The URL can be used to link to this page

Home My WebLink AboutROSHA LT 10BRosha Lot 1 OB #051-281-78 Municipality of Anchorage Page 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: .o~ k~c~r.'t. 0 ~ PID Number: ~ ~ ~ ~&~ - ~ N,,.~: ~o~ ~Y/~ Wastewater Syslem: ~ New ~Upgrade Address: ~(~ ~'~/~¢~ .~.~,/~_~o~ .~/4 ~'~S'~--~ v~ ABSORPTION FIELD Pbone: 0'] Gfl6 ~ ? ~fl U Deep Trench E] Shallow Trenoh ABed EJMound UOther Total DepU~ from original grade: bEGAt. DESCRIPTION s°""~'i"~: ~ ,5 ¢,./s,.~,. 1' - _ t or: '~O ~ Block: Subdiv~ion: Deplh lo pipe bottom from original grade: Gravel depth beneath pipe ........] ownship: Range: ~ectlon: Fill added above original~grade:~ FL Gravel length: WELL: El New ~ Upgrade Gravel width: ~ Ft, Number ollines:~I ~1~ ~ i~la~?li Ft.Disla~ce elweenline*: ClassiScation {Privale, A,B,C): Tolal Depth: Cased To: %oral absorption area: Pipe material: Driller: Dale Drilled; Static Water i.eveh Installer: Date installed: GPM Ft. Ft. TAN K SEPARATION DISTANCES ~Septlc ~ Holding E] S.T,E P, To Septic Absor¢lon big Holding )ubllc/Pdva~eManufaclumr: Capacity in gallons: LIFT STATION Remarks: ¢'o,~ ¢~co~,,T~¢~ O~,~,~o- BENCH MARK Location and Description: , 'FN n /, Inspections performed -Dates' 1st ~gle River~ A asl(a 993~ -- ' ,,,~m'w''~''''~''~¢ ............. Departmenl of Health and Human Services approval fiT-.:-".., . . y~ ' . ]; ',? Reviewed and approved b ~, ~ Date: ]-/~-bo ;,...~ 72-013 (Rev. 9/91) MOA 25 PEnMIT NO SW990346 PAGE 2 OF 3 ~unicip, aLi-t oP ~EPARYHBNV OF HEALTHAN~ ~AN SERVICES ENVJRONH~NYAL SERVOCES BWOSOON P.B, Box 196650 eAmchomage, A[ask~ 995]9-6650~Te~ephone: 343-4744 OB:SITE WASTBWATB~ ~SPOSAL SYSTEH AND/OR WBLL ONSPECYJON REPORT LEGAL LOT lOB, ROSHA S/D P.I.P. ~o. 051-281-78 PERMIT NO SW990346 PAGE 3 OF 3 Hunicip, o, ti~ of' Anchor'aGe DEPARTHENT OF HEA~.TH SERVI ANB B~AN CES ENVIRONMENTAL SERVICES DiViSiON P,O, Box 196650 ~hnchopage, ~aska 99519-6650~Telephone: 343-4744 ON-S~TE WASTEWATEa DOSPOSAL 5YSTEH AN~/OR WELL ~NSPECT~ON REPORT I,EGAL LOT lOB, ROSHA S/D P.I.D. NO. 051--281--78 MT1 CO2 CO3 MT2 F1NAL .~_.~ GRADE INSULATION · WATER FOUND ?3,9' 69.4' B.O.H, A B C :'CO 3.0' 25,5' - ST1 50.5' 56.9' - ST2 59.5' 64.0' -- DBL1 63.0' 67.5' - DBL2 64.0' 68.5' -- DV 65.0' 69.5' _ 301 47.~0_' 53.5' - MT1 90.5' - 115.5' 302 83.0' - 105.0' MT2 100.0' 115.5 - 303 100.5' 118.5 - 304 94.5' 97.0' .- 305 188.0 195.2 - 93.7' ST1 ST2 FINAL -ONSULATOON NEW 1250 GAL SEPTIC TANK MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Sep 22, 1999 Expiration Date: Sep 21,2000 Permit Number: SW990346 Legal Description: ROSHA LT 10B Design Engineer: 0003 S & S Engineering Owner Name: Bob Shaw Owner Address: 18012 HILLCREST DRIVE EAGLE RIVER , AK 99577-9317 Parcel ID: 051-281-78 Site Address: 018012 HILLCREST DR Lot Size: 45830 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic'rank ~ 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 ( 18AACS0 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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. Soils at bottom of bed are to be verified for consistency during installation. SEWER & WATER MAJN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST 801LTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ROBERT C. COWAN, P.E. August 25, 1999 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Se~wices P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 10B, Rosha S/D Reqnest yoll issne a permit to install a septic system to serve the existing four bedroom dwelling on tile referenced property. Two test holes were excavated and percolation tests perforated. The approximate location of the test holes is located on the attached site plan. At the time of excavation, 8-23-99, water was found between 10' and 11'. After seven days of ground water monitoring, water was found at 10'. We do not anticipate ally adverse effects on neighboring wells, septic syslems, reserve areas or drainage patterns by the installation of the proposed septic system. Tile construction of tbis system will not prevent any fi~ture development on any of tile adjacent properties. If yon require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/bjj Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 1" = 60' DESIGN SITE-PLAN I c I /~ ~ N. T.S. DESIGN DETAIL o o~ /~ Municipalily ol Anchorage ~ 825 "L" Stree~ Anchorage, Alaska 99502-0650 ~,,,,~ ~..- ~. SOILS LO(~ -- PERCOLATION TEST 6 7- 8- 9- 10. 11 13- 14- 15- 16- 17 18 19- 20- WAS GROUND WATER GSND°'NT "ED?. IF YES, AT WHAT DEPTH? / / ,s I0-// ~o E Depth Io Waler ADer ~0 ~onilorlng? Dale: Reading Date Gross Net Depth to Net Time Time Water Drop ~.~.- ~o ~ ~u,./ ,¢" I.~4" .~ 0 ~o~ ~ ~/~ ~o ~ ~ ~ ~ s/~" /_ PERCOLATION RATE '~'4 _ (m,nutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN [ ~' FTAND~ '" FT COMMENTS S & S ENGINEERING WITIEiI~t~"~.4~,~IIXL GUIDELINES IN EFFECT ON THIS DATE. DATE: DEPARTMENT OF HEALTH & HUMAN SERVICES ~ ~z 825 "L" Street, Anchorage, Alaska 99502-0650 ~.~-,~~,,,, ~, ......... ~ .... ~ .... PERFORMED FOR: DATE PERFORMED: ~,".~,~//~¢, LEGAL DESC.,PTIO.: ~T 10 ~; ~ Townsh,p. Range. Sect,on: ~N/~ /- ~L~ SIT~ PLAN I- 7 8 9 10 11 12 13 14 15 16 17 18- 19- 20- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT /~//.~ SL DEPTH? pO E Deplh lo Waler A(ter Monilorino? .__ Cae: Fleading Date Gross Net Depth to Net Time Time Water Drop .- ~ / ?~" ._ PERCOLATION RATE ~'~o~_ (mlnuteslmch) PERC HOLE DIAMETER TEST RUN BETWEEN ,~ -- FT AND ~- FT COMMENTS ACCORDANCE WITFE~IB~V~E~A~JD~I~01N~I~,~II_ GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) IN ROBERTC. COWAN, RE. ROBERTA, SHAFER, EE. WELL INSPECTION & FLOWTEST ROAD DESIGN SOIL lEST PERCOLATION TEST ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEErlS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 1 OB, Rosha Subdivision August 25, 1999 GENERAL: The scope of this project includes the verification of a 1250 gallon septic tm~ and installation of an absmption bed to serve the existing four bedroom residence located on the referenced property, f~ ~/Jct~ce s ~ r,c ro,~z< IF- ~,v 7- ~ 6.,z~ >'y I.~ /ad o ,~. , Construction shall be in accordance with the approved site plan and design drawings, Municipal permit or ADEC Authority to Construct with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department or ADEC if required, for system installations. Owners installing their own systems must also receive prior approval fi'om the Mnnicipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Page 2 Lot lOB, Rosha S/D August2~ 1999 All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts. These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The ilrst cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away fi'om the septic tank. LEACHFIELD BED INSTALLATION: Excavate the proposed Bed Area to the depth shown on the design. The bottom of the excavation shall be within 2 inches of level. If the bottom of the excavation becomes smeared, it must be raked or scratched (ruffed-up) before gravel or sand placement. Ifa sand layer is required, place sand over entire excavation to the required depth shown on the design. The top of the sand layer nmst be within 2 inches of level. Sewer rock shall be placed uniformly throughout the entire bed. Perforated distribution pipe must be installed level with perforations down. Gravel depth below the perforated pipe shall be a minimum of six (6) inches. Gravel depth above the perforated pipe shall be a minimum of two (2) inches. The total gravel depth throughout the entire bed shall be a minimum o f twelve (12) inches. The perforated distribution pipes must be no mom than six feet apart. The distance between the oute~xnost perforated distribution pipes and the sidewall of the absorption bed must be no more than three feet. Silt barrier material must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tabes shall be of four (4) inch diameter, installed at the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending tba'ough the gravel depth shall be perforated six (6) inches below the bottom of the horizontal distribution Inies. The monitoring tube should not extend below the bottom of the gravel surface. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finished grade over the bed must be mounded to prevent the formation of a depression after settling. Page 3 Lot ~0~, Rosha $/D August2$, 1~99 8. A mound system is to have the upper six inches of top soil and be seeded for vegetation. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed fol' installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved fol' use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast It-on Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use ora type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between thc final leachfield gravel layer and the native soil backfill. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current MOA or ADEC requirements. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 825 L Street- Anchorage, Alaska >9'~? l'~[ephone 264-4720 ON-SITE SEWAGE DISPOSAl. SYSTEM A~/OR WELL INSPECTION REPORT ~ DISTANCE TO:_ I wo,, / ¢;.~ ' I Ab,orption ,,~, ,_ OwolIing SC/ PERMIT ~.~ ¢¢ ¢¢__ }- ~ Manufacturer~ ¢~ ~ Materialj No, of compartments Liq. capacity in gallons ~ Inside length Width Liquid depth ~ / E,¢O IF HOMEMADE: ' ~ Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons O Well ' Foundation//¢0 ' Nearest Jot line ~. / PERMIT NO~ Length of each line Total len th of Ii es Trench width Distance between lines N°' °f lines / /()Z~ / ~GP ~ inches ~ p Top of tile to finish grade, Material beneath tile Total effective absorption areax~ Length Width Depth PERMIT NO. < ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line m DISTANCE TO: j Class Depth Driller Distance to Jot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING / -- iNSTALLER ' 72-013 (Rev. 3/78) ~MI ILJi Ih,41 ]C ti: I: F" ,~-~. IL_ ::E 'T' ~'¢ IL':]~ F= ,f=N ~'~11 II:,'.:: IF-*~ IE'.]I IF=~:: ~ IEE,$ DEPARTMENT OF HEAL.TH AND EINIVIROI~IMIENTAL F'ROTE[C'T'ION E]25 L STREEI', ANCI'~ORAGE!, Al< 995011. 264.-.4720 I- t=~NM 11 NO: DATE .... .[ S,:~UE'.D 840685 OB / 10184 AF'I::'L. I CANT." BI'ONES EXI_ CONTA['.'T' PI~ONE: 688-2915 , , , ..... ,, - . , , _.IE'.GAL DE.E,[ RI:. p~iBD]:vI.~I[~,, R(':iDI~AW , , LOT: 10B BL.[K]I.:::: NA ' /8E~T[ONI:~.) TOWNSHIF: 15N RANGE: 2W I..OT SIZE: /1..d[~ (~D.F]'. OR AE;RES) - ' · system, Ch(:~a~= '~:.he (:)~'Li~i'l {hat. b~)s'L f~'Ls yl~l.lr' DEF~"I'I"I 'TmO PIPE: BOT't"OI~ (F:T.) 4,, 0 4,, () 4. () GRAVEL DEPTH (F:"I".) 5,, 0 0., 5 3,, 5 TOTAL DEPTFI (FI".) 9,, 0 4,, 5 7,, 5 GRAVIEI.,.. WIDTI-I (I=T.) 2.5 20,, 0 5.0 E;RAVEL LENGTH (FT.) 50,, 0 38.0 54,, () GRAVEL VOL,UHE (CU.YDS.) 25.4. 28, 1 40.0 TANK S I ZE (GALS) t, 250,, 0 a..~ 1~ 250,, 0 '~"~' . 1 ~ 250,, 0 '~"~ SOIl_ RATING (SQ.FT,,/BR) :L25 125 125 '~.~ TANK Muff'r HAVE AT LE:AST TWO C[IMFARIMEN]o ]: Cel"L:i,i'y t.l"~at: 1.,, I am fam:i. ].iai- 4. with 'Lhe r'equJ, r'emelntS for' on-site. ~ew~:~Ps and w6~l].~ as set [or"M'~ by 'Lhe Municipality of Ant:homage (MOA) and the State o~ Alasl.::a. I will :h~s'La].l the system in acccmdan, ce wi'Ua all MOA codes and r'egulations, and in compliance with the design cpitecia o~ this pePmJ, t. I will adhere t.c~ all MOA and State mi Alaska Pequipements [o~ the set back distances f'r'c~m any existing wm:[].~, ~astewa'hep disposal sys'Lem op public sc>wepage system on this op al'ly adjacent or nepal"by lint. ~ t.u]depstand 'Lha'L this i]er, mi'L is valid for a maxi. mum of 4. bedrooms and ~l'ly E.FJlaPgE~IE~rTI:, N~.].]. r'l~qLlil'B af'l additional. IF:' A L. IFT STATION IS INST~LI..ED IN AN ARE:A COVERED BY MOA BUIL. DING CODES, THE:Iq (1) AN E2..ECTIR]'.CAI... F'ERMIT AND ]:NEiPECI'I[IN MUST BE OBTAINEI); (2) AS'-'BiJIL.TS Will NOT BE AF'F:'I~OVED WI'THOLIT AN EI_,.EC"FRICAI.. INSF'ECTION, RIEF:'OI::tT; AND (3) TI'ilE IELIECTI:::]:CAL WORI'::: PILlS'l" BE: DE)NE BY A LICENEJED EL. ECTIRICIAN,, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AN[) ENVIRONMENTAL PROTECTION 825 L. Stroot, Anchora0e, Alaska 99501 264-4720 SOILS LOG .- PERCOLATION TEST SOILS LOG PERCOLATION TEST 8 10 11 SLOPE SITE PLAN 16 17 19 20 COMMENTS WAS GROUND WATER ,F YES, AT WHAT Gross Net Depth to Net Readin9 Date Time Time Wator Drop __2 . ~ ~ ~-~ 2a ~ _~'~.,1~ _~L~ ,, ~ ; 19 /o joZ PERCOLATION RATE ~ ~..7 (minutes/inch) TEST RUN BETWEEN ~'~ FT AND .~-~ FT PERFORMED BY: 72-008 (6/79) SOILS LOG MUNICIPAI.ITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION 'rEST PERFORMED FOR: LEGALDESCRIPT,ON: ~/' 1 3 ~S'LdP E 6 9 PERCOLATION TEST 10 11 12 13 14 ,-~. . 15 16 17 18 19 2O COMMENTS PERFORMED BY: ; ...... ~DP JO?~ ....... tPH, 694-2979 72-008 (6/79) WAS GROUND WATER /~V/i~) S ENCOUNTERED? , L O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Dato Time Time Water Drop PERCOLATION RATE ~//~' (minutes/inch) TEST RUN BETWEEN FT AND ---- FT DATE: MUNICIPALITY OF ANCHORAGE DIVISION OF ENViRONMiENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIROnmENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal D~esc~r~iption (incl~ude lotz, block, subdivision, section, township, range) Location (address or directions) (b) APplicants Name~%~- Applicants Address (c) Applicant is (check one) Lending Institution ~ ; Owner/builder ~ ; Other Buyer ~--~ ; ' '~ -' (d) Lending Institution ~/25~o~ po~c~'f-/~l~c~o~. Telephone Address C~ ~_~F- (e) Real Estate Co. & Agent ----- Address (f) Telephone Mail the HA~ to the following address: 2. T__ype of Residence Single-Family~ Multi-Famil~--~ Other (describe) Number of Bedrooms ~ 3. Water Suppl~_ Individual Well ~ Community k ! Public ~__~ Note: If community well system, must have written confirmation from the State Department of Enviropm~ental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite ~--~ Public ~ Community l i Holding Tank l [ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information 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 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 regula- tions in effect on the date of this inspection, tvfz¢,pT Name of Firm ~j A ~' ~,~ i'~.~(~,~ Telephon~_/~ Date ~ ~ 7 ~ Approved., ~ Disapproved __ Conditional Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOI~LY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY ~N INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF .A_LASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES ~ND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP bO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ~CHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 Am ~LL DATA Well Classification MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHO}LITY APPROVAL (~[AA) CHECKf.IST - FEBRUARY 1984 Legal Description: Well Log P~esent (_Y/N) y Total Dept~. /~(~ ' Static Water Level .~-/ / Casing' Height Above Ground Cased to Electazical Wiring in Conduit _(Y/N) y Sepa~ation Distances f~om Well: To Septic/Holding Tank on Lot /~,~i To Nearest Edge of Abso~lption Fielld on Lot If A, B, c~ C, D.E.C. App=oved_(Y/N) Date Completed_ 6' _E~z/_. Yield /~0 / Depth of G~outing ~,//~ Pump ~t At ~/~ Sanit~y ~al on Casing (Y~) ~p~ession ~ound ~l~ead (Y~) ; On Adjoining Lots__ /OD "7c / ¢ ;~" ; On Adjoining Lots /'~6~ ' J- To Nearest Publio Sewe~ Line _ /V.//~ TO Nearest Public Sewer Cleanout/Manhole... /DO~-/- To Nearest Sewer Service Line on Lot Water Sample Collected By ~a~)~ /., 7-),~,¢.t"-e. _; Date ~-~ $~/ Wate~ Sample Test P~sults ,~;¢,~Jrf¢~o~)/ Comments SEPTIC/HOLDING TANK DATA Date Installed ~-~D '-~>,~ ~ Size_ /~5~ No. of Compartments ~ Standpipes (Y/N) y Ai~-tight Caps (Y/N) ~ Foundation Cleanout .(Y/N) ~ Depression Over Tank (Y/N) .~ Date Last Pumped _~/V~V3~e~ ~-~r/ Pumping/Maintenance Contract on File (Y/N)~/~ ; fo~ Holding Tank High'Water Ala~T~ (Y/N) A///$ . Tempo=a=y Holding Tank Permit .(Y/N) ~//4 Sega~ation Distances f~om Septic/Holding Tank: . , To Water-Supply 9~all TO P~operty Line To Water Main/Servioe Line Corpse I00 '¢'- To Building F~ndatioq To Disposal Field ~ To' Stream, Pond, Lake, o~ Major. D~ainage Cor~nents [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field *305'~r,~;~ Al/6:, Type of System Design ~e~ Length of Field /~/ /o~l~l ~ ~,,~ Depth of Field /~ Gravel Bed Thickness ~ ~z Square Feet of Absorption A~ea ..//~ ~ ~ Standpipes P~esent (Y/N) ~p~ession ove~ Field (Y~) ~o ~e of ~st A~a~ Test Results of ~st ~a~ ~st ~/~ ~ Separation Distan~ f~ ~s~ption Field: To ~te~-Supply ~11 /~ ~ ' To ~o~ty Li~ ~ ' To Building Foun~tion /~ ~ To Existing or ~ndo~d System Lot 3~ '~ ' ; ~ ~joining ~ts ~O T6 Wate~ Main/~vi~ Line /~D/-~ To ~t~(if pre~nt) ~/j To St~e~ond~ke/~ ~jo~ ~aina~ C~se To ~iveway, Pa~ki~ ~ea, o~ Vehicle St~a~ ~ea. /~/~ LIFT STATION Date I~stalled ~./~ Size in Gallons "Pump On" .Level at High Water Alarm Level at Tested fo~ Electrical Codes(Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. M~ets MOA Co~ents ** Check Permitted Bed~oc~ Rating Against HAA Request ** I certify that I have checked, verified, c~ ~onfc~med to all MOA H~A~,~_ ~._~_~s in effect on /f ]the ~te of this i~i~. ' ~[~.~ Sl'~ed/~ ~ /~+ Date KB1/d5/s 2~15-84 /~2, 32 LOT ~? I/VH T~,~ 5 LOT A~-BU/L T su£VEY : dAMES B. RODGE~S R~gistered L and Surveyor SRA Box I~1~ G ~nchorage~ Alasha 9~507 ~-z~-~l = ~.~. ~-4 /ot I and