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HomeMy WebLinkAboutT15N R1W SEC 9 LT 92T15N/ Rlwf Section 9 Lot 92 #051-104-42 Development Services Department Building Safety Division 6 E 8 On -Site Water & Wastewater Program o 4700 Elmore Road P.O. Box 196650 a c Mark Begich Anchorage, AK 99507 s AE T Y Mayor www.muni.org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: osl - WL1 `/a Legal Description 715iV R 10 Pump Installation Date: See, 9 L %9 Pump Intake Depth Below Top of Well Casing: 3nfeet Pump Manufacturer's Name: A,7e4.7a-c.L -t— Pump Model: $sz Pump Size r hp Pitless Adapter Burial Depth: I feet Property Owngr Name & Address: Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: Well Disinfected Upon Completion? . Yes ❑ No Method of DisinfectioAf C Comments: Pump Installer Name: +i"° ANCHORAGE WELL & PUMP SERV. 330 EAST 76TH AVENUE ANCHORAGE, AK 99518 PHONE: 907-243-0740 AWPS.COM Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. \\ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 1 ENVIRONMENTAL ENGINEERING DIVISION 825 L Street • Anchorage, Alaska 99501 Telephone 264-0720 \ - ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME —J -- Q. sm 7--('P-t4 PHONE ONEW 24VPdRADE MAILING ADD ESS 3 LEGAL DESCRIPTION 63 Fz I W S LOCATION ^ r 1l u5 NO. BEDROOMS _7 uY DISTANCE TO: Well O f' re Absorption 7-61 � Dwelling r �-� PERMIT NO 78OR00 E Q W Manufacturer / G-ev Q l/ Material No. of compartments d a Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth �10 DISTANCE T Well Dwelling PERMIT NO. S=f Manufacturer Materia Liquid caps O W = DISTANCE T0: Well I QO * Foundation Nearest lot line LF �` Of PERMIT NO.�t [ 0 U LL = F C6 No. of lines J Length of each line Total length of line Trench widt inches Distance be n 1' ss p <F.. o Top of tile to finish grade Material beneath lila (YYincnes Total effecti eb oration area �Fo�'O W t7 Length Width Depth PERMIT NO. Q iL as. Type of «ib Crib diameter Crib dept Total eflecti m i area W DISTANCE W Building fou anon rest lot line J J Clas Depth Driller Distance to lot line PERMIT NO. WBuilding foundation DISTANCETO: Sewer line Septic tank Absorption area(s) OTHER Q PIPE MATERIALS ltfG SOIL TEST RAN P5 r INSTALLER ^ W ✓w REMARKS 14 Jac, 10 APPROVED DATE LEGAL 72-0134hev. 1, 8) V •° MU" I C I PnL I TY OF= n"C1 HOFZnC3E DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET. 2ANCHORAGE, AK. 99501-4720 O" -SITE SEWER PEFZM I T jy��,(� PERMIT NO. C 780900 ) -- 'APPLICANT FRED SMITH BOX 1053 694 2677 :LOCATION WHITE BIRCH RD (LEGAL LOT 92 T15N R1W S 9 LOT SIZE 100000 SQUARE FEET ,TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH ,MRXIMUM NUMBER OF BEDROOMS 3 SOIL RATING CSO FT/BR)= 85 'THE REQUIRED SIZE OF THE SOIL ABSORPTI04 EM IS: E7EPTH= 20 LERIGTH= C3FZnvi=EL THE LE14GTH DIMENSION IS THE LENGTH (IN 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 ON FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). - FZE:MU I REE} SEPTI 0 -rnNK S I ZE= 1000 GF9ILILOMS 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. . --- TWO <2> I MSPECT I OtVS ARE MFMQU I REO --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELD OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I T EXP I RES E>ECEMOER 3:1_. 15?B '1 CERTIFY THAT 1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. -- 2: 1 WILL INSTALL THE SYSTEM IN 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 RPPLI ISSUED BYLL�L.ZA. _ Z _------DATE=1__��11 V3.2 ��A1�C�1-1���]A ='i C7 YT I J1=1`'� T J 11.'1! tt•y ! 110IT33TOOl .IrtTII7"lA0glVW1 411A HTJA3Fl 90 T113:•M1rYlD--.1: _ tO�E^_ .NA .30A'a0H�1?.l .T339T2 `_1` i''^ I . � "f' T 11513�1 :-1231423c 7T I z�—tlo ( 06$'M) ) .011 1111:n39 £,fOl X03 HTIM2 i73a9 Tl1t;:3IJg3*l' (71 HNIS 3TIH41 MIJITAOOJ' T33-1 3`3G1_Ip-:f f10,:�rJ9t 3=I2 TOJ (? 2 1.119 MUT cp TOJ JA03J. 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SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST PERCOCATION i� • Pouch 6650, Anchospe, Alaska 8%02 276-2221 SOILS LOG — PERCOLATION TEST PERFORMED FOR:F4lg1 r.M •+!s A.Y 12111, &A Liver AA, 25.77 DATE PERFORMED: LEGAL DESCRIPTION: r• ••- Fob q2 Ser. W. _I`l-an! i�.AA . CAO;.kt Ak. oR6ANlc /`1A7ERIAL 0'0 SLO _7 SITE PLA 0,S 1 7% SILTY SAN► v/ PME G -RAVEL l6ei) °•: e' 6n..A, Sl:�k+ly Pte;s+r 2 2.a 3 5� a 4 a° _ 0o Q • v. 6 .ai. 7 • p.Q SAs� VRAVEt •-/ 7RAcE srcT /� cex-- lS7• C' les 10 Oa 12 d4! 13 i 40°0 14 m� 15- 516171819 mmmmmm 16- 17- 18- 19 20 mmmmmmmmm mmm m� mmmmmmm mmmmmm A �wr 7o sc, se WAS GROUNDWATER S s ENCOUNTERED? Ne L, OI Pr— IF YES, AT WHAT E 7 . - DEPTH? �e.).l Pea•? h l al. o ' Ne �Fe=tn `7faJnJ Fncevn')ut� . 'flay kc ies! dl/ �I I. -�-I -pi =®mmm mmm m� —___m_ PERCOLATION RATE TEST RUN BETWEEN -. /it (minutes/inch) FT AND FT PERFORMED BY: c /0/7. % CERTIFIED BY:` f P;y . �jysI DATE: 9 72008(7/76) /�� 6�� �� �� r �° � �� .P� � G w �4._,_ � ' � � �-� �� I O 1 � �<� - � �pob� c, ��,,i ��r August 4, 1978 Fred Smith Post Office Ragle River, r� nos 1053 Alaska 99577 Subject: T15N n147 Section 9 hot 92 The request for approval on the individual sewer and water facilities can not be approved for the following reasons: �1) The tank must be pumped for maintenance purposes and also to verify its size. It should be 1,000 gallon septic tank. (2) The standpipo to the seepage area needs to be located The seepage area :aunt be one-hundred(100) feat away from the well. If it is not a one-hundred(100) feet separation it will need to be relocated so that it iv. If it is Moved a per -nit must be obtained from this department. If the seepage area is one-hundred(100) feet away frog tha Quell a percolation test must be performed. (3) The sanitary seal on the wall needs to be tightened so that it ikewater tight. If there are any questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.E. Sanitarian rwP/1 j w Cc: Spokane Mortgage Co=pany 3201 C Street 99503 Page: 1 Document Name: untitled PARCEL: 051-104-42-000-01 CARD: 01 OF O1 RESIDENTIAL SINGLE FAMILY STATUS: RENUMBERED TO/FROM: 000-000-00-000-00 ---------------------------------------------------------------------------- CAMPBELL SHIRLEY A T15N R1W SEC 9 LT 92 PO BOX 670906 CHUGIAK AK 99567 0906 SITE 20420 WHITE BIRCH RD LOT SIZE: 108,900 ---DATE CHANGED--- ----DEED CHANGED ---- ZONE : R6 OWNER : 05/01/98 BOOK : 3235 PAGE: 07 TAX DIST: 022 ADDRESS: 05/01/98 DATE : 04/24/98 GRID 000000 HRA # 00-0000 PLAT : 00-0000 NOTES ----------------------------------ASSESSMENT HISTORY ------------------------ --- LAND-- --BUILDING- ---TOTAL--- FINAL VALUE 1998: 52,600 110,100 162,700 FINAL VALUE 1999: 52,600 104,200 156,800 --EXEMPTION-- FINAL VALUE 2000: 52,600 113,600 166,200 -----TYPE---- EXEMPT VALUE 2000: 0 0 0 STATE EXEMPT 2000: 0 -COMM COUNCIL FINAL VALUE 2000: 166,200 BIRCHWOOD Date: 5/2/ 0 Time: 09:20:35 AM age: 1 Document Name: untitled PARCEL: 051-104-42-000-01 RESIDENTIAL SINGLE FAMILY STYLE : TWO STORY STORY HT : 2.0 YEAR BUILT : 1969 REMODELED: AREA TOTAL ROOMS: 06 BEDROOMS : 03 FULL BATHS 2 HALF BTHS: 0 HEAT TYPE CENTRAL HEAT SYST: HOT WATER FP: STACKS 9 OPENINGS : EXTRA VALUE: EXTRA VAL: CONDO STYLE: CONDO FLR: GRADE : AVERAGE CST/DESGN: 05/02/0 EXTERIOR WALLS: WOOD EFFECTIVE YEAR: 1969 RECREATION RMS: 0 ADD'T FIXTURES: 0 FUEL HEAT TYPE: NATURAL G FREE STAND E -Z SET FIREPL: 1 CONDO COM PROP: CONDITION : FAIR BASEMENT 0 FIN/BSMT BASEMENT GAR: CAR TOTA 1ST FLOOR : 1,372 2ND FLOOR : 600 3RD FLOOR 0 AREA HALF FLOOR: 0 ATTIC AREA: 0 RECROOM AREA: 197 ------------------------------ADDITIONAL FEATURES --------------------------- BASEMENT: IST FLOOR: 2ND FLOOR: 3RD FLOOR: AREA COV'RD OPEN PORCH 9 Date: 5/2/ 0 Time: 09:21:17 AM a;3�vm :R FACILITIES )) days for Processing. 9. Township 15 North. Range I West, Seward Meridian iak, Alaska 99567 PHONE 694-2677 NUMBER ❑ One ❑ Four ❑ Other HONE 688-9094 SINGLE FAMILY 688-9094 ❑ MULTIPLE FAMILY PHONE 277-0543 7. WATER SUPPLY PHONE INDIVIDUAL' S. LEGAL DESCRIPTION r Government STREET LOCATION NHN Lot 92. Section White Birch Road, Chu 9. Township 15 North. Range I West, Seward Meridian iak, Alaska 99567 6 TYPE OF RESIDENCE NUMBER ❑ One ❑ Four ❑ Other ® SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY ® Three ❑ Six 7. WATER SUPPLY © INDIVIDUAL' ' ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since Jute 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM "If individual/on-site, installation date unkown oldeSr than 2 ® INDIVIOUALlON-SITE" give If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-01013/781 1 ^ too, cLk-- 7 l ✓rs. THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY C? MOLTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3 SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑ Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES--714=SaPti� WELL TO: Holding Tank Absorption Area r Lineof rta Absorption Area to nearest Lot Line 5. COMMENTS ^ c ^ APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ZI � DISAPPROVED DATE ` r^ 8- l'1- 1 �� BY (Titiel / r2_C, ,441 i' t "' LEGAL DESCRIPTION 72010 (Rev. 3/78) Municipality of Anchorage e .r 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. nSl— 1014 142 HAA# 11#P305 -77 - Expiration Date:? %f og 1. GENERAL INFORMATION Complete legal description Lot 92, Sec. 9, R1 W, T15N Location (site address or directions) 20420 White Birch, Chuglak, AK Current Property owner(s) Philip Bordelon Day phone 688-5442 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address P.O. Box 670352, Chugiak, AK 99567 Unless otherwise requested, HAA 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 ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑✓ Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify 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 Douglas T. Kenley Phone (907) 746-1073 Address 9960 E. Puffin Dr., Palmer, AK 99645 Engineer's Printed Name Douglas T. Kenley Date it, 11.03 OF 5. DSD SIGNATURE 0• • i `t •j'r" ;4!:8'- DOU947�5 T. KI Approved for -3 bedrooms. 1j` ".' CE 6176 Disapproved. (, •.. ,•.� Conditional approval for bedrooms, with the following stipul�aili7rx�t` HAA Checklist X Maintenance Agreements Septic System Advisory Well Flow Advisory Supplemental Engineer's Report Other_ By: Original Certificate Date:A4114j Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 108650 Anchorage, AK 99519-6650 www.muN.org/onsdo (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 92, Sec. 9, RI W, T15N Parcel A. WELL DATA Well type a"40 K A, B, or C provide PWSID # Date completed 190 Sanitary seal (YIN) Y Total depth 326.5 ft. Cased to 40' ft. FROM WELL LOG Date of test Static water level ft. We"F "droll 9 - p.m - WATER SAMPLE RESULTS: Coliform 0 cobnies/l00 ml. Nitrate 0.616 ng.fl. Arsenic: WA mg.li. Date of sample: B. SEPTICIHOLDING TANK DATA Tank Type/Material SePtIdSteeI Tank size 10W gal. Number of Compartments 2 Well Log (YIN) N (see comments) f Wires property protected (YIN) Y Casing height (above ground) 12 in. AT INSPECTION 11/12/03 121.1 ft. See ooh g.p.m. Jr f< Other bacteria 0 colonies/100 ml. Collected by: Fred W. Kenlev Date installed 10/06/03 Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) WA Date of pumping 11/04/03 pumper Sanitary Pumpers C. ABSORPTION FIELD DATA Date installed 10=98 Length 40 ft. Sail rating (g.p.d./fe or fe/bdnn) 85 Sim type trench Width 3 ft. Gravel below pipe 4 ft. Total depth B.5 ft. Eff. absorption area 680 flr Monitoring tube Y Depression over field N Date of adequacy test 11112JO3 Results (Pass/Fail) Pam For 3 bedrooms Fluid depth in absorption field before test 34 in. Water added535 gal. New depth41=54 in. Elapsed Time: 109 min. Final fluid depth 44 in. Any rejuvenation treatment (past 12 mo.) (YIN & type) Absorption rate >= 450 g.p.d. N If yes, give date D. LIFT STATION Date installed 'Pump on' level at _ in. Size in gallons 'Pump off' leve Cycles tested. Manhole/Access(Y/N) at in. Meeh atemi 8 circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAtft station on lot °""""°"s° '•' "' On adjacent lots 100+' Absorption field on lot 100+' On adjacent lots 100+1 Public sewer main N/A Public sewer manhole/deanout WA Sewer /septic service line .`+' Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 50+' Property line 50f Absorption field 10+' Water main N/A Water service line 25+' Surface water 100+' Wells on adjacent lots 100✓ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 60+' Building foundation BD+' Water main N/A Water Service line 25+' Surface water 100+' Driveway, parking/vehicle storage 60f Curtain "in N� known to wdm Wells on adjacent lots 100+' f !F i�..L rate iia,c a,. /L'o/� 4.•G. �µl�Ls+y td•s.e� -Fo a -L L/ • „G.e.�! r/t�i fwcL` I.�:l �r,.w�• i�✓rcr tNr�.l �� , F. COMM NTS G (alt v n ?raw+�j EwP- t« CF</cLCC(.- 5'S'rLvfla L✓1 z it<caw r�� t r !ft u u! C-� Lcyf.t t-t..cil4J Cr �2.Sg c•L. .w 8? 7+'4+v<- , . �'LGeox A1-4 icy / 7-p. r7. A The weft was fractured twice find the depth of well information came*om one ofkteg5had. G. ENGINEER'S CERTIFICATION - - I I cernry that l have determined through geld inspections and -WP tN review of Munkost records that the above systems are in conformance with MOA HAA guidelines in effect on this date. �� t Engineer's Printed Name Douglas T. Kenley 1(1 Date CE 8176 HAA Fee $ Hi/o-`IO / Date of Payment Receipt Number TTT (Rev. 12/01) Waiver Fee $ _ Date of Payment Receipt Number ent By: RE/RAX OF EAGLE RIVER, INC.; 8078980214; Atay-28.00 1:08PM; Page 1/1 —� f N.'i's I �r= .rp � .,Pow � •UriL�fY �rrra�ur .SBUILT SEHARD &ASSOCIATES LAND SURVEYING 6 HEREBY CERTIFY,THAT I HAVE SURVEYED THE SCAL�,�.t�� 1l -LOWING DESCRIBED PROPERTY, DATE OF At l � ID THAT NO ENCROACHMENTS EXIST EXCEPT AS40 IDICATED. IT 13 THE R43PONSIBILITY OF THE t�Y�po y,`P,. S YNER TO DETERMINE THE: EXISTENCE OF ANY1M +� ORIDi LSEMENTS, COVENANTSOR RESTRICTIONS iYt'✓�s� • i VCH DO NOT APPEAR ON THE RECORDED SUBDI- SION PLAT. UNDER NOIRCUMSTANCES 3HOULD FB+ �� �, .'° �,-'0918 .ld i IY DATA HEREON BE USED FOR CONSTRUCTION ori �L!FENCE LINES, OR FOR ESTABLISHING BOUND- ORAWNI NES... A— -- —.. _'`* ;..,•' o..rr DM4r Fax Note 7071 o.r 6 �� 11-1a-03: 5:IaPM; let t PAIS Thank YOU :607 5415301 0 3/ 3 7 7 y - ,200 W. Potter Drive Drinking Water: Analysis Report for Total Coliform Bacteria Anchor eAK 39318-1605 READ INSTRUCTIONS ONILEyERSE SIDE BEFORE COLLECTINGS oPLE OMPLFTE BY 6LABORATORY IYl V J � ✓r �"' OPUBLIC WATER SYSTEDII.D.11 ■ PRIVATE WATER SYSTEM - p Se�nld Rewla 1] Sendla"Ics . yitlGL�4 '� . 72 43 - ewe um rr ;/G Dr - q; su Ak-' 99so z fJnc�wv O Send Result 13 Send lnroree w, • / / O ✓ SAMPLE DATE- Month Day Year SAMPLE TYPE: ® Routine t3 Repeat Sample(for routine sarnple with lab ref - no. O Special Purpose SAMPLE LOCATION Comments: D Treated Water q Untreated Water Time Collected Collected By 3 Ss�H Fred jLem rwe hw Analysis shows this Water SAMPLE to be: - it Satisfactory c Unsatisfactory O Sample over 30 hours old,.rrselts may be unreliable O Sample too long in transit; sample should not be oveT3lVhours old at examination to indicate reliable results. please send new sample via spe6al delivery mai Date Received Time Received . _1az—e Analysts Began LLEL Analytical Method: 0 'tl�M Muo "eW ml. 1037448 Y Result* w Analyst Anch Puke .tun 0 Fazed Date. Time: :Client notified of unsatisfactory results:, onaz Phoned Spoke with Fazed Date. Time: BACTERIOLOGICAL WATER ANALYSIS RECORD?d E Coli MMO-b1UGResult: Total Coliform ��r E3 J1go j oly Colonleslt00 j Membrane Filter: DilectCount rffc•roea'u.e.ewrroc"wr AGB _COLIFIRM verification- LTII _r�� OB -aweds"wis Fecal Coliform Confirinatlon ' i. � COL.�'0 ryy _ Col{fornv'100 ml Final Membrane Filter Results 1� 1 Date �l=s— Time -421, bra 1 Reported By , CT&E Environmental $r:rv;c:z Inc-, Po11MDrhe.An&xxaW'AK99516-1605 IM071562.2343 t100T1561-5301 wvr.lerole sss o1.vr noaw si.uw e. fvlwimed 11-19-03: 5:18PM: J SGS Ref.# 1037448001 Client Name Douglas Kenley P.E. Project Namel# L 92, Sec 9 RI W Tract 1 SN 9, RIW Tract 15N Client Sample ID L 92, Sec Matrix Drinking Water PWSID 0 Sample Remarks: :807 5815301 • 2/ 3 All Dates/rimes are Alaska Standard Time Printed DateMme 11/18/2003 10:57 Collected Datelrime 11/13/2003 15:52 Received Datdrime 11/14/2003 10:00 Technical Director t;epheo, Ede Release y Allowable Prep Analysis Ind Parameter Results PQL Units Method Container ID (mitt Daze Date i Waters Department Nitratc,N 0.616 Microbiology Laboratory Total Coliform 0 0.100 mg/L EPA 300.0 B (<=10) 11/14/03 )JB coV100mL SM1892228 A (<-)) 11/14103 BAG 11/11/2003 16:55 _ 3183865916 _ PMT. BORDELON Fu.n,P )Ftplacemen�T Philip Bordelon, P.O. Box 670352, Chugiak, Ak. 99567 Water Well at Philip Bordelon'a home, Chugiak Ak. New Pump installed June 19, 2000. Well depth: 326 ft., 6 in. below top of casing. Top of casing to bottom of pitleas adapter approx. 6 ft., 6 in. Distance from bottom of pitleas adapter to bottom of well: 320 ft. Statiater well)c(72 ft. 6/17/00. o well)a253yftp 11 in below top -of water moving pump casing. Static water level, 6/19/00, (Approx. 126 ft. above bottom of well) Approx. 200 ft. 6 in. below top of casing. New Pump is GPM, Patriot model, 5 gpm•, 3/4 hp, ie stage, 1 -ph., 230 V., 2 wire motor. Power is supplied by 12/2 w/gnd. twisted pump wire with pvc. insulation. A 1/4" o.d. polyethylene tube was installed, from the pthe outlet. toe tie top of the well casing, for the purpose of determining the well from the top of the whichell. The end of the b is the pump outlet. Thet be e taped to the hex portion of the pump, a also taped to the drop pipe, along with the pump wire. Approx. length of water pump, with check valve is approx. 3 ft., 3 1/2w ith n. Pump is suspended from 313 ft. of new, domestic, 1" galvanized pipe, 150 lb. galvanized malleable iron couplings, and 2 check valves, in addition to the check valve at the pump. (The bottom of the pimp is approx. 3 ft. above the bottom of the well.) The additional check valves were installed on the first and second sections of pipe. A torque snubber was installed immediately above the pump to resist the starting torque of the pump, as well as center the pump in the well. Cable guides were installed on the second as well as every other piece of pipe. Pump motor resistance readings: Motor Leads Only: B -B 3.3 ohms B -G O.L. (so high that the Fluke model 26 multimeter couldn't read it.) B -G O.L. Motor Leads Plus 1,000 ft. of #12/2 copper wire: B -B 6.4 ohms F -G O.L. (so high that the Fluke model 26 multimeter couldn't read it.) B -G O.L. Motor Leads Plus 325 ft. of 012/2 copper wire: B -B 4.1 ohms B -G O.L. (so high that the Fluke model 26 multimeter couldn't read it.) P -G O.L. Amperage reading in red line, 8.6 amps. Started pumping at 10:15 pm. The pumping rate was 5 gal. in 52 sec., or 5.8 gal./min. Well was empty at 10:40 p.m. 11/11/2003 16:55 3183865916 PMT BORDELON PAGE 02 Water Well at Philip Bordelon's home, 20420 White Birch (Off North Birchwood Loop) Chugiak Ak. Well depth: 326 ft., 6 in. below top of casing. Top of casing to bottom of pitless adapter approx. 6 ft., 6 in. Distance from bottom of pitless adapter to bottom of well, approx 320 ft - Static water t.Staticater -level, It. below of 60, (immediately after removing old pump frog ap Static water level, 6 /,) 19/00; Approx200 ft. below top of casing. n Recovery rate of the well was found to be approx. 3 gallons per hour. An attempt was made to develop the well with water pressure on 7/13/00. Water was pumped into the well at pressures of up to 160 lbs. for approx. 2 hours. (Pumped at approx. 110 lbs. most of the time, with pressure increased to 160 lbs. for approx. 10 min.) After the well was filled to the top of the casing, the well accepted very little additional water, wit) pressures up to 160 lbs. After this attempt was made, the recovery rate of the well remained a- approx. 3 gallons per hour. After pumping water out of the well, with the water level approx. 111 ft above the pump outlet, or approx. ll7 t. above water could behheard trunning intoom of the pth- (Approx. 209 ft. below top ll of casing) ose sl well. As the there water is vel smail amount f esound disappeared. 1 appear: waterseepinginto the wel as approximately 209 feet below the top of the casing. MUNICIPALITY OF ANCHORAGE O DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services us On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLINGF� Parcel I.D. # t���' �d —�. HAA # Orma H 1. GENERAL INFORMATION Complete legal description ��� y,Z SEc.9, .Qin/ Location (site address or directions) 2o�z0 uJN�Ya rte. icy eo, e,. Pan% i9� qs 1C.o 99.4 6 7 Propertyowner SN/¢L6�/L/A�/fQG=LL Dayphone Ze&­909;�l Mailing address ✓�4i�d A -s 9�0�� Lending agency Mailing address Agent Address _ Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72 -=(PW A/91) Fm MOAC21 5. STATEMENT OF INSPECTION BY. ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of.this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I f urther 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 wastewaterd)sposal system )s in compliance with all Municipal and State codes, ordinances; and regulations in effect on the date of this inspection.. Name of Firm l��ui, Few�r �," P. Phone �9°�, �`i "-1a 7(v " Address qql o. F—taffil, S �> •ZS.00 Engineers signature Date - .OF.•q/ �.'•9� CO.*'r'H tl 9 DOUG KENLEY' 6. DHHS SIGNATURE" �t� CE 8176 Approved for - bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By, Date.- 31 • The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. rasa P. IM) Z. Mw m . r RECEIVED Municipality of Anchorage aW DEPARTMENT OF HEALTH & HUMAN SERVICES�Y 26 Environmental Services Division "AttCwAUTYC* (jlp f 825 L Street, Room 502 • Anchorage, Alaska 99501 • (��9'}'�3�a�Itacrs DMsr Health Authority Approval Checklist Legal Description: _L�r 9Z, ✓r�G, 9'iu' TistJ Parcel A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Ale Date completed 9 6 9 Total depth Cased to Casing height (above ground) /Z Sanitary seal (Y/N) Y FROM WELL LOO Date of test Static water level a Well production -9-P-m- WATEA SAMPLE RESULTS: a _.i•w Nitrate 0.6 Wires properly protected (YM) % AT INSPECTION /Jra,t .^y zcao g.p.m. .560 s 7:4.j-t'- If .o.a.0 Other bacteria -p- Date of sample: vO 1 °CO Collected by: Fr�y tCJ n l/�y B. SEPTIC HOLDING TANK DATA Date installed 1 lel7g Tank size /°'od Number of Compartments .Z Cleanouts (YM) Y Foundation cleanout (YM) Y Depression (YM) Al High water alarm (YM) AZ41 Date of Pumping -^� y^9, Y`00 Purr Sa.u, r -.v tY P.•r�v�¢S C. ABSORPTION FIELD DATA �i�arao`O �//7B Date installed Soil rating (g.p.d./Itr or ft'/bdrm) 95- System type �t`.J'fA/ Length ya�Width 9 " Gravel thickness below pipe </B „ Total depth G ' 6 " Effective absorption area 66b/"/7' Monitoring Tube present (Y/N) Y Depression over field (YM) Al Date of adequacy test /� 9/co Results (Pass/Fail) e-Qss For bedrooms Fluid depth in absorption field before test (in.); G Immediately atter ye9ga1. water added (in.): Fluid depth -2G 14J (ins) Minutes later. Zy^'^j Absorption rate = -3W a.p.d. Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)' N If yes, give date D. UFT STATION Date installed Size in gallons Manhole/Access (YM) "Pump on" level at' "fartip oir level at' High water alar level at' ------ /QDatum Gycftsted E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: SepticJholding tank on lot On adjacent lots /0, 0 `el Absorption field on lot I e o ~ On adjacent lots i © o 7�47-/ Public sewer main t%y Public sewer manhole/cleanout A)IIV Sewer/septic service line ZS'� Lift station ��r? SEPARATION DISTANCES FROM SEPTICMOLDING TANK ON LOT TO: Foundation �E iFf Property line -f-,O `Ff" Absorption field Water mainiservice line Zit �� Surface wateddrainage /.Va'`F Wells on adjacent lots /00 /F>` SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property Ane ✓r© `�f Building foundation 6P Water main/service line Zs'« Surface water /o Driveway, parking/vehicle, storage area 6 e, 4Fel Curtain drain✓O�� ��� ra e xisr' Wells on adjacent lots /C Z, F� F. ENGINEER'S CERTIFICATION 'OLs 0F..4 .,. I certify that I have determined Mru field inspections and review of Municipalrec9f fhe a am in conformance with MO HAA guidelines in effect on this date. g: Signature 0.. `• %••� Engineer's Name Date 2S oo `i=,; CEti176 .: HAA Fee $ �✓ ' C� Waiver Fee $ 2- , /-)-Z) Data of Payment �� /07) Date of Payment Receipt Number 4 % 6, % (-7-9S- Receipt Number 72-026 (Rev. 3/96)' MUNICIPALITY OF ANCHORAGE M E M O R A N D U M WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO.114000214 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Lot 92 Block — of 715N 61W SEC y Subdivision, the well's productivity was determined to be 0.2 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 bedroom residence is .31 gallons per minute. All parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. .�� Aft iicipality of Anchorage Department of Health and Human Services 825'L" Street R,ck Mysrrom. P.O. Box 196650 Anchorage. Alaska 99519-6650 Mayor hlip://www CLanchorage.ak.u5 May 31, 2000 Doug Kenley, PE 9960 East Puffin Dr. Palmer, AK 99645 Subject: Waiver Request for T15N, RIV, Section 9, Lot 92 Waiver Request #VrR000031 Parcel ID #051-104-42 HA000214 Dear Mr. Kenley: Your request for a waiver of the required 100 feet horizontal separation from the septic tank to private well has been approved. The approved separation distance is 93.0 feet. This waiver approval applies to the existing septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. %Sinc�erel�y,� `/ u"'r'J 9 -/ Daniel J. Roth Civil Engineer On -Site Water Quality Program MUNICIPALITY OF ANCHORAGE Department of Health & Human Services Onsite Services Waiver Review Worksheet WRM WR000031 PID#: 051.10442 HAM HA000214 Date Received: May 26, 2000 Legal Description: T15N, R1 W, Section 9, Lot 92 Engineer. Doug Kenley, PE 9960 E. Puffin Dr., Palmer, AK 99645 Applicant: Shirley Campbell .......... Waiver Requested: 93 foot waiver from the well to the septic tank Criteria: 1. Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation 2. Special Conditions: 3. Other. Points: Total: Permit#: .......... Waiver Is Granted: x Waiver is not Granted: List Conditions or Reasons for above: SFE /117-fieHF D Date: 3'-31-00 By: PWA Name of Reviewer .......... Rec#: 06767 Amount $625.00 Date Paid: 05125/00 .. . -MV vvv LA RI✓ER REi�►c ESr FOR rlf-* R/ W XEC. 9 L Or 71 ,LIVER. Rr-i?'u Esr NUPfFER WR 00009/ Aiv,6/q J?EQuEsr FOR o.✓ LOT writ TO SEPT/t lf1A'/f of ' *Pef SEpric HWOKY— TKF 36PTiL rysrL<M L•wJ kP BRAD6P /w 1978 AAID rys fF/TIC rAN/'r w, LOr/ar60 0" -FEET rjtoM 7 -HI W)frEK ►reLt DOA.N fLOPE 7-1(E moose is tOCort<D OTwv rKK t.ELL 1 JEPric rAv/+, I..ITMALL rlYl! /� tiNtIO6RMnv.v n+t K£ /f A+0 4V* --CE Of su,ePAe-E CowM,"1. 7140'' f 6lrlc T'**vN / s Du,fRI4'P Pgr"V' "O -CA -7L Y /� T,� uCY 617w✓tY r. Sp -4x SILT. rH.11 IS rrPICAILr VER1' COVPMCIVt TO TR,s ATK+FAIT c SEPTIC rAvf-K EFFLWENT. W SLL DI►r14 -. 7-l?6lf6 If ,vOrA WELL LOk FOR TI+E IWMIT61Q µ.71-M," 4w6fTrei✓ 'rKFRi .Arte I drw6✓ER vu,w 6,20»f 4-6L L L I%Gl FOR 7/YE t hfROu t D/n,�, ofRs/9. BtsdQOCK /.1 A VARt.af OEPTNJ /A' 7f+C aict 4.06J wIru, rms fHALLOp.itr ROPOgrJ kt/.Ip,#O/E.vr FRpK Till LOr /U ie stne A -,vs TKE p6EPEsr /JEDRpc/f REPORTED O,#wv b,R►lv leA.r, MIS ll!0kA V rke SLOPE OF j74E IVPJPOCR >3S% orep" rsp Foor r/ -+,t Cslem'&V fK,IQFACE, HOOT W I`LL LOA,,$ D6SCKiOE TKE DEP ROCAC Af rOLl/7 lr, NO !'RACrtjeef kA'r/L P&E#o Pgoryr x170' *0 tv,+r&lz arrttA/f! TO R".v +CCITO" 7,mv rive OF rKs 00A.COe/a gr rr*r/c *407w -/e 4VA'EL ARE APPROxf,"A rte 100 FeeEr fY,VP /w Ptorr eoref aesIoe,0 774.4 1 rug LEVEL /lEO.CccQ ►+�T ,tA/C0lt�TE,PEi7 7YAIcwL4Y /.v Aa04ocl WexLs IF #j0OnT/vV OF rkE ►.»rcrt CoM6s F)eO+H rl+E SOIL NCVWOclj /NlEp1<ACE: 7 -UE: rkar t rr4rlc r.,►4TER L r✓et .945-0 uE5- ATrTNCc' r,*V77W vF PAPROcr. wp-r�12 sAv►s,�LEt !ted/c�rE ArO DA-G%E,PIA PREfE�T A�lra/�res Ort .617 o•j // . 7-"jr /t ,7p*rr Rg)ppwl, /J I'RAcrcALLr �vti F.acl s 7'&,v7' Y2 - P. E. C. S. K W. !r. for C, V. MOIL seRermw_ WWW j- 000 � �oa n H H M HhH eRtt i�iT SAKE ,4t AOo✓F / (p. Ar ER TADL.F 6/P,o 3.f % f . eR�Zov7AL SE/AFaT�o�v l 20 2.8 (rRpao 7-07NL /4.8 C0IV 14-:110 CA00 /94 MAI CIE CKM.FA, ! /{IP! EX/lTEtD Jia[E �y7B fOK 22 r Yf �. mr R J/lhoLE1 ��� Ex GE/TiowAL GA'1gs�r w�i✓ER, Douglas T. KenleX, PE 9960 E Puffin Dr., Palmer, Alaska 99645 (907) 746.1076 May 25, 2000 Mr. Dan Roth Municipality of Anchorage Health R Human Resources On-site Services Re: Waiver on separation distance from well to septic tank. On Lot 92, Section 9, R1 W, T15N 20420 White Birch Road, Chugiak, Alaska 99567 Owner: Shirley Campbell Dear Mr. Roth On behalf of Mrs. Shirley Campbell, we are sibmitting information necessary for your determination of a waiver of separation distance, well to septic tank, to 93 feet for the above -referenced lot. The septic system was upgraded in 1978 and the tank was listed as being 100 feet from the well, but in actual measurement, it is approximately 93 feet. An accurate measurement is difficult to obtain since the ground level at the septic tank is approximately 20 feet lower in elevation than the ground level at the well, down a wooded hillside with a slope of approximately 35 degrees. No well log is available. During testing of the septic system and well, it was determined that the static water level was 121 feet, and during the test, the pump started taking on air when the water level reached 261 feet. The residence had a 375 gallon water -holding tank, which has been replaced by K R L Plumbing with a 1,000 gallon water -holding tank. Attached is a site plan showing adjacent properties with approximate locations of wells and residences. Lots 80, 90, 92, and 110 had as-builts available. Other information was gathered by on-site observation and information that was available from the fact that they were adjacent to those lots with the as-builts. Also, property owners of Lots 89, 93, and 109 were contacted individually and information was obtained verbally. The area in question has numerous low -producing wells with bedrock present from anywhere from 8 feet to approximately 40 feet on most properties. The depth of the wells averaged over 200 feet deep. One was 505 feet deep. Lot 89 has two wells with one house on the lot. Lot 88 has two wells and two houses, which is evidently indicates the lot has been subdivided, but not officially platted. Lot 109 also has two wells and two houses. The slope of the area is downhill from the south to the north with contour lines running east and west. The difference in elevation from the highest point to the lowest is approximately 35 feet. If there are any questions, or if additional information is required, please feel free to contact me at 746- 1073 or 243-5372. EiI4- 8176. Encl.: IIAA certificate application; Adjacent properties site plan; Available well and soil logs Sent By: May -28.00 11:06AM; Page 2/2 May -28.00 11:18AM; Page 1/1 KENLEY CONSTRUCTION SERVICES; 907 248 5774; earl% ey: Mt/MAX OF LAOLE RIVER, INC.; 9076960214; i .so ' .Pow or cif/Lifr` .rO F -.... 3Jo � ASBUILT SEWIRD d ASSOCIATES LAND SURVEYING 694-0829 HEREBY CERTIFY. -THAT I HAVE SURVEYED THE SCALE, 'OLLOWING DESCRIBED PROPERTY ��'� ��• OF a,�� IND THAT NO FNCROA04MMTS EYtgT EXCECT AS DATEr NDICATED. IT 18..THE RESPONSIBILITY OF THE WNER TO DETERMINE THE EXISTENCE OF ANY BRIDr to �� r :/ISfiMENTS, COVENANTS, OR RESTRICTIONS i►+aii�,ry. � •. ...••• rHICH DO NOT APPEAR ON THE RECORDED BUBDI- r 'ISION PLAT. UNDER NO CIRCUMSTANCESIFd ♦ ow . w.� a -. r NY DATA HEREON BE USED *FOR CONSTRUCT BOON: ��s ♦i�,�'• is -6918 F FENCE LINES, OR FOR -ESTABLISHING BOUND -RT LINES. DRAWN � °'�isAxul� OI••i , 05-13-00 11:09 FROM -CTE ENVIRONIENTAL 5615301 AL ME Environmental Services Inc. ME Ref 10 1002046001 Client Name Douglas Kenley P.E. Project Namem Client Sample 10 N/A 1-92, Sec9, R1W, T15N Matrix Drinking Water Ordered By PWSID 0 T-035 P.02/03 F-195 Client POn Printed Date/Time 05/13/2000 10 50 Collected Dste/1'ime 05/092000 12:00 Received Datefrime 05/092000 16:15 Technical Director Stephen C. Ede Released By I I.....n. .. �- ''0 .loft Results POL Unita Metnoa 1.1a1 to Date Date Paranrccr WATERS 09PT 0.637 0.500 ra/L EPA 300.0 aitrate-M MICRO LAY 0 col/100nV. SM18 92228 Toral coltforn - PRELIMINARY - 10 awx 05/10/00 SCL 05/09/00 KAP 05-16-00 09:55 FROW-OTE ENVIROMENTAL AE 5615301 T-082 P.03/04 F-567 C7&E Environmental Services Inc• laborstory Division Irinking Water AllalysiS Report for Total Coliform Bacteria NREVERSESID oBEPOREROCLECTING S- REdD INSTRVCTIONSO-ro BE COMI PL An&,ysis shows this Water SAMPLE to be Sansfactory p Unsatisfactory O Sample over 30 hours old, resorts may be unreliable C, Sample too long in ttanstt: sample should not be over 48 hours old at examrnanon to indicate reliable rtsMlbt.Please send new sample via spa del very ?b W. Porter Drive hmada. AK 99518.1606 - :vtwt oma,,,,.... ---- O PUBLIC WATER SYSTEM I.D•lf epRIVATE WATER SYSTEM p Seat fntet o srelltt>.As am+. ., Ssea tesVke O Sryr/!areaes pcla �JC6xJc 4 C-4 1002045 Date Receival TlmeRecdved Aoalysls Began An&,ytJal Method, Membrane Filter O MM0,MUG • Namber of colonres/l00 m1. Result* Analyst Em ME SAMPLE DATE: g --'Yat Mouth Day SAMPLE TYPE' Routine a Repot Sample (for routine aampk viirh lab ret. D Special Nrpost SAMPLE LOCATION �L'lEItIQLOGICAL WATER ANALYSIS RECORD Comments: p - Treatbd Wa p Using w Water Time C.ollec" Collated By rw. rim r �® Time: � Client notified of ansatlsfalory results: 0 A�b Fblo Jue Furo Dec Time: � Client notified of ansatlsfalory results: Spoetrnrn Faaxe4 In"" Dace: Tune: MMO-MUG>eaalet TOW CWforfo Coleolesrl00 ted Membrane FUM' MS:tCon" COLIFfRA1�—� Veri0atlos: LTB ��--- 8C8 �~ Feral Coliform Confirmadoa e;VllforaUloo ml Fla&, Membrane Filter b Time bts Reported ley to IWC. r» n....w To c.-. oil OAff9W10W1 MOMW of the SGa Group lSoueA Generate a Surrenlenwr _ , ...... MISSOURI. NEW JER6EY. OrrIO• WEST VIRGINIA Tisa (;Ecq J V k, ltJBc � m C,,sH, rarer nviv, e,� . (�j i,vrrs.rsFv .osa ,;b.o�a�t r�war +b tieyc.� �ir.ss►�c fyts...-ras..►K., © itJ..•avrs o. tt` Swine '. Ne oa/wfyCrG � . �✓� lr Ago" A Ai6L ® BrFt�,C A 1 11 DATE LEGAL A PPOV D . IA/ L.tc b • f1241 !Rt OP ANCHORAGE • MUNICIPALITY HEALTH 0 ENVIRONMENTAL PROTECTION • '`� DEPARTMENT OF L DIVISION ENGINEERIN "'cPho 2" AT20 �• r L .%k- • • 119501 825 L St,stlaAncno .9.AA INSPECTION REPORT F ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL y, NEW " '• Ll:ppGRADE � NAML G - MAILING AD NESS I LEGAL OESCRIVT10n'-'-- V � J 3 LOCATION 7 - 1 it. a xn• y -i r « y[NMIf NO�pC�-COO r75'CFI 'iNO. W 1 Apdeuen � I OI tayMnrMm• DISTANCE 70: wl«W �J ,r[I - u M«,y1K1VIN /' �Z Gov o f Wbin n LPWq erol^ a MM IIM MP LIytMNtrlr nePlOM IF NOMEMAOC: t( .ERMIi NO. 1{{ L:aunlc aw DISTANCE TO. M««.N p><A Mwd KwrNN f Nr«IlolxM Z WI10•I,M ( ,• DISTANCE 70: I C TIeMn •Nel io1N INpm Of x ,r{tnN r L«yln al •«n xM r- No. elxMl ouI .11Ku K 0On«N F7� xn:N. r••1• MI • me m•lo c .n Wym ' L•MI^ .. TOIN MIKI• •V'' ' oeC••. a«Mln Gle erol ar lrw l toll rNUo1bM . W = W Eur«M Iw Iron - tEPM11 N0. w DISTANCE rtllN DnlMtt \o bl lrM D G Dro•n EtplN IM. AMNOUM tndN J r l Et«« IrM EWb:M IeIIMmM i DISTANCE TO: ' OTHER - A RIA EST AApNG Il 45 - { INSTALLERrI q 1 11 DATE LEGAL A PPOV D . IA/ L.tc b • f1241 !Rt Sent By: RE/MAX OF EAGLE RIVER, INC.; , O ' i I Bio in 9076960214; Mar -13-00 10:42AM; Page 1/1 • g; v 93 W o:e�s' �:^ tte'•a•ss'��� r��.a (e�cy • i M WVMAgIC 4i�S•> 'L I QO 1317 e7 ' r•_.a M e LOT CM I r J I�r � N alb d Z S-Z-ZNI Z• • Fp PA ' ; .1. LPr:L �s"r=N nl 91 • zo9Z • ""� f I?It 93 W o:e�s' �:^ ,mss' M WVMAgIC 4i�S•> 'L I QO 1317 e7 ' r•_.a M e � I� e vow g u,:^• 72 •66'F�"L>.e4 tit ,ASIS OF 6EA9_iKJe_qi Ito '30' ,Z1Ca'.T Ct WA`1 jUTIL1Tti . c:E2JAT as E 3��•%3 tzE:�� • L CGQI j D Z W1 G16-4 52A� CRP del to 19 -or t pipe_, RI<Cov'A. B Z-1)(44 Hub J TACL' (VdHr—M) 2ECDVtr2CD. ppr f�ANciL Matt;, 2Etove2ED. SURVEY CERTIFICATE I hereby certify thot I have surveyed the following described propertyc-,ova:zKjMEj- Lar qZ s_._ C1. r.1 -;n.1, rz.1 Vim, srn.._ni and that the improvements situated thereon ore within the property lines and do not overlap or encroach on the property lying odjwent thereto, that no improvements on the property lying odjocent thereto encroach on the premises in question and that there are no road- ways, transmission lines, or other visible easements on sold property except as indicated hereon. °NOT !:r 5 - R=G02t7 yJl=o2IV�ATIC)r.i TAr,: FCS M BLtA PLAT Or T. I's x.1,.2.1 Vi, Z. n:o 1_17eT r. -n S -_Ozj q. AS -BUILT SURVEY LJ'r 'c3Z. 15 vel , M.1 W, M. STAN SEARS 81 ASSOCIATES REGISTERED LAND SURVEYORS POST OFFICE BOX 283 EAGLE RIVER, ALASKA 995TT VM t� t e.1.71{, 0-1cY�' :v=$_% CheeMdcbc- D-a-t^ec Stanle E. Sears, R.L.S. I