval for bedrooms, with the following stipulations: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other ST.— / Original Certificate Date: (Rft. 111M Municipality of Anchorage • Development Services Department Building Safety Division On-SRe Water& Wastewater Program 4700 Bregew Street P.O. Bou 198850 Anchorage, AK 99519-6850 www.muni.org/onsRe (907) 943-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Maxwell Lot 1 Parcel ID: 018-281-25 A. WELL DATA Wen type Pri If A. B. or C provide PWSID # Date completed 10V1/83 Sanitary seal (YAC Yes Total depth 180 R. Cased to 124 R. FROM WELL LOG Date of test October 1. 1983 Static water level 115 R. Wen production 4.5 Q,p_m. WATER SAMPLE RESULTS: ColUorn 0 cwionlesmoo mL Nitrate <0.1 mg& Arsenic: <0_005 nw Date of sample: 1/1201 S. SEPTIC/HOLDING TANK DATA Wen Log (Y/N) Yes Wires properly protected (YRS Yes Casing height (above ground) 28 in. AT INSPECTION Aug 17, 2005 117 R, 4.7 9 - p.m - Other bacteria 1 colonies/100 mL Collected by: Cindy Eats Tank TypelMaterial Steel Septic Tank Date Installed October 14, 2005 Tank size 1250 gal. Number of Compartments 2 Cleanouts (YM) Yes Foundation cleanout (Y/N) Yes Depression over tank (YIN) No High water alarm (YM) N/A Date of pumping New Pumper N/A C. ABSORPTION FIELD DATA Date Installed 10/14/05 Son rating (g.p.dJR? or R2/bdrm)0.8 System type Deep Trench Length 50 R. Width 2.5 R. Gravel below pipe 8.0 R. Total depth 112A R. EtT. absorption area 100 R� Monitoring tube Depression over fleki No Date of adequacy test WA New ResuRs (Pass/Faip For _ bedrooms Fluid depth in absorption Real before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >- g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) If yes, give date D. LIFT STATION Date installed NA Size In gallons Manhole/Access (YIN) 'Pump on' level at _ in. •Pump (C level at _ In. High water alarm level at in. Datum Cycles tested Meete alarm b circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 105' On adjacent lots 100'+ Absorption field on lot 129' Public sewer main 100'+ Sewer /septic service line W On adjacent lots 100'+ Public sewer manhole/cleanout 1017+ Holding tank WA Animal containment areas 100'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 14' Property One 37' Absorption ffeld 111' Water main 100'+ Water service line 55' Surface water I W+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 17' Building foundation 100' Water main 100'+ Water Service line 128' Surface water 100'+ Davewa , y parldnyvetude storage 3d Curtain drain NIA Wells on adjacent lots 100'+ F. COMMENTS: Well deepened In 1988 G. ENGINEER'S CERTIFICATION I corny that I have determined through field inspections and review of Munrdpal records that the above systems are f) conformance with MOA COSH guldellnes M effect on this date. Engineer's Printed Name Cindy W Ellis Date 1123/08 COSA Fee E ' a Date of Payment Vra5 p Receipt Number Ty� (Rev. 11 M Waiver Fee $ Date of Payment Receipt Number rIj:-1N!` Ellis CE. tosn SCS MN 1060217001 All Dates/Cimes are Alaska Standard Time Client Name Watkins Enginccring Printed Date/Time 01/20/2006 17:45 Project Name/# Maxwell Lot 1 Collected Date/rime 01/12/2006 15:15 Client Sample ID Maxwell Lot 1 Received Date rime 01/12/2006 15:39 hlatrir Drinking Water Technical Director Stephen C. Ede PWSID 0 Sample Remarks: Allowable Prep Analysis Panmctcr Results PQL Units Method Cowainer ID Units Date Date Init Nitrate -N 0.100 U 0.100 mg/L EPA 3532 B (< 10) 01/13,106 JC Metals by ICP/MS Arsenic 5.00 U 5.00 ug4. EP200.8 C 01/16/06 01/20/06 SCL Microbiology Laboratory Total Coliform IOB. NOColi col/100mL SM -IOP -22B A (<-1) 01/12/06 TLF SGS/CTk ENVIRONMENTAL SERVICES —S Drinking'Water Analysis Report for Total Coliform Bacteria READ PSTRUCT ONG ON REVERSE BIDE BEFORE COLLEC S4 SAMPLE MUST BE COMPLETED BY WATER SUPPLIER ,EI KIRLIC WATER SYSTEM IN grPWATE WATER SYSTEM I ja aW P,,ft w• atnd knalot . SAMPLE COLLECTION: e..rrr r .rwrw/ .rr•+ Dttt: 0 l (Z trw Dw w. TMA: 3: IS AM r M Tnn@PMW a tae sr. ❑ Sema as cokcbr TO BE COMPLETED BY LABORATORY Date: t"- f2LT4 Timx Temp wind: C-1 Received By. ❑ S.mdt a•« So nen cid: w.r.m.rb@ L " " L 0 and Rtae XRoutlne 200 W. POTTER DRIVE - ANCHORAGE. ALASKA 96516 Tet 907582-2513 Fox 907581-5301 106021'1 yA O Repeat sampN send a tvviot 0 Treated Water .%untreated water (refer to lab rte 1 ❑ Special Purpose ❑ . RUSH SAMPLE Phone #*.' . Faxt. .............................................................................................................................................. Amy" MMIad: L Membrane Fitter MMO-MUG (PIA) MMO•MUD (PIA) RESULTS: TotMCaBome E Cot• MEMBRANE FILTER RESULTS: Dwd count Ochi WRL vreowrt Na CeG% SottaAD€c ' ANC RRC JUN oermi»: sora to Care ' Planed 0 Food Q DeWrlmt• Spoke VAft. „re,r,r ( O Unsatisfactory I.TMrrr ftct DatsITIrne: /%� �° G f .RCT: u a .otre.r.r . ' FamSFW-o065 12nT/5 w.......�.n...uv n�..�.u..uau.+nn.rr:.mero..e......�..r.`.a t:.....+.•m+w. r Q O 00 0£ a U 7 C Q c_ N T LL co co ai N r co W C-� C O O .A fm 0 M r U N 2i M Y J 00'OOZ MmO17,90o00N — — _ IUOWOS83 V30 A 6 _ \� o ( SI O i SNI \\ eOO�� I I �eQao ti / r—J l ae�e�` S 00'OL Mu59,50o00N aue-I ueWol 001 I- I� W a J m ;ll , W y CL 00'0£6 3,,OO,ZOo00N 2a C 0 U- P7 O Q ui M r � N W o c o till Lit! air Lit �S a all °'g Z•o � a�i �W egg e• s w m or 40 a =YQ a . Ir 44 N Cb 0- L6 L6 0 U. a w �9Qz W0W OWW 0 0: LIJ U�� tL �7OSN 0y6 9=Z W WN W F u��Fga MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRCW1ENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information (a) Legal Descr Application Date S Aa IFA - (include lot, block, subdivision, section, township, range) Location (address or directions) ('I (t 1 (b) Applicants Nano �•� w+u e1 P')c. L c.)✓ II Telephone 3d S IPFG Applicants Address S P h' I'>K S 4 A f 13 (c) Applicant is (check one) Lending Institution ; owner/builder ; Buyer r:::l ; Other Q (explain); (d) Lending Institution iVa'4 f PL ^ L .•-F AL Telephone 2 L• 113 Address d -, � ., L,, � t k !' C' - (e) Real Estate Co. s Agent 1) /u Address Telephone 2. Type of Residerce Single -Family M Number of Bedrooms 3. Water Supply Multi -Family Z Other (describe) Individual WallI " ( Cc=unity � Public Note: if ca=nity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Is the well adequate for the number of bedrooms specified in this HAA (YIN) >' 4. Sewage Orsite FZJ Public �_j Community f -::l Holding Tank Is the wastewater disposal system adequate for the number of bedrooms (Y/N) (Page 1 of 21 2-15-84 W n 5. Engineering Firm Providing Inspections, Tests, Data and Information_ I certify that I have checked, verified, or conformed to all MITA HAA Guidelims in effect on the datee..of this inspection. signed ��1 1 Date Nam of Firm Telephone '3 a Address 7 I.1 7 /_) S Ali J Signed by /1.%N r l�n ra-n F Date (ENGINEER SEAL) 101•M= - Approved • J• Approved for 3 bedroonn Approve`"�'�isapproved Terms of Conditional Approval _ 4. :rig'HAWT1:or.>i_ CE -4354 %- 1 4y�'46C,ma� 6'si iftional Date The Municipality of Anchorage Department of Health and Environmental Protection does not guarantee the continued satisfactory performance of the water supply and/or the wastewater disposal system. This approval indicates that, as of the validation date shown above, based on the data and information furnished by an engineer registered in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional unstional for the number of bedroom and type of structure indicated. (DHEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s [Page 2 of 21 2-15-84 ^- MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH 6 MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 A. FELL DATA 1AAY 101 b4 �rgMU Well Classification /ritIA TG If A, B, or C, D.E.C. Approved(Y/N) N Well Log Present (Y/N) ✓e�'S Date Completed /D --/-S3 Yield Total Depth Cased to MVIKN IjN Depth of GroutingiJ1geAf6 Static Water Level _ //-S Pump Set At UNXeOIdN Casing Height Above Ground 3 __ Sanitary Seal on Casing (Y ) Electrical Wiring in Conduit (Y/N) VCS Depression Around Wellhead (Y ) Separation Distances from Well: To septic/Holding Tank on Lot /M' t On Adjoining Lots /GYS ' To Nearest Edge of Absorption Field on Lot /^4"f ; On Adjoining Lots 111p'4 To Nearest Public Sewer Line Nl,,# To Nearest Public Sewer Cleancut/Manhole 19 To Nearest Sewer Service Line on Lot /W' Water Sample Collected By Date Water sample Test Results $ Comments B. SEPTIC/HOLDING TANK DATA Date Installed 9-3-53 Size /" TAG No. of Compartments Z standpipes (Y/N) Ae= Air -tight Caps (YIN)YP.S Foundation Cleanout (Y/N)Ye5 Depression over Tank (Y/N) A Date Last Pumped Al ICJ e\/r Pumping/Maintenance Contract on File (Y ) ; for A-'11? Holding Tank High -Water Alarm (YM) N Temporary Holding Tank Permit (Y/4) A11A Separation Distances from Septic/Holding Tank: To Water -Supply Wall /Gd 0'0 To Building Foundation /3 ' To Property Line 0,6-' -�- To Disposal Field /,01 To Water Main/Service Line /S-''` To Stream, Pond, Lake, or Major Drainage Course ///a - Comments (Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA , Soils Rating in Absorption Strata �9n Type of System Design ree,6/ l Date Installed -P.3 Lergth of Field L / Width of Field Depth of Field i Gravel Bed Thickness Square Feet of Absorption Area A Standpipes Present (Y/N) yP� Depression over Field (Y/N) . Date of last Adequacy Test ,4/«u Results of Last Adequacy Test N Iii% Separation Distance from Absorption Field: To Water -Supply Well /DD ' r To Property Lire /,S' r� To Building Foundation -V9' To Existing or Abandoned System of LotAViYG FOnNa ; On Adjoining Lots _ _ NnNG Fau.uo To Water Main/Service Lire /5�7-- To Cutbank(if present) N119 To Stream/Por:d/Lake/or Major Drainage Carrse /V -2 To Driveway, Parking Area, or Vehicle Storage Area ?Q Cain, nts D. LIFT STATION lliq Date Installed Dimensions Size in Gallons "Pump On" Level at High Water Alarm level at Tested for Electrical Codes(Y/N) Coin, nts Manhole/Access %YIN) "Pump Off" Level at Vent (YM) Pumping Cycles curing Adequacy Test. Meets MOA "* Check Permitted Bedroom Rating Against HAA Request *' I certify that I have checked, verified, or conformed to all MOA HAA Guidelires in effect on the date of this inspection. Signed � � ,.,,� Date 5-/8 1Pi9- Canpary P Az "/4 k & rr a MOA No. S_1 P9 00RS-? RB1/d5/s [Page 2 of 21 � -15. •• CE -43-"? �e.�r- '•.......•' G;".7 2-15-84 1 n n . ClIE31ICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562.2343 ANCHORAGE INDUSTRIAL CENTER T t 5633 B Street l ' ` 1 Drinking Water Analysis Report for Total Coliform Bacteria t r TOB COMPLETED BY LABORATORY TO BE COMPLETED BY WATER SUPPLIER a� �FEy; �41 ,/J &A 45e Am- reS:.t L -T5 7a a '�P L tL'T 1G ,11L A shows this Water SAMPLE to be: WATER SYSTEM: � (•) See h on back a11Ysis I �atlsfactory I.D.NO. /�4 Y& �L� _ <� YS /EV-) ❑ Unsatisfactory water System Name + Phone Na. O Sample too tong In transit; sample should 71-1-7 i.at•t" ( not be over 30 hours old at examination to Mailing Address �� i v jrjs d' Indicate reliable results. Please send new sample via special delivery mail. City - state Zip Code r (- y 0 7 (�i� DATE: LSL�IJ f—'� ( Date Received SAMPLE Mu Day Year Time Received Ana (tical Method: SAMPLE TYPE: ❑ Routine ❑,Check Sample (tor routine sample) ❑ Treated Water ❑ Fermentation Tube Membrane Filter with lab ref. no. ❑ Special Purpose ❑ Untreated Water SAMPLE - Time Collected BY Lab Ref. No. Result* Analyst NO. LOCATION /7AA 6-1 tkP� c Collected Ela I I -L -- I m 2 I 3 I I J' m L m 5 ----i .NO of cdorvp/loo M 0, No Or aorto.. whr i.1220 NI BACTERIOLOGICAL WATER ANALYSIS RECORD alt...1se0 READ INSTRUCTIONS Membrane Filter. Direct Count Coluorm1100ml verification: LTB BGS 1Collform1100ml Final Membrane Filter Results BEFORE Reported ByS�ti Dals�� ( Time: a.m. p.m. COLLECTING SAMPLE TNTC= Too Numerous To I Count