HomeMy WebLinkAboutFISCHER BLK 1 LT 4C-1Fischer
Blk 1
Lot 4C 1
#015-292-39
GREOR ANCHORAGE AREA BOPOGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
600
NAME AIWOL I %/ 0ODAP/]��M_�AI LING ADDRESS '7007 //1!/4J,C` +�� PHONE
LOCATION Al&' C0RNE72. 0" 'ZD LEGAL DESCRIPTION LO%
E T
SEPTIC TANK:
DISTANCE/ NUMBER OF
FROM WELL �Ob MANUFACTURER 6RZ_r�W MATERIAL 07 -£EL COMPARTMENTS /
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY/2-f-6 GALLONS.
TILE DRAIN
TOTAL LENGTH
DISTANCE FROM WELL /FOUNDATION 7-0 NEAREST LOT LINE �� OF LINES
NUMBER OF LINES �-/ DISTANCE BETWEEN LINES IkM TRENCH WIDTH -a IN. TOTAL EFFECTIVE
ABSORPTION AREA �9SQ. T. LENGTH OF EACH LINE / @ 3.C/
"T'ee7a ti D�Vr7v 1 / 41 DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE 61- 7/ MATERIAL BENEATH TILE 7- /21x+r. ABOVE TILE Ll IN.
WELL:
TYPE-S"-'?"/--'OGC.&/C CONSTRUCTION_
BUILDING NEAREST
FOUNDATION . LOT LINE
CESSPOOL , OTHER SOURCES
APPROVED DISAPPROVED
DISTANCES: V lL
DyrSS
INSTALLED BY:
-2/EY' c.E/t__
SEWER LINE DEPTH:
G/— 71
PIPE MATERIAL: 6457' _Z: -god
AS P��o, ALEX 771_E
LOT SLOPE:
REMARKS: k'o o'
Form EQ -032
NEAREST SEPTIC / SEEPAGE
SEWER LINE , TANK 1O6 , SYSTEM_
REMARKS
DISTANCE FROM:
//7/
DIAGRAM OF SYSTEM So/ e- 8.r y -/8 /
we"_
O_
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s�
F
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3S1
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DATE 4t(Z-17CAPPROVED
G.A.A.B.
GRE* ANCHORAGE AREA Bo* HI
—�rs—
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT Nd
3330 "C" STREET ANCHORAGE, ALASKA 99503`
.TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT
NAME OF APPLICANT T' ^•�-7 -MAILING - MAILING ADDRESS 7�0 • WIN� ONE 04"t
INSTALLATION LOCATION AJ FT COrinov 4-F Qum R -d . .� 17e />/4r�2). 44&*
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK SEEPAGE PIAT DRAIN FIELD-,OTHER'dt36.[1_,
TYPE AND SIZE OF FACILITY TO BE SERVED " • /�D` ��"�� ' '�^'�/y
FINANCED THROUGH TO BE INSTALLED BY
SOIL TEST RESULTS -�'S ( NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
% J
COMPLETION DATE ANTICIPATED • 1;
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION] BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
r
SEPTIC TANK S1ZE /^vim TYPft • " �aFb, SEEPAGE .AREA SFSE _ Y 4 _ _ TYPE
E .,
i
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK V
FOUNDATION TO SEEPAGE PIT AO r DRAIN FIELD /O
SEPTIC TANK TO SEEPAGE PIT WALL
�
j
SEPTIC TANK- r SEEPAGE PIT DRAIN FIELD V
TO NEAREST LOT LINE.
WELL TO SEPTIC TAN /00 /00 A I , SEEPAGE PIT do/ ,
DRAIN FIELD O&W /90 ALSO CONSIDER AREA
qq WELLS.
WATER MAIN TO SEPTIC TANK �O / SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, D SEEPAGE PIT �%V Q DRAIN FIELDD�
TO RIVER, LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OI
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PI'
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
.CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G.A.A.B.
OR
LICENSED DE511R
DIAGRAM OF SYSTEM -€_
1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-58 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE �J _71y APPLICANT'S SIGNATUREk
FORM NO. EQ -016
X666 a4
,.
Performed for
Legal Description:
This form reports:
Depth
Feet
I _ _.
ANCHORAGE
Qua lTiy ala dye\
3330 "C" Street
Anchorage, Alaska 99503
SOILS LOG - PEROLATION TEST
Performed
2-
3
4-
5 -- >
6-
7
R -
V -
c> W - �J
10
11 -
12 -
13 -
14 _
Was ground water encountered? c, If yes, at what depth?
Reading I Date
Percolation rate
-Proposed installation:
Depth of Inlet
COMMENTS:
Performed 6y:
EQ -040 (6/74)
Gross Time I Net Time
I.. nu mac.
ge Pit Drain Field
Depth to bottom of pit or trench
ed By:
to Water Net Drop
-- Date: -- ---
;. APPLIgrT FILLS OUT UPPER HA ONLY
Property Owner dry2AlvC�J f�F.%��1- -
Phone
Mailing Address 716, 4,-- Zip S2de �/
3 3 �
Buyer %"iii✓t'7L.li' \%.
Date -
Address P .J, 13o,C 5–.eq i J} ... (. 41VC x/ .. 4 Ac- Zip Code
Lending Institution ���/. hr .4 %I 'V't-�I--Ilttr._''ec, : -
Phone
Address Zip Code
Date
U-
Realty Co. & Agent /. /� �tl� - -
V
Phone.
Address Zip Code
Inspectors
Legal Descriptio
Street Location
Type of Residence -.
Ingle Family -
❑ .Multiple Family No. of BedroomE/
❑ Other - - -
Water Supply _
er ividual - - -
ATTACH WELL LOG. A well log is required for all wells drilled since June 7975.
LJ Community
For wells drilled prior to that date, give well depth (attach log if available).
- ❑ Public Utility
lL 1-'V /rte t
Sewer Disposal
individual - Year Individual Installed.
❑ Public Utility - - When Connected to Public- Utility:
O Holding Tank -
- NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
- Time -
Time
Time
Date -
Date -
Date
-
Date
U-
..Inspector -
Inspector -
Inspectors
Inspector(/
Field Notes: Wc" 17- ^'t c iL
MUNICIPALITY OF ANCHORAGES
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
OCT44 1 i3
-
,01�
RECEIVED.
(. ) APPROVED BEDROOMS /D,j��j
QONDIITION/S�
5�
�OF APPROVAL
(. ) DISAPPROVED
(y) CONDITIONAL APPROVAL'
DATE
BY:. Gs I "Q-0, P2'5..
Soils Rating
Date Sewer Installed _
at -7
Well To Absorption Areari 7
Well Log Received /L `q r
Septic. Tank Size / -z 0
— t.2 "
Well to Tank 104
72023(3182)
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f! r MUNICIPALITY OF ANCHORAGE of K
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
\ 264-4720
Application Date 5�2r/B(o
91.: GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
/nT 4C1 ,BLOCK I F/SCNcIe SUED .SECT/ON /5 TUIP /z N0 Z 3 W
Location (address or directions)
/030/ Dura RoAo
(b) Applicant Name 4d?AIQLb_WOODAzo Telephone: Home Business .563 -36 tTO
Applicant Address /03Di 009 PLAAD 99.x7%in
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder; Buyer ❑ ; Other ❑ (explain);
(d) Lending Institution F1251- Telephone
Address
(e) Real Estate Company. and Agent k i lt
Address
Telephone
(f) Mail the HAA to the following address:
Ui00bA2b CON Sr-SE✓cTlOnf
5 11 t>IEST Sq i -k AVG.
4MCHORAGE , .4K Q9$/8
2. TYPE OF RESIDENCE
Single -Family, Multi -Family ❑ Other
Number of Bedrooms 4
3.
WATER SUPPLY CiASSCG
Individual Well ❑ Community)$ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite 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 2 72-025 (11i84)
my seal affixed hereto and as of the validation date'shown below, I verify that my investigation of this Health
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The Muncipality of Anchorage' Department of Health and Environmental Protection (DHEP),
issues Health Authority `
1
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
Page 2 of 2
y',f 72-025 (71/84)"
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
• MUNICIPALITY OF ANCHORAGE (M• ENVIRONMENTAL PROTECTION
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984 J L L 1 0
264-4720 R Ir- F (�
Legal Description: LDT '14C o T `f'�6Y SW.S4;z'0
A. WELL DATA
Well Classification CLA55 C If A, B, C, D.E.C. Approved (Y/N) Y
Well Log Present (Y/,N) Date Completed /94,q Yield- Sr 6PNt
Total Depth 305' Cased to 90 4- Depth of Grouting ATONE
Static Water Level ze ql Pump Set At Nor AErCrMJ.ueA
Casing Height Above Ground ZA/" Sanitary Seal on Casing (Y/N) Y
Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) A!
Separation Distances from Well:
To Septic/Holding Tank on Lot JO �' ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot Iz ig ; On Adjoining Lots
To Nearest Public Sewer Line AcT /N Alt GA :To Nearest Public Sewer
Cleanout/Manhole N /A To Nearest Sewer Service Line on Lot AV/A
Water Sample Collected by K'FADDEAI ; Date g&�B 4,
Water Sample Test Results 4T1SF ACr0re —
Comments WELL ApF 1xeVAL To 0Rg"-re Cit( A.D.e.c.
B. SEPTIC/HOLDING TANK DATA
Date Installed 84-16 Size /2`�a6sAG No. of Compartments 1
Standpipes (Y/N) Air -tight Caps (Y/N) Foundation Cleanout (Y/N)
Depression over Tank (Y/N) Date Last Pumped i�8ln
Pumping/Maintenance Contract on File (Y/N) y ; for )iso
Holding Tank High -Water Alarm (Y/N) 0 Temporary Holding Tank Permit (Y/N) AVIA
Separation Distances from Septic/Holding Tank: --.
To Water -Supply Well Eby' To Building Foundation 7T
To Property Line , fI0` To Disposal Field
To Water Main/Service Line R7' To Stream, Pond, Lake, or Major Drainage
Course ffi00` j
CommentsSEp-rle _r IS %RAEQ✓ATE
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata S�s-
Type of System Design %t?E.vcN
Date Installed
Length of Field 35'
Width of Field
Depth of Field 7'
Gravel Bed Thickness 7
Square Feet of Absorption Area 990
Standpipes Present (Y/N) w
Depression over Field (Y/N) IJ
Date of Last Adequacy Test S 6
Results of Last Adequacy Test PA56E D
Separation Distance from Absorption Field:
To Water -Supply Well /ZS i
To Property Line /7
To Building Foundation q3'
To Existing or Abandoned System on
Lot A10AIE
; On Adjoining Lots /o0' f -
To Water Main/Service Line 17-14'
To Cutbank (if present) &Q7 PeESE.vr
To Stream/Pond/Lake/or Major Drainage Course
600, f -
To Driveway, Parking Area, or Vehicle Storage Area
Zo'
Comments AJ5:SP7RP7-/0&f F/ELD /S f/DEQ,IAr.E
D. LIFT STATION
Date Installed N/n
Size in Gallons
"Pump On" Level at
High Water Alarm Level at _
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
— Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
`* Check Permitted Bedroom Rating Against HAA Request **
Icertifythatlh`vechecked, verified, orconformed toall MO an HAAguidelines ineffect onthedate ofthis inspection.
Signed %rVAGf�ir•�te 7
Company Q/Rmm GVG/r/MOA No.
Receipt No. 3—q1 rf'.,
Date of Payment y'%Fw4to OF qt°%i
Amount: $ �� va Ei� .••° °'Os�� Engineer's Seal
Page 2 of 2
72-026 (11/84)
S &YE
�IF&L&SN& BILL SHEFFIELD, GOVERNOR
DEPT. OF ENVIRONMENTAL CONSERVATION Telephone: (907)
Address:
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303 274-2533
ANCHORAGE, ALASKA 99501
DATE:
PWS I.D
To Whom it May Concern:
According to records on file in this office the Z- o f 4Z r-
V� Water System is in compliance with the State Drinking
Water Regulations
Sincerely,
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site 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. 015-292-39 COSA # OSC. � D- I
Expiration Date: 4p — 3 d ~ f
1. GENERAL INFORMATION
Complete legal description Fischer, Block i, Lot 4C -i
Location (site address) 1o3o10ur Road
Current Property owner(s) Arnold & Kayla Woodard Day phone
Mailing address
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. -TYPE OF WATER SUPPLY:
Indivldual;Well "' ❑
Individu� IYWater Storage ❑
Community Class C 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 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 affxed 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 is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm _Pannone Engineering Services, LLC Phone 272-8218
Address P.O. Box 100217, Anchorage, AK 99S o /
Engineer's Printed Name Steven R. Pannone, P.E. Date _7712 1'Z_
Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions
encountered at the time of the test, and separation distances measured to readily identifiable features. .�,�`��1
The operational life of all wells and septic systems depend on the local soil condition, ground water �J OF
levels that may fluctuate during the year, and the water usage of the family being served by the system. •.........
These conditions are outside the control of the evaluator of this system All systems eventually fail and : c ) V
satisfactory test results do not guarantee future performance of the system, nor do they guarantee that .° qgm \ r}�1�
there are no hidden defects or encroachments. PES can therefore not provide any warran for future • n ••• ••h.•.••�
performance nor give any estimate of how long the system will continue to meet the operational..0
[��yyy
requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed j .j.........n.. , .., „o,,, ........steoen R. Pannone3/.0 •
above. Any reliance upon or use of this report by any other person or party is not authorized nor will it SIL' % No. CE 8149
confer any legal right whatsoever. �1�q, •,,.•°�
5. DSD SIGNATURE �h���,;,c..•�
LZApproved for 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: k Original Certificate Date: 3-3 C `/,,7—
(Rev. eros)
Municipality of Anchorage&
• _��s}o
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: Fischer, Blocks. Lot 4C --i Parcel ID: 025-292-39
A. WELL DATA
Well type Class'C' If A, B, or C provide PWSID # 224817
Date completed _ Sanitary seal (YIN)
Total depth ft. Cased to ft.
FROM WELL LOG
t
Static water level
Well production 9 -
p.m -WATER SAMPLE RESULTS:
Coliform Ngg_colonies/100 mL Nitrate 3.76 mg/L
Well Log (YIN)
Wires properly protected (Y/N)
Casing height (above ground) in.
AT INSPECTION
Arsenic: NQ ug/I Date of sample: 11142012 Collected by: PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic I Steel Date installed 9112ho75
Tank size 12S0 gal. Number of Compartments z Cleanouts (Y/N)
ft.
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping 3h512022 Pumper A+ Home Services
C. ABSORPTION FIELD DATA
Date installed 91121%o71; Soil rating (g.p.d./ft2 or ftz/bdrm) zz sf br System type Deep Trench
Length ac ft. Width 3 ft. Gravel below pipe 7.s ft.
Total depth iz.5 ft. Eff. absorption area szs_ff Monitoring tube Y Depression over field N
Date of adequacy test 1/15/2022 Results (Pass/Fail) Pass For 4 bedrooms
Fluid depth in absorption field before test 44 in. Water addedsoi gal. New depth57 in.
Elapsed Time: zap min. Final fluid depth 44 in.
Absorption rate >= 45o+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
D. LIFT STATION
"Pump on" level at
Datum
Size in gallons
in. "Pump off'
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot io4*
Absorption field on lot 217*
Public sewer main 71;+
Sewer /septic service line 25+
Animal containment areas 50+
Manhole/Access (Y/N)
water alarm level at
Meets alarm & circuit
On adjacent lots iia*
On adjacent lots ioo+*
Public sewer manhole/cleanout ioo+
Holding tank zoo+
Manure/animal excrete storage areas ioo+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line zo+ Absorption field 5+
Water main io+ Water service line 2S+ Surface water 200+
Wells on adjacent lots iso+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line zo+ Building foundation io+ Water main 75+
Water Service line 20+ Surface water Zoo+ Driveway. parking/vehicle storage io+
Curtain drain so+ Wells on adjacent lots Zoo+
F. COMMENTS
* See DEC Waiver Class'C' Well to septic / Approval to operate Class'C' well - 3.0/22/2a82
G. ENGINEER'S CERTIFICATION
-�,r -s•-y -�
1 certify that 1 have determined through field inspections and
review of Municipal records that the above systems are in �.....a.. a
conformance with MOA COSA guidelines in effect on this date.
............n
♦ ;Steven Pannone; �-i
Engineer's Printed Name Steven R. Pannone. P.E. ♦j� `s R. No. CE 81
♦1
Date •••''••... .....•
COSA Fee $
Date of Payment
Receipt Number
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number
in.
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_SGS
SGS Ref.#
1120803001
Client Name
Pannone Eng. Srv.
Project Name/#
Fischer BLK I Lot 4C-1
Client Sample ID
Fischer BLK I Lot 4C-1
Matrix
Drinking Water
Sample Remarks:
Parameter Results LOQ
Metals by ICP/MS
Arsenic ND 5.00
Waters Department
Total Nitrate/Nitrite-N 3.76 0.100
Microbiology Laboratory
E. Coli Negative 1
Total Coliform Negative 1
Printed Date/Time 03/22/2012 13:05
Collected Date/Time 03/15/2012 12:00
ReceivedDate/Time 03/15/2012 12:50
Technical Director Stephen C. Ede
Allowable Prep Analysis
Units Method Container ID Limits Date Date Ina
ug/L
EP200.8
C
(40)
03/21/12 03/21/12
ACF
mg/L
SM214500NO3-F
B
(a10)
03/20/12
AYC
100mL SM219223B A
100mL SM219223B A
03/15/12 DLC
03/15/12 DLC
2 of 4
G3110/zulL G7:lO bbbb((U
SYAp16HT f[
P ;e ♦ � uJy
A FULL NpJ
A+ HOME SERVICES
7501 E. 140th Avenue
xx:*,Anchorage, Alaska 995.16
345-1890
CUSTOMER
•
10301 0nr
chorage, AR 99516
Block � Lot
DATE
xxx
(;r'LUb h A6E IJl
INC.
DESCRIPTION
REMARKS
INvo►CE # 416 5 8
AMOUNT
it% VV _
Gallons Septic Leach Area HoldingTank /0; Z.5 -
Standpipes Time
❑ PROBLEM AREA — CALL FOR MORE INFORMATION
❑ NEEDS TO BE DONE AGAIN 1W6 MONTHS
Good Shape Sludge buildup on bottom
❑ Jim cap missing or CJ Cut standpipe to V above ground
needs replacing
❑ Floater on top
❑ Needs Septictrine
Pppp" ALASKA RLTA
CONTROL SERVIC.IC.
1220 West 25th Avenue Suite B
ANCHORAGE, ALASKA 99503
276-1361 279.2917
W 15U
JOB 0-u__ C_ E r
SHEET NO OF
CALCULATED BV /AAC KAPi.ANE DATE
CHECKED BY DATE
Or
ALASKA EnUIR0I1UTAL COUROL SCRUICCS, inn.
Engineering & Enuironmental Studies
October 5, 1982
Alaska Department of Environmental Conservation
437 E. Street
Anchorage, Alaska 99501
Attn: Burce Erickson
Dear Mr. Erickson:
On October 4, 1982 we inspected the wells and sewer systems
for lots 4C1 and 4C2, Block 1, Fischer Subdivision.
Both houses share a common well which is located on lot 4C2:
The well is located in a small box type enclosure, the
location is shown on the attached drawing. The well is
located over 100 feet from any sewer system.
Results of a bacterological test of the water was provided to
us by one of the owners. It was satisfactory. It, along with
the well drilling log, is attached. The well is 305 feet
deep.
Both sewer systems were installed under Municipal supervision.
There was no evidence of either system overflowing.
I believe that if the requirement for 150 feet separation
between class C well and the sewer system were waivered it
would not create any health or environmental problems.
I therefore recommend that you grant the waiver of distances
for this class C well.
If you have any questions please let me know.
.•tip` , .' f' u
6.c 1 ...r. a.
ti.., ; Leroy C Reid, Jr.
4v' No.:2:1-a
``f .!•XPi: p � °•°..a...a•n�.
Sincerely,
Leroy C. Reid, Jr., PhD PE
President
1220 Fest 2% Auenue • Anchorage, Alaska 99503 0 (907) 276.1361
CONSTRUCTION AND OPERATION CERTIFICATE
ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION
PUBLIC WATER SYSTEM
APPROVAL TO CONSTRUCT
Plans for the construction
public water system located
in Alaska, submitted in accordance with 18 AAC 80.100
by N� �'Q�� have been reviewed and are
®approved.
❑ conditionally approved (see attached conditions).
y �iF/OS io is
A
If construction has not started within two years of the approval date, this certificate is void and new
plans and specifications must be submitted for review and approval before construction.
APPROVED CHANGE ORDERS
Change (contract order no.
or dexripti" reference)
Approved by
Date
The "APPROVAL TO OPERATE" section must be completed before any water is made available to
the public.
APPROVAL TO OPERATE
The construction of the public
water system was completed on moo, _��P'L (date). The system is hereby
granted interim approval //to operate for 90 days following the cpmpletion date.
//.OS' /O
/ TITLE
DATE
As -built plans submitted during the interim approval period, or an inspection by the Department has
confirmed the system was constructed according to the approved plans. The system is hereby granted
final approval to operate.
l/ nTLEDATE
�
®0w