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HomeMy WebLinkAboutTALUS WEST #1 BLK 6 LT 8rlawa Lj..�to� 'I 0 0\13 A.,JAJA Municipality of Anchorage Page of 2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION 70n-S�ite 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 astewaterDisposal System and/or Well Inspection Report, Permit Number:. _SW_9to333 PID Number:_ 015202 Name Wastewater System: ❑ New Ijd Upgrade Pao Y. PARK Address Rn -33 ABSORPTION FIELD 3231 SPEORD RD. Nchl 19503 Pnono Nii or 11i•dri""n' 532 3 L Deep I rench LI Shallow Trench U Bed U Mound U Other 562 - Sod flabrry Total Depth from Onguial grade. LEGAL DESCRIPTION GPD15i F1 Lot Block Subdivision ;)epin 10 pipe botlom from original grade Gravel depth beneath pipe Si L.' Td7 ut 1.vFGT 1 Ft FI Township' Range Section Fill added above original grade Gravel length. 12N 3W ZZ Ft Ft Gravel width Number of Imes 7otance Oerxeen hoes: WELL: ExISTI New ❑ UpgradeFt Classification (Private. A.B.C) Total Depth Cased To Total absorption area Pipe material: FI Ft SG FI Driller' Dale Dolled Slatrcwater le.0 Installer 1 nstalled.6�2319Z SrRAr,4 Co. FI Yield Pump Set al I Casing height Above Ground TANK GPM FI FI SEPARATION DISTANCES ❑septic 14Holding 0S.T.E.P. To Septic Abae,pl.on Lill HOldmg 'uhl1UP11vale Manufacturer- REEK capacity In gallons 40D0 From Tank Reid Stmion Tants Si'wnr Lines MalermL Number Of Compartments' Well 1$5 STEEL slifface LIFT STATION >too' Water Lot3or Site ni yalluns Mirllaauror m Line 'Pi1inP on Irvel at "Pump oil" level at High water alarm at: Foundation 1p' 'urnp Makes Model Electrical Inspections performed by Curtain I Remarks: 14olo(;Aq frtilkk fns10(1ed BENCH MARK et f rry vfeC aCt1 f y-. Ac,W Vof foj! cdcce's' Location and Description /n It tCX #At rcln kV-1rLl[Ac TOP OF DEce AT sovT No &feetrrc PtrMit ar fASpechrae re?mter-C, f+� d rg Fn a9 f Ql k t 11. Assumed Elevation: Ofd t A 114mofct. er'Whect add 100-D burted_ an till -C. 'Olet SepHe %UAK ill f••Gti" ro�AOC hole in -ENGINEER'S SEAL il,nfil Soil in ept ✓, on 4Ztr hoictlAg &4A Ir war i5teA �, ��+► �►\\1 5'rev Vitt. (.LSMAI-). a M • ,��` Oa F•A4 j( ,41 .! p � V•e���eeV ,'�j��� • TH •'•`v L TTOP TEC N_ I2 192 * •9— Inspections performed by: F1�__l'CS_ Dates: 1st1p�-- r..................r.�.g.,,.:... 2nd.. _ _ ...- — ..........l' E Department of Health and Human Services approval {4� cE-3539 Reviewed and approved by:/ - - --- Date: _ 7/�' g i R'it `.r-. -- ; +•�• 7201] IRev 9191) MOA 1b PermltNo. SW910333 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES . ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343=4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT S. BLK�, TALVS WEST 71 PIDNo.:OIS202LI# LOT $ $Lk (o N DECK =100' 3 NOW l r. ,7 6 1 WELL Q if Coo 6 -AL. U( 11.L0114- R1� 3 BPRM TANK , 8 KOVSE _.... Co. SCALE I4�soI TBA-. -roe OF DECK SWING TIES M �. 6� CLEANOUT AT B rton: NOOSE CORNERS T A B C.O. 241 ..ZI, _ (` FRONTIER LANE •C" —� P t. A N 7BM TOP OF DECK FLE✓n 100.0 100 ._ VEQTICNL SCALE: Ian 5 GRourLD NO NoR1204TAL SCALE 92.(0 ELEVATION Flattop Technical Services 14530 Echo Street 90 Anchorage, Alaska 90rlc ENGINEER'S SEAL OF t 4000 GALLON a Q`.• ,%�� INCE Aw� • �.. Ls�� SS HotDING 'rANk � . .._ i G�� 4�tHf, .�•,.� *p ELEV-- 88.1 %................... .... tmu(of 1 tt PRO F1 LC - 72 -012 A (2/21( MOA 25 Q'a PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE Apm DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 (Y)OD12P ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW910333 DATE ISSUED:10/17/91 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES EXPIRATION DATE:10/17/92 OWNER NAME:PARK PIO YOON JAE & KYUNG SOOK OWNER ADDRESS:225 CORDOVA ST. ANCHORAGE, AK 99501 PARCEL ID:01520244 LEGAL DESCRIPTION: TALUS WEST #1 BLK 6 LT 8 SEC 22, T12N, R3W, SM LOT SIZE: 27259 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: HOLDING TANK SYSTEM 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: PER SITE VISIT ON 10/17/91 NO WATER IN DITCHES. SEASONAL FLOWS CAN BE EXPECTED BUT DOES NOT APPEAR TO BE SURFACE WATER. A WIAVER IS THEREFORE NOT NECESSARY. RECEIVED B' ISSUED BY: c�<rraos� DATE • /a/2-1 /9J DATE:LLY 9� ``Ikn HLO M Dm !I �I t t I ' 1;0T 7 6 � 1 I srsr � � R = goo• 1 I' lop. moo , I -OT, 1 QL.k7 HauSE SEPric S Ysr II 1 II I Flbrttop Technical Sen 14530 Echo Street Anchorage, Alaska f wELt watt J LOT 2, 64k 7 HOUSE' :4 •• ;z*� r0 -CE -3589 E E. MOORE0 4ras�•• SBPr�G LOT 8, 61.k• 6, TAt uS WE-ST4 SEPTIC SYSTEM C4P6--(i41)E S 17,F PL.,4N SCA LE : I" c So DRr•e : IU/91 pwN. at' TFn MOTE : THIS fl NOT A SW? v6 Ye D PI•A7 .4" LOCATIONS ARC APPROXIHATE I l,oT g, al. k. 6 t t` N 1 'r /-HOLO W IyLtj I I 3. TRFivcll IO4` 3 BDRrt IFI % NauSE � I I S I t000 GAL i9er srEaNi: TRPNcII p E Re PtAteO �✓.TO H Now �V i000 6A4. 11040Iw6rom �rFRot{TIt=R LAP:E _— I' lop. moo , I -OT, 1 QL.k7 HauSE SEPric S Ysr II 1 II I Flbrttop Technical Sen 14530 Echo Street Anchorage, Alaska f wELt watt J LOT 2, 64k 7 HOUSE' :4 •• ;z*� r0 -CE -3589 E E. MOORE0 4ras�•• SBPr�G LOT 8, 61.k• 6, TAt uS WE-ST4 SEPTIC SYSTEM C4P6--(i41)E S 17,F PL.,4N SCA LE : I" c So DRr•e : IU/91 pwN. at' TFn MOTE : THIS fl NOT A SW? v6 Ye D PI•A7 .4" LOCATIONS ARC APPROXIHATE e�(� Ut•_A(;!o Flattop Technical Services �� • Z;INEEf'stAIV, 14530 Echo Street IQjy� Anoora e Aj( 1,g 99516 r••••••••••••••••••••..' !! Munki�al(ty al Anchorage /V' - a +. DEPARTMENT OF HEALTH 8 HUMAN SERVICES �+ •;•••••••. ...../�. 825 "L" Street, Anchorage, Alaska 99502-0650 ♦ � ;T'sEot 10 f. MOORE:: 10'.0% VCE-3539 , SOILS LOG — PERCOLATION TEST 41�f/c�••..,,,.•. PERFORMED FOR: Pic, Y. Par I; DATE PERFORMED: 10/3191 LEGAL DESCRIPTION: i -g Q6 T -C, luJ (,yerf41 Township, Range, Section: sec•22, T -12N/ R3[t/ DEPTHSLOPE SITE PLAN rt 2 ML 6:vy Sr(f 3 / 11 --• S P 01josAfinuoul MlIXtl4r• Saait 5 occgJrona( Sderl 6 ] I M J. Gmr Silt DeAse 9 10 WAS GROUND WATER ENCOUNTERED? Y 11 SP F#ne 61ASanaC s Nio Seeool IF VES, AT WHAT a o-Cct�yrt O 12 DEPTH? sf'w� em p E Depth to Water I1* " 13 51„IIML Monitoring? P_'2n'Date; to II/91 14 Fin e/' y Sagdy S111h 15 16IH, 15''6" 17- 18 f E1 20 Reading Date Gross Net Time Time [1y� Depth to Water Net Drop (r" 12" it In lo/j y130 27 -1V e: 3,1:30 27 3/8 3:03:00 27 Y 3:2Y:30 6 40 27 '(f r/ Qu1t :30 :OG 27 Yg PERCOLATION RATE-Z2Yo Immuteennch) PERC HOLE DIAMETER TESTRUNBETWEEN K -S FT AND 10 FT P/ COMMENTS Pee -c. rrAl�e /lot .r"tiahl/ / yor O/? -S%%! Soa1 ctjgso!n71wn PERFORMED BY: Ffa t!92 TecA. Sr. e. I -?rt�X //10� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 10/11 1.91 72-W8 (Rev. 4/85) T(attop ?echnica(Services 14530 Echo Street, 31nchora©e, Ax99516 Thone (90 7) 345.1355 Lot 8, Block 6, Talus West S/D 4211 Frontier Lane IIolding lank installation Specifications 1.0 General: 1.1 The scope of the project consists of removal of an existing 1000 gallon septic tank and installation of a 4000 gallon holding tank in the same general location. 1.2 Construction shall be as depicted on the approved drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. 1.3 All separation distances shall be in conformance with Municipal requirements, unless specifically waived. IA The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 2.0 Holding Tank: 2.1 The existing 1000 gallon septic tank is to be thoroughly pumped, removed, crushed and buried on site, or otherwise properly disposed of. The contractor shall provide equivalent alternate means of support for the portion of the building deck which is currently supported on the ground over the septic tank. The hole remaining after the septic tank is removed shall be backfilled with sand up to and around the level of the waste line from the house to the new holding tank. The sand backfill shall be mechanically compacted to 95% of maximum density. 2.2 A new 4000 gallon Municipally approved holding tank is to be installed in the approximate location shown. The tank shall have a 6" diameter cleanout, and shall have an approved high level alarm float installed and set to activate an audible and visible alarm mounted inside the building whenever there is less thaw700 gallons of fluid capacity remaining in the tank. 2.3 The holding tank shall be installed level with the top no less than 5' below the original ground surface. The backfill over the tank shall be mounded at least 6" higher than the surrounding undisturbed soil to allow for subsequent settlement. The top 4" of cover material over all disturbed areas shall be topsoil. Special care shall be taken to minimize disturbance to presently landscaped areas, and excess material resulting from the tank installation shall be removed from the site by the contractor. 3.0 Inspections: 3.1 A total of 3 engineering inspections will be required during the course of the project: (I) initial stakeout with the contractor to establish the location of the system and to discuss the construction procedures, (2) after the tank has been installed and hooked up, but prior to backfill, and (3) after final backfill and grading is complete and the high level alarm is operational. 3.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. C Municipality of Anchorage Department of Health and Human Services 825 "L" Street Tom Fink, p,o, Box 196650 Anchorage, Alaska 99519-6650 Mayor October 17, 1991 Mr. Pio Y. Park 225 Cordova St. Anchorage, AK 99501 Subject: Case #CM910056, LT 8, BK 6, Talus West #1 Dear Mr. Park: I wish to thank you for your prompt attention to the violation of overflowing sewage on the subject property. It is apparent, from both my site visit on 9/4/91 and from the data supplied by your engineer that a holding tank is necessary. As you are aware the presence of septic effluent on the surface of the ground presents a substantial risk to public health. Such a discharge is a violation of AS 18ACC72 and AMC 15.65.020. Attached is a copy of the laboratory test results, taken 9/4/91. This test confirms that fecal coliform bacteria was present in the water discharged from the western extremity of the absorption trench. Upon installation and approval of case will be closed. Should you aspect of this case feel free to Sincerel , Daniel N. Bolles On-site Services cc: db/157 the proposed holding tank this need clarification of any contact my office at 343-4744. John Smith, P.E., Program Manager On-site Services u CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE. ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561.5301 LMILISIS REPORT II SAMPLE Lot WORRotdert 57878 Data Report Printed: SEP 7 91 8 12:24 Client Sample ID11AG11111 PMSID :01 Collected SEP 4 91 8 09:20 his. Received SEP 4 91 4 12:00 hts. Praeerved with &IS 1EQOI1ED lnalysls Completed :SEP 5 91 Laboratory Supervisor eSIEPEER C. EDL Released Ry : �( /(y lFfa �iC Choalab Ref 8: 911567 Lab Sept ID: 1 Matrix: MATER Parameter Tested Meal Coli[ori Sampl• SWLE COLLECTED W. D. 101193. Remarks: Result Onits r600_tol/AOOml Client Mane :101'HEILI11 4 80M►N SE9-1120 QUALIIY Client Leet WkleP0 DPO t 04985 (IIP. 12/91) PO 1 Req 8 Ordered E7 :DAM DOLLES Send Reports to: 1)NOl'HEILT9 r MOMAM SRV -820 QOILIII 2)MCNICIPILIII OI ANCHORAGE Allowable Method Limits RECEIVED OCT 17 1991 Municipality of Anchorage Dept. Health & Human Services --•-•-•-1 Iests Performed ••-•---•-•-• -•See Special Instructions bole •--„-OI.Onanilable NO. Mona Detected ” Seo Sample Remarks lbove . ML- Not ►rvlyred LI -Less Than. CI -Greater Than 111.8hSas Member of the SGS Group (SoclM6 (1dndrale de Surveillance) 41- FLATTOP - TECHNICAL SERVICES CIVM& ENVIRONMENTAL ENGINEERLNG • ENERGY CONSERVATION & ANALYSIS 77tEODORE F. h100RE, P.E. October 14, 1991 14530 ECHO P11: (907) 345.1355 ANC110RAGE, ALASKA 99516516 MUNICIPALITY OF ANCHORAGE M.O.A. DHHS ENVIRONMENTAL SERVICES DIVISION P.O. Box 19-6650 Anchorage, AK 99519 OCT 15 1991 Dear sirs: RECEIVED The purpose of this letter is to provide the required design narrative in support of our application for a permit to install a 4000 gallon holding tank on Lot 8, Block 6, Talus West S/D, located at 4211 Frontier Lane. A soils log, perc test results, site plan and specifications are enclosed for your review. The proposed 4000 gallon holding tank will is to be installed in the vicinity of the present septic tank Ns can be seen from the soil log, the native soils on this lot are predominantly a dense silt with scattered seams of sand. -The measured perc rate in excess of 240 minutes per inch coupled with a shallow groundwater table make a holding tank the only feasible alternative. There is no suitable soil which could even accept the effluent from an intermittent sand filter. At the present time there is some standing water in the roadside ditch near the intersection of Frontier Lane and Bragaw St, located approximately 50 feet from the proposed installation site for the holding tank_' This water does not continue to now along the Bragaw roadside ditch, and it may totally disappear once the holding tank is installed. As already requested of Dan Bolles, we need a ruling from DHHS as to whether or not you consider this to constitute surface water requiring a 100 foot separation from a holding tank. It would be possible to locate the holding tank further away, however such a location would have less good access for pumping, and would be more expensive to install. The topography of the lot slopes to the west at approximately 5%. The proposed project will have no impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any impact on reserved space/surface and subsurface. The project will remove a present source of contamination to the roadside ditch alongside Frontier Lane and Bragaw St., and will also decrease the water flow in these ditches during periods of runoff. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. / MUNICIPALITY OF ANCHORAGE //• DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 1' ENVIRONMENTAL ENGINEERING DIVISION / 825 L Street • Anchorage, Alaska 99501 Telephone 264-4720 �^ nr.a,a! C r.tconcef cVSTFM AND/OR WELL INSPECTION REPORT �� VfV-JIICJG•er+V�V.v. .•—••-------- - PHONE UNEW NAME 0/v/ • : 00 PGRADE MAILING ADDRESS L N ,� C LEGAL DE CRIPTI% G L U S Z� O� J1 fJ / NO. OF BEDROOMS LOCATION C^ "U J L Well Absorption area DISTANCE TO: Dwelling PE IT/0 •y- tJ � YMaterial nQ Manufacturer ///U� W Inside length r�' Lkl. capacity in gallons IF HOMEMADE: Width No. of compartments Liquid depth Well welling dOZ DISTANCE TO: _ OK -1 Manufacturer W I Foundation DISTANCE TO: W of lines Length o li Total le f IyAes J No. Material Nacres 10 lnl , CJ Y- Trench wi th / InChP.S PERMIT NO. Liquid capacity in gallons P •a ! 9 v Distance bet a li es ~ Top of tile to finish grade Materia beneath tile // inches Total e five a/ rtion area V Length W.dt W Depth PERMIT NO. Q t— Type of crib oy W 0 DISTANCE TO: J Cla Crib diameter Cri apt Total effective absorption area Nearest lac line Distance to lot line PERMIT NO. Well De Buildin, ounciation rill J 'u ..— T+ DISTANCE TO: ullding foundation Sewe line Septic lank Absorption areals OTHER { PIPE MATERIALS 7. Z SOILTEST RATI ti / INSTALLER REMARKS / i �P � v..,, `•� 1 r,r �, d A? JS � c �' •. elserl A. Shofar No. 1157-E r\• w IV LEGAL y e• a ^ t r APPROVED SRB 19Gri - DATE �� RIVER has/�- /Z� / �� B/a K 72013 (Rev. 31781 PERMIT NO: DATE ISSUED: APPLICANT: ADDRESS: Mu" I C I F`nL- I TY or-' A"c::"arzAO'E- DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 025 L STREET, ANCHORAGE, At-, 99501 264-4720 CONTACT PHONE: ON—SITE SEWl�� 840969 12/03/84 p CARL H. HARM ON SRA BOX 1641-L ANCHORAGE, A!; 99507 345-6707 LEGAL DESCRIP: SUBDIVISION: TALUS WEST TOWNSHIP: RAl. NGE: SECTIONc 22 LOT SIZE: 27259 (SQ.FT. OR ACRES), MAX BEDROOMS: 2 8 i Listed below are the options available,to you in designing system. Choose the option that best -fits your _site. - -iv_ algia=� 4.0 1.0 5.0. 5.0 53.0 14. 8 1,000.0* 150 *� DEPTH TO PIPE BOTTOM < �} ULATION * DEPTH TO PIPE BOTTOM { (I CHCS+ )iA LIFT STATION ►* TANK MUST HAVE AT LEAS' G3 `1~ti� 50b ---------------- -------- - - - - -- �Sllt i . I certify that: f site sewers and wells as set 1. I am familiar with.the Alaska - forth by the Municipal IA) and the State of Alaska. I will install the syr �th all MOA codes and regulations, t. and in compliance with the design.cri eria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set bacl: distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a ma::im_im of 2 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST DE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DON- DY A LICENSED ELECTRICIAN. SIGNED -- DATE: APPLICANT: CARL F. HARMON DATE: -- d ISSUED BY TRENCI- -�=u ja DEPTH TO PIPE BOTTOM (FT.) � "7 ��`` ^s�1 4.0 O.5 GRAVEL DEPTH (FT.) 4.5 TOTAL DEPTH (FT.) 2.5 15.0 GRAVEL WIDTH (FT.) ,qe 330.0 GRAVEL LENGTH (FT.) E . 14.6 16.7 GRAVEL VOLUME (CU.YDS.) 1,000.0 *1� 1,000.0 *x TAMC SIZE (GALS) 150 SOIL RATING (SO.FT. /BF:) -iv_ algia=� 4.0 1.0 5.0. 5.0 53.0 14. 8 1,000.0* 150 *� DEPTH TO PIPE BOTTOM < �} ULATION * DEPTH TO PIPE BOTTOM { (I CHCS+ )iA LIFT STATION ►* TANK MUST HAVE AT LEAS' G3 `1~ti� 50b ---------------- -------- - - - - -- �Sllt i . I certify that: f site sewers and wells as set 1. I am familiar with.the Alaska - forth by the Municipal IA) and the State of Alaska. I will install the syr �th all MOA codes and regulations, t. and in compliance with the design.cri eria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set bacl: distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a ma::im_im of 2 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST DE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DON- DY A LICENSED ELECTRICIAN. SIGNED -- DATE: APPLICANT: CARL F. HARMON DATE: -- d ISSUED BY SOILS LOG MUNICIPALITY OF ANCHORAGE 0 PERCOLATION \ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST 01 0 825 L. Street, Anchorage, Alaska 99501 2644720 SOILS LOG - PERCOLATION TEST DATE PERFORMED:—/-, PERFORMED FOR: LEGAL DESCRIPTION: �•' �/' v TA L Lj SCOPE SITE PLAN 1 t" 2 cva 3 Cr ! 6 5 6 Cr 7 / 8 •J 9 J 10 a 11 u / r (/ 12 13 .IL 14 15 16 �I C/ 17 l 18 19 20 PERFORMED 72-008 (6/79( Tp�svic �pSA -7- 02 —r7 NI c S��-ty sq,�oy �ik'NdEc cr-a -- L /C N T 5711- 7' I /S -Z �1ee A�:�S� 1 ' i%v Payers A. Shafer r No. 1157-E :0 0 :�F1tOFESS��J S Z;4LE• WAS ENCOU UNE WATER ENCOUNTERED? r i IF YES, AT WHAT DEPTH? l 31■ in Reading Date Gross Time Net Time Depth to Net Water Drop • .j t •� DEPT. OF EALTH & NVIRONME is PERCOLATION RATE N (minutes/inch) TEST RUN BETWEEN FT AND FT CERTIFIE DATE• 'l f N MUNICIPALITY OF ANCHORAGE t DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM ANDW WELL INSPECTION REPORT PHONE EW NAME ^ r f� ' 1 • �G s' rylP av 3 a ❑UPGRADE v1AILING ADDRESS D.3 1 t 3�r� � L, /V I 1 LEGAL DESCRIPTION L 8 (� b I G�uS NO. OF BEDROOMS LOCATIO 0.1� lJ e_I"G Well Abs tion area Dwlymg PERMIT ­­N0.c DISTANCE TO: rJ-- / a �_aterial No. of compartments �z Manufacturer ST tL W I- N Liq. capacity gallons IF HOMEMADE: Inside length Width uyv.0 U.".• Type of crib rib diameter Crib OfTotal ell absorption area a w PERMIT NO. Well Building foundation 1 Dwelli DIST CE TO: Y t7 Z _10Z DISTANC � Class Material Liquid capaci Mons < Ma surer , L r J Sewer line Septic tank Absorption arealsl _? Building foundation Found tion Nearest lot hne PERMIT 0 7 DISTANCE TO: DISTANCE TO: Niels d "Y = D Length o(E,tc ine Total length Ines Trench width Distance Ivaeen lines No, of lines _ -- inches W -_. Total effective absorption area_ 1 q f Top of rile [o finish graceq fl. V 6 ice' i cher tj0'-1 OTHER ;n 1k✓—.7Lr- (Rev. 1/78) a 1\ I Length Width Depth _...._ _ / W Q F o. Type of crib rib diameter Crib OfTotal ell absorption area a w Well Building foundation earest lot line w DIST CE TO: Driller 1 Drst I I I [o lot hne PERMIT NO. /D' �-/ Class Depth , L r J Sewer line Septic tank Absorption arealsl w Building foundation 3: DISTANCE TO: OTHER ;n 1k✓—.7Lr- (Rev. 1/78) a 1\ I ,A MlJt J I C I^,ISL_ I TY OF Fit�7CF �'r)F2FIGE -&� ' DEPARTMENT HEALTH AND ENVIRONMENTAL .ROTECTION 825 'L' STREET. ANCHORAGE, AK. 99501 264-4720 W ELL FIt-1I7 CAr4--�7_ I TE SEFJEFZ F=*F-= I T J PERMIT NO. ( £10117 ) froon Cre. APPLICANT CARL H. HRP,MON 3103 W 33RD #4 99503 243-2919 LOCATION TRIGR DRIVE LOT SIZE 27259 SQUARE FEET LEGAL L 8 B 6 TALUS WEST S/D #1 TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BP.>= 150 THE REQUIRED SIZOE OF THE SOIL ABSORPTIONSYSTEM IS: OEF=--r L_EZr4C31-r C3FZF NAEL G+EF'TH- THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF R 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. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). FZ ECAL_� I FSEO 55E&ir I co TF r4 F: OF ITY Department( !UHealthLand Environmenta�rotection 825 L Street, Anchorage, AK. 99501 '. 264-4720 * * * HANDWRITTEN PERMIT j� W LL AND/OR ON-SITE SEWER PERMIT / Applicant: (i A_i9n, rr�n_ I� __ Mailing Address: Location: =,4A,-,,9- Phone Number: Legal Description: !� T /.ic G(,���'J'7 Lot Size: Type of Soil Absorption System Is: Trench: [/ Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms:_ Soil Rating(sq.ft/br)� The Required Size of the Soil Absorption System Is:' DEPTH LENGTH aS GRAVEL DEPTH —?-- WIDTH The length 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(in 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(in feet). * * REQUIRED SEPTIC(HOL-DI-N6) TANK SIZE _ 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. * * * TWO(2) INSPECTIONS ARE REQUIRED Backfilling of any system without final inspection and approval by this departmer will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee 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 this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 1 * * * I certify that: (1) I am familiar with the requirements for on-s4te sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may =quire enlargement if Utheriden is remodeled to include more tha bedrooms.Signed• Issued by•ant Date: SWP/024(1/81 L/ Test }tole No. 6-8 W.O. #17069 Depth in Feet From To Soil Description Sam le Depth 0 1.0 Brown Peat, damp, soft. P+ 1.0 3.0 F-1, Grey to Brown very Silty very Sandy (ravel, damp, 2.9 SP N K medium density, 2"- GAl 10.0-11.5 18-37-115 --- SP ---- ---- 5.0 NFS, Brown Sand— Gravel with a trace of silt, damp, medium 83-38-77 — •' density, 3"- P 1'Z 6 4 20.0-21.5 14-47-190 5.0 9.0 NFS, Brown Gravelly Sand with a trace of silt, damp, medium 25.0-25.25 250for density, 9.0 13.0 F-4, Brown Gravelly Sandy Silt, damp, stiff -hard, 3"-, (^1 25/100' 13.0 23.0 F-4, Tan Sandy Silt, with F-2 Silty Sand lensing to F-2 Silty Sand with F-4 sandy silt lensing, damp, dense, NP, S^1, "I 23.0 25.25 F-2, Olive GravellSilty Sand, damp, dense, 3"-, S'+1 Bottom of Test Hole: :5.:5 ft. Frost Line: None Free Water Level: None a Remarks: 1. Group refers to similar material, this study only 2. Dry strength, N = None, L= Low, P1 = medium, It = high 3. Type of Sample, SP = Standard Penetration Type of Pry Sam le Depth Blows/6" %I% Sample Stren th Group 1 5.0-6.0 61-135- 2.9 SP N K 2 10.0-11.5 18-37-115 --- SP ---- ---- 3 15.0-16.5 83-38-77 17.4 SP L -N B 4 20.0-21.5 14-47-190 --- SP --- --- 5 25.0-25.25 250for --- ''SP --- --- 25/100' Remarks: 1. Group refers to similar material, this study only 2. Dry strength, N = None, L= Low, P1 = medium, It = high 3. Type of Sample, SP = Standard Penetration 0I STATE OF ALASKA I,&%Survey$ (DGGS) DEPARTMENT Of NATURAL RESOURCES RETURN T0: Division of Geological and ie' 27)•6615) 7001 Drive r8geAlaska 99501Te • /'AMMrage, + � yATE A W E L L A ( C 0 A D • ,( U.S.G.S. Local 110- NO S "_ Drilling Permit - company no. Drilling Comy ` I LOCATION OF WELL ►l a fe complete sitMr la. Ib, or Ic. Tpwsnlp Range n Nerldlon , Subd lvi tion Lot Block It. fraction Section E/y la. Brough LLtf+ktJl� 6 / / / N/S I LlQ l 7, OWNER OF WELL: C� Ica Distance and Dl rection from Road Intersections Address: .'1'4 uS W P-qcl Street Address and Area of Well Location 4. YELL DEPTH: (carolted) S.rface Elevtlon C•wgl tion Fut gelow 2. WELL LOG %.•face ft. M terlal Type Top BottomttoA 5• gGble tool (D0.oG ry 00rl wn 0 Dug ❑Auger ❑J*tted ❑brad ❑Other: 6. USE:Domestic Public Supply 0 industry O ❑ Recharge ❑ Commercial 0Irrigatlon 1 OTtt W11 00ther: Q 7. CASING: L]Threaded ®Welded �Ibs/f t. S Depth Wight in. to q�. -s�•—Into ft. Depth 8. FINISH OF WELL: r♦ TyDe:� H /l- Diameter: Slot/Mesh Si9u Length: ft. and ft. Set between Fittings: j, STATIC VATF0. LEVEL: ft. 0 Above 081 land surface Type of measurement: 10. PUMPING LEVEL below land surface O/ ft. after Art. pumDIng g.p.A. ft. after Mrs. Pumping 9•P•0. 11. WELL HEAD COMPLETION: In Approved ►it VPitless Adapter Inch,$ above grade 12. GROUTING: Well Grouted: 0 Yes DaNo Itterlal: ❑ Neat Cement ❑ Other: 13. PUMP: (If available) HP 7;0)2-#t• capacity 9•p. Length of Drop Pipe ®Submersible ❑Reciprocating Type: ❑Other. ❑ Jet /- IA. REMARKS: t{/ A2+ 15, WATER WELL CONTRACTOR'S CERTIFICATION: nI and belief: Thl well mas drilla wder my Jurisdiction and this sport Is true to A best �lodge 3 1:) '31 vPiA1 II// d't f onvcJJt Luoor ' Ce9 •stoned mos Mame r Address:9J .s Date: Signed: utnon aed Repro ut.w Copy Distribution: WHITE - State DGGS. PINK - Driller. CA14ARY - Customer FOrA 02-WWR Municipality of Anchorage -�\ Development Services Department Building Safety Division On -Site Water & 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 Parcell.D. 016-0q1)9 qq COSA# 1. GENERAL INFORMATION Expiration Date: 9 ' Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address TALUS WEST SUBDIVISION #1• LOT 8 BLOCK 6 4211 FRONTIER LANE • ANCHORAGE AK 99516 JOSEPH & DANA SNYDER Day phone 345-9399 4211 FRONTIER LANE • ANCHORAGE AK 99516 Day phone MmssA sHiri BY w/ .Q:1. :. TRUST Day phone 351-5372 W . - • *116 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site ❑ 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Onsite 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 certiried by my seal affixed hereto and as of the validation date shown below, l 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. f 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. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's'Printed Name JEFFREY A. GARNESS, P.E. Date _LL7 OL _ Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines B Regulations. The reported results described the performance of the system under the conditions encountered et 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 solls condition, groundwater levels that may fluctuale 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 bonefit 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 right whatsoever. 5. ,DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the flowing stipulations: Attachments: COSA Checklist C/ Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other Jar,.• .,•10 WATER AND `QpASTEWATER PROGRAM By: _�? Original Certificate Date: 6 - .2 1 -0 G Municipality of Anchorage + Development Services Department BuiSalety Division On -SIG water d, Wastewater Program " 4700 Bregaw Street P.O. BOX 1965W Anchorage, AK 99519.8850 www.muni.aWonalte (907)343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: TALUS WEST SUBDIVISION i1 • LOT 8, BLOCK 6 Parcel ID: 0 f -E'1'02 r / A. WELL DATA Well type FPoVAIE If A, B, or G Provide PWSID# A Well Log (YIN) YES Date completed 6/24/1981 Sanitary seal (YIN) YES Wires Property protected (yM) YES - Total depth -11-511. Cased to 93.5 It. Casing height (above ground) 18+ In. FROM WELL LOG AT INSPECTION Date of test 8/24/81 6/8/2006 Static water level 60 ft. 23 ft. Well production 8 O.P.M. 4.8 g.p.m. WATER SAMPLE RESULTS: - Coliform Q_ colonies/100 mI l. Nitrate Uf mGJL. Other bacteria 0 c0100e31100 ml. Arsenic: -9Lu9JL. Data of sample: 6/8/2005 Collected by: GEG. Ltd. e. SEPTIC/HOLDING TANK DATA Tank Type/Materlel HOLDING/STEEL Date installed 6/23/1992 9a1 1 Cleanouts (YIN) YES Tank sae 4000 Number of Compartments ._ Foundation cleanout (YIN) YES Depression over tank (YM) NO High water alarm (YIN) YES Date of Pumping 6/2/2008 _ Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA HOLDING TANK Date installed Son rating (9.P.d.lft'or ft%drm)_ System type Length ft. Width ft. (are PIDe ft. Total depth ft. Eff. absorption area _ ft' Mon gression over field Data of adequacy test ass/Fa6) For_bodrooms Fluid depth in absorption field b st _in. Water added _gal. New depth _in. Elapsed Time: n. Final fiuld depth _ in Absorption rate >= 9 p d uvariation treatment (past 12 mo.) (YIN 6 type) H yes. give date D. LIFT STATION Date installed Size in gallons 'Pump on' level at ---in. 'pump or E. SEPARATION DISTANCES High water alarm level at in. Cycles tested Meets alarm & COMM requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tenkAifi station on lot — N/A Absorption field on lot N/A Public sewer main N/A Sewer /septic service line Animal containment areas 50"+ On adjacent kris — 100'+ On adjacent lots — 100'+ Public sewer manhole/cleanout N/A Holding tank 75'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ property line 5'+ Absorption field - N/A Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 75'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Water service line F. COMMENTS 0. ENGINEER'S CERTIFICATION Building foundation Water Wells on adjacent lots parking/vehide storage I cartiry that I have determined through field inspections and review of Municipal records that the above systems are in • • • • • • • • • • • • • . • • conformance with MOA COSA guidelines 4► effect on Nis date... Engnsees Printed Name JEFFREY A. GARNESS Y �E 7a Date 6437 f a6 •�,e 6%t ?,[ COSA Fee S I/ - tQ, On Date of Payment -L� 2 -7 Receipt Number 4a 3Cl i 7 M". 111M Waiver Fee $ Data of Payment Receipt Number SGS ReLa 1062917001 Garness Engineering Group, Ltd. Client Name Project NamelN Talus West 1 Lot 8 Blk 6 Client Sample ID Talus West 1 Lot 8 Dlk 6 platris Drinking Water Sample Remarks: Parameter Results Metals byICF�MS Arsenic ND Waters Department Nitrate -N 1.67 Microbiology Laboratory Total Coliform 0 PQL All Datee/fimes are Alaska Standard Time Printed Date rime 06/20/2006 14:13 Collected Date rime 06/08/2006 10:10 Received Date/time 06/08/2006 13:28 Technical Director Stephen C. Ede Allowable Prep Analysis Units Method Container ID Limits Date Date Mit 5.00 ug/L EP200.8 0.100 mg/L EPA 353.2 C (<10) 06/12/06 06116/06 SCL D (<10) col/100ml- SN1209222B A (<I) 06/08/06 ALR 06/08/06 TLF E o .•e' L1 #ST ��4 m 41, 9F�1 �� pp N bo �'•, y �j1, •�� v 8MMy 1'n I;o 10 I� 'm IA I ,D Im Ob'OZ! 3aOW-13 4^ N 000340"W 90.00 — Ff=.] - — - — — — — — — — — — — — TI. C3 �� pp N P 8MMy N e 0 f N N O so e J 1'n I;o 10 I� 'm IA I ,D Im Ob'OZ! 3aOW-13 4^ N 000340"W 90.00 — Ff=.] - — - — — — — — — — — — — — TI. C3 N P N e 0 f N N O so e J e FA C a�6v \�O O MUNICIPALITY OFANCHORAGE�` � `-DEPARTMENT OF HEALTH & HUMAN SERVICES Division of EmIronmental Services : On -Site Services Section P.O. Box 196650 'Anchorage, Alaska*. 99519-6650 ..343-4744 CERTIFICATE OF HEALTH AUTHORITY 'APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. k R1 I'S — An -0- LA 9- HAA V bl EA060l ln-1 -1. GENERAL INFORMATION Complete legal description _ �o F '8• Q/uck 6 Te+/u, Lcie . r 1 Location (site address or directions) Property owner--­-Pro=-Y Park - _ Day pho` 256 os3G Mailing address 79SN li�o{1lccnofEr pr1�Cyne f}k 99S1& =2626 Lending agency Day phone _ -Mailing address —' — - - ;.Agent Terne Fsa 61 pJnQn+cP.or�rhe� Day phone 26r=7637; Er fess otherwise requested HAA will be -held s 2- NUMBER OF BEDROOMS 3 v • - 3._TYPE OF WATER SUPPLY: Individual well n Community well �.. ._ ...ri. _... Public water •+ _ _ ..• 4111 _ NOTE. If community well system, provide written confirmation from State AbECattest ing to the legality and status of system 4.- TYPE OF WASTEWATER DISPOSAL > t Individual on-site Holding tank ✓ E.1do`I•p i 1f _Community ;^'.• '. �! .�, a•.-Y.illi 1 .f SJA✓ {� 3,1�\; �.:. ommunity. on-site _._�._�.... i,.. ,u T:.1., ..t..E. a.J L' �1 C•. i _ _ Public sewer.' --`NOTE: If commirnity':westewatersystem; provide written conf�rmatfon from State ADEC -.. >. ... ...... ....-.ter......... n .... ... ... ... .,•._r,,, y.... ..... attesting to the legality and status of system. 72.WS (R.v. 1/21) c..m wog nl S. -- STATEMENT. OF- INSPECTION BY- ENGINEER As certified by.myseal affixed _hereto _and -as 'of the validation date shown below, I verify that my Investigation of this Health Authority Approval application shows that th6 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 furtherverify 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 in compliance with all Municipal and State codes, ordinances, and regulations In effect on the date . of this . Inspection. Name of Fi`rm -r'cn ; ccf -Se r, 6Cr Phone �?41r-lzsr Engineer's signature Date ",Tl 9 OP of, J0 i Of •P: Z ""-1 THEODORE F. MOORE '.'-CE-:3589 DHHS Approved for bedrooms. �­L .--Additional Comments—- : p f ro essionalengi :and their lending . conduct Inspect responsible k N: Date 19 S/ of Anchorage Department of Health and Human Services (DHHS) Issues Health Authority ... -1:11' ates based only upon the representations given In paragraph 5 a" by an in'd-ep-'e'n-.de-.nt-'z-..'--" leerregi3tered In the State of Alaska. The DHHS does this as a courtesy to purchasers of homes -nst—itu-tlo-n"s-liW'O;aiitiiiitlifi6i6riiinfe�la-n'ditate-*6ir"e'-m'n'is.'Er�p16ye�6f DHI­[Sddnot'�--- ons or -data. -before - a . c ertlfi6ite Is Issued. The Wnidaifltj_of Anchorage 'cors or omissions to the professional engineers work. rims 1111'/.1/91) 6r MOA 821 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L,ot 8 Black ,t T rwr Wolf#1 Parcel I.D. A. Well Data Well type PV t- If A. B, or C, attach ADEC letter. ADEC water system number M v oz �(mn� 0 cn Log present (Y/N) _ ,r Date completed 6/2Y/_g/ Driller (/ern S - Total depth 9715" Cased to 93. t' Casing height 3 0 Sanitary seal (Y/N) Yes Wires properly protected (Y/N) _ FROM WELL LOG AT INSPECTION Date of test 6 / 2 Y / 8r Static water level Well Ilow Pump levelt 6o' 15' 8 9•p•m• 6.7 t g.p.m. -7 g, S" SEPARATION DISTANCES FROM WELL TO: Septictholding tank on lot l'IS ; On adjacent lots -� I 0CP ' - Absorption field on lot N • A. ; On adjacent lots > too, Public sewer main N • A. Public sewer manhole/cleanout N A. Sewer service line > ZS' Petroleum tank N040 SPP n WATER SAMPLE RESULTS: Colitorm0 r0 (./ (0 0 T l Nitrate _0. 60 rJ It Other bacteria nom rYno�A�r Date of sample: Max S 1991 Collected by: Fr'►f,,, ?ecl, Svc B. -MOLDING TANK DATA Date installed <t? -3192 Tank size 1000 a«Compartments f Cleanouts (Y/N) ____K_Foundation cleanout (Y/N) Y Depression (YIN) N High water alarm (Y/N) Y Alarm tested (Y/N) r Date of pumping 1/21 /9S Pumper A + SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot IHS* On adjacent lots ':;, 100' Foundation lot To property line __2 0' Absorption field N.A. Water mairvservice line Surface water/drainage > 100' CONTINUED ON BACK PAGE 72-026 WM)* Front C. LIFT STATION N. 1� . Date Installed Manufacturer Size In gallons Manhole/Access (Y/N) Vent(Y/N): 'Pump on' levet 'Pump oft" Level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA N - A. ClldiS Tun k) Date Installed Soil rating (GPD/Ftz) System type Length Width Gravel thickness Total absorption area Total depth Cleanout present (Y/N) Depression over field (YM) Date of adequacy test Results (pass/fail) for Bedrooms Water level In absorption field before test Aftertest Peroxide treatment (past 12 months) (YM) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: yes, give date Well on lot On adjacent lots Property line To building foundation To existing or abandoned system on lot On adjacent lots Cutbank Water maiNservice line Surface water Driveway, parking/vehicle storage area Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and NAA guidelines in effect on th, g date of this inspection. =%........ 1 Signature �/!—` `.� %I1o_,�* >9 .....:.......... , Engineers Name `Aecdo•YF• I�fuo..y O�•1•••a. •r. '?�.,it.r�e3,..r..a Date Mo?, 9 /995— C� - 3537 �.�•n•........ HAA Fee $ 3 00 == Date of Payment / %S Receipt Number 877 t a 7.30 72.026 (397)' Back Waiver Fee $ Date of Payment Receipt Number ��I ME Environmental Services Inc. Laboratory Division CTLE Ref..". 95.1672-1 Laboratory Analysis Report Matrix WATER Client Sample ID L8 BLK6 TALUS WEST S/D W'i Client Name FLATTOP TECHNICAL SRV Ordered By TED MOORE project Name Project# PWSID UA Sample Remarks: SAMPLE COLLECTED BY: TED. WORK Order 14315 Printed Date 05/04/95 a 11:27 hrs. Collected Date 05/02/95 a 11:00 hrs. Received Date 05/02/95 a 12:25 hrs. Technical Director STEPHEN C. EDE Released Hy� �� �.-.r�'��+�►-� OC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date ------- Date Init __________________________________________ 05/03/95 CMR Nitrate -11 0.80 mg/L EPA 353.2 10, ........................................................................................IIA . unavailable + See Special Instructions Above NA . Not Analyzed See Sample Remarks Above LT . Less Than U . Undetected, Reported value is the practical quant if icacion limit. GT . Greater Than D . Secondary dilution. .i g 200 W. Potter Drive, Anchorage, AK 99518-1605 —Tel: (907) 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA. ILLINOIS. MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA r*�, MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL'&EALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date . I Z�Zq - S+ (a) Legalsscriptin (include lots bloc ,5 bdivi ot7nctipn,, township, range) Location (address or directions) (b) Applicants Name ''ARL I 4ARALW Telephone - Home Business Applicants Address OTA -11 (c) Applicant is (check one) Lending Institution ; Owner/builder _; Buyer = ; Other [� (explain); (d) Lending Institution C,-3ri-n►JE-XPVAA- f�/�►`�1� Telephone Address (e) Real Estate Co. & Agent Address Telephone 1nI'D (f) .PR the HAA to the following address: 2, Tvpe of Residence Single -Family multi -Family 1. Number of Bedrooms 2 _ 3. Water Supply Individual Well EE1 Community = Other (describe) Public = Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite � Public Community Q Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. (Page 1 of 21 n n 5. Engineering Firm Providing Inspections, Tests File Search, Data and Information 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 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 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 in compliance with all Municipal and State codes, ordinances, and regula— tions in effect on the date of this inspection. Name of z".77 Date 6. DHEP Approval Approved for r.:?_ bedrooms Approved —X— Disapproved Terms of Conditional Approval t.b.n A. Na td CAUTION Conditional Telephone THE MUNICIPALITY OF ANCHORAGE DEPARVIENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT— ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENLENT PROFESSIONAL ENGINEER REGISTERED 0 THE STATE OF ALASKA. THE DEEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE— MENTS. M4PLOYEES OF MEP DO NOT CONDUCT INSPECTIONS CR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 (Page 2 of 21 7-19-64 MNIGPld1;7 C' MUNICIPALITY OF ANCHORAGE (MOA) Cu T. HEALTH AUTHORITY APPROVAL (HAA) JAN 7 1985 CHECKLIST - FEBRUARY 1984 RECEIVED A. FELL DATA Well Classification S�!'� If A, Be or Co D.E.C. Approved(Y ) f Well Log Present )Date Completed ��?��-f I Yield. 4P01 Total Depth 3 sed to 3 �Z Of Depth of Grouting Static Water Level PuzV Set At Vif 4 Casing Height Above Ground 12 iii Sanitary Seal on Casing d _ N) Electrical Wiring in Conduit dTM Depression Around Wellhead _ Separation Distances frau Well: To Septic/opkdtr2l Tank an Lot 14- ; on Adjoining Lots -J 1 L To Nearest Edge of Absorption Field an Lot 14 ; or. Adjoining Lots I IZ.�'1" To Nearest Public Sewer Line /: To Nea=est Public Sewer - Cleanolt/Manhole W/p To Nearest Sewer Service Line on Lot Z Water Sample Collected By SE'S £-AJ64 ; Date Water Sample Test Results sib -rlsr7AC 70 r2 Comments Lo P ALAS KA T -F,0 .S64 Vic S B. SEPTIC/tl0� TANK DATA i% -81 Date Installe Size /n00 No. of Carpartments 2 Standpipes C)Q2 Air -tight Caps 1) Foundation Cleanout (Y Depressionover Tank (Y Date Last Pumped Pumping/Maintenance Contract on File (Y ) '�� for Holding Tank High -Water Alarm (Y .) A Temporary Holding Tank Permit Separation Distances from SeptiTank: To Water -Supply V1311 Zoo �i To Building Foundation /D To Property Lire To Disposal Field To Water main/Service Line A To Streams Rird. Lake. or Major Drainage ,J A Course Co rents I-'1-454 `a5. OD [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata �SD /' Type of System Design I�I2/Lint�tp Date Installed /2-/2-f34 Length of Field _ 4L Width of Field ten Depth of Field _ rJ Gravel'Bed,Thiccness —34ko si Square Feet of Absorption Area 3M'O Standpipes Present QON) Depression over Field (Y Date of Cast Adaquacy Test /0613 Results of Last Adequacy I6st A Separation Distance from Absorption Field: To Water -Supply Well 2_ao /./- To Property Line /p To Building Foundation /D It To Existing or Abandoned System on Lot / o / On Ad'oining Lots 3D '4 To Water Main/Servioe Line A- A _ To Cutbank(if present) "v A To Stream/Pond/Cake/or Major Drainage Course "7A1 To Driveway, Parking Area, or Vehicle Storage Area 3D /t C,:nD Psi/nl F/ Ec rl DiJE/� 1=i92 6.P S 7`C -.r 7 t3y /4 .q- x -.S D. LIFT SCATI Date Installed Dimensions Size in Gallons Manhole/Access (Y/1q) "Pump On" Level at A Off" Level at High Water Alarm Level at Vent (YIN) Tested for Pmpi . C dying Adequacy Test. Meets MOA Electrical Codes(Y/N) • Convents �* Check Permitted Bedroom Rating Against HAA Request '* I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed a & g E. HIEEIUNR bete wrrrl;'A 82n go= s Company jx.,::LE R PALASK% 479 MOA i.^�(F ....... KB1/d5/s Y�k.A A. •sh.kc • '� ;'. [Page 2 of 21 1457-E t 5-84 ALASKA ejjjIRonMenTAL COMR01, Inc. Enginarinq E Enuiranmtntal Smdits DECEMBER 3 1984 CARL HARMON 4211 FRONTIER LANE ANCHORAGE AK 99516 SELLER — CARL HARMON BUYER — SUBDIVISION — TALUS WEST11 BLOCK — 6 LOT — 8 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 530 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 150 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 1200 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS NOT ACCEPTABLE FOR A HOME OF 2 BEDROOMS. THE SEPTIC TANK WAS PUMPED ON NOV 29 1984 . A FLOW TEST WAS PREFORMED ON THE WELL. 492 GALLONS OF WATER WAS GPM OVER A DURATION OF 1.1 HOURS. PUMPED AT A RATE OF 7.56 AND DTHE RAWDHE WN WASIC 41.48'ATER WITHVEL SRE16V76Y FEET. TIME OF 60 MINUTES THE WELL IS ADEQUATE FOR THIS 2 BEDROOM ROME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 2 BEDROOM HOUSE. $my G. Rald7Jr, No. 2251-E . 1200 Wtst 33rd Autnut. Suilt B 9 Anchorage, Alaska 99503 •(901) 561-5040 n n MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date g% Not) $t/ (a) Legal &escriptior&(include lot, block, subdivision, section, township, range) Location (address or directions) 411, Fe,,4tFu Ln Nt' j V 4 -1i70i (b) Applicants Name CARL A&MG-1 Telephone - Home Business 274-1131 µ Applicants Address L47,11 FCD.4.4, Ca tr 44s,-6* IAOt RC ggflto (c) Applicant is (check one) Lending Institution Buyer r__1 ; Other F71 (explain); (d) Lending Institution Telephone Address Owner/barer (e) Real Estate Co. d Agent Address Telephone (f) Mail the 'HAA to the following address: 2. Type of Residence Single -Family pEl Multi -Family Other (describe) Number of Bedrooms 2- 3. Water Supply Individual Well � Community Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite L�Ej Public Community [= 'Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 21 r `i A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) :41CIPALM OF ANCHOMAO; DEPT. OF HEALTII - 41RONMENTAL PnJTCCTIOY JAN 21985 CHECKLIST - FEBRUARY 1984 Legal Description: [.'r Well Classification -IUD If A, B, or C, D.E.C. Approved(Y/N) N4 - Well Log Present(WN) Date Completed' *Y- 4 s 4-11 Yield 7� Total Depth s`Q3•S Cased to-VfV- q3,'f� Depth of Grouting 4mic Static Water Level 16.74 Pump Set At (Am e - Casing Height Above Ground I.i , Sanitary Seal on Casing rs Electrical Wiring in Conduit cu )gyp S Depression Around Wellhead ryywyo Separation Distances from Wall: To Septic/Holding Tank on Lot o 4 of Adjoining Lots To Nearest Edge of Absorption Field on Lot -F iso' ; On Adjoining Lots CrTiou� To Nearest Public Sewer Lire &IA- To Nearest Public Sewer Cleancut/Manhole Ni 4- To Nearest Sewer Service Line on Lot &rNo Water Sample Collected By Gatoo-W ; Date a *. (vow 3 Water Sample Test Results _ C- kn&eh f2 B. SEPTIC'NOLDING TANK DATA Date Installed -7-4c4 &-A 1 * Size �UUt�� 3' -No. of Ccnpartments * 2 Standpipes ((JM) S Air -tight Caps (Y ) LIP5 Foundation Cleanout CY)t,4-S Depression over Tank (Y Date Last Pumped 30 W 0 a `� Pumping/Maintenance Contract on File (Y/N) juh- fcr Nf►- Holding Tank High -Water Alarm (Y/N) p,A- Temporary Holding Tank Permit (Y/N)wor- Separation Distances from Septic/Holding Tank: To Water -Supply Wall IL4U 1f- - To Building Foundationliil-q ' To Property Lira I- 1n' To Disposal Field * I -T I To Water Main/Service Line NA- To Stream, Pond, Lake, or Major Drainage Course , x` .'IJ' -- Comffints�- 1:t"w As 6..14- #X- m941gftcn r -r-.. ..4..,1wiltp, ��laa. owls (Page 1 of 21 �'ao Z otp 2-15-84 I LtAl Erb Tialus was' - C. ABSORPTION FIELD DKTA D. ^1 Soils Rating in Absorption Strata ASO a`��a� Type of System Design 41 Date Installed * '7.4u&31 Length of Field * 6'3' Width of Field * u N k Depth of Field U ' Gravel Bed Thickness S r. Square Feet of Abscrption Area + 5-30UL Standpipes Present�i) Depression over Field (Y*I) UD Date of Last Adequacy Test .".430 uou 8y Results of Last Adequacy Test LANsG�:sF.�{uK4 Separation Distance from Absorption Field: To Water -Supply Well �- -t 1 Y U ' To Property Line ,Z o To Building Foundation 4 ,i1.4+' To Existing or Abandoned System on Lot VA- ; On Adjoining Lots ' *ir T 2.o' To Water Main/Service Line "(&T S'u' To Cutbank(if present)yrr- To Stream/Pond/lake/cr Major Drainage Coursezcut' To Driveway, Parking Area, or Vehicle Stcrage Area - Ut Caments 4 Facw% A5-&.li- i-4. M44r41uKeO rco,,, sys+Q 4 .-A(rf of 60- 0"...44 Date In -R a d Dimensions Sine in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Pumping Manhole/Access (YM) "Pump Off" Level at Vent (YIN) C du-iW Adequacy Test. Maets NDA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MDA HAA Guidelines in effect on the date of this inspection. Signed � fl Date _o7$ Nou$y CcupanY ,4rc5 MDA No. -02 KBl/d5/s (Page 2 of 21 2-15-84 �_r(o grc'd TAI4s W#%j- 5. Engineering Firm Providing Inspections, Testa File Search Data and Information As certified by my seal affixed hereto and verify that my investigation of this Health water supply and/or wastewater disposal sys the number of bedrooms and type of structur based on the information obtained from the as of the validation date shown below, I Authority Approval shows that the on-site tem is safe, functional and adequate for e indicated herein. I further verify that, Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of FL Telephone Slo�-S'Oy V Address I'IOOw SSa AVC- ANtlioRA6E /-IC 9 Q Date 3064L3`f ih~PeeOr a�; ��p0 �, t�,p • �'.,q aiiY rY c� rr.:.....�..•�k7 6. DHEP Approval Le C. 1� spa, Approved for 1P, bedroom tga p• Anoroved L Disapproved �Y" Conditional Date /— -7—OS— CAUTION OS 1 CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HONES AND THEIR MENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP 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. (DHEP SEAL) RR4/ej/D18 7-19-84 [Page 2 of 21 ALASKA rJII1011MEnTAL COIITROL SEI" ices, Inc. Enginurinq 6 Enuironmtmal SNdits DECEMBER 3 1984 CARL HARMON 4211 FRONTIER LANE ANCHORAGE AK 99516 SELLER — CARL HARMON BUYER — SUBDIVISION — TALUS WESTM BLOCK — 6 LOT — 8 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 530 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 150 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 1200 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS NOT ACCEPTABLE FOR A HOME OF 2 BEDROOMS. THE SEPTIC TANK WAS PUMPED ON NOV 29 1984 . A FLAW TEST WAS PREFORMED ON THE WELL. 492 GALLONS OF WATER WAS PUMPED AT A RATE OF 7.56 GPM OVER A DURATION OF 1.1 HOURS. THE DRAWDOWN WAS 41.48' WITH A RECOVERY TIME OF 60 MINUTES AND THE STATIC WATER LEVEL WAS 16.76 FEET. THE WELL IS ADEQUATE FOR THIS 2 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR TRIS 2 BEDROOM HOUSE. 1200 Wtst 334 Autmt. Suitt B • A.nchorogt. Alaska 99503 •(907) 561-5040 r � L T.me Time .pie Date ,a Date Date Inspector Inspector Inspector ��..// Comments Conditional Approval t/(��� Date Sewer Installed Permit No. Septic Tank Size led O r/ / to i -Foils �'� d /�, Holding Tank Size �- Rating Well To Absorption Area Well Log Received /J"t) Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner / Phone Mailing Address yah / / J�oiJ7 e2 ,l.+i✓ e LooPAR yp-(o707 a7y'aS3 Buyer Address Lending Institution 71t4k,4 Phone Address ,; �p yQ«' a1vP.S7LS—/ Realty Co. & Agent Address �L71^i Phone Legal Description /B' Ei /J O �- �� �jl�•� S�� Street Location J«, �cifN tom, Typee,ppf Residence ✓_ ingle Family ❑ Multiple Family No. of Bedrooms ❑ Other Watgupply Individual ❑ Community ATTACH WELL LOG. A well log Is required for all wells drilled since June ❑ Public Utilltv 1975. For wells drilled prior to that date, give well depth (attach log If available. Sew Disposal XIndividual Year Individual Installed: 74/46( O Public Ut illty Ll Holding Tank When Connected to Public Utility NOTE. THE INSPECTION FEE MUST COMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.