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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 I I I I I I 1 t 1 \ 1 \ 1 \ 1 \ 1 � � 1 El / \ 3 / 1 \\ o ( ( ) a O � I z I •R.A � 9 t ^. b TY� a trocar • rwAw[ wouR[ 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 1 �p 1 I� 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. ENEyy xi {�� �T9s1 w ;.. 1 :�t-iV�isC S F TMALLEY RD. ENEyy xi {�� �T9s1 7-2 Y Wn � P z W Q j{III 7-2 J 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