HomeMy WebLinkAboutRABBIT CREEK VIEW & HEIGHTS BLK 11H LT 17ARabbit Creek
View Heights
Block I I H
Lot 17A
#020-581-71
Municipality of Anchorage :':i; :r
Development Services Department b n'
Building Safety Division . • .
On-Site Water and Wastewater Program. 4700 S. Bragaw SL
P.O. Box 196650 Anchorage. AK 99519-6650 Page/ of*2
www.cd.anchorage.akus (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: W ioo 9 PID Number. 020 —ll/ — 63
Name. all/ It hrrnor 4ru e
Wastewater System: ❑New 0Upgrade
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Development Department Approval
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:THEODORE F.
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Reviewed and approved by: � Date: S -Z/-O/
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PERMIT NO: SWO10096
PID NO: 020-111-63
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SWING TIES:
FROM: COR. "A"
COR. "B"
TO:
A
DBL. C.O. "C"
33'
26'
H.T. C.O. "D"
37'
17.5'
H.T. P.O. "E"
42'
17'
H.T. C.O. "F"
46'
18'
6"
NEW 2000 GALLON
HOLDING TANK
�F" /—ALARM FLOAT
E6"PUMPOUT
"D"
DE G
t
ALARM_
BOX
LOT 17,BLOCK 11
RABBIT CREEK HTS
TBM
PAGE 2OF2
PLAN VIEW
SCALE: 1" = 30'
PROFILE VIEW
SCALE: 1" = 5'
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COVER
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.....................�
INV.
NEW 2000 GALLON
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PROFILE VIEW
SCALE: 1" = 5'
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1CHNICAL- SER'V,ICES
CIVn.6 ENVIRONMENTAL ENGLNEERLNG • ENERGY CONSERVATION: ANALYSIS
THEODORE F. MOORE, P.E.
P11: (907) 345.1355
May 15, 2001
MOA Dev. Svcs. Dept. (Attn: Dan Roth)
P.O. Box 19-6650
Anchorage, Ak 99519
Dear Mr. Roth:
14530 EC110 ST.
ANCHORAGE, ALASKA 99516
On May 2, 2001 you issued a horizontal separation distance waiver (WR010022) allowing the
proposed holding tank on Lot 17, Block 11, Rabbit Creek Heights S/D to be as close as 70.0 feet from
surface water. We are now requesting that you amend that waiver to allow a reduction of the separation
distance to 66 feet between the holding tank and surface water. Please refer to the original site plan and
the enclosed as -built inspection report in reviewing this request.
At the time of our initial waiver request it was our concept that the new holding tank would be
installed immediately to the east of the existing substandard holding tank so as to maximize the
separation distance from surface water. Unfortunately, when the excavation was begun for the new
holding tank the excavator encountered a large quantity of saturated sewer gravel in that location and it
ultimately became apparent that this was a "drywell" for the building's footing drain. In order to
position the new holding tank on native ground in a dryer site it was necessary to shift its position a few
feet further to the east. Once the tank was installed it became apparent that the installed site was closer
than originally anticipated to the spring shown on the original site plan and on the as -built drawing. I
immediately phoned you to discuss what to do, and you indicated that you would be amenable to
amending the waiver. It should be noted that the spring is located at a similar or higher elevation than
the holding tank and that the flow path for effluent potentially leaking from the holding tank would be in
a northerly direction away from the spring and that the surface flow path would still traverse
considerably more than 100 feet of ground before reaching any surface water.
Thank you very much for your consideration in amending this waiver. Please give me a call if you
have any questions.
Sincerely,
1!:v %'lab,
Ted Moore, P.E.
cc: Bill and Mindy Dwyer
57 5-- 6' Q%
MUNICIPALITY OFANCHORAGE �• 3�F `�'
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SWO10096
Date Issued: May 02, 2001
Expiration Date: May 02, 2002
Parcel ID: 020-111-63
Legal Description: RABBIT CREEK HEIGHTS BLK 11 LT 17
Design Engineer: 0019 Flattop Technical Services Site Address: 017001 NICKLEEN ST
Owner Name: BILL J. & MINDY C. DWYER Lot Size: 21249 SQ. FT.
Owner Address: PO BOX 111163 Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE. AK 99511-1163
This permit is for the construction of:
❑ Disposal Field ❑ Septic Tank ❑✓ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date: _s /y /O/
Date: ,/ — 2 Z/1
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. O zo —m I —63 Permit Number SW0/0096
Property owner(s) 6r 11 P wy e r Day phone
Mailing address (1) 1—T—ob + r h P.O. 60r. 111163
Mailing address (2) A -n Cj1C'rage , r1—k Zip Code 99111
Legal description (Lot, Block & Sub'd.) R98817' ClIf F k NEf&HTS SLA 11 (07' /7
Legal description (Section, Township & Range)
Lot Size 21, 249 Acres/ZZ:) Number of Bedrooms 3
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade 19
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Date of Payment:
Receipt Number:
(Rev. 12/00)
Date of Payment:
X, LA TT0P'TEG'IN ICA
WROICO22
t
SERY�LCES:.:.
CIVn.A ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION 6 ANALYSIS
THEODORE F. MOORE, P.E.
PH: (907) 345.1355
April 25, 2001
M.O.A. DIMS
P.O. Box 19-6650
Anchorage, AK 99519
Dear Sirs:
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
The purpose of this letter is to provide the required design narrative in support of our application for
a permit to replace a substandard holding tank with a new 2000 -gallon holding tank on Lot 17, Block 11,
Rabbit Creek Heights S/D, located at 17001 Nickleen Street. We are also requesting a waiver allowing
a reduced separation distance between the holding tank and surface water of no less than 70 feet. A site
plan, design drawings and specifications are enclosed for your review.
The inability of the soils on this lot to support an on-site soil absorption system was documented in
1982, prior to the installation of the original holding tank. This finding is in conformance with my
observations this year based on surface moisture and vegetation.
Unfortunately, the only feasible site on this lot for a holding tank is constrained by the presence of
an open flowing spring located approximately 70 feet to the east and by a roadside ditch on the far side
of Nickleen Street located approximately 70 feet to the west. While this ditch is presently snow -filled,
and thus I could not observe surface water in it, the property owner states that the ditch does carry
flowing water most of the year.
The topography of the lot and surrounding area slopes downwards towards the north at
approximately 15 — 20%. The single best justification for granting the requested waiver is that this
natural topography means that, should the holding tank leak or overflow, the surface flow path would
traverse considerably more than 100 feet of ground before reaching any surface water. The surface flow
emanating from the spring and small pond shown on the site plan flows in a generally northerly
direction as indicated by the slope arrow on the site plan. The surface flow in the roadside ditch is
constrained to flow in a northerly direction and remain on the west side of Nickleen Street.
Other factors supporting the granting of the requested waiver are (1) The holding tank, being a
watertight vessel, when operating properly should prevent any contamination to nearby surface and
subsurface waters. (2) Should the holding tank fail and the alarm not function properly, it would either
cause a backup into the residence or allow effluent to daylight onto the ground surface immediately in
front of the residence. In either case the homeowner would have ample notice and strong incentive to
make necessary repairs without the need for regulatory oversight. (3) There is no other feasible option
for this property.
The proposed new 2000 -gallon holding tank will be installed immediately to the east of the existing
substandard holding tank and will be equipped with an audible and visible high level alarm. The
installation and continued proper use of this holding tank should ensure that there is no adverse impact
on nearby water supply and wastewater disposal systems. Please give me a call at 345-1355 if you have
any questions on this submittal.
Sincerely,
/�x 21111�
Ted Moore, P.E.
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LOT 21 '•
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LOT 17 /
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2000 GALLON
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LOT 17,BLOCK 11
RABBIT CREEK HTS
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LOT 17, BLK. 11, RABBIT CREEK HTS. SID
HOLDING TANK INSTALLATION
SITE PLAN
FLATTOP TECI MCAL SERVICES IIINCH=50FEET
14530ECHO STREET DRAWN BYTFM
ANCIIORAGE, ALASKA 99516 1 APRIL, 2001
NOTE: THIS IS NOTA SURVEYED PLAT.
ALL LOCATIONS SHOWN ARE APPROXIA
LOT 17 /
j I WELL
DRIVE
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LOT 17, BLK. 11, RABBIT CREEK HTS. SID
HOLDING TANK INSTALLATION
SITE PLAN
FLATTOP TECI MCAL SERVICES IIINCH=50FEET
14530ECHO STREET DRAWN BYTFM
ANCIIORAGE, ALASKA 99516 1 APRIL, 2001
NOTE: THIS IS NOTA SURVEYED PLAT.
ALL LOCATIONS SHOWN ARE APPROXIA
Iy
ALARM FLOAT
IN 4" C.O. -
121kimil
GROUND
NEW 2000 GALL
HOLDING TANK
PLAN VIEW
1"=10'
4.5' SOIL
COVER
2000 GALL
TING TANK
SECTION "A - All
SCALE: 1" = 5'
ALARM FLOAT IN 4" C.O.
PUMPOUT
- C.O.
------------
DECK
HOUSE
A(��e
TY.EODORE F. MCGRE
l
FROM HOUSE
TFlattop 7echnicaCSeroices
14530 Echo Street, flnchorage, AX 99516
(Phone (907) 345-1355
Lot 17, Block 11, Rabbit Creek Heights S/D
17001 Nickleen Street
Holding Tank Installation
Specifications
1.0 General:
1.1 The scope of the project consists of abandonment of an existing substandard holding tank and
installation of a new 2000 -gallon holding tank and high level alarm system.
1.2 Construction shall be as depicted on the approved site plan and design 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 to Municipal and State
requirements. All separation distances shall be in conformance with Municipal requirements, except
that the required separation distance from surface water has been waived to 70 -feet.
1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around
any buried utilities.
1.4 The contractor shall provide adequate cover material and rough grading over all system
components and adjoining terrain to ensure that proper drainage is achieved after settlement and that
there are no residual depressions or surface water within 70 -feet. Insofar as possible the contractor shall
minimize damage to trees and existing lawn areas.
1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading
after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the
construction.
2.0 Holding Tank:
2.1 The existing holding tank must be properly abandoned by thoroughly pumping, removing the
top and backfilling with soil.
2.2 The new 2000 -gallon holding tank shall be Municipally approved and shall be set level on
undisturbed soil in the approximate location shown on the site plan. The contractor shall verify that the
site achieves the required 70 -foot horizontal separation from surface water. It is anticipated that
groundwater will be encountered in the process of excavating the hole for the septic tank. The
contractor shall make appropriate provisions for dewatering the excavation to ensure that the tank sits on
solid material. During backfilling, the top of the tank shall be covered with a minimum of 4.5 feet of
dry soil to prevent the possibility of tank flotation after pumping.
2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The
tank shall be provided with a 6 diameter pumpout. The tank shall also be equipped with a low voltage,
high level float that triggers an approved visible and audible alarm mounted inside the residence. The
float level shall be positioned to trigger when the fluid depth in the tank is approximately 48 inches to
allow sufficient remaining capacity before the pump truck arrives.
3.0 Inspections:
3.1 A total of 3 engineering inspections will be required during the course of the project: (1) initial
stakeout with the contractor to establish the location of the system and to discuss the plans,
specifications and construction procedures, (2) after the tank has been set in the excavation and the
piping connected, but prior to backfill, and (3) after the alarm is installed and final backfill and grading
is complete.
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.
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
OnSfte Services
Waiver Review Worksheet
WR#: WRO10022 PID#: 020.111$3 HAM Permitil: SWO10096
Date Received: 4128101
Legal Description: RABBIT CREEK HEIGHTS BLOCK 11 LOT 17
Engineer. THEODORE F. MOORE.
FLATTOP TECHNICAL SERVICES. 1453C ECHO ST. ANCHORAGE, A
Applicant: BILL DWYER
..........
Waiver Requested: ON -LOT SEPTIC HOLDING TANK TO SURFACE WATER OF 70 FEET
Criteria: 1. Geology
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
2. Special Conditions:
3. Other.
Points:
Total:
..........
Waiver Is Granted: �< Waiver Is not Granted:
List Conditions or Reasons for above: S Af fk6r/*AlFR S L jPrY-- P of .Tu ST//r/ll4J/O�t/
Q/9T;Eo Mown- 2Z 200%
Date: By: jQ/1 A/
Name of Reviewer
..........
Rec#: Amount: 825.00 Date Paid:
5/2/2001
Mumcipanty of Anchorage
George I.li'uerch,Mayor Department or
Public Works
Bttildirlg S1fcty Dh-Isiort
P.O. Box 196650 • 4700 S. Bragaw Street
Attchorage, Alaska 99519-GG50 • (907) 343-&301
h ttp://%%i%iv.ct.auhorage.nk.us
Theodore F. Moore, PE
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99519
Subject: Waiver Request for Rabbit Creek Heights Block 11 Lot 17
Waiver Request #WR010022
Parcel ID #020-111-63
Holding Tank Permit Number SWO10096
Dear Mr. Moore:
Your request for a waiver of the required 100 feet horizontal separation from the
on-site wastewater disposal system to surface water has been approved. The approved
separation distance is -M feet.
This waiver approval applies to the existing on-site wastewater disposal system to
private well separation only. Any future upgrade to the on-site wastewater disposal
system will require all separation distances be met or another approval from this
department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
Daniel J. Roth
Civil Engineer
On -Site Water & Wastewater Program
MUNICIPALITY OF ANCHORAGE
Departmen of Health and Environment Protection
825'L Street, Anchorage, AK. 99501
264-4720
Permit ± 9A/,)C191 * * * HANDWRITTEN PERMIT
•- *:�/OR ON-SITE SEWER PERMITC/ 3;E GlEEN
Applicant: AME OA(91. Mailing Address: PD,-I3x !D•Jo°l �
Location: p� Phone_ Number: �ysl-•/,S3/ ( C-Xft�
Legal Description: 7, �% lyF, /� Fh88,T6&'ekh/)r, Lot Size:
Type of Soil Absorption System Is:
Trench: Drainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: i Soil Rating(sq.ft/br) "IA
The Required Size of the Soil Absorption System Is: ,,''
DEPTH LENGTH �A///7 //^^. GRAVEL DEPTH WIDTH F�
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 anc
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 HOLDING TANK SIZE = 4000 GALLONS
SEE TES
3ermit applicant has the responsibility to inform this department during the
_nstallation inspections of any wells adjacent to this property and the number
,f residences that the well will serve.
INSPECTIONS ARE REQUIRED
3ackfilling of any system without final inspection and approval by this departure
,ill be subject to prosecution.
iinimu:n distance between a well and any on-site sewage disposal system is 100 fe
.or a private well or 150 to 200 feet from a public well depending upon the type
,f public well. Minimum distance from a private well to a private sewer line
.s 25 feet and to a community sewer line is 75 feet. Well logs are required
ind must be returned to this department within 30 days of the well completion.
)they requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 3 2
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 in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is remodeled to include more that 3 bed%ro S.
Signe$: 1 2a KbnullIssued by r1eGG.✓�
A licant
Date: %^Z 3 -e2.
/Tod/iyCT.9Q dltE�' 'yG'W'fff/NG RFi°c,r7`'AKS /982" %%N?Na //e
k3�v1/E A.cEA A� N✓eN �Fn�Ty, �;/f, �/��
S97P/024 (1/81) D
'.�` f1 I,IH✓N�F/,'CE Iuw;41,yC_ c_oN7Knc7- mitrT 8 ,.v e)�c_T 7o GuKc,cM�'t
Pu»�Pii✓G /) yO 7o 0%37,41 ✓ 14541711 4.7NoFrT 15'gaxou r/
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r'1ur-.1 I r- I�L_ I Tv ID I= Ftr-.1rV-" IF?nGE
DEPARTMENT HEALTH AND ENVIRONMENTAL , FATECTION
825 'L' STREET, ANCHORAGE, AK. +9501
264-4720
WEL-1L F EF= r•1 I T
PERMIT NO. < 820186
APPLICANT ALFY BAKHOUM 4210 TERRACE DRIVE ANCH 243-6337
LOCATION
LEGAL L 17 B 11 RABBIT CREEL: HTS. LOT SIZE 20000 SQUARE FEET
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 SEWED LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AFJD CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F'EF<_r1I T EXF• I FRES GtECEME:EFS: =::3_: A SQL
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND IJELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
SIGNED
APPLICANT ALFY BAKHOUM
ISSUED BY_L_J__Lindggist---------------DATE_4_16_82V4.0
Issuance of this well permit does not constitute approval for on-site
septic systems. Holding tanks are not allowed for new construction.
This well may not be used without an approved on-site septic system.
MIJMt I C I P 1=1L I TY QF
9=1"r -'"0F:;: 1=10E
DEPARTMENT OF HEALTH AND EFIVIROtIMEtITPi-,,PROTECTION
825 STREET, ANCHORAGE. AI:. _ •501
264-4720
S L- WELL F?EFRM I T
PERMIT NO. C 211139 >
APPLICANT ALFY BAKHOUM 4120 TERRACE DR 243-6337
LOCATION L17 B11 RABBIT CREEK HEIGHTS
LEGAL L17 E11 RABBIE CREEK. HEIGHTS LOT SIZE 20000 SQUARE FEET
MINIMUM DISTANCE BETWEEN A 14ELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR. 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER, LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAM_ ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
FEFt:t'1 I T aXF7I F2E5 LtiECEME Ems: 31 . 1. 4r= 7...
I CERTIFY THAT
1: I AM FAMILIAR. WITH THE REQUIREMENTS FOR ON-SITE SEPIEP.S AND WELLS AS SET
FORTH B4' THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
SIGI
HPFL.ICANT &fFYBAF:
ISSUED BY _ U_ `'Yt_ _-- _ --_---DATE--- // =--- e/
Issuance of this well pmi�not constitute approval
tics new
for on-site
septic system. Holding tanks are not allowed for new construction.
This well may not be used without an approved on-site septic system.
V4, 0
J-1 L_1 C -d I r'- I F' FI L I "T Y n F' H r-4 ::: H 17:5 F: n 1:3 E
DEPARTMENT 0 HEALTH AND ENVIRONMENTAL K°OTECTION
825 'L STREET, ANCHORAGE, AK. 9' ,01
254-4720
WELL F'EFSM I'T
PERMIT NO. { 811189 )
APPLICANT ALFY BAKHOUM 4120
LOCATION L17 Ell RABBIT CREEK HEIGHTS
LEGAL L17 E11 RABBI'j' CREEK, HEIGHTS
TERRACE DR. CKS off-- 243-6337
LOT SIZE 20000 SQUARE FEET
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER, LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN! 20 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F`EFz'rl I T EZXF=` I FSE = C]ECEf•7E:EF? - Lr :I_ =-1
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 IN ACCORDANCE WITH THE CODES.
SIGNED:- -= _ -- ---------------
rf CANT Y BAKAQ}Jtl
ISSUED BY___DATE__ _ 3 _ u V4. 0
Issuance of this well p mi�not constitute approval for on-site
septic system. Holding tanks are not allowed for new construction.
This well may not be used without an approved on-site septic system.
r 4'� • , r, '�iji}r• J
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L.•6traet, Anchorage, Alaska 99601 264.4720
SOILS LOG — PERCOLATION TEST
C�SOI LS ItOG
❑ PERCOLATION
TEST
PERFORMED FOR: I •r( .1i L. <' Fns '' DATE PERFORMED:
LEGAL DESCRIPTION: '-CZ 11 'fit'' 1 �, %t CJS"�, T I�_r 1.. h•/ I S
DEPTH SLOPE SITE PL
(FEET)
2
3 �^
4 ,v '
6-
7-
•8
,9
• 10
11
12
.13
14-
15-
16-
17-
18-
19-
20
4151617181920 J
v\1% �� • v\1%
r IC' S-1 "C
A■
U -QENCOUNTERED?
,(y 1'1�C' �Y• ERED WATER \
IF YES, AT WHAT /
• rn 1C•S1 i C. DEPTH? �f
C, Z r Y-
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
�Drop
mom
ENNo
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
�Drop
PERCOLATION RATE •••C`'�•: •tlmi;lu�es/inch)
'FT',
TEST RUN BETWEEN .ri �``••I ••'I 'I%I •'�
= PIIAND
f ; r
•
PERFORMED BY: ReA,-1—y E4 C1{c CERTIFIED BV!.•vfr"' as ets�•!T•'!;(
72-00e (6/79) //Af/ �'• I�. / 1 •wa�:
( '•
I �Y , r(,•ale � i ,....I L•..
'1
T):O- -76-r
:MunicipalkL.Y
of
Anchorage
January 18, 1984
POUF .6-650
a �, ,,.�, ANCHORAGE. ALASKA 99502-0650
(907) 786-8211
TONVRNOWZES.
/ a+a von
PUBLIC WORKS DEPARTMENT
Building Safely Division
Ward C. Goodman
P. O. Box 6350
Anchorage, Alaska 99502
Dear Sir:
Re: Property Located Outside of Service Area 30
After reviewing our current maps, we have concluded that your
property being Lot 17, Block;l, Rabbit Creek Heights, located
on Nickleen Drive is indeed out of Service Area 30.
Only Service Area 30 residents are subject to the enforcement
of the 1982 Uniform Building Code as adopted by the
Municipality of Anchorage.
Sincerely yours,
L u llis
Code Enforcement Officer
. Municipality
of
Anchorage
October 7, 1983
PUBLIC WORKS DEPARTMENT
Building Safety Division
Mr. Ward Goodman
P. O. Box 6350
Anchorage, Alaska 99502
Dear Mr. Goodman:
n
POUL,H 6-650
ANCHORAGE, ALASKA 99502-0650
(907) 786-8211
TONY KNOWLES.
MAYOR
Based on an on-site inspection by Lou Ellis, a Code Abatement
Inspector, it appears that your house located at 17001 Nickleen
is outside the Building Safety Division service area as it
relates to the enforcement of Title 23 of the Anchorage Municipal
Code. Specifically, the Building Codes (mechanical, plumbing,
electrical, and Uniform Code for the Abatement of Dangerous
Buildings) do not apply in this area.
The Building Safety Division has begun the administrative pro-'';
cedures to refund the amount paid,at the time you -requested a
code abatement inspection, -and you should consult:'Joyce Byler, the
Counter Supervisor, to. determine the status of your refund.
Sincerely,
John C. Bishop, P.E.
Building Official
JCB:mh
cc: Joyce Byler, Counter Supervisor
Lou Ellis, Code Abatement Inspector
L �lun L(�iipauiPO r i -650
ANCHORAGE. AI.A,)K/, 99502-0650
®
Cr(907) 2G,I-4111
F?� hIAYOR ......
DEPARP.IEN f DI HEALTH AND ENb9.;014%1ENTAL PROTEC::UN
<Permit #: 820981
-January 31, 1983
TO: Permit Applicant
Subject: Lot 17 Block 11 Rabbit Creet Heights Subdivision
A permit issued by this department for an individual well
and/or on-site sewer system has expired as of December 31,
1982.
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 needs to be sent
to this department for documentation of the installation
date and to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, please have them send us the as-builts
for our files and documentation.
If there are any further questions, please call this office
at 264-4720.
SincerelUdj-
Robert
P, C. Pratt, R.S.
Acting Program Manager
Sewer and Water Program
RCP/ljw
enc: Copy of Permit
SWP/057
}
ALASKA MUIROIlUTAL C011TROL SCRUICCS, Inc.
Enqineerinq 6 Enuironmental Studies
September 21, 1982
1220 W. 25th Ave
Anchorage, Alaska 99503
MUNICIPALfTy OF ANCHORAGE
Judy Green fNvl, �:
Century 21/Shennun
209 W. Dimond
f99
Anchorage, Alaska 99502 2
Dear Judy, RECEI-VED
On Tuesday Sept 21, I went up to Rabbit Creek Heights
Subdivision Block 11, Lot 17, to measure areas available
for an on-site septic system.
A small area in the Southwest corner of the lot is over
100 ft. from the sring. This area is only about 115 sq. ft,
which is not large enough for an on-site septic system, con-
sidering the soil conditions normally encountered in the area.
The accompanying diagram illustrates the available area.
If you have any further questions please contact me.
Sincerely,
� � a
Dan MacFarlane
Approved
Leroy C. Reid .,PhD; PE
President
1220 West 25th Auenue • Anchorage, Alaska 99503 9 (907) 276-1361
ALASKA ENVIRONMENTAL
CONTROL SERVIC( }INC.
1220 West 25th Avenue Suite B
ANCHORAGE, ALASKA 99503
276.1361 279-2917
JOB
SHEET NO. / i OF /
CALCULATED BY^4AC t-AIiGAkIr DATE 2I
CHECKED BY DATE
SCALE
`'
ANCHORAGE, ALASKA 99501
Q,Li rI :r� U (907)26.14111
'1 t !•, ,� \ `� �':'. `" GCORGf N. SULLIVAN,
UI IIf AL III ANOI NV IIu �N'.11 P;'f .U. PRO TL(: I In'l
January 4, 1982
Alfy Bakhoum
4120 Terrace Dr.
Anchorage, AK 99502
Permit T 811189
Subject: L 17 B 11 Rabbit Creek Heights
A permit issued by this department for a well and/or sewer
system has expired as of December 31, 1981.
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.
If there are any further questions, please call this office
at 264-4720.
Sincerely, %/%
0�'9 0e. 24_ I
Les N. Buchholz R. .
Program Manager
Sewer and Water Program
Enclosure: Copy of Permit
i.
�I
i.
5hfS
j+
I'
�i2(�Z2Q �?P�ct�c' 0.y�pCccc�nf Icy_ �4��1Occn�
SQ�n �cus i� �cc.�ic-r pn abode
55 4 e,6 �<,o L4=�k Y-J�_Z_
I
ji
li
i
ii
i'
I'.
it
LOCATION OF WELL (Places complete either to. Ite or ICA
"WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological a Geophysical Surveys
Drilling Permit No.
A.D.L. No.
Ed Borough
I Subdivision
Lof
Blo<e
Ib. 1/4 el ra.
Section No.
Township No
I Range E0
Meridian
A 11
17
_ef_oI_ot—
y❑
W
Ice DISTANCE AND DIRECTION F OM pAD INT RSECTIONS
S. OWNER OF WELL:
Alfie Bakhoum
Rabbit Creek Heights
Strut Address and Area of Well Location
Address: SRA Box 440 A
Anchorage, Alaska
2. WELL L06 Feet Belo.
Surface
Material Type Top Bottom
0. WELL DEPTH: (first)
102 It.
S. DATE OF COMPLETION
6 11 - $U
brown ravel till w cobbles 0
0
s. ❑cabs. tool [3Rala.y ❑Drie.n ❑Dug
❑Auger ❑Jetted ❑Bored ❑other:
town si Y
brown till little gravel 70
97
T.USE: ® Domestic ❑ Public Supply ❑ Industry
❑ Irrigation ❑ Recharge ❑ commerical
❑ Teat Well ❑ om•r:
brown silty till w grave
ana seepage
brown silty gravel H20 100
1021
B. CASING: ❑ Thn°d�eQ ® Welded
did..�_In. to 10�'i 1. Depen Wight tbs./ ft.
dlam. In. to_fl. Depth 511ceup it.
S. FINISH OF WELL:
Type: Dlamely+
Slat/Mesh Site: Length:
Set between ft and ff.
Bacafllling Gravel pats
10. STATIC WATER LEVEL: fl.
❑ Above or ❑ Below land surface Data
Equipment used:
r -,T c it nr T•1
11. PUMPING LEVEL bolo° land surface and YIELD
f+. after—hrs. pampi.g_g.p.m.
_ ft. after are. pumping—I.P...
ENVIE
J
12.GROUTING Wall Grouted: ❑ Yet ❑ No
Material: ❑ Neat Cement ❑ Other:
IS. PUMP: (if available) HP
Length o1 Drop Pipe ft. capacity g. P.M.
❑ Subm. ❑ Jet ❑ Centrifl<al❑pOth•r
Id.REMARKS:seepage @ 121,221,841
pumped at 15 grim-701D.D.
S.L. 25
IS. WATER WELL CONTRACTORS CERTIFICATION:
IS. Water Temperature ❑ F ❑ C
This well was drilled under my jurisdiction and this report Is true
to the best of my knowledge and belief;
Vern's Drilling & Enterprises
Registered Business Nam•
[J=Qf-'sa'/
Contract License Number
Address:
Signed:
Dal*:
Authorized Representative
Form 02•WWR (11/81) Copy Distribution: WHITE' State
DGGSr PINK •Driller. CANARY - Customer
C
an
m
w
r
o_
Z
.
Municipality of Anchorage
• Development Services Department
jBuilding 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
/ 1�� M, M11
"�nit1 1o_
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D.O20 -581 -7/
1. GENERAL INFORMATION
COSA# Orf611YO9'
Expiration Date: - - Q 7
T
Complete legal description I -o f I7 A, S lock 11 H! Rab(,;/ C.rlvre if h S Ca
Location (site address) 17 001 NIe4l een $/
Current Property owner(s) Day phone (j a 7) 1S7 - 39 7y
Mailing address P-C'0e0C Sy1/3 F.r_.b4� A -k ¢9 7,::,c9
Lending agency Co.,�.,.r„�e Ke v� Day phone
Mailing address
Real Estate Agent I4cL/tr^In. De.,mSwi P"ordtoha(Day phone ZZ"h1-6929
Mailing Address 36-01 CfAL*0eelet D;1�r 4,ne4onaeV 99sa3
Unless otherwise requested, COSA will be held by DSD for pickup. Pl eore ecr 1/ it ea11(y „ 1 2 yH-6-9Z9
10,4
2. NUMBER OF BEDROOMS: -1?_ an CasA roacfy
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site ❑
Individual Holding Tank
Community On-site ❑
Public 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 Onsite 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. l 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.
NameofFirmTechnics/ SPiw'etoi Phone 35's-�3sS
Address f H s 3 o Eula elanj'e2' Rd
Engineer's Printed Name T�eocea • e L MOO --e Date 26 r'et.y 2•Gy7
: nKpDOar F. ASHORE �� Q
5. DSD SIGNATURE '.. Cl: .35g9 > r.
Approved for bedrooms. �•.�P--7;.ray-.�
Disapproved. '
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Nitrate Advisory . Other
By. z zz�!/ Original Certificate Date:�—
(Rev. 11105)
SGS Ref. M
1070627
Client Name:
Flattop Technical Service
Project Name:
Rabbit Ck Hts, L17A, B11H
Client Sample ID:
Rabbit Ck His. Ll 7A. B11H
Matrix:
Drinking Water
PWSID
SGS Environmental Services Inc
200 W. Potter Drive
Anchorage, AK 99518
Tel: (907) 562-2343
Fax: (907) 561-5301
All dates/times are Alaska Standard Time
Printed DateMme:
02127/07 16:15
Collected DateTme:
021`16107 14:15
Received DataMme:
02/16/07 ,j4:50
Technical Director.
St*rpheq,� //
10T6—
Allowable
0T6—
Allowable Prep Analysis
Parameter Results PDL Units Method Limits Date Date Init
Bacteria 0.00 9222B 02/16107 02/16/07 dpt
Nitrate
3.41 0.10 mg& EPA 300.0 10.00 02/18107 02/18/07 jds
Arsenic ND 5.00 ug1L 200.8 10.00 02/22/07 02/26107 tk
-\ Municipality of Anchorage
Development Services Department
Building Safety Division : "
_ On -Site Water and Wastewater Program a ^ r
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. 07_o-591 'H COSA# uL'�DJ
Expiration Date: I ( - :2 S - 0 Ce
1. GENERAL INFORMATION
Complete legal description J,oP 17& Z 1C C 1- 11(} Rab G:f Creek Iib .ti /A
Location (site address) 170G1 Nick le en CF.
Current Propertyowner(s) Lrn.ru "C Carr#X&A Dayphone&07) 157-3t>y
Mailing address
Lending agency
Mailing address
P.O. GO% ey113y rut IP.tOnfy� +&C 9!>G6
Adm e.�ve Day phone
Real Estate Agent Lt✓e►et Ptµse!!� oyep4 a Pre, Dayphone 261-76BO
Mailing Address 3111 "C" C1 :t1640 hnchoro 47
Unless otherwise requested, COSA will be held by DSD for pickup. p leull Ce41/ Rea //., C cetitroe
Pei -Ary of 261 ->/bio cc+hen Crt!//
2. NUMBER OF BEDROOMS: riryay Jq, prek ,Y,
3. TYPE OF WATER SUPPLY:
Individual Well
❑
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
❑
Individual Holding Tank
Community On-site
❑
Public 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 Onsite 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 seat affixed hereto and as of the validation date shown below, I verify that my Investigation,
based on procedures outlined in the Certificate of Onsite 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. l 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 T.cGFnlro/ 5Ac1 Phone 3'/S-13SS
Address H.C30 Ecco Sh /ocAcie o A -ti 9QS/C
Engineer's Printed Name '7-A io da r� r+c. are
5. DSD SIGNATURE
✓ Approved for bedrooms.
Disapproved.
Date 2 3 iL�vV, -Z 6 -
OF A, `e
�. �•:'"s
r... 6 . 0.06...0• s
THEODORE F. FdOORE•: A
s�,1,.• CF -3589 ��
) dY.. •.6�&�O� i �ti
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By. P"// Original Certificate Date: —'2— 93 — 0
(R".11R)S)
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/onske
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Lo YAS$for k Illi 13*11,4 Ck Hbr Parcel ID: 020-111 ' 63
A. WELL DATA
Well type 12V If A. B, or C provide PWSID # = Well Log (Y/N) Y
Date completed jkLIs/67- Sanitary seal (YIN) Y Wires properly protected (YIN)
Total deptho� :.s ft. Cased toof 2.S ft.
FROM WELL LOG
Date of test 6 / rs
Static water level
Well production rs g.p.m.
WATER SAMPLE RESULTS:
Coliform _Q_colonies/100 mL Nitrate J. ff mg/L
Arsenic: 4.67 ppb date of sample: a /.9 /40d -
B.
B. SEPTICIHOLDING TANK DATA
Tank Type/Material f'61 a# y Ta m k / SfY•/
Tank size '2~ gal. Number of Compartments
Casing height (above ground) !_in.
AT INSPECTION
8i t9 /06
g.p.m.
Other bacteria e> colonies/100 mL
Collected by: Rrw,A . 7,-t4 S✓c-
Date installed S"/ �B/ 2o0i
Cleanouts (YIN) Y
Foundation cleanout (Y/N) Y Depression over tank (YIN) 14 High water alarm (Y/N) Y
Date of pumping 5'117 / 06 Pumper MCdw 4 c -r
C. ABSORPTION FIELD DATA N A
Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) System type
Length ft. Width
ft.
Total depth _ft. Eff. absorption area _ft2 Monitoring tube
Gravel below pipe ft.
Depression over field
Date of adequacy test Results (Pass/Fail)
Fluid depth in absorption field before test _ in. Water added_ gal.
Elapsed Time: _ min. Final fluid depth _ in.
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
For _ bedrooms
New depth_ in.
Absorption rate >= g.p.d.
If yes, give date
D. LIFT STATION AA A.
Date installed
"Pump on' level at _ in.
Datum
E. SEPARATION DISTANCES
Size in gallons
"Pump off" at _ in.
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot —
Absorption field on lot —
Public sewer main —
Sewer /septic service line 7 2.f
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots 7 /00
On adjacent lots > 100
Public sewer manhole/cleanout
Holding tank /TO'
Animal containment areas t DO * Manure/animal excrete storage areas ICJ&' t
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 46" Property line _0'
Water main
Absorption field
Water service line "> 197 Surface water 66 1 t«
in.
Wells on adjacent lots 7 7.f'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line Building foundation Water main
Water Service line Surface water Driveway
parking/vehicle storage
Curtain drain Wells on adjacent lots
F. COMMENTS
r War twee 0jr"rGe
•••......
G. ENGINEER'S CERTIFICATION
^E
I certify that 1 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.
•••••••••......
c.
Engineer's Printed Name i%lsr006re T Mcc),.n
y, .. ...... ..........
1. ; C; _
•.�/�' r, ;�
Date 23 AVWOL 2oav/
moo.
o
COSA Fee $ 1 J0 -� Waiver Fee $
Date of Payment _ 9 / s 3 /06 Date of Payment
Receipt Number85 j Li{ , Receipt Number
(Rev. 11/05)
SCS Retd
1064568001
Client Name
Flattop Technical Srv.
Project Name/ti
L17 RIk 11 Rabbit Ck [Its
Client Sample ID
L17 Rik 11 Rabbit Ck Ills
hlatris
Drinking, Water
All Datesffimcs are Alaska Standard Time
Printed Datdfime
08/21/2006 16:56
Collected Date/time
08/09/2006 12:30
Received Date/Time
08/09/2006 13:45
Technical Director
Stephen C. Ede
Sample Remarks:
Allowable Prep Analysts
Pammcter Results PQL Units Mcdad Container ID Limits Date Date Inn
Metals by ICP/M3
Arsenic
Waters Department
Nitmtc-N
Microbiology Laboratory
Total Coliform
ND
3.99
0
5.00 u8/L EP200.8
0.100 mg(L EPA 353.2
C (<10) 08/15/06 08/17/06 Mll
D (<I0)
coU100ml. SM209222B A (<I)
08/09/06 ALR
08/09/06 TLF
LLI
Z I
J
UI
rW
30.00'
t
� \
Septic k— —
ng
l.� —F—
/ �' V• pPMP
Ir
_.W 1 / /AIam
30.00'
Cot 2
i
S 673'45•
/� foremen/ E x/•23'
= \
t Staff I `
W
t -&"v /
1 '
t
\ t oM
t
Ott-'�� I
r20,917 sq. ft.
\ 2 Start"
2 Sten".
%
Ise r nar �v
Lot 3
Lot 16
eo R-50.00'--
L-24.61' �' LEGEND
., G-26.12'10; ;
Found 3/8" mbar w/ red collar cap
Well .i R' �' + • t —oA— Overhead Utility Line
So•�, rets. aa,
Or I •�F,OFgC 44
• ,......
•`�49 _.�1�.
HARWOOD Court ' j /t� ROBERT T. KEAN At
iv
- NOTES
N 89*2380.002• E
1. Record info don is from the plat of Rabbit Creek View and
' Rabbit Creek Heights Subdivision Replat (P2004-91).
2. Easements of record:cmatedafterdate of Mg of record plat
ale not shown. I
3. New cleanouts and alarm float pipes located this survey 6/27/06.
4. RC record monumenis ate 313" Rebar w/ 2" Red Collar Cap.
S. Sewer line and tank tram May 2001 as -built, Flattop Technical
Svcs. I
SURVEYOR'S CERTIFICATE
I hereby certify that I have surveyed the property and facilities described
hereon and that the improvements situated thereon do not encroach on
adjacent property, that Improvements on adjacent property do not
encroach on the surveyed premises, and that there are no other visible
eassmeat;or rights-of-way, EXCEPT AS SHOWN OR NOTED HERE(
8-7-06
Date
EXCLUSIONS
No data hereon should be used for positioning additional structures,
for building fences, or for locating the boundary lines. It is the
responsibility of the owner to determine the existence of any easement
or restriction that does not appear on the recorded subdivision plat
and to verify that all improvements meet all subdivision covenants
and zoning ordinances.
"As -Built"
Block 11H Lot 17A
Rabbit Crk View and Rabbit Crk Heights
(Subdivision Replat
i
1 LOCATED WITHIN THE
Wt/2 E1/2 OF SECTION 1, T11N, R3W, S.M., AK
ANCHORAGE RECORDING DISTRICT
Lindy McCarriston
PWAREO Br 1
KEAN & ASSOCIATES
6927 Old Seward Hwy #101
Anchorage ,W 99318
W.O. R
W06118 (Ref. WO1111)
V=30'
DATE DRAWN: WaA GRID:
8/7/06 3341
\
�o
N0.
ENCROACHMENT PERMIT
THIS AGREEMENT, made this day of 19
between ANCHORAGE; Grantor, ani _ward.C. Goodman
Grantee,
WITHNESSETHs The Grantor does hereby grant an Encroachment
Permit in the following described Public Right -of -Way or Easement
Area to Wit: /•--- t- v..l .1 4 Q,\F A, ,4 c, nn T.nF 1 7 Al n,I, 11
s aescriDea as
the following:
to
In consideration for this permit, the Grantee agrees Wait
he will indemnify and hold harmless the Grantor against any and
all claims which may arise or be caused by the construction,
alteration or maintenance and existence of the above described
encroachment or for any damages whatsoever arising out of the
granting of this permit.
The Grantor reserves the right to revoke this permit upon
twenty (20) days written notice to the Grantee. The Grantee,
agrees upon said notice of revocation, to immediately remove said
encroachment from the easement, street or public right-of-way.
Should the Grantee refuse or fail to comply with said written
notice, the Grantor, may without further notice to the Grantee,
remove or cause to be removed the encroachment, and the Grantee
hereby agrees to reimburse the Grantor for all cost incidental to
the removal thereof. The Grantee hereby agrees to pay an annual
fee of $ tn.nn
IN WITNESS WHEREOF, the parties hereto have hereunto set
their hands and seals the day and year first above written.
Grantee:
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT)
Grantor: ANCHORAGE
�L...f��
D rector; Public Worcs Dept.
THIS IS TO CERTIFY that on this /I day of uJ .
,
196, before me, the undersigned, a Notary Public dn and for the
State of Alt�ska, duly sworn and commissioned as such, personally
appeared (_ uit V ki.a'�r1t r known to me to be the
Municipal Engineer of the Muity of Anchorage, who executed
the foregoing instrument and acknowledge that he/she executed
said instrument as the free and voluntary act and deed of said
corporation for the uses and purposes therein mentioned, and that
he/she was authorized to execute said instrument.
WITNESS my hand and official seal the day and year
in this certificate first above written.
Iwo '1"y� a GumNOTARV PUBLIC in and for ska
My Commission Expires: 1
STATE OF A
ss.
THIRD JUDICIAL DISTRICT )
BEFORE ME, the undersigned, a Notary Public in and for
Alaska, duly cammtiss1*qrA;."4 swgf4 as such, this day personally
to me known and known to me to be the person described in and who
executed the above instrument and acknowledged to me
that and sealed the samere€�el—y—a-nT voluntarily for the
uses and purposes therein mentioned.
�► WITNESS my and and notarial seal this day of
Q 19
a
o «m�MUC
tUI KLBURKM TA PUBLIC IN AND FOR ALASKA
w My Commission Expires: E)
4-01
)
Municipality of Anchorage
Development Services Department'
Building Safety Division � On -Site Water and Wastewater Program
4700 South Eragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. e 20 rr L-7— G3 HAA # HA 0 U 2a2 --
Expiration
IExpiration Date: S -2 i - O l
1. GENERAL INFORMATION
Complete legal description Lot 17 Black its fi ay b1 f Creek 14e ry A #r s 4f,
Location (site address or directions) r -7 o r Nick leen Ck.
Current Property owner(s) i3r u� ^ �'� D "'Y er Day phone
Mailing address f o
GoNt r S3
RnRn c_ %}k 99.11
Lending agency an k.
Day phone
Mailing address
Real Estate Agent nlolc
FSQD
Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual On-site
❑
Individual Water Storage
❑
Individual Holding tank
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Deve!opment Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results less than 30 days cid. (Certificates may be reissued for a period of up to one year with
valid water samples.) Certificates are valid for cre 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.
i
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below. I verify that my Investigation,
'based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure Indicated herein. I further verify that based on the Information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system Is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm Flafi�,p Terin+ta/ Eel -vice/ Phone_ Sys--13sr
Address ►NS '3U Ectio Sf Ancf. Ak 99sr�
Engineer'sPrinted. Name' TAoo.z- F Moo•e Date_ May is-, 2001
5. DSD SIGNATURE
_L/ Approved for 3 bedrooms. :s •%:�::"f�g+t. •.....:. 6
.. F. 0.fooT.E 1"
Disapproved.<'•. Ce-3�av ;.,.E'�T
Conditional approval for bedrooms, with the following stipulatixiris,:
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: azzo/ z2z_ Original Certificate Date: D /
(Rw. MIN)
w
rT73'•�r�ii7
••
���
�'� Q
_L/ Approved for 3 bedrooms. :s •%:�::"f�g+t. •.....:. 6
.. F. 0.fooT.E 1"
Disapproved.<'•. Ce-3�av ;.,.E'�T
Conditional approval for bedrooms, with the following stipulatixiris,:
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: azzo/ z2z_ Original Certificate Date: D /
(Rw. MIN)
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water b Wastewater Program
4710 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519.6650
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: c.& f f 7 Q /vc if /f R a 6 6 i E C ree k
H k( Parol ID: 070-111-63
A. WELL DATA
Well type Pv} If A, B, or C provide PWSID # =
Well Log (Y/N) Y
Date completed e115-167- Sanitary seal (Y/N)
Wires property protected (Y/N) Y_
Total depth 102. S ft. Cased to o Z ft.
Casing height (above ground) 3 0 in.
FROM WELL LOG
AT INSPECTION
Date of test 6 / IS / B 2
S /to / zoo I
Static water level 2 S ft.
2 2.s- ft.
Well production I S 9.13.m.
6. 7 f- g.p.m.
WATER SAMPLE RESULTS:
Coliform _0colonies/100 ml. Nitrate 3.Z0 m9.A.
Other bacteria 0 colonies/100 ml.
Date of sample: S /9 / 0 r Collected by: F/n /-/oA Tec4n, ;rG f Sue,(
B. SEPTICIHOLDING TANK DATA
Tank Type/Material f+o l A Tun k /S et/
Date Installed 5'/8 / 2yo !
Tank size 2000 gal. Number of Compartments
Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N
High water alarm (Y/N) Y
Dale of pumping N. A. — A e CO Pumper
C. ABSORPTION FIELD DATA N• A.
Date Installed Soil rating (g.p.d./fe or fF/bdrm) _
System type
Length ft. Width ft. Gravel below pipe ft.
Total depth _ ft. Eff. absorption area ft2 Monitoring tube _ Depression over field
Date of adequacy test Results (Pass/Fad)
For _ bedrooms
Fluid depth in absorption field before test _ In. Water added_ gal. New depth_ in.
Elapsed Time: _ min. Final fluid depth _ in.
Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N 8 type)
If yes, give date
D. LIFT STATION N. A.
Date installed
"Pump on" level at _ In.
Datum
Size in gallons
'Pump off" level at _ in.
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Manhole/Access (YM) _
High water alarm level at
Meets alarm & circuit requirements?
Septic tankAi t station on lot On adjacent lots > r00 '
Absorption field on lot — On adjacent lots > r ua '
Public sewer main — Public sewer manhole/deenout
Sewer /septic service line > Z S ' Holding tank / 741,
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 2 S Property lure 30 ' Absorption field —
Water main > ZS" Water service line Z -r' Surface water 66
Wells on adjacent lots 7-s
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: N. A.
Property line _
Water Service line
Curtain drain
F. COMMENTS
G. ENGINEER'S
Building foundation Water main
Surface water
Wells on adjacent lots
I certify that I have determined through fieldmspectlons and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name Tl+t c, as r r > M u a r
Date r-Y&g Ir Zoo r
-T
Driveway, parkingtvehide storage
HAA Fee $ 3 00 " Waiver Fee $ _
Date of Payment 5 / I (, / 20o r Date of Payment
Receipt Number Receipt Number
(Rev. 12100)
ENGINEEiVr'?
STAMP , — ''��., �
In.
MAY -15-M 15:11 FROM -
CUE Emrironrnsrual Services Inc.
T-659 P.03/05 F-938
CUE Rsta
1012389002
Cikst POs Pte -Paid Co1is/NO3
Client Nave
Flattop Technicd Srv.
Printed Date/Plmc 05/15/2001 13:30
ProjectNamds
N/A
Ca0aetedDate nme 05/09/2001 10:30
Client Sample 1D
L17, Bl1, Rabbit Ck Hta
Reedvtd MUM= 05/09/1001 14:30
Metric
Drinking Water
e
Teckakal D4atar Stephen FAC
Ordered By
PWSID
PWSI
0
Rdeased Bx
Sample Remarks
� Allowable Prep Analysis
Parwr7n
PQL Units Mie w Limits Date Due laic
kators Dspartatatat
Nitrate -N 320 0.500 mWL EPA 300.0 (<10) 05109101 SCL
tticrobiology Laboratory
Total Coliform 0 0 col/looml. SM18922MB 05/09101 KAP
.�N
A q-03;3rj
i
MUNICIPALITY OF ANCHORAGE
DIVISION OF E,WIROIZENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information
Application Date 7_4) JUN P.4
(a) Legal Description (include lot, block, subdivision, section, township, range)
lot 17 R1L.0CK II RAHAjT (at :FTC SORT i IIN Ie;W 50C1. &tit
Location (address or directions)
- t.- -(-N 57- C*;: n ew le 5 R OA D -17 1 N e t- 14
js
(b) Applicants Name IVAP-p C-rrA yAn1 Telephone - Home /�00 Business
Applicants Address Po C3olLAtieF1okAC-r ,Al< 995_°2_
(c) Applicant is (check one) Lending Institution ,� ; Owner/builder
Buyer [:::I ; Other E:::l (explain);
(d) Lending Institution Telephone
Address
(e) Real Estate Co. 6 Agent
Address
Telephone
(f) Mail the HAA to the following address:
2. Type of Residence
Single -Family Q Multi -Family
Number of Bedrooms 1
3. Water Supply
Individual Well M 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 Q Public Q 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
r,
5. Engineering Firm Providind 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 Firm SSS CNC I/JC-� lrS /n]G. Telephone '349
Address
Date 10 (ULq A3
6. DHEP Approval
Approved for
Approved
(ENCS
bedrooms By
Disapproved Conditional
Terms of Conditional Approval
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 DREP 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 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 2] 7-19-84
MUNICIPALITY OF ANCHORAGE (MOA)MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTECTION
CHECKLIST - FEBRUARY 1984 1111 2 61984
Legal Description:
A. WELL DATA d,.na,r rark� arc
Well Classification /A10Jy1pVA4 If A, B, or C, D.E.C. Approved(Y/N)
Well Log Present (Y/N) YES Date Completed 6 - 15 -SZ Yield IS6PM
Total Depth MZ, S ' Cased to 102-451 Depth of Grouting A( -1A
Static Water Level 2-5 Pump Set At IC.W-m
Casing Height Above Ground 0' Sanitary Seal on Casing Mw Y� S
Electrical Wiring. in Conduit (YIN) Yr -5 Depression Around Wellhead (YM) AJO
Separation Distances from Wall:
To Sep".q/Holding Tank on Lot 14 Z On Adjoining Lots > 1501
To Nearest Edge of Absorption Field on Lot; VA ; On Adjoining Lots >-160
To Nearest Public Sewer Line K11A To Nearest Public Sewer
Cleanout/Manhole IbO"+ To Nearest Sewer Service Lineon Lot 112
Water Sample Collected By M Agwiiisrw ; Date 2 {VLdA4
Water Sample Test Results
Cam ants
B. -aBPlSC/[iOLDING TANK DATA
Date Installed MARC" A2-* Size 2_00L2 r -AL No. of Compartments
Standpipes (Y/N) �(CS Air -tight Caps (Y/N) YOS Foundation Cleanout (YM)
Depression over Tank (Y/N) AID Date Last Pumped '1ISM4
Pumping/Maintenance Contract on File (Y/N) - for 4.S N Dt 11 - aVbkriue TTL
Holding Tank High -Water Alarm (Y/N) No Temporary Holding Tank Permit (Y/N) gTT,gtIcb
Separation Distances from•sapt4e/Holding Tank:
To Water -Supply Well 14 V To Building Foundation_")
To Property Line To Disposal Field 1,11
To Water Main/Service Linera�m«ar o Stream, Pond, Lake, or Major Drainage
A114Course �Q 46
.CameRts TA.su,•,�, m •' C tin MAALk %4 - to &rTC ATTAG4 ,n-%
(Page 1 of 21
2-15-84
C. ABSORPTION FIELD DATA
NOT APPcicaaLE HOLDI:JG TM)K
Soils Rating in Absorption Strata
Date Installed
Width of Field
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Square Feet of Absorption Area Standpipes Present (Y/N)
Depression over Field (Y/N) Date of Last,Adaquacy pest
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water -Supply Wall
To Building Foundation.
To Property Line
To Existing kr Abandoned System on
Lot ; On Adjoining Lots
To Water Main/Service Line To Cutbank(if present)
To Stream/Pond/take/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Can, nts
D. LIFT STATION NOT
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm level at
Tested for
Electrical Codes(Y/N)
Cannents
APPucAeLC
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Tast. Meets MDA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or eonfcrmed to all MDA HAA Guidelines in effect
on the, date of this inspection.
44
Date 17!O l� 'CE OF.•,••• .fb�
Ccany S�fL SlEi v,-zx c /NG MOA No. -4- +M9 -y 2
•� Z
RB1/d5/s
t NAIN L SWANSON. ,�,�
(Page 2 of 21
15-84
MIDNIGHT
PUMPING CO.
328 Boniface nsse
AnChOrAge, Alaska 99804
NAME
ADDRESS
PHONE 0 0 Y DATE
SEPTIC TANK
L
CESSPOOL
HOURLY RATE
TOTALS1
15 61 ......... COftP.ANCHO.^49 ALA.. . ...... .
rJ us 7>
A / ay
X30
l
r
`
` Uf-.r1�
C
x
•. r
() 4.O' decK
0
I-7
0
0 di
tp � 4.0 <4.q :.porch
Well
1
.6.4-
F
L.
O
�a
i
cam.�n Corner i1 ' Oi
Found B.L.M.8ro39"��-��'[I•,
cop Mon. (1950)
0
0 2W •
/."lrj
SO,a ,• 5¢+ Sib" x 50• Rebo,
4 all cnr5.
b¢arin95
Ln
T. 11 N. R.3 W• S.M.
Found 5LM 5ra55
dap Mon. (1950)-)
from plat- No. P. X0-381
BOOK : 194- p, 54, 6i
JOB No: 4-0055
X GRID: 3341
DRAWN
BY: MGG CHECKED BY:W
SCALE: 1 >'sO' SURVEY PLAT AND AS -BUILT:
i`,i u,I N E.R S..
T NHE
7125 OLD SEWARD H"
a sa7D�
' S -E �.
_5
D PROPERTY.
E SURVEYED
THAT HAVEAK.,
I HEREBY CERTIFY
A,�IB HGHTSANCHORAGENRECORDINGEDISTRICT.
LINES
i Q• •• ••:��
LOT T , THE IMPROVEMENTS
AND THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY
THERETO. THAT NO
(�
ENCROACH ON THE PROPERTY LYING ADJACENT
ON THE PREN25E5
49TH.
AND 00 NOT
IMPROVEMENTS ON PROPERTY.LYING ADJACENT THERETO ENCROACH
LINES OR OTAER
�.• •r,•'��• `moi;
IN QUESTION AND THAT THERE ARE NO ROADWAYS. TRANSMISSION
PROPERTY EXCEPT AS INDICATED HEREON.
/ /
VISIBLE EASEMENTS ON SAID
A swnvso+
gO�DAY OF APP11L..1984, ANCHORAGE, ALASKA.
•!W
�.�; •, LS
4/!
DATED THIS
BUILDER, PRIOR TO CONSTRUCTION,
..�
17 IS THE RESPONSIBILITY-OF.THE OWNER OR
TO FINISH GRADE AND UTILITY
` \fir �do�
TO VERIFY PROPOSED.IBUILDING.GRADE RELATIVE
EXISTENCE OF ANY EASEMENTS,
CONNECTIONS AND TO DETERMINE THE
ON THE RECORDED SUBDIVISION PLAT:
OR RESTRICTIONS WHICWDO NOT APPEAR
•a
>
, Yv,w J 4✓" tib. ." Y„ war
` �Air Y o. "7•I.�+♦I'T'X-�`"V, i +` 's'�cS"W t'ZJ r,`••, yrs S+;%7?;
� -> ...y ;A� �.f 't. vl ✓ 1 '.�,. I j,>r 1 �a.x .,. ..le'..
a�
CASH CM ECIC/
/\
n
DATE
F
DESCRIPTION
CAPACITY
\,
SEPTIC TANK
MIDNIGHT
—
CESSPOOL
PUMPING CO.
HOURLY R''A��T�fE
328 Bonllserr /2586
Anchorage. Alaska 99504
O 0--)
'y 'a ' `'
NAME
�o
N i C- K LF_
ADDRESS
%
PHONE
DATE
CASH CM ECIC/
/\
CHARGE
DATE
TIME
DESCRIPTION
CAPACITY
AMOUNT
SEPTIC TANK
ZOW .
CESSPOOL
HOURLY R''A��T�fE
-7-
rTOTALS
TOTALS
t 1560
•. �54,'S i < �_- '' .�' '�{ nwrwon co.r...w<wo
ya.r.W.I;.Y•.sow.+r+�a°Ve�ar'+r+i^*,WIF>�Y+��+.r^�sa..w«i+ere�,l..'..,�r-.rr �w-Jp:'c=�w 4 J
1
0
^_ n.., WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological 9 Geophysical Surveys
Drilling Permit No.
LOCATION OF WELL (Please complete either lo, IE or le.) A.D.L. No.
I Borough
Subdivision
Lot
11
Black
ID 1/ gtrs.
Section No.
Township N�
Range E❑
Meridian
ft 11
17
— of— of—of _
SE
w�
F
it, DISTANCE AND DIRECTION 6M -ROAD INT?SECTIONS
3. OWNER OF WELL:
Alfie Bakhoum
Rabbit Creek Heights
Street Address and Area of Well Location
Address: SRA Box 440 A
Anchorage, Alaska
2. WELL LOG FeelBlow
So, lot e Bolcom
Material Type Top
4. WELL DEPTH: (final)
102 ft.
S. DATE OF COMPLETION
—L — 15 — �.SL.2
broom ravel till w cobbles 0 0
a. OCable tool [30101011 ODrivon ❑Dug
11pAuger ❑Jilted ❑Bored ❑ Other 1
roans y i
brown till little gravel 70 97
7.USE: ® Domestic O Public Supply O Industry
O Irrigation O Recharge O commerlcol
O sea Well ❑ am.r:
brown silty till w grave
and seepage luu
brown silty gravel H 100 1021
S. CASING: O Thread,,sp [3 Welded
ala-. 6 In. to 10 1. Depth Weight lbs./a.
dram. In tom It. Depth SHtkup ft.
9. FINISH OF WELL:
Type: Diameter:
Slot/Mesh Spe: Length:
'
Set between It. and ft.
Backfilling Gravel pack
10. STATIC WATER LEVEL: ft.
E] Above ar C] Below land surface Date
Equipment used:
lei
r" T
II.PUMPING LEVEL below lona surface and YIELD
ft. after—ere, pumping.g.p.m.
ft *It*, hre. pumping_g.p.m.
ENV!i, .. 1: ..A. ! :O E _.J
JUL 195
12.GROUTING Well Grouted: O Yee O No
EIVED
Material: ❑ Neat Cement O Other:
13. PUMP: (If available) HP
Length of Drop Pipe ft. capacity g. P.M.
O SVbm. O Jet O Centrificol E)other
Ie. REMARKS: seepage @ 121 3 221 5 841
pumped at 15 am-701D,De
S.L. 25
16. WATER WELL CONTRACTOR'S CERTIFICATION:
IS. Water Tem pualur• _e C] F E] C
This well was drilled under my )urisdlollon and this report Is true to the best
of my knowledge and belief(
Vern! s Drilling & Enterprises ,z 3a -/
Regrsteled Business Nome GOntfaft LlC onfe Number
Address:
Signed:
Dale:
Authorized Rsprosemalive
Form 02•WWR (11/8I) COPY DiHribulion: WHITE -Stale OGGS, PINK-Drillor, CANARY -Customer
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ALASKA EnUIROW11TAL C011TROL SCRUICES, Inc.
Enginttrinq 6 Enuiranmmlal Studies
PERCOLATION TEST DATA SHEET
CLIENT Jud /l% Lyme-- /A/X7ZDATE
ADDRESS"
ZIP CODE 1
LEGAL LOCATION 4, / R 421 7L Cfef-k At"t klr
TOTAL DEPTH OF HOLE /1? ft.
ZONE TESTED S— ft TO L ft
READING A
CLOCK TIME
NET TIME
DEPTH TO i NET DROP
DATUM/
RATE (min/in)
iv
-L 7-
i
p-o/Z
0
I
d
l7 Zo
to
FIW,L PERCOLATION RATE -"-,1") /,,, k' ,.,Z (min/in)
PERFORMED BY _12j, -,r -
lei not ac' -o7 4/e �r G�-1,� rple jf .3r 1:z
c), a )try 74;4
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