HomeMy WebLinkAboutT12N R3W SEC 21 LT 1BT12N R3W
Sec 21
Lot 1 B
#015-273-40
Municipality of Anchorage
• Development Services Department • '"
Building Safety Division
On-Site Water 8 Wastewater Program, 4700 South Bragaw St.
e
P.O. Box 196650 Anchorage, AK 99519.6650
www.cl.anchorage.sk.us (907) 343-7904 Page 1 of 3
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number. SW060212 PID Number. 015-273-40
Nome:
GEORGE STEWART
Wastewater System: ❑ New ■ Upgrade
Address:
10936 ELMORE ROAD • ANCHORAGE, AK 99516
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 522-1062 4
■Deep Trench OShallow Trench 08ed Oklound Cl Other
LEGAL DESCRIPTION
Sall "°`"° 0.6
Total ° N«n "" 1 s
CPO/Sq.
n. o MAX rt
Block: Lot: Subdivision:
- 1 B -
o.Ple t. PIPs baltam Nv„ -"grad.:
Gavel d.Pm e.neem Pp.:
SEE DWG.
n 6.2 n
Township: T72N Range: R3W Section: 21
n mdod aww rkkal grad.:
Goa wpm:
SEE DWG.
R 90 n.
WELL: ❑ New ❑ Upgrade
Growl widen:
2.5
NUM« a Mnp:
1
Diaonae Mle..n lk e -
-
FL
FL
Ga.«Iwa,«, (Pena..• /.e,C): rola o.pm: Ca.od To:
TOW ee.an;,Wn r«:
Poo ma.na:
n
1116 so.n
D 3034/ F-810
ba.r: a.d: $lake Mar Levi:
sulallon
GEG, Ltd.
pate Installed:
8/30/2006
Wade
P,enp saw
Corp tlepnl Ma,e Gava..
dPY
n
it
TANK
SEPARATION
DISTANCES
ClSeptic 0Holding 0S.T.E.P. 0Other
To
Septic
Absorption
Lift
Holding
/PAvate
Manidack' .
copac.q In dosaw:
From
Tank
Field
Station
Tank
5..« linea
Well
150'+
150'+
—
—
25'+
wtwla:
Nava« a oa.avruvonl..
Surface water
100'+
100'+
—
—
—
LIFT STATION
Lot Line
5't
10'+
—
—
—
See N peens:
Ydnulaekrr.
Foundation
5'+
10'+
—
—
_
an Is.a ol: al W al « al«+n dl
Curtain Drain
NONE KNOWN
Pa .taw a
unto! ti.P.awa. Wannae M:
Remarks: EXISTING SEPTIC TANK WAS VERIFIED TO BE
BENCH MARK
Lou ata o..criplwn:
OF GOOD INTEGRITY ON 8/29/2006.
TOP OF CONCRETE STEP ® FRONT DOOR
OLD DRAINFIELD TO BE USED AS A RESERVE SITE
6�O f,�rF..k wn R33nu 0a /3
~ 100.44 n
GEG, Ltd. i
Inspections performed by: Dates: 1st 8/30/2006
ENGNEEN'SSM
8/30/2006
_ooa000
3rd
Ole .OF..
�0�0
Development Services Department Approval
...... ....... .....
Reviewed and approved by: Date:
•. •• ••.. ...
QO'P '•• of r y ess,. ��
QO CEI-79 3 F°O�
Reviewed and approved by: � Date: 1-10-0-7
4p°a yf es ion
ro o
(o«. e/oe)
Q (eesla°
�OO0000�
PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER:
SW060212 015-273-40
J
NEW DRAINFIELD
INSTALLED FLOW
DIVERTER/
� INSTALLED DOUBLE
CLEANOVTS
k—EXISTING 1250 GALLON SEPTIC
TANK. VERIFIED TO BE ON GOOD
INTEGRITY ON 8/29/2006
1
EXISTMG .t.�:•
HOUSE
EXISTING GRAINFIELD TO BE \
USED AS A RESERVE SITE \
MA
OBLI
OBL2
48.2
74.01
FO
53.9
77.3
COI
25.3
56.3
MTI
28.6
58.4
CO2
113.0
121.6
MT2
111.8
120.8
_ �.__�c� ,•• _ _ _._. _ _ _
GARNESS ENGINEERING GROUP, Ltd. H
CONSULTANTS & GENERAL CONTRACTORS Q....:.. ...... ..........
3Mt L TOM MM. AO[ 10, . MOt011 M M N00) • /ttd[ (907)W] t» . IM (W»SL-]3N M91L w..pww�pYwYy.yw O
PREPARED FOR: PHONE NUMBER: PACE NUMBER: • • • • • •....... ..........
GEORGE STEWART 522-1062 2 OF 3re amess..
Qa
LEGAL DESCRIPTION: DRAWN BY: Op a� CE -7953 •. R`
T12N, R3W. SECTION 21. LOT 1 B, C.J.G. p� g�S/�• ' oQo
TWE OF WORK: DATE: �D�d Pro/sasiona4o
AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 95/2006 ��D0000�o
PERMITNUMBER: AS -BUILT DRAWING PARCEL ID NUMBER:
SW0
SW060212 015-273-40
ORIGINAL GRADE MI L:u FINAL GRADE
96.47 O ff f 95.68+
THjjt HIGH POINT
FILTER FABRIC
INVERT OF PIPE
92.18 (AVG.)
BOTTOM OF
TRENCH =
85.97 (AVG.)
RELATIVE ELEVATION OF BOTTOM OF
TESTHOLE - 79.97 (TESTHOLE DRY)
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS&GENERAL CONTRACTORS Q••• .. •• • . • ••••• ......•••
3N1 L 1{g00 RWA M 101 • MICIOV(G Mt =l01 • HOE (G011.M?- M • !Mt (101)JY Q • OOi41[-apll�wpti,rNim.1
PREPARED FOR: PHONE NUMBER: PACE NUMBER:••• ••••••••••
GEORGE STEWART 522-1062 3 OF 3 OQap f ey A. GDrness:
LEGAL OESCRIPTON: DRAWN BY: GE -7953 e,
T12N, R3W, SECTION 21, LOT 1B, C.J.G. 4�ere'9//c1L'�c4o
TYPE OF WORK: OATE: 404O4ro f 0 s oo
PROFILE AS -BUILT OF SEPTIC SYSTEM UPGRADE 9/5/2006
(RN. 01M)
GARNESS ENGINEER & GENERALINGq�TORS GROUP, Ltd.
CONSULTA
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: T12N, R3W, SECTION 21, LOT 1B,
PERFORMED FOR: GEORGE STEWART D1
DEPTH
(feet)=__y ORGANICS TEST HOLE #1
1
2
3
4
5
6
7
SOIL CLASSIFICATIONS
I
•.
GP
SM
to-
01213141516
CL
/.%GCNNN
OIL
Iiff ff]
SP
CH
�fl{7��IiSmY/V�.
OH]
SC
9
SM
to-
01213141516
12-
13-
14-
15 -
1 6
B.O.f
1.
17
18
DEPTH TO DATE
GROUNDWATER
DRY 8/29/2006
Q A
SEE ATTACHED
SITE PLAN
t9� PERCOLATION RATE _ (MIN./INCH) PERC. HOLE DIA. — (INCHES)
TEST RUN BETWEEN FT. AND FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ❑ NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: —
COMMENTS:
PERFORMED BY CEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS P RFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: r1sloi
•S
89053136"W
84.54
/
wort:
I /
woR[u • e•aeTn m Lor ISIS Acwou for u
I 1
I I
^ LOT 1A
I I
6.20
I i I
4q.
I I
2`�9•
'
601
I
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1 \
1 \
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N 89047156"E 297.5
TIE NFORWTION HEREON IS FOR THE USE OF LE,SImG STRUTIONSSPECIFICALLV TO S MIVCWMTS BE
TMEEN
EXISTING SIRUOTWES MOPLATTED IAT UNESOR EASEMENTSMO IS NOT TO BE USEDFORPO TTI .NOXOITX Al
STRUOTURESORFENCEUI S
EASEMEMS OF' RECORO. OTHER THAN TIIOBE BHOKTI ON THE RECORDED PUT. ME NOT BNDMN HEREON
NOTE ANY FEIOELMESSHDVM ME LOCATED APPROXIWTELV MO ME NOT TO BE USED TO DETERMBIE PROPERTY LMS
OR LOCATE STRLICTUNE9
o C� C3F'A�9��4
?gyp.,.• S ��I
c� 49?H� •�a
..............................
5/- f/
Y SHANE A. HOLT: o
n i
LB -6914
m
N
N
N
N
3
c
N
'a
0
z
AS -BUILT
1
1
I
im
'r
IK
10
I;a
m
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I HEREBY CERTFV THAT I NAVE PER mWO A
MOR TOAGE ES NBPECTION OF THE FOLLO
DESCRIBED PROPERTY.
LOT IB, SECTION 21. TIM RSw. B M (PLAT 77-123)
ANCHORAGE RECORDRO DISTRICT. AIABNA AN) TNT
TNA YPRGYEMENTS SITWTEO THEREON ME N1TE1114
%iOPERTY LRES AMD NO NSBLE EMCROA011EMS MST
OTHERT NOTED
DATED ATANCNdNOEAUSIUTNS 1ST
DAVOF SEPTEMBER lCOS�
HOLT WID SUNEV 1 1 IS
TEL LSSBIB
C-29 :56A FROM: TiZnlI (z?W) SI;L. -
Li9
AAROW PUMP fit. WER SERVICE, LLC
P.O. Box 110496
Anchorage, AK 99511
Office: (9Q7) 346,9355 • Fax (907) $33-8976
Palmer: (907) 745-9077 • Eagle River: (907) 622-9335
r CUSTOMER
TO:3383246 P.1
oj�lU L04 IJIJU O0 VE
7458
pq3 6
_ JOB SITE
L J
INVOICE DA E
WELL DEPTH eWL CHLOR NATEDPDMP
gEPTFj
aA'L ASON
QUANTITY
DESCRIPTION
PRICE
AMOUNT
"J$ i
114 CA
LABOR
HOURS
RATE
AMOUNT
TOTAL MATERIAL
TOTAL LABOR
WORK ORDERED BY
DATE COMP.
TOTAL
LABOR
PAY THIS AMOUNT
Thank You
SIGNATURE
(I Hereby Acknowledge the Satisfactory Completion of the Above Desortbed Work.)
TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE.
SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE. ACCOUNTS.
z _
WALTER J. NICKEL, GOVERNOR
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE DISTRICT OFFICE
800 E. DIMOND BLVD., SUITE 3-470
ANCHORAGE, ALASKA 99515 (907) 349-7755
January 11, 1995
Mrs. Kathy Stewart
Countryside ConOos
10936 S. Bragaw St.
Anchorage, AK 99516-1517
RE: Lots 1A & 18, Section 21, T12N, R3W, S.M. - 10936 Elmore Road. Countryside
Condominiums, Class "A" Public Water System Identification No. 217194. Request
For Public Water System Reclassification. ADEC project no. 9521-WV-34"22-
Dear
521-WV-346-022
Dear Mrs. Stewart:
This letter is in response to the materials received in this office January 9, 1995,
requesting reclassification of the existing Class "A' public water system to a Class "C"
public water system. The request for reclassification is based upon a total population
served by this water system less than the minimum population required for status as a
Gass "A" public water system.' The Department has completed its review of the
information submitted which included a notarized statement attesting to the current
population served by this water system being less than 25 since the current system
received operation approval in 1991. Based upon this review it appears that there is
reasonable justification for reclassification of the on-site public water to a Class "C" system
subject to the following comments and conditions:
1. This Class "C" public water system is subject to the following monitoring
requirements:
a.) Routine total colfform bacteria sampling shall continue on a quarterly
basis as granted earlier by this office.
b.) Inorganic annual sampling for nitrate.
2. This office must be notified within 30 days if the residential population
served by this water system is greater than or equal to 25 people and the
system will revert to its previous status as a Class "A" public water system.
Mrs. Kathy Stewart 2 January 11, 1995
Thank you for your cooperation with this Department, if there are any questions regarding
the above please do not hesitate to call.
Sincerely,
�4
Michael W, E.I.T.
Environmental Engineer
cc: Lynn Johnston, DW/SCRO/ADEC
f�u:i•
TMALLEY RD.
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MUNICIPALITY OF ANCHORAGE
Development Services Department
On-SiteWater& Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jul 21, 2006
Expiration Date: Jul 21, 2007
Permit Number: SWO60212 Parcel ID: 015-27340
Legal Description: T12N R3W SEC 21 LT 16
Design Engineer: 0855 GARNESS ENGINEERING GROUF Site Address: 010936 ELMORE RD
Owner Name: GEORGE STEWART Lot Size: 115645 SQ. FT.
Owner Address: 10936 ELMORE ROAD Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE. AK 99516-1517
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:
Date: 717—A.-
Municipality of Anchorage
r\• Development Services Department
� Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcell.D. Kiri-915.140
Property owner(s) GEORGE STEWART Day phone 522-1062
Mailing address 10936 FLMORF ROAD * ANCHORAGE AK
Site address Zip Code 99516
Legal description (Sub'd, Block & LotN/A
Legal description (Township, Section & Range) T12N. R3W. SECTION 21, LOT 1R -
Lot
B.
Lot Size 116. 645 Sq.Ft.
THIS APPLICATION IS FOR ( ®all that apply):
Absorption Field
❑
Septic Tank
❑
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Number of Bedrooms
THIS APPLICATION IS AN:
Initial
❑
Upgrade
Renewal
❑
I 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.
GARNESS ENGINEERING GROUP, Ltd.
Permit/Rush Fees:
Date of Payment:
Receipt Number. 1
(Rev. 1105)
Waiver
Date of Payment:
Receipt Number.
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
July 13, 2006
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650,
Anchorage, AK 99519-6650
(907)343-7904
Ref: Proposed Septic Upgrade for T12N, R3W, Section 21, Lot 1B,
To whom it may concern:
The existing 4 bedroom house is served by a class "C" well and private septic system. We are proposing
to expose the existing 1250 gallon septic tank and verify its integrity. If it is of poor integrity a new 1250
gallon septic tank will be installed. We are also proposing to install a deep trench type drainfield. One
test hole was excavated on the property by S&S engineering in October of 1991. We are proposing to dig
a confirmation testhole prior to construction. The drainfield will be designed around the 30 foot radii of
these test holes. Comments regarding the design are summarized as follows:
1. SOILS: See the attached logs which show the soil classifications, groundwater monitoring, and the
percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system.
4. TOPOGRAPHY: As can be seen on the attached design drawing the average topography below the
drainfield is a 1-5 percent slope running approximately east to west. In short there are no slope concerns.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems.
If you have any questions, please contact us at 337-6179. Thank you for your assistance.
E., M.S.
NOTE: Attached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for
this septic system. (Contact C.E.G. Ltd. for 7 page construction specification letter.)
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259
Ph: (907) 337-6179' Fax: (907) 338-3246' Website: www.gamessengincering.com
OWALLEY ROAD
1
-------------------
T12N. LOT '1AEC 21.LANG S/D;
I
LOT 2
If
/\ ♦ I amu°
11Qo' WELL RATXLn S
\ / I `-SEPTIC AREA
\ 100' WELL R lr
�\\ // ROPOSED SEPTIC UPGRADE
(SEE DESIGN PACE 2 OF 2)
I \
LANG Sro:
III I�\ LOT
Ilii \��---,�/ ;; ;I i , , .•. c �\
I I I r. rs I p m
III I c�
I I S&S ENC I :' • �L'
I I TESTHOLE \ I W d rc
I I I IANC Sro:��---�\ I %;t i(.<:, is ;;i \ I o o0
LOT 4 / / \ I / ;-, k t� � _Ey:' \ � N u
Ld
II I
III I Iwnt RADIUS\ / �
I I \\ EXISTING SEPTIC
(I I \ SYSTEM /� 4 BEDROOM
HOUSE
- Ft
- - - - - - - - - - — --- (-----------F------- 1 ---
I I T12N. LOT R3W.
SEC 21.
\J� / LYNN LODALE S/D.
N I I CSEPTi
I
/LYNNOOALE Sro:
® / (NO CONCERN) I I I I I
1' 100'
000 ��4
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS S GENERAL CONTRACTORS Q ..........
>a. t nun .o.o, surto .o• ..oun.x... ro1o1 . r.unr LwnIm-.:r • . fmnv ". • .! .... Q
PREPARED FOR: PHONE NUMBER: PACE NUMBER: ••••• ......•
GEORGE STEWART 522-1062 1 OF 2 �QTnp ••.`k A. rness-
LEGAL DESCRIPTION: DRAWN BY: yO�p,� CE- 3 \FOS
T12N. R3W. SECTION 21. LOT 1B J.N.T./B.F.M. pp
TYPE OF WORK: DATE:Is�PI•olassio
SITE PLAN FOR PROPOSED SEPTIC SYSTEM UPGRADE 7/13/2006 �0004000`�
(Rev.01u5)
NUMBER OF BEDROOMS:4
GALLONS PER DAY (GPD): 600
PERCOLATION RATE/5:27 MIN./INCH
PROPOSED APPLICATION RATE: 0.6
MINIMUM DRANFlELD SO.FT.:1000
DRAINFIELD DESIGN:
MAXIMUM DEPTH:10.5 FEET
MOTH: 2.5 FEET
LENGTH:90 FEET
M.O.A. APPROVED SAND FILTER: N/A
EFFECTIVE:6 FEET
REDUCTION FACTOR: N/A
ACTUAL SO.FT.: 1080
BE
GEG, Ltd. HAS A 7 PAGE SPECIFICATION
LETTER THAT PERTAINS TO THIS DESIGN.
TO OBTAIN A COPY OF THE LETTER
CONTACT CEG. BY PROCEEDING FORWARD
WITH THIS INSTALLATION, THE ENGINEER,
WELL DRILLER, CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
WEST LOT LINE FLAGGED BY A REGISTEREDII
LAND SURVEYOR PRIOR TO CONSTRUCTION.
PROPOSED DRAINFlEID
1—Sx ..\.:i •.�A.� ..rte
. ..;r.�.,r:^. �::'•' .s . /
INSTALL FLOW
<�DIVERTER
1 Sx r'• �.-� •• • INSTALL DOUBLE
CLEANOUTS
\ •`. {•.; '••- EXISTING 1250 GALLON SEPTIC
• •.. TANK TO BE INSPECTED. IF OF
POOR INTEGRITY INSTALL NEW
5&S ENC. \ I.A. _�.''' 1250 CALLON SEPTIC TANK,
TESTHOLE
1 5X C b �•sl Y„',�; 4.".:?•:. Y'14` ' EXISTING WELL
TO BE
.. : •:.r..'r'
\ ..�!'.” J.•: . .; ...: COMPLETELY
. •�,'• �...�; ..1. DECOMMISSIONED
~EXISTING ~•`, ):° t
_ I { BASE I jl
1 Sz I \ I N
I` INSTALL FOUNDATION \
CLEANOUT S E,
ISTI110 DRAINFIELD
TO BEED AS A /
RESEPKE SITE
GARNESS ENGINEERING GROUP, Ltd.p;?:` T •.;y �
CONSULTANTS& GENERAL CONTRACTORS �••••••• •• . •••••• ......••••••
l01 C TAM MA WOE 101 • MgCMZ m ll 0 toorim-n" • .09R: w .aw
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: •• ••••••••••••
GEORGE STEWART 522-1062 2 OF 2 e r A. C rness:• I
LEGAL DESCRIPTION: l
ooOo CE -7953
DRAWN BY: •,FG
T12N, R3W, SECTION 21, LOT 1B, C•J•G•00 a 71k Fo4v
TYPE OF WORK: DATE: 40O�O�QO0000
DESIGN FOR SEPTIC SYSTEM UPGRADE 7/13/2006
(Rm. OtA5)
%
odS(
Municarlasg-e
M �'
DEPARTMENT OF HEALTF78 P1tlMANSERViCES-
825 "L" Street, Anchorage. Alaska 99502-0650 i
SOILS LOG — PERCOLATION TEST
s ea4LQ, �
1504621
P4�'
'•,91
h49*FF '� '•*�00
....
��• .. . ... /�i
RDa JS f31P.E P
G.• II :.t s
PERFORMED FORAR Fentg&--steL]IArt DATE PER FORME. R SS
LEGAL OESCRIPTION.4j-i "i --,--czI �- iz&4a0Ip kTownship. Range, Section:
E
P SLOPE SITE PLAN
• WASGROUND WATER
10 \ ENCOUNTERED) AIO
S
it \.\ _77Q j
IF YES, AT WHAT p E
12 \ • DEPTH) E
Depth to waur tiler
13 menkarinp7 V¢ fJ
Dale. Lp�1=af
OTH
14-
4
1
~�"
cJ Q.
15
15
O
,
2
�M LOAM
\ \♦
17
a
/
�
a
\
\ \
5
M
6
7
•�
8
9
�
• WASGROUND WATER
10 \ ENCOUNTERED) AIO
S
it \.\ _77Q j
IF YES, AT WHAT p E
12 \ • DEPTH) E
Depth to waur tiler
13 menkarinp7 V¢ fJ
Dale. Lp�1=af
18
19
20
COMMENTS
PERFORMED BY: -'v1
d .'1
ACCORDANCE WITH
72-0081Rev. 4/85)
PERCOLATION RATe..c— (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN _ FT AND FT
420 I CERTIFY THAT THIS TEST WAS PERFORMED IN
GUIDELINES IN EFFECT ON IS DATE. DATE I1� 1 411
14-
4
15
15
O
,
16-
17
18
19
20
COMMENTS
PERFORMED BY: -'v1
d .'1
ACCORDANCE WITH
72-0081Rev. 4/85)
PERCOLATION RATe..c— (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN _ FT AND FT
420 I CERTIFY THAT THIS TEST WAS PERFORMED IN
GUIDELINES IN EFFECT ON IS DATE. DATE I1� 1 411
Municipality of Anchorage Page — of-7,
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: 6I,jvl1C5-:t22 PID Number: 61ZZ�57a5AC
Na e:
r
Wastewater System: ❑ New �pl grade
Address:
ABSORPTION FIELD
Phone:
C/0 j'
o. of Bedrooms:
Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating:
G (AO
Total Depth from original grade:
G
GPD/S . Ft.
Lot: Block: Subdivision:
L 1?::�
Depth to pipe bottom from original grade:
r
Gravel depth beneath pipe f
Ft.
Ft.
Township: `
Rang
Section:
Fill added above original grade:
:
Gravel length:
�fT
_
,B
� 1)4 Ft.
Ft.
WELL•• El New El Upgrade
Gravel dopila, wrp" /
Number of lines:
Distance between lines:
% Ft.
Ft.
Classificat' n (Private, A,B,C):
Total Depth:
Cased To:
Total absorption area:
5ZG
Pipe material�Q
Ft. I
Ft.
-Z�?Q. Ft.
.AS
Driller:
Date Drilled:
Static Water Level:
Installer:
I Date instaild:
Ft.
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION DISTANCES
jXseptic ❑ Holding O S.T.E.P.
To
Septic
Absorption
Lift Holding
Public/Private
Manufacturer: Capacity in gallons:
From
Tank
Field
Station Tank
Sewer Lines
Wellt
I�
`
0 4-
l
Material: Number of Compartments:
�(�'}k�
�t�LJ
—
—
LIFT STATION
Watere
r
Lot
lOr�
�,�
__
--
Size in gallons:
Manufacturer:
Line
—
Foundation
16--.
l
f /) '..�
V
--
--
"Pump on" level at:
ump off' level at:
High water alarm at:
Curtain
�—
rE�l , 1
Pv
Pump Makes Model
Electrical Inspections performed by:
Drain
Remarks:
BENCH MARK
`
Location and Description:
Assumed Elevation:
17'j-/O
an�siN� R"�s; L
1 p
``d'
4y'9
.
Inspections by:v�+�11tes:
performed
2nd _
c� a• pp J. i,H.^. ERr P.E. "v b9
n•
__
� epi c+iY15 n . s9
”
Department of Healt n Hu ices approval
111t F����.•„•n,.°���ti
Reviewed and approved b : L-- ' Date:
72-013 (1/91) MOA 25
Permit No. 0;5 Page �_ of
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater �Dii1sposal System and/or Well Inspection Report
Legal Description ��4`� .-22G� 21 , L dQr f� PID No.: Dl�✓Z � fJ
�6 ✓
C41s
(tool� �o wA-r -oU ND
Gds Pa(vti Its°
air lie
ov I -F -w lo�l N't
Ll
01r
72-013 A (2191) MOA 25
EN(i'i6EFi
e
s 1
' 49Ytti
��• •• • e e'er -r-•'• • • e • de
. �•, cR J. 61 iAFER,P
���'�'Fp�,°•nee•e�1�'�, pyo
s
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON—SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW910368
DESIGN ENGINEER:S & S ENGINEERS
OWNER NAME:STEWART GEORGE L
OWNER ADDRESS:4949 KNIGHTS WAY
ANCHORAGE, AK 99508
PARCEL ID:01527340
LEGAL DESCRIPTION: T12N R3W SEC 21 LT 1B
LOT SIZE: 115645 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED:11/21/91
EXPIRATION DATE:11/21/92
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
EXTEND WELL CASING
INTENDED TO SERVE
RECEIVED BY:
ISSUED BY:
2 ABOVE GRADE, AS THIS WELL IS
41 DROOM SINGLE FAMILY DWELLING.
DATE:
DATE:-
1Z.',0
ATE:
1Z.'OD 111Z 71,11 s�s
I
PULMONARY:
Beth A. Baker, M.D., FCCP
George L. Stewart, M.D.
Norman J. Wilder, M.D., FCCP, FACP
GASTROENTEROLOGY.'
Richard F. Buchanan, M.D.
Charles R. Shannon, M.D.
James B. Watson 111, M.D.
RHEUMATOLOGY.-
Michael
HEUMATOLOGY:Michael B. Armstrong, M.D.
NEUROLOGY:
Marjorie J.L. Smith, M.D.
Internal Medicine Associates, Inc.
A Professional Corporation
2841 DeBarr Road, Fifth Floor
Anchorage, Alaska 99508
Telephone (907) 276-2811
Fax (907) 258-7217
D:_. i_. t... L. tY, v:.!Y�.. •'r .'P._il(i[a f"j .. !.,�;
1. c..._ ... �.,'..
nur,:.__ii. l:l.. i t.ynt_I i:`;rzaCl�.:.
;1 ='`. ='!'1't� 3 Cjrl lei! 7 1_�C] i 25ii _.
f.. I �.
i' ll cit f"d:' ng
i.JP-':r. g . 1'1 Ft
r r.. r.',_,:-.. 24
T 4 I tir r;• -'r ,r
INFECTIOUS DISEASES:
Paul L. Steer, M.D., FACP
NEPHROLOGY:
Steven B. Tucker, M.D., FACP
HEMATOLOGY/ONCOLOG Y. -
Mary L. Stewart. M.D.
ONCOLOGY/INFECTIOUS DISEASES:
Frank M. Domurat,M.D.
GENERAL MANAGER
G.J. Mumford
:. '%: ;. SS Ci l.t i J. l' Y'l:: EE' i i' E' r ; i,_ Fa .. i %s F r -:'r'' :i t::i l f I s't .t W �:...i. 7:�. C: i'•: 7. "� L�:.' I" V J. t::: r-?
a
d'....� i r ,.. .. ....
Vd •- i. �. 7':� t'ra r-ryp. ,t._�..tE :n TI'J ic:• !-t'-_'V�d �',i F:a a. 1. t�; ). .17. ....ii:!!^t-3 ...
j.: _i.y ,....:r t t r:?
1:)i't_)ill:r c.. ra,:7'l. esa- .+...' _.1-I: L:: :.rl...I"7 �.. i^p vt. _iC t:_._if'i C:I C.!111 .!.. r,. i..il!! 1 -Y -•t_! _ _. 1.. ,�
S_
J. 1-i C
W
N
,
,.ry
1;,.) ` C , f`3J
. i
Iu
Pr,c;,cra�c
rLti��url mac, vices
November 4, 1991
HEALTH AUTHORITY
APPROVALS Municipatity o4 Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
P.U. lox 196650
SEWER &WATER Anchorage, Atasiza 99519-6650
MAIN EXTENSIONS
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
PERCOLATION SinceAety,
TEST
STRUCTURAL& ROGER J. SHA R, P.E.
MECHANICAL RJS/gm
INSPECTIONS
ON SITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
REFERENCE: Lot 1B, Sec. 21, T12N, R3W. S.M.
Request you .i66ue a permit to upgrade the 6eptic 6ystem 6erv.ing .the 4
SEWER&WATER
bedroom hou6e toeated on the re6ereneed property.
INSPECTION
The original 6y6.tem which consist/ o4 a 1000 gaUon eon(2Aete Septic
tanfz and a tog crib 6eepage pit was Lnsta ted to 1970 under Mun�Lcipal
permit. A portion o4 thi6 pit appears to be o46 .the property and the
ENGINEERING STUDIES
entire pkt i,6 to be abandoned. In app)tox.imatety 1976�.p a new trench
AND REPORTS
upgrade was constructed on the property with apparently no permit.
Thin tAench was te6ted and bound to have an ab6orption capacity
adequate 6or a 3 bedroom hou6e. The trench was excavated and 4ound to
have dimensions o6 approximateby 50 4.t. tong with an e64ective gravet
WELLINSPECTION
depth o6 6 4t. we propose .the .in6.ta22ati.on o4 a new 1250 gaUon septic
&FLOW TEST
tanfz and a .trench addition to match the new soiZ6 test per6ormed on the
property. An alternate teaeh6.ietd bite has been du ignated.
The adjacent property to the west tz currently vacant but we do not
SITE PLANS
anticipate any adverse e66ec.t6 on ,the neighboring prapert.ies by .the
.in,sta tat.ion o6 .the propo6ed upgrade.
The property is eunrentty served by a Class 'A' well as depicted on the
ROAD DESIGN
site ptan. However, there exist6 another well shown on the 5.Ae ptan.
The owner. wizhes to onty .temporarily abandon this well 6o ,that .in .the
6uture, the house may be connected to the well creating a private water
,system to .increase the 4inancing potent%at 4or .the property.
SOILTEST
14 you have any question,6 or requike addctionaE' Ln6owatLon 6or your
review, ptea6e contact us.
PERCOLATION SinceAety,
TEST
STRUCTURAL& ROGER J. SHA R, P.E.
MECHANICAL RJS/gm
INSPECTIONS
ON SITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
� o
Municipality of Anchorage �, s'ro 4 10 0 .
DEPARTMENT OF HEALTH & HUMAN SERVICES ` ° ° ° ° ° ° ° ° ° °� ^°
825 "L" Street, Anchorage, Alaska 99502-0650 ° ° , ° • �/
SOILS LOG — PERCOLATION TEST �!�" rn'e 110a�'--.' �''P'� , <`�>
y o 0111. 5
!ri.o
v � y�D • ° ° ° ���' GYY
PERFORMED FOR: Fxd'G�7A.0 Art DATE PERFORME
LEGAL DESCRIPTION:al,, "i.5CC.21 • T/ZnJ•r-v;tId MTownship, Range, Section:
DEPTH SLOPE SITE PLAN
(FEET)
1 ~tip d R.
2 � \ '.
.ti
l- O A M
3
13 \
14-
15
4 15 A
16-
17
R
19
6M
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
!�—
S
L
O
P
E
Depth to Water After
Monitoring? —V"— Date: I12-9/4
20 I r
IL_—JI PERCOLATION RATE 271 (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN —'K FT AND (n FT
COMMENTS PrC - SvAKcd Prior
i3 f"x r1 �r5>a'IfYCCRIIVV 1
q..
PERFORMED BY: • (,i Fa911IQ River Loon Road ft 204CERTIFY THAT THIS TEST WAS PERFORMED IN
,;44,°tic; Alaska 99577
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON TU DATE. DATE:
72-008 (Rev. 4/85)
G,`��ATER ANCHORAGE AREA BORO" ' H
DISTANCES:
Ar4e7_ 7-41
St�'T/c iV9i✓eC
7".
�rLG T71
5�7�l3/�OaiT---
/l.20 ��
HEALTH DEPARTMENT N? 154
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING PHONED/�
��-�`'' �L=ADDRESS�Q��/��C �j/'
NAME
-�f3%�2iS�
LOCATION�%f�//'��%
/��� X4%1 LEGAL DESCRIPTION 1 C
/�Z �, 5.14"
SEPTIC TANK:
DISTANCE FROM WELL
/ NUMBER OF
C� MATERIAL ��/��'�«'�� COMPARTMENTS
�1�/�Olo9/��LJ
CAPACITY
LIQUID z"LIQUID
e2490 —GALLONS. INSIDE LENGTH 4�INSIDE WIDTH �� DEPTH
SEEPAGE SYSTEM:
SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH � ', LENGTH,3 � �, DEPTH ,
LINING MATERIAL
� DISTANCE FROM WELL � �� BUILDING FOUNDATION= 22
NEAREST LOT LINE
j�J
"" TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) a �� SQ. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELL
FOUNDATION NEAR T LOT LINE OF LINES
NUMBER OF LINES
DISTANCE BETWEEN LINES TR CH WIDTH AL EFFE TIVE
ABSORPTION EA
SQ. FT. LENGTH OF EACH LINE
DEPTH: T P OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE-IN.ABOVE TILE
WELL:DISTANCE
` FROM
�SAMPLE
TYPE �/y/� � DEPTH- , BUILDING FOUNDATION. NEAREST
NEARESTSEPTICS iSEEPAGE �d `- OTHER
��CESSPOOL
LOT LINE L/
ii
SEWER LINE-, TANKSYSTEM ,SOURCES_
DIAGRAM OF SYSTEM
DISTANCES:
Ar4e7_ 7-41
St�'T/c iV9i✓eC
7".
�rLG T71
5�7�l3/�OaiT---
/l.20 ��
GAAB-HD-2 GREATEI -- ANCHORAGE AREA . DROUGH Case No.ZZIL)
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
Y
SEWAGE DISPOSAL SYSTEM - APPCATI�,�ON- PERMIT
rr �.k F
el
e
NAME OF APPLICANT��°/ fP � %'� MAILING ADDRESS PHONE NO.3
RESIDENCE ADDRESS / LOCATION OF INSTALLATIO ��L?-
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK_, SEEPAGE PITS/_ , DRAIN FIELD , OTHER
TO SERVE THE FOLLOWING FACILITY Za4w e -
FINANCED THROUGH `G' / 0 BE INST LLED BY
PERCOLATION TEST RESULTS �r%�GANTICIPATED DATE OF COMPLETION
/ BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS -,PERMIT PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED 4 `4,�<l✓t��
. SEPTIC TANK SIZE _/
DISTANCES:
&-e-
HEALTH
e-
HEALTH AUTHORITY
OR
LICENSED DESIGNER
VCV1' C rtify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
ove described system is in accordance with said code.
i
DATE G` ,/ ` C�APPLICANTS SIGNATURE
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION -
ENGINEERING STUDIES
ANDREPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
ROBERTSHAFER, P.E.
ROGER SHAFER
CIVIL ENGINEERS
(907) 694.2979
Deeemben 4, 1990 FAX 694.1211
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
Ms. Jan Pennington CGG" 41°9D
JACKWHITE COMPANY
3201 C S thee# Suite 100 RECEIVED
Anchouge, A.P_ ka 99503
REFERENCE: Lot 1B; Sec. 21, T12N, R3W, S.M.
Dea+c Jan,
We have %eceived a nesporve bnom the Depantinent o5 Envitonmentat
Conaenvation (DEC) .to our subm.itta2 tetter dated October 17, 1990 (see
attached) .
Ptea,6e note the %equ.inement6 and deadP.i.nes outP.i.ned .in the second
panagtaph of the nespon4e.
14 you have any questions, p.2ease contact us.
S.ineeut y., 1 /A'
' �
ROGER J. SHAFER
C.ivit Engineer
RJS/gm
cc: John Smith, DHHS
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
STEVE COWPER, GOVERNOR
MUNICIPALITY OF ANCHORAGE
'-
DEPT. OF HEALTH $
ENVIRONMENTAL PROTECTION
DEPT. OF ENVIRONMENTAL CONSERVATION LY i �r 19910
a-CTIO_AGE -7.E0TEPT7ISTR vT O^^
RECEIVED
3601 C STREET, STJITE 322
ATICII0RAGE, ALASI.A 99503
November 30, 1990
:?r. Robert A. Shafer, P.E.
S u S Engineering
17034 Eagle River Loop, Suite 204
Eagle River, Alaska 99577
5'03-6775
R' : Lot lE, Section 21, T. 21 N. , R. 3 W. , S. I. , AD7,C Project
?umber 9121 7A-007; Review
Dear it . Shafer:
This is in response to your submittal, received in this office on
October 19, 1990, in whJ.cl you requested the Department's
concurrence with the two conclusions noted in your letter
concerning the Class A Public T`?ater System Source well and the
oXisting wastewater disposal system serving the structure located
on the above -referenced lot. I have completed my review of the
submitted information and find that I have to agree :with you that
the separation distance between the Mass A Public Water System
Source 'dell and the wastewater disposal system can not be waived
and the Class A Public Hater System has not received operation
approva'_ to serve water to the public (residents of the
con -'o niniu:;ls on Lot 1A and the home on Lot 1'r) .
The operation of the existing Class A Public Water System with out
the necessary separation distances and final operation approval is
a violation of State Drinking Water Regulations, 13 AAC 30.020 (d)
and 100 (e). To resolve these apparent violations, engineering
plans to bring the existing public :eater system into Co;,piiance
with State Regulations will need to be submitted to this office by
December 20, 1990. In addition, crater samples will need to be
collected from the eXisting public water system and analyzed for
Total Coliform nacteria and TIitrate (as Nitrogen). The results
will need to be submitted to this office within ten days of receipt
of this letter.
Thant; you for your coordination with this Department. If you have
any questions, please do not hesitate to contact rie.
ete"4A,f-i
n
_teven :Cleweno
Environmental Engineer
CC: John Smith, DTIMS
$.
46`
Oetobet 17, 1990
ROBERT SHAFER, P.E.
ROGERSHAFER
CIVIL ENGINEERS
(907) 694.2979
FAX 694.1211
HEALTHAUTHORITY
State o6 Ataeka
APPROVALS
DEPARTMENT OF. ENVIRONMENTAL CONSERVATION -
3601 C Street Suite 322
Anchorage, Ataaka 99503
SEWER&WATER
REFERENCE. Lot 1B, Sec. 21, T12N, R3W, S.M.
MAIN EXTENSIONS
At the tequeat o6 out client, Jan Pennington -Jack White Company, acting
on behat6 o6 the te6eteneed ptopetty owner, SEATTLE FIRST NATIONAL
have pet6otmed an initi.at a8aeaament of the watea and
MORTGAGE,,,
SEWER&WATER
INSPECTION
pw•e
'aeweA 6acititi" aeAving the tebeAenc d ptopeAty.
In 6eateh.ing your (DEC) 6.cte6 we have bound no ,i.njotmati.on on edtheA
the welt of the aepti.c ayatem. In aeatehing the Muni ipaZ o6 Anchotage.
(MOA) Department o6 Heatth 9 Human Setvtcea teeotda we bound an on -A to
ENGINEERING STUDIES
ANDREPORTS
deptic inapeetcon tepont 6rom October, 1970. In compa4ing th.i,6 tepo&t
to the 6.ietd conditi.ona, it appears to be the apptoptiate .inspection
tepott. We atao found a permit to .inatatt the ayatem, eoti,jotm
baetetiatog.ieat water anaty,6i6 teauW and a water and 6ewet apptovaQ
ihaued .in Auguat, (1971. (At thi,6 point ptea4e note the weP,C depth
WELLINSPECTION
& FLOW TEST
noted on the apptovat .i.a shown to be 801, wheteaa the weU shown on the
attached as-bu ttt was determined to be a minimum o6 149 6t. deep by out
acouatic.at weft sounder!)
SITE PLANS
It ,i6 our understanding the pAv.iou4 property owner, Dt. Geotge
Stewart, atao owned Lot IA, tocated fust to the North of thi6 property.
On Lot IA there exa.4t6 eight - 2 bedroom eondomdniulm4. Aceotding to Dt.
Stewatt, the 80 6t. wett re6eteneed in the MOA apptova2 was tocated on
Lot IA. Th.i4 weP.Z had gone dry around 1980-1982. Thete6ote, a new wW
ROADDESIGN
wa,6 d&iUed at that time on the tejeteneed ptoperty. Th.ia .ia the weU
shown on the attached as-bu i t t. Da. Stewart Gaya there was no apptovat
obtained to dt.iU thio weft, and the weft eutrentty aeuwea the zingte
jamity home and eight - 2 bedroom condominium. TheAe6ote, the wett
SOILTEST
woutd be pati o6 a Ctaaa "A" water ayatem.
On Oetobet 10, 1990 we tested the 4eptic 46y4tem tocated on the
re6ereneed property and bound it adequate jot a 3 bedroom home.
PERCOLATION
However, - there appears to be an undocumented trench - added ` onto the
TEST
septic 6y,6tem with the end o6 the trench aaaumed to be at.the -PVC "vent
pipe" shown fust north o6 the hou4e. From the a6-bu.itt.4utvey we see
the aept.te tank to be tocated approximatety 90 6t. 6tom the CW,6 "A"
weP.Q and the teaeh6tetd to be tocated onty 104 6t. 6tom the CW46 "A"
STRUCTURAL&
vett. Thi6 46 as oppoaed to the 200 6t. 6etback %equiAed when the weft
MECHANICAL
INSPECTIONS
was d&iUed between 1980 and 1982.
ON SITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
Page Two
Lot 1B, Sec. 21, T12N, R3W.. S.M.
October 17, 1990
We have come to two ptimaty eonctu,6.ion6 on the teseteneed pnopetty:
1. The ex.i,6ti.ng CW6 "A" weU doe, not appeat to have eveA been, not .i,
it pte6entey .in comptianee with the State o6 AP,a.6ka. Dtink.ing Water
Regutation6 .
2. Due to the ptoximity o6 the 6ept.ie ay6tem on the nebeteneed ptopetty to
the C&a6 "A" weU. tht6 Cta.66 "A" wet cannot be btought into eompt i.anee
w.ith.State Regutati.on6 without 6itst tetocating the aepti.c ayatem. (Th,i,6
.c6 to bay the aept.ie 6y6tem .i,, unwaivetabCey ctoae to the Cta66 "A" weft.)
Out cZi.ent,having heard out conetu6.ion6, Seen, .it important Son the
govetnmentae pehm.itti.ng authotity (DEC) to concur with out concPua ion6.
Thetesote, we tequat you teview yout te6outeea and the .inbotmation we have
pnov.ided and agtee, di6agtee of osseh comment on out two eonceu6ion6 ,fated
above.
Ib you agtee with out conct"ion6, then woutd it be nece6aaty bot the ptopetty
owneta to d.i6eontinue u6e o6 the weet and/o& .immediatety take 6tep6 toward
bt.inging the water 6y,tem .into compP,ia.nce?
15 you have any que6tioa, of tis you %equite additional tnsotmation Sot yout
review, ple 4 contact u6.
A. SHAPER, P.E.
/gm
Attachment6
cc: Jan Pennington/JACK WHITE COMPANY
MUNICIPALITY OF ANCHORAGE
• '� DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D.# ��� �-�A(_) HAA# lAQ'IaD�
1. GENERAL INFORMATION
Complete legal description Lot 1B; Sec. 21, T12N, R3W, S.M.
Location (site address or directions)
Property owner Geo4ge Stewart Day phone 273-3241
Mailing address 4949 KnigW Way, Anchorage, AWka 99508
Lending agency Day phone
Mailing address
Agent Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual well
Community well XX
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
XX
Individual on-site y
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
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm
Phone
S & S ENGINEERING
Address
Eagle River, Alaska 99577,
Engineer's signature Date
6. DHHS SIGNATURE
Approved for
Disapproved.
Conditional approval for
0
Additional Comments
bedrooms.
0
,e;nue�Q�oaJ,�� •?
n J.IaFE-n
No. 8215
Pyr,
6�9p•ytiL
bedrooms, with the following stipulations:
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025 (Rev. 1/91) Back MOA a21
MUNICIPALITY OF ANCHORAGE
Municipality of Anchorage IRONMENTALSERVICES DIVISION
Department of Health & Human Services re3 )992
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: r 1 ZT� Parcel I.D. R E r E WE D
A. WELL DATA
Well type lk
Log present(Y/N).
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
Well flow
Pump level
If A, B, or C, attach ADEC letter
Date completed
Cased to
FROM WELL LOG
ADEC water system number Z1-1 14 -
Driller
Casing height
Wires properly protected (Y/N)
AT INSPECTION
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot Z�)k ; On adjacent lots
Absorption field on lot '% ; On adjacent lots
Public sewer main
Sewer service line
WATER SAMPLE RESULTS:
Coliform
Date of sample:
B. SEPTIC/HOLDING TANK DATA
Public sewer manhole/cleanout
Petroleum tank
Nitrate
Collected by:
g.p.m.
6;.,.1 l� n,2 IM
— Other bacteria
Date installed �'' 21 9 1 Tank size �.2Z:5-LD Compartments Z
Cleanouts MN) Foundation cleanoutoN) �-
High water alarm (Y/N) Alarm tested (Y/N)
Date of pumping � n� Pumper
Depression (YdR r -A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Wells) on lot�� I On adjacent lots Foundation
r '
1 dl
To property line Absorption field y Water main/service line
Surface water/drainage
1 c::,I_V_
72-026 (Rev. nst) Front _. _ 'CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on" level at
Meets MOA electrical codes (Y/N)
Manufacturer
Manhole/Access (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
D. ABSORPTION FIELD DATA
On adjacent lots
"Pump off" level at
Cycles tested
Surface water _
Date installed \1_ql �a� t . Soil rating CIL-1 �F�"� System type
Length Width Gravel thickness G (. Total depth 1 o,s — I Z
tion area 1 22
-1b 145P. 1�'G� I4sP. �i-�drt-r
Total absorption Cleanouts present 09N) _`)'
Depression over field (Y/By
Date of adequacy test 1 6`f I[ 2 `,'tom C_�
Results kjsAlfail) for `-t-
Peroxide treatment (past 12 months) (Y6rF fd If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
1
Well on lot On adjacent lots ZE�I t Property line to
To building foundation l u �,_ _ To existing or abandoned system on lot m(4-
(
On adjacent lots "Jo Cutbank f Q1J)e� Water main/service line 1 I_V_
(
Surface water , CAD -t' Driveway, parking/vehicle storage area
Curtain drain t�pr 1&_ �_/r \"A r -J
E. ENGINEER'S CERTIFICATION
bedrooms
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on. the date of this inspection.
�k
S & S ENGINEERING''"In
•
Signature 17033 Eagle River Loop Road N6,20
act a rver, as a v
Engineer's Name
,1
Date u v,
HAA Fee $ (7)_CP--
Date of Payment / -701 '-7
Receipt Number Z3- L4-�5 ( ! 7
72-026 (Rev. 3/91) Back MOA 21
Waiver Fee: $
Date of Payment
Receipt Number
INTERNAL MEDICINE ASSC TEL No.907-25S-7217 Feb 13,92 15:38 No.005 P.03
Sz STATE OF ALASKA
"y DEPARTMENT OF ENVIRONMENTAL CONSERVATION
J �! CONSTRUCTION AND OPERATION CERTIFICATE
for
PUBLIC; WATER SYSTEMS
A. APPROVAL TO CONSTRUCT
Plans for the construction or modification of--_,ilt2.2_ ...1411 -13,L .6ze f.
,W . ice_ c/,,-. - k__ - -__.___. _ publi:. water system located
In44-0— - _ _ --, Alaska, submitted In nocorda ice with 118 AAC 80.1104
by—,51 - .__ `A _. _ —. —.have been reviewed and are
❑ approved. > l
conditionally a proved (see attached conditions)TITLE
DATE
If construction has not started within two years of the approval date, this certificate is ,old and new pians and
specifications must be Submitted for review and approval hefo(n construction.
8, APPROVED CHANGE ORDERS
Change fcordract D'64r rw. or damripure ref,renoe)
C. APPROVAL TO OPERATE
Approve; by
Date
The "APPROVAL TO OPERATE" section must be completed and signed by the Depart nent before any water
is made available to the public. ``�
The construction of the�p/,�_t 4 F_�i , ;��r D, y4 ?I 5 11i _ ����_� public
water system was completed on_�¢r �3a. viz____..___ ___—(date). The system is hereby
gran ed Inlerim approve to operate for yz following the completion date.
tITj DA
As•built plan ub tted dur+�the lnf ri , va�� j3f1n in�
P 9 e � app peCocf, o a ,pectiors by the Department, has confirmed
the system was constructed according to the approved plans. The system is hereby or€rated final approval to
operate.
BY TITLE
16-W7 (Ftev IM3)
- GATE
0!31819j,:")N I WHRE . EN0!r4(4R Ii;i p:eie Sectwn C)
2 YELLOW - WATtR SYS7LM FILE fOomplete Sa I.on C)
3. ANF; - @ir®f?.'Ee`Fi%A; Iik:.)r6ROlY3k Icxnplets BBCtion C)
i. uJLM AGp MjN1 tWMp),Ie $i [.Ori AI
INTERNRL MEDICINE RSSC TEL No.907-258-7217
DEPT. OF ENVIRO N1i41ENTAI, CONSEItVATION
ANCHORAGE DISTRICT OFFICE
800 E. DIMOND BLVD., SUITE 3-470
ANCHORAGE, ALASKA 99503
Mr. Roger J. Shafer, P.E.
S & S Engineering
17034 Eagle River Loop, Suite 204
Eagle River, Alaska 99577
Fel, 13,92 15:38 No.005 P.07
9
WAL7ER J. HIC:KEL,GCr`1LPN/D t
February 13, 1992
(907) 349-7755
Subject: Lots 1A & 1 B, Section 21, T. 12 N., R. 3 W., S.M., Anchorage, Alaska, ADEC
Project Number 9221 -DW -003; Review
Dear Mr. Shafer:
have completed my review of the it lformatiuri that you �;ui UI tteU rr'r re<,porisE to my
November S, 1991 letter regarding the Class A Public Water Systern that serves four
dupiexeS at id une sing'J6 faf E iiiy i lu! I icl iu-;&'LdU Ui I u lu abjl tR rei-61 of v"ci : pr'- P61 iy. &a x uu
on this review, I have the following comments.
It appears that the new public water source well and water supply system may have been
installed Substantially in conformance with pertinent State Reg"Ations and the
construction approvals issued on .July 19 and November E, 1991. Therefore, an interim
approval to operate the public water system serving the four duplexes and the single
family home is being granted. An Interim Operation Certificate, constituting this approval,
is enclosed. Prior to the expiration of this approval (.lune 24, 1992), the following items
will need to be addressed:
1. The location of the existing public water system source we'[ in longitude
and latitude will need to be subi-nifted to this office.
2. Verification that only lead-free pipe, flux, and solder was used in the
upgrades as required by 1$ AAC 80.800, will need to be sui:fmitted to this
office.
3. Verification that the provisiona of 18 At\0 80.015 (b) (.1) have been
addressed will need to be submitted to this office under the stamp of a
Professional Engineer (P.E.).
4. In, regards to grouting the new source well as requlred by 13 AAC 80.015
(b)(2), I propose the following. If under your stamp as s. Professional
INTERNAL MEDICINE RSSC TEL Ne.907-250-7217
Roger Shafer
2
Feb 13 , 92 15:358 No , 005 P.08
Feb'uary 13, 1992
Engineer, you can state that grouting will not sufficiently increase the
protection of the ground water, grouting will not be requires. However, if
you are unable to do so, grouting will be required in accordance with 18
AAC 80.015 (b)(2). In response to your request for the Department's
recommendation and specifications, I can only recommend that you review
the text entitled, "Groundwater and Wells" which is referenced in 18 AAC
80.340 (11).
6. Concerning the sampling requirements for this Class A Public Nater System,
the routine sampling and analysis is outliner' in 18 AAC 80.200. 1 have
enclosed a copy of 18 AAC 80.200 for your use.
In my July 19, 1991 Ietter, I assigned the Public Wat4r System Identification plumber
(PWSID #) 217194 to this system. This number will need to be included .m all analytical
results submitted to the Department.
This approval does not imply the granting of any addi.ional authorization:3, nor obligate
any state, federal, or local regulatory body to grant required authorizations.
Thank you for your cooperation and coordination with the Depe)rtment. If you have any
questions, please do not hesitate to contact me.
Sinsoreiy,
/
Kevan K. Kleweno
Frivironmental Engineer
Enclosures: As Stated
KKK/cf
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
��eow�rowr 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301
ANALYSIS RESULTS for INVOICE 1 41381
Chemlab Ref.# 91.6798 Sample # 1 H•stxix: WATER
Client Sample ID DRINKING WATER LIB R3W T12N S.M. Client Name :S & S ENGINEERING
P03ID UA Cl:.ata g v'ISE c
Collected DEC 26 91 @ 13:45 hrs. BPO# : PO# :NONE RECEIVED
Received DEC 27 91 @ 13:30 hrs. Req#
Preserved with AS REQU'_=EE Ordered By :R. SHAFER
Analysis Completed : DEC 27 91 Send Reports to:
Laboratory Supervisor : SIEPHE'rl C. EDF 1)S & S ENGINFFR.'_V
Released By 2) t. .
.................. ...................................
......................................
Parameter Results Units Niethod Allowable Limits
-------------------------- ------------ ------------------------------------------------------------------
c EPA 502.2/524.: n/a
,1,1 TRICHLOROLIF'ANE ND(0.0010) mg/L FPA 502.2/524.2 0.200
1 nTr11i.0ROFTHYIFNF ND(`C ^. *- rn 11[^4 o 0.007n
1.2 DICHLOROETHANE ND(0.001G) mg/� LCA SOL.i/524.[ 0.0050
CARBON TETRACHLORIDE ND(C.001G) mg/L LPA 502.2/524.?. 0.0050
VINYL CHLORIDE ND(0.0010) mg/L EPA S02.2/524.2 0.0010
BENZENE ND(0.0010) ao/1 FPA 502.2/524.2 9.0050
1.4 -DICHLOROBENZENE ND(0.0010) xg/L EPA 502.2/524.2 0.075
TRICHLOROETHYLENE ND(O.0010) mg/L EPA 502.2/524.2 0.0050
TT'l ND(C.0010) mg/L FPA 502.2/524.2 0.100
BROM)EENZENE ND(O.0010) mg/L EPA 502.2/524.2
th:'ti :;H:.GRuM;; 1'tm-� .•^'^ nn lrl _^1I. rP7 cr,^ .. 7
FR�MODICF:.LOROMETHkI+£ ND(O.OGL6 ;:q;'L EPA 502.2/514.2
BROMOMFTHAN, NG(C.c51c) rv;% ltr. iO2 1!524.
n EUTYLBENZFiiE tiD(C.Cn:.9; mg/!, EPA Sfi2.2/524.2
SEC-BUTYLBEM EYE ND(0.0010) mg/L EPA 502.2/524.2
TERI-BUTYLBENZENE ND(0.0010) mg.';. EPA 502.2/524.2
CHLOROBEN'ZENE !.I. ..'' � ng/L EPA 502.2/524.2
CHLORODIBROMOMETHANB ND(0.0010) mg/L EPA 502..2/524.2
CF, ��OEYi1AN? ND(0.0010) mg/L EPA 502.2/524.2
CHLOROFORM ND(0.0010) mg/L EPA 502.2/524.2
CHLOROMETHANE ND(0.0010) mg/L EPA 50)..2,1524.2
'7PROM^-3-CHLOROPP.OPANF ND(0.0010) mg/L EPA 502.2/524.2
o-CIILOROTOLUENE ND(0.0010) mg/L EPA 502.2/524.2
p-CHLOROTOLUENE ND(0.0010) mg/L EPA 502.2/524.2
DIBROMOMETHANE ND(0.0010) mg/L EPA 502.2/524.2
m "ICHLOROBENZENE ND(0.0010) mg /T EPA 502.?,524.2
o -DICHLOROBENZENE ND(0.0010) mg/L EPA 502.2/524.2
DICHLORODIFLUOROMETHANE ND(0.0010) mg/L EPA 502.2/524.2
1,1-DICHLOROETHANE ND(0.0010) mg/L EPA 502.2/524.2
cis-1,2-DICHLOROETHYLENE ND(0.0010) mg/L EPA 502.2/524.2
trans-1,2-DICHLOROETHYLEHE ND(0.0010) mg/L EPA 502..2/524.2
DICHLOROMETHANE ND(0.0010) mg/L EPA 502.2/524.2
(ah5`7s Member of the SGS Group (Soci4t6 Gdn6rale de Surveillance) .
a:aple a;PdA1t1E SAMPLE COLLECTED BY: UA. SAMPLE RECEIVED WITH .l IR BUBBLES IN
Renarks: BOTH 40RL VIALS.
...................................................—.............._..,........................... .........................................
60 Tests Performed See Special Instructions Above UA -Unavailable
ND- None Detected See Sample Rema'kv s*
.iA- Not Analyzed Li -Less Than, GT -Greater Then
raN SGS Member of the SGS Group (Soci6t6 G6n6rale de Surveillance)
-a -
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
o? : C�
5633 B STREET
ANCHORAGE, ALASKA 99518
TELEPHONE (907) 562-2343 FAX: (907) 561-5301
LAsowwtowr
ANALYSIS RESULTS
for
INVOICE 9 41381
Chemlab Raf.4 91.6798
Samclp
4 1 Matrix WATER
1,2-DIULI OROPROPANE
ND(0.00i0)
mg/L
EPA 502.2/524.2
1,3-DICHLCROPR.OPANE
Nu(.L;
2,2-DICHLOROPROPANE
ND(O.GO'D)
r,!L
;U A 502.4/524.2
i.L-Di�iIL030PRCPENE -
N0(0.001J)
L
EPA 502.2/524.2
1,3-DICHLCROPROP.ENE
I;D(0.0010
^/j
^''A 502 2/524-2.
ETH'!L5EN2,0E
ND(0 0010)
mg/L
EPA q;i2.2%524.2
E"'U N7 .i060'.gl`E W6)
Nrrr 4r,
,120uE'i[!A56
ND("v i
..L'.. .i, ... .,.w Li1'i
OPRO'..-P.EN"s ENE
NDi,i.i_C!01
!/L
FA 50). i/5 4.,.
A?1HA1 `E
q:;; ;€1"1
-;, _
EPA .102 2/524..
VC.r, ,..-
;,PA 50'.)r+24.2
"_5....
HD(J.00101
i
PA 592.2!524.2
`:T*
-A,
4D(O.0 l l
:/L
E7A 5:i2 2/524.:
2,2-1t'AACHLOROETH4NE
9(0.00!0;,
.,;!L
SPA 502 2/524.2
6TAliCHLCnOETHYLENE
ND(0 On,',
pw L
EPA Ji 21524.2
i"`!IENZ
N11(0.0010)
sg/i.
EPA 502.2/524.2
3 -IR.
.4-T-" - "NLCR.CBENZ SNT
EPA SG2.:i!524.2
L i, iR.CHLv"ROET'RANL
Lie.t;
1.,2,3-TRiCHLORUROPA E
N0(n D9!0)
e;;/'.
EPA 50"..2/524.2
1.2,8-i8:'SETHYLBEN2EAd
SD(O.JJLi,�
:y��
'.,. =i•-• � .. -
i.,3,�-TniA:ELi'LdtilZ Lt,{
!10(0 OlU)
Mg/1
EPA 502. 2/:1'1.4.2
p & m X"LEIiE
ND(0.0010)
+:)7/L
EPA 502.2/524.2
EFA 59"'..';1524.'
a:aple a;PdA1t1E SAMPLE COLLECTED BY: UA. SAMPLE RECEIVED WITH .l IR BUBBLES IN
Renarks: BOTH 40RL VIALS.
...................................................—.............._..,........................... .........................................
60 Tests Performed See Special Instructions Above UA -Unavailable
ND- None Detected See Sample Rema'kv s*
.iA- Not Analyzed Li -Less Than, GT -Greater Then
raN SGS Member of the SGS Group (Soci6t6 G6n6rale de Surveillance)
i
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301
i
ANALYSIS REPORT BY SAMPLE for WORRorderf 37987
Date Report Printed: OCT 17 91 @ 12:36
Client Sample ID:SAMPLE 42 LIB SEC 21 T12N R3W SM Client Name :S & S ENGINEERING
PWSID :UA Client Acct :SNSENGP
Collected SEP 3 91 @ 15:30 hrs. BPO t PO 4 NONE RECEIVED
Received SEP 4 91 @ 15:30 hrs. Req #
Preserved with :AS REQUIRED Ordered By :ROGER SHAFER
Analysis Completed :SEP 26 91 Send Reports to:
Laboratory 3upeevi�nr :STEPHEN C. EDE 1)3 & S ENGINEERING
Released By : 2)
....................................................................................................................
.. tle.:.iv Lei , 1il:/d acC "q)l 1b: Aa[IIi: AA t11
Allowable
Parameter Tested Aesult Units Method Limits
— -
GROSS ALPHA 0.8 +/- 0.9 pCi/L 15
Sample ROUTINE SAMPLE COLLECTED BY: R.J.S.
Remarks: ANALYZED BY CH2M HILL, REDDING, CALIFORNIA.
.................................................................................................a............
1 Testa Performed See Special Instructions Above UA -Unavailable
ND- None Detected See Sample Remarks Above
NA- Not Analyzed LT -Leas Than, GT -Greater Then
IS? SGS Member of the SGS Group (Soci6t6 GdnBrale de Surveillance)
R�C'D 0 C 15 1991
Hers
conomists
-agairScientists REPORT OF ANALYTICAL RESULTS Date: 10/04/91
Client: CHEM. & GEO. LAB. OF ALASKA
5633 "B" STREET Project Number: LRD28221.XY
ANCHORAGE, AK 99518
Laboratory Number: 30780
Atten: MS. JOYCE WINDEBANK Date Received: 09/11/91
xxxaxxxxxaxaxsaaxaxxcaasasxxxxaxxxxxxxxxxxcxccaxx=xxxxxxxx=xcxxx-xx-x
Sample Description: 91.4578-3
Laboratory Sample Number: 30780006 Date Collected: 09/03/91 Matrix: WATER
-----------------------------------------------------------------------------------------
Analytical Parameter Method Rep Limit Result Units Ana Date
-------------------------------------------------------------------------------------------------------------------------
Gross Alpha EPA900.0 ---- 0.8 +/- 0.9 pCi/L 09/26/91
-----------------------
Results for non -aqueous matrices are based on dry sample weight unless noted ther ise.
Reviewed by.
INRPRPT(v910325)
000007
CH210 HILL Redding Quality Analytical Laboratories 5090 Caterpillar Road, Redding, California 96003 916.244.5227
XW ( 6 t4 -i4/
i
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
L��OR.LroRY 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301
ANALYSIS REPORT BY SAMPLE fox WORKJrdet# 38400
Date Report Printed: SEP 24 91 @ 14:09
Client Samole ID:L1B SEC 21 T12K RMI Client Hama :S i; S ENGINEERING
PWSID :U1 C pert Acct :3N3ENGP
Collected SEP 16 91 @ 15:55 hrs. BPO PO 4 NONE RECEIVED
Receired. SEP 15 )1 @ 16:40 hrs.
Pxeserved wit". :AS REQUIRED Ordered By :R. SHAEER
Analysis Completad :SEP 20 91 Send Reports to:
S ailJTa:Ot'� J•i-,.'_.._ ...., ., .. .. liJ 4 J LhbinEEL.....
?.Teased By II/hi. r,t._,
_.........I......� ...,
.......................:- :...< _-.... z., ... ........_.,. ,.. -.., .. ....., ................... .......-..
;::za:iab Ref 3. 911843 Lab Smpl ID: I :;ztri:.: WATER
?elameter '.Tested
Rasclt
Units
t''ethod
A ILE 0MV'ANIC C}IENICAL?
n:a
n/a
EPA
502
2/524.2
1.1 DICHLOROETHYLENE
ND(0.00.0)
RgiL
EPA
502.2/524.3
_.. 1)1 HLOROETH1.rE
10.0010)
mg/i,
EPA
SC2.2/524.2
:ARBON TETRACHLORIDE
'!1)(0.0010)
„I/I.
EP.,
502.2/524.2
,iIN(/L CHLORIDE
ND(O.Oulo)
ml!s
EP.4
502.2/524.2
i,4 -DICHLOROBENZENE
ND(0.0010)
1ag,'L
EPA
502.2/524.2
0ICHLOROETHYLF,NE
ND(0.
On. 1 1
:rr"i
FPA
`.02
2/524.2
•I03
ND(0.01,10)
:rg; L
SPA
502.2/524.2
BROMOBENZENE
11D(O.GO10)
:gig /S
EPA
502.2/524.2
OVOC .'CAIE T VA1E
BRO..O.F:LC.,_:.�:.
10`0.0"v
�
i0 1
r ;L
g
E^A
502.21524.2
BROu0DTCHLC%'J1!ETHANE
ND(0.00101
mg/L
EPA
502.2/524.2
BROiiOFOR;{
N)(0.0010)
¢g/L
EPA
502.2/524.2
ND(0.0010)
;ng/L
EPA
502.2/524.2
s"Y':BE;t^,ENE
ND(0.0010)
rag/L
EPA
502.2/524.2
SEC-BUTYLBEN2ENE
91)(0:0010)
MA
E?A
14D(0.0010)
mg/L
EPA
502.2/524.2
CHLORDBE112E;iE
91)(0.0010)
:'iL`;RODIBP.CdOMBTHANE
N (^.0010)
mu/L
EPA
502.2/524.2
CHLOROETHANE
ND(0.0010)
mg/L
EPA
502.2/524.2
CHLOROFORM
ND(0.0010)
mg/L
EPA
502.2/524.2
CHLOROMETHAhE
ND(0.0010)
mg/L
EPA
502.2/524.2
1,2 DIBROMO-3-CHLOROPROPANE
ND(0.0010)
mg/L
EPA
502.2/524.2
n-CHLORGTOLOENE
111)(0.0010)
rtg/L
EPA
502.2/524.2
p-CHLOROTOLUENE
ND(0.00I0)
mg/L
EPA
502.2/524.2
DIBP,OKOMETHANE
ND(0.0010)
rag/L
EPA
502.2/524.2
m -DICHLOROBENZENE
ND(0.0010)
mg/L
EPA
502.2/524.2
o-DICHLCROBF,1T;SNE
111)(0.0010)
mg!L
EPA
502.2/524.2
DTLCHLORODIELCOR014ETILANE
ND(O.0010)
mg/l,
EPA
502.2/524.2
1,i 1)`a::: ;6CEIiIANE
ND(0.0010)
mg/L
EPA
502.2/524.2
cis-1,2-DICHLOROETHYLENE
ND(0.0010)
mg/L
EPA
502.2/524.2
trans-1,2-DTCHLOROETHYLENE
ND(0.0010)
o'L
EPA
502.2/524.2
Ailouab.:e
Limits
n %a
0.0070
11.0050
0.0050
0.075
00':2
!.CO
��)13GS Member of the SGS Group (SociAtd GAnBrale de Surveillance)
A
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL
TESTING
& ENGINEERING CO.
r`
5633 B STREET
ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301
ANALYSIS REPORT BY SAN:PLE for
WORSorder$ 38400
Date Raport Printed: SEP 24 91 9 14:09
Client Sarplo L➢:LLB SEC 21 'I'll R'3W
.iHat 6se.: ) a
Client Acct :SIISENGP
PWSI➢ :UA
B
BPO B PONONE RECEIVED
Collected SEP 16 91 4 15:55 his.
Req B
Receired SEP 16 91 @ 16:40 hrs.
Ordered By :R. SIULKR
Presecyec with :AS REQUIRED
ACaAS1= Ca d esc 91
sand Reports to:
:plata
Laboratory Cupar Visor `:tl' SIi i,. Clic
•. .. .•� .....
Released By / ,,
21,.
.................,/ ...........,_...,...,....
,.... ........... _,.. ,__....."......r,...,...........,...,,..........
....... .......... .... _....-...,.,.. .. _.
41.1043 Lsb `nrl i➢
..ter..
�1..'-..
Tested
ara nat=: .
Result
1. ]':ail
M4`thQ 4x:::7 to
-
:.CcLCr. dsE'iAid
ND(C. COld�
;rag/`,
EPA 502 2/514.2
-D'GHLOROPROPANE
:iF(O.CO?;)
m9l=
PA 502.2/529.2
I''O.00lO.i
"�
n!l
EPA 502.2/52.1.2
1,3-DLCHLORCr"P,0?AHE
2.2 DICNLOROFR°PANE
. .. _
i D; CHLORvFROPEIIF.
ED(2.COli.:
q/L
TA ;02.ac25.2
1.3 DTCHLORGF?OPEN@
:%.u01C•,
mg/L
EPA 502. /324.1
'Mt LR 0Z ENE
!➢(0.0010)
r.a%L
FPA 502.2/529.2
EIHYWI'i DIBROMIDE (EDB)
1,D(O.OUl3i
Ligi;
-
FA =-
:D(O.DOlO
mg/ L
EPA 502.2x524.2
HLCROBUTA)?ENE
i:... R.:..Lc;.:i;EI:E
E?A 5 , S,
"D(0.0010)
mg/L
EPA 502.2/529.2
a iSOPRCPYL!.^,LUENE
n-PROPYLBBNZEIIE
N 1,0.0010)
me/L
EPA 502.2/524.2
STYRENEn;
:,L,i,2-TETRAC3LOROETHA11C
Via.
!m(G.00101
Mg/L
EPA 502.2/521.2
2,2 TETP,ACHiORCETHANE
ND(O.0010)
ug/L
EPA 502.2x'524.2
l-^rn !n•nl
....,l1
S.PA 502.2/524.2.
ND(0.0010)
rg/L
EPA 502.2/524,2
^•,OENE
2,4-TRICHLOR03ENZENE
ND(0.0010)
mg/L
EPA 502.2/524.2
1,2 IL1CAL 'e, ETi0t
ND(0.00:0)
mg/L
EPA 502.2/524.2
1.,2,3-TRICHLOROPROPANE
ND(0.0010)
mg/L
EPA 502.2/524.2
1,2,4-TRIMETHYLBENZENE
IWO.0ol-)
tug/L
EPA 502.2x524.2
4D(0 .,. ,-.,.
n -I[..
Eor 502 2!524.2
METIMLRF �!j17
ND(0.0010)
mg/L
EPA 502.2/524.2
& ro XYLENE
o^.fc qn
nn!`
FPA cnj �'r,221.2
XYLENE
111,22% S13S Member of the SGS Group (Socidtd Gk6rale de Surveillance)
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
�.eow�ronr 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301
ANALYSIS REPORT BY SAMPLE for WOREordox# 37987
Date Report Printed: SEP 20 91 @ 09:48
Clten- S=mo?.e ID:SAYPLE 41 UB SEC 21 R3W T12N SM Client Namo :S & S ENGTNEERING
-'W31D :UA Csrer.r. Acc: :34i''fGP
Collected 5" 01 a 1i:10 '-,rs BPO # PO # NONE RECEIVED
Rea #
Ordered BV 10GER SU7;
ana1,,,,s mrl:. 3 :SE? 19 9t Send Deports t9.
La , %nLii C. EDE
t1S ^y S ENG?VEERING
a;ncle ROUTINE SAMPLE COLLECTED BY: R.J.S.
Ram?_C'i3 .
..._,,..,.,..._..:..--..a.,-..,..a=_.„,.....Seo..,._.`
2
[ests Performed
...............
S?ee+'1
t
Instructions Above !•A -Unavailable
YD-
None Dotected
See
Samole
Remarks Above
Fk-
Not Analyzed
LT -Less
Than.
GT -Greater Than
1I ;
0.00017
vgil
ASTM 1)29%2
0.05 raxxr..0
EAdil`"?
1(D(G.OSOj
exiil.
PA 200."
;.0 rae;m,.cr:
;VS 14e -
.. .� ..
J. a•i51
;ap; i
EPA 239 2
;; fi;DY
h•`O.GO'i'.'t
trq/1
SM14 301tiJj
' �nl
LLS
u.j , p�,0y,
-
•ii
A4TM D3859
0.01
-
:.4
3 ........... .
r-17 mv
"3.1
0 Mayi 7xm
a;ncle ROUTINE SAMPLE COLLECTED BY: R.J.S.
Ram?_C'i3 .
..._,,..,.,..._..:..--..a.,-..,..a=_.„,.....Seo..,._.`
2
[ests Performed
...............
S?ee+'1
t
Instructions Above !•A -Unavailable
YD-
None Dotected
See
Samole
Remarks Above
Fk-
Not Analyzed
LT -Less
Than.
GT -Greater Than
QN S13S Member of the SGS Group (Soci6t6 Gdndrale de Surveillance)
3
AEATER ANCHORAGE AREA BOROUGH
I1:EALR11 DEPARDENT
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
279-2511
DRECEIVED
INSPECT:
TIME:
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWAGE AND WATER FACILITIES
FOR
1. Approva
Address
Phone
2. Property Owner �S�/1��� Phone SOih
3. Legal Description !lam- &0&-e S 4(
y.
4. Type of Facility to be InspectedSTREET:
Vit,
Number of Bedrooms
S. Well Data: AD
A. Type
B. Depth0'p 00
C. Size rte
D. Construction
E. Bacterial Analysis
6. Sewage Disposal System:
A. Septic Tank (If homemade, show diagram on back)
1. Size
2. Age
3. Manufacturer '
4. Installer
Approval Request for Sew L & Water Facilities '
^� Page Two
B. Seepage Pit
1. Size �
2. Lining
C.—Disposal Field
1. Number of Lines
2. Total Length
7. .Required Measurements
A. Well to Septic Tank
B. Well to Seepage Pit
C. Well to Sewer Line
D. Well to Property Line
E. Well to Other Possible Contamination
F. Foundation to Septic Tank
G. Foundation to Seepage Pit
H. Seepage Pit to Property Line
8. COMMENTS:
APPROVED:/ v ��� DISAPPROVED:
DATE: l % C DATE:
APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT
ED1170