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T12N R3W SEC 33 LT 82 E150'
T12N. R3W. Section 33 Lot 82, E150' #018-251-20 (0 1 17MCO Aa\J% �Z%,�%ts0003v# 001SGJok -sluawaimbei jpjad liem apnjoui jou SGOP JeAoidde siq4 :91ON Qo , , f PE) 047 AojddV 45RI -'sSqo�oo 'V, 1,T) oildeS .11 .. . ...... ..... ........ T 4L H V jo :IeAoiddV Ieu0il!puo0 dwels SlBGU16U3 IVAO'dddV N0110EIS 2JBIVMUSVM CINV 2191VM giIS-NO �HA JO dOi BZ/9 UZ � q1t, RV9 � we uoildijosep pue uopoo-1 oz/wu Puz oz/gL/Zl iso :salep uoiloodsul Ij 00.001 (U0ljeA@jG pownssv) ANVW HON38 jo;oadsul �cocc] -Lvq/oo 170000 Pl@gUlBJCI 6301A2J3S DNOH +V t,eoC(]P""l"P V0004 Nue} -lVlN91VW3dld of �ue I Jallelsul Aq pallelsui leoll Uolle0ol wielv 2,0Z:J0 E)Nl�JdS �Hl NI Odn i:Gd 03NOISSINNO030 ge 1-11M MVi 010 l:iOl0VHlNO0'd3d s�pmad jainjoejnueA +.0 +,o U014 punoA NOiiV.LS.L:Ill DdGH VN +'o +.9 au!-! 101 sluawliedwoo jo jaqwnN lailalevq +,00� +'ou jajeMaospnS 'leo o9z � NNV13EMJ0H0NV Alpedeol jainjoepuevq J@410 M 5ulPl0H El cf*Ey-L,S E] oild@S M A NVi +'OU +.ou JIGAA sepuail ua@Neq -1siCi z�aM sapuail jo jaqwnN +Z98 eaje uoildiosqe lelol 'T uIP10H uollels)wl U01 IdjosqV oildeS W"=l of 9 IR 9 S30NV1SlG N011VNVd3S s9uijua@/vqaqaouejsicj s@uijjojaqwnN:sP@i3 qlp!M IGALIJLZ) U01pas abuel:f diqsumo_L 05'8 09 'E)MG 33S 416U81 19AM0 GPE16 JEU16110 GAoqe pappe ll!-] 09 63 Z810_1 CC NOLODS AA62l NZ 61 101 �oole UOISIAlpqnS zo,tR zo,t 'SM(l 33S N011dlNOS30 -lV931 adid qjeauaq qjdap ]GAME) 9P2J6 JeUI51JO WOJJ V@AUl adid ol qld@C] (XVA) J- 'R L 9,0 9 �Z9-09Z-L06 apeJ6 leulblio w04 qjdap lelo_Ll— 5ulleld Hos swooipae nN jo jaqw @uOqd J@qlO El -W'DSVJOHOM- EINVI ia)sm StZZ punoA F] pao F� qoueji ap!AA Fm-] qoueji deaci E] SSGJPPV @}!S NESVH NEIZ130 H70S/H.UJON (]-131j NOlidNOSSVI aweN apej6dn � MGN 0 :10@fOjd Al!wej GIBUIS omi- F-] (a) xeldnC] F -j nov q4!m E] (jS) Apwed @15uiS j :Buillem(] OZ-�qZ-q �o :,GqwnN Old KWZdSO :,aqwnN 4!WJE)d iNOd3N N01103dSNI bGIVAUiSVAA 3116 -NO CIO ( @62d t706L-Ct7C (L06) - U01409S JG4emG4seAA Pue J94eAA 84!S -U0 l7n? qz WVC a5ejoqouV jo Al!ledioiunA �CCIJ1,J L � P- M-' � tic Oil � - ni, ERM T NUMBER: POSP201438 RECORD DRAWING NEW DRAINFIELD \ CO T4 v \'9 d Q O. X d MT DBL1&2 A e. \ n 01 m l� MT o .d• m d DRIVEWAY a \ STI o !! a— H e I \ / C EXISTING 4 \ / d BEDROOM HOUSE \ / DECK \ /Od / roe, lwF`C �OrUs o• �� d v 4 PARCEL ID NUMBER: 018-251-20 NEW 1250 GALLON HDPE GREER TANK APPROXIMATE 100' WELL RADIUS / ENGINEERING SALES CONSULTING 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, AK 99507' PHONE (907) 337-6179' FAX (907) 336-3246' WEBSITEg.--g--q PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DEREK HAGEN 907-250-5216 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: Tl 2N R3W SECTION 33 LOT 82 E150' D.J.G. TYPE OF WORK: DATE: SEPTIC RECORD DRAWINGS 1/11/2021 OSP201438 RECORD DRAWING TOP OF MH = 100.00 FINAL GRADE = 99.62 ST2 2" INSULATION PER CONTRACTOR TOP OF TANK AT INTLET = 95.93 --\ I I I I / i- TOP OF TANK AT OUTLET = 95.93 PARCEL ID NUMBER: 018-251-20 INVERT OF BUNG AT INLET = 95.24 NEW 1250 GALLON INVERT OF BUNG AT OUTLET = 95.10 H.D.P.E. GREER SEPTIC TANK ORIGINAL GRADE AT NORTH SOUTH HIGHEST POINT = 96.11 �O� FILTERFABRIC HIGHEST FINAL GRADE 6 97 0 HIPOI96.18 2020 T.H. ORIGINAL GRADE 1 FINAL GRADE = 97 2020 T.H. I�'I( TER FABRIC t 4.02' INVERT OF PIPE = 93.13 4 102'W-1 INVERT OF 1 1IPE = 93.20 5' BOTTOM OF TRENCH = 89.11 BOTTOM OF TRENCH = 69.18 B'+ RELATIVE ELEVATION OF RELATIVE ELEVATION OF BOTTOM OF T.H. = 80.68 BOTTOM OF T.H. = 80.61 .••,��. OF]+� `9 ENGINEERING SALES CONSULTING 0 3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, AK 99507 -PHONE (907)337-6179- FAX (907)338-3246 * WEBSITE: www.gamessengineedng.com��,,,., I, ; +•.......•••...• .••..•...•••• 0 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 C'n A._Gar eSS w AV DEREK HAGEN 907-250-5216 3 OF 3 ��'' r C 79P3 ;`•_: PROJECT/LEGAL DESCRIPTION: DRAWN BY: `�� •• 12, I•.` �� Tl 2N R3W SECTION 33 LOT 82 E150 D.J.G. �1� FQ•p•f••. ..... ROFESS\•• '•', TYPE OF WORK: DATE: LICENSE 11110L**w • SEPTIC SYSTEM PROFILE RECORD DRAWING 12/30/2020 #AECC884 1 � / Municipality of Anchorage On -Site Water and Wastewater Program nr P.O.. Bos 196550 470061) 34tu trona Anchorage. Alaska 995196650 Pnonc: (907)34}790a F-. (907) 343-7997 httpa(ww mUnl.veybmne —� cparlmcnl Review Comments Engineer, GARNESS ENGINEERING GROUPLTD 213!2021 Legal Description: EPLANS T12N R3W SEC 33 LT 82 E150' ParcelID: 01625120000 Permit: OSP201438 Sephc Completed By: R Carroll Report Type: As Built Review The application has been reviewed and the fonovnng comments have been generated These are to be sabsfaclonly addressed prior to MOA approval: 1 Gond Sora:approval will be granted, tvrtn ofd sePtk tan4Lft station to be decommrssgned m sp^*t9 of 2021 `Grale� 1 -gyp Qd Io OPnv��"J Delivered Yesterday 2:25 PM Yes when the regrade was done Oeii,i as Text Message 0111, ZIW S996ZM S9S,51 06 zm -= r • � PA CC pQi (,Lu. �c Eq at Q 14 0 Ud Z n LZ Q '7Kcc ` LUw � W Z W cnEL Q U 1 "SIV. Ui (�y V �i� 'V.. :z/ uj iz R uu cc a-- 'w+UJ T� , ,Er+Y M� t�+ M W C) Ct CC caUi CQ..'A.�. '•'spy. '^V "•'"syn � r.� � �"'� -= r • � PA CC pQi (,Lu. �c 4-4 Q 14 0 Z n LZ Q '7Kcc ` -= r • � PA Q cs� ' glE A W cc :j Clb ,) c, c� o iz cc Bi owQ z U o 4m ua C/l Vs oQ P-- Uj ua zz U cn t vi j �5az cl U - CIS uj (L Z8 CO O U z �LL - wz�--vsw'c�>- zuu MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program mot S, PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 ,�� i http://www.muni.orglonsite It I)c1);1 51 It On -Site Wastewater Disposal System Permit Permit Number: OSP201438 Effective Date: 12/15/2020 Work Type: Septic Upgrade Expiration Date: 12/15/2021 Tax Code Number: 01825120000 Site Legal Address: T1 2N R3W SEC 33 LT 82 E150' G:3034 Site Mailing Address: 2745 NUGGET LN, Anchorage Owner: HAGEN DEREK A & KIM E Lot Size in Sq Ft: 49500 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 4 This permit is for the construction of: Z Disposal Field d Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15"65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: Date: � jC ) Z� Z- X ' Date: �� On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 018--251-20 Property owner(s) DEREK HAGEN Day phone 907-250-5216 Mailing address 2745 NUGGET LANE *ANCHORAGE, AK 99516 Site address 2745 NUGGET LANE *ANCHORAGE, AK 99516 Legal description (Sub'd, Block & Lot) T12N R3W SECTION 33 LOT 82 EAST 150 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 4 APPLICATION IS FOR: Single Family (SF) ( ® all that apply) (w/wo ADU) Absorption Field Duplex (D) Septic Tank Multiple Dwellings Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: N/A TYPE OF DEWELLING: Single Family (SF) (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) Distance: - I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 4y6, a CAVI p-11 Date of Payment: 1 /19 a C)a D Receipt Number: 0 H 7 5 1 G Permit No. 0 5 P 1')-O 1 11 3S Waiver Fees: Date of Payment: Receipt Number: Waiver No. (Rev. 01/11) (JARNESS ENGINEERING GROUP, Ltd ENGINEERING SALES CONSULTING �� , September 30th, 2020 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System Upgrade for T12N R3W Section 33 Lot 82 East 150th To whom it may concern: The existing 4 -bedroom house is served by a private well and septic system. The existing drainfield is in a state of failure and must be upgrade. We are proposing to decommission the existing septic tank and lift station per UPC and install a new 1250 -gallon HDPE Greer tank and a dual shallow trench type drainfield. One testhole was excavated on the property and the driainfield is designed within its 30 -foot radius. Comments regarding the design are summarized as follows: 1. SOILS: See attached 2020 testhole by Garness Engineering Group, Ltd. which shows, soil classification, percolation test and groundwater monitoring. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface water concerns. 4. TOPOGRAPHY: There are no topography concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If yo have any questions, please contact us at 337-6179. Thank you for your assistance. I I .E., M.S. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com il T12N R3W SECION 33; LOT 79 T12N R3W SECTION 33 LOT 78 T12N R3W SECTION 33 LOT 82 W180' T12N R3W SECTION — 33 LOT 83A / t APPROXIMAT I / 100' WELL R/ tUS \ \ u WELL \ gppROXIMAT 100' WELL RADIUS ,(NUGGET LANA/ / ;THAT ( RADIO I / T12N R3W SE1O11 33 LOTAi / (:SEPTIC AREA ( AF 100' CSEPTIC AREA i _ RADIUS T12N R3W SECTION / 33 LOT 111 B / T12N R3W SECTION 33 LOT 110A - SERVED BY WELL ON LOT 110B PER MOA RECORDS 1 Ltd ENGINEERING, SALES = CONSULTING 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE. AK 99507' PHC*E (907) 337-6179 -FAX (907) 338-3246 - WEBSITE: w .gamessengineering.wm PREPARED FOR: DEREK HAGEN PROJECT/LEGAL DESCRIPTION: T12N R3W SECTION 33 LOT 82 EAST 150 TYPE OF WORK: �, SEPTIC SYSTEM DESIGN UPGRADE PHONE NUMBER: 907-250-5216 PAGE NUMBER: 1 OF 2 DRAWN BY: D.J.G. DATE: 9/30/2020 oT s N I 1" 100— \ / # AV 0 . • ....... 0/ / 0 , f r ari4ess1. : Lv . 0#. • ,l C 7957 � '�� ..� �' ii RO LICENSE•,�� FESS, #AECC884 r�\",' DESIGN CRITERIA: NUMBER OF BEDROOMS: 4 GALLONS PER DAY (GPD): 600 PERCOLATION RATE/S: <1 & 1.7 MIN/INCH PROPOSED APPLICATION RATE: 0.8 GPDIFTI MINIMUM DRAINFIELD SQ.FT.: 750 FT' DRAINFIELD DESIGN: MAXIMUM DEPTH: 7 FEET WIDTH: 5 FEET LENGTH: 50 & 50 FEET EFFECTIVE: 3 -FEET (PROPOSING TO INSTALL 4 FEET) REDUCTION FACTOR: 0.58 ACTUAL SQ.FT.: 862 FT, GEG, Ltd. HAS AN 8 PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE NOTE: CONTRACTOR TO HAVE EAST LOT ENGINEER, WELL DRILLER, CONTRACTOR AND LINE FLAGGED BY A PROFESSIONAL LAND PROPERTY OWNER AGREE THAT THEY HAVE SURVEYOR PRIOR TO CONSTRUCTION READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. PROPOSED DRAINFIELD 10' OFFSET \ M •a O< a• ° ° DRIVEWAY \ a., I EXISTI 4 BEDROOMOUSE I/A EXISTING FCO d 1 APPROXIMATE 100' WELL RADIUS I 4 / APPROXIMATE LOCATION OF GEG T.H.#1 TI 2N R3W SECTION 33 LOT 83A PROPOSED 1250 GALLON HDPE GREER TANK; INSTALL DOUBLE CLEANOUTS BEFORE AND AFTER TANK EXISTING SEPTIC TANK AND LIFT STATION TO BE DECOMMISSIONED PER UPC APPROXIMATE LOCATION OF EXISTING DRAINFIELD TO BE ABANDONED IN PLACE FOR POSSIBLE FUTURE USE il N SCALE: V=40' s•�P�� OF ���,Ad 1 �s GARNESS ENGINEERI 1.1 ... NG GROUP, Ltd,,..............�..j.�...........................• ENGINEERING SALES CONSULTING f l� �! f 3701 E. TUDOR ROAD, SUITE 107 •ANCHORAGE, AK 39°07' PHON= (57r) 337 5779 • F.1;C (S07) 338-3246'N.cBSITE: crc,i.r,�m-=r_or.,r:-edng.ccm f -� ..... i. , ai,u,.:, , f PREPARED FOR: PHONE NUMBER: PAGE NUMBER: I ,• jJeffrey.A. Guess �� = DEF.EI'; HAGEN�I 907-250--5216 2 OF ? •j� CE -7853 PROJECT/LEGAL DESCRIPTION: / J' • i T '12N�! RMI SECT IOM 33 LOT 82 ; 1ST 150 Dip e •�1�F�AF�'••9„;' 114 /, ��F��: TMPDE SIGN! OF S=DTIC TANK AND DRAINFIELD UPGPADE DATE: LICEN�Ota„S"**' •• 1 �! I (/2020 #AECC884 3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, AK 99507 -PHONE (907) 337-6179' FAX (907) 338-3246' WEBSITE: m ga ssengineenng.com SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: Tl 2N R3W S PERFORMED FOR: DERECK HAGEN DEPTH (feet) 1 2 GM 3-11 111 11 ML WITH LOAM 4- 5 6 7 8 9 10 11 12 13 14 15 B.O.H. 16 17 18 19 PERCOLATION RATE "1.7 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 6 FT. AND 7 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO SOILS LOGGED BY: DAVID GARNESS, PE PERCOLATION TEST PERFORMED BY: ERIK WIDGER COMMFNTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. *RECOMMEND A 0.8 GPD/FT APPLICATION RATING GM ECTION 33 LOT 82 E 150TH DATE: 9/18/2020 TEST HOLE #1 - LOWER BENCH SOIL CLASSIFICATIONS DEPTH TO DATE GROUNDWATER DRY 9/18/2020 DRY 9/25/2020 r SITE PLAN DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 9/18/2020 1 11:42 - 6" 101191 2 11:52 K/ZP, 0 6 :�1't�ICi]iCY '� - M O 4 12:02 /y�/�/�p 0 6 5 12:02 DEPTH TO DATE GROUNDWATER DRY 9/18/2020 DRY 9/25/2020 r SITE PLAN DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 9/18/2020 1 11:42 - 6" - 2 11:52 10 0 6 3 11:52 - 6" - 4 12:02 10 0 6 5 12:02 - 6" - 6 12:12 10 0 6 7 12:12 - 6" - 8 12:22 10 1/4 5-3/4 9 12:22 - 6" - 10 12:32 10 1/4 5-3/4 11 12:32 - 6" - 12 12:42 10 1/4 5-3/4 PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 3701 E. TUDOR ROAD. SUITE 101 'ANCHORAGE AK 99507 ' PHONE (907) 3376179. FAX (907) 336x246' VNESSITE.-gamessengineenng.cam SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: T12N R3W SECTION 33 LOT 82 E 150TH PERFORMED FOR: DERECK HAGEN DATE: 9/18/2020 DEPTH (feet) TEST HOLE #1 - UPPER BENCH 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 GM ML WITH LOAM GP/GW WWI SOIL CLASSIFICATIONS DEPTH DEPTH TO DATE GROUNDWATER DRY 9/18/2020 DRY 9/25/2020 I SITE PLAN I DATE READING CLOCK I NET TIME WATER LEVEL NET DROP TIME (MINUTES) I READING (INCHES) PERCOLATION HOLE ABSORBED 10 GALLONS IN LESS THAN 4 MINUTES 19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. _ TEST RUN BETWEEN 4 FT. AND 5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO SOILS LOGGED BY: DAVID GARNESS, PE PERCOLATION TEST PERFORMED BY: ERIK WIDGER COMMENTS: PERCOLATION READINGS ARE WITHIN 1/160F INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE FO MED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: lb - 6 (INCHES) NNE,um DEPTH DEPTH TO DATE GROUNDWATER DRY 9/18/2020 DRY 9/25/2020 I SITE PLAN I DATE READING CLOCK I NET TIME WATER LEVEL NET DROP TIME (MINUTES) I READING (INCHES) PERCOLATION HOLE ABSORBED 10 GALLONS IN LESS THAN 4 MINUTES 19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. _ TEST RUN BETWEEN 4 FT. AND 5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO SOILS LOGGED BY: DAVID GARNESS, PE PERCOLATION TEST PERFORMED BY: ERIK WIDGER COMMENTS: PERCOLATION READINGS ARE WITHIN 1/160F INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE FO MED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: lb - 6 (INCHES) Municipality of Anchorage Page 1 of 2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343=4744 Onsite Wastewater Disposal System and/or Well Inspection Report I Permit Number. SW000101 PID Number. 018-251-20 ! Name: PAULA YOUNG Wastewater System: ❑ New ❑ Upgrade Address: 2745 NUGGET LANE ANCHORAGE, AK 99516 ABSORPTION FIELD Phone: (907) 345-5851 No. of Bedrooms: 4 i O Deep Trench CI Shallow Trench ClBed CIIbund OOther LEGAL DESCRIPTION Sa Tell DepN ham waft DPD/Sa R I rt Lot, Block: Subdivision: D"M Io pip. sotto hon or,puw raft C w W pU s«wdn pipe 82 n Township: 12N Range: 3W Section: 33 N added ebm angina rade: \�G roa WVft i I R rL WELL: ❑ New ■ Upgrade arwwl wkfh: Number of Net DWt be Mee: I FL n Ckweilkalbn Prhole. Aa.0 : Taw Depth: Coved To; Told„ Pipe ne,er,ok PRIVATE 1 400' pt 360 pt m. rt 0r .. Deb Drwed:Slaua wafer la.ek Dela Yutuoef: ALPINE DRILLING &ENT. 5/6/00 52' pt i Ywb: Pvnp 50 u: cools Hdah, Abwe Q..t TANK 7.0 cPw U.K. rt 2 rL SEPARATION DISTANCES 0Septic Cl Holding To Septic Absorption Uft Holding blk/PrMele wandactw.r: �N cepadq 1. gnuww: From Tank Field Statbn Tonk Sewer Unee Well 100'+ 100'+ 100'+ — 25'+ webw oe Naniw d w ro«un a,e wiar° - - - - - LIFT STATION Lot su. ti ga1Me Hwanealuar. Una — — — — — ' urrp onW.d d: oL HO w,er dorm at- tFoundation Foundation — — — — — Curtain NO KNOW P,anv waw ewveauaw p«+wm.a Drain I Remarks: BENCH MARK I taeelbn .af Dw� I,paan: I I FL eNoerecfn eve. 4006�4pp 0 PSE. • I ��DO Inspections performed by: AWWC, INC. Dates: 1st N/A .............. O 2nd N/A 3rd N/A OQ r y A.' Ga r Department of Health and Human Services approval � �pp4ee^e�P �9530\�0`•+0� Reviewed and approved by: / W Oyu 2o-o Dater �p rofessto� �440�0000 -013 «. • , woe 25 ° oo PERMIT NUMBER: PARCELID NUMBER: AS—BUILT DRAWING swoolol018-251-20 I i A 8 I WELL 1 40.3' 1 36.2' EXISTING I 4 BEDROOM HOUSE 1 I I / \ EXISTING I EXISTING WELL SEPTIC ABANDONED COMPLETELY I SYSTEM PER AMC 13.33.060 \ 1 \ / i fU)T1 NEW WELL 100 / LOCATION \ I D I \� /NUGGET LANE DATE: // 6/15/2000 6opd0O4 o Fi �In DRAWN BY: • . -•, _! 11 I _.. ,.., ALASKA WATER & WASTE NVATER J L'" SCALE: CONSULTANTS, INC. 1 » - 50'"""' " ' ' """ ......Q 6901 DFBARR ROAD, WYE 29 ' ANCHORAGF, AK 90504 ' PHOMF (907)]57-0170 • FAX (007)1193246 — Q PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••.s: PAULA YOUNG 907 345-5851 2 OF 2 Q of ey, A.! Car OQ LEGAL DESCRIPTION: LOT 82; SECTION 33, T12N, R3W G• •, C 7953 S� �� ' •., I �dG 4400�P�Ofesslo(\ TYPE OF WORK: AS-BUILT OF NEW WEL LOCATION 4ppp000 From : ALPINE DRILL 907 345 0202 W I - 3 2 r/� i Jun.15.2000 W.27 PM Municipality of Anchorage 191 Department of Health and Human Services 825 -L' Street �Wj_ P.O. Box 196650 Anchorage Alaska 99519-6650 Rick Myetrom hhpJMww.ei.amh=ge.ek.us Mayor Permit Number: RSW 01 Date ofbaue:5-12-00 PareelldenlificalionMumbtr. D18251-20 Hate Started: "4-00 Date Completed: 516-00 Is well located at approved permit location? ® Yea ❑ No Legal Descriptio 112n r 3w Sec 231182 E 151' property Owner sme & Address: Tim & Paula Young 2745 Nugget Lane Aftlwag&, A4 W16 Borehole Data: Snil'I'ypc, 71i"ness & Water Strata Depth (ft) From 1'0 Method of Drilling Nair rotary ❑ cable tool Casing type: stool stick-up 0 2 Wall '11ickness:,025'inches organic &silt 2 4 Diameter:'¢ inches Dcptlt: 460 feet gravelly silt 4 57 liner Type: water sand & gravel gravelly silt water sand & gravel 57 61 99 61 99 102 Diameter: inches Depth: I feel Casing stickup above ground::? feet Static water level (front ground level): 52 feet Pumping level: 105 feet after silt 102 107 2 hours pumping 7 gpm gravelly silt 107 141 Recovery Rate: 7 gpm silt 141 150 Method of Testing:lLrA Well Intake Opening Type gravelly silt -inlet silt & clay 150 400 ❑ Open find ❑ Open Hole ❑ Screened Startfat Stopped feet N Perforations Star( 101 foci Stoppod l05 feet RECEIVED Grout Type. IkratoDite tt 8 ( Volume: jig Depth: Start0 fat Stopped ± feet Pump: Intake Depth feet JUN 76 2000 Pump size hp Brand Name pe unfcipality of Anchorage P Health & Human Services Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: Cbnne Tablets Comments: I Well Driller: Alpine Drilling & Enterprises P O Box 110496 Anchorage AK 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion andl the property nnm,w n. t6. "..It A-nlw •MII 1nn In t6. 1bM nrl I..m, s, �n Aove nr �mm�4l:nn Sent by1AAROW PUMP AND WELL Jun -17-00 091414n rron 90733389761907 338 3246 AAROW PUMP & WELL SERVICE L.L.C. P.O. BOX 110496 ANCHORAGE, AK. 99511 TO: Munidpalq of Anchorage Dept of Health and human Sm ices. FROM: ARROW Pump & Well Service L.L.C. Referenced Property: 2745 Nugget law. Anchorage. AK 99516 71aA! 1-3 W Sec 9 3 Lo ' cl 0 - The The old well at the above property approx. 10 R off the west side of house has been abandoned in Accordance with the current MOA well ordinance. Do due high level of nitrates well was shot pelferated from 72-78ft , and from 45.57ft. Bottom of well was sealed with bentonite drips then well was pressure grouted k"OW Pomp & well Suslce LLC. Brian Wille ,e . MUNICIPALITY OF ANCHORAGE Department of Heafth and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ONSITE WATER SUPPLY PERMIT Upgrade Permit Number: SW000101 Legal Description: T12N R3W SEC 33 LT 82 El 50' Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: Paula Young Owner Address: 2745 Nugget Lane Anchorage , AK 99516-3935 This permit is for the construction of: Date Issued: i May 12, 2000 Expiration Date: May 12, 2001 Parcel ID: 018-251-20 Site Address: 002745 NUGGET LN Lot Size: 49500 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: i ❑ Disposal Field ❑ Septic Tank Holding Tank ❑ Privy Q Private Well ❑ Water Storage I 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 ). I 3. The engineer must notify DHHS at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-4744 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 1 5. The following special provisions. t. EXISTING WATER WELL SHALL BE ABANDONED PRIOR THE WELL DRILLER LEAVING THE PROPERTY. Received By: Issued By: I Date: CX) I Date: —(Jd ALASKA WATER & WASTEWATER CONSULTANTS, INC. May 11, 2000 Municipality of Anchorage Department of Health & human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Well Upgrade for Lot 82; Section 33, T12N, R3W, To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The existing septic system was installed on 7/7/81 and it is unknown when the well was drilled. The existing septic system passed an adequacy test on 4/25/2000. A well flow test was also performed on the same date and found the well production to be 4.3 gallons per minute. Recent water samples taken from the existing well showed nitrate levels between 12.9 and 13.1 mg/L. Attached are the results of the water samples. Given the high level of nitrates;' we are proposing that a new well be drilled. Attached is a site plan showing the proposed well location. The existing well shall be completely abandoned per AMC 15.55.060. I I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Sincerely .E., M.S. 6901 Debarr Road, Suite 2B — Anchorage, AK 99504 — Ph: (907)337-6179 — Fax: (907)338-3246 T12N, R3W, SEC 33, LOT 79 I I I I 1 1 I I I I T12N, R3W, SEC 33 LOT B2 _--' 1 I EXISTING WELL IS TO BE I ABANDONED COMPLETELY I PffR AMC 15.55�060--�' 1 � 1 I I PROPOS WELL I \ UPGRADE LOCATpN- I \ \ I \\ I 1 ♦ C T12N, R3W, SEC 33 LOT 111A T12N, R3W, SEC 33, LOT 78 r ------------ -------------------------- -EXISTING 4 BEDROOM 1 HOUSE 1 �� �♦ I T12N, �R3W, SEC 33 \ \\ I EXISTING LOT 838 \ I SEPTIC I ` 1 1 SYSTEM I 1 1 I T12N, R3W, SEC 33 I LOT 834 I� 1 I 1 I NUGGET LANE 712N, R3W, SEC 33I T12N, R3W, SEC 33 LOT 1118 LOT 110A 1 L T12N, R3W, SEC 33 LOT 1108 ALASKA «'ATKR & `'WASTEWATER �•w,M, CONSULTANTS, INC. Ste. t 4 M 901 OEBARR ROAD, SUITE 28 • ANCHORAGE, AX 9950. • ENONE 907 57-0179 • FAX 9071156-3246 1 = 100 % ...... 'j EPARED FOR PHONE NUMBER: PAGE NUMBER: r . . . . ........ PAULA YOUNG (907) 345-5851 1 OF 1 v. i of re G Oe94' LOT 82; SECTION 33• T12N• R3W SITE PLAN FOR PROPOSED WELL UPGRADE LOCATION. 1 I I I I 05-08-00 13:4T FROM -CTE ENVIRMLENTAL 5615301 CUE Environmental Services Inc. Laboratory Division 200 W. Potter Drive Anchorage, AK 99518 Tel (907)562-2343 Fix: (907) 5615301 i T-841 P.01/02 F-214 CTBE Ret. s: 1001958001 Client POs: Na Client Name. AK Water 8 Wastewater Cons. Printed DateTme: 05/O1i100 13:40 Protect Name: Na Colleaed Date/Time 05/04/00 21:00 Client Sample ID. 2745 Nugget Ln Hose Bib Received Date/Time: 05/05.100 D9:30 Matrix: Drinking Water Technical Director. Stephen Ede PWSID h/a Released By: M w n A sample Kemam s - i i Allowaole Prep Analysis Parameter Re;utty POL Units Method Limits Date Date I mit Nitrate/ 13.1 0 l myL EPA 300 10.0 05105/00 SCL WO -01-00 16:31 FROM -CTE ENVIROMENTAI. 5615301 T-692 P.03/03 IF -978 C7&E EnvironmeM i Services Inc. I.6bor.t�arY awttiea 200 W. Pour DfmQ I Report foi Total Coliform Bacteria �«+w AK 6!6"'1606 frig Water Analysis Rep TM: 19071662.23433 1 REApINSTRUCT/ONSONRBY[RS6SI�YREFORCCOLL£CnMGS"PLE For 49n561 -Ml ! mar enol rmn BY LABORATORY o PUBLIC WATER SYSTEM LD. 10 - i9, PRIVATEw^T9RSYSTP( D sod Amb O ........ I --- Aneti^- r. AK 99504 • O SdRo O SwrNw4v SAMPLE DATE: Ypr SAMPLE TYPE: O Tnum wow a• R..dao a U6as9adwow D Repeat smq& (fer feud" "ll with lab tett. o+. i D Spocw hrp000 Tbw CoBNtod SAM U LoCATIOM t> sbcw NY J e i sec 33 L�si Sa r-,�� Commons: ArAhSa *AM dug Www SAMPLP ri be: q k 30 boors OK MAN loa7 be I O SMMW No bf 6a ww it osmplo shtid Ngkdxmltw ICRw6rMr JWWMMM Vag >� •vcry tIol�R000PeA 1741 TUN b ed"d _ 3 Am** bOm w Fair A99:>fNallKrdo� O ADdt�MUG p�k' i Malyft 1001766 � �� .__.�... ...�. Ebb 'Jon 13 hs" Des TMS ' cuem Osla d of 3' 662N: norm; wft vl 9 I Pa 4 O Tiw e CrVffOUX=ALW*T aANALYst =COM ."xOol ammw T*A Co6&m s cer maw"sM wow Ohw CAMIN C"� Co1NIoo13N NI VWM=O a LTg 67G1 Fetal C46Ettn CoalSrouum Co6loesYlN r Foal M.r►rw rawR4NIn bee >Vte Oreo TINS i I rner-r«a.w.rrrr.+. pa i Drat■ i OEIernOar el Mn 906 Woo dt4ntw OinMsto d 6Uooid�► _ _�. .......� u•wn ars Wora" M650N91. Mi1N �QtdEY. O�s0. WEST vt044MM \\ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION !I ENVIRONMENTAL ENGINEERING DIVISION / 825 L Street •Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT I NAME PHONE r O NEW t L'-UfrGRADE MAILING ADDRESS Sazo -� LEGAL DESCRIPTION �r/` A,Y/ -3�J 3-3 7`/ / LOCATION NO. OF BEDROOMS 44 DISTANCE TO: WellAbsorption lool area Dwelling PERMIT NO. O EY GManufacturer W A� Material No. of comparIS L n � Liq. c�asuy �Cl n gallons IF HOMEMADE: Inside length Width Liquid depth Z DISTANCE TO: Well Dwelling PERMIT NO. d C7 _ _ 4 Manufacturer Material Liquid capacity in gallons O ANCE T0: Well V' CP if Foundation Nearest lot Ime� —� PERMIT NO. W =rT.p 99 .W.1 LL 2 f ? G ines Length of each line 2— Total length of lines t_ Trench w� th � inches Distance between lines /n /U /)' H tile to finish grade Material beneath file r Total effective absorption area inches Length 40dth Depth PERMIT NO. W U Wi Type of crib Crib diameter Crib depth Total effective absorption area a DISTANCE TO: Well Building foundation Nearest lot line i J Class Depth Driller Distance to lot line PERMIT NO. —1 DISTANCE TO: Building foundation Sewer line Septic tank Absorption areals) OTHER PIPE MATERIALS / D SOIL TEST RATING ` z INSTALLER • � 1 4.4 l REMARKS S r i I I APPROVED DATE LEGAL 72.013-tRev. 3/78) C/ v ! • MJJN I C I F- AL I Tyr• ,OF= Ffr-4iCt-IL+RAGE DEPARTMENT OF HEALTH AND EFJVIP.ONMEFJTAL PROTECTION In�An 7 825 'L' STREET, ANCHORAGE, AK. 99501 i �Y 264-4720 (DN—ESE: I TE S~E4JER F='ERM 17 - PERMIT TPERMIT NO. C 810589 ) 'aLt, L!4 ,juchq APPLICAFJT DAVID P. HOLLINGWOP.TH SRA BOX 4020-A 344-6864 LOCATION NUGGET LN LEGAL T12N R3W SEC 33 L82 _ LOT SIZE 49500 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (50 FT/BR)= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: E>EF�TH= O LENGTH= 63 (3RAtieEL_ QEF=TH= THE LENGTH DIMENSION IS THE LENGTH (IFJ FEET) OF THE TRENCH OR DRAIFJFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTAFJCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIFJ FEET): THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MIFJIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIFJ FEET). REnLJ I REE> SEF}T I C TAr-4K S 12: E: ::IL C GALLONS~ PERMIT APPLICAFJT 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. --- -rL40 C 2 7 ARE REG!lJ I FREL? --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MIFJIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING Igor! THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER. LIFJE IS 25 FEET AND TO A COMMUNITY SEWER. LIFJE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F='ERM I T EXP I RES E>ECEME3ER 31r 1_?S1 I CERTIFY THAT 1: I AM FAMILIAR. WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IPJ ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER, SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE j REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. QgjLo 6L; =1' ►.Q.a lc «hrRthl�&h J. 1066 ,Z�td 46 SIGNED:_-�---------------- -- ------ n ° 14 �� T►.¢ (J I lbw;..y APPLICANT DAVID P. HOLLINGWOR dt u5 a.�l Ia,.JIi� ✓rear b¢ +Sad -Da pi t, = 10 (4, 'Le th ISSUED BYV -------DATE_;L w _QC12L _ Yhisr lowir )VA6. 0 . !// GEkTi F�Ct9Tx�N a= N ' Sa.L3 LC(r. Municipality of Anchorage 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264.4111 GEORGE M SULLIVAN, ; MAYOR i DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION December 31, 1980 David P. Hollingworth Star Route A Box 4020-A Anchorage, Alaska 99507 Permit # 800622 1 Subject: T12N R3W Section 33 Lot 82 A permit issued by this department for well and/or sewer system has expired as of this date. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. i If there are any further questions, please call this office at 264-4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental cialist LNB/ljw enc: Copy of Permit SWP/057 i MUtJ I C I PFiL I TY OF Fit�FCH�RFiGE DEPARTMENT /'HEALTH AND ENVIRONMENTAL, ACTION 825 STREET, ANCHORAGE, AK. 9_ 01 264-4720 .• - I OtV-S I TE 'SEWER PERM I T PERMIT NO. C 800622 ) APPLICANT DAVID P. HOLLINGWORTH SRA BOX 4020-A 344-6864 LOCATION NUGGET LANE LEGAL iT12N R3W''SEC."'33 "GVT "LOT -82 T LOT SIZE 49500 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RRTING CSO FT/BP,)= 125; THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: F>EPTH= :S L_EtJ(3TH= S3 GRF VaL_ E>EPTH= 4 i THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). FtEGtU I REF? SEPT I G Tl=tr lK I ZE= 1254 GFiLLOFVS I 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. T44G <:2> FARE REG[U I REF7 --- 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 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. ' OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERMIT EXP I RES ©EGEMFIER 311 AL55G0 I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. j 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. i SIGNED:/r__�(_�3L'�------------- — APPLICANT DAVID P. HOLLINGWORTH ISSUED V4. 0 ,CONST, UCTION 18C ^W. 4811-1 AVE. SIE. 'C' ANCHORAGE, ALASKA 99503 TEST LAB 248-1333 PERFORMED FOR, DAVE HOLLINGSWORTH DATE PERFORMED:10/23/80 LEGAL DESCRIPTION: Lot E 150' of 9M Govt Lot 82 Subdivision T12N, R3W, Sec. 133, S.M. THIS FORM REPORTS: ;RVisual Salts Examination O Percolation Test PROPOSED INSTALLATION; - O SEEPAGE PIT 10 DRAIN FIELD O OTHER COMMENTS : Inspection of the drain field may be necessary if additional depth of trench is needed to drain sewage ram existing house and ver fy�nous layer of gravel I TEST.PERFORMED BY -.KRB DATA CERTIFIED BY:_xTNNFv u_ nnxTFR P F DATE: 10/23/80 O 4o of x J'1v rv,.-c:�-.- dc.d- (-- vD- ,l ��- I i I / r(Ir r I� L� R g` 12-t do i I / r(Ir r I� L� R g` 12-t do 180C")W 48TH ST E.TION�ONSTF'�JCC ANCHORAGE, ALASKA 99503 Q TEST LAB 248-1333 PERFORMED .FOR: DAVE HOLLINGSWORTH DATE PERFORMED: 1 7/10/81 LEGAL DESCRIPTION: Lot E 150' of Block Gov't Lot 82 SubdivisionT 12 N R 3 W. 1SPc-33 S -M. THIS FORM REPORTS: VVisual Soils Examination O Percolation Test DEPTH SOIL FEET DESCRIPTION — 0.5 -Overburden — 1.51 Organic Sil — 12.0 Gravelly Sand Sandy Gravel Silt 16.01 BOTTOM OF HOLE WAS GROUND NATER ENCOUNTERED. No IF YES, WHAT DEPTH LEGEND c - Perc zone a S - Sample taken C - Frozen zone c - Water table NOTES 100 s 125 sf/b _ C 1 :a •:y �� 4 Kinney R. axter 3656-E •��i �F�OFE;$VOUd+ DEPTH TO H2O NET DRAINAGE — — F- I — 7. 0 Z w — - e- — `- o - w — - Z — w — 125 sf/b _ C 1 :a •:y �� 4 Kinney R. axter 3656-E •��i �F�OFE;$VOUd+ DEPTH TO H2O NET DRAINAGE I I — 7. I — Xist -Hous --- — `- Nu GENERAL SITE SLOPE I READING DATE GROSS TIME NET TIME DEPTH TO H2O NET DRAINAGE I I — I ---ERCOLATION RATE:_ ROPOSED INSTALLATION: COMMENTS :This is a that time only 12 may be required. DRAINAGE REQUIREMENTS: 125 slbr -- O SEEPAGE PIT X DRAIN FIELD O OTHER of trench the 12 t material is unus r� — TEST PERFORMED BY: Kinney R. Baxter _ DATA CERTIFIED BY: Kinney R._Baxter,- P.E. DATE: 7/10/81 _— Municipa'ty of P.O. BO?L4?6650 ANCHO... ,GE, ALASKA 99519-6650 (907) 343-4200 1 Anchorage MAYOR OWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES October 20, 1987 Alan Wien Alaska Environmental Control Services 1200 West 33rd Avenue, Suite S Anchorage, Alaska 99503 Subject: T12N, R3W, Section 33, East 150' of Lot 82 Waiver Request WR87-062 Dear Mr. Wien: Your request for a waiver of the 100 foot separation required between the well and septic tank on the subject property has been granted. This distance has been waived to the existing separation of approximately 96 feet (the septic tank cleanout -to -well separation was measured at 99 feet). This waiver is valid for the existing septic system only. Future upgrades of the sewer or water system are not covered by this waiver. I Sincerely, ��-- � • moi---� Stephen S. Morris Civil Engineer On-site Services cc Gus Andress, P.E. Manager, On-site and Water Quality Programs i � n n • `�, ALASKA C(IUIROCIf( nTAL COnTROL SBUICCS, inc. Engineerinq 6 Enuironmenlal Studies AtUNICIPP.LITY Oi�aG= Municipality of Anchorage Department of Health & Human Services 825 L Street Anchorage, Alaska 99501 CLAVI: AI �" CN U"J 1 51 97 October 2, 1987 I:ECEI Re: Lot 82, T12N, R3W, Section 33 Waiver Request — Well to Septic Tank ED On 8/24/87, an adequacy test, well flow test and Health Authority inspection were performed. Adequacy test results are adequate. The well flow test was run for 3.2 hours at 4.3 GPM. Static water level was 64 feet with 16 feet of total drawdown and recovery in less than 30 minutes. There Is no well log available for this lot. During the flow test, the water level dropped to 80 feet without reaching the pump intake. Attached are sample well logs from the area that range from 65 feet to 369 feet with no bedrock encountered and all cased to the bottom. Looking at the type of soil on these logs, the subject well would also be cased to the bottom. We also see areas of clay and hardpan. From the HAA inspection, we find the separation distance to be 99 feet from the well to the septic tank cleanout pipe. The inspection report, done by Les Bucholtz of the MOA shows the distance to be 100 feet. The well is at a slightly lower elevation than the tank, but any surface flow from the'tank would be to the north and to the south. Water samples taken 9/29/87 are satisfactory. The house is also located directly between the well and tank. Due to the above listed conditions, we feel this 1 percent reduction required separation distance will not pose a threat of contamination well. We request that you grant the appropriate waiver. If you have any questions, please call. T..lk�•F w;+c. A. of ...�. I! �•s..{ � �a�%b: /,'t., �'.SG...//o.r �..rt �w fi o n //5� aO'fa. ✓ L.. �[. C/a� � !e� cecco...�i r LI�J4flK CN0.a3• HG 1 -•Ll G•s. NQS .. c OQ L�oa_ wi.fG. N r v,•�r-... L o,C Approved by: S M OF %* 497" -9* • REIn, 1R. •2251 , A/ Sincerely, Alan C. Wien Engineering Technician 1200 U61 33rd Auenue. Suite B • Anchoragc. Alaska 99503 • (907) 561.5040 the the Lj�, Municipality of Anchorage • �� Development Services Department / Building Safety Division Onsite Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. COSA 1. GENERAL INFORMATION Expiration Date: Complete legal description 111M 183rd SEC 3.3 LOT 8Z Clsol Location (site address) _2745 Nsy -} bane Current Propertyowner(s) 11 UL All.,Ll ii j Day phone Mailing address 12"145 /1�N �r�} [a,� , A„ �e-atz K 99516 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSH w171 be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site 19 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 On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions In the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further 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 Islam) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Address 'hone 219- 351160 Engineer's Printed Name Lacs S�,rb1z�1 5. DSD SIGNATURE L/ Approved for —4 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By' v, Original Certificate Date: 9 - 27- O 6 (Rev. 11)05) 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 CHECKLIST Legal Description: _ T11 JV R3W 5EC 33 LOT 132 E ISO' Parcel ID: 0 10 A. WELL DATA Well type ri✓:+te_ If A, B, or C provide PWSID # _ Date completedA W Sanitary seal (Y/N) y Total depth O0 ft. Cased to —ft. FROM WELL LOG Date of test rt. Lo0 Static water level Well production g.p,m, WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate 0.1 mg/L Arsenic: Np ppb dale of sample: !S (o B. SEPTIC/HOLDING TANK DATA Well Log (YIN) Y Wires properly protected (Y/N) i Casing height (above ground) 20 In. AT INSPECTION 8/Soto 9r y5 g.p.m. Other bacteria f colonies/100 mL Collected by: _ n _SAljCV,.J Tank Type/Material An lorme. Wd I&I Date installed rf 1 81 Tank size Uso gal. Number of Compartments –2– Cleanouts (Y/N) y Foundation cleanout (Y/N) ,–± Depression over tank (Y/N) 1High water alarm (YIN) JV Daleofpumping llzavrr Pumper Dnali C)CG3V Gt1U Y1 C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2 or �_tis_ System type Otte Trtot Length ft. Width 3 ft. Gravel below pipe Total depth n. Eff. absorption area 500 ft2 Monitoring tube i Depression over field d Date of adequacy test G(p Results (Pass/Fail) IS For 4 bedrooms Fluid depth in absorption field before test 12- in. Water added V gat. New depth 18 in. Elapsed Time:11% min. Final fluid depth 3V in. Absorption rate >= W g.p.d. •' Any rejuvenation treatment (past 12 mo.) (Y/N & type) r0 If yes, give date – D. LIFT STATION Date installed t gt Size in gallons3�a�15ATManhole/Access (Y/N) 9 "Pump on' level at 32 in. "Pump off" level at 2 y in. High water alarm level at 35 in. Datum Me^ A nUf- Cycles tested 3 Meets alarm & circuit requirements? Yf- 6_ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >100 4 L.S. Absorption field on lot > too' On adjacent lots On adjacent lots too' -,too' Public sewer main A/ Public sewer manhole/cleanout N/A - Sewer /septic service line > Z5 • Holding tank ,V LA Animal containment areas Al V • Manurelanimal excrete storage areas N O SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation > 10 Property line )10� Absorption field > S Water main Water service line >10 Surface water N• 0• Wells on adjacent lots )too SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line )11 Building foundation ) to• Water main Water Service line )10 Surface water ^/.0 • Driveway, parkinglvehicle storage i So r Curtain drain N•0 • Wells on adjacent lots >100 F. COMMENTS G. ENGINEER'S CERTIFICATION CR I certify that t have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. r 4S�H. f Engineer's Printed Name L ars S �� Date Stu10te 111,}��• yZ1�0�•;;F`�� t,, COSA Fee $ Waiver Fee $ Date of Paymentg�zs�o� Date of Payment Receipt Number O oJ� Receipt Number (Rev. 11/05) SCS Rcf.# 1064764001 All Datc&Mmes an Alaska Standard Time Client Name Tobben Spurkland P.E. Printed Daterrime 08282006 8:09 Project Name/N T12N R3W Sec 33 Lot 82 Collected Date/time 08/152006 14:00 Client Sample ID TI 2N R3W Sec 33 Lot 82 Received Date rime 08/162006 9:20 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results PQL Units Method ContainerlD Limits Date Date [nit Metals by ICp/MS Arsenic ND 5.00 uP/L EP200.8 C (<10) 08/17/06 0823/06 SCL Waters Department Nitnuc-N ND 0.100 mgfL EPA 353.2 D (<10) 08/16(06 ALR Microbiology Laboratory Total Colirorm IOD. No Coli tot/100mL SM209222B A (<I) 08/16(06 TLP TL 0 WEST 150' of Ro Gov't Lot 82 Olt 6r than Moffman: LS -9020 * .......... (A 0 BLM 79 VZ EAST 150' of Gov't Lot 82 EXISTING GRAVEL, C11 - DRIVE 17, 9.2 LmiiiNG BUILDING 12.3 N L3 _O1 S 89*59'30" E 150.00' FA 0 0 C5 01 A Ln 0 -4 LIFT STATION H BLM 78 LOT 83A C4 L4 NUGGET LANE L4 (UPPER PORCUPINE TRAIL) 0 1 Legal Description: AS -BUILT Ordered By Catherine Newton with BPI Empie The EAST 150' of Govilt Lot 82, Legend: Set FndSeptic Standpipe© T1 2N, R3W, Sec. 33, 5/6'RB W/CAP @ 5/8' R8 0 War well Overhang lliilii Fwc*—X—X— U L_� - C Rabbit Creek Small Tracts 3.25' ALMON. 4j6MONUMENT -0 ght pole Woad EXCLUSION NOTES: It Is the owners' responsibility to determine the existence of any easernents, covenants, or restrictions which do not appear m the recorded ftbdIvislon plot. NOTE: Under no circumstances should any L antemn data hereon be used for construction or for establishing property lines. LAND & CONSTRUCTION SURVEYORS—PLANNERS—ENGINEERS SURVEY CERTInCATION: LANTECH has conducted a physical survey of this 440 West Benson Boulevard, Suite 200 Phone: 5:26-5291 property as shown on this drawing and that the Improvements situated thereon are within the property lines and no encroachments exist other Anchorage, Alaska 99503 Fax: 561-6626 than noted. Plot: lWd:SW3034 Date: SEPTEMBER 20, 2006 IDrawn By: TM I,Vofk Order. 2006L230 Fb/Pg: REF:87LI83 IScole: 1* -40' lchecked Or. APH MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services _ On -Site Services Section P.O. Box 196650 Anchorage, Alaska 995196650 (907)343-1744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING Parcel I.D. # 018-251-20 HAA # _ J90602S7 GENERAL INFORMATION Complete legal description T1 2N- Raw. SFc ss- LOT 82 i Location (site address or directions) 2745 NUGGET LANE, ANCHORAQF AK 99516 Property owner PAULA YOUNG Day phone (907) 345L 5851 Mailing address2745NUGGET LANE, ANCHORAGE AK 99516 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well xxx Community well Public water 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 xxx Holding Tank Community on-site Public sewer NOTE: if community wastewater system, provide written confirmation from State ADEC ing to the legality and status of system. 72-025 (Rev. 1/91) Front MCA 921 Computer version Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1760.00 at, or prior to closing for the engineering services provided. 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 further verify that band on the Information obtained from the Municipality of Anchorage files and from my investigation and Irr��pection, the on-site water supply and/or wastewater disposal system is In compliance with all Municlp I and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Phone (907) 337.6179 Engineer's Signature I f Date 6: ItIG u In conducting this evaluation, AWWC, In q Y ted to provide a thorough, conscientious engineering analysis o/ the system in accordance with ADEC and , AI DIS Guidelines & Regulations. The reported results described the performance or the system under the condition encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic system. on the local soils condition, ground water levels that may fluctuate during the year, and the usage o/ the family being served by the system. These conditions are outside the control o Me 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. AWWC, Inc. can therefore not provide any warranty for future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DHHS. The content o/ this report Is for the sole benerit of the owner listed above. Any reliance upon or use o/ this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 6. DHHS SIGNATURE Lff Approved for 4 bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: Additional Comments LIM Date i', - 2 n - 00 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. 72-025 (Rev. 1191) Baric MOA X21 Computer Version KKEIVEU Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICEOUN 16X000 Envtronmerdal Services Olvlslon i 825 OV Street, Rm 602 Anchorage. Alaska 69501 (907) 34340WAuTy OF 111W'N AENrALseRVICEs Health Authority Approval Cheddist j j Legal Description: T12N, R3W. SEC 33 LAT 82 Parcel I.D.: 018-251=20 A. WELL DATA Well Type PRIVATE If A. B, or C, attach ADEC letter. ADEC water system number I N/A Log pent (Y/N) YES Date completed 5/16/2000 Total depth 400' Cased to 360' Casing height (above ground) ' 24" I Sanitary seal (YIN) YES Wlres properly protected (YIN) YES FROM WELL LOG Date of teat 5/16/00 Static water level 52' Well production 7 g.p.m. WATER SAMPLE RESULTS: Conform 0 Nitrate 0.5 MG/L Other batters I 0 i Date of sample: NnPATES SAMPLE 531 00 Collected by: A.W.W.C.. INC. I BACTERIA SAMPLE 6 12 00 B. SEPTICIHOLDING TANK DATA g.p.m. Date insWed 7/17/81 Tank size 1250 Number of Compartments 2 Clearwuts (YIN) NES Foundation cleanout (YIN) YES Depression (YIN) NO High water alarm (YM) YES Date of Pumping 4/25/2000 Pumper ISAAC'S PUMPING C. ABSORPTION FIELD DATA Date installed 7/17/81 Son rating (g.pAJI12 or 1t7J)drn) 125 System type i TRENCH I Length 32' Width 3' Gravel thlc1dx= below pipe 8' Total depth 18.5' — 11' EfleWve absorption area 512 SQ FT Monrax ft Tube present (Y/N)YES Depression over field (YIN) NO Oats of adequacy test 4/25/2000 Results (Pass/Fall) PASS For 4 ( Bede Fluid depth in absorption geld before test Qmn _DRY Immediately after 725 gal. water added (in.r 10.5' Fluid depth DRY (Ins) Minutes later. 38 Absorption rate = 600+1 Peroodde treatment (past 12 months) (YIN) NONE KNOWN K yes, give dam --- I- 72426 Ow. ilYeJ' Canpuur Wnbn D. LIFT STATION Date installed 7/17/81 Size in gallons 3' DIAMETER, 15' DEEP Manhole/Access (Y/N) YES "Pump on" level at" 170" "Pump o1P level aY 175" High water alarm level ar 135" .Datum TOP OF CULVERT E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: SepticRwlding tank on lot 100'+ On adjacent lots 100'+ Absorption Held on lot 100'+ On adjacent lots 100'+ Public sewer mein N/A Public sewer manhololdeanout N/A Sewedseptlo service line 25'+ LIR station N/A SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Absorption field 5'+ Water malniservice Ane 10'+ Surface wateddrainage 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property Ane 5' Building foundation 10'+ Water meinlservloe Ane 10'+ Surface water 100'+ Driveway, parking/vehicle storage area 10'+ Curtain drain F. ENGINEER'S I cer* that I l of MunloW n with MOA HAS Engineers HAA Fee S. 3 zrV e Date of Payment 6 / Receipt Number 72-M (RIv. Mr Cwo" VMflan Wells on fd inspections and review stems ane In confbrrmance MIS date. Waiver Fee Date of Payment Receipt Number 06-06-00 12:10 FR011-CTE ENVIRONIENTAL 5615301 T-812 P.02/03 F-633 //11 CC CTAS Environmental Services Inc. CUE Rets 1002603001 Client FOR CUent Name AK WaTer& Wastewater Consultants Inc. Printed Date/time 06/052000 8:51 Project Namc/N T12N R3 W Scc33 L 82 Nugget Ln Collected Datelrime 05/3120M 13:00 Client Sample ID T12N R3W Sec33 L 82 Nugget Ln Received Date/time 05/312000 13:00 Matrix Ordered By Drinking Water Teebsical DiA1,14tp Sepbei C. Ede� MID 0 Released SampleRemarks: Paranraer Results PDL Allowable units netaoe LfwIts Prep Analysis Date Dare lnit WATERS DEPT Nitrate -N 0.578 0.500 Rq/L EPA 300.0 10 RNn MICRO LABORATORY 05/31/00 SCL Total Coli Yore 16 00 r/ Coll Col/IDORAL SN16 92228 1 05/31/00 KAP 06-11-00 11:23 L1E FROM -CTE ENVIRON►ENTAL 5615301 T-123 P.01/01 ME Environmental Services Inc. Laboratory Division F-007 200 W Porter Drive Drinking Water Analysis Report for Total Coliform Bacteria Anchorage. z3 ;519.1606 READ INSTRVCTIONSONRE VERSE SIDE BEFORE COLL£CTLNCSAMPL£ Fax 007) 561-5301 MUST BE COMPLETED BY WATLK SUrrLICK O PUBLIC WATERSYSTEM I.D-R PRIVATE WATER SYSTEM Svaf Rss�Jp., r w ^ Ssn4ln.ass S- 3ZO .r..mer 337- l�9 y W r O Send Reface O re.Jlawrre ..,o.... +.rr..r «v 4 SAMPLE DATE: Month pay Year SAMPLE TYPE: ��T,'(��Rou1109 O Treated Water li �l�Ftept 11 Sample (for routine sample Untreated Water with lab Ttf. no. ) 0 Special Purpose SAMPLE LOCATION -(IZ 0 P3 W Src 33 (-0fg2 Comments: Analysts shows this Water SAMPLE to be: ySatisfactory O Unsansfactory O Sample over 30 hoars o1q, res"Its may be unreliable 1 0 Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable resuits. Please send new sample via special dell very mar Date Rfceived Timt Rteelved Analysis Began Analytical Method: (`Er- Membrane Filter Y] KMO-MUG l mi. 100287Q Resuh' Analyst Time Collected Collected By M46byyl C• Ell1 s BACTERIOLOGICAL WATER ANALYSIS RECORD MMo-MUc Rtlenb: Total Couform A cote Membrane Filter. DireaCount i7 Colonlaslloo mi Verification: LTB BGB COLIFIRM Fecal Coliform Confirmation Final Membrane Filter Results _ ,n\ Clol�rmA00 ml Reported By --t" 4`"'Time , brs PvTC. TM n.....e To ce- of I P.rrfaMM Memoir of the SGS Grown lSoereta Genarale w Surve.uenee7 ENVIRONMENTAL FACIUTIES IN ALASKA. CAUFORNIA fLORIOA. rluN01S. MARYLAND. MIChrGAN, MISSOURI. NEW JERSEY. ONTO, WEST VIRGINW mi 9 Sent toA.D-E•C. Anna Fbira Jun ❑ fazed Dam: Trmc Client notified of unsatisfactory results: ❑ ❑ tboaed Spokirwla Fazed Darr Time BACTERIOLOGICAL WATER ANALYSIS RECORD MMo-MUc Rtlenb: Total Couform A cote Membrane Filter. DireaCount i7 Colonlaslloo mi Verification: LTB BGB COLIFIRM Fecal Coliform Confirmation Final Membrane Filter Results _ ,n\ Clol�rmA00 ml Reported By --t" 4`"'Time , brs PvTC. TM n.....e To ce- of I P.rrfaMM Memoir of the SGS Grown lSoereta Genarale w Surve.uenee7 ENVIRONMENTAL FACIUTIES IN ALASKA. CAUFORNIA fLORIOA. rluN01S. MARYLAND. MIChrGAN, MISSOURI. NEW JERSEY. ONTO, WEST VIRGINW _AGE. ! MUNICIPALITY OF ANCHORAGE %� ! ._tC1. p,*• , S:I l` i C:lwlvN DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL��_�'�'� OF ON-SITE SEWER AND WATER FACILITY C r I \ / RECEIVED [ E D 264-4720 {` L 1. G 1 V Application Date A 47 1.'• GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) -- 1 -- .ice Location (address & directions) L/ c.aari cr7:v� 1 Business I (b) 'Applicant Name" ,elephone' Hom _`�JI— -Applicant Address ' (c) Is ((check on Lend ng Institution 13; Owner/builder ; Buyer ❑ ; Otherx(explain); ,,Applicant : j t '• "` Telephone (d) Lending Institution I �1. .' Address (e) Real Estate Company and Agent ;. Address , Telephone 5 : zz (f) Mail the HAA tot the following addres : , , . f -•2. 1 A-:7 TYPE OF RESIDENCE,.,-.':, ; Fami C3 Other Single-Fam!ly� "Multi y I l a Number of Bedrooms • t WATER SUPPLY,' ( : aV Community ❑ Publ+c ❑ individual Well ` Note Ilcommundywell systemmust have writtenconhrmationfromthestateDepartmentofEnwronmentalConservatlon "4 attesting to the legality and status --.4.. SEWAGE DISPOSAL ._ Onsite' Public E3 " Community 13Holding Tank 13 Note: if communitywell system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Pagel of 2 5. ENGINEERING FIRM PROVIDING( l,'3PECTIONS, TESTS, FILE SEARCH, DATA.AND INFORMATION As certified by my seal affixed heretoand as of the validation date shown below, I ver,.y 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 regulations in effect on _the date of this inspection. Name of Firm Az�:cA-S Telephone 5J& 1^50) V6 Address IZrV Al 33 e+'C Ja172-- $ A%tol At' 99roj I Date �• t�.r+'6' _".of wmt( W.�fe.� "/d ;',`l.. S..i+G. tt•....t - �...Y'.+...f+ /�.��/S 1 � _Q I ' CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations 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 homes and their lending Institutions in order to satisfy certain federal and state requirements. 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 engineers work. Page 2 of 2 72-025(11!84) A. WELL DATA r111 ...CN MUNICIPALITY OF ANCHORAGE (MOA) �-• 11 51537 HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 h LC D 264-4744 f Legal Description: c`/so LoT S Z T/2.✓ e3JJ See- J3 Well Classification 11 A, B. C. D.EC. Approved (Y/N) NJp Well Log Present (Y® Date Completed 7xr.�!� Yield 7•j 6,4H r Total Depth 80 /'f Cased to ITO r Depth of Grouting AfA Static Water Level 61� Pump Set at !JM I i Casing Height Above Ground a Sanitary Seal on Casing&) Depression Around Wellhead (Y�I Electrical Wiring in Conduit) Separation Distances from Well: To Septic/Holding Tank on Lot " ; On Adjoining Lots /400 To Nearest Edge of Absorption Field on Lot A70 't ; On Adjoining Lots /" t To Nearest Public Sewer Line JIA To Nearest Public Sewer / Cleanout/Manhole a. To Nearest Sewer Service Line on Lot Water Sample Collected by f 4, ikh/, Date 7 -Ag X87 Water Sample Test Results �� �' wlmlfrwl Comments t R Tc7T d s�-87. /l�EbarYltr, B. SEPTIC/HOLDING TANK DATA Date Installed 7 17 of Size IX -5-0 No. of Compartments .Z 1 Standpipes oY N) Air -tight Caps 6N) Foundation Cleanout (Y© 1 Depression over Tank (Y© Date Last Pumped e -7_9-e7 /S.b1e5 Pumping/Maintenance Contract on File (Y/N) 418 ;for 'J A 1� Holding Tank High -Water Alarm (Y/N) ��L4- Temporary Holding Tank Permit (Y/N) N Separation Distances from Septic/Holding Tank: To Water -Supply Well 99 To Building Foundation -e�7 i S To Property Line .s �-� To Disposal Field 1 To Water Main/Service Line Al r To Stream, Pond, Lake, or Major Drainage Course, �� t Comments ' %, Page] of 72-02611, .8'661 r,onl '`1� L8L 77X4 )UUAJ 1rt33 1 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design 7�G� Date Installed 7-/7-.?/ Length of Field 3y / r Width of Field 3' � Depth of Field �i Gravel Bed Thickness Square Feet of Absorption Area S/y Standpipes Presente)N) Depression over Field (Y© Date of Last Adequacy Test Results of Last Adequacy Test _CZlu/iT� Separation Distance from Absorption Field: To Water -Supply Well /00 rr To Property Line i To Building Foundation 14 -t- I To Existing or Abandoned System on Lot WA ; On Adjoining Lots - /O � -)X- To To Water Main/Service Line /0 �f To Cutbank (if present) J To Stream/Pond/Lake/or Major Drainage Course lOa 71 - To To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed 7—/ 7 b/ Dimensions -3 D/i{, bE71711 Size in Gallons Manhole/Access Y�i J) i "Pump On" Level at /Z •L "Pump Off' Level at i High Water Alarm Level a -t — /Z VentON) Tested foryw—E Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes&) Comments Check Permitted Bedroom Rating Against HAA Request .. Icertify thatlh the ked iefiied,orconformedtoall MOAandHAA guidelines ineffect onthe date ofthis inspection. Signed L/ 4-- Date -- 1O'1$'F7 Company /s MOA No. — 89'02-/ Receipt No. 309/-- 000.), - Date of Payment i0 — 7 Amount: $ Page 2 of 2 72078 (Rev 8'881 Pack rA n ilex � •.7 4 CITH,gip* DY G RECD, JP.J J 1 CE - 2251 ,xc� 0l16•a'I.6 I SNEO p. e� •rM 0 12y I I M II � yt, n r 33 )TAME I n HCVSE I P I (0I IWI Itb a r I� � / 1 -s ig 9 "l, 9 I a\ r, im sip �.� rRob•.r P. Oro t u pose r� o 1 �FEsslalN.�� + ,w f>m�sfon xare � r 1f1. w�ur oft I.- of Iny mawmilk r�yon>IlElflty b dol•trlllr� � R resMNmn vAk% M twl I�q••r , a"wmded r PIX WW r dlswmt&MM I 00M xw " howl W MW for sm"C n" w IV SeleMM" bow"WY Of Miw Ira& I - � M 30 0 Ev ECF 50. _ UGG g�T Z AN 01ISURVEY CERTIFICATION: t MnDy r•u al "Val r h••• w,, It ...t a PTO•61 Y ll KrIWA hereon •n0 M•t M• ITpIOMT•Atl tlN•tld Mwon n• wlMln M• pr•p•rty Ihw •nE •n�rerhrw•ntl ••IR Oth•1 MM nOtld. �Keka El�etkle. 9Ke. 349-3231 or 376-5062 Anchorage Wasiiia October 1, 1987 McLin Construction P.O. Box 8835 Anchorage, Ak 99508 Re: Sewage lift station located at 2745 Nugget Lane. To whom it may concern: Fuchs Electric, Inc. installed a low voltage, high water alarm for a sewage lift station located at 2745 Nugget Lane. Low voltage control systems less than 120 volt A.C. do not require an inspection by the Municipality of Anchorage Building Safety. All work was done by a qualified electrician. Sincerely, Fuchs Electric, Inc. Gary Momosor, Vice -President GLM:cs 1601 Eat Dimond Blvd. ANCHORAGE, ALASKA 99507 P. O. Box 502 WASILLA, ALASKA 99687 n MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIROM4ENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIR0NMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date Legal Description (include lot, block, subdivision, section, township) range) �13 0 07- 8-P- SaC I-& 7—/XN, 27, Vel SM I Location (address or direptions) 9-7 4/__, /V u e% e. .- -1 4 a.cu (a) (b) Applicants 6"-3/tiles %e - Home U Applicants Address i (c) Applicant is (check one) Lending Institution ; Owner/builder ; Buyer F:::[ ; Other E -:::j (explain); (d) Lending Institution G Lo V V Address (e) Real Estate Co. 6 Agent NGNL.- Address Telephone (f) Mail the HAA to the following address: 2. Type of Residence Single -Family r5a Multi -Family Other Number of Bedrooms '% 3. Water Supply Individual Well M Community 1= Public (describe) I Q 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 M 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 5. Engineering Firm Providing Inspections, Tests,File Search Data and Information As certified by my seal affixed hereto and as of the validation date shownlbelow, 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 filesiand 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 spection. I Name of Firm 0. Telephone _aW.7 /G - ICM, Address 3 IXC 5 �j Date 2' OFA jXX% I r �P��•... ISsf�l] OW 6. DHEP Approval Approved for _I bedrooms T (ENGINEER SEAL) ' —'.. /..Oi . .. ............ 2225-E • i^- `�,' By it Conditional Approved Disapproved Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND E.NVIRON?SENTALIPROTECTION (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 HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATAI 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 2] 7-19-84 /, MUNICIPALITY OF ANCHORAG: DEPT. OF HEALTH 8 ENVIRONMENTAL PRCTECTICtI MUNICIPALITY OF ANCHORAGE (MOA) 1,1AY pl3 95HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 RECEIVED A. WELL D4TA Legal Description: E 150.L 1018. SEC 33 I u, Well Classification If A, B, or C, D.E.C. Approved(Y/N) `Rd�._ Well Log Present (Y/N) N Date Completed '?A a, 19 7 o Yield 3,64,,,,,E Total Depth • V H Iwo M+ 4otCased to Li O �' Depth of Grouting N y%4A Static Water Level Pump Set At �rZO Casing Height Above Ground to Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) y Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank of Lot 100 t On Adjoining Lots 100 f To Nearest Edge of Absorption Field o1 pot On Adjoining Lots 1004. To Nearest Public Sewer Lira NOt./t= To Nearest Public Sewer Clearcut/Marhole NdNC To Nearest Sewer Servioe Line on! Lot 5a+ Water Sample Collected By i- S I Date 61%It5 Water Sample Test Results Sa�+�► Ad., � Comlents f? ..w � 5.5 4�,w,1 c TS 5r '. . B. SEPTIC/HOLDING TANK DATA Date Installed -7/ Size /;150 No. of Compartments % WO Standpipes (Y/N) Y Air -tight Caps (YM) Foundation. Cleanout (Y/N) y Depression over Tank (YIN) N Date Last Pumped _ 713h8 J5 Pumping/Maintenance Contract on File (Y/N) "lAr ; for N%/A Holding Tank High -Water Alarm (Y/N) -- Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holdirg Tank: To Water -Supply Well (CJO I To Building Foundatior. 60 To Property Line To Disposal Field / I To Water Mair,/Service Linc 5o To Stream, Pond, Lake, o: Major Drainage Course N ON Er Comlents i I Receipt N 6b�� Date Paid: a� Amount: yti [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption. Strata ►Q- Type of System Design % QLNC* Date Installed 7/1 Length of Field 32 Width of Field Depth of Field ) Gravel Bed Thickness 8f Square Feet of Absorption Area Soo Standpipes Present (YIN) pt)C Depression over Field (YIN) PQ Date of Last Adequacy Test S/S/gS Results of Last Adequacy Tbst 5,..[,+ Separation Distance from Absorption Field: To Water -Supply Well 10c) + To Property Lire To Building Foundation (n0 I To Existing or Abandoned System on Lot LJ 0 N E On Adjoinirg Lots 20 To Water Main/Service Line S J' To Cutbark(if present) N o N tz To Stream/Pond/Lake/or Major Drainage Course N o N G To Drive -day, Parking Area, or Vehicle Storage Area 'lot> Comrrts D. LIFT STATION Date Ir -stalled -17181 Dimensions .38 7" — 14, Size in Gallons Marhole/Access (YIN) "Pump On" Level at 1'3 "Pump Off" Level at 5 High Water Alarm Level at Vent (Y/N) y Tested for Pumping Cycles during Adequacy Test. Meets NCA Electrical Codes(Y/N) f comments ** Check Permitted Bedroan Rating Against HAA Request ** I certify that I have checked, verified, or ocnfor.md to all MOA H.AA Guidelines in effect on the date of this irspection. Signed Date -5" 54 Carpany MOA No. Q 5 sr -o ( KBl/d5/s (Page 2 of 21 =SOFA 11 1�[SCE rr LUNE 25 1371 / 2-15-84 WGJEG LAAD9 OPoCa 203 W. 15th AVE "C" ANCHORAGE, ALA: TELEPHONE: 1907 MAY 3, 1985 i R E S I D E N T I A L W E L L I N S P E C T I OIN LEGAL: LOCATION: OWNER: TYPE OF WELL: WELL LOG AVAILABLE: INSTALLATION REQUIREMENTS MET: WELL YIELD FROM WELL LOG: PUMP YIELD: DATE OF INSPECTION: TEST PROCEDURE: TEST FOR COLIFORMS: TEST RESULT: A ;. OF Al"sg �.... W... Vo. 2225-E lc NE 25, 1371 :�,j E150', LOT 82, SEC. 33, T12N, R3W. 2745 NUGGET LANE i DAVID HOLLINGSWORTH 1 RESIDENTIAL MUNICIPALITY OF,ANCHORAG: NO DEPT. OF HEALTH 8 ENVIRONMENTAL I PROTECT ICI I YES f IM p 3 1985 NOT AVAILABLE 5.5 GPM AT 35 PSI RECEIVED MAY 3, 1985 WELL WAS PUMPED AT A CONSTANTIRATE OF 5.5 GPM AGAINST A CONSTANT PRESSURE OF 35 PSI FOR TWO HOURS. TEST WAS NEGATIVE The Municipal requirement for well flow is 150 gallons of water! per bedroom per 24 hours.This !well surpasses this requirement. The assessment of the condition of this well applies only to the con- ditions as of this date. The Iflow, rate of the well may change due to subsurface conditions that may! not be observed from the surface,i and changes in land use and other fac- tors that may impact the conditions of the aquifer feeding the well. �G-JnG3umv pvCo S E P T I C LEGAL: LOCATION: OWNER: RESIDENCE: WATER SYSTEM: SEPTIC SYSTEM: DATE OF PUMPING: DATE OF TEST: TEST PROCEDURE: TEST RESULT: tEvP -4 la1 �...... t of * � 4931•.•. f: `.,n• o. 2225-E • UNE 25. 1971 101. n 203 W. 15th AVE "C" SLNTE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: 19071 2 79- 391 6 S Y S T E M A D E U A C Y E1501, LOT 82, SEC. 33, T12N, R3W, 2745 NUGGET LANE DAVID HOLLINGSWORTH SINGLE FAMILY, FOUR BEDROOMS ON SITE WELL MAY 3, 1985 T E S T S.M. MUNICIPALITY OF ANCHORAG; DEPT. OF HEALTH 8 ENVIRONMENTAL PROTECTIO,I I IJAY 0 3 W5 RECEIVED FROM MUNICIPAL RECORDS: TANK: ANCHORAGE STEEL, 1250 GAL COMPARTMENTS. LIFT STATION ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 500 SQ. FT. SOIL RATING: 125 INSTALLATION DATE: JULY 1981 MAY 3, 1985 MAY 3, 1985 TWO SYSTEM WAS INSPECTED ON MAY 2, 1985. MONITORING TYBE FOR TRENCH WAS DRY, ILIFT STATION WAS HALF FULL OF WATER. ON MAY 3 WATER WAS ADDED TO THE MONITORING TUBE AT A CONSTANT RATE OF 5.5 GALLONS PER MINUTE.I THE WATER LEVEL IN THE STANDPIPE WAS MONITORED. AFTER THE ADDITION OF 600 GALLONS THE STANDPIPE WAS STILL DRY. THIS SYSTEM ACCEPTED 600 GALLONS OF WATER IN A TIME PERIOD OF TWO HOURS. THE SYSTEM SURPASSES THE MUNICIPAL REQUUIREMENTS. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being sereved by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not!give any estimate of how long the system will continue to meet the operational requirements of the Municipality and State. r— Time APPLICVT FILLS OUT UPPER HAL'"ONLY j Pra "-rY Owner u i Phone Mailing Address S Q!l t t/ O ? O 21p Code r Q Buyer ' � a.N C,L� �- Date Address Zip Code I Lending Institution n�, n / ScLOo �^'1P oyers -moi-. �Lr�, &(.; Phone Address C � Q 5f . Zip code ;ri'so 3 .27z -1 YY G, Realty Co. & Agent Inspector Phone Address Zip Code Legal Description. 1�(cLTA- f 3 5 / ! 7-7-,/,2 N /C ipW N . Street Location A)kL Type of Residence 1. - C 1 1932 gYSingle Family ❑ Multiple Family No. of Bedroom °�3'L - ❑ Other RECEIVED rz Water Supply ( yt APPROVED BEDROOM /�) &(ndlvidual ( DISAPPROVED ATTACH WELL LOG. A well lop Is required for all wells drilled since June 1975. ❑ Community For wells trilled prior to that date, give well depth (attach lop If available). ❑ Public Utility DATE Sewer Disposal BY: @'Individual I Year Individual Installed: lfg� Date Sewer Installed ❑ Public Utility Well Lop Received When Connected to Public Utility: ❑ Holding Tank Well to Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time drt0 ctrdct Date Date Date Date l Inspector Inspector Inspector Inspector 1�(cLTA- Field Notes: DcoT C' )r. lj p, ENVIR.:i L'.'cLP. .. :-0.cJ._CTION 1. - C 1 1932 `� �• °�3'L RECEIVED rz ( yt APPROVED BEDROOM /�) 'CONDITIONS OF APPROVAL ( DISAPPROVED ( ) CONDITIONAL AP VAL- DATE BY: I Soils Rating Date Sewer Installed Well To Absorption Area Well Lop Received Septic Tank Size Well to Tank December 6, 1942 David P. Hollingsworth SPA Box 4020 A Anchorage, AK 99507 Subject: E 150 of £12 Sec 33 T1211 R31I S!1 Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: �z A well log submitted to this office for our files and review. A well permit is required by ordinance. Our records indi- cate a well permit has not been issued. Prior to approval, a well permit must be obtained frost this department. Q Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, Ln3/p/EII Les Buchholz Program Supervisor 1 hil GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274 Date Received OF Time of Inspection I Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER 8 WATER FACILITIES FOR 1/ Al -' ` Approval requested by:l'�nF+dra e �66e17�1 Mailing Address: 1FPhone: 2. Property Owner: S,C t Phone: Mailing Address: 3. Legal Description: �'3 ,Ci,FoZ S�sr 3.� T/2N .E'3Gc/ SCJ 4. Location: a`0if%bkaa� 0-.4' 4`41444' 5. Type of facility to be inspected No. of bedrooms �S 6. Well Data: A. Type—,4'y[U.�f�. ®I�K�GB. Depth i C. Construction .yup D. Bacterial Analysis SATiS 44 C 14 w 7. Sewage Disposal System: � A. Installed �' GS .7 B. Installer C. Septic Tank: 1. Size 7.50 2. Manufacturer — D. Seepage Pit: 1. Absorption Area — 2. Material 64 E. Disposal Field: Total length of lines I (St.✓�-�..o�i...� �.a�yt�a� .T�i7/Y.Z idsi y'f�v G.+v w B/�ors""q% 8. Distances: A. Well to: Septic tank 4&41 Absorption area 1461 Sewer Lines Nearest lot line (D t4 Other contamination -- B. Foundation to septic tank eqd " , Absorption area ore C. Absorption area to nearest lot line s20 EQ -034 (1/74) Page 1 of two pages 9Y •4 'S"'y I --- — 47 Datc Greater Q -j 3 1 i ty S Y'S T E f ..4 ^\ 61, -BITER ANCHORAGE AREA 60ROUGh " DEPARTMENT OF ENVIRONMENTAL QUALIT 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-86$6 DATE REC INSPECT: Z TIME: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES fvRe.r� FOR t. APP110TAL REQUESTED BY: p(JiC�J AWR.ESS: i'LP• /dmgrA' fOCS�� .C✓�T�l�?�•(� � M ME : � ��� . ,P %�L L✓0/1JC '� � Flo_, . �L ��.MMISM OWNER: IQ�LC/1 Pi�.4o�/ PHORE: • CRIPTION: BI. VM- CKMITY TO BE INSPECTED: STitEET: lil tr L.�hr� KOBER OF BEDROOMS: 2 6so tJ�'� fit•✓ fermi/ .ysi 007 w,~n o e -"o B. WECL QATA: �-v.4./tE70- .9sdi.e✓"- /jr a B.►TN C R IF lip�V o. Gax UCTION Oct E. CAMBIAL ANALYSIS ct�sar• �5vi ,�a+.s.+d 6. CEWAfiE DISPOSAL SYSTEM: "+�° v� �JJYYf✓ 73 rgvy ,gX+ts,irT A. SEPTIC TANK• (t. HOMEMADE,. SHOW: QIAGRAM ON BACK) 1 . SIZE !Q„fl T• 2. AGE ��///LOQ• /�, sr.�r� /�6� 3. MANUFACTURER 4. INSTALLER. 7. .-) ^) APPROVAL REQUES1'FOR SEWER 6 WATER FACILITILS PAGE TWO B. SEEPAGE PIT 1. SIZE 2. LIKING a 4-- cle'e'S C. DISPOSAL FIELD 1. NUMBER OF LINES 2. TOTAL LENGTH REQUIRED MEASUREMENTS A. WELL TO SEPTIC TANK B. WELL TO SEEPAGE PIT_/00 C. WELL TO SEWER LINE 0. WELL TO PROPERTY LINE E. WELL TO OTHER POSSIBLE CONTAMINATION F. FOUNDATION TO SEPTIC TANK S t G-. F0UNOATION TO SEEPAGE PIT N. SEEPAGE PIT TO PROPERTY LINE COMMENTS: I APPROVED DI-SAPPROVED: 60,0007o DATE: DATE: i APPROVAL Y LID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY February 23, 1972 Ms. Doris Darvon P.O. Cox 1A053 Klatt Station Anchorage. flasVa Subject: Doris Damon Property Located on Nugget Lane. Dear Vs. Dar.on: Thr sevrcr syster. serving the subject property 1s functioning satisfactorily and has the proper distances from the system to the rrell. The weli is located in a pit. Cefore this'Dc- rartrent's arproval can be given, the well will need to be upgraded. The upgrading would consist of extending the well cosine above ground, installing a pitless adapter, and fill- ing in the r+ell rit with dirt. Temporary approval can be given rending the escrow of funds to upgrade the well. If you have any ouestions regarding the above, please do not hesitate to contact this office. Sincerely, Lynn S. Coad Environmental Specialist s cc: VA Administration GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 94507 374-9686 Date Received Time of Inspection "% % 1�% 2 i Date of Inspection 21Y % —'— REQUEST FOR APPROVAL OF INDTVTDUAL SEVER b WATER FACILITIES V/ 1. Approval Requested 91/: a Address: Pr&oarty Owner : �• 3. Legal Hca 4. Location: phone: 3�9—lei Afloones 5. Tvas or Fa C111ty &o oe i:.af)UUL�. i Nor of Bedroc®s: S. Wall Data: A. T'pa /1►%/��'U 9. Depth (d , ,�� C. Construeti rn+-� D. 9a ' cterial Analysis 67/73 7. Sftage Disposal System: i A. installed/��j ;fI 9. Installer i C. Septic Tank: 1. Size �'~� 2. Manufacturer D. Seepage Pit: I. Size 2. Material L ee, I E. Diaposal Field: Total Length of Lines 9. Distances= A. Well To: Septic Tankj/0-&'7 Absorption Area1lJo Seser Lines . Nearest Lot. Line. Other Contamination B. Foundation to Septic Tank—AftorPtion Area C. Absorption Area to Nearest Lot Line O em, 1P ' ) gaggeat for Approval of Y _ vidual Sewer d Nates Faeilitis. Pani Ito 9 - Comments: �— Date ✓ Z Approval Valid for One Year From Date Signed Greater Anchorage Area Aorough, Department of Environmental QualitY DIAGRAM OF SYSM I cartify that the information contained in this requess ror approval w ua a Mas an& accurate representation of the subiect sewer and water facilities located at: i Signed Date��