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HomeMy WebLinkAboutKENO HILLS #7 TR BKeno Hills #7
Tract B
#020-171-45
Municipality of Anchorage
Development Services Department _0 i
BuMug Safety Division
On -Site Water and Wastewater Program, 4700 S. Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6650 Page of
www.ti.anchorage.akUS (907) 343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. PID Number. 407,01-17 I "•4.5
Nam,
h r �e
Wastewater System: ew
Y .� ❑Upgrade
AGa.aa:
ABSORPTION FIELD
P wr.e: Nuniwr a B.aocma:
D De.pTmrrls O SHeFw Tr.rvT kaed p MaaN p polan
LEGAL DESCRIPTION
soa Ham4
C). .5
Taal D.plh Iran QVAd paha
2-,5
cpo*p
Fr.
9:crk Lac subcWsim
KC=No 7
D.pn n ppe boaan trap oripiW pace:
'.
Cravat depth baraFt pipe:
141t15
-O n.
P
Tawnsnip: Range: Sam.rc
FA amb ab" a" pada:
C-"Lwgn
• iL
c'] Fl.
Well: ®.New ElUpgrade
Grew advt
15
eaart«o14,.e
D�abiw. Groan wa:
Fl,
5 it
CaSsir"at (Prlvale, A 9. C1
Taal DepIrc
Casa to
Taal absapw arta
r 2 OC
P" AAatanal: /'�
I C--
Ig 6Fl.
Ft
F?
STM D ((J
/�,
DaeMW*
shbawaalewt
wWl.r(�' rh Naarr'�
Drohswn.0:Au ✓tf
T:eia Pump At
/
Casiq H-0 AW_ Grant
TANK
�o GPM FL
2 Ft
SEPARATION DISTANCES
QSeptic ❑ Holding ❑ S.T.EP.( FO ❑ Other.
To
Septic
Absorption
Lift
Holding
PutrriPlivat
M"^if9°`
h
c,panly
From
Tank
Station
Tank
Seer Lin
I Gal.
vie"
/Fiielldd7/
✓ /
N
NIA
MalenL`
p
Numb a aanpaM.M13:
C
SUwCewal.r�Oryre
A/ r
`
LIFT STATION
La Line
/ /4
Sue.
Gal.
MarWa .r.
Fa avcn
Al
'Pure ar lrv.l
'Pump ar kw at
High wmer sta at
Curtain Orin
/ v
p
P Rfate a I,boel"
E!earcY hsp.aaa+tMp rnm0 Dy
Rema/.s: .
F'r e id r r h
BENCH MARK
No
tanmarl ano D.smpaat
60i9irzallY t19e Nom' !n Z3;rrh
Asaur...o E "accm
IeU, Sh 115 6/,4
a e FYI v,1000 -Per 41 c7
-
Engineees Stamp
Inspections performed by S f ?:(--~4f Dates: 1" u �
JIiA'
_J'
l l°.
49Iti Q l
2^°SE
Development Services Department Approval
0 !
,
Reviewed and approved by: �i /pDate: D- O
`
0 FSO? r
1�, .J
R
SW980325
AS BUILT PLAN
1
FROM
TO
DIST.
Field
Well
132
CO1
A
73.8
Col
B
61.2
MT
A
77.5
MT
I B
163.7
STCOI
I B
119.6
STCO1
I C
131.1
1500 Gal
IS' a 00'
T. I
T. It
�o b
t.
z
z
0
I � Y
I I w
I I o
1��... T. ahoy+
r lav e
JAMES SIZEMORE & ASSOCIATE$
CIVIL ENGINEERS & SURVEYO
SW980325
AS BUILT DETAILS
1_�i- g17.6 _I_ - 3-2,s
I
� l�o3aiD4- Pere
I h
1.2 -So Gaf 5c7' -
/A5 541 L -r P5E0 PLO
q2o qg2 �
6oT T [!I 784-7
SEc,T 10
/` BYu-13oand Ln 54
4-er Fob,
JAMES SIZEMORE & ASSOCIATES
CIVIL ENGINEERS & SURVEYORS
AweMunicipality of Anchorage
Department of Health and Human Services lam
825'L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
Rick Mystrom http:mvww.ei.anchorage.ak.us
Mayor
Permit Numher: #S\Y 980325 Date of Iccue: 8-26-98
Date Started: 8-3-99 Date Completed: 8-3-99 Is %%ell
T r 91 D rriMinn• Kenn Hills # 7 Tracl E
Property Owner Name & Address: Chris Harare
P.O. Sox111490
Anrhorano A QQ.ri 11
Parcet Identification Number: 020-171-45
located at noproved remit location? 2 Yes ❑ No
Borehole Data:
Depth (ft)
Method of Drilling ® air rotary ❑ cable tool
Soil r)pe, llticl.ness & N'a0.v Strata
From
To
Casing hype: Steel
Stick-up
0
2
W311 Thickness:.25 inches
organics & silt
2
3
Diameter: 6 inches Depth: 20 feet
gravelly silt
3
10
Liner Type:
bedrock
10
185
Diameter: inches Depth: feet
Casing stickup above ground: 2 feet
H2O
140
160
Static crater level (from ground level): 8 feet
Pumping level: 185 feet ager
2 hours pumping:j gpm
Recovery Rate: 4 gpm
Method of Testing: airlift
Well Intake Opening Type:
❑ Open End ® Open Hole
❑ Screened Start feet Stopped feet
❑ Perforations Start feet Stopped feet
Grout Type: Genlnnite # S Volume: I b(ZQ
Depth: Start 0 feet Stopped _ feet
Pump: Intake Depth feet
Pump size hp Brand Name
Well Disinfected Upon Completion? ® Yes ❑ No
Method of Disinfection: clorox
Comments:
Well Driller: Alpine Drilling & Enterprises
P.O. Box 110496
Anchorage, AK 99511
::........:. ':.`.:..ct: � il:.-...`:;tf Fn..:: a ad! :: L :: tic pr:;i•�.t; ouncr svitSir. 30 ;:� • : n:'c; •rrlcrnr, a..:: t;;c prnperij
.:,.0— .i, n!. -:4-n r.: the Tyro .+£TToarI, .r- TT........ Al" rt..•:.:.
MUNICIPALITY OF ANCHORAGE
' Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
9_10-q5 Z 30pm
ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Permit Number: SW980325
Legal Description: KENO HILLS #7 TR B
Date Issued: Aug 26, 1998
Expiration Date: Aug 26, 1999
Parcel ID: 020-171-45
Design Engineer. 0027 James Sizemore & Associates Site Address:
Owner Name: Chris Hamre Lot Size: 435702 SO. FT.
Owner Address: PO Box 111490 Total Bedrooms: 4 Permit Bedrooms: 4
Anchorage . AK 99511-1490
This permit is for the construction of:
❑✓ Disposal Field ❑? Septic Tank ❑ Holding Tank ❑ Privy Q Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 (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.
5. The following special provisions.
The excavation shall be for the removal of the organic layer to a maximum depth of 1.5 feet.
Received By
Issued By
Date: a
Date: 6.Z&7 .19
169•]9.22•
.6S feat -
N IH o.
1 Well
f).- - - -
O
Proposed 1250 Gal r ST�
H
P[oDoaed 15• a BO• �•Ir w '
Bed DlepoaalPleld y «lS •e
T. 01 � ;
T. n.. IC—�
Alternate Bed Site �•
T. B. IS 7
w t•
w wee o
622.56 feet
JAMES SIZEMORE & ASSOCIATES
TRACT B, KENO HILLS ADDN. NO. 7
PROPOSED WELL 6 SEPTIC SYSTEM
SITE PLAN
Scale•. 1' - 200• Drawn By:_�y�_ DATE: AUG. 5, 1998
Cekd. By: GRID 3438
James Sizemore & Associates
Civil Engineers &
Surveyors
6410 Switzerland Drive Anchorage. AK 99516
(907) 345-1572
WASTEWATER DISPOSAL SYSTEM
TRACT B. KENO HILLS ADDN. NO.7
0.0 GENERAL
0.1 The scope of this project consists of installation of a 1250 Gallon Septic Tank and a 15' x 80'
bed drainficld containing 1.0 feet of surer rock.
0.2 Construction shall be in accordance with the approved site plan and design drawings,
Municipality of Anchorage permit with any special provisions or conditions. Deviations from
the approved design drawings shall be coordinated and approved by the engineer conducting
the inspections.
0.3 All construction procedures and material used to construct the system shall comply with
Municipal and State regulations.
0.4 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading
arras after the system is constructed and soil is compacted and mounded over the bed disposal
field and the Septic Tank.
1.0 SEPTICTANK
1.1 The 1250 gallon septic tank shall have two compartments and shall comply with Municipality
of Anchorage Requirements. The tank shall include two 4" cicanouts for pumping access.
1.2 The septic tank shall be set level and shall be bedded as necessary to prevent settling or
shitting of the lank.
1.3 All pipe connections to the septic tank shall be made with waterproof mechanical couplings.
A cleanout shall be installed upstream of the tank within 5 feet of the house foundation. A
double cleanout shall be installed downstream, within 5 feet of the septic tank. The first
cleanout downstream of the septic tank shall clean toward the drainfield. The second cicadout
shall be to clean toward the septic tank.
2.0 SUBSURFACE DISPOSAL FIELD
2.1 The subsurface disposal field shall consist of a 15' x 80' bed. The bottom of the bed shall be
excavated level and shall be approximately 2.5' beneath the existing ground level.
2.2 The bottom of the excavated trench shall be level within +/- 2". And compacted or smeared
surfaces shall be raked to allow for proper infiltration of effluent.
2.3 A minimum layer of 1.0' of filter sand shall be placed over the excavated area.
This will insure the separation distance to the water table, and the sand can be
used to insure a level bottom for the bed.
2.4 A total of 1.0 ft of sewer rock shall be placed over the excavated arca. The perforated
distribution pipes in the drainfield shall be placed as shown on the drawings and shall have at
least 6 inches of sewer rock beneath the invert. The distribution pipes shall be placed level,
with holes in the perf pipes pointed down .
2.5 Sewer rock shall be 0.5 — 2.5", screened gravel with less than 3% passing the # 200 sieve.
2.6 Cleanout pipes and monitor tubes shall be 4" diameter and installed as shown on the plans.
The portion of the monitor tube extending through the sewer rock shall be perforated All
monitor tubes and cleanout pipes shall have waterproof caps conforming to Municipality of
Anchorage Specifications.
2.7 Filter fabric shall be placed over the scwcr rock, and a minimum of 3 feet of backfill shall
cover the rock. If less than 3 feet of fill is available, rigid insulation will be placed over the
field
3.0 ENGINEERING INSPECTIONS
3.1 A minimum of four engineering inspections will be required during construction of the
system. One after the septic tank is set prior to its backfill, one after excavation of the
Bed prior to placement of filter sand, one after placement of the sere er rock and the
distribution piping, eleanouts and monitoring tubes are in place. The final inspection shall be
alter filter fabric is placed, the bed is backfilled and the final grading is complete.
3.2 The contractor shall coordinate with the engineer at least 24 hours prior to start of
construction. If the contractor desires, a site -0sit with the engineer prior to start of
construction can be arranged.
/
PROBABLE IMPACTS TO ADJACENT PROPERTIES
A) WELLS
The proposed wastewater disposal system is designed in accordance with current Municipal
Wastewater Disposal Regulations. The proposed bed a ill be greater than 100 lt. from the well on
this lot, and adjacent lots. Therefore there should be no adverse impact on wells from this new
bed
B) WASTEWATER SYSTEMS
The system is designed in accordance with current Municipality of Anchorage regulations. There
should be no adverse impact of adjacent wastewater disposal systems.
C) RESERVED SPACE/SURFACE AND SUBSURFACE
There is enough space on this lot to put in another replacement system and still maintain the
required protective distances between wells and disposal systems.
D) DRAINAGE
The location of the disposal system will not interfere with any drainage. The arca disturbed during
construction of the system will be graded and sloped to prevent ponding of water
S'- 9`I (03
Municipality of Anchorage
7 TV
DEPARTMENT OF HEALTH & HUMAN SERVICES
$25 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG - PERCOLATION TEST
PERFORMED FOR. 7/ `� /L��//c--!,(/J DATE PE
LEGAL DESCRIPTION �� "', `O•" ,^ �juis�
9
t0
11
Q-
13-
14-
is-
16 -
17
21314161617
18-
19-
20-
COMMENTS
81420COMMENTS
e�76d � Grew el
e) cc
/17,0
WAS GROUND WATER
f! 7
ENCOUNTERED)
Time
IF YES, AT WHAT
WAIN Drop
DEPTH'
r)
WON
�T •
7— _ ..
MINION
MEMO
Immm
Milos
ONION
milm
Is
ommoommom
MORMON
ME
WAS GROUND WATER
f! 7
ENCOUNTERED)
Time
IF YES, AT WHAT
WAIN Drop
DEPTH'
0epih to Water Art r/ P
Mxdoring7 .f) Date.
Reading Date Gros:
Net
Depth to Net
Time
Trme
WAIN Drop
r)
�T •
7— _ ..
PERCOLATION RATE 4— t,,' uses mehi FERC HOLE DIAMETER i
It I HUNBEIWkLN _�'_ 1 A4J —FT r
-
PERFORMED By. _ ae�IO�C" 1 ~� �CER1ifY AT THIS TEST WAS PERFORMED IN
ACCORDANCE W11M ALL STATE ANO MUNICIPAL OVIVELrNES IN EFF CT CN TMIS DATE DATE.
72.00E (ROV 4/ES)
L
PERFC
LEGAI
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
,EST RUN BETW EN .� FT AND 7 FT
COMMENTS C-2- ';5 rev �1� 7
PERFORMED BY: J • 7-
ACCORDANCE WITH ALL STATE AND MUNICIPAL
72-O08 (Aft. 4/85)
IFY THAT THIS TEST WAS PERFORMED IN
EFFECT ON THI DATE. DATE: / r` cz �L
PERFORMED
LEGAL
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
r%4 ( Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG - PERCOLATION TEST
r
m/''Iqa n icr
6L
DATE PERFORMED:
���Townshlp, Range, Section: IV iiy 7
SITE
g311dr 6raca-l
©
cc, a 57, CC9 We
iEy o
ye
PERFORMED BY: ZZ I =,j JZj L
ACCORDANCE WITH ALL STATE AND MUNICIPAL
72-008 (Rev. 4185)
WAS GROUND WATER Y
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
?
Depth to Wrier After
Monitoring? Dire:
w••w• Y
Jame. F. Slauma• � yqf
*11411 ,a"!
®®mmm
W44900r- %s
r�A��VNE".v a
PERCOLATION RATE (minuteain�cjh) PEERRC HOLE DIAMETER
TEST RUN BETWEEN cCi� FT AND • 7 /FT
CERTIFY THAT THIS TEST WAS PERFORMED IN
IN EFFECT ON THIS DATE. DATE �•i����in
RUC 16 98 03126P Denali General Contractor 19071 561-1843 P.1
�- DENALI
GENF1tALCONIRACTOILS
F.O. Box 111490 Telephone (907) $61-1540
Ancnorage. Alaska 99611 Fax (907) 501-1643
TO: On Site Services
Attn: Jeff
Fax: 343.4788
From: Chris Hamre
Pages: 1
Tel: 343.4744 Arte: August 17, 1998
Re: Installation of Septic System 0 Tract "B", Keno Hills Addition tR
O Urgent 0 For Review 0 Please Comment 0 Please Reply 0 Please Recycle
e Comments:
Jeff:
I have applied for a permit to install the above referenced system. This system is on my personal Property
for my Ilully and I have plannod to install the system myself.
I own the necessary equipment and have the expertise for the installation and have employed an engineer
who will supervise and document the I,mialtalion as required by ordinance.
If you have any questions, concems or require additional information please contact me.
• It you did n .t receive all pages, please call (907) 561-1340
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FORA SINGLE FAMILY DWELLING
Parcel I.D. ©7o- 17 / —45 H ^A # P4C204Q,-Z
Expiration Date:_ I —
GENERAL INFORMATION
Coat Sl e legal description K6 N0 q 1 LL 5- 7 r8 8
Location (site address or directions)
i.. __..:�...
Ct1} ntt Property owner(s) chis Ha 2 re Day phone
nire��n address 'O C ,OAA -
Lending
Lending agency Day prone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, HAA 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 ❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank ❑
Community On-site ❑
Public Sever ❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health .Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and!or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Appreva! are
valid for 90 days from the date of issue for properties served by a private or Class C we!] 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 we!ls or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work.
MunicipaPty or" Anchorage
<o,
sQ �-
Development Services Department
.•��<
Building Safety Division
On Water and Wastewater Program
;wu,a�' ''�"�•
-Site
,
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 9951M650
www.ci.anchorage.ak.us
(907)343-'904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FORA SINGLE FAMILY DWELLING
Parcel I.D. ©7o- 17 / —45 H ^A # P4C204Q,-Z
Expiration Date:_ I —
GENERAL INFORMATION
Coat Sl e legal description K6 N0 q 1 LL 5- 7 r8 8
Location (site address or directions)
i.. __..:�...
Ct1} ntt Property owner(s) chis Ha 2 re Day phone
nire��n address 'O C ,OAA -
Lending
Lending agency Day prone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, HAA 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 ❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank ❑
Community On-site ❑
Public Sever ❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health .Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and!or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Appreva! are
valid for 90 days from the date of issue for properties served by a private or Class C we!] 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 we!ls or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown belrnv, 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 cedes, ordinances,
and regulations in effect at the time of installation.
NameofFirm J�-)MCS-S `i zzes�dr'� f���5c Phone 4si—!57Z
Address Co -f-i0 Or'
Engineers Printed Name J=21-726ri a!f Date Ayr, % d
5. DSD SIGNATURE
Approved for --4— bedrooms.
Disapproved.
Conditional approval for
Additional Comments
bedrooms, with the following stipulations:
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: / Original Certificate Date: - %- O Z.
(R.. 0M)
Municipality of Anchorage
• Development Services Department
Building Safety Division
Onsite Water & Wastewater Program
4700 South Bragaw St
P.O. Box 196550 Anchorage, AK 99519.6650
www.ci.encharage.ek.us
(907) 3437904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: & CNO H I LLS ?w ? T R B Parcel ID: OZ,O— [ 71-153
A. WELL DATA 4
Well type J -9C I U134C If A, B, or C provide PWSID a _ Well Log (YIN) Y -
Date oomple 7 f Sanitary seal (YIN) Wires Property Pied (Y/N) _
Total depth Wsft. Cased to ZC_R. Casing height (above ground) n.
FROM WELL LOG AT INSPECTION
Date of testAuZ /3 10Z
Static water level !,� fL / ft
Well production g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform—0--colonies/1 00 mi. Nitrate FZQQ mgA. Other bacteria oolonies1100 ml.
Arsenic: _ mg.fl. Date of sample: T )3—O Z Collected by:
B. SEPTICIHOLDING TANK DATA
Tank V Tyq� g rial S'F = -7 Date Installed 4 Lj
Tank ; v 90 ' ,7 Number of Compartments c-. Cleanouts (YIN) Y
Foundation detinout (Y/N) Depression over tank (Y/N) Gln _High water alarm (Y/N) N
Date of pumping Lb i Pumper _ Q d G ��,�id �PTdn26)�
C. A,�RPTION FIELD DATA
Date installed _?9� Soil rating (g.p.d./A= or ft'/bdrm) System type 1304
Length) ft. Width i ft. Gravel below pipe CJ- S ft.
Total depth ftEft. absorption area(Z o Monitoring tube _j_ Depression over field A)
Date of adequacy test — 3 —© Z Results (Pass/Fail) For bedrooms
Fluid depth in absorption field before test e0D in. Water added j"O al. New depth ©in.
Elapsed Time: _min. Final fluid depth _ in. Absorption rate >= 01-5 g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) �% 0 If yes, give date
D. LIFT STATION
Date install _ Size in gallons
'Pump on" level at in.
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lOslatlem on lot 1 rC
Absorption field on lot
Public sewer main /ylA
Sewer /septic service fne> I ®O +N,
Manhole/Aceess (Y/N)
water alarm
Meets alarm &
at in.
On adjacent lots / ns� /
On adjacent lots � 00 /
Public sewer manhole/cleanout
Holding tank A/ / t
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
1
Building foundation --I-Y—, _ Property line Absorption field 7 5 ' Z
Water main
Wells on adjacent lots > I co
Water service line >4 3 Surfacewater I/O (j P
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO -
Property
6 C(oc,C
Property line 14-01 l Building foundation r.J. z Wateir main
Water Serviceline %O / Surface water Vato C/!B Drivewsy. parking/vehide storage %u '
Curtain drain NOAH K(U1n Wells on adjacent lots I Q'r)
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
• s+ `1
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name J,2 /?%(f'- S12
F s r ��%�� , ° t •r•
Date A,`1 17 ©�;''�..�...»...• �•
�� ,:yfv ss+t``►tas�
HAA Fee E 6-75. o o Waiver Fee $
Date of Payment V-7 2/6 2 Date of Payment
Receipt Number ?moi Receipt Number
(Rev. 12101)
AUG -16-02 10:IIAM FROM -MEC ENUIRONI,ENTAL SRU
Lt�CUE Environmental Services Inc.
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CUE ReLN
1025202001
Client Name
James Sizemore & Associates
Project 11ameM
Keno Hills #7 TRB
Client Sample ID
Kenn Hills t/7 TRB
Matrix
Drinking Water
Ordered By
P%%'SID
0
Sample Rematkt
90?5615301 T-833 P.02/03 F-162
All Dates/Tlmes are Alaska Standard Time
Printed Daa!Tlme 08/1612002 8:48
Collected Date/Time f R/13/2002 11:50
RecetsedDate/fime 08/13/2002 13:30
Technical Director Stephen C. Ede
Released By-ws+'Y�F'
Allowable
- Prep Malysis
Results p L Units Anhal Limits Date
Date Init
Waters Department
0.359 0.200 mg,L EPA 300.6 (<=10) 08/13/02 JDT
Microbiology :.: �rntory
Tnial Coliform
IOn, NoColi co!/100ml. SM18922213 (c-1) 08%13102 SDH
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