HomeMy WebLinkAboutMOUNTAIN PARK ESTATES BLK 11 LT 8
Municipality of Anchorage Page I of
DEPARTME:NT 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: ,~'b~'c)7'OOqy PIDNumber: OI~Y g // /
~am~: Wastewater System: D New ~ Upgrade
Address: t~gff ~l~,~a D~t~t ABSORPTION FIELD
Phone~ ~) No. of Bedrooms:
~ ~. ~ ~ ~ Deep Trench ~ Shallow Trench ~aed.~Mound DOther
Soil Rating: Total Depth from original grade:
LEGAL DESCRIPTION ~, ~ ~s~. ~. ~,~
Lot: Block: Subdiv~ion: Depth to pipe bottom from original grads: G ravel depth beneath pipe
Township: Range: ] Sect;on: Fill added above original grade: Gravel length:
Number of lines: 0istancebe~eenlines:'
WELL: E~JT Q New Q Upgrade Gravelwidth: ~ Ft, 8 I' J/ Ft~
Classification (Private, A,B,C): ~ u Total Depth; Ft, Cased To: Ft. Total absorption/~ ~ ~are~; SQ. Ft. Pipe~.~o~ymaterial:
Driller: Date Drilled: - ~tic Water Level: Installer: ~ Date installed:
Yield: GPM,~ Pump Set at: Ft. ~ Casing Height Above Ground:Ft, TAN K
SEPARATION DISTANCES s Septic D Holding ~ S.T.E.P.
To Septic Absorption Lift Holding ~ublic/Prlvate Manufacturer: CapAcity in gallons:
From Tank Field 81ation Tank Sewer Lines ~ ~ ~ ~ / ~
~ ~l' ~ ~ ~ ~ l/ Material: ~¢~ / Number of Compartments:
s'u,~ LIFT STATION
Water ~ t~ ~t~ -- ·
Lot Il o¢~, ~'~ch Size in gallons: Manufacturer:
Line ~ ~o' ~ ~e~/ - -
"Pump on" level at: "Pump off" level at: High water alarm at:
Foundation ~ ~ [O~ ~ - ' -
Gu ~ain ~ Pump Make & Model Electrical Inspections pedormed by:
Drain ~, ,. ....
Remarks: ~~f /~r~/led ~e~ ~/~ BENCH MARK
Location ~nd Description:
I Assumed Elevation:
EN61NEE~'S 8E~L
'~_,,.,~ .~.~,,~ ~;.~
Inspections pedormed by: ~/~ ~ ~c~. ~c. Dates: 1st ~ / ~ ~ / 9 7 ~,,,,,...,..,.,,,.,,.,,,,,~ ~ · '":' .....
Department of Health and Human Se~ices approval *~(;~,?~.
~:'kf~."~*~ ~ ~
Reviewed and approved by:.~,dk~J~.~.v¢"t~" Date:~uc/,['~ --~ ,~¢
PERMIT NO: SW970044
PID NO:01744111
DOME
HOUSE
PAGE 2 OF 3
L8, BLK. 11
MTN. PK. EST. #1
NEW SOIL
TRENCHES
DRIVE
'E,,F!~,,~.~ SEPTIC TANK
~ DOUBLE C.O
ORIGINAL SOIL
-- "~,,i. % "BULL RUN"
· 52' ~"~-' DIVERSION
"H" VALVE
/
/
/
/
/
/
/
SWING TIES:
FROM: "COR. "A"
TO:
C.O. "B" C.O. "C"
S,T. C,O. "E" 97.§' 58' 58'
S,T. C,O. "F" 95' 57.5' 63'
DBL. C.O. "G" 93' 57.5' 67'
VALVE "H" 82.5' 60,5' 97'
C.O. 'T' 70' 55.5' 109.5'
M.T. "J" 53' 39' 112'
C.O. "K" 34' 14' 115'
C.O. "L" 68' 63' 124'
M.T. "M" 47.5' 46.5' 126'
C.O. "N" 24.6' 28' 128'
L 8, BLK 11, MTN. PK. EST #I
SEPTIC SYSTEM UPGRADE
AS-BUILT PLAN VIEW
FLATTOP TECHNICAL SERVICES SCALE: 1" = 30'-0"
14530 ECHO STREET DRAWN BY TFM
ANCHORAGE, ALASKA 99516 dULY, 1997
PERMIT NO: SW970044
PAGE 3 OF 3
PID NO:01744111
1000 GALLON
SEPTIC TANK
INV.
83.4'
"BULL RUN" DIVERTER VALVE
ALLOWING FUTURE RECONNECTION
TO ORIGINAL TRENCH
NOTE: BECAUSE GROUNDWATER
WAS ENCOUNTERED AT 12' BGL
IN T.H. #2, TRENCH EXCAVATION
DEPTH WAS LIMITED TO 8' B.G.L.
ADDITIONAL FILL WAS PLACED
OVER TRENCHES TO IMPROVE
DRAINAGE AND FROST PROTECTION
FINAL GRADE
INV.
81.8'
ELEV. 76.8
T.H. #1
WATER @
ELEV. 64.2'
5/28/97
ORIG.
ND
ELEV. 84.6'
INV.
81.8'
ELEV. 76.8'
L 8, BLK 11, MTN. PK. EST#1
SEPTIC SYSTEM Ur'GRADE
AS-BUILT CROSS -SECTION
FLATTOP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, ALASKA 99516
NOT TO SCALE
DRAWN BY TFM
JULY, 1997
PAGE
1 OF
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 1.96650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASRA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PE~IT NUMBER:SW970044
DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES
OWNER NAME:CASSIDY MAURICE W & SANDRA K
OWNER ADDRESS:12515 ALPINE DR
ANCHORAGE, AK. 99516
DATE ISSUED: 3/28/97
EXPIRATION DATE: 3/28/98
PARCEL ID:01744111
LEGAL DESCRIPTION:
MOUNTAIN PARK ESTATES BLK i1 LT
LOT SIZE: 24800 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
THE ATTACHED APPROVED DESIGN.
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 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
DATE:
I[,44-z- ¢E¢'7t-[ 6iz -Tla~/uc~l .Cff¢~-
TECHNICAL:::
CWIL & ENVIRONMENTAL ENGINEERING · ENERGY CONSERVATION & ANALYS£$
TttEODORE F. MOORE, P.E. 14530 ECHO ST.
PH: (907) 345-1355 ANCHORAGE, ALASKA 99516
Jim Williams
M.O.A. DHHS
P.O. Box 19-6650
Anchorage, AK 99519
Dear Mr. Williams:
June 24, 1997
R[!CEIVED
dUN 2_4 199'/'
Municipality of Anchorage
Dept. Health & Human Services
Transmitted herewith is a soils log for a third test hole and a new site plan reflecting our design modification for the
proposed septic system upgrade to serve the 3 bedroom residence on Lot 8, Block 11, Mountain Park Estates Itl, located at
12515 Alpine Drive - Permit # SW970044. Please give me a call if you have any questions.
Sincerely,
Ted Moore, P.E.
LOT 1, VICKERY S/D
L7, BLK 11
INSTALL NEW 1000 GAL.
SEPTIC TANK
ABAN'DGN EXISTING
HOUSE 1000 GAL.' FtBERGLASS
SEPTIC TANK,,
EXISTING
WELL
SOIL ADS. --
~--'- %~_.~TRENCH
O%
L8, BLK.11
~_~MTN. PK. EST. #1
/ DOME'~
\HOUSE /
DRIVE
~LE C.O.
INSTALL "BULL RUN"
'ERSION VALVE
T.H.
HOUSE
WELL
SEPTIC
SYSTEM
100'
CONSTRUCT 2 PARALLEL 50'
: % S~IL ABS. TRENCHES /
. / T.H. ~,~ /WITH 5.0 GRAVEL BELOW PIPES/
BLOCK 10 ........ / ~RL°° .j ~
/~ / 2~ ~ [ %~ 2o 4o ~o oo
/'//. ¢¢;/49~ '~,¢~" ~ SEPTI~ SYSTEM UPG~DE
~// "--. ~,~¢, ......... '~,'~ ....... ~ SITE PLAN
/ ~ ~, %% CE-3589 .,~,~ J DRAWN BYTFM
/ J
FLATTOP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, ALASKA 99516
NOTE: THIS IS NOT A SURVFYED PLAT.
ALL LOCATIONS SHOWN .ARE APPROXIMATE.
[
TEST HOLE
LEGAL DESCRIPTION:
DATE PERFORMED:
PERFORMED FOR:
DEPTH
(feet)
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
Lot 8, Block 11, Mountain Park Estates #1
J~ ~ne 19~1997
~Maur~sidy
Pt. Peat
SM Reddish silty loam
GM/ML Gray silty gravel
Similar to ML below
but more gravel lenses
ML Gray gravelly silt
Dense, damp
Sidewalls smear
SLOPE
O%
;%
)%
SP/SM Black silty sand
B.H. Water seeps
~',~¥:,-' ,~ -...~,~'~,
THEODORE F, MOORE
'% CE- 3589
SITE PLAN
DOME ~
HOUSE
SEPTIC
TANK
T.H.
#2
Depth to Groundwater Date
--Water ~12' 6/197~7
RIVE
T.H./
#3
10%
3% ~
Clock Net Time Percometer Net Drop
Date Reading Time (minutes) Reading (inches)
6/19 12" Presoak 6 3/4
Add water & start 3:20 10 7/8
#1 3:50 30 11 9/16 _11/16
~,dd water 3:51 10 5/8
#2 4:21 30_ 1 ~ 3/8 3/4
Add water 4;22 10 7/8
_ J¢3 4:52 30 11 5/8 3/4
PERCOLATION RATE 44 (minutes/inch) PERC HOLE DIAMETER __
TEST RUN BETWEEN 6.5 Fi' AND 7.0 FT
COMMENTS: This test hole was dug to evaluate soil suitability for realigning the proposed trench to avoid shallow seasonal groundwater
encountered at test hole #2. Base redesign on 0.45 gpd/sq, ft. Required area is (3 x 150)/0,45 = 1000 sq. ft, Need 100 ft trench w. 5'
PERFORMED BY FLA'I-FOPTECHNICALSERVIOES. I ,~"._~ ~ CERTIFYTHATTHIS TESTWAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: O""/ 2-.. ,/ /~' ?
Rick Mystrom,
Mayor
of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
March 28, 1997
Ted Moore, P.E.
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99516
Subject: Waiver Request for Lot 8 Block 11 Mountain Park Estates #1
Waiver Request #WR970008 , PID #017-441-11
Dear Mr. Moore:
Your request for a waiver of the required 10 foot separation
between an on-site wastewater disposal system and a lot line has
been approved. The waived distance is 1 foot from the existing trench
to the west property lot line common with Lot 7.
This approval applies to the existing on-site wastewater disposal
system lot line separation only. Any future upgrade to the on-site
wastewater disposal system will require all separations be met or
another approval from this department.
If there any further questions or concerns regarding this waiver,
please call our office at 343-4744.
~i~incer ely, r~
James P. Williams
On-site Services
ljw #7
Cassidy
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR~ WR970008 PID~ 017-441-11 HA~ HA970089
Date Received: March 17, 1997
Legal Description: Lot 8 Block 11 Mountain Park Estates #1
Engineer:
Applicant:
Permit
Ted Moore, P.E.~ Flattop Technical Services
14530 Echo Street, Anchorage~ Alaska 99516
Maurice Cassidy
Waiver Requested: Lot Line waiver of 1 foot from the existing trench to the
west property line common with Lot 7
Criteria:
1. Geo].ogy:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
Special Conditions:
Points:
3. Other:
Waiver is Granted: C~-- Waiver is NOT Granted:
List Conditions or Reasons for above:
BY:N ,,,~' o~f RdT~evi ew~~'/9~'
Rec ~: 02684/5979 Amount: $ 115.00 Date Paid: March 17~ 1997
CIVIL & ENVIRONMENTAL ENGINEERING · ENERGY CONSERVATION & ANALYSL$
THEODORE F. MOORE, P.E.
PH: (907) 345-1355
March 13, 1997
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
M.O.A. DHHS
P.O. Box 19-6650
Anchorage, AK 99519
Dear Sirs:
The purpose of this letter is to provide the required design narrative in support of our application for
a permit to upgrade the wastewater disposal facilities on Lot 8, Block 11, Mountain Park Estates, Unit
itl, located at 12515 Alpine Drive. Based on a recent adequacy test, it was determined that the present
system is no longer able to absorb water at an adequate rate for a three bedroom residence. Soils logs,
perc test results, a site plan, design drawings and specifications are enclosed for your review.
In addition to the upgrade permit, we are requesting issuance ora lot line waiver allowing the existing
trench to be within 1 foot of the west lot line common with Lot 7, and the issuance of a conditional HAA
certificate allowing the present system to continue to be used pending completion of the proposed
upgrade by July 15, 1997.
The proposed system will be constructed between test holes ~1 and ~2. As can be seen fi'om the soil
log for test hole #1, the native material below 6 feet is predominantly a gravely silty sand with a measured
perc rate of 16 minutes per inch. Using a slightly conservative soil application rate of 0.45 gpd/sq, ft. to
allow for possible variations within the stratum, this 3 bedroom system requires (3 x 150)/0.45 = 1000
square feet of effective absorption area. The proposed 63 foot long trench design with 8 feet of effective
gravel depth has a total absorption area of 1008 square feet.
The topography of the lot in the area of the proposed construction can be best characterized as the
bottom of a broad swale which slopes down towards the west at approximately 3%. To the north of the
proposed construction area the topography slopes down into the swale at approximately 25%, and to the
south of the proposed construction area the land slopes down into the swale from the street at
approximately 20%.
The proposed project will have no significant impact on present or future water supply and
wastewater disposal systems serving adjacent properties, nor will it have any significant impact on
reserved space-surface and subsurface, or on drainage. Granting the requested lot line waiver allowing
the existing soil absorption trench to remain within 1 foot of the west lot line will have no impact on the
ability to construct future wastewater disposal systems on Lot 7, since the location of the well on Lot 7
precludes septic system construction in the affected portion of Lot 7, Please give me a call at 345-1355
if you have any questions on this submittal.
Sincerely,
Ted Moore, P.E.
LOT 1, VICKERY S/D
/ / ' ' L8, BLK. 11
R 100 L7, BLK 11 /
........... ~ / ~] ,' MTN. PK. EST. #1
~/ I SEPTIC TANK ',, ~ / ~- / /
-- -- -- --/ I ',/ % 25% / / INSTALL ';BULL RUN"
.m ~ -- ~RI. IN~ , /./ ~-~'7/ / DIVERSION VALVE/
WELL ~ EXISTING /;' '~o/_ ~ ~2
SOIL ABS
'~ T.~NCH
~ /./ ~'~ .... ~_NEW 63 3NC
~-'' ~ ~ ~ ~-SOI~AB TRENCH
/
LOT 3 / ~ ' ~ ~
.,oc~o /~ ~ ~ ~~
~ % ,~~ ........ ....~ ,~k M~30 ECHO STILT DRAWN BY TFM
',:~.¢..' ':.,... ,' ,-,., ,:; NOTE: THIS IS NOT A SURVEYED PLAT.
':'; '* : ' ' :' I ALL LOCATIONS SHOWN ARE APPROXIMATE.
~.~;,,,~,:. ;.~ 'r:
/ EXISTING
1000 GALLON FIBERGLASS
~_~=-~',,~z,~To Oc~iOiN,, SEPTIC 'FANE- RETAIN IF
~~ ,-.~/ STILL IN GOOD CONDITION
r~ INSTALL "BULL RUN" DIV. VALVE
CONSTRUCT NEW 63' LONG ~ INSTALL DBL. CLEANOUT ~--I "A"
I
SOIL ABSORPTION TRENCH -~
!
C.O.--
4" DIA. F-810
PERF. PIPE
PLAN VIEW
SCALE: 1" = t0' - 0"
MONITOR TUBE
CLEANOUT
MOUND BACKFILL 12"
~--ORIGINAL GROUND
FILTER FABRIC
-- 4" DIA. F-810 PERF PIPE
"- 2 1/2" SEWER GRAVEL
BOTTOM OF EXCAVATION
SECTION "A - A"
SCALE: 1" = 5' - 0"
L8, BLK. l l, MTN. PARK EST. #1
SEPTIC SYSTEM UPGRADE
PLAN AND CROSS.-SECTION
FLATTOP TECHNICAl. SERVICES
14530 ECHO STREET
ANCHORAGE, AK, 99516
SCALE: AS SHOWN
DRAWN BY: TFM
MARCH, 1997
Flattop Techaical Services
14530 Echo Street, Anchorage, AK 99516
Phone (907) 345-1355
Lot 8, Block 11, Mountain Park Estates, Unit #1
12515 Alpine Drive
Wastewater disposal system upgrade
Specifications
1.0 General:
1.1 The scope of the project consists of construction of a 63 foot long soil absorption trench
containing a total of 8.5 feet of sewer gravel. If after inspection the engineer determines that the existing
septic tank is no longer in good condition, it shall be replaced with a new 1000 gallon steel septic tank.
1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor
deviations from these drawings may be allowed or required by the engineer conducting the inspections.
All construction procedures and material specifications shall conform with Municipal and State
requirements. All separation distances shall be in conformance with Municipal requirements, unless
specifically waived.
1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around
any buried utilities.
1.4 The contractor shall provide adequate cover material and rough grading over all system
components to ensure that proper drainage is achieved after settlement and that there are no residual
depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas.
1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after
the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the
construction.
2.0 Septic Tank:
2.1 The existing 1000 gallon fiberglass septic tank may be retained in service, only if it's structural
integrity has been verified by the inspecting engineer, and if it has functional cleanout pipes with airtight
caps, allowing pumping access to each compartment. Any existing septic tank or seepage pit which is
not retained in service must be properly abandoned by thoroughly pumping, removing the top and
backfilling with soil.
2.2 If needed, a new 1000 gallon, 2 compartment Municipally approved septic tank shall be installed
and set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover
and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved
burial type, rigid insulation.
2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The
waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot, and the
waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot.
2.4 A "Bull Run" diversion valve shall be installed downstream of the septic tank allowing effluent
from the septic tank to be switched between the new and old soil absorption drainfields. A double
cleanout shall be installed within 5 feet downstream of the diversion valve.
3.0 Soil absorption system:
3.1 The soil absorption system shall be constructed by excavating a 63 foot long trench to a depth of
14 feet below original ground level in the vicinity of test hole #1.
3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked
to allow proper infiltration. Sand for leveling or serving as filter material shall comply with Municipal
specifications.
3.3 A total of 8.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with
the perforated distribution pipes laid level such that the pipe inverts are no less than 8.0 feet above the
bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing
the #200 sieve.
3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on
the design drawings. The portion of the monitor tube extending through the sewer gravel shall be
perforated.
3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum
of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet,
two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in
addition to the filter fabric.
3.6 The top surface of the cover material shall be raised a minimum of 12 inches higher than the
surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill
slopes shall be no steeper than 3:1.
3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have
the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and
seed to promote rapid revegetation of all areas disturbed by the construction.
4.0 Inspections:
4.1 A minimum of 4 engineering inspections will be required during the course of the project: (1)
initial stakeout with the contractor to establish the location of the system and to discuss the plans,
specifications and construction procedures, (2) after the native material has been excavated to expose the
infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test
information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected
up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and
grading is complete. The septic tank requires one inspection after it is set level and the piping connected,
but prior to backfill. This inspection may be incorporated with any of the above inspections.
4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in
advance to ensure the availability of the engineer.
TEST HOLE # ]
LEGAL DESCRIPTION:
DATEPERFORMED:
PERFORMED FOR:
FLA'rTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
Lot 8, Block 11, Moun~tain Par~k E~states #1
February 25, 1997
_Maurice Cassidy
DEPTH
(feet)
Pt.
SM Reddish silty loam
ML Gray gravelly silt
dense, damp
SP/ML Clean sand pockets
interspersed with ML
SM/ML Gravelly silty sand
Dense, hard digging
Damp in spots
Some cobbles
SLOPE
I0%
5%
Depth to Groundwater Date
No groundwater - ~
Monitor tube d_ry 3/5/97
;LO
SI'rE PLAN
DOME
HOUSE
SEPTIC
TANK
32 T.H.
36
57
lO%
3% ~
SP/SM Coarse, somewhat
silty sand - dry
Date Reading Clock Net Time Percometer Net Drop
Time (minutes) Reading (inches)
2/25 12" Presoak --
Start 2:50 23 1/4 --
#1 3:10 20 22 1 1/4
Add water 3:10:20 23 5/16 -
#2 3:30:20 20 22 1/16 1 1/4
Add water 3:30:40 23 1/2
#3 3:50:40 20 22 3/16 1 5/16 --
PERCOLATION RATE 16 (minutes/inch) PERC HOLE DIAMETER 6"
TEST RUN BETWEEN 8.5 FT AND 9.0 FT
COMMENTS: Because of soil texture variability within the stratum, recommend using soil application rate of 0.45 gpd/sq.ft, bet~veen the
depths of 6 and 15.5 feet below ground level.
PERFORMED BY FLATTOP TECHNICAL SERVICES. I ,~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ,..~ ~/ ~"~ / ¢~
TEST HOLE
LEGAL DESCRIPTION:
DATE PERFORMED:
PERFORMED FOR:
DEPTH
(feet)
14--
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
Lot 8, Block 11, Mountain Park Estates #1
Feb~ruary 25, 1997
Matzrice%;a~idy
Pt. Peat
SM Reddish silty loam
SM/ML Gravelly silty sand
Many large boulders
Hard digging
Coarser and dryer
than T.H. #1
SLOPE
I %
%
Depth to Groundwater | Date
~o groundwater ~72579%
Monitor tube dry 3/5/9~
¸LO
38
SITE PLAN
DOME ~
HOUSE
SEPTIC
TANK
32 T.H.
57
3% 10%
Reading
PERCOLATION RATE
TEST RUN BETWEEN
Clock
Time
Net Time
(minutes)
Percometer
Rending
Net Drop
(inches)
COMMENTS: The material below 4' is similar to that encountered in test hole #1.
(minutes/inch) PERC HOLE DIAMETER
FTAND FT
Use perc rate measured in test hole #1.
PERFORMED BY FLATTOP TECHNICAL SERVICES. I '~..~-- ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: '~ / ! ',L / ¢ ~
GREA ANCHORAGE AREA BOA,
~ ; Department of Environmental Quality
~: 3330 C Street
Anchorage, Alaska 99503
iNSP'~Tj~N ~'c)RT ON-SITE SEWAGE DISPOSAl. SYSTEM
SEPTIC TANK',
DISTANCE /~'~' .~
FROM WELL Z~- /00
INSIDE LENGTPI _
INSIDE WIDTH_
/. NUMBER OF
COMPARTMENTS
MATERIAL
LIQUID DEPTH _ LIQUID CAPACITY /~*°''-GALLONS'
TILE DRAIN FIELD:'~-~-/~-~-"~v 0( TOTAL LENGTH
_OF LINES-
DISTANCE FROM WELL FOUNDATION-- NEAREST LOT LINE . ('
ABSORPTION AREA-~[ 9-- SQ, FT, LENGTH OF EACH LINE -
~ DEPTH OF FILTER ? IN. ABOVE TILE ~*' IN.
DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATN TILE - ~ - --
WEL. L,~
TYPE C~'{'v~"~ ('-~' CONSTRUCTION _DEPT"
BUIt_DING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION----- LOT LINE ~ SEWER LINE TANK .... SYSTEM
CESSPOOL OTI4ER SOURCES
APPROVED . DISAPPROVED ~REMARKS
DISTANCE FROM:
DISTANCES: --
INSTALLED BY:
\
SEWER LINE DEPTH:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
G.A.A.B.
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::.•_.,t.`�, Via: ;`�
AS-�3UILT �ORVEt' FB
R&M
•NOCONSULTANTS, INC.
Lr�O/NT PARS BFcYClr� GRID
NY•PP 0°OS
PROD NO C�57/ yfj
DWG. N0. / 01 /
June 30, 1976
R & M No. 656258
Bob Tan~urelli
FRA 1561 Z
Anchorage, Alaska 99507
RE: Test Hole and Soil Log Report for Sanitary System
Lots 6, 7, 8 and 9 Block 11 Mountain Park Estates
Subdivision
Dear Mr. Tambmre].li:
We are submitting herewith the boring logs, percolation results and our
comments regarding soil conditions encountered at the subject site.
This investigation was performed in accordance with your request of June
21, 1976, and those procedures outlined in a letter dated July 15, 1976
by Mr. Rolf Strickland of the Municipality of Anchorage, Department of
Environmental Quality.
A single test hole was put down within each of the Lots 6, 7, 8, and 9
for the purpose of defining general subsurface soil conditions and
conducting percolation tests for the proposed sanitary system. Excavation
was accomplished with an auger type drilling rig and the test holes were
extended to a total depth of 18' feet below ground surface. The final
log prepared for the test hole has been included in Drawihg A01 through
A04.
Ground water was not encountered in the test holes.
We appreciate being given this opportunity to be of service to you.
Should you have any questions with regard to the above, please do not
hesitate to contact us.
Very truly yours,
R & M CONSULTANTS, INC.
James W. Rooney
Vice President
JWR/ddp
TH 3
6- 30- 76
ORGANIC (PT)
Silt With Trace Sand
0.0
Sand with Some Silt
and Trace gravels (Sbl)
Silty Sand (SP-SM)
(200 Sq. Ft./Bedroom)
-18' .0' TD
TH 4
6- 30- 76
ORGANIC. (PT)
Silty Sand with
Trace Gravel
Sand With Some
Silt (SP-SM)
200 Sq. Ft./Bedroom
18' TD
I,og, Represents
Location of Test Hole 3
Lot 8 Block 11
Mt. Park Estates Subdivision
Log Represents
Location of Test Hole 4
Lot: 9 Block 11
Mt. Park Subdivision
1Ag of 2'est Holes
3ob Tamure!li
., 656258
'
.Lot 9
T. fi. 4
Lot 8
®
T.H. 3
Lot 7
Lot 6
Test Hole Locations Are
Approximate and Have Not
Been Located by Survey
Methods,
Log of 'Pest Holes
t~ob ?nmurelli
Anchoraqe, Alas]ca '
Time
4:00
4:01
4:02
4:03
4:04
4:05
4:10
4:15
4:20
4:25
4:30
4:40
4:50
5:00
PERCOLATION TEST
BOB T~4BURELLI
R & M NO. 656258
Elapsed
0
1
1
1
2
5
5
5
5
5
10
10
10
60 Minutes
Lot 8 ~ 11
Mt. Park Estates
Subdivision
Total Drop
Drop In
Inches
0
.4
.35
.25
.4
1.1
1,4
1.5
1.5
1.1
2.5
2.0
1.0
13.5'
DRILLING, INC
DRILLING LOG
Well uwner .... ·
...... Use of WelL_Z ......
Location (address of: Township, Range, Section, if known; or distance main roafL
!,~.Ji. (, i.(C~Ci,' [ ~. ? ~i : ;- !',
Size of casing. "~ ; r ';[I~[
Depth of Hole -' L :, ~ .feet Cased to. feet
Static water level_ ~ ''¥:
- ft. '(~b6v~) (below) land surface. Finish of well , ,ne) open end ( );
Screen ( ); Perforated ( ).
Describe screen or perforation
Well pumping test at_ 3:" ___gallons per (i~6tir) (minute) for ~ _hours with_ ~,3~)Y:: _ft.
of drawdown from static level
Date of completion.
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
,',/~rT;'~-t ~ ~ ~:ii,~
: TO '~'
.......... TO
' "--_2]['0_
....
.... TO.. Z ~' :-' .~
~il D ..TO _~2't- ~
_~_ 10 .... ,.
3 -. CONTRACTOR
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
F.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPFIOVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # 01'7~¢~/III HAA# ~-fA ¢ '7 oO~
GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner ~I~z~¢,c~. ~'¢_¢_r'i~_,.(',// Day phone
Mailingaddress ~00/ ~o, p~r R~, ¢ ~1~ ~w~.
Lending agency ~5~,~ ~0%. ~,~ ~¢~ Day phone
Mailing address /~/ ~. F~ ~ k~
Agent Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
NOTE:
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State AD£C
attesting to the legality and status of system.
72-025 (Rev. 1/91) Fronl MOA ~t21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval 'application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection. R~ j-~,~,/./~ / ~
Name of Firm ¢/~: ~-./~/~
Address ///5' ~,¢'
Engineer's signature
bedrooms.
DHHS SIGNATURE
[/ Approved for
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
The Muni. cipality of Anchorage Department of Health and Humr . Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations giw. ~n 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-O25 (Rev. 1/91) Back MOA ~,21
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVIC~ C E IV E D
Environmental Services Division
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907)lB&3-~.~f4~97
Municipality of Anchorage
Health Authority Approval Checkli~tept. Health & Human Services
Legal Description: /--.o
A. WELL DATA
Well type ~'[,~,.r~- '~'"
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
If A, B, or C, attach ADEC letter. ADEC water system number _
Date completed
Cased to
FROM WELL LOG
Date of test
Static water level
Well production
WATER SAMPLE RESUI..TS:
Coliform 0 col
Date of sample: '~ / / ~ /
B. SEPTIC/HOLDING'rANK DATA
Casing height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
Nitrate
g.p.m.
,./
Collected by:
Date installed 7/t,~'¢7 Tanksize
Foundation cleanout (Y/N) Y
Date of Pumping /U./¢. (',I ~,.)_ Pumper
C, ABSORPTION FIEI. D DATA
Date installed 7,/l~(~'7
Length q~¢~"~ -~(o~" Width 3f
Effective absorption area. I,~ ~ O
Date of adequacy test )u.,5, (/1
Fluid depth in absorption field before test (in.);
Fluid depth - (ins) Minutes later:
Peroxide treatment (past 12 months) (Y/N) ~J
g.p.m.
Other bacteria
{¢.4¢~,~/ Number of Compartments '2 Cleanouts (Y/N)__
Depression (Y/N) /v High water alarm (Y/N) /,/.
Soil rating (g.p.d./fF or fF/bdrm) ¢. '¢5'.~'f__¢' System type '7
Gravel thickness below pipe .CT.O' Total depth
Monitoring Tube present (Y/N) Y' Depression over field (Y/N)
Results (Pass/Fail) P,~'-.cf For --~
~ Immediately after - gal. water added (in.):
~ Absorption rate = '~ ~r'O g.p.d.
If yes, give date /V.
bedrooms
72-026 (Rev. 3/96)*
D. LIFT STATION ~J, ~,
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
Size in gallons
"Pump on" level at*
*Datum
"Pump off" level at*
On adjacent lots
On adjacent lots
Public sewer manhoie/cleanout
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation ,5-O ' Property line -~ ' Absorption field ~/5~ '
Water main/service line .O Io' Surface water/drainage ~ ! oo ' . Wells on adjacent lots ~ /~ '
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
I ' Om~/ ~,~/~. ,
Property line fo' ~?~.~r,~ ~ Building foundation gO Water main/service line ~> [o '
Driveway, parking/vehicle storage area
Wells on adjacent lots ~
Surface water ~ /oo '
Curtain drain /~'~,~¢ ~,,.~
ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review
in conformance with MOA HAA guidelines in effect on this date.
Signature ~-~
Engineer's Name ~'-,'~ ~'~__..~'~,
HAA Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D.# d2!'7~*// ~/I I
1, GENERAL INFORMATION
Complete legal description
HAA # ~ ~.0~'~
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
Day phone
Day phone
Agent /~¢¢ I.~lJ~'~O (.ofo~'u,,,-¢il l~o. nl¢~ ~- Day phone~.'Fd'~,'
Address ~ 801 "C" -¢/..~ ~n~/~or~/ ~I~
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
NOTE:
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72*025 (Rev. 1/91) Front MOA ~21
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm ~'~//~,~ %',~o~ ~-,,d'
Address 1¥.¢w2o ~,~r__A~ ,..¢/-,~
Engineer's signature T~.~¢.¢~,.~_. %
6. DHHS SIGNATURE
Phone
Date
Approved for
bedrooms.
Disapproved.
Conditional approval for '-~i¢-¢~(~) bedrooms, with the following stipulations:
Escrow monies to perform all work necessary to upgrade the septic system
per engineer's dem~gn (permit #SW97044~. AIl monies to remain in
escrow until final approval is granted from this department. All work
must be cemp!et~d no later than ~une !5, 1997.
See attached design.
Additional Comments
· -: :' "By: :.
Date
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 DH HS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Em ployees 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 engineeCs work.
72-025 (Rev. 1/91) Back MOA ~21
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES . .
..... Environmental Services Division RE C, ~' IV E D
825 L Street, Room 502 · Anchorage, Alaska 99501o (907) 34~474~
M^R '17
Municipality of Anchorage
Health Authority Approval Checklist o~ pt Healt[ & - uman Services
Legal Description: ~'/lt
A. WELL DATA
Well type ~ I~'.f£ '~ '°
Log present (Y/N)
Total depth
Sanitary seal (Y/lq)
/-'//~r~ Port-lc ~£P 4~) ParcelI.D.: OITqqlt I
If A, B, o C~,' ttach ADEC letter"~ADEC water system number
Date completed
Cased to
FROM WELL LOG
Date of test
Static water level
Well production
WATER SAMPLE RESUL'rS:
Coliform ~' e_:o / /
Date of sample:
B. SEPTIC/HOLDING TANK DATA
Date installed Itg /~( /
Foundatiou cleanout (Y/N)
Date of Pumping ~/6' /~ 0/
C. ABSORFrlON FIELD DATA
Date installed t ~ / Et(/7o"
Length ~ or' Width 09'
Effective absorption area ~¢ t 6' ~ '
Date of adequacy test
Casing height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
g.p.m. . g.p.m.
Nitrate I, 1,5' ~/'~ Other bacteria _N o,o¢ r'eforJ-ec,,(
Collected by: F [e~/-/oF 7~'e~ _Ct'C.
Tank size I~O0~? Number of Compartments
Depression (Y/N) b/ . High water alarm (Y/Iq)
Pumper
Soil rating (g.p.d./fl2 or fl2/bflrm) I ~'or ~ System type
Gravel thickness below pipe ~' Total depth
Monitoring Tube present(Y/N)_'( . Depression over field (Y/N)
Results (Pass/Fail) p~'z For I ~/~-. bedrooms
Fluid depth in absorption field before test (in.)i ¢~ ¥~- hnmediately after 7o/ gal. water added (in.):
Fluid depth ~ ~/t~_(ins.) Minutes later: ~ ~tff Absorption rate = ~ 3' ~/ g.p.d.
Peroxide treatment (past 12 months) (Y/lq) None /,c~oeo~ If yes, give date
LII~ STATION ~d. A-,
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Size in gallons
"Pump on" level at*
*Datum
"Pump off" level at*
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Sewer/septic service line
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 7t~ ' Property line .~ t9 ~ Absorption field 3"' '~
Water main/service line ~ t~' Surface water/drainage ~, too ' Wells on adjacent lots 7' t O o '
SEPARATION DISTANCE FROM ARSORFUON FIELD ON LOT TO:
Building foundation ~"
Surface water ;> t OCJ '
Curtain drain b/one
ENGINEER'S CERTIFICATION
Property Line g' '~ Water main/service line
Driveway, parking/vehicle storage area
Wells on adjacent lots
I certify that I have determined thrufield inspections and review of Municipal records that the above systems
in conformance with MOA ~TAA guidelines in effect on this date. ('o
~; .,% ,~ , ..... ~ ' ::, .~-
Engineer'sName T~ e a do rF ~ ~ o o ~ En~ae~flng'S6a~Herq
Date ~ / t7 /97
Waiver Fee $
Date of eament
HAA Fee $
Date of Payment
Receipt Number
Receipt Number (~.~La~LI I ~cl ~.~
Rev. 8/95 OSS: haa.wk.doc
. ,'~ "~ ~?.: ,, .......
· ./~ ~ ,~,;., ~.. · ,,~/~.,~ ~,, .. , ..... .. · , .... . · .
C~ ~ ENVmON~NT~ ENG~EER~G ' ENERGY CONfiE~VA~ON
THEODO~ F. MOORE, P.E. ~CHORAGE, ~ 99516
PH: ~07}
~AX COV~R L~TT~
RECEIVED
MAP, 2 8 '19.97
Municipality ol Anchorage
Oept. Health & Human Services
Total # of pages (incl. cover letter)
=
c~'~1 ~
TOTAL p.oi
MAR-18-%99~ 16:88 ~L.ATTOP TECH. SVCS.
'APPROVAL OF ON.SYI'E RESIDENYIAk WAT~ AND ~EW~ ~y~8
p~p~ D~RI~ION
a uarant.e of any kited, ev.~llolt or mpe as to the performance
A ~nt ~r ~mpl[ wa . ~ d~ ~' ~
lng water ~ndi~B for to~ COhfOfm ~ e ~ ~
The domewtl~ wa6tewater ay~term~a ·
~ inep~tad
qutmm~t6 of
of 18 ~O 7~ or fl~ - ~a~ence of tM System la zatiefa~t~
I
~ :: ...:.. - ...... .._
TOTRL P, 83
D~. O~ ~NV~ONM~T~L CONSERVATION ,:
ANCHO~~ERN PUBLIC SERVICE ~ OFFICE
555 COR~VA S~E~ (90'~ 26~7505
~o~ge, AK ~516
S~ECT; Lot B, BIo~ 1~ MounMIn Pa~ EoMt~ ~1 S~Ivlsion - t251S
~nt ~ef ~ple anal~ for te~l ~m
~ubm~ info~, wh~ [nd~ed ~paR~
~da and ino~ani~ faf nltm~, a~ a ~pY of a pmv~us
water e~m. Since ~is d~n~ng wa~r s~m hao ~n p~i~oly app~ed
~pa~ a~ he. USa E ~ ~ss than 13 ~d~ms or 25 msiden~, this
sy~m la ~:~ as a Class "C" Pubil~ W~ 8~m. Ver~n flint ~e ~ter
supp~ has been m~nW ~ will ~ ~ul~ to mai~n ~mpl~n~ ~ S~te
Dr~ ~r ~gulafione. ~ 8ubmi~ ~Mr una~es ~m ee~fa~o~
of ~ls ~a~ thie s~t~ 181 mp~ w~h ~ ~ A~ unnmng wamr
a~ ~e~f SynC" ~nga~ ven~m8 u,m -x .....
~nk ~u ~f your ~maan ~'~ Dep~n~ ~ ~m ~ any ques~o~
~a~g ~e abo~, P~ do n~.h~te to ~1.
Mi~l- ~.~u, E,hT.
Environmental Engineer
MUNICIPALITY OF ANCHORAGE
I:)epartment of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. Cf
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL. OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
('~i-I-fl~ I-~ \ HAA# ~¢~.~ ¢2~¢,~ ('~C~...~
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
(b) Property owner /¢~,r
Mailing Address
(c) Lending Institution
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone
(e) Mail the HAA to the following address: (or check here ~d for pick up.)
List contact person and day phone number below:
2. TYPE OF RESIDE/~,E"
Single-Family ~ Number of bedrooms
3. WATER SUPPLY
Individual Well [] Community Public []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DI~OSAL
On-site [!~// Public [] 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.
72-025 (Rev. 7/88) Page 1 of 2
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6u!puel ~!eql pue sewo4 jo sJeseqoJnd ol/~selJnOO e se s!41 seop SHHQ eq.L 'e~selV jo elelS eql u! peJels!be~
~eeu!Sue leUO!SsejoJd luepuedepu! ue,~q e^oqe ~ Llde~SeJed u! ue^!8 suo!lelueseJdeJ eq~, uodn/[lUO peseq pe~,eoijpeo
le^oJdd¥/,lpoqln¥ qlleeH senss! (SHHQ) seo!^JeS UeLUnH pue q~leeH jo lUeLUl~edeo eSe~oqou¥ jo ,OJled!ojunl~ eq/
le^oJddv leUOR!puoO jo sw~e/
leUOpjpuoo pe^oJddes!Q
~- ,~oJ peAoJddv
"lVAOblddV SHHO '9
leas s,JeaU!SU3
A. WELL DATA
Well Classification
~{~"~ MUNICIPALITY OF ANCHORAGE (MOA)
· !~ Health Authority Approval (HAA)
~'f o~ ^t'~C~4~l~t~~KLIST ' FEBRUARY 1984
~u~' ~.v~c~s ~)~v~oN 343-4744
:,,},~ }~ ~ ? 19~fl Legal.Description:
Well Log Present (Y/N) ~ Date Completed [0~/'~ Yield ~¢'¢ '~
Total Depth ~1 ~Cased to ~l:3,"~Depth o~ Grouting
Static Water Level ~ ~.2('~ I
Casing Height Above Ground ~_~1
Electrical Wiring in Conduit (Y/N) Y
Pump Set At ~,~.//l,
Sanitary Seal on Casing (Y/N) _ Y
Depression Around Wellhead (Y/N)
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot ~_.~_4:~
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line ~'-~7/¢~ To Nearest Public Sewer Cleanout/Manhole
To Nearest Sewer Service Line on Lot
Water Sample Collected by
Water Sample Test Results
Comments ,~[~-~ll
; On Adjoining Lots ~
; On Adjoining Lots
B. SEPTIC/HOLDING TANK DATA
/
Date Installed /~/?-4~/').~_Size IO(?~g:~J,,_No. of Compartments
Standpipes (Y/N) ~ Air-tight Caps (Y/N) Y Foundation Cleanout (Y/N) Y
Depression over Tank (Y/N) ~-~ Date Last Pumped ~k.~', ~ I.d~c~c~ ~.-)11¢..
Pumping/Maintenance Contact on File (Y/N) ~,~,//~- ; for /t,j~/, ~
Holding Tank High-Water Alarm (Y/N) _ ~///~--- Temporary Holding Tank Permit (Y/N) bd/4A'
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well ~ '2-C~C~I To Building Foundation
To Property Line
To Water Main/Service Line
To Stream, Pond, Lake or Major Drainage Course
Comments
To Disposal Field
72-026 (Rev 7/88)Fro,t Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata I~'~%~ DJi//~ &'q~t_ Type of System Design
Date Installed I O/'~E¢,/'~ ~ Length of Field 2 ~::~ I
Width of Field ~(~ ~V~ ~ Depth of Field 1~,~_(~¢,l
Gravel Bed Thickness ~ I
Square Feet of Absortion Area z~ l (.,¢¢ ~; I Statndpipes Present (Y/N)
Depression over Field (Y/N) ~ Date of Last Adequacy Test
Results of Last Adequacy Test ~------~- ' C:L+~,~, .~-~
I
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well ~1~ "Z-~PO [ To Property Line i ~ I ..~
To Building Foundation ~::~(_l I .ffu-/.~ To Existing or Abandoned System on
Lot it'"~/~-' 'On Adjoining Lots_ ~1/~.
To Water: Main/Service Line '~' ¢ O I To Cutback (if present)
To Stream, Pond, Lake, or Major Drainage Course /'--)
To Driveway, Parking Area, or Vehicle Storage Area ~ ~ L Jr/'~
Comments "-~ P~C ~-,'F ~L~i (;"/f'"' ~lr,/zZ-~/4'76,?
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Dimensions
Man hole~"'~-~
? ..~A ::l;~:rf~p Off" Level at
A Vent (Y/N)
Meets MOA Electrical C~)
Comments ~
Pumping Cycles during Adequacy Test.
**Check Per d Bedroom Against HAA Request**
I certify that/I,l~v~ checke~edfied, or conformed to all MOA and HAA~(
i n s pa ct i on.//////,/~,/~.~~
Signed
Date
MOA No,
Receipt No.
Date of Payment_ /~' ~ '-~¢ Waiver Fee: $
Amount:
$
/ "~20 Date of Payment
72-026 (Rev. 7188) Back
Page 2 of 2
;s in effect on the date of this
Engineer's Seal
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE WESTERN DISTRICT OFFICE /
3601 C STREET, SUITE 322
AMCHORAGE, ALASKA 99503
November 15, 1989
Mr. Bruce Corwin
Corwin & Associates, Inc.
1000 E. Dimond Blvd., Suite 205
Anchorage, Alaska 995].5
STEVE COWPER, GOVERNOR
563-6775
SUBJECT: LOt 6 & 8, Block 11, Mountain ]?ark Estates Subdivision
Anchorage, (8721-FA-028, 8721-WA-012, PWSID #216287)
Dear Mr. Corwin:
According to our records on file the water system servicing the
subject property is in compliance with the State of Alaska Drinking
Water Regulations. Enclosed is a Certificate to Operate.
The following public water system identification number' (PWSID) has
been assigned to Lot 6 & 8, Block 4, Mountain Park Estates
Subdivision:
PWSID ~t 216287
Use this nu~er when filling out the laboratory forms for water
analyses, such as total coliform, or, when inquiring about your
public water' facility. This number expedites t~e crediting of the
reports to your facility and assures that your system is properly
credited.
Our records indicate that this facility is a Class C system in
accordance with the Drinking Water Regulations of the State of
Alaska and frequency of sampling required is found in the Drinking
Water Regulation, Title 18 Alaska Administrative Code, Chapter 80,
Section 60, Table C (].8 AAC 80.060), see attached.
Also attached is an Inventory Maintenance Sheet. Please fill in
the requested information and return it to me within fifteen (15)
day of receipt.
Mr. Bruce Corwin
Nover~er 15, 1989
Page Two
If you have any questions, please contact me at the above address
or phone nuraber.
Thank you,
Cindy Thomas
Environmental Engineer
ATTACHMENTS
1. Drinking Water Regulations
2. Inventory Maintenance Sheet
cc: Lynette Dean, SCRO, Anchorage(w/o attachments)
Jim Allen, EH, Anchorage(w/o attachments)
CT:bas
STATE OF ALASKA
DEPARTMENT OF ENVIRONMENTAL CONSERVATION
CONSTRUCTION AND OPERATION CERTIFICATE
for
PUBLIC WATER SYSTEMS
A. APPROVAL TO CONSTRUCT
Plans for the construction or modification of
(, ~ 77-A-- ~'~- o7_-~'") public water system located
, Alaska, submitted in accordance with 18 AAC 80.100
have been reviewed and are
[] approved.
conditionally approved (see attached conditions).
BY TITLE DATE
If construction has not started within two years of the approval date, this certificate is void and new plans and
specifications must be submitted for review and approval before construction.
APPROVED CHANGE ORDERS
Change (contract order no. or descriptive reference)
Approved by Date
C, APPROVAl.. TO OPERATIE:
The "APPROVAL TO OPERATE" section must be completed and signed by the Department before any water
is made available to the public.
The construction of the ~ ~:x~ O~ ~,_3'~5 ¢_~c_~% public
water system was completed on (date). The system is hereby
granted interim approval to operate for 90 days following the completion date.
BY TITLE DATE
As-built plans submitted during the interim approval period, or an inspection by the Department, has confirmed
the system was constructed according to the approved plans. The system is hereby granted final approval to
operate.
18-0407 (Rev. 11183)
DISTRIBUTION: 1. WHITE - ENGINEER (Complete Section C) 2, YELLOW, WATER SYSTEM FILE (Complete Section C)
3. PINK - ENGINEER/MUNI,BOROUGH (Complete Section C)
4. GOLDENROD · MUNI-BOROUGH (Complete Section A)
CHEMICAL & GEOLOGICAL I~tBORATORIES OF ALASKA, INC.
B STREET ANGHORAGE,2[~[$1~A 99518 TELEPHT;qE (907)562-2343
~ 5633 FEDERAL TAX ID # 92-0040440
P. euF.'l Y~:
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
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
(b) Applicant Name ~ ~ /~/:l~"~¢n~o>-¢nTelephone: Home 3~.~--, ¢ 5'~ D~ Business
Applicant Address ~1~ ,~1~¢ ,f~l/-~L_ r~A~(/ ]~ ~1(~ ~
(C) Applicant is (check one): Lending Institution ~; ~r~builder ~.; Buyer ~; Other D .(explain);
(d) Lending Institution /'~o,~1~ -~¢zu4~' ¢' /,,~_Lo_L~_.A:.c~e, _ Telephone
Address ~/~,'bl t~' ~¢~.~¢) ¢-~/',/~ ~'l'~_~r~/ t~.IY~
(e) Real Estate Company and Agent _6J/: ,-~.:.t)/~co,'~tr- __
Address
Telephone
(f)
Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family~.-~ Multi-Family []
Number of Bedrooms .~
Other
WATER SUPPLY
Individual Well ~ Community/~,
Public
[]
Note: If community well system, must have written confirmation from the State Department of'Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite,,~ Public [] 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 (11/8,0
ENGINEERING FIRM PROVIDIJ,.~ INSPECTIONS, TESTS, FILE SEARCH, DJ,,A 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 slructure 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.
Date .'Z ¢ 2, ..> o ~,
Approved for ~--~) bedrooms by'~,~-~'.//~'_~E_~C~,E~ate ~/~%~;
Approved ~ Disapprov~ / ]-ConditJon~;
~erms of Conditional Approval
CA U TI O N
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 rending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do riot 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)
MUNICIPALITY OF ANCHORAGE (MO,-,i
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description: -
WELL DATA
Casing Height Above Ground --
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
Well Classification .~~~ If A, B(~D.E.C. Approved (Y/N) ~-~/
Well Log Present (Y/N) ~ Date Completed _ [o- I~ Yield
Total Depth ~ ~' Cased to I~~ _ Depth of Grouting Uq~~ ~
~ ~.~ leu~l Pump SetAt j~n
Static Water Level I ~ ~l~-~ d
~ Sanitary Seal on Casing (Y/N)
~ e 5 Depression Around Wellhead (Y/N)
~ To Septic/Holding Tank on Lot ~ ¢
~ To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line ~)A
Cleanout/Manhole 1'4 ~
; On Adjoining Lots ~' 1515'
; On Adjoining Lots .'> 1-~' (uL,~Ja_¢) '
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
Water Sample Collected by -~.~¢ar~ pr~,ts ; Dat~ q-&~ ~& l'?-N'~ -
Water Sample Test Results O_ ~o~ ~l~-~m; ..~! ~/[~
SEPTIC/HOLDING TANK DATA
Date Installed Io-~6-~ Size (n~ nnl~ NO. of Compartments /
Standpipes (Y/N) y~ s Air-tight Caps (Y/N) _ ~es Foundation Gleanout (Y/N)
Depression over Tank (Y/N) __ ~o
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N) _ CA/A_.___
Separation Distances from Septic/Holding Tank:
TO Water-Supply Well > ~oO/
To Property Line ~ '
To Water Main/Service Line
Course _ N,~ '~ :? ::
Date Last Pumped
; for __
Temporary Holding Tank Permit (Y/N)
To Building Foundation -
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments
Page I of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed I,o - %~,
Width of Field ."&/./' 4~
Square Feet of Absorption Area
Depression over Field (Y/N) r'/o
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well > 'z.oo'
To Building Foundation Iai' +.
$~4'+/~.~,, Type of System Design
Length of Field '~ ~ ·
Depth of Field I ~ t
Gravel Bed Thickness ~ ' '~
Standpipes Present (Y/N)
Date of Last Adequacy Test
J'r~r~ch
To Property Line IO '
!~' ~ '~;~h'~'~'~ .~,~¢_ To Existing or Abandoned System on
; On Adjoining Lots ~'n,~O~l
To Cutbank (if present)
Lot /g~
To Water Main/Service Line h3f~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments . ~'¢JE ¢-h ~,~¢
LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
Signed (~"'~L.4'~,'~,~ Date
Compan/_~'~,R - '
/.E,~J~.e~,Yto -L/~c ~ MOA No.
J
Receipt No. _ ~ ~)~ -
Date of Payment _
Amount: $ ~
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
7-2.~- ~/.,
Page 2 of 2
72-026 (11/84)
EBA Engineering Inc.
Geotechnicsl and Materials Engineers
July 25, 1986
0045-0023
Department of Environmental Conservation
437 "E" Street, 2nd Floor
Anchorage, Alaska 99501
HEALTH AUTHORITY APPROVAL
CLASS C, SE'MI-PUBLIC WELL
LOT 8, BLOCK 11, MOUNTAIN PARK ESTATES
Gentlemen:
On July 23, 1986, EBA Engineering, Inc. representatives
performed an adequacy test for the well located on Lot 6, Block
11 servicing Lot 8, Block 11, Mountain Park Estates. Property
owners are Brett and Barbara Thompson.
A flow test was performed for 2 hours at a flow rate of
4.5 gallons per minute. The water level in the well dropped 2
ft during pumping and had 100% recovery within 10 minutes after
pumping ceased. A water sample was collected on July 23, 1986,
and tested by Chemical and Geological Labs of Alaska for
coliform. The sample was suspect of contamination and
indicated 4 colonies of coliform. A second water sample was
taken on July 24, 1986, and tested by Northern Testing Labs.
Results showed zero coliform colonies; this sample is accurate.
Nitrates tested at .51 mg/liter.
This well is currently accepted in non-compliance with a
protective radius of 117 ft. However, during the field
investigation, this distance could not be verified.
Measurements on Lot 6, Block 11 were 84 ft to the septic tank
and 98 ft to the absorption field. The well log indicates
casing to 150 ft, (5 ft into the underlying bedrock) and a
total depth drilled to 325 ft.
Please determine approval for non-compliance for the
Health Authority Permit. Attached is a copy of the
Municipality of Anchorage application as well as backup
information for your use. If you should require any additional
information pleas ntact the undersigned.
Si ncerely,
EBA ENGINEERING, INC.
Adams, P.E.
Senior Engineer
- C~FI7 F~.~t Dowlino Road, Suite £7, ANCI-IORAGE, Alaska 9951B
NOR HERN TESTING LAbdRATORIES, INC.
6(X) UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS, ALASKA 99709 :/~, L,~ 907-479-3115
6957 OLD SEWARD HIGHWAY, SUITE 101 ANCHORAGE, ALASKA 99518 907-349-8623
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY CLIENT
PUBLIC WATER SYSTEM I.D. #
IPRIVATE WATER SYSTEM
AME
~ .¥\ng Address
,ty State
Phone ~& I- 4.0 c~ S
Purchase Order No.
;AMPLE DATE: O1
MO. Day Year
[] Treated Water
,~ Untreated Water
;AMPLE TYPE:
] Routine
] Special Purpose
-I Check Sample (for original contaminated
sample with lab reference no.
Collected by
~mple 'nme
i~. Location Collected
Zip Code
10
~ignature of Representative
Laboratory Ref. No.
FOR LABORATORY USE ONLY
CHARGE j~ d~PAlO TRANSMInA! SPECIAl INSTRUCIION$ MAIL
TO BE COMPLETED BY LABORATORY
Received at: ~] A~ch./ [] Fbks.
Date Received
Time Received
Next Sample Due
COMMENTS:
SATISFACTORY '~)
UNSATISFACTORY U
RESAMPLE R
OTHER BACTERIA OB
TOO NUMEROUS TNTC
TO COUNT
Direct Verification Final
Count LSB BGB Result*
*N~)T~iform. Colonies per 100 mis.
/.500
Time
CI-IEMICAL & GEOLOGICAL LABORATORIES OF ALASI(A, INC.
TELEPHONE (907) 562-2343 5633 B Street
Anchorage, Alaska 99518
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
~',uBL,c WATER SVS*EM ,.D., FI I I I I
[] PRIVATE WATER SYSTEM
Name Phone No.
~ailin0 AddFe~
State
Mo. Day Year
SAMPLF~ TYPE:
[] Routine
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
[] Treated Water
E]' Untreated Water
SAMPLE
NO. LOCATION
~1
4 L
Time Collected
Collected By
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
[] Satisfactory
[] Sample too long in transit; sample shoukt
not be over 30 hours old at examination
to indicate reliable results. Please send
new sample via special delivery mall.
Date Received
Time Received
Analytical Method: Membrane Filter
* No. of colonies/100 mi.
Lab Ref. No, Result*
I Y(/~; I~'FT'Z
I
I ICI
I
Analyst
BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Membrane Filler. Direct Count ,~
Verification: LTB /0~ '~"/~
BGB_
Final MembraneFter~Results[
Reported By '"'~'.--'~ /?'~~ Date
Time:
TNTC = Too Numberous To Count
Colllormll0Oml
Coiltormll00ml
~ ,:>OD a.m.
OB = Other Bacteria
.~x APPLIf ~IT FILLS OUT UPPER HAl ONLY
Property Owner ~. ~_.~.~)~.~'~,~,,.)i/~} Phone
" , . ....
Address Zip Code
Lending Institution ~- Phone
Address Zip Code
Realty Co, & A~nt ~-~,~,)~ Phone
Address v /~-% Zip Code
Type of Resi~nce
~ingle Family
E] Multiple Family No. of Bedrooms.
E] Other
Water Supply
~,.Individual A~ACH WELL LOG. A w~l Icg is required for all wells drilled since June 1975.
E] Community For wells drilled prior to that date, give well depth (attach Icg if available),
E] Public Utllily
Sewer Disposal
~[~dtvidual Year Individual Installed:
E~ Public Utility When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time Time Time
Dale Date Dale Date
Inspector Inspector Inspector Inspector
Field Notes:
(,~..~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL'
DATE ~'Z--?-~ Z: ___
Soils Rating Date Sewer Installed Well To Absorplion Area Well Log Received
Well to Tank Septic Tank Size
72-023
· CHEMICAL & G )LOGICAL LABORATORIE~ )F ALASKA, INC.
TELEPHONE {907)-27§-4014 ANCHORAGE INDUSTRIAL CENTER
...... ~ Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
I.D. NO.
.~ ' ~ ~ ~,. / ~ ,
Water System Name '. Phone No.
_/~ ~-0 ~ ~.:-r f~ /~ x ~-'~.~ ,".~
Mailing Address
City :~/ State
MO. Day Year
Zip Code
SAMPLE TYPE:
~;~ Routine
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
E] Treated Water
~ Untreated Water
SAMPLE
NO.
1
2
3
4
5
LOCATION
BII
Time Collected
Collected By
.L,~.I _-5>,'or :/~
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
J~Sat~sfactory
[] Uns'atisfactory
[] Sample too long in transit; sample should
not be over 48 hours old at examination
to indicate reliaNe results. Please send
new sample.
Date Received
Time Received
Anaiytlcal Method:
[] Fermentation Tube
tembrane Filter
Lab Ref. No. Result* Analyst
I-i-]
~
FTq
F'Tq
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
06-1220 (b)
Rev. 3.978
BACTERIOLOGICAL WATER ANALYSIS RI[CORD
(:)ate Collected Source _
i<:al veal ! Lib. No.
24 Hours
48 H..0.~ r s
Confirmatory
48 HOU[~
Multiple Tube Report;
M. lmbrane FUter~ Direct Count
Verification: LTB
Final Membrane Filter ReSultl
Collform/10Oml
BGB
Coliform/10C~nl
o.,. ?-¢-
ALASKA UIROFlm F1TAL COnTBOL S8RUICeS, IFIL
~nqJneerinq $ ~nuJranmcnlal $1udics
July 7, 1982
Municipality of Anchorage
Department of Health & Environmental Protection
825 L. Street
Anchorage~ Ak, 99501
Re: Health Authority
One July 1, 1982 our company collected a water sample from the
house located on Mountain Park Estates Block 11 Lot 8. The
property owner is Mark Godwin. The water contained no
coliform bacteria.
The well was located over 100 feet from the septic tank. The
electrical wires are encased in conduit annd the well seal was
adequate. The well casing stands are 1 foot above the
ground.
Ail cleanout pipes had caps.
A copy of the report is attached.
1220 LUcsl 25th Auenu¢ · A,choro% ALaska 9~5os * (~07) 276-1361
ALASKA nUIROBF TAL CONTROL $ RUICeS, I C.
6/30/82
MARK GODWIN
SRA BOX 1611C
ANCHORAGE AK 99507
SELLER '- MARK GODWIN BUYER-BRETT THOMPSON
SUBDIVISION-MOUNTAIN PARK ESTATE #1 BLOCK-ii LOT-8
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 450 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 748 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 BEDROOM HOME.
THE SEPTIC TANK WAS PUMPED ON 6/23/82 .
FLOW TEST ON WELL
THE WELL FLOW RATE WAS 5 GPM FOR 2.5 HOURS.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR
THIS 3 BEDROOM HOUSE.
THE WELL PUMP TEST SHOWS THAT 'FHE WELL PRODUCES MORE THAN
5 GPM, HOYiEVER THIS QUANTITY IS DELIVERED TO THE HOME IS 5
GPM, THIS IS AN ADEQUATE SUPPLY FOR THE HOME.
'~ ,~ ~ROpE SS~I~~
1220 UJesl 25tN Auenue · Anchoroc~e, Al,~sk~ 99503 · (907/ 276-1361
MUNICIPALITY OF ANCHORAGE
) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
~ 825 L Street - Anchorage, Alaska 99501 MUNICIPALITY OF ANCHORAGE
DEPT. OF
ENVIRONMENTAL ENGINEERING DIVISION ENVIRONS[ ~1,','.. L t_CTION
Telephone 264-4720
.Eou,_s'r FO. ^,,.ovAl. oF ND WDU^L w^TE. AND
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, glease allow (1
1. PROPERTY OWNER I PHONE
349-5363 Home
Leslie & Miri~ 5k)rrow
/1Al kl ~IG ADDRESS
SRA Box 1609A, AncJlorage, Alaska
99507
276-1911 Work -
IPHONE
PHONE
277-7369
~ROPERTY RESIDENT (If different from above)
!, BUYER
Mark Godwin & B&rbara Shreffler
-~AILING ADDRESS
1805 McKinley, Anchorage, Alaska
~. LENDING INSTITUTION
United Bank Alaska
JPHONE
276-19Z~
MAILtNG ADDRESS
645 G Street, An_chorage,.AK 99501
4. REALTOR/AGENT
Marston Realty - Sheila Green
JPHONE
248-2804
MAILING ADDRESS
2804 W. Northern Lights, Anc~ora~_ Blaska 99503
YLiriam
.5. iE~AL DESCRIPTION
Lot 8, Blk 11, Mountain Park Estates
STREET LOCATION
NHN Alpine Drive
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] Four
E~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY [] Three [] Six
[] Other
7. WATER SUPPLY [] INDIVIDUAL~
[] COMMUNITY
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. Fol' wells drilled prior to that date, give well
depth (altach Jog if available,)
8. SEWAGE DISPOSAL SYSTE'M
[Z~ NDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
**if individual/on-site, give installation rlate_ 1977 ,.
f system is over two (2) years old an adequacy test is required
by this Del)artment,
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
, w , DATE F~ECEIVE~)
INSPECTION APPOINTMENTS
~ TIME TIME TIME
DATE DATE DATE
INSPECTOR I-NSPECTOR I NSP ECTOR
DIRECTIONS:
1, TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
2. WATER SUPPLY PERMIT NUMBER
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDiVIDUAL/ON -SITE OATE INSTALLED
[]PUBLIC UTILITY
Connection Verified
INSTALLER
[]Septic Tank or []Holding Tank
Size: ~ ~ °~) If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest I~ot Line
WELL TO:
<; ROVEOFOR 3 EOROOMS
[] CONDITIONAL APPROVAL (letter must acco~pa)4y certificate)
3/78)
April 4, !9:30
Z,e s lie/~4irim~'~
;.'?~;.ar Rou{:e k Box 1609A
Anchorage, Alaska 99~07
Su~jec't~ Lot ~) Z~lock 1]. ?iountain Park Es'ha~ss Sub~it,vision
Ap~2roval for you~' individual sewer aud wate'¢ facilities
can not be g'rante,.3, until {;he follov~ing items haw3 been
~~ office ~kom Che~ Lab,. 5G33 B :~troet~ ~or our
ii! tJ.iero ~i.~e a~y furtzhc_~,r questionF~ please cont'a~t this
office a~; 26404720,
l~obert C, Prat't,
As soc:i,at,c, ,~pecia!
JnJ. t~d i]~ank Alaska
64(i G Street 99501
Sheila Gresen
% '?,laruton i~leal
2~()4 West Northern Li(lhts
99503
ISAACS PUMPING SERVICE
(Norm Tibbetts, Owner)
6218 Quinhagak Street
ANCHORAGE, ALASKA 99507
Phone 344-0114
MUNICIPALITY OF ANCHORAGE
DEPARTMENT DF HEALTR & ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
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,
PROPERTY RESIDENT Ill different from above) PHONE
2. BUYER Jt_)/~... PHONE
MAILING ADDRESS
3. LENDING INSTITUTION
_ l TTr>
MAI LING ADDRESS
PHONE
PHONE
~ ~E~3/~L DESCR PTION
'~TR EFT LOCATION
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] Four
[~'N~G L E FAMILY [] Two [] Five
[] MULTIPLE FAMILY [~ree [] Six
Other
7. WATER SUPPLY
[] INDIVIDUAL" * ATTACH WELL LOG, Awel log is required for all wells drilled
D~'"~COMMUNITY since June 1975 For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach log if available,)
8. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE **If individual/on-site, give installation date.~l,/ ~/7~
If syszem is over two [2) years old an adequacy test is reouired
[] PUBLIC UTILITY by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
~2.010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED -' ' "
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE /'NUMBER OF BEDROOMS
/
/
M SINGLE FAMILY [] ONE E~ THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
./icN DiViDUAL DEPTH OF WELL
OMMUN,TY
DATE DRILLED
Connection Verified LOG RECEIVED
tyWA E D,SPOSALSYSTEM PERM,TNUM.ER
L~ INDIVIDUAL/ON -SITE DATE INSTALLED
E~ PUBLIC UTILITY /
Connection Verified INSTALLER
[]Septic Tank or []Holding Tank
Size: / ~(.3 If Tank is homemade SOILS RATING
give dimensions:
T Y.~F~ MANU FACTUR ERe--.
4. DISTANCESwELL TO: Septic/Holding//~O(~)/Tank Absorption/,~) tArea Sewer Line/_~.~ /Il Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
[~APPROVED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
E] DISAPPROVED
LEGAL [~ESCR (PTION
72-010 (Rev. 3/78)
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
1. Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
3. Legal Description:
4.
5.
6.
A. Installed
C. Septic Tank:
D. Seepage Pit:
Date Received December 29, 1976
Time of Inspection.
Date of Inspection ~-~$.]~
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Cony.
National Bank of Alaska % Ruth
Post Office Box 3-,3859
Michael Tapley
Post Office Box 2407
Phone: 279-2506
Phone:
'
Lot 8 Block 11 Mountain Park Estates
Location: Alpine Drive
Type of facility to be inspected Sinqle Family
Well Data:
A. Type Community ' ' B. Depth
C. Construction
Sewage Disposal System:
1. Size )./Z)afga~),
1. Absorption Area
E. Disposal Field: Total length of lines
No. of bedrooms 3
Distances:
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
D. Bacterial Analysis
On-site system ~U~z/
B. Installer
2. Manufacturer
2.
, Absorption area
, Other contamination
, Absorption area
C. Absorption area to nearest lot line
Material
, Sewer Lines ,
EQ-034 (1/74) Page 1 of two pages
MUNICIPALITY OF ANCHORAQI~
DEPT. OF HEALTH &
F'NVIRONMENTAL PROTECTION
~'?r;.,~.?'l DEC 2 9 1976
RECI iVI D
4. Nam~ of l undin~t tnstitul:ion:
Mailing Address:
., .......
~. Name of
Mailino Address:
Type o[ F~militv to be ' ' ...... ~P ~ - No. [~drms .......................
'l"~pe o'i .Supply:
.it JtV IndR',dual .................................
il Indivkhml, num!aer o~ dv.,,'ellh~gt [',resel;ti~. s~iv'~-,,d ...............................................................
l~[ Individ'~ a, dci:,il~ o'[ ,,,,,ell
If Indhd,Ju:_fl, dM.e o{ i~,sL:~ll:t ,',n
Lo.os ,' (
Page 2 of two pages - Req :t for Appreval of Individual S ~r & Water Facilities
Legal Description ..Lot 8 Block 11 Mountain Park Estates
Comments
Approved Date
Greater Anchorage Area Borough, Department of Environmental Quality
Disapproved
Approval~Valid for one year from date signed
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)