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Home My WebLink AboutSEQUOIA ESTATES BLK 2 LT 1Sequoia Estates Block 2 Lot 1 #017-152-24 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water 8 Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW070077 PID Number. 017-152-24 Name: JOSEPH MARSHACK Wastewater System: ❑ New ■ Upgrade Address: 6741 PRISM CIRCLE a ANCHORAGE, AK ABSORPTION FIELD Phone: No. of Bedrooms: (907) 257-0116 4 O Deep Trench n Shallow Trench a Bed O Mound ■ Other LEGAL DESCRIPTION W Ration: 1.0 rota Depth from wtgb endo: SEE DWG. GK/Sq. n. n. Block: tot: Subdivision: Dpth to PIPs bettwn Iran odek,ol poo.: Gavel septh benwlh pier. 2 1 SEQUOIA ESTATES SEE DWG. n. 0.5 rt Township: Range: Section: ret tailed row'• eAq^ol arae.: aero Mqu% - - - SEE DWG. n. 25 n. WELL: ❑ New ❑ Upgrade crave width: 24 Nambw of rnn: 4 Dwtonee between swe: 6 rt P. Cb.wf'wotion Prtvot.. AD.C: Taal De cooed T0:t...0oo Total ro.wPtiw, p,sic Pare mabrbk 600 D 3034/ F-810/ SCH40 ff. rL so. rL waver: W. awed: static wax L.+a: e,etalw: A+ HOME SERVICES Dote Imta 6%13-18/2007 R rlew: Pomp Set Ab CasiN Iwieht Atwve Grwnd: TANK Gvuw R n. SEPARATION DISTANCES aseptic ClHolding ■S.T.E.P, 0Others io Septic Absorption Pump Holdingblit/Private NwNdoctww: ANCH TANK cepawty ti y°wm' 1500 From Tank Field Vault Tank sows, Lines, well too'+ 100'+ too'+ - 25'+ Yalerfa: STEEL NunW.r of cowlPmunen4:2 Surface Water 100'+ too'+ 100'+ — — PUMP VAULT Una 5'+ 10'+ 5'+ — —. ti 4s,ww. SitLot 94i fs,onvfoctar.r ORENCO Foundation 5'+ 10'+ 5'+ — — 0",.wvel hri: 31' ;7p al l a: 17' NO waw alarm aL 36' Curtain Drain NONE KNOWN Ptime N.Me • YodN: o"Ancal brpectiorw Pwfwmed by. ORENCO MOA Remarks: OLD SEPTICTANK WAS ABANDONED PER BENCH MARK locatwn and D..Aption: THE UPC. THIS IS AN ADVANTEX TREATMENT SYSTEM. BOTTOM OF TRIM AT NW CORNER Aowrwd EI«ttm: 100.00 rL /+ GEG Ltd. Inspections performed by: Dates: 1st 6/13/2007 ENGINEER'S SEAL 0�000 �iJ 2nd 6/14/2007 0 �.0•.., •.. q 04 3rd 6/15/2007 Development Services Department Approval'?: DO Conditional approval: Date:p . .......rness- :.J. A f O Q E-795//,33 ear O�Q �olZc/ G .,,,� �., Reviewed by: Date: G 2g-oZ e^. V,i �DOp4p0000�� and approved TOP OF TANK A INLET - 95.30 INLET INVERT OF AT INLET BOTTOM OF EXCAVATION THROUGH CONTAMINATED SOIL 92.64-93.85 - FINAL GRACE - 99.3 PASSIVE AIR VENT ADVANTEX TRICKLING FILTER - a`4o(s► *c . ' 1500 CALLON S.T.E.P. TANK VAL GRADE - 98.64 24' - BOTTOM OF THE OLD BED WAS 0 93.86 TOP OF TANK AT OUTLET - 95.27 VAULT ' ORENCO EFFLUENT PUMP 2' INSULATION —FILTER FABRIC GARNLSS ENGINEERING GROUP, Ltd. -------------a— CONSULTANTS d GENERAL CONTRACTORS. -------W-.• =I L n0W IOWA sun[ 101 . ACHOR14L M Nw% • FlOrt (907).100�In . IM (9079M�". A512 w..M^�V�9mn i PREPARED FOR: PHONE HUMBER: PAGE NUMBER: JOSEPH MARSHACK 257-0116 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: SEQUOIA ESTATES SUBDIVISION. LOT 1. BLOCK 2 K.D.M. TYPE OF WORK: DATE: AS -BUILT DRAWIG 6/20/2007 (Rw. 01105) TOP OF SAND - 95.86 INVERT OF DISTRIBUTION LINE - 96.37 (AVG.) THE DISTRIBUTION LINE IS 1.25 INCH PVC WITH J INCH HOLES SPACED 38 INCHES ON CENTER. (7 HOLES PER LATERAL/28 HOLES TOTAL ff�f70R1655' CE -79 3 PERMrrNUMBER: AS DRAWING PARCEL INUMBER: SW0 SW070077 017-11 52-24 DEARMOLIN ROAD ORENCO PUMP VAULT NEW 1500 CALLON,4:.;;s S.T.E.P. TANK �TM/1 W I ADVANTEX POD ,:: •.4. �.;• TREATMENT UNIT Z1 �w O TH/ cn Z I T I11T 0 I I A I IMr NEW 24' X 25' / DRAINnELD/ I \ •`�i•^ / EXISTING {, ' • ^. 4 BEDROOM g' / ..':.. ]//. HOUSE d / .SIII`; � ;Y�• �!' � $.. � Y•�Y •• ~4••11•. •1r1 •� •_':e• I —S E. ' I PRISM CIRCLE �`\ ,' 40 `\ v GARNLSS ENGINEERING GROUP, Ltd. H ' 170 i.....�-----••—•- --- CONSULTANTS 3 GENERAL CO ••••••• •• •••••• ••••. NTRACTORS •. .7101 G Tm bO, furt 101 . wowr; wl Nwl • n.o.[ (Y07)1] lm • RJI oorAm_w" • p91C' •wq�nwwMn,w•pasn D PREPARED FOR: PHONE NUMBER: PACE NUMBER: •• ...••• ...... ...... •• JOSEPH MARUSHACK 257-0116 2 OF 3 QQ y '•J Y A. mess. LEGAL DESCRIPTION: DRAWN BY: p O: EEj'7J 3 eQ SEQUOIA ESTATES SUBDIVISION, LOT 2. BLOCK 1 K.D.M. pp�/e ?1�,q.�go4 TYPE OF WORK: DATE: 40QO-or f oo� AS -BUILT DRAWING 6/21/2007 (K"v y1105) Jun.28. 2007 11:23AM Garness Ensineerins Group, Ltd. No -9013. P. 13 3 % 7 "/ ' GARNESS ENGINEERING GROUP, Ltd. rtam Jnr xr•_-._ = CONSULTANTS S GENERAL CONTRACTORS.—=—.+ter.-tis.+:.:; .z June 28, 2007 Municipality of Anchorage Development Services Department Building Safety Division On -Site water and Wastewater Program 4700 Bragaw Street Anchorage, Alaska 99519-6650 Attn: Jeff Poct Ref: Sequoia Estates Subdivision, Lot 1, Block 2 Mr. Poet: As we discussed, the contaminated material that was removed from the drainfield was mixed with native soil and used for backfill over the new drainfield. Although the septic system is not a mound, the septic system area was topsoiled and seed. If you have any questions, please contact me at 337-6179. 3701 East Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: gamcssengincering.com EL.: -LECTRIC INC 907 272 4590 06/19/07 04t91p. P. 001 From Appliedlticrosystems Tue 19 ]un 2_007 0_6:05:4_7 AM AXDT Page 1 of 1 MUIJICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION 4700 SOUTH BRAGAW INSPECTION INFORMATION 3 HELP. 347-790^. INSPECTION: VOICE 243-8300 INSPECTION: FAX (907)249-7777 www iTlutv.org13501Inspections.clm NAME. Nene PERMIT#: 07-8207 COMPANY: None v INSPECT DATE: 0/19/2007 PHONE It; 272 4591 PHONE #: PHONE #: ADDRESS: $741 PRISM CIR LOT 1 BLOCK 2 CUDDIVICION: SEOUOIA ESTATES GRID #: SW2239 COMMENTS or DIRECTIONS AM Inspecl Please ca!I to meet TYPE OF INSPECTION: Final Elevncal COMMENTS: (FOR INSPECTOR USE ONLY) r �ILG�'v�L 6a''�1411c.�i �VT .n�iC ��>LCM Gy�prolCC� 0� WI PRINTED NAME(a;r�1{ o MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water Q 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: May 29, 2007 Expiration Date: May 28, 2008 Permit Number: SW070077 Parcel ID: 017-152-24 Legal Description: SEQUOIA ESTATES BLK 2 LT 1 Design Engineer: 0855 GARNESS ENGINEERING GROUF Site Address: 006741 PRISM CIR Owner Name: JOSEPH MARUSHACK Lot Size: 31889 SO. FT. Owner Address: 6741 PRISM CIRCLE Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99516 - 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. 5. The following special provisions. -NEED TO SUBMIT MAINTENANCE AGREEMENT WITH SUBMITTAL OF INSPECTION REPORT. Received By. Issued Date: a R Date: -� Municipality of Anchorage -� Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0715" 15;x_ a4 Property owner(s) JOSEPH MARUSHACK Day phone 257-0116 Mailing address 6741 PRISM CIRCLE • ANCHORAGE. AK Site address Zip Code 99516 Legal description (Sub'd, Block & Lot ) SEOUOIA ESTATES SUBDIVISION: LOT 1. BLOCK 2. Legal description (Township, Section & Range) N/A Lot Size 31 1 U9 Sq.Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR ( ® all that apply): Absorption Field ❑ Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ 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: (-)0 Date of Payment:� r 7 q Receipt Number: + q U J C (R". 11/05) Waiver Fees: Date of Payment: Receipt Number: GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS v=! May 25, 2007 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Attn: Joe Goodall Ref: Revised Dcsign for Proposed Septic Upgrade at Sequoia Estates Subdivision; Lot 1, Block 2, Mr. Goodall: First, thank you for taking a time to make a site visit to the subject property on 5/24/07. Per your earlier request on 5/8/07, we performed an additional test hole and percolation test within the vicinity of the existing drainfield that we are proposing to rebuild. The test hole was excavated to a depth of 10 feet. Seeps were encountered at 6 feet, and seven days later water was encountered at 6.75 feet. Water was encountered at 5.4 feet below grade the day after the test hole was excavated, but this is most likely due to water that was displaced upward after the test hole was backfilled. Approximately 40-50 feet north of this test hole, at a similar ground elevation we monitored groundwater (in TH #1) between 4/20/07 & 5/24/07 and the water was never shallower than 11.3 feet below the ground surface. Based upon this information, it is reasonable to believe that the water we encountered in the confirmation test hole, at 6.75 feet below grade, is at least partial the due to water migrating laterally from the surcharged bed. It is our assertion that GEG TH # 1 is more representative of the actual groundwater level. According to MOA records the existing bed was excavated to a depth of 4.5 feet. If we rebuild the bed, it is reasonable to assume that we will excavate out about 1 foot of contaminated soil, making the total depth below original grade approximately 5.5 feet. This is only 1.25 feet above the elevation we encountered water, which we believe to be the result of hydraulic mounding from the surcharged bed, in Tfl#2. It is our intent to import enough MOA sand so as to insure that the bottom of the drainrock in the new bed is 2.0 feet higher in elevation than the existing bed (2.5 feet below O.G.). In short, the top of sand in the new bed will be 4.25 feet above the water level we encountered in TH#2 on 5/24/07. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: vAm.gamessengineering.com We are still proposing to use a Quanics advanced treatment system; however, given the 5 minute per inch percolation test in T11#2 the size of the drainfield will be reduced. Based upon our knowledge of the area, it is reasonable to believe that the soils throughout the bed are not "five minute per inch" in terms of their application rate, so we are proposing to design the bed based upon a percolation rate of 60 minutes per inch. Given that we are using a Quanics treatment system, the allowable application rate is 1.0 gpd/sq.ft., which equates to a drainfield size of 600 sq.ft. (four-bedroom house). The existing 24' X 50' bed will be rebuilt to a 24' X 25 bed. Attached is the revised bed drawing. 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. Thant' you for your assistance. .E., M.S. 3701 E. Tudor Road, Suite 101 r Anchorage, AK 99507-1259 Ph: (907) 337-6179 • Fax: (907) 338-3246' Website: www.gamcssengincering.com GARNESS ENGINEERING GROUP, Ltd. r — ----.. ' CONSULTANTS & GENERAL CONTRACTORS'=- May 1, 2007 Municipality of Anchorage Development Service Department On -Site Water A Wastewater Program 4700 Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic Upgrade for Sequoia Estates Subdivision; Lot 1, Block 2, To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The septic system is in a state of failure and needs to be upgraded. A testhole was excavated on the property on 4/20/07 and a percolation test was performed on 4/24/07 which showed a percolation rate of 120+ minutes/inch. Given the percolation rate it is our recommendation that the existing bed be re -built and a Quanics Aerocell Treatment Unit be installed. We are proposing to install a new 1500 gallon septic tank and a 30-36 inch MOA approved pump vault. The existing bed is to be re -built 1 foot above the existing elevation. All contaminated material is to be excavated and removed. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE RATERS: 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 drain6eld is a 5-10 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. P.E., M.S. rLVAttached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for septic system. (Contact G.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.gamesscnginecring.com GREENBROOK; LOT 1, BLOCK 2 (NO CONCERN) GREENBROOK; LOT 1, BLOCK 1 (NO CONCERN) GREENBROI LOT 2, BLO( (NO CONCE ------+'--------------- _� 1 PROPOSED SEPTIC UPGRADE DE ARMOLIN ROAD ' (SEE DESIGN PAGE 2 OF 4) ExISnNG I / I EXISTING SEPTIC SYSTEM I AREAG I I se ESTATES: 1 1�\ LOTT 2. BLOCK 2 1 1 \ SEQUOIA ESTATES; I I \\ \\ I LOT 1, BLOCK 1 I I �+ CSEPTIC ARE!D q EXISTING 4BEDROOM :cs ca mat` t. EPTC 1 I I I •�� HOUSE ) \\\\ PRISM CIRCLE PINECONE\\CIRCLE // w / \ ARaD / SEQUOIA ESTATES; \\\\ LOT 3, BLOCK 2 Cl)\ SEQUOIA ESTATES; / I LOT 4, BLOCK 1 / SEQUOIA / LOT 5. BLOCK 2• [SEPTIC / ARLAD �.�...._ � v GARNESS ENGINEERING GROUP, Ltd. p, --..: •.....•--.-.��.-..••• CONSULTANTS& GENERAL CONTRACTORS ......• •• • • •• • '• •••••• �ro� [ nAn •ao. fur[ fol . w,c,o.wz, m N . n ?"1" . ru baa-u.s . �-.... PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••• • •• ........... JOSEPH MARUSHACK 257-0116 1 OF 4 Q p *.. t o G rness: LEGAL DESCRIPTION: DRAWN BY: Q°o,• E— 3 SEQUOIA ESTATES SUBDIVISION; LOT 1, BLOCK 2 K.D.M.••......• •°oG TYPE OF WORK: DATE: r'o 000�0 00 SITE PLAN FOR PROPOSED SEPTIC UPGRADE 5/25/2007 (Rm. OINS) ` / a ^ 0r—, I (/ 4UMBER OF BEDROOM$:4 GALLONS PER DAY (GPD): 600 PERCOLATION RATE/S: N/A PROPOSED APPLICATION RATE: 1.0 MINIMUM DRAINFIELD SO.FT.: BDO IM DEPTH: N/A 24 FEET 1:25 FEET APPROVED SAND FILTER:2+ FEET NE: 0.5 FEET DON FACTOR: N/A . SOTT.: 600 EXISTING SEPTIC TANK TO BE PUMPED, CRUSHED AND COMPLETELY ABANDONED. - PROPOSED OUANICS AEROCELL TREATMENT UN PROPOSED JANDI VALVE--� EXISTING DRAINFIELD TO BE REBUILT. ALL CONTAMINATED MATERIAL TO BE REMOVED AND BED TO BE REBUILT 2 FOOT ABOVE EXISTING ELEVATION— NOTE: THE CONTRACTOR SHALL HAVE THE WEST LOT LINE AND THE 100• WELL RADIUS FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. DEARMOUN ROAD KTO OBTAIN A�COPY �OF THE LETTER CONTACT GEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, PROPOSED 30-36 INCH MOA WELL DRILLER, CONTRACTOR AND APPROVED PUMP VAULT PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND INSTALL DOUBLE AGREE TO ACCEPT THE TERMS AND CLEANOUTS CONDITIONS OLTLINED. PROPOSED GALLON SEPTIC TANK,•,•',"::', •%." 4TMH ,... W �I i / EXISTING 4 BEDROOM HOUSE ice'— '..�--'—'��• ��: PRISM CIRCLE �� 40 GARNESS ENGINEERING GROUP, Ltd. p 4 7 --�.�.. •••• CONSULTANTS d GENERAL CONTRACTORS '••••' ••. • ' ' "••• '•••"'•• ]]01 L T NWA f 101 • AHMVKM L M M 7 eUMM' w..pn..e�wYgsen PREPARED FOR: PHONE NUMBER: PAGE NUMBER: •• •• ••• •••• ••••; ••• JOSEPH MARUSHACK 257-0116 2 OF 4 Q y J try Gar es.. LEGAL DESCRIPTION: DRAWN BY: Yoh- CE -7 e�� SEQUOIA ESTATES SUBDIVISION; LOT 1. BLOCK 2, K.D.M. D Z.ocooG TYPE OF WORK: DATE. Q4O4p�OOrofes oo , DESIGN FOR SEPTIC SYSTEM UPGRADE 5/25/2007 (Rw. 01105) _ VT ___—__ S —__— _ _ LONG �� _ _ PROPOSED JANDI VALVE O O , ��FROPOSED OUANICS ��j• MIDI , BED TO BE REBUILT 2 FEET ABOVE EXISTING ELEVATION. EXCAVATION LIMITED TO THE REMOVAL OF ALL CONTAMINATED MATERIAL 4' WIDE GRADE INSULATION -FILTER FABRIC PROPOSED FEED AND RECIRCULATION LINES Ilk" -114 1c� ill,-�i� G "\v.• - TI��U GARNESS ENGINEERING GROUP, Ltd. o .. .--.�•�•w�•+•+�•�-+••—••�-•a�CONSULTANTS 6 GENERAL CONTRACTORS �'••'•••' . ""' ........ )Nt L lUDOe NWA trll[ tot - N CMR*4L Nt a rV (rG1i11rJZM . gylC ew.,s..wyrrvpe.ie O PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••• • •••• ......•••• JOSEPH MARUSHACK 257-0116 3 OF 4 Q P ';J ey GOrness.: LEGAL DESCRIPnON: DRAWN BY: oo CE -795 ,• \FL SEQUOIA ESTATES SUBDIVISION; LOT 1, BLOCK 2, K.D.M. OO SJ.zS°7�ca� TYPE OF WORK: DATE. 4PtoresO4OpQslo 0\ PROFILE DRAWING OF PROPOSED DRAINFIELD 5/25/2007 (Rev. 01105) ' � t F I .. I I I I I I I I I I I I I w I I I � t I � I N I a � � I K tot C m r N N 3 C--� "1�7 5 09.7 7 bplrllg ��• 3 n,i� c $�F.xj I� z II � o � a m m a z .j: % 1 �T„fir :•:�, s' i•!. tsYW. .' F WTE: RAWN BY: 0...... .. ... ........ D 4/30/2007 C.J.G. 0 GAL DESCRIPTION: �Y a� ”" "' • • • •; • • • •Q f e ness: Q SEQUOIA ESTATES S/D; LOT 1, BLOCK 2, GARNLSS ENGINEERING GROUP, Ltd. 00 a; cE 7 s3 :ate TYPE OF WORK: CONSULTANTS&GENERAL CONTFACTOFs O DESIGN OF SCAT AEROCELE SYSTEM � w� �'•�� fj. woo aw. c rmi m �.w wr. wooac a wwr woo Iwnl nrr.w/r.c fbrl rn >e•• • o� w.r.�w,�. � F. RLPARLO FOR: PHONE NUMBER: PACE: -rof o M.O.A. - D.S.D. 257-0116 4 OF 4 GARNESS ENGINEERING GROUP, Ltd. ._.,...•.v.•._••a.�...�..+.� CONSULTANTS S GENERAL CONTRACTORS SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: PERFORMED FOR: JOSEPH MARUSHACK DEPTH --- (feet) TEST HOLE 1 1 --- �= FILL SOIL CLASSIFICATIONS ORGANICS _'^ GW - - ORG DRY - == 12.0' =�=_ GP ML 3 3:54 GM CL 3/8. 3 GM GC OL 4 - 4 4:24 30 6- SW MH •� •'� CH 5 22SP 2. SM OH SC 6 7 H a 101 1IIIIIIII ML 5/17/07 12 13 14 15 16 17 18 DEPTH TO GROUNDWATER DATE DRY 4/20/2007 DRY 4/24/2007 12.0' 5/2/2007 12.2 5/24/2007 STH' I 1 K.A. ' Q N •-- ; 1 a>w� i t PRISM CIRCLES6LE: 100 DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 4/24/2007 1 3:24 - 6' - 2 3:54 30 5 5/8" 3/8. 3 3:54 - 6" - 4 4:24 30 6- 0. 19 PERCOLATION RATE 120+ (MIN./INCH) PERE. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 6.0 FT. AND 6.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES E NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: CALEB GALL COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERF RMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2 O 0 GARNESS ENGINEERING GROUP, Ltd. !^ U .,.......+..:�n...r:.+m.+�= CONSULTANTS & GENERAL CONTRACTORS 3701 0 L TUDW R00A SUM 101 • SOILLOG•�PERCO7_N" • PERCOLATION TEST SEQUOIA ESTATES SUBDIVISION; LOT 1, BLOCK 2, ••.J y A. rness- O LEGAL DESCRIPTION: u •• PERFORMED FOR: JOSEPH MARUSHACK DATE: 5/16/2007 'p6. •.,....... .•'��0 (feet) ORGANICS 44o4pffff�Q�0000 TEST HOLE 2 1 ==== SOIL - SOIL CLASSIFICATIONS 2 GM/SM -d io;. GW cc ORG GP ML GM CL 4 GC OL N '• •°• o SW MH SP CH 5 SM OH SEE SITE PLAN FOR 6 SC TEST HOLE LOCATION 7 CM 8 DEPTH TO DATE 9 ••6S® t• . tw' 10 B.O.kI. 11 12 13 14 5 2:30 15 16 17 18 PERCOLATION RATE 5 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19 TEST RUN BETWEEN 4.0 FT. AND 4.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: JORDAN TROISI COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WA!; ED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: Zr ( GROUNDWATER READING CLOCK TIME SEEP m 6.0' 5/16/2007 •5.4' 5/17/2007 .75 5/24/2007 30 0" 6' DATE READING CLOCK TIME NET TIME WATER LEVEL NET DROP (MINUTES) READING (INCHES) 5/16 2007 1 1:30 - 6" - 2 2:00 30 0" 6' 3 2:00 - 6" - 4 2:30 30 0" 6" - 6" - 6 3:00 30 0" 6" *LIKELY DISPLACED H2O WHEN TEST HOLE WAS BACKFILLED. "LIKELY INFLUENCED BY SURCHARGED BED. Municipality of Anchorage • Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: GARNESS ENGINEERING Legal description: SEQUOIA ESTATES SID BLOCK 2 LOT 1 ®Permit ❑C.O.S.A. ❑Inspection Report The attached paperwork has been reviewed and is being returned for the following reasons: 1. -NEED TO SUBMIT TESTHOLE FOR AREA OF PROPOSED SEPTIC FIELD UPGRADE. NEED ENGINEERING STATEMENT TO VALIDATE ORIGINAL TESTHOLE OR PROPOSE TO DO AN ADDITIONAL TESTHOLE OR SOIL ANALYSIS. 2. NEED A MAINTENANCE AGREEMENT. Name of reviewer. JOE ,r,13�,07 Date: May 8, 2007 �PSt �o le - 7—, -s r k o /- Was 1nvhXai"/ W:Ni -to h0V-V, S'`' 4",o W<r f crl— %� Wit Y<✓ )Croll. to Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK ` MUNICIPALITY OF ANCHORAGE -2 DE' TMENT OF HEALTH AND HUMAN SERV S M` ' Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name Ae lao ou / 6 DISTANCES TO FRO(0 SEPTIC TANK ABSORPTION FIELD WELL Address WELL Phone(s) Permit No. 61001'Z4 No of Be rooms LOT LINE LEGAL DESCRIPTION Lot - Block Subdivision FOUNDATION Township, Range, Section -�� cjr. AS-BUILT DIAGRAM (Show location of well, septic system, property hoes, foundation, driveway. water bodies, etc.) TANKS V,e'SEPTIC ❑ HOLDING Man lacturer 1 1ow Capacity in gallons /�Zs_n Material ta+ No. of Compartments r OF SYSTEM r r TYPE ❑ TRENCH k BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from original grade '� v FT Total depth from original grade , FT U r �r r , n YR� Fill added above original grade FT Gravel depth beneath pipe �y (1• :S_ FT _ Gravel length /� �✓ FT Gravel width j Q`{ FT Total absorption area / / SQ FT Distance between lines / FT Number of lines Soil rahhng i SOFT Pipe material A61-1A Inst Iter //tt J�/ � aC Q 61 I f Date Installed WELLS RIVATE ❑ OTHER (Identifv) Classification ,�� B C) f Total Depth FTJ Cased to FT Installer Date Installed: REMARKS: �—✓�� { Ids 1'1 l �P Scale; - Inspections Perfor ed by.`�> 'ra Uwf7 .04G SgRl.i o e sP if tl� � l l'�g „f v� °e d. CE-5233 e° ; Date: j v1 lik*-f I i, ..I C' I conify Ilial Isis i Own was pe�ocmod according (a ail Municipal and Slateguj el4 es in effect on this dale: Health Department Approval: - ��"�-� ` Date: 72-013 (3/85) PERMIT NO: DA|E ISSUED: APPLlCAN[: ADDRESS: CONTAC[ PHONE: LEGAL DESCRIP: LO[ SlZE: MAX BEDROOMS: ucmru omn �mor�nmwFNT�/ P�OT�CTION « u�r�n/n�n/ U°`,"`~^,^_,��~ ��~�_- �� 825 L STREET, ANCHORAGE, AK 99501 264^472O 860121 O5/12/86 ACREAGE SYSTEMS, INC 601 E. NORTHERN LIGHT SUITE 165 ANCHORAGE, AK 99503 276~6552 SU8DIVISICD, SEQUOIA EST, LOT: 1 SECTION: 26 TOWNSHIP: 12N RANGE: 3W 31889 OR ACRES> 4 ' w-� �u�/ -="�' &n . BLOCK: 2 Listed below are the opti�ns availab]e to you in designin � system. Choose the option that your site. , _�~~~~^�^`^ � DEPTH lO PIPE BOTTOM (FT.) 4.0 GRAVEL DEPTH (FT.> |OTAL DEPTH (Fl,) 4~5 GRAVEL WJA) [H GRAVEL LENGTH (F|.) 47.0 � GRAVEL VOLUME (CU.Y�S.> 43,6 /�� / TANK SIZE (GALS) 1,250.0 S�IL RA[lNG (SQ.FT^/8R) ** TANK MUST HAVE AT LEAST TWO C8MPARTMENTS I certify that: � 1. I am [amiliar with the requirements �or on~site sewers and wells as set �orth by the Municipality o� Anchorage (MOA) �nd the State of Alaska" 2" I wi1l install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances rom any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot" � 4. I understand that this permit is valid for a maximum of 4 bedrooms and � any enlargement will require an additional permit. � IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES' THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) ASILTS WILL NOT BE APPRO�E� WITHOUT A� ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRJCAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN" =UK= APPLICAN[: IS�U�D BY _ _... ......... ... ..... ______... ..... ACREAGE SYSTEMS, lNC F-T'---�-�-~T--------T�'-------- � ^ DATE: .... ~..... DATE: � �� }_ F .3�FIyQfNEE &SEAL) g Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 8 ce J. Corwin SOILS LOG — PERCOLATION TEST 6'@ s,° cE-'-03 7n 144' /'R0FES5`... PERFORMED FOR: &- 5aGe Sw-.na l5 DATE PERFORMED: M� - II, IgB(o LEGAL DESCRIPTION: EbOT I BX' ((' - Township, Range, Section: uoiA F-mii1-T;—::'S SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS OL L.I('WC °FSnu-z 1 GM pa(? nOWL> GM END WAS GROUND WATER K(^ ENCOUNTERED? _ IF YES, AT WHAT DEPTH? _ Depth to Water Aft ©R r yf Monitoring? Date: Reading Date Gross Time Net Time Depth to Water Net Drop 1N20 3�// 4120 50 r() to '4 ilio 11 i zSi '44"70 0Sb Ica `I r LO 0 ,50 ( GO tQ VA N 1z .i L * y s 6"60 � Q ' 00 ,'mob S. 10 l0 mwu t 1 rte / 16 3p (011ll PERCOLATION RATE JJ� (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 3 FT AND =' FT PERFORMED BY:ynuc-IA ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINE IN EFF 72-008 (Rev. 4/85) CERTIFY THAT THIS TEV WAS PERFORMED IN 3 THIS DATE. DATE: � In O �oF Qn & associates,inc. Consulting Engineers 4790 Business Park Blvd. • Bldg. D • Suite One • Anchorage, Alaska 99503 • (907) 561-6151 June 19, 1986 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION Municipality of Anchorage JUN 2 51980' Department of Health RECEIVED and Human Services 825 "L" Street Anchorage, Alaska 99501 SUBJECT: LOT 11 BLOCK 21 SEQUOIA ESTATES SUBDIVISION To Whom It May Concern: As you will note, the on-site disposal system for Sequoia Estates Subdivision, Lot 1, Block 2, was not installed per approved plot plan. At the time of excavation for the system, it was discovered that the approved receiving soil strata was not continuous and therefore, the installation site was adjusted. Because the new location is at the same relative elevation with no topographical variances, and the soils matched the original report with the receiving strata between 2 feet and 5-1/2 feet below ground, additional soils information was judged not necessary. No ground water was indicated to 14 feet below ground. Plot Plan ##2 shows this change in location of the system. We hope that this additional information is sufficient and believe that all the requirements effective on this date are met. Sincerely, CORWIN & ASSOCIATES, INC. C: "a C9 0'r Laura Ogar Environmental Engineer LO/d 7- 7 —P-6 'N5A,PMOuN ► ORD $flop A f aA Rgse�V � d For - 5 C -WA -F Or gira� 2 1 ropoSP }�ausE� tu 031 PR ism C- f 2CL.E- I2 U 0 I� V m 1°O ! r r N�Z IPropc e� 'Veil wS SEWER SYSTEM LOCATION PLAN 61-c s e SECTION/TOWNSHIP/RANGE 0 '�tC,Z4p �- sa :•'t SCALE, II - / _ �'O NOTE, THE ACCURACY OF LOCATION OF EXISTING l PROPERTY CORNERS. WELLS, AND SEPTIC 4) DRAWN BY, SYSTEMS INDICATED IS NOT EXACT. NORTH L a r� DIMENSIONS INDICATED HAVE BEEN DETERMINED BY USE OF CLOTH TAPE AND . ...... ••r;- HOT BY SURVEYING TECHNIQUES, Vgc��P'ea C� 5223 ° / ©' PREPAAEA ROAD+. oc ^` . ®t!1 %Boa •.:e occ �� - Y. Y I t �-.•• . r� rs .►� ,. GATE, � 9TUMR � SMEET OF -[�-rrM)000 Fop,) NOTE: THE ACCURACY OF LOCATIPN-'OF EXISTING PROPERTY CORNERS, LS, AND SEPTIC SYSTEMS INDICATED XS NOT EXACT. DIMENSIONS INDIC TED HAVE BEEN DETER— MINED BY USE OF LOTH TAPE AND NOT BY SURVEYING TECHN OUES. Li F- 'R9'jA(q.Qj bOc re 44- OYP SEWER SYSTEM LOCATION PLAN . ..... Lot: BIOC Subdi Prepared for: 6E sysrims tx, Date OF free f G° 4A PP u 3. Corwin CE -5283 PROFESS\')' It, SEWER SYSTEM LOCATION PLAN . ..... Lot: BIOC Subdi Prepared for: 6E sysrims tx, Date • ' :lun-11 -�J9 02:12P • • Bonnie Mehner & Assoc. (•JU/) /bG-1LSbU SATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING & WATER MCMT WATER WELL RECORD LOCATION OF WELL P.Uj aOMOuoN supolvis10N LOT stoex tt=ONQTAa teeT10N TOWNCHI► IIANO( OIAN AW 1-2 ON ❑E ❑s Ow LOCATIONISKETCH: WELL OWNER: t DEPTHS MEASURED FROM:Ocasing top ❑ground surface WELL DEPTH: DATE OF COMPLETION Depth of We:Ciro t BOREHOLE DATA: Depth Depth of casing; 'A If 0 t / Motorial Type and Color From To ! DEPTH TO STATIC WATER LEVEL: It below S top of casing ❑ ground surface W G Date: —.fa t__r METHOD OF DRILLING: `Df air rotary [3 cable tool 6 ❑ other /'''' USE OF WELL: Z domestic ❑ irrigation ❑ monitor 3 70 ❑ public supply ❑ other jv A CASING STICK-UP: ft. Olam td13Zft _In. Casing type: In. to it WELL INTAKE OPENING TYPE: ❑ open end ❑ screened perforated (] open hold Depths of opening:: 3410 toft t SCREEN TYPE: Diam: In. Slot/Mesh Size: Length: ft GRAVEL PACK TYPE: 146 Volume used: Depth to top: GROUT TYPE: Volume: Depth: from ft to ft DEVELOPMENT ME OD: �Lc Duration: // PUMPING LEVEL AND YIELD: ft after •Z I'sf pumping Spm PUMP INTAKE DEPTH: p0� �' 1t Horsepower: / WELL DISINFECTED UPON COMPLETION7 ') YES ❑ NO CONTRACTOR INFORMATION: t? 0 eg raa$usm/esxr/dame a 9 yg Signature o nze0 ut l0ieiot n taGDate— REMARKS: ve ate REMARKS: PLEASE MAIL WHITE COPY OF LOG TO: DNR/DIVISION OF MINING & WATER MGMT 3601 C St. Suite 800 ANCHORAGE AK 99503.6936 err. len�••r.w ss.w .__. •nn..r..n .,w. LOCATION OF WELL - (Please complete either to, Ib or Ic.) la. Borough Subdivision - LoT Black Fb I/4 gtrs. �qom 1 1 f-af_of _ 1c.1I DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS WATER WELL RECORD /' STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological a Geophysical Surveys Drilling Permit No. - - A.D.L. No. - Section No. Township N ❑ Range E ❑ Meridian 3. OWNER OFF WELL: W❑ Address: - Street Address and Area of Well Location - - - Feet Below 2. WELL LOG Surface M uteri I Type Top Bottom Z 4. WELL DEPTH: (final) 5. DATE OF CO�MPLETIO e�ix� _yF ft. 6. ❑ Cable tool Rotary ❑ Driven ❑ Dug ❑ Auger ❑ Jetted ❑ Bored ❑ Other: Psr " 7. USE: KDomerfic -.,❑ Public Supply ❑,industry - ❑ Irrigation- ❑ Recharge ❑ Commerical ❑ Test Well ❑ Other:. O 8. CAST G ❑ Threaded -)4 Welded to It. Depth Weight lbs./fI. ..am. in. tgrs.0 a ft. Depth - Stickup ft. - - - _- - 9. FINISH OF WELL:�- :.Type:. "- Diameter: Slo1/M sh Size; - - Length: - Set between - - It. and -ft. - Backfilling Gravel pack - - M- - Q _ - - - - - - ��"yy�� 10. STATIC WATER LEVEL: 2 tt. zit Date ❑ Above or z Below/land surtoe - - Equipment used: -'— I I . PUMPING LEVEL below land surface and YIELD �_0ft. of ter �hra.. pumping�9.p.m. �1 - ft. after hrs. pumping 9•p -m- 12.GROUTING Well Grouted: ❑ Yea ❑ No Material: ❑ Neat Cement ❑ Other: - - - - 13. PUMP: (if available) HP - Length of Drop Pipe ft. capacity 9 -P.M. - - ❑ Subm. ❑ Jet ;❑ Centrifical - ❑.Other "14. REMARKS: -- - - 16. WATER WELL CONTRACT CERTIFICATION: 15. Water Temperature --o ❑F ❑ C This we was dril ell ^ 49:i n r y..ju ris dictio n and this report is true to the es of -my knowledge and bel let - .�i®� Registered Busines Name Contract cense Nu,nbe AUare53 Date: ^ �7 Signed: - - _A thor zed Re esentative - - - Form 02-WWR (11/81) - Copy Distribution: WHITE -State DGGS,PINK-Driller, CANARY -Customer _ ^� ''h��A ��.�� ^��i - DEPARTMENT OF HEALTH AND ENVI�ONMENTAL PROTECTION 825 L STREET, ANCHORAGE, 264-4720 4 .111J., R�� U P£RMIT NO: 860351 DATE ISSUED: 09/15/86 APPLICANT: ALPINE DRILLlNG ADDRESS: P"O, BOX 110496 ANCHORAGE, AK 99511 CONTACT PHONE: 345-0202 LEGAL DE�CRIP: SUBDIVISION: SEQUlOA ESTATES LOT: 1 BLOCK: 2 SECTION: 26 TOWNSHIP: 12N RANGE: 3W LOT SIZE: 31889 <SQ.FT. OR ACRES) I certi�y that: 1, I am amiliar with the requirC,,ments �or on-site sewers and wells as set �orth by the Municipality of Anchorage (MOA) and theState C. Alaska, 2. I will install the system in accorUance with all MOA codes and regulations� and in compliance with the design criteria o� this permit. 3, l will adhere to all MOA and SLate of Alaska requirements for the set back distanceom any existing well, wastewater disposal system or public sewerage system on this or dj C., k- or nearby lot. �-~ ___/ ____ _��,^__��_"w APPLICANT: ALPINE ' ISSUED BY DATE: • '� Municipality of Anchorage On-Site-Water and Wastewater Program u5 x (907) 343-7904 113- CERTIFICATE CERTIFICATE OF ON-SITE SYSTEMS APPRO ^ LAPR'2 5;2016 3 Parcel I.D. 017-152-24 Expiration Date: 9 1. GENERALINFORMATION Complete legal description SEQUOIA ESTATES BLOCK 2 LOT 1 Location (site address) 6741 PRISM CIRCLE ANCHORAGE AK 99516 Current Property owner(s) DAVID & JANE McVEIGH Day phone Mailing address 6741 PRISM CIRCLE ANCHORAGE AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: tK Single Family (w/wo ADU) El Duplex Multiple Dwellings (Single Family acid/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER` DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank Community Class _ Well ❑ Community ❑ Public Water System ❑ Public Sewer WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer; -unless othe - s quested by the engineer. COSA Fee $ sZ(o' Waiver Fee $ Date of Payment ��a�l��_ Date of Payment Receipt Number. Receipt Number COSA# Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed herefo: and as of the validation date shown below, I verify that my investigation, se *, p," edures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows thaf t -on-sitewater supply and/or wastewater disposal system is (are) safe, .functional, and adequate for the number of bedrooms and type of structure indicated herein.'I further verify that based on the information' obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply,and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and; regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone -868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M.DUFFUS- Date 4/21/2106 Engineers Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the -surface, -changes inland: use, local Sol[ characteristics, groundwaterlevels that may fluctuate during the year -and `the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra-can not give any estimate of how long a system will function satisfactory.for current orfuture occupants or can ArcTerra guarantee that no unseen OF AL\\ encroachments, deficiencies oudiscrepancies exist. > <46 4 Tx y " 6. DSD SIGNATURE /. _� System #1 Approved for bedrooms. -A. s" 1e ° System #2 Approved for bedrooms.\n F Fes toK� Disapproved. Conditional approval for bedrooms, with the following stipulations: %A1LqTF-\hlATERz PROGRAM o� �C , B i�dy 7 Original Certificate Date: We Municipality of Anchorage Development Services Division (DSD) issues Certificates of Onsite Systems. Approval (COSA) based only -upon lite represeptations.given in paragraph 5 by an independent professlopel.civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory _ArsenicAdvisory Well Flow Advisory Other COSA blue sheet_10-10-12.tlae. If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system _ ____Certificate of On -Site Systems Approval Checklist Legal Description: SEQUOIA ESTATES BLOCK 2, LOT 1 Parcel ID: 017.152.24 A. WELL DATA Well type PRVT Date completed 6/911998 Total depth 380 ft. If A, B, or C provide PWSID # _ Well Log (Y/N) Sanitary seal (YIN) Y Cased to 380 ft. FROM WELL LOG Date of test 61811998 Static water level 205 ft. Well production 11 g.p.m. WATER SAMPLE RESULTS: Wires properly protected (Y/N) Y Casing height (above ground) 12 in. AT INSPECTION 4/812016 210 ft. 6.7 g.p.m. Coliform NEG colonies/100 mL Nitrate 5.69 mg/L Arsenio ND ug/L Date of sample: 400M AlIgIl(p Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC I STEEL Date installed 6113.1812007 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation clean ut (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y fns ew Date of 47/1016 Pumper A+i Anchorage Tank- Advantex Maintenance C. ABSORPTION FIELD DATA Date installed 6113.1812007 Soil rating (g.p.d./ft or ftZ/bdrm) 1.0 System type BED Length 25 ft. Width 24 ft. Gravel below pipe 0.5 ft. Total depth 3A ft. (Measured 4/8716) Eff. absorption area 600 fta Monitoring tube Y Depression over field N Date of adequacy test 4/8/2016 Results (Pass/Fail) PAS$ For 4 bedrooms Fluid depth in absorption field before test 0 in. Elapsed Tirime:10 titin. ' Final fluid depth 0 in. Any' rejuvenation treatment (past 12 mo.) (Y/N & type) Water added 700 gal. New depth 2 in. Absorption rate >= 600+ g.p.d. If yes, give date D. LIFT STATION Date installed 6113.1812007Size in gallons 94 "Pump on' level at-Stin. =- gDuff ip off' level at 17 in. Datum BOTTOM OF TANK Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 1004 Absorption field on lot 1001+ Public sewer main 751+ Sewer /septic service line 25'+ Animal containment areas 50'+ SEPTIC/HOLDING TANK ON LOT TO: Manhole/Access (Y/N) Y High wateralarm 1welat 3e in. Meets alarm & circuit requirements? Y On adjacent lots On adjacent lots Public sewer manhole/cleanout 100'+ Holding tank Manure/animal excrete storage areas 1001+ Building foundation 54 Property line 51+ Absorption field 54 Water main 104 Water service line 101+ Surface water 4001+ Wells on adjacent lots 1004 ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 104 Water main 101+ Water Service line 101+ Surface water. 1001+ Driveway, parking/vehicle storage 104 Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines to effect on.this date.OF Al, t Engineer's Printed Name KENNETH M. DUFFUS C F Date412112016 COSA canary sheet 2-6=15.doc - L" .� Sim M.'�.. RL A \� ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND .(l usx) �E 1Z zrD t -i tj SO h-% M,Prr y & Soko50D+ THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this — �-ArrP R :30&rj o" ) /P rC vlj C,.SoGNsok Day of 01 Apr`of 20 16 , by and between , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Advantex AX -112848 located at (legal description). Sequoia Estates Blk 2 Lot 1, 6741 Prism Circle, Anchorage, AK 2. Definitions. Alteration. Any change to the design or function of an AW WTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC') 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations. Installation and Removal of Additional Eapipment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider anproved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AW WTS. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner: (Suver) Tc - b (t U -V h aS o n% I leI lr%/ a ToHH SOn b. Municipality: Director, Community Development or desiguatgd MWIQ-rAiY C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER By:ignature Date: Z� — Zvi 4 / f o 69 �� • - (print name) /y7 l % �(�j►�Jat/ v,Y1 e -V -V -Y ir, So�HsoY. STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this :Y;,� day of Apr 20ICe , by . `TWe VZ. 50MnSon O.hd MUrr G ,.� nson NOTARY PUBLIC FOR ALASKA My Commission expires: Ap"A Nmee D�GI'rJ i�U X11 C� MUNICIPALITY: By: (signature) Date: (print name) Title: RPM : ..E H.... .. r �OTAAy ..r T 4r OF Of. - �0� F �,. I�rrB@�On ExplrO$,P' Municipality of Anchorage h: K Development Services Department Building Safety Division s`,' F.: On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # OSC161133 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot 1 of Sequoia Estates subdivision. This inspection revealed a nitrate concentration of 5.69 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 - 't CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. N r4 - i 5ag-Ay COSA# aup-1 1. GENERAL INFORMATION Expiration Date: !3— 9,9 —07 Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address SEQUOIA ESTATES SUBDIVISION, LOT 1, BLOCK 2 6741 PRISM CIRCLE ' ANCHORAGE. AK 99516 JOSEPH MARSHACK Day phone 257-0116 6741 PRISM CIRCLE ' ANCHORAGE, AK 99516 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well N Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined In the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineers Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 1—/ bedrooms. Disapproved. 337-6179 Date Uzi o Conditional approval for bedrooms, with the flowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory (/ Arsenic Advisory Maintenance Agreements Supplemental Engineers Reort Other .1' G\Q�........... ON-SITE . WATER AND •; WASTEWATER : PROGRAM By: ` 4/�! Original Certificate Date: (0 — g " 0 (Rm. 11105) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water b Wastewater Program 4700 &agave Street P.O. Box 196650 Anchorage, AK 99519-66W www.muni.orglonsits (907) 343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SEQUOIA ESTATES SUBDIVISION, LOT 1, BLOCK 2 Parcel ID: A. WELL DATA Well type PRIVATE If A. B, or C provide PWSID# N/A Date completed 6/9/1998 Sanitary seal (YIN) YES Total depth 380 ft. Cased to 380 ft. FROM WELL LOG Date of Gest 6/8/1998 Static water level 205 ft. Well production 11 — 9 -p.m - WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 3.77 mg./L. - 4W Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12 in. AT INN / SP7ECATION 1 211 ft. SIB g.p.m. *WELL TEST PERFORMED BY S&S ENGINEERING Other bacteria 0 colonies/100 ml. Arsenic: N.Dug./L. Date of sample: 6/4/2007 Collected by: GEG. Ltd. B. SEPTIC/HOLDINOTANK DATA ADVANTEX SYSTEM Tank TypelMaterial SEPTIC/STEEL Date installed 6/13-18/2007 Tank size 1500 gal. Number of Compartments E Cieanouts (Y/N) Foundation cieanout (YM) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date of pumping NEW Pumper C. ABSORPTION FIELD DATA Date installed 6/13-18/2007 Soil rating O.E. r ft=/bdrm) 1_0 Length 25 ft. Width 24 ft. System type BED Gravel below pipe 0.5 ft. Total depth *.2.78+ ft. EfF. absorption area 600 ft' Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test = in. Water added =gal. New depth =in. Elapsed Time: = min. Final fluid depth = in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN 3 type) NONE KNOWN If yes, give date D. LIFT STATION Date installed 6/13-18/2007 Size in gallons 94 Manhole/Access (YIN) YES "Pump on" level at 31 in. "Pump off' level at17 in. High water alarm level at 36 in. Datum BOTTOM OF TANK Cycles tested NEW Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankfliR station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicie storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 6124 / c i COSA Fee S Yy • C Date of Payment (0 a 110 7 Receipt Number U -r. y G ci 7 (Rw. 11105) Waiver Fee $ Date of Payment Receipt Number DEARMOUN ROAD S 89°56'30"E 1 52.351 / _____PRISM_ CIRCLE_____ THE INFORYATKVI HEREON IS FOR THEME OF IENdMG a15MVTIONS SRECIFICALLV TO SHOW ANY CONFLICTS BETWEEN EMSTINOSTRUCTURESANOPLATTEDLOTLINESMEASEMENTSANOISNOTTOSEUSEDFMPOBITIOMNOA 7iOkAL STRUCTURES OR FENCELWES EASEMENTS a RECORD. OTHER THAN THOSE SHDWN ON THE RECORDED PUT. ME NOT SHOM11 HEREON (UNLESS INDICATED) NOTE ANY FENCELINES SNONN ME LOCATED APPROM"TELY MOME NOT TO SE MEDTO DETERMINE PROPERTY UNES OR LOCATE STRUCTURES ANY PAVING SHOVM MAY BE APPROXIMATE WE TO SNOW CONDITIONS �OFAtN O SHANE A. HOLT: %' 1.5.6914 � tNi s G AS BUILT SURVEY (NO CORNERS SET THIS DATE) 1".3D 1 HEREBY CERTIFY THAT I HAVE PERFORMED A MORTGAGEE S INSPECTION OF THE FOLLOW NO DESCRIBED PROPERTY LOT 1. BLOCK 2. SEQUOIA ESTATES ANCNORwGERECORONODISTRICT.ALASKAAWTKAT THE VIABLE IMPROVEYEKTS SITUATED THEREON ARE W THIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS MST OTHER THAN NOTED DATED AT ANCHORAGE ALASNATHS 1STH_ DAY OF JUNE 1WT. HOLT LAND SURVEYIN4 1 WSP. FS 12615 TEL UA "12 O Opp 1 JA Y 1 j INw O PP OP ev. . r a'n LO 0 N W 0 rN 0 ih 0 t SINGLE FAMILY 0 FRAME HOUSE Z ens a F .PNT DRIV[WAV DLl S 69`5600"E 132.213, _____PRISM_ CIRCLE_____ THE INFORYATKVI HEREON IS FOR THEME OF IENdMG a15MVTIONS SRECIFICALLV TO SHOW ANY CONFLICTS BETWEEN EMSTINOSTRUCTURESANOPLATTEDLOTLINESMEASEMENTSANOISNOTTOSEUSEDFMPOBITIOMNOA 7iOkAL STRUCTURES OR FENCELWES EASEMENTS a RECORD. OTHER THAN THOSE SHDWN ON THE RECORDED PUT. ME NOT SHOM11 HEREON (UNLESS INDICATED) NOTE ANY FENCELINES SNONN ME LOCATED APPROM"TELY MOME NOT TO SE MEDTO DETERMINE PROPERTY UNES OR LOCATE STRUCTURES ANY PAVING SHOVM MAY BE APPROXIMATE WE TO SNOW CONDITIONS �OFAtN O SHANE A. HOLT: %' 1.5.6914 � tNi s G AS BUILT SURVEY (NO CORNERS SET THIS DATE) 1".3D 1 HEREBY CERTIFY THAT I HAVE PERFORMED A MORTGAGEE S INSPECTION OF THE FOLLOW NO DESCRIBED PROPERTY LOT 1. BLOCK 2. SEQUOIA ESTATES ANCNORwGERECORONODISTRICT.ALASKAAWTKAT THE VIABLE IMPROVEYEKTS SITUATED THEREON ARE W THIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS MST OTHER THAN NOTED DATED AT ANCHORAGE ALASNATHS 1STH_ DAY OF JUNE 1WT. HOLT LAND SURVEYIN4 1 WSP. FS 12615 TEL UA "12 JUN -25-2007 0:05 S&S ENGINEERING 907 694 1211 P.04iO4 S& FEALTMAUIItl Y APPROVALS s W AAWATER LM CKTFMX" SEWERS WATER SL'EEC1" V,G'wEEn-NGSTLIDES NAAMAIs WELLF6iEulq l FLOW TEST SITE FLA.4 ROADDESIGN SOIL Itst KnCOLADDN tEST STRL CTLVM S woviacm. SUPMRON^S ONSRE WASTEWATER 06YOSALEISTEM DEM" fig WELL FLOW TEST DATA CLIENT: f ( or_ L(7 LEGAL DESCRIPTION: L } E, ROBERTC.COWAN.F ROBERTA. SHAFER F CML ENGINEERS (907)69.42979 FAX(907)694.1211 DATE:• WELL DEPTH: 3�i , CASING DEPTH: k42oe n DATE DRILLING COMPLETED: fi • I -t DRILLER: u>,,; -e MISC. DATA: CASING HEIGHT: V SANITARY SEAL: WIRES IN CONDUIT: —I=: --GRADING O.K.: BACTERIA AND NITRATE SAMPLES COLLECTED (date): TEST DATA: CLOCK TIME METER READING (GAL) PUMPING RATE (GPM) DEPTH TO WATER (FT) REMARKS I:ySrrn 5/S2, 6• 211 swl z:cc. X238 5'.73 z1Z 21.15 5343 57.63 Z(5 S3 tZ 5 S SAS z RESULTS: WELL CURRENT\ ODUCES GPM WITH A __q� DRAWDOWN TESTED BY: FLOW RATE NOT GUARANTEED -SUBSEQUENT VARIATIONS CAN OCCUR. COus/576k)r P -i4& p -e7 (=L-ou) rolel- oA315, 7400tz 7 S to u E "ts &,44m /je>. to6 - T . 17034 NORTH EAGLE RIVER I OOP A SLATF 204 • EAGI. E RIVER• ALASKA 9'.15» TOTAL P.04 SGS ReLN 1072505001 Client Name Garncss Engineering Group, Ltd. Project Name/p Sequoia Est Ll B2 Client Sample ID Sequoia Est Ll B2 .Matrix Drinking Water P\NSID 0 Sample Remarks: All Dates/fienes are Alaska Standard Time Printed Daterrime 06/132007 9:55 Collected Datelrime 06/042007 11:30 Received Daterrime 06/042007 13:45 Technical Director Stephen C. Ede Allowable PMP Analysis Parameter Results PQL Units Method Container ID Limits Date Date Init Metals Department I lardncss as CaCO3 Waters Department Total Nitmic/Nitrite-N Private Individual Analvsis Aluminum Antimony Arsenic Barium Cadmium Calcium Chromium Copper Iron Lead Magnesium Manganese Phosphorus Chloride Fluoride Potassium Selenium Sodium Silicon Silver 142 5.00 mg/L SM20 2340B D 06/05/07 06/07/07 TK 3.77 0.100 mg/L SM20 4500NO3-F D (<10) 06109/07 JDS ND 20.0 ug/L EP200.8 D 06/05/07 06/07/07 TK ND 1.00 ug/L EP200.8 D (<6) 06/05/07 06107/07 TK ND 5.00 ug/L EP200.8 D (<I0) 06/05/07 06/07/07 TK 11.8 3.00 ug/L EP200.8 D (Q000) 06/05/07 06107/07 TK ND 0.500 ug(L EP200.8 D (<5) 06/05/07 06/07/07 TK 42200 500 ug(L EP200.8 D 06105/07 06/07/07 TK 3.34 1.00 ug(L EP200.8 D (<100) 06/05/07 06/07/07 TK 44.1 1.00 ug/L EP200.8 D (<1300) 06105/07 06/08/07 TK ND 250 ug/L EP200.8 D (<300) 06/05/07 06/07/07 TK 1.16 0.200 ug/L EP200.8 D (<15) 06/05/07 06/07/07 TK 8840 50.0 ug/L EP200.8 D 06/05/07 06/07/07 TK ND 1.00 ug/L EP200.8 D (<50) 06/05/07 06/07/07 TK ND 200 ug/L EP200.8 D 06/05/07 06/07/07 TK 19.1 0.100 mg/L EPA 300.0 C (Q50) 06/09/07 06110/07 JDS 0.100 0.100 mg/L EPA 300.0 C (Q) 06/09/07 06110/07 JDS 796 500 ug/L EP200.8 D 06/05/07 06/07/07 TK ND 5.00 ug/L EP200.8 D (<50) 06/05/07 06/07/07 TK 4070 500 ug/L EP200.8 D (Q50000) 06105/07 06/07/07 TK 5580 200 ug/L EP200.8 D 06/05/07 06/07/07 TK ND 1.00 ug/L EP200.8 D (<100) 06/05/07 06/07/07 TK SCS ReEp 1072505001 Client Name Garness Engineering Group, Ltd. Project Name/a Sequoia Est Ll D2 Client Sample ID Sequoia Est LI 132 Matrix Drinking Water All Daic%rrimes are Alaska Standard Time Printed Date rime 06/13/2007 9:55 Collected Datell'ime 06/04/2007 11:30 Received Datelrime 06/04/2007 13:45 Technical Director Stephen C. Ede PN'SID 0 Allossahle Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date Init Private Individual Analysis Thallium ND 1.00 ug/L EP200.8 D (Q) 06/05/07 06/07/07 TK Sulfate 14.0 0.100 mg/L EPA 300.0 C (Q50) 06/09/07 06/10/07 3DS Zinc 487 5.00 ug/L EP200.8 D (<5000) 06/05/07 06/07/07 TK Total Dissolved Solids 180 10.0 mg/L S%120 2540C E (<500) 06/04/07 ACF Nickel ND 2.00 ug/L EP200.8 D (<100) 06/05/07 06/07/07 TK IICO3Alkalinity 93.3 10.0 mg/L SM20 2320B E 06/06/07 CLS CO3 Alkalinity ND 10.0 mg/L S%12023200 E 06/06/07 CLS 011 Alkalinity ND 10.0 mg/L SM20 2320B E 06/06/07 CLS Conductivity 285 1.00 umbos/cm SM20 251013 E 06/07/07 CLS pl l 7.80 0.100 pl I units SM20 4500-11 D E (6.5.8.5) 06104/07 CLS Alkalinity 93.3 10.0 mg/L SM20 23206 E 06/06/07 CLS Total Coliform 0 coVIOOmL SM20 9222B A (<I) 06/04/07 DLC MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Dlvlsian of Environmental Sendoes On -Site Services Section P.O. Box 196850 Anchorage, Alaska 995IM850 (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY: ' APPROVAL FOR A SINGLE FAMILLY DWELLING } Parcell.D.# 017-152-24 HAA# &,X0SB'1� 1. dEWERALINFORMATION'. Complete legal descriptlon sF6UoiA, FsTAT S- , Cor Location(site'address.or.direc(lons)'"'Jya' 'oAJ�6RC` F ANCHORAGE 'AK. 99516 ;'t' p 9071 522-5538 ' ,,.�:�':Property`owner '•Dayptione_1• • g ,;mew i'.n •"irunc.-e�irHORA, AK'oo5rit' Mi111ngadd ress Day. phone' • �. Lending agericy- ., Meiling address Agent' BONNIE MFHNFR w/ PRUDFNTtAI JACK..WHITE Day phone ,(90711),76 —3189 AddraSs t 3201 "C' 'STR ET 'ANCHORAGE AK 99503 -- Unless otherwlse requested, HAA w11lbe held fqr jitckup.': ' 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: ` "Individual well XXX "'Communitj%yeli' ' Public water NOTE: If community well system, provide written confirmation from State ADFC aKest= Ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xxx - Holding Tank. Community on-site Public sewer NOTE: If communitywastewatersystem, provide wrfften confirmation from State ADFC . Ing to the legality and status of system.. 72-025 (Rev. 1/01) Front MOA 021 Computer Version Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1060.00 at, or prior to, closing for fhe eng/needng seMces provided. S. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigatlon 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 hereinA further verify tha#Iction,'the n the Information obtained from the Municipality of Anchorage riles and from my investigation aon-site water supply and/or wastewater disposal system is in compliance with all Mud State codes, ordinances, and regulations In effect on the date of this inspection. Name of Firm Phone /9071 V 6T 9 Engineer's Signature f✓! l .J Date - 3 In conducting this evatuaf/on, AtNWC, l C. tf pied to provfde a thorough, oonsciehdous englh rfng analysis of the system In accordance wltti ADEC and CA 1 !HS Guidelines & Regu/atlons;;The reported results described the performance of the system under.the condlilons encountered at the time ofthe test, and separa lion distances measured to'readltytdenttllable feetures: The operatlonarlife of all wells and sepoo systems depend on the local solls condrtlon, ground waterleveis thatmay fluctuate during the year, and the water usage of the:famll , being served by the systom. These condldons are outside the control of the evaluator of the system. Satlsfactory test results do not g&ersntee future jierformanoo c of the system, nor do theyguarantee that there are no hidden defects cr encroachments... . S; AMVC, Inc.'can therefore notprovfdo ani.iverranty for fulure'sillmato of how long the system will continue to moot the operational requirements of theADEC or MOA DHHS.. *,;, , ,,,, ,,,, The content o! this report Is for the sole benefit of the ownerllsted above. Any' . reilance upon or use of this report by any other person or party Is not authorized, ......... nor will It center any legal nghtwhatsoever. OQ f y A cor ass, 6. DHHS SIGNATURE �1 Q f •., E-795 ; _x Approved for bedrooms pooil """' • .. �DOp�Do on ,� Disapproved Conditional approval for bedrooms, with the following stipulations: Additional Comments 5EE 191mckIE0 EAI. 1AIPns rPNAeFAvT5 Dato II 14 --DO The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues Heall1i Authority Approval Certificates based only upon the representations given In paragraph 6 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 ceitaln federal end state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is Issued. The Municipality of Anchorage to not responsible for errors or omissions in the professional engineer's work. n-025 (Rev.1191) Back MOA 021 Computar Venlon Municipality of Anchorage R E. C E I V ED . DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services DivisionN(�V 14 2000 825 V Street, Rm 502 Anchorage, Alaska 99501 (907) 343-47V MUNICIPALi ry OF ANCHORAGE Health Authority Approval ChecklisgN\nR%MENTALSERVICES DMSION Legal Description: SEQUOIA ESTATES; LOT 1, BLOCK 2 Parcell.D.: 017-152-24- A. WELL DATA *WELL HAS POSITIVE DRAINAG AWAY FROM CASING Well Type PRIVATE If A. B, or C, attach ADEC letter. ADEC water system number N/A Log present (YIN) YES Date completed 6/22/86. DEEPENED 6/9/98 Total depth 380' Cased to 242' Casing height (above ground) Sanitary seal (YM) YES Wires property protected (YIN) YES FROM WELL LOG Date of test 6/22/86 Static water level 209' Well production 11 g.p.m. WATER SAMPLE RESULTS: AT INSPECTION 10/24/2000 212' 9.2 g.p.m. Coliform 0 Nitrate 2.27 m9/L Other bacteria 0 Date of sample: 1111012000 Collected by: A.W.W.C., INC. B. SEPTiC/HOLDING TANK DATA Date installed 7/86 Tank size 1250 Number of Compartments_ 2 Cleanouts (YM) YES Foundation cleanout (YIN) YES Depression (YIN) NO High water alarm (YRV) N/A Date of Pumping 10/25/2000 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA *BELOW ORIGINAL GRADE +*SEPTIC INSTALLED IN 1986 AND NEVER USED. Date Installed 7/86 Sod rating (g.p.dJft2 orft3lbdrm 193 System type BED Length :50' Width 24' Gravel thickness below pipe 0.5' Total depth •4.5 Effective absorption area 1200 SO FT Monitoring Tube present (YIN) YES Depression over field (YM) NO Date of adequacy test N/A Results (Pass/Fall) For Fluid depth in absorption field before test (in.); Imm ysR r gal. water added On.): Fluid depth ('ins) Mi trtes k Absorption rete = P�nxkl past 12 months) &/N) If yes, give date 12-M (Roy. JABr Canpubr Venlon D. LIFT STATION Data installed Manhole/Access (Y/N) 'Pump on' Iev High water alar level at• •Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOTTO: In gallons 'Pump off' level at* _ Septiclholding tank on lot 100'+ On adjacent lots 100,+ T Absorption field on lot 100'+On adjacent lots 100'+ Public sewer main NSA Public sewer manholelcloonout N/A _ Sewer/septic service tine 25'+ Litt station N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+Property line 5'+ Absorptlon field _ 5'+ Water maln/service line 101+ Surface water/dralnege 100'+ Wells on adjacent lots 100'+ ` SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 100+ Water maln/service line 10'+' Surface water 100'+ Driveway. parking/vehicle storage area 101+ Curtain drain NONE KNOWN Wells on adjacent tots F. ENGINEER'S 1 cortify (hat 1 of Mun/clpal n with MOA HA, Enginoer's HAA Fee Date of Payment .0 field Inspections and review systems are In conformance on this date. Waiver Fee $ Date of Payment Receipt Number �D`+' a'� �J / Receipt Number 72-029 (Roy. 3196r ComputerVerslon .....4. W. R. L.....I....... ................. A. Garneasr —7953 0 F1 ALASKA WATER & WASTEWATER 'r..- ej CONSULTANTS. INC. I_- :.•-rtmntr �crca w:as� November 14, 2000 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: HAA for Sequoia Estates Subdivision, Lot 1, Block 2 To whom it may concern: RECEIVED NOV 14 2000 MUNICIPALITY OFANCHORAGE ENVIRONMENTAL SERVICES DIVISION Attached is the HAA package for the subject property. The following items should be noted: D The well casing extends approximately 8 inches above grade. There is excellent drainage around the well casing. ➢ The well was originally drilled on 2/22/86 and deepened on 6/9/98. Both logs are attached. ➢ The septic system was installed in July of 1986 but was never used because there was not A. structure built on the property for occupancy until November of 2000. ➢ The septic system inspection report, approved by the MOA on 7/7/86, shows the septic tank south of the bed. Our (AWWC, Inc.) site visit found the septic tank to be located on the north side of the bed. See the attached as -built survey. All of the sepdc pipes were found. If you have any questions, please contact us at 337-6179. Thank you for your assistance. M.S. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Websitc: akwwc.com I I-I3-UU IC:41 f•KWI.It MVIKuml "IAL JYHJVI I Jw I..II v. 1 wv ME Environmental Services Inc. Laboratory Division 200 W. Porter Drive Anchorage, AK 99518 Tel: (907) 682-2343 Fax (907) 561-5301 CTSE Ref. #: 1007140001 Client Name: AK Water & Wastewater Cons. Project Name: n/a Client Sample ID: Sequoia Est SIP L1 52 Matrix Drinking Water PWSID Ilia Remarks: Client PO#. rde Paned Datelrime: 11/13100 16:25 Collected Datemme: 11/10/00 11:22 Received Datelfime: 11/10/00 14:15 Technical Director. Stophen Ede Released 6y: Allowable Prep Analysis Parameter Results PDL Units Method Limits Date Date Init Total Coliform (MF) 0 o011100 ml SM9222D 11110100 JDT Nitrate 2.27 0.5 mplL EPA 300 10.0 11110100 SCL 11-13-111) 10.36 re�ic en•6RvmmnrnL ALME Environmental Services Inc. Laboratory Division vininia�n�a►iii�►i��►�ii�►�i��ii��iiii rinking Water Analysis Report for Total Coliform Bacteria REM 1NS7RUCTI0NSONREVEM SMZJIEFOJW COLLECTINGSAMPLE o PUBLIC WATER SYSTEMI.D.M C3 PRIVATBWATER SYSTEM IN p . Send tnwke )tri ..-- � • w• a •� r �' s'� O Send Results 20o W. Potter Drive Anchorage, AK 99519-1605 An ysis shows this Water SAMPLE to be: Satisfactory G Unsatisfactory O Sample over 30 hours old, results may be unreliable p Sample too lona in transit: sample should not be oy4 toure old at examination to indicate reliable ieidlts. Please send new sample via ,pedaldelr 1 t int. !)'� Dap Reeelved Time Received i D Analysis Bepa t/7 2sV AnalytieaifMci6odi " Y'Membrane Filter ...-- CI MMO-MUG' I. e . cs/100 ml. 0 - Raulta SAMPLE DATE: O Month Day Year SAMPLE TYPE: C3 Routine O Repeat Sample (for routine sample with lab ref, no. ) cl Special Purpose SAMPLE LOCATION 1007 1 r -t O Treated Wates IR Untreated Water T,me Collected Collected By f kw rn31 rest to AD.E.C. Analyst Dale: Time: Client notified of uaeatisfactory raultto ?balled spoke with Fated Dur Time: BACTERIOLOGICAL WATER ANALYSIS RECORD MMO•MUG RU1,117 Totei Collfortn �t1 & Cett MembraneFaterr. DlredCeaal , / % Coloaleslleoml verification: LTB DGS COLIFORM 010 .0offs"NM Fecal Coliform Confirmation ENVIRONMENTAL FACILITIES IN ALASKA. CAUFORnMk, rwmvti n+ —"' •^^ ^^ ^ - - Aneh Fbk1 Jun ❑ Fazed Dale: Time: Client notified of uaeatisfactory raultto ?balled spoke with Fated Dur Time: BACTERIOLOGICAL WATER ANALYSIS RECORD MMO•MUG RU1,117 Totei Collfortn �t1 & Cett MembraneFaterr. DlredCeaal , / % Coloaleslleoml verification: LTB DGS COLIFORM 010 .0offs"NM Fecal Coliform Confirmation ENVIRONMENTAL FACILITIES IN ALASKA. CAUFORnMk, rwmvti n+ —"' •^^ ^^ ^ - - f " �N'`0 o 0 a °imp'/ .1sra4smo Nr. zot..r• VA Vva•F4,kalat14 fiats. N' P � 4 • oKttiri., eyrny Ce.,re..e oxs,o'er Ce 0 LO'r I 31,6L91.T• a t'•P•m.,toc,3• I p �t PL, soS.a I g z , ti H^ •". J, ,,. 60.00 x n Peu»r e pytllTl•>vs qQ WYt.I� J - [��.IS►:.l�G l lT1.l:E-- i is WIA61-1, \rnm-. toP ®t -Ls ---P Ltfr�s.ty •1 ` to 4•S Q1ioPo8tso IaWJ. Sttf Petst_Rtt.buufrL PLOT PLAN AS BUILT SCALE i •:!'o GRID 'M'') Project No. ��•I'L �yatt m�ii 1731 George Bell Circle tt;r. 115 qV �•ay. Anchorage, Alaska 99515 (&9,-077) 3445W*405--X6.4776 er 1 Hereby sanity that 1 bsve surveyed the rollowing described prop""' � �.T Y.t � Lot_(_, Blocb?- '-`LTi ne"� C Fs -`T p, Z. �, -15�r C_ Mtaiv2aav, Rccordiag District, Alaska. and that the improvsmcuts sttuued .V- h. . _ thereon are withia the property Maes and do not encroach onto the property V�:;�'�-� sdjsccot thereto, that no immu proveanon the property lying &distant thereto p •• , • t encroach on the surveyed ramices and that there are no roadways, transmission •�••• ••y ••.:..-o lines or otber visible eaaamnnta on said property exonpt as indicated hereon.p,N� ,��CC�,11 4 Dated With* So- Day of___"�.19Z%, at Aaeborags, Alaska /i ; ., �.520Q �`ir Ar 1t Is the responsibility of the owner to determine the existence of gay e•semsota, 1, ••••.•••re••• �1 covenants, or restriatlons wbieh de get appear an the recorded subdivision plat. MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES M} i 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. # HAA# LAQ9�LU(31 1. GENERAL INFORMATION Complete legal description S,e =9 r Location (site address or directions) Property owner cnn Day phone Mailing address ( (� \"l � Eia) 1 tit Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: y 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site I Holding tank Community ori -site Public sewer NOTE: if community wastewater system, prowe written conamativn rfvm state 6oec attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 021 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 furtherverify 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 Khj (e0�taky Phone Address 4S( Engineer's signature `'`'/ // Date_ 6. DHHS SIGNATURE By: Approved for bedrooms. Disapproved. Conditional approval for Additional Comments ; +G1r A4,1 a�p q A►... Oq A l�,. Robert E. Kniefe J� Itis •. No. 4149-E 4t PROFESSO bedrooms, with the following stipulations: 11ITlr 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 (Fiev. 1/91) Back MOA #21 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION Municipality of Anchorage 7 1991 Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST OEIVED ��I�ia3 l � ? 1i�7-/52 - 29 ---Oo(D Legal Description: � Parcel LD. A. WELL DATA Well type V rfi lla lk, If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N)_ Total depth 22- Sanitary seal (Y/N) Date of test Static water level Well flow Pump level _ Date completed �` � Driller A 412 i yLe 611; LY) a Z� II Cased to Casing height FROM WELL LOG 7 Z ? C+ SEPARATION DISTANCES FROM WELL TO: Wires properly protected (Y/N) N AT INSPECTION A_Z8_ !J I g.p.m. g.p.m. Ncs 7�IwD Septic/holding tank on lot �� ; On adjacent lots mi t �- Absorption field on lot On adjacent lots - A Public sewer main too) Av" Public sewer manhole/cleanout Sewer service line N 16- Petroleum tank N N V �° WATER SAMPLE RESULTS: Coliform 0 Nitrate Other bacteria Date of sample: L✓ �7t Collected by: B. SEPTIC/HOLDING TANK DATA U Date installed u I �� Tank size rlI I Compartments Cleanouts (Y/N) ' Foundation cleanout (Y/N)f "�T Depression (Y/N) High water alarm (Y/N)/n 44 Alarm tested (Y/N) N Date of pumping Ilk Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: I (' � / & 7 Foundation VLA Wel I(s) on lot On adjacent lots To property line 3Absorption fielo �� I watermain/service line fJ A Surface water/drainageN& 72-026 (Rev. list) Front CONTINUED ON BACK PAGE C. LIFT STATION l� r Date installed Y J _ Manufacturer Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y. Manhole/,Ae6e-ss (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on D. ABSORPTION FIELD DATA On adjacent lots "Pump off" level at Cycles tested Surface water Date installed 6~ r Cf (,9 Soil rating 9� System type `9'e e-3/ � ) fl Length —� Width � __Gravel thickness 0°5.- Total depth �� 0 C l,. Total absorption area 7a, — Cleanouts present (Y/N) Depression over field (Y/N) Date of adequacy test Results (pass/fail) r fc a a for Peroxide treatment (past 12 months) (Y/N) I" MA t'• If yes, give date V11 A - SEPARATION DISTANCE FROM ABSORPTION FIELD TO: t Well on lot I I I r�On adjacent lots 13 5 Property line ayl To building foundation N �� To existing or abandoned system on lot On adjacent lots Cutbank _ 14hWater main/service line / �� .. Surface water j`� Driveway, parking/vehicle storage area / l / I t r Curtain drain L) / A E. ENGINEER'S CERTIFICATION bedrooms f certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature _��/ _ ra f' Engin Date �d� f�/ °� o - Robert E. Kniefel��e' T. -' 1 ®® No. 4149. E �w Q 00 �.<, .�r ®®p0FEi51US1� HAA Fee $ — ��< _ Waiver Fee: $ Date of Payment �� % Date of Payment Receipt Number Receipt Number 72-026 (Rev. 3/91) Back MOA 21 NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-3116 • FAX 456-3125 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 (907) 277-8378 • FAX 274-9645 Kniefel Engineering 8441 Miles Court Anchorage AK 99504 Attn: Robert Kniefel Our Lab #: A113563 Location/Project: - Your Sample ID: 67411 Prism Sample Matrix: Water Comments: Method Parameter Units ------------------------------------------------- EPA 300.0 Nitrate -N mg/l Reported By: William E. Buchan Anchorage Operations Manager Report Date: 09/06/91 Date Arrived: 08/29/91 Date Sampled: 08/28/91 Time Sampled:00 Collected By: DAJ Flag Definitions U = Below Detection Limit DL Stated in Result B = Below Regulatory Min. H = Above Regulatory Max. E = Below Detection Limit Estimated Value Date Result Flag Analyzed ------------------------- 0.5 U 09/04/91 f ' 1 1 i 1 1 I f I i i