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Home My WebLink AboutMOUNTAIN PARK ESTATES BLK 5 LT 1 f- ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION , ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAILING ADDRE~ LEGAL DESGRIPTI~N -- ~ ~ ~ ]Well .. --f ~sorpt~n are~ Dwelling P ER M IT~/d -- Matori~?q~ 'No. of compa~nts ~¢ ~Liq'7%~ll°ns IF HOMEMADE: Insidelength Width -- Liquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons ~ Well PERMIT DISTANCE TO: /~0 /'~ Found~tion~¢/ Nearest lot l in~ / lines~ Lengt of ea h I~ e '~~ lengt~¢s Trenc~h Distance betw~ ~.~ No. of ~ ~¢ Total inches ~ Top of tMe to finish grade ~ ~ Materia, beneath t~l~ ~¢ inches T°tal~fectiv:~TM, Length Width Depth PERMIT NO. ~ ~ Tvpe of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ¢ DISTANCE TO: Class Depth Driller Distance to lot line PERM~ ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER SOIL ~ST REMARKS Box 1369, ..~TAR ROUTE A ANCHORAGE~ ALASKA 9950~ 3a~-7714 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF DRILLED At THE RATE OF ~20o00 Per FOOT. [1'~o [/Le.~e ~ee,.t,e,,z. 34513742. PROPERTY OWNER LOC^TION Of WELL S:T~, ~- / ~z~. ~ s~. ~,~, DRILLER 2..91 7ee_.L. WELL LOG: 0 ..... 16~ 16 .... 92---154' 154--212' 212--2.90' 290--291' DEPT. OF HEALTH & ENVIRONMENTAL t ;!OTECTION bii~'f 2 0 198! Vi!l) i~aZe~t p~odttoLd, on. i~:a. te~. q~'.e. Ld .oh. ou..IZ .Ozot. eo~e t~.OtA woe off LO'eLL. fleet oM'- bo.e2-o~ /.o,z .f.u,L,t Co.o~c o[ ;)~M.X.6.0W.: 291 fie,eX:. X ,~20.00 pe.,z. ~St_: 5~5520.00 &e..U. Seoi.: ' ,:/2o. oo COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF THANK YOU VERY MUCH. BERNIE~LA4J. SOF RAMPART DRILLING WORKS --,<' . ~ERVI~E CHARGEOF I~% Per MONTH WILL ~E A~SESSED ON PAST DUEACCOUNT~. ~584 o. oo FEF. Hll NO. DEPRF.'.TMENT ur HERL_TH RND EN'v'IRONMENTRL .... £ TEET 10[.4 ,- , - ....... , ..... ,..'r4 ,~ ~: o.-,,.'.; '"L'" =,TREE. Y, RNL. HUF. H.~E, RFC 26,4 - 47 ;2 O t...g r-J __, Z "T E %:¢ E l..,.~ E 't546E FFL] _.t'.N r [1EF..LE K. E, EETEF.. SRR L.OCRT I ON DERR. HON,.."R I DGE'v' I EI.,.I LEGRL LOT i BLK 5 MT. F'K. EST. SUB LOT :, I ..'.E · ' '%¢ ' ' ' ¢"'q" ' IS TF..EN..H T'¢PE OF SOIL I-E,=.F.F'fION -,~...FEH : , r" ['IRXIMUM NUMBER OF E, EDF..UOH .... z, E IL RFITING ,::SQ FT. E,R. ~.. ~ ,- .... _ _ ,-, ,,~ , ,- · THE R. EQ_~RED :,~E OF THE ';FiZL RBSORF'TZON :re_TEll ~:, THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIEL. D. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BET[4EEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE E',:..','CRVRTION (IN FEET.".,. THERE IS [.40 SET 14IDTH FOR TRENCHES. THE: GRRVEL DEF'TH IS THE HIF,IIf'IUM DEPTH OF GRR',,,'EL BETNEEN THE OLrT'FRLL PIF'E RND THE BOTTOM OF THE EXCR'v'RTION (IN FEET). F'E:Rr'I I 'T RPF'L ! CRNT HR5 THE F.:E2;F'ON.?, [ E: I L I T'¢ T .3 I NFOF.:~ TH Z .'-q PEF'RP;:T~IEF,IT DUF;: :[ NO THE: INSTFILLRI'ION IN_,FEL. TIUN_, FiF RN'T' b. IELLS RDJ'RCENT Tr"~ THIS F'ROF'ERT"r' RND THE NUMBER OF RESIDENCES THRT THE klELL klZl_L SER',,,'E. . - .-- .r:.-. --. -, .... l'-II.,-JC) .:- 2 ... ::[ IR-J: t- E _.. T · LiiR-.I:=. RF:E F:E,2-:.,IJ ~ '- "- - ' '- ' ' .... '"' "'~' ~ E:RCKFILL. ING OF RN"r' z,~z, TEM I.,.IITHOUT FINRL IN.:,FEL. TILN RND HFFF. L,HL. THIS [:,EPFIRTMENT klILL E:E -,LIE,..fE.,T TO PR"r=E'I TION. MINIMUH DISTRNCE BETNEEN R NELL RND RN¥ ON-SITE SENRGE E:,ZSPOSRL SYSTEM IS :~OO FEET FOR R F'RIVRTE bIELL OR :1.50 TO 200 FEET FROM R PUBLIC NELL DEPEND'rNG LIPON TFIE T'-r'F'E OF PUBLIC F4EL. L I"IINIMUM DISTRNCE FROH R PRIVRTE 1.4ELL TO R PRIVRTE SEL4ER LINE Ih"; 25 FEET RND TO R COMMUNITY S.,ENER LINE IS 75 FEET. 14ELL LOGS RRE REE..'UIRED RNr:, HI.JST BE RETURNED TO THE DEF'RRTMENT 14ITHIN 2:0 DFI'¢S OF THE NELL COMPLETION O'rHER REQLIIREMENTS [,1R¥ RPF'L"r'. SPECIFICRTIONS RND CONSTRUCTION DIRGRRHS RRE.r. R',,,'RIL. RBL. E TO INSURE PROPER INSTRLLRTION I CERT I F"~" THRT J..: I RM FRMILIRR I.,.IITH THE REQUIREMENTS FOR ON-SITE SEI.4ERS RND L4ELL..S FIS SET FORTH B"r' ]'HE HtJNICIPRLIT¥ OF' RNCHORRGE. 2: I NILL INSTRLL ]"HE S"r'STEM IN RCCORDRNCE 1.4ITH THE CODE"-';. .7.'.::: I UNDERSTRND THRT THE ON-SITE SEklER S'¢~,TEM HR'¢ REQUIRE ENLRRGEMEN'T' IF' THE RESI[:,ENCE ZS REMODELED TO INCLUDE HOR. E THRN 4 BEDROOMS. RPPL. ICRNT HERLE K. BEETER El SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 ..... 16 17 18 19 20 COMMENTS [] PERCOLATION TEST SLOPE SITE PLAN ! / WAS GROUNDWATER ,~.~A ~~"'' S ENCOUNTERED? ~ V'"I~ L 0 P E IF YES, AT WHAT DEPTH? '-~' '"~ ~ ~ ..... ) Gross Net Depth to Net ~)~'~ ,~ Reeding Dete Time Time Water Drop ~ ? - . PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND ~ FT CERTIFIED BY:.. TE: 72-008 (6/79) December 29, 1978 ~780337 Larry Smith Star Route A Box 64E Anchorage, Alaska 99507 Subject: Lot 1 Block 5 Mountain Park Estates Subdivision A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If there are any further questions, please contact this office at 264-4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental Specialist I~S/ljw enc: copy of permit PERMIT NO, IBIF'r~LITY Or ANcHI3RA~E MIjN DEPARTMENT HEALTH AND ENVIRONMENTAL 3TECTION 025 ~L' STREET, ANCHORAGE, AK. 2~4-47~0 WEI_L 8N[) ON--SITE SEWER PERMIT 780~7 ) RI F L I &ANT I..,..,~. ~TIUN LEGAL LnRRY SMIT, ?ERRMO RIDGEVI[W ~. ~ B~MT PARK E~TATE~ SAR BOX G4E 99507 LOT SIZE 40100 SQUARE FEET TYPE OF SOIL 8BSORBTION .~=.TEM IS: TRENCH M~XlMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR)= 1~5 THE REQLIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEF'TI-t= ~_~Z LENGTI,~= 46 BRR'~'EL DEPTI.-t= G THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH I5 THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). REQUI RE[:~ SEPT I C TFtr~l<] S I ZE: ~I-250 GFILLOP~IS PERMIT APPLICANT HMS TIlE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING TI.IE INSTALLATION INSPECTIONS OF ANY WELLS RDJRCEHT TO THIS PROPERTY AND THE NUMBER OF' RESIDENCES THAT THE WELL WILL SERVE. TWO ( 2 ) I t~ISPECT I Or~lS f~IRE RE~'~LI I RED BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY TI'tIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELt. AND ANY ON"'SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE WELL~ OR 150 TO ~00 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAY5 OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I T EXP I RES ['~ECEMBER ~..~-,~, l, , TltRT 1: IRM FAMILIAR WITH THE REQUIREMENTS FOR ON*'SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND TI'IRT THE ON-SITE SEWER S~TEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. ttAIa¥ PLAYI~ VEN CONSULTING GEOLOGIST I3OX 476-M, STAR ROUTE A . ANCHORAGE, ALASKA 99507 · PFIONE 344-7071 SOILS LOG Performed for ~-~L~ ~> ~V/t~ Date ~o~on ~+-iI . Soil Type Water Level Remarks 0 ..¢ .~o -~ 12 ~ 14 16 18 2O 1'2--'~f G 'S ,.,0 Total Depth of Excavation Groundwater ~ot Reached Depth, if Reached Classification Method ~Visual ( ) Sieve Analysis () Material at Total Depth Bedrock ~ot Reached Depth, if Reached Gary F.~r, Const~ting Geologist MUNICIPALITY OF ANCHORAGE ~' ' DEPARTMENT OF HEALTH & HUMAN SERVICES ,-:.' Division of Environmental Services ,, On-Site Services Section P.O. Box 196650 Anchorage. Alaska 99519-6650" 343-4744 ' '~" ' Parcel LD. # 4,' 1. - GENERAL INFORMATION Corn piete legal description CERTIFICATE OF HEALTH AUTHORITY · - APPROVAL FOR A SINGLE FAMILY DWELLING.~ Location (site. adi:lress or directions) · -~, '~j~ ,., ?-. ...... .; Property owne,r_~, address ,, . %;(. Lending agency;'~? ',:Mailing address. Day phone Day phone '"'- -Address ?'' "Q,~'~--" ~ ' . i~ be held forpickup.,~, :. ;,~,.~ 2.,,,~ BEDROOMS ....... ? ~ ' ........ : .-. , -: :--:-.-:?:~.::.~::,~, ;?:,::~,. Individual wel ;: . ' NOTE: If communi~ well system, provide walden confirmation from State ADEC a~est- -' . lng to the legali~ and status of system. 4, ~PE OF WASTEWATER DISPOSAL: · . Communl~ on-s~te ..... ' ":": ''~. NOTE: If communi~ wastewater system, provide wri~en confirmatioh' from State .- ~ affesting to the legali~ and status of system. ' .~':,": ::'.."~ ~ e STATEMENT OF INSPECTION~BY ENGINEER AS certified by my seal affixed hereto and asof 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 thenumber 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 inves_t~ation 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 ~ ~ e,~v; <.~-$ .Phone Address ~4--~ I (g~o,?~ ~ z3.ac_H - /~-, ~ ~:~-0 DHHS SIGNATURE X Approved~for.~. ~ "~ '.~/bedrooms~ Conditional approval'lor'~' "-''?'::~ .......... bedrooms, with the following stipulations: ......: "' Additional Co ,- 'f-'l'llPll ': '. The M~Jn Cfpal ~ of,~nchorage Department of Health and Human Se~mss (DHH$) ~ssues Health Authori~t , '*, Approval [Certifi,q~,[e~?b~sed only upon the representations given in paragraph 5 above by an independent '., '~r6fessionilen~ ~ ste~ in the State of A ~ka The DHHS does this a~ a courtesy to purchasem of homes and, th~i~ 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 (R~,1/91) Back MOA~21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST L.o'r' Legal Description: Parcel I.D. o1'-7- oG/- Z l Log present (Y/N) Total depth '~ I Sanitary seal (Y/N) , A. Well Data Well type ~'-~T'F~ If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~/zs/Bl Driller Cased to ~_71J Casing height Wires properly protected (Y/N) FROM WELL LOG Date of test .~ /Z ~ /~ J Static water le~?el Well flow / Pump level1 ~,~ -+ SEPARATION DISTAN'CES FROM WELL TO: Septic/holding tank on lot Absorption field On lot g.p,m. AT INSPECTION MAY 2 3 1995 Mu,'¢o.p~llty of Anchorage Depl. Health & Human ServiGe~s g.p.m. ~ Z.~8 r-i ; On adjacent lots .; On adjacent lots / Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform Date of sample: ,~'/~-/ Public sewer manhole/cleanout Petroleum tank Nitrate I. O n,,~/~ Other bacteria Collected by: ~-¢£ B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) High water alarm Date of pumping Tank size t~.~'O ~ Compartments Foundation cleanout (Y/N) ~E~ ~ Depression (Y/N) /'J//~ Alarm tested (Y/N) rJ ,_,~-/,.~/,~, ~c- Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot t IO/ To property line ~7.~ Surface water/drainage On adjacent lots Absorption field Foundation z~ I ! Water main/service line '> /0 72-026(3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date ~nstalled "--..... Size in gallons Manufacturer ........ '--.,. Man~(Y/N) "Pum~'-on!l.llevel at "Pump off" Level at High water alarm level ~. Cycles tested Vent (Y/N) Meets MOA electrical codes (Y~LN~ _ SEPAR~ROM LIFT STATION TO: ~ lot On adjacent lots D. ABSORPTION FIELD DATA Date installed Length Total absorption area Date of adequacy test Soil rating (GPD/Ft2) Width ~ Gravel thickness [oO (~ rTz Cleanout present (Y/N) ~-'///8/~/5'-~ . Results (pass/fail) / Water level in absorption field before test System type Total depth Depression over field (Y/N) for ~- Bedrooms Peroxide treatment (past 12 months) (Y/N) ~,~;r A~ r'ZF_~o~T- After test /'J [/~ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water ~J/A- On adjacent lots N ~ ~ oo Property line To existing or abandoned system on lot Cutbank t,,t/,~ Water main/service line Driveway, parking/vehicle storage area ~rO Waiver Fee $ Date of Payment Receipt Number HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back Curtain drain ~I~A E. ENGINEER'S CERTIFICATION I ce~i~ that I have checked, verified, or~onfor~e~ to ali MOA and H~ gu/Nelines/N eE~ ~ the date of this inspection. - , Engineer's Nam[ ~~ Date G ZO ff~ Alaska Water & WaStewater Services "Preserving The Last Frontier" RECEIVED May 20, 1995 MAY 3 199,5 Municipality ol Anchorage Dept. Health & Human Services Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section P.O. 8ox 196650 Anchorage, Alaska 99519-6650 Ref: HAA, Lot 1, Bk 5, Mountain Park Estates S/D To whom it may concern: The subject property is served by an private well and septic system. An analysis of each system is summarized as follows: GENERAL: I made an initial site visit on 4/27/95 to take a water sample and make a visual inspection of the septic system. The house had been unoccupied for a week or two at that time, per Christi Brazelle (RE/MAX Realty). Upon inspecting the sump I noted that it was surcharged to within several feet of the ground surface. I could also bear water running in both the septic tank and the foundation clean- out, leading me to believe that there was a fixture on in the house. Further investigation (4/29/95) by a maintenance contractor found a toilet to be running continuously. /he problem was corrected, and the system was allowed to recover until 5/3/95. On 5/3/95, prior to starting the adequacy test I attempted to measure the liquid level in the sump and found there to be an obstruction about 5'-6" below grade (The drainpipe is buried about 7 feet deep, and the reck extends 8 feet below that. Total depth is approximately 15 feet.) /he 'tank was pumped on 5/5/95, and the pumper tried to clean out the sump but was unsuccessful (only minimal liquid was removed from the sump). A contractor (Monte Acheson) was then retained to fix the sump. Mr. Acheson was able to remove about 7 feet of soil from the sump, so that it now extends 5'-5" below the invert of the drainpipe, and fix a separated joint in the pipe. The sump does not extend to the bottom of the drainrock ~' below the pipe invert). According to Mr. Acheson any effort to excavate deeper would have compromised the integrity of the trench. Ne also commented that the drainrock :in the upper part of the trench appeared to be Telephone: (907) 337-6179 · Fax: (907) 338-3246 · 8471 Brookridge Drive · Anchorage, Alaska 99504 clean (uncontaminated by sewage). Tile sump was converted to a monitoring tube, and a clean-out was installed on the end of the perforated pipe. INITIAL ADEQUACY TEST: The first adequacy test was done on 5/10/95, eleven days after the leaking toilet was fixed. In short, the trench had 11 days to recover. Upon inspection I found the monitoring tube to be dry. I introduced water into the trench clean-out, at an average rate of 3.15 gpm, for' a total of 238 minutes (750 gallons). It took an introduction of 204 gallons before there was standing water in the monitoring tube. /he liquid level then rose 11~75" (4615 gal/inch). Ihe liquid was monitored 22 hours later and found to have dropped only 4.75", an absorption of 221 gallons. Since the drainrock was only filled to a depth of 38.75 inches, arrd it has a total depth of 96 inches, I opted to try another test after filling it to a greater depth. CEQO_ HE ADE____QUAC__~Y_ TES__T (5/17/95_l~ The monitoring tube was dry upon inspection. Starting at 4:15 PM on 5/17/95, water was introduced into the clean-out at a rate of 2.22 gpm for a total of 870 minutes (193~ gallons). At 6:45 AM on 5/18/95 the liquid level in the monitoring tube was 25.125 inches deep (58.125 inches above the bottom of the drainrock). Starting a 6:45 AM, 5/18/95, I continued to introduce water into the clean-out at a rate of 2.14 gpm for an additional 425 minutes (908 gallons), during which time the liquid level rose another 12.875 inches (908 gallons/12.875 inches = 70.5 gallons/inch). I stopped introducing water at that time. At 6:45 ~M on 5/19/95 the liquid level in the monitoring tube was found to have dropped 9.25 inches, cerresponding to an absorption of 652 gallons. There was still an additional 25 inches of draimrock above the highest liquid level attained during this test. In short, I could bare filled it more and achieved a higher absorption rate. Based upon this data the septic system was deemed to be adequate for a 4 bedroom house (600 9pd). SEPTIC TANK: The septic tank (Greet) is over 14 years old and is probably reaching the end of its useful life. It was no__~t exposed and inspected for structural integrity. The buyer should anticipate replacing it within the next 5 years WELL: The well was tested on 5/10/95, concurrently with the septic system. The static level was 25~ feet~ Water was pumped at a rate of 3~15 gpm for a total of 258 minutes (750 gallons)~ The water level dropped to a depth of 267 feet and then stabilized. In short, the well was recovering as fast as the water was being pumped out (5.15 gpm)~ Twenty- four hours later the well had recovered 100%. Based upon this data the ~ell was deemed to be adequate for a 4 bedroom house (600 GPD). If you have any question, please call me a S37-6179. Sincerely, NOTE: The adequacy of a septic system is influenced by numerous factors, including, but not limited to, seasonal surface water infiltration, groundwater- variations, sept;Jo of b~ological additives), condition of dra~n pipe and pipe joints (which can be damaged by seismic activity and deteriorate w~ th age), type of substances depos~ ted ~u septic system (cigarette butts, sanitary napkins, m~sc objects), and the amount of water being ~ntroduced on a continual bas~$. Consequently, the results of th~s adequacy test are only valid ¢*or the spec.if~c day of the test. Keycorpl.wps zTL CT&E Ref.# Matrix Client Sample ID CT&E Environmental Services Inc. Laboratory Division 95 . 1626-1 Laboratory Analysis Report L1 BLK5 MOUNTAIN PARK EST HOSE BIB Client Name AK WATER & WASTEWATER SERVICES WORK Order 14257 Ordered By JEFF GARNESS Printed Date 05/02/95 @ 13:20 hrs. Project Name Project# Collected Date 04/27/95 @ 20:35 hrs. Received Date 04/28/95 @ 15:55 hrs. PWSID UA Sample Remarks: SAMPLE COLLECTED BY: GARNES$. Technical Director STEPHEN C. EDE Released By QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date Init Nitrate-N 1.00 m~/L EPA 353.2 10. 05/01/95 CMR * See Special Instructions D~bove ** See Sample Remarks Above UA = Unavailable NA = Not Analyzed ~ = Undetected, Reported value is the practical q~antification lilnit. LT = Less Than ~ = Secondary dilution. GT = Greater Than 200 W. Potter Drive, Anchorage, AK 99518-1605 -- Tel: (907) 562-2343 Fax: (907) 561 -5301 N 8~," I.~ 'E- 1~2 I AI~I"IOLIN ~URI_~: POR'S CERTIFICA~O_N HERES~ ,qTIFY THAT I HAV~ SURVEYED THE PFFOPERT~ , ~S~HIBED ON THIS PkAT AND THE IMPROVEMENT8 ~IYUATED THEREON ANt LOCATED A9 ENOWN ON THIS PLAY, LEGEND 0 LOT CORNERS FOUNDATION DRAINAGE ARROWS NOTES ~ I, IT GHALL BE THE REgPONEIBILITY OF THE GUt~.DI~R OR O~N~R TO BUILDING LOOATIOR IHOWN MEEI'D ALL IUBDIVItIO~ COV~NA~TI ORDtNANC~a. I. IT I~ TH~ R~PON~IBILITY Of THE BUILOI~ TO VERIFY ALL ELKVATIONI R~SPE~T TO A~L UTILITIEi, S, THI~ PLAT REPRE~ENTa THE PAFl~EL OF PROP~RT~ D(IORIIED IELOI PROM TH~ RE00RO[~ PLAT OE~RIBtNg THAT ~AR~EL, IN~TRUUENTI PRIOR TO OR AFTER THE fILING OF THE REeORD~O PLAT AR~ NOT 4. THE INFORMATION ON THI8 P~AT lB FOR TH! Ual OP LENatNa aPEOIFIOALLy TO ~HOw ANY ~ON~LICT8 B~TWE~N EXIBTI~G ~TRUCTURE~ PLATTED LOT LIN~B OR EAaEMENT~ ) THE PLAT 18 NOT TO AS- I~LItLT LOT I ? /~LOCR ~ MOUNTAIN PA~F-, · ESTATE5 .... BE$~:, EPPS"& POTT$ 2220 E. 88th. AVE, $49.6452 ANCHORAGE t ALASKA 99507 DRAWN EY, OLL ~cAc~, F'~fiOF ~-o DAYE~ . - I rkO.~K.t ~: B~, ,., , ....... ~.. j~ ~. 5Ul~r2 NO, TOTRL P.01 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date __/~f,,~.~4 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location. (_address.or directLons) , / (b) Applicant Name~;,'Eoj¢[-'-£' /~- .3u///.&-/~' Telephone: Home Business _ _ Applicant Address /.~.~fc// ,/~Z2¢Z,~ Institution [] ' wne builder ' Buyer []; Other [] (explain); (c) Applicant is (check one): Lending ~__~__.w~n'~ (d) Lending Institution Address /-~/¢/~ __~' (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the tollowl, ng address: TYPE OF RESIDENCE Single-Family [~ Multi-Family [] Other Number of Bedrooms .... ~/z ......... WATER SUPPLY Individual Wetl,J~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE ~.I. SPOSAL Onsite J~ Public D Community [] Holding Tank [] 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 72-025 (11!84) 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, l 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 regulations in effect on the date of this inspection. ~ Name of Firm / z::~-,/:: ) ~_' /:_~_)Tg Telephone ,"~<:'/¢; '- L: w/¢.~'Li DH P APPROV 'I Approved for ¢_~_~(_~edrooms_~b_y _ Approved --~:~L_ Dis~b~ Terms of Conditional Approval Conditional CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 {11/84) WELL DATA MUNICIPALITY OF ANCHORAGE (MO~,j HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION Legal Des~ Well Classification Well Log Present (Y/N) Total Depth ~(~ Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot Water Sample Collected by Water Sample Test Results If A, B, C, D.E.C. Approved (Y/N) Date Completed ~'//'~1//g/' Cased to ,~/ Depth of Grouting (~3. ~ ~ Pump Set At ,~ ,~,f,,~ ~ Sanitary Seal on Casing (Y/N) Y' ~' Depression Around Wellhead (Y/N) To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole B. SEPTIC/HOLDING TANK DATA ; On Adjoining Lots /OO'/'-- On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date 8 Date Installed Standpipes (Y/N) "( Air-tight Caps (Y/N) Depression over Tank (Y/N) ~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~/z/./~ Separation Distances from Septic/Holding Tank: TO Water-Supply Well /OO -I' ~ Size l?.--s'"'O ~ No. of Compartments 2 ~ 't' Foundation Cleanout (Y/N) Date Last Pumped '~/~-5"//~'~f' /~ ~/.~.,"~' ;for "'"'- Temporary Holding Tank Permit (Y/N) To Building Foundation / To Property Line To Water Main/Service Line Course Comments To Disposal Field To Stream, Pond, Lake, or Major Drainage Page I of 2 72-026(11/84) BESSE, E' PS & POTTS August 30, 1985 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALiH & ENVIRONMENTAL PROIECltON RECEIVED Department of Health and Environmental Protection 825 "L" Street Anchorage, ~K 99501 Attn: John Kennedy Re: Lot 1, Block 5 Mountain Park Estates Depar~nent of Health and Environmental Protection Approval (Schlegel) Dear John, The slight 1' depression over the leach trench (noted in the inspection report dated 8/27/85) has been filled in. Please release approval to client and call if you questions. Sincerely, Engineer RPW/lbs ENGINEERING, PLANNING, SURVEYING 2220 E. 88th Ave. / Anchorage, Alaska 99507 / Telephone 907-349-6451 / 344-1352 "ProvidinCl a qua#tv oersonalized service to those buildincl Alaska's future" DA1 E-RECEIVED TIME TIME TIME DATE DatE . ' NSPECTOR~L..~ ~,~, ~'IUI'qlC. IHALI I y MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH · ENVIRONMENTAL PROTECT~IRONMENTAL PROfECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION JUL 1 1981 Telephone 264-4720 R E C E ! V E D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed, Please allow ten (10) days for processing. 1. PROPERTY OWNER~~~--~ I PHONE MAILING PROPERTY NT (If different from a~ove) PHONE 2, BUYER PHONE 3. LENDING INSTITUTI~ (~ ~ PHOM~ 4. REALTOR/AGENT~,~ MAILING ADDRESS2 ~ C.:,B ~, ~ / 5. LEGAL DESCRIPTION STREET LOCATION / 6. TYPE OF RESIDENCE ~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One j~ Four [] Two I-- Five [] Three [] Six [] Other 7. WATER SUPPLY .~ INDIVIDUAL~ [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give wel depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM ]~ INDIVIDUAL/ON-SITE*' PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 {Rev. 6/79) ] I