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Home My WebLink AboutMOUNTAIN PARK ESTATES #2 BLK 5 LT 12 WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological ~ Seophysicol Surveys Drilling Pecmit No. LOCATION OF WELL (Please complete either la~ lb or lc.} A.D.L. NO. ate~ial Type Top Bottom ~ ¢ ~;'/ 7. USE: ~Domestic 0 Public Supply 0 Industry ..... ~.-~..~,... Set between ft. and ft. // ~ Above or ~ Below~'~ndg~ sur~c. Dote ~DNICIPAglIY aP AN~HO~G~ ~ F~ ff. utter ~' hrs. pump ng .' g.p.m. ~EPT. OF HEALTH [ ENVIRONMENTAL PROTECTION ~ ft. offer ~ hfs, pumping g,p,m. 12.GROUTING Well Grouted: ~ Yes ~'No 15, PUMP: (if oveilQble) HP 15. WQfer Temperature ~o ~ F ~ C .~d Business Name / Confroct,~icense.Number -. . DEF'ARTMEI',-IT OF HEALTH AND ENVIROt',IMEI'qTAL PROTECTIOIq 825 L' S"t"Ft:EET, ANC!qORAGE~ Al< 99501 R64-4720 PERMIT NC]: c,o DATIE I,m:~UEL. APPLICANT: ~' r~ ".,':: C:. a,_, DR[..~,,_: CON'I"ACT FIHONE .- 840805 09/2 1/84 WILLIAM C, HIGGINS P 0 BOX 11:1.463 ANCHORAGE, Al-::: 99511 345-0:502 LEGAL DESCRIF': SLIBDIVISION: M(]UNTAIN F'ARK EST ¢2 LOT: ].2 SECTION~ 3 TOWNSHIP: :I.:[N RANGE: 3W . LOT SIZE: 20000 (SQ.FT. OR ACRES) LOT' LOCATION: ~ LUF'INE E .._L. CI .... 5 I certify 'that: 1. I am familiar with the requ:i, rements for on-site sewers and ~ells a~s set ¢or'f.h by {he Munici'pality' of Anchopage (MOA) and the State oF Alaska. 2. I will irfs{all the system in accordance ~i'[.h all IdOA codes and r'egu:l, at, ions, and in compliance with the design criteria'of this pe,rmit.. 3. I will. adhere t.~ all M(]A and StaLe m]¢ Alaska requiremer'its ¢or' the set back ' distances from any ex:[sting we!l, was'Le~,~ater disposal system or public sewerage system (:)n this or ally /~'~ja(::ent ar nearby la'L. A,":',"LICANT: WII...LIAM C HIGGINS ~'"-~"-~-- I SS[.IE~ BY MUNICIPALITY OF ANCHORAGE ' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4?20 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE I .~NEW [,di/hC_m /d z,4 - ez/ [].PGRA.E LEGAL DESCRIPTIOb] fi( DISTANCE TO: WelXot Vn Absorption area Manufacturer I F HOME.DE: Inside length Well Dwelling DISTANCE TO: Manufacturer DISTANCE TO: ~.¢~. ~r//7 No. of lines ~___ LengthT/~¢-°f each line/4z//. Top of tile to finish grade ~//__ I Material Foundation/~o//~ Nearest lot line Total length of li_nes / I Trench width/ /,~ /ZU I Material beneath tile 2 V inches Length Width Depth Type of crib Crib diameter Crib depth NO. OF BEDROOMS~_~/ PERM, 73 3 No. of compartments ~ Liquid depth PERMIT NO. Liquid capacity in gallons P E R M IT.J~C.Q. Distance be~nes Totel effect PERMIT NO. Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Sewer line Building foundation Septic tank Absorption area(s) OTHER PIPE MATERIAL~,/~ SOIL TEST RATING INSTALLER~ .EMARS DATE APPROVED 72-013 (Rev. 3/78) LEGAL PERMIT NO. BPPLICBNT WILLiBM M HiBER LOC~TiON LEGAL L±2B5 MT PBRK ESTATES DEPRRTMENT HERLTH BND ENVIRONMENTBL ~OTECTION 825 'L~ STREET, 8NCHORRGE, BK. 9950i 2~4-4720 ( 8~0~D~ ) 2211 JEFFERSI]N 248-4D2± LOT SIZE 9DDD:DD SQURRE FEET T'.r'F'E OF SOiL FiBSOF.:PTION _~=,TEI'I IS: DRRINFIEL[:, t'"IRXIMUM NUMBER OF BEDROnMS = 4 "SOIL RRTING ,::SQ FT,.."BR)=_ 2t,2, .-, '.- THE REQUIRED SIZE i]F THE SOIL RBSORF'TtON =,'rz, TEI1 [:"BERTH= 5 ~ E t-,i ~'-~ T H-- :¢_ 2-I L~ F-: Fl'-.." E b [:,EF' TFi= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE [:'ISTRNCE BETI.4EEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). THE TF.:Ei-,IE:H ~---I ~ [:,TH Z S 5. C~C~C'~ FEET. THE GRRVEL DEPTH I'-] THE MINIMUM DEPTH OF GRR'v'EL BETWEEN THE OLITFRLL PIPE RND THE BOTTOM OF THE EXCR'¢RTION (IN FEET). F-:E L----.~IB ]:: F-:EE:. SEF'-F 1' C: TI:If. II-:: ":-; i ZE= i25~_---', ,.3F]IL_ L,_-~I-,IS F'ERMIT RPF'LICRNT HR'-] THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT [,_F.'IhlF4. THE iNSTRLLRTION INSPECTIONS OF RN'¢ WELLS R[:,JRCENT TO THIS PROF'ERT"r' RN[:' THE NUMBER OF RESI[:'ENCES THRT THE WELL WILL SER'¢E. Ti.q,], ,:: 2 ::, ][ t-,ISF"E £:T ]] Cit-~"_:. KIF-:E F: F L----., LI ii F-:F[:. BRr':KFILLI.NG OF RNY SYSTEM WITHOLIT FINRL INSF'ECTION RND RPF'RO',,,'RL BY THIS [:,EF'RRTMENT WILL BE SUE:JECT TO F'R]SE]_TI]N. MINIMUM DISTRNC:E BETWEEN R WELL RN[:. RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS ±00 FEE]' FOR R PRI'¢RTE WELL OR 'i50 TO 200 FEET FROM R PUBLIC HELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTRNCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS :-35 FEET RND TO R COMMUNITY SEWER LINE IS 75 FEET. HELL LOG,,,] RRE REQUIRED RND MUST BE RETURNED TO THE DEF'RRTMENT WITHIN --':0 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENT,,,] MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE R'v'RILRBLE TO INSURE PROPER iNSTRLLRTiON. I CERTIFb' THRT ±: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE ,,,]EWER,,,] RND 14ELLS RS SET FORTH BY THE MUNICIPRLITY OF RNCHORRGE. 2: I WILL iNSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODE,,,]. 2: I UNDERSTRND THRT THE ON-SITE ,--]EWER SYSTEM MRb' REQUIRE ENLRRGEMENT IF THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 82§ L. Street, Anchorage, Alaska 99501 264~,720 SOILS LOG- PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: L~,,,~ C~q DATE PERFORMED: SLOPE SITE PLAN I 2 ~3 ~5 ~ · r~.~ y,'s~-% ~ ~ ~d/~. 10 ~ 5% WAS GROUND WATER S 1 1 ENCOUNTERED? bio L O P 12 E IF YES, AT WHAT DEPTH? 13 Reading Date Time Time Water Drop 3;H5 ,o .~Z 14 15 16 17 18 19 PERCOLATION RAT E/~'~ TEST RUN BE~EEN ~ ~/~ FT AND ~ ,. FT COMMENTS ~o;I ~ ~ 21~'/~r~ ~ ~' ~ ~. PERFORMED BY: ~¢vO1 S CERTIFIED BY: DATE: ~2~ -- ~, Parcel I.D. # DEPARTMENT OF HEALTH & HUMAN SERVICES ~ Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 .~. - ~ -[ ~ ~/ , CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ~ 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual o n-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 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 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 ail Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Nameof Firm J2~FT)~-,~ ~i'--~:~P"/~:~/~4~- ~/~-¢~, Phone ~-/'~ 7 ~.' Address ~/~ ~:~//~/~~}~ DH,~H/S SIGNATURE ' Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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. Em ployees 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, I/91) Back MOA#21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES APR 0 2 190 Environmental Services Division MUNICIPALITY OF 825 L Street, Room 502 · Anchorage, Alaska 99501 · (90ff~,~V~'~,,~'?~i~A~ SEP, VICES DIVISION. Health Authority Approval Checklist Legal Description: ~-J'~-- ~'-~/~'~' ~j~zf~___~_~ Parcel I.D.: A. WELL DATA Well type /' ~"~r~./'cd~f---~ IfA, B, or C, attachADEC letter. ADEC water system number Total depth '-~ '~ Cased to ~'~ 7~ Casing height (above ground> Sanitary seal (Y/N) / Wires properly protected (Y/N) AT INSPECTION Date of test Static water level Well production FROM WELL LOG g.p.m. I , ~.Z~. g.p.m. WATER SAMPLE RESULTS: Coliform ~"?~ ,. Date of sample: ~ ] .5 ~'~ Nitrate ,-~' '~ ] Collected by: Other bactena B. SEPTIC/HOLDING TANK DATA Date installed (~'7-~'~/T~ank size I ~-~50 Number of Compartments *'~--~ Cleanouts (Y/N) Y Date of pumpingF°Undati°n cleanoutg/~_~b(Y/N) ) C~9PumperDepressi°n~ t:/2 '0 f-'?'(Y/N) FC--~'~Av//~//~pHigh water alarm (Y/N) -~ C, ABSORPTION FIELD DATA Date installed ~'~- ~x ~ Soil rating (g.p.d./fForft~/bdrm) ~,/~/~/~/Sfs~emtype ,~ ~y~ Length t~/-~0I ! Y / Width 5 Gravel thickness below pipe /'~ --(~ Total depth .~.,-- Effective absorption area ~.~0 O! Monitoring Tube present (Y/N) y Depression over field (Y/N) Date of adequacy test T~._._[~-~_ _~_ Results.(Pa~s/Fail) ~ ~ ,~2 For ~ bedroom,~,/ Fluid depth in absorption field before test (in.); "~' ImmediatelyafterC'~-~al. wateradded (in.): Fluid depth ~'~.. . (ins) Minutes later: f ~)~ Absorption rate --~'~ (~ .g.p.d. Peroxide treatment (past 12 months) (Y/N) /~_~ If yes, give date 72-026 (Rev. 3/96)* LIFT STATION Manhole/Access (Y/N) High water alarm level at* Size in gallons "Pump on" level at* *Datum "Pump off" level at* Cycles tested SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot l I ~ / On adjacent lots _. ~ / Absorption field on lot C~ '~t O/¢/~? ~"/[ ~/~Z~- -'/-/m/{' ~/'e ~'0¢¢'~'' On adjacent~nlots~'l.*'~'~ Public sewer main /~,) //~ Public sewer manhole/cica,out / Sewer/septic service line ~('~(~2/ ~L- ~ Lift station /¢"v/~/'~'~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation // (' l Properly line ,,~ (~/~'~- ) Absorption field Water main/service line Surface water/drainage '¢'"v/O/K)¢--- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TOi ( · Property line ~/~ r~__ Building foundation ~ ~'~ Water main/service line ~ ('~'~/~"J'L h Surface water ~/k (~,Y)_ ~ Driveway. parking/vehicle storage area ~_~O ~;~L ) Curtain drain ~h,,,~ ~ ~ ~ Wells on adjacent lots F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal recor~.tba't"Jtt~abp. Ye systems are in conformance, with MOA HAA g ' lines effect on this date Sit, nature ~ Engineer'sNameJ~m~'~, Date ~ ~ ~ ~ HAA Fee $ ~ · Waiver Fee $ Date of Payment ~¢ '~¢ ~ ' ~ ¢, Date of Payment Receipt Number ~¢~ Y ~ ~ ¢~,) Receipt Number 72-026 (Rev. 3/96)* CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID Sample Remarks: 990966001 Sames Sizemore & Associates L12 B5 Mtn Park Est No. 2 L12 B5 Mtn Park Est No. 2 Drinking Water Client PO# Printed Date/Time 03/23/99 11:46 Collected Date/Time 03/15/99 10:45 Received Date/Time 03/15/99 13:15 Technical Director: Stephen C. Ede Released BY~~~t~ Parameter Results PQL Units Allowable Prep Analysis Method Limits Date Date Init Iota[ Coliform Waters Department Analyses Nitrate-N 35 OB/lO0 ML, NO COLI 4.31 0.500 mg/L SM18 9222B 03/15/99 KAP EPA 300.0 03/15/99 03/15/99 SCL RECEIVED APR 2 1999 Municipality of Anchorage Dept, Health & Human Services CT&E Environmental Services Inc. ~rink[ng Water Analysis Report for Total Coliform Bacteria 2oo w, Po.e, o,,vo An,'horage. AK 99618-1605 ~E.4D fiVSTRUCT[ON$ ON R£FEE$£ SIDE ~£FOR£ COL/.£CTZNG ,.~,!,1P££ Tel: {907} 562-2343 Fax: 1~O7) 561-5301 ~{UST BE COMPLETED BY WATER SUPPLIER PUBLIC WATER SYSTEM I.D. ~ P~RIVATE WATER SYS'f~M SAMPLE TYPE: Q Routioe 13 Tf~ted Wnt~ wi~h lab m~ a~ ) ~me Coll.~ SA~L[ L~ON, '~ C~ ~ TO BE COMPLETED BY LABORATORY Analysis shov~ dfi$ Water SAMPLE to be: ~---.. Sadsf~'tory U~o~ S~le ov~ 30 ho~ o1~ ~ulm m~y ~ ~i~le S~ple t~ long in t~sit; s~ple should not be ov~ 45 ho~ old ~t excision to indi~ ~ii~le ~ PI~ ~d ~it~ Analyst EI IOEIE E ~b Fblm J'~o [~ clreat notified ofuoaatisfactory rffult~: BAcrERIOLOGICAL WATER ANALYSIS RECORD -RECEIVED APR 2 1999 Comments: ~fembrane FilM~. Diri~tCollmr V'erifkaflo.: LTl COUlqR~' ,,ept. Health & Human Services ColiForm/lO0 mi ~~ Mi,~.4; of tho SOS Grouo ~Socidte G~flMIII de Suweiilir-:G) zTF. FROU-CTE ENVIRONMENTAL 56i530) T-642 P.01/01 F-215 CT&E Environmental Services Inc. Laboram~ Division ~ar~ ~drlar~amr~.~:4mr~r~14r~l.~,ff'~'arar- 200 W Po. er Drive Drinking Water Analysis Repor~ for Total Colifmm Bacteria READ INSTRUCTIONS ON ~VE~E jIDE BEFORE COLLECI~NG SAM~ZE Fax (qO~) fi61-5301 MUST BE COMPLETE~ BY W'ATER SUPPLIER ~ B~ COMPLETED BY LABO~TORY PUBLIC WATER SYSTEM ID. ~ PRIVATE WATER S¥SYEM F~ ~uml~r Mon[h Day 9~.MPLE TYPE Routine [] R~peat Sample ti'or routine sample wi[h lab ret'. no. ) Q Sperial Purpose Tim~ SAMPLE LOCATION Collgc~ Y~ar Untrealed Wa[er Collecled By Analysl~ shows ~his WaJcr SAMPLE :o Unsansfactoty ~ Sample over 30 hours old, resu[~ may ~e unrehabte Sample ~oo long in transit, sample shoutd not be owr 48 hour~ old aI tO indicate retiabt= :esul[s. please s~nd new sample wa special dO)~eu marl. Time Re~eiv~ ~_ (~ .~ Anal3nieal Me[hod: ~l~ M=mbran= FiLer '~ .~vIMO.MUG 51 11 054 Analyst ~nt lu ,q,,U,[-L, ~-. ..... Fbg~, J un Client ~o~ified or' un~oti~facT0ry resuRs: Phonea Spog~ wim BACTERIOLOGI/C,a~L WATER ANALYSIS RECORD RECEIVED ,MMO-MUG R~uh: Total Coliform Membrane Fitter: Dlrec~ Coum Verification: LTB Fecal Colitorm Confirmation Final Membrane Filter Results .... R~poc~ed By dz~~ Colfformt'100 mi Commcnt$; ENvIRONM£NTAL FACILITIES IN ALaSkA. CAL!FO~NIA, FLORIDA, ILLINOIS, MARYLAN0, MICMIGAN, MISSOURI, N£W JERSI~Y, OHI ' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONEqENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORIVlATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) /_,..p,-,.~ 4%/ 2) ~, /t,--,..~,-.., (b) Applicant Name /{'/°,'~M~-ir'l~ 4~°'~' '/~"~'</% Telephone: Home ';~ ¢/.~ o .~ C, ~. Business ApplicantAddress Po &~ ~ ii ! ,¥ ~ ~ A~,.,: ]-, .... ?~ /~'1~ (C) Applicant is (check one): Lending Institution []; Owner/builde ; Buyer []; Other [] (explain); Lending Institution Address Telephone (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: Other TYPE OF RESIDENCE Single-Family~/ Multi-Family [] Number of Bedrooms ~- WATER SUPPLY Individual Well~]~ Community[] Public [] Note: If corem Unity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4, SEWAGE DISPOSAL Onsit ~ublic [] Community [] Holding Tank [] Note: If bommunity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 E~GiNEEI~IING FIRM PROVIDING ..,JSPECTIONS, TESTS, FILE SEARCH, DA'l,-. AND INFORMATION As cedlflod 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 tho numbor of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from tho Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewator 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 /¢~C~' Telephone 5-4 I 5-0 ¢~/ O Address laos) 42 ~ ~ "-¢J /~,: ^ ?~-~ -?f,,..,,~-ko ~*~ Date / ! - S" - ~' b" DHEP APPROV/~" Approved for ~(J~ P* ~4~,~bedrooms by Approved ~ Disa~ved Cond~nal Terms of Conditional Approval Date 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 engineer's work. Page 2 of 2 72~025 (11/84) A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION Well Classification ~or~¢(~'4 Well Log Present ~)N) Total Depth ?~'~'; Cased to Static Water Level S45 Casing Height Above Ground Electrical Wiring in Conduit~'¢4) Separation Distances from Well: IfA, B, C, D.E.C. Approved (Y/N) Date Completed //- '~ - ~ ~- Yield ~z'2'~ Depth of Grouting Pump Set At / Sanitary Seal on Casing Depression Around wellhead (Y/~ To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole ~ Water Sample Collected by "/~¢-~"] //¢ ; On Adjoining Lots ~;] ~'~-~- ; On Adjoining Lots ~7' To Nearest Public Sewer To Nearest Sewer Service Line on Lot ,2 5- -h Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Size / z ~--o No. of Compartments Foundation Cleanout ~JN) Date Last Pumped /v ; for Temporary Holding Tank Permit (Y/N) To Building Foundation // To Disposal Field ~z To Stream, Pond, Lake, or Major Drainage Date Installed Standpipes ~¢)N) Air-tight Caps Depression over Tank Pumping/Maintenance Contract on File (Y/~)_ Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well //¢ To Property Line ¢O -~o To Water Main/Service Line Z¢ ~' [ Course ~ )- Comments '~ A,/o ¢,~e A..cs Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ;Zig /2'/& Date Installed ~ - ~-'~- - ~ .7, Width of Field Type of System Design Length of Field / 21 g '/' Depth of Field ~' -- g' P': Square Feet of Absorption Area Depression over Field (y/~2 Results of Last Adequacy Test Gravel Bed Thickness -~ Standpipes Present~(~) Date of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot /VA To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line To Existing or Abandoned System on ; On Adjoining Lots ~.' To Cutbank (if present) -~'f 'T- /~0 ~T 20 Date Installe'~~-.-- Dimensions Size in Gallons . -_ "Pump On" Level at ' -- High Water Alarm Level at Tested for Electrical Codes (Y/N) ~ ~ Comments Manhole/Access (Y/N) J "Pump Off" Lev~ ~- Vent (Y/N) ~ ~ ¢~'~ :::-.'--"~ Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I ~:~/.e checked:verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. ://J~../~q/'¢~' Date'/ Signed //' ~ -~ ~' Company /,,,'qGc..f'- ~,;.~ ,~-s- o z c( MOA No. Receipt No.."~C[[ ~C) Date of Payment ! ,~' ~-' ~' ~'"'- Amount: $ Page 2 of 2 72-026 (11/84) P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES, MA YOR DEPART[~,'IENT OF HEALTH & HU~IAN SERVICES December 13, 1985 Darcy Bevens Alaska Environmental Control Services 1200 West 33rd Avenue, Suite B Anchorage, AK 99503 Subject: Lot 12, Block 5 Mountain Park Estates S/D Waiver Request WR 85-059 Dear Ms. Bevens: This department has reviewed and granted your waiver request for the subject loto The required 100 foot minimum separation between the well and absorption field has been waived to 97 feet. This waiver is valid for the existing septic system only. Upgrades of the system will be required to meet separation distance standards. Sincerely, Stephen So Morris Civil Engineer On-Site Services SM3/dEH6 ALASKA eFIUIROFIITII FITAL COFITROL SeRUICI $, IFIL ~/l(]JrleU'Jll§ ~. I~nuiroQm¢,I~l $ludies November 6, 1985 Department of Health & Human Services 825 L. Street Anchorage, Alaska 99501 Dear Susan: /',4UNICIPALffy OF ANCHORAQ~: D.~PT. OF HEALTH & ~NVIRONMENTAL PROTECTION uEC 0 RECEIVED This is in regards to Mountain Park Estates, Block 5, Lot 12. The septic system was installed 8/22/83, although no one has ever lived in the house. Around October 1984, the owner of the lot became concerned as to where to drill a well so as to maintain the required separation distance of 100 feet from all septic systems, especially since there only was a cleanout at the west end of the trench, and the east end was buried so that'an unsuspecting well driller might not realize the septic system was there and might drill the well too close to the east end. Consequently, the owner had an engineer from our office, Steven F. Cords, visit the site and flag the spot for the well to be drilled. Steve picked a spot in the extreme NE corner of the lot, where it could be 110 feet from the septic system on Lot 12. It would be well over 100 feet from all other septic systems. On November 3, 1984, the well was drilled. I recently went out to do a Health Authority Approval on this lot. In order to determine exactly where the leach field ended towards the east, I stretched out ll2'feet of tape measure, with one end at a stake left in the ground marking the 90 degree turn made at the west end, and the mid-point passing through the place 7 feet south of the tank (the as-built shows that to be the field's location) and then continuing in a straight line. Where the leach line is located can be determined by observing where all the trees have been cut down. Now, by measuring from the well to this point which appears to be the easternmost end of the leach field, the distance turns out to be only 97 feet. Since the stake Steve put for the well driller had been removed or buried, I proceeded to measure the distance from this well to the neighbor's septic system, which Steve had recommended be 110 feet. The distance was 118 feet. This indicates that the well drillers did not drill at the place Steve had flagged, and thought they had several feet of leeway, which unfortunately they did not. The well is 72 feet deep and cased to that depth. It goes through a couple of clay layers from 2 to 51 feet, which undoubtedly would prevent any possible contamination of the drinking water. In fact, several percolation tests had been performed in the past by AECS in the silty area near the well, and the percolation rate was greater than 60 minutes/inch, neccesitating the the careful location of the septic system to the south where the good soils were found. Graywater will probably not be able to penetrate this tight silty soil, since water did not penetrate it during the percolation test. Ground level 1200 LUesl 33rcl Auenue, Suite J~- Anchora% Alaska 99503-(907) 561-5040 at the well is roughly 3 feet higher than ground level at the leach field, so graywater is not likely to flow in that direction anyhow. Furthermore, in the testhole dug by the septic system, no ground water was encountered to 12 feet. Therefore, we are requesting a waiver of the horizontal separation distance between the well and the leach field on Lot 12, Block 5, to be only 97 feet. This well is over i00 feet away from the tank, and over 100 feet from all neighboring septic systems. The septic system is over 100 feet away from all other wells. Enclosed are copies of the well log, soils test, and correspondence by Steve Cords concerning the location for the well. If you have any questions please feel free to call. Sincerely, Approved by: ~ /~ · uarcy ~Fevens Engineering Geologist MUNICIPALITY OF ANCHOP, AGF. DEPT. OF HEALTH & ENVIRONMENTAL PROTIfCTION RECEIVED ALASKA ENVIRONI~NTAL CONTROL SERVIC. , INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO CALCULATED CHECKED ~Y SCALE / OF DATE DATE PERFORMED FOR: LEGAL DESCRIPTION: ~"~o'~,'ta-',~ '~--,r~t E.g+o-.~ '~-..~ L~"-//~c ''~ T l)~J ~ '{'"J / [AOA ST ~50Z~r 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19- 20- IF YES, AT WHAT DEPTH? ~LOPE WAS GROUND WATER S L tot4 ENCOUNTERED? NO O P E SITE PLAN <5% Gross Net Depth to Net Reading Date Time Time Water Drop ,5; 'fff -- ,~o PERCOLATION RATE/2,~) H:O"~~ (minu~!:;J/i~ch) TEST RUN BETWEEN · ~-- FT AND FI DATE: Charles Higgins Northridge Construction PO Box 111463 Anchorage, AK 99511 Dear Charles: The proposed house you plan to build will have 4 bedrooms which is a private single family dwelling and will require a well set-back of 100 feet. The site chosen to install a well on Lot 12, Block 5, Mountain View Estates meets all of the requirements for set-back distances set forth by the Municipality of Anchorage regulations. This lot is currently undeveloped excepting for the septic system that was installed in August 1983. The proposed location of the well is in the Northeast corner of the lot about 3 to 5 feet in from the corner. Measurements from this point to the existing absorption field on the lot and on Lot 14 show that these systems are 109 and 110 feet away respectively. The systems on Lots 11 and 13 are located behind the houses and are far beyond the 100 foot mark from the well. This area is the only location on the lot that meets all of the requirements. Should you have any questions please feel free to contact me at AECS, Approved By: Sincerely, .~ '! Stevefl F; Cords Civil Engineer MUNICIPALITY OF ANCHORAGZ: DEPT,:.f)F HEALTH & ENVIRONMENTAL PROTECTION RECEIVED.