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Home My WebLink AboutMOUNTAIN PARK ESTATES BLK 7 LT 1 Municipality of Anchorage Page " DEPARTMENT'OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alask. a 99519-6650 · Telephor~e: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~ ~ ~",~ ~ L~ {"~('~ .~-~ PID Number: Name~/~.~. ~ ~ ~~ ~~ Wastewater System: ~ New ~pgrade Address~ ~ ~~'~ ~' ABSORPTION FIELD ~ ~ ~No. of Bedrooms: ~~ ~ ~&~_~/~ ~ ~ Deep Trench ~ Shallow Trench ~ ~ Mound ~ Other Soil Rating: ~ ~ i~ Total Depth from original grade; LEGAL DESCRIPTION ' ~.~ ~;~ ~,~. ~. ~.~' Block: Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe Lot: / 7 ~0~ P~ ¢~ ~. s ' Ft. /' ~ ' Ft. Township: ~ Range: Section: Fill added above original ~rade: Gravel length: Ft. ~ ~ ~ Ft. WELL: D New ~pgrade Gravel/~/width:¢ ~ ~ Ft, Number~ of lines: ~Distance be~een~_~Ft.lin~: Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: ~'~ ~?~ Ft. /~ Et, ~ SQ. Ft. ~5~ Driller: Date Drilled: Static Water Level: Installer: Date installed: Yield: Pu~p Set at: Casing Height Above Ground: TAN K /- ~ GPM ~ ~O Ft. 1' 3 Ft. SEPARATION DISTANCES D Septic D Holding ~E.P. To Septic Absorption Lift Holding ~ublic/Private Manufacturer: ~ Capaci~ in gallons: From Tank Field Station Tank Sewer Lines ~~ ~ Number of Oompa~ments: were /~2' /~ /e //&~ ~/~ Nb ~ ~t~,i~: 5~/ Sunice w~t~ u/~ ~//4 ~/~ ~/~ ~/~ LIFT STATION Lot / / / [~/~ Size in gallons: Manufacturer: Foundation ~ ~/ 7 ~ I ~/~ ~/~ "Pump on" level at: "Pump off" level at: High water alarm at: ~.~ ~.o' Pump Make & Model J Electrical Inspections pe~ormed by: Cu~ainDrain ~/~ H/~ ~/~ ~ ~/~ ~l~¢''~-d ~'~' ~' Remarks: ~ ~p ~ ~'~[~ ~,~ ( BENCH MARK ~¢ ;$ ~ ~~ ~/~ ~'~(2 Location and Description: J Assumed Elevation: ENGINe8'8 ~EAL Inspeotionsperformed by: ~¢~ ~.¢,~, Dates:lEt/~¢ /~¢ ~"~'~"~"~' ~t.~-~ ~" ~ DO~S T. <EN .E~ Department of Health and.Huma~ Se~ices approval '~. CE8176 ..~ I{~ ....... Reviewed and approved by: , . , 72-013 (Rev. 9/91) MOA 25 Permit No. Page ~-/ of / z/ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal DesCription: z ~;" / ~',~ 7 ~¢~,~/~',4/^/ F~AxZ~: =,~kt"~z'¢~, PID No.: ~J ¥ / / ' I , KENLEY CE 8176 72-013 A (1/93) Permit No. Page ~ of .- / ~/ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION PiO. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: 72-013A (1/g3)' CE 8116 Permit No. Page ~ of / ~/ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION PiO. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 on-site Wastewater Disposal System and/or Well Inspection Report ' 72-013 A (1/93) * ........... 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[ '~ ? ........ ~ .... ~ ~ .... .... .... ~.....~,.~..~ ~ ...... ~ .... ~ ........... ~ ..... ~.~u~ ........ ~ ....... ~.~:~;.~%~.~..... ~.....:~ :?,:.~:.:. ~ ~..?~..~ ........ · .................... ] ............ ~ ...... g ~ : ] ......... j ........ ~..~.~.~.~..~..~.~.....~ ............... j ~ ~. ....... ~ ..... ~ ......... [ .....~ ........ ...... ~ ....... ~ ..... ~ ..... i .....~ ..... ~'" T" ~ ~ ~ . ~ ~ ~ ~ ............ ~i..~ ~ ......... ;........~e ~ ~-~.~..~...~.~.~-', .... '~ ..... - ~.-..?...~ · .... ~ ........ ~ ....... ~ .......... ~ ...... ~ ....... ~ .... ~ ......... ', ..... ~":"' '~ ....... ~ ..... ~ '"'""~ ~ ....~ ~ ..... t'"'z ~ ........... ~ ' ' ~ ...... ~ ....... i ' [ ......... ~ ....... ......... ~ ......... ~: .... ~ ~... ....... ~ .... ~ ........ ~. ( .............. ] ~ '-'~"~ ..... ?'""~ ~:"'"'t ...... ~ ~ ~ .......... ~ ~ ~ t ~' "~ ~ .......... ~ .......... ~ ....... ~ ...... t .................. ~ ...... ~ t~ ~'"'-'d~m~ ~ ~ ~: ~ ? '""!' ...... ~ ~..~........-~, ~ .......... ~ ...... ....... ~,.~? .~...-:~, ~ ,, .... . ~ ~ ........ ~ ~ ......................... ~ ~ ....... ~ .................. .... ~., · ...~,t~ ~.. ~. /...........; ............ 7-22-94 1:46 PM ;DOWL Engineers ALASKA T E S T i. A [] A O~v;=ion of DOWL, In=orporatecl DoUg Kenley 7920 I-Ionoy~uekle Anchorage, Alaska 99502 Attention: Mr. Doug Kentey Subject: Particle-Size Analysis L1 B7 Mtn Park Estates 9075633953;# '2/ ALASI~'S ONLY AASHTO ACCREDITED CONSTRUCTION MATERIALS LABORA, TOR¥ W.O.#A26051 July 22, 1994 Dear Mr. Kenley: The pro'dele-size distribution of your soil was measm'ed in the laboratory. The published methods for this test are: ASTM C 117, "Material Finer Than 75-gm (No. 200) Sieve in Mineral Agg,'egates by WasMng;" · ASTM C 136, "sieve Analysis of FJ~e and Co.se AggregateW' · ASTM D 422, ?article Size-Analysis of Soils;" · AASHTO T-I 1, "Material Finer Than 75-gm Sieve in Mineral Aggregates;" · AASHTO T-27, "Sieve Analysis of Fine and Coarse Aggregates;" AASHTO T-30, "Mechanical Analysis of Extracted Aggregate;" AASHTO T -88, "Particle Size 3atalysis of Soils;" and · ' AK DOT/PF ATM T-7, "Sieve Analy$ia of Fine and Coarse Aggregates." Alaska Testlab's standard procedure is in conformance with these standards, with the following descriptions: The coarse fraction of non-extracted soils is not washed unl,~s tho ~oar:v partiole~ appear to bo $iDaifioantly coated with fines; · The fine fraction of the soil is always washed; · The phs 3-hlch fraction is not routinely included ia the test due to the large smaple mass requk~ for a representative sample; The estimated percentage of plas 3' inch material in the smnple ~s shown on the test report; and · IM mass of the coarse and f'me test fractions are r0ported. The sail is classified in accordance with ASTM D 2487, "Classification of Soils for Engineering Purposes (Unified Soil Classification System)." The frost classification is identified in accordance wlth Corps of Engineers and Municipality of Anchorage (MOA) procedures. The test results are attached, If you have any questions regarding the test procedures or the results, please call.' ALASKA TESTLAB I4oward K. Weston, P.E. Technical Director 4040 B $TREET ', ANCHORAGE · ALASKA 7~22-§4 1~46 P~ ;DOWL Engineers 90756339~3;# 3/ '~ Tom Fink, Mayor ] unicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 ENGIN-g.F.I~. BULLETIN 94-2 May 27, 1994 TO: Engineers Involved with Design, Inspection and Construction of On-site Water and Wastewater Disposal Systems SUBJECT: Proposals for Innovations Systems Initial test results from the intermittent sand filter systems indicate that these systems are capable of producing a Very high quality effluent. Based on these results and discussions with Alaska Department of Environmental Conservation engineers, DHI-IS will permit and encourage the installation of approximately 10 additional systems this year. The following guidelines and criteria should be used in the design and construction of future systems: 1. The systems will still be considered innovative and a property owner agreement will he required which will specify a one year o~perafional test period with effluent sampled and tested _£or TSS. BODS, fe~)_~l ~liform, NO3, and TKN ~n a monthly basis. The agreement will 9°//~Tspecify~a~e owner will pay for the ~*_9 ~ '~ sampdi'ng program for a period of one year. 2. Use of a sand filter r0ay be used as justification for waiving the required 4 ft. vertical separation from groundwater down to 2 ft., and the required 6 ft. vertical separation to bedrock Or an impermeable layer down to 4 ft. Waiving these vertical separation distances will apply to the secondary drain field and will be approved based on a risk analysis prepared by the engineer that supports a conclusion that drinking water supplies and/or adjacent surface water drainage will not be jeopardized by the secondary discharge. 3. Application rates for the secondary drain field shall be 4 GPD/sq. ft. for soils that perc at a rate of less than 30 minutes per inch, and 2 GPD/sq. ft. for soils that perc at a rate of 30 minutes per inch to 60 minutes per inch. 4. 'Design of the intermittent sand filter shall be based on the current Orenco design of an 18 ft. by 20 ft. filter with the following modifications: a. The bottom of the sand filter shall be insulated with a minimum of 2 inches of extruded direct burial polystyrene insulation or an approved equal. Engineer Bulletin 94-2 May 27, 1994 Page Two b. An insulated 3/4" airline shall be used to connect an air pump (specified in the design package) with the'sand filter. This airline will connect to a 1" airline furnished by Orenco which will be installed in the sand filter in a 1 ft. on center spiral located 6 inches up from the bottom of the sand layer. (See the design package for details.) 5. Two mandatory field inspections during the construction phase of the sand filter will be conducted by DI-IHS personnel. These inspections will be coordinated by the engineer a minimum of 24 hours in advance. 6. Proposals to install sand filters must be submitted to DI-IHS in the same format as a permit application. No permit fee must be paid until the proposal is selected for construction. These proposals should be submitted by June 13, 1994. ~s CroP,ssrely' Civil Engineer On-site Services MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW940057 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:DUEL RONALD E & ',.., OWNER ADDRESS:P.O.BOX 1276 ANCHORAGE, AK 99510 PAGE 1 OF DATE ISSUED: 3/29/94 EXPIRATION DATE: 3/29/95 PARCEL ID:01739118 LEGAL DESCRIPTION: MOUNTAIN PARK ESTATES BLK LT 1 LOT SIZE: 20106 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 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: DATE: 1". = 80' SCALE LOT 23 50' & / ROBERT SHAFER, P.E. ROGER SHAFER, P.E. March 21, 1994 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER &WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIl. TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 'L' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: LOT I; BLOCK 7; MOUNTAIN PARK ESTATES Request yo~ issue ~ p~ to upgrade the septic ~ystem and to drill a netu r, ue~ 6e~.u,/..ng ,Ot.e ~,/_ue be.d~oom hoaae on ,Om ~ce~enene_.ed The existing septic system is in a state of failure. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The approximate location of the test hole is located on the attached site plan. The test hole was checked for ground water on 3/18/94 and was found to be dry. Research has revealed the existing well is within an easement and is located 65 ft. from a septic system on adjacent Lot 8, Block 7; Mountain Park EstateS. · ' We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your review, please contact us. ~1/ /~/~/ LSU/ jk ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 ~ m_o o 0 Z ~ ]AIHO iHOdHZNOS ~ NYqd ~J. IS I' Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ,. (ENGiN. E~) DATE PER LEGAL DESCR,PT,ON:L/,, ~',/ .,/]//Z/U' P/~' ~_~,Township, Range, Section: SLOPE SITE PLAN 10 12 13 14 15 16 17 19 20 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Monitoring? ~,J[C.k(" Date: Gross Net Depth to Net Reading Date Time Time Water Drop q'.O ~ I.g~,,,. 2.~¢', ,, ~ /~ ,, 3. PERCOLATION RATE q~ (minutes/inch) PERC HOLE DIAMETER S ENGINEERING TEST RUN BETWEEN AND __ FT 17034 Eagle River Loop Read No. 204 COMMENTS I=='C!e ~.~:'e.", ~&$[G~ ~'~l'~ ~ ~ __ ~ 'ON peoa d~1 aeAla elfia~ u~n/s ~ THAT THIS 72-~8 (Rev. 4/~) ' / / HEALTHAUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER &WATER INSPECTION ENGINEERINGSTUDIES ANDREPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAO DESIGN SOlE TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN ROBERT SHAFER, P.E. ROGER SHAFER, P.E. ON-SITE WA~£~NA'£~a DI~ SYSTI~I OONSTRUCTION PPJ~CTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 Lot 1; Block 7; MOUNTAIN PARK ESTAES The scope of this project includes the installation of a 2000 gallon septic tank effluent pumping (S.T.E.P.) system and a series of parallel pressurized absorption trenches to serve the five bedroom residence located on the referenced property. The existing septic tank(s) are to be excavated, pumped, crushed, and abandoned in place and the existing leachfield is also to be abandoned in place. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wast.water Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wast.water disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. S~-£ICTANKINSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4' of cover shall be insulated. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Page Two Lot 1; Block 7; Mountain Park Estates o A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10' from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TR~N~/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (roughed-up) before gravel (sewer rock) placement. 2J Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter and installed approximately in the locations shown on the design. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Lot 1; Block 7; Mountain Park Estates o Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. 1. Se MATERIAL SPECIFICATI(~NS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: 4e Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140/N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. Page Four Lot 1; Block 7; Mountain Park Estates 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. Se The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required, especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractor's activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractor's activities. Final acceptance of the contractor's work rests with the owner and the M.O.A. Page Five Lot 1; Block 7; Mountain Park Estates S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER Douglas T. Kenley, P.E. HC01 Box 6034, Palmer, Alaska 99645 (90?) 746-1073 May 6,, 1994 RECEIVED Lot 1, Block 7, Mountain Park Estates Anchorage, Alaska MAY 1 o 1994 Municipality of Anchorage Dept. Health & Human Services AND This is in reference to designing a replacement system for an on- site waste water disposal system that has failed. The subject property .is located at the southeast intersection of Birch Road and Ridgeview Drive. A deep trench design, prepared by another engineering firm, was earlier permitted by the Health Department. However, during excavation, it was discovered that the ground water was seven feet below grade. Subsequent monitoring seven days later showed the water table at nine feet below grade. Therefore, due to the high ground water, a deep trench is no longer feasible. Preliminary calculations show that a bed system must be approximately 2,000 square feet. The available space for the replacement system is bound on all four sides by either property lines or the 100 foot well radius setback. The 2,000 square foot bed would need to encroach on tile well radius by approximately 27 feet. Discussions with Health Department personnel have ].ed to two viable options: 1) a holding tank, or 2) an intermittent sand filter by Orenco. We propose to install a 19'x 19' Orenco sand filter and a 20' x 20' bed system. Two additional percolation tests were taken on April 25, 1994 to assess the adequacy of soil to accommodate the replacement of the proposed Orenco filter system. The results of these tests are attached to this report. The test site had adequate peroclation rate to support the 05/06/94 page 2 proposed five bedroom residence. Subsurface soils were found to be silt with some sand and gravel, with some overlaying by 12" of surface organics. The two tests ranged between approximately 20- 30 minutes per inch. If there should be any question concerning the percolation rate and characteristics of the site, please call me at 746-1073. Sincerely, DO~lg_as . K E. PE #8176 I~ermit No. Page /~ of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: ~ .Z' z~x~ 2' ,'~//~^,,~-A/z,/,~mzz~' ~.~x~'piD No.: 72-O13 A (2/91) MOA 25 ~ 30 MIL PVC UNER SCH 40 PVC LATERAL [w/1/8' dia. orifices] 1-1/4" PVC BOOT O 0 D o O [] [] [] D D ~ ORIFICE SHIELD [] [] [] [] [] to drainfield o,- CLASS 125 SLOTTED PVC PIPE [cut 1/4' wide'slots 2-1/2' deep at 4" o.c.) 0 0 [] [] ~ 18' [] D [] PVC MANIFOLD (class PO0 minimum] O [] D D [] [] [] [] D FLUSHING VALVE AND ENCLOSURE O [] [] 0 TOP VIEW CE SHIELD DETAIL , , slope ~o~drain~ --· ,~ VALVE BOX LOAMYSAND J FLUSHING PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: ~ / ~;~--" ,~ '/~"/~ '~'/~ Township, Range, Section: 1 2 3 4 5 6- 8 9 10 11 12 13 14 15 16 17 18 19 20- .' COMMENTS SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT DEPTH? ~' P Monitoring? " . Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~" ~ (minutes/inch) PERC HOLE DIAMETER TEST RU..ETWEE". J r2 FT A.D ¢/" FT cT&E Ref. ~ Client Sample ID ~4atrix Commercial Testing & Engineering Co. Environmental Laboratory Services LABORATORY ANALYSIS REPORT 94.6094-1 L1 BLK7 MT PkRK ESTATE WATER Client Name DOUGLAS F~ENLEY, P.E. WORK Order 11366 Ordered By Printed Date 12/19/94 ~ 10:55 hrs. Project Name Collected Date 12/13/94 @ 10:30 hrs. Project# Received Date 12/13/94 @ 12:55 hrs. PWSID UA Technical Director STEPHEN C. EDE Sample Remarks: ROUTINE S~34PLE COLLECTED BY: F. KENLEY. QC Allowable Ext. D~nal Parameter Results Qual Units Method Limits Date Date Init BOD5 1.0 U m~/L EPA 405.1 12/13/94 12/18/94 .TMW Residue, Non-Filterable 4.5 m~/L EPA 160.2 12/14/94 12/14/94 ~ Fecal Coliform 0 ~/100ml SM17 9222D 12/13/94 12/14/94 TMW Nitrate/Nitrite EPA Nitrate-N 43.2 D m~/L EPA 300.0 10 12/14/94 MCE Nitrite-N 1.00 U mg/L EPA 300.0 1.0 12/14/94 MCE * See Special Instructions Above UA = Unavailable ** See Sample Remarks A]0ove NA = Not ~alyzed Eu ~ = Undetected, Reported value is the practical quantification limit. LT = Less Than ~ D = Secondary dilution. GT = Greater Than 5633 B Street, Anchorage, AK 99518-1600 -- Tel: (907} 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA ... ..... 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 .GRADE LEGAL DESCRIPTION LOCATION ~~~~, ' ~ ~¢~~ NO' OF WOOMS - Wel'~ AbsorptioT Dwelling PERMIT ~ DISTANCE TO: ] ~[00 ~ ~ ~ Manufacturer / ~ - No. " Liq, ca~sallons IF HOMEMADE: Inside length _~ Width -- Liquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons ~ Well FounOatio¢ ~C, Nearest ]°t 1~ f PERMIT N?O .o. of lines __ Length of each I?nx Total length of ,in?~ Trench widths ~.,nches Distance betweeG lines TOp of tile to finish grade~? ' Material beneath tile Length Width Depth PERMIT NO. ~ Typeofcrib ~ Crib diameter Crib depth Total effective absorptionarea~ ~.GI~SSDisTANCETO:C ~ D, fller/~ Distancetolotline PERMITNO. Building foundation Sew~e Septic tank Absorption area(si OTHER PIPfi~ATER. IA LS SOIL TEST RATING ' INSTAE~ , 72-013 (Rev. 3/78) PERMIT NO, FIPPL I CFINT LOCFIT I ON LEGFIL DEF'ARTblENT 4EALTH AND ENviRONMENTAL ,TECT%ON ,,~ 825 'L" STREET., ?'~CHOR~GE., ~K. ~950~ O~ ,D~4--S I TE SEb, E~: IJF',3 E: ~ E:.E F'ERrq I T ~~ TOM STEWRRT ~2El WZLL]WR ~]RCLE ~5~ ~.:.~-8~8~ SOUTHPORT..'"R Z DGEV Z EW EOT. · BLOCK 7 MT PRRK ESTRTES" LOT ~]~E 2EleeE1 5QURRE FEET TYPE OF SOIL RB=,ORFTI_N SYSTEM I~,. TRENCH MR~-'.IMUM NUMBER OF BEDROOMS = 4 SOIL RFITING <SQ FT/BR)= :[40 THE F.'EQ IRED _I..'E OF THE SOIL FIBSORPTIQN SYSTEM IS: [~-, E P T H = t2 L El"4 G T", ,'----. 1;~:: GAR ~/EL [:, EP T H = ? THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRBINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURF8CE OF THE GROUND 8ND THE BOTTOM OF THE EXCFIV8TION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRFIVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTF8LL PIPE FIND THE BOTTOM OF THE EXCFIVFITION (IN FEET). ~:, SEPTIC: TANK SIZE= 500 GALLC~4S PERMIT RF'PLIC8NT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTFILLFITION INSPECTIONS OF ANY WELLS RDJFICENT TO THIS PROPERTY 8ND THE NUMBER OF RESIDENCE_ THAT THE WELL WILL SERVE. TI-GO ( 2 ) INSPECT I O~-tS F~F;:E REQU I RED, BRCKFILLING OF FINY _T_.TEM WITHOUT FINFIL INSPECTION FIND FIPPROVtRL BY THIS DEPFIRTMENT WILL BE sUBJECT TO FRO~EbLTIi]N. MINIMUM DISTANCE BETWEEN Fi WELL FIND FINY ON-SITE SEWFIGE DISPOSAL SYSTEM IS 100 FEET FOR Fi PRIVATE WELL OR t50 TO 200 FEET FROM Fi PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM 8 PRIVATE WELL TO 8 PRIVFITE SEWER LINE IS 25 FEET AND TO Fi COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MFIY APPLY. SPECIFIC8TIONS FIND CONSTRUCTION DIFIGR8MS 8RE FIVRILBBLE TO INSURE PROPER INSTBLLFITION. RES DEC:EI~IBE R _--<-1.. :1_980 I CERTIFY THAT t: I 8M FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS FIS SET FORTH BY THE MUNICIPALITY OF FINCHORBGE. 2: I WILL INSTALL THE SYSTEM IN FICCORDANCE WITH THE CODES. 2: I UNDERSTAND THfiT THE ON-SITE SEWER SYSTEM MFIY REQUIRE ENLFIRGEMENT IF THE RESIDENCE IS F~MODELED TO INCLUDE MORE THAN 4 BEDROOMS. ,'/ _. . , __, ISSUED B~ __ V4. 0 ~, 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 PHON~ E~NEW LOCATION~"~ ~ NO. OF BEDROOM~ ]~ell ~ PERMIT NO, ~ I DISTANCE TO: I ~~ ng .~ t ~ Z ~ Manufacturer I I ! _ r No. of c~rtments m Liq. cCpacity in gallons ........... Inside leng~ Width ~ ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. OZ~ Manufactur~ ~~~ ~ ~ ~--~ Material~ Li~acity in gallons ~ ~ ~ No.DISTANCEof lines TO: ~ ~m Fo~~ Nearest lot line PERMIT N~ Length of eac~ To~l I~g* ~s Trench wid* ¢-- Dfstanc~bT~ fines -- ¢ ~ ~¢ inches Total effectiv~ion area ~ ~ Top of tile to finish grade ~ Material beneath file ~on~th ~idth ~opth P~BMIT ~O. ~ DI ST~C[ TO: Buildln0 foundation Se~er line Septic tank Absorotion area{s) OTHER PIPE MATERIALS SOl ~ T~ST ~T~ ~G A~~ DATE LEGAL 72-013 'I"OI',1 ?f'E 141::IR T fi; O U T I.-.I F' O F~'. T LT. :l. E:M-(. 7" fq"FN PI.(. L. EGI::IL i"tFI/',ZP1UI"] h~LIl"l[3l:::.'F..' OF: F;:E~DFi:OOt'q:;5 ..... SO .T.L. Fi:FIT ); .N(Ti (5g! F:'I",-."E!:Fi: > ::: :i. 4 0 THE Fi:Eg!U I }~::'F_:~[;:, S ]i ZE Cfi:' 'T'FIE ::_:;Eli ii; L. i::IE!!::'5OI::?.F'TI ON 5;'.,":E;TEN i115;: -I"FE~ L.I:~iff,lC:FT'H D ;111"I1~:1'.,1:5 ]: OIq ii: '..5!; THE LJ:~i'-,!(3TH ( ); I'.d I::E:ET ::, OF THE "FFi:ENC:H OR !::,l:~ff::~ )7 NF )~ ELD. THE I)EF"H'-'I OF F:I "f'f~:E:NC:H OF;'. f:'ZT IS THE [:, :E STF~N('7:F:: E:E'I"NEEI",] THE: ~5;IJF?.FI::I(~:f~ GFi:OI..IND I::IND THE E:OTTOI"I CIl:::' THE E::':~CF!VFtTZOI'.,I (~:h,! FEET). 'F'HEF~:F~; ]:S NO SET t.,.I;[D'I"H I:::OFi: THE Ci[;:l::l',,,'[~;l... DEPTH ;!; 57; THE; t"1Z N ;[ NI..II',I DEF:"I"H OF GI;?.FI'v'EL. E:E'TkIEE:t'.,I "f'H!Z OI.J"I'FI::!L[.. F' J7 {:::'l~; FIt'.,I[:, THE E:OTTOP1 OF THE EF:iCfl',,,'f::IT Z ON ( ]; N I:::EET). F'Ef~:f'l ;( "F F:IF'PI... I C:F1N"I' I'"IFi'.:.'!; "I"HEZ I;;:ESI::'Oi",IS .'[ E": .1~ L.. :( 'T"t' TO ]; IqF:'Of;:l"i 'tr'l..l :[ :!7; I)E[!::'FtR"!"P!ENT Dt_II:;;: ;I; !q(:i THE ].I'.,!STF:IL.L.I::tT;[OI'4 ;[i'.,I'.E;F'EC:TZCIf.~Si; !:;il:::' FI !'.,! '.r' I.,]i~!~;L!_5 I:::ID..H::I(::E(iqT 7'0 TH ]: '..'ii; F:'I:;i;Cff::'I.~[Fi:"F't' FiI'-,I[.', THE NUI"tE:E::R OF f;;:IZS ]:[::,E;NCI~;5; THFr'F THE; I.,.IEI..L !4 P'i ~( i'.,i;i' i',ll..It,'l D i[ :5'T'Fff.,!C:E I..:3'E;]'H[.E~i~N f:~ NIE'L L FIN[) Rl",!"r' Oi'.,!'."-5~; ::LOO F'IS:ET F'O~;ii FI .r::'I:i:];V!::ITE( I.,.I[5;[...L..; OF..: 51..!50 'T'O ;21OO FEET I:::F?.CJt"I t::1 PI..IE:L. ]; C: I.,.!I~EL.L.. E:,EF'_r'.5;ND];i'.,I(iii L.!PON THE 'T'"~"F:'IS: OF' F'Llli?,L]:C !d.!Ei....I .... N[CL.L LOG5 FIt:r:?E F:'.I~)~.:!I.J)j};~[};[:, FIND I"ll...t'._':;T [!!',Iii; !;;iE2fUli'.l'.,t[ii~D TO 'T'HE[ O1::: THE .~,.]IZL. L.. COt"IF:'LI~i21" ]; ON. C!THIE!:;;: F.':Eg!LI :[ r~:[~I"iENT':'!i; I"ll::!h" f:tt'::'F:'l.."d. :!:31::'[F3Z Z F:' ¢:t'v'F:I:[LI::I[~:L.E TO :[N:51.Jt:;;:E F:'F;tOI::'EF;! ]:N::ST!::ILL. FIT ]: OI",!. :1~ C:EI:;;:T :[ I:::'"r' 'THF:!T :;L: ]: Fit;t FI:rlI"!]'L:[F:Ii:;;: [,.IZ'T'I"I "[','"lEE F;'.Eg!UZI:;i:ENE'~i",!T:5 F'Of~: O!",!"-'-S];"I",E!; 5[!EI.,.II'iiZ[;;'.S f:!F,ID I.,.iEEL!...S F:iS .'.:.'!; !'E "i ' F:OI?.TI"~ E~"r' "I"HI~.:: IVlt..tI"4ZC:]:F:'I:::IL:t.'T"r' t'.')F:' I:::II",IC:I".ICIF;'.F:t(3.r'~:. Z t4 ]: LL :( 1",!51;TF:iI.J... "l"l'-ttFZ :SV!!STIEI"I :[ N !:::IC:C:O[~:!::,F'Ii"¢,('::[/. 1.,.1 ]: 'TH THE 3:: Z I...tI',ID[E[~::E;'rF:iI'.,tD TI..41::~T THE:: '~d'-,I-.-:~;]:Ti~: 5;iEI.,.tE:[;i: S'.r'::ii;'T'[i~h! I-"IF:I'~.' F::Ei:g!l..l:[,r;~:E: I.:Ei'.41..F:!i:;:GiJi~NE.f--..IT Z,r,::' 'f'Hti~ ,':iF'F-.]: C:FthFT ' r ClY}'~:"5 T l~i: t.'., FI [~: T ............... ............ ..:.. 2204 Cleveland Anchorage, Alaska 99503 Performed 7or Thomas Stewart ~Date Per¢ormed Leaal .escr~ntton: Lot 1Block Thts Form Renorts Sotls LDo Yes 3-15-78 7 SU~t¥ts~Dn Mountain Pmr~ ~m~= ~'~d. Percolation Test Yes .neeth Feet Sot1 CharacterlstJcs Brown Gravelly Silty Sand (Moist) More Gravel 12-- 14, Brown Sandy Silt 18--~-------~-~"B°tt°m of Test Hole 20-- Was ;round Water Encountered? I~ Yes, At what Depth? ReadJn; Date Gross Time Net Time De,nth to H20 Net Dron J 3-15-78 ,3: 15 ~" j 3-16-78 10:00 19 hrs. No water i , 3-16-78 10:05 10 min 35" 0 i 3-16-78 1O;l~ 10 m~n a7" ]?" ' 3_16_78 10:25 ],O m'~n 50" ~" 3-1~-7~ 10:35 10 m~n .59" 9" 3-1~}-78 10;45 ,],O m~n 54" ?," 3-16-78 10:55 10 m~n 56" 9" ,i i 3-16-7{~ ]1:o5 In ~ 57 , 5" 1 , 5" Percolat~nn Rate 1"/8 titnute Pro.osed Installation: 'Seeaaae Pit Drain Ffeld Berth of Inlet Devth To Bottom Of Pt~ Or Trench C~H~NTS: 140 s~. ft._fraina~e area required, per bedroom. Test Performed Data Certified B~:CONSTRUCTION TEST Date: . LAB LOCATION OF WELL BOROUGH I SUBDIVISION' I LOT BLOCK LOCATION/SKETCH: DEPTHS MEASURED FROM:[]casing top I-Iground surface BOREHOLE DATA: Material Type and Color Depth From To STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF WATER WATER WELL RECORD SECTION QTRS SECTION []N DE ' []S []W WELL OWNER: WELL DEPTH: DATE OF COMPLETION Depth of hole: .~-5,~, ft Depth of casing: )EPTH TO STATIC WATER LEVEL: 7~/- / ftbelow [D top of casing [] ground surface METHOD OF DRILLING: ~ air rotary [] cable tool [] other USE OF WELL: /~domestic [] irrigation [] monitor [] public supply [] other, CASING STICK~~ft. Diam: ~ in. to/~'¢~ft Casing type: ~',~/-/ '~, in. to ~t INTAKE OPENING TYPE: [] open end [] screened [] perforated /~ open hole Depths of openings: to ft SCREEN TYPE: ~ Diam: in. Slot/Mesh Size: '~ Length: ft Dept. Health & Huma]lS~rvicesI GRAVEL PACK TYPE:"~ Vo~um~ used: ~' Depth to top: GROUT TYPE: "~, Volume: Depth: from ~- ft to ft DEVELOPMENT METHOD: Duration: /~ ~/.~-'~:? PUMPING LEVEL AND YIELD: .~'/~) ft after ~ hrs pumping /,,~"" gpm PUMP INTAKE DEPTH: ft Horsepower: WELL DISINFECTED UPON COMPLETION? [] YES [] NO CONTRACTOR IN FORMA.,T~ION,: REMARKS: N Reg~i'~recf~Bus' es . ~ /' . m.:^c....a,. ~r~U,T; cnpv nF LOG::TO: Sigd~ture df Authonzed Respre~entat~ve Date PO BOX 772116 ~GLE RIVER AK 99577-2116 P. O. Box 4-1224 . 1310C International AJrpoJ't Road MUNICIPAL TY OF ANCHORAGE (907) 274-4611 DEPT. OF .'-!fALT;I & ANCHORAGE, ALASKA 99509 EN~VIRONMENT,:.L 2, ,;TZCTI/gN DRILLING LOG FEB '8 980 Location (address of: Township, Range, S~etion, if known; or distance main road Lot 1 Block 7 ~ountain Park Estates, Anchorage 6" Hole~60 Size of easing_ Depth of feet Cased to_206. 30 feet Static water level Screen ( ); Perforated ( xx ). Describe s~P,,~tAXor perforation Perforations from 198-202' Well pumping test at 2 gallons per (t~iti~ (minute) for !,____hours with of drawdown from static level. LSO--ft. (axl2RReJ (below) land surface. Finish of well (check one) open end ( 100% Date of completion 8 / 8/.79 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of m~terial, color and hardness 0 .TO. 2 Casing s ticku~ 2 .TO_ 3 Organics 3 TO 35 35 TO 83 83 TO 121 121 TO 146 172 199 202 TO. 240 TO_ 360 TO TO _TO. .TO. ); 146 ~O. 172 ~O J99 TO 202 240 Silty_gravel Sand & gravel Hard pan Sandy gravel _ Gravelly clay _Boulder ?~x~*h(~'~d~- W~ro~_gr~v~l_(] gpm) Green bedrock Bedrock: water seeps in sporadic fractures throughout 1 CUSTOMER MUNICIPALITY OF ANOHOPAGE DEPARTMENT OF HEALTH & HUMAN SERVICES_ · Division of Environmental Services . - · . · .... On-Site Services Section . P.O. Box 196650 Anchorage,Alaska '99519.6650 .......... '~ ' ' ' 'r 343-4744 --' '-' ~CERTIFICATE OF HEALTH AUTHORITY ' APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# t~)/7'... '~/-/~ 1. GENERAL INFORMATION' ' 'Complete legaldescription ProPerty owner,~/~'~ ~_.~/,g//.~.~_./,, y..~ ~'-~-~,'-~'~-~z.4.. Day phone Mailing address ' · '~ - Lending agency Day phone Mailing'~dd~ess. : Agent Address 4. TYPE OF WASTEWATER DISPOSAL: - individual on-site ;.J:'-~:!; {'::! ': ~;:!-': :';i'' i Hoid ..... -'ii:'.-~ ..... . '.....' i~g ta:~k ;~..'~!'i:i~ NOTE:.. If c mmunity wastewater system, provide written confirmation Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: :'- ~ : .... - ~ ' .S: ..... ': .' '. ~- ' 3. '~PEoF'WATERSUPPL'y: ..... ' - - individual'well ......... ~. "' ......... '~0m'm u'hitg'w'~;i} ..... 'fi: -' "- " ........... Public Waier .......... :' ....... '- NOTE: If com~uniW-wo~i';y;iom, provide wri,e ' -~;' -' ,ng to the legali~ and status of system.- ~ cOnfir~ati°n' Day phone ~-: :' 'S;~J- ' ? - 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.,, , -, ~ :"'"' ' ' '"~ ;: Phone '7'.¢'~ Nar~e of' Fi rm g:~ ~'~"~'~' ~--r/~, ~--'~.,v¢. EngineeFs signature ~" ~ , Date _~' &% '~ '-- - ~ ~ . D~UGU, S T. KENLEY~ ¢~ ~., CE 8176 6. DHHS SIGNATURE __~ Approved for Disapproved. _ Conditional approval 'for bedrooms. bedrooms, with the following stipulations: Additional Comments The M'u~ni':'cipality of ~,nc~orage Department of Health and Human Services (DHHS) issues Health Authority ~ re resentations given in paragraph 5 above by an independent ' Annrnva ' ertificates based only upon the . .P. ..... -u~=Hn~th s acourtesytopurchasersofhomes r,~,~- .... C .F'.' _. ..... H in the State of AlaSKa./ne ~mr~ ......... as professional engineer re9~t~ ....... and their lending institutions in order to satisSJ certain federal and state requirements. Employees of DHHS do not t ns ections or analyze data before a certificate is issued. The Municipality of Anchorage is not conduc ....'P~r errors or omissions in the professional engineer's work· : : i ' responslol~u : . . i ,: :, : 72.025(Rev. 1/91) E~¢k MOAiff21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Parcel I.D. If A, B, or C, attach ADEC letter. ADEC water system number Date completed //'~ ~/5~ y Driller A. Well Data Well type P,~,MA~' Log present (Y/N) Y Total depth Sanitary seal (Y/N) )/ Cased to ' FROM WELL LOG Date of test Static water level Well flow /' Pump level1 -~ '5/~' -~ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line / ~ ~"~ Casing height Wires properly protected (Y/N) Y' ~.. AT INSPECTION g.p.m. ; On adjacent lots / '~ o -~/~'~z ; On adjacent lots / Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: ~?,~-'~/~ / ~y Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) High water alarm (Y/N) Date of pumping ~¢v.// Tank size ,~.~ ~ ,~'~z.. Compartments FoUndation cleanout (Y/N) ~" Depression (Y/N) )/ Alarm tested (Y/N) ~"~/.~--~',~y' Pumper '----- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: ~ .//~3.~'~ Well(s) on lot /~ ~:~' On adjacent lots To property line Absorption field / Sudace water/drainage /~,c/~ ~'~,~'~ Foundation Water main/service line ? Z~ ~',~'~ 72-026 (3/93)° Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) "Pump on" level at Manufacturer ,,~'~,,~ ~ .,/.¢'~ ,~..,~' ~ Manhole/Access (Y/N) · ,5"'/~ ,~/ "Pump off" Level at Cycles tested .~' SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot //''~' // On adjacent lots / ~' / ~'? Sudace water /~//"~ D, ABSORPTION FIELD DATA Date installed Length Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/FF) ~,,/1~./~'~ ~,~- ~ystem ty~ ~ Gravel thinness ~' / Total depth ~ Cleanout present (Y/N) ~ Depress~n over field (Y/N) ~~ ResuEs (pas~fail) for ~ Bedr~ms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot / ~ ? To building foundation On adjacent lots z_/,~',~-/ Sudace water /u/'~"~'~' Curtain drain ~,~ If yes, give date On adjacent lots / '~ ¢ ,z-/._ Property line .J"~ ,~-',," To existing or abandoned system on lot Cutbank A/~ Water main/service line Driveway, parking/vehicle storage area Y ~ E. ENGINEER'S CERTIFICATION I ce~'fy that I have checked, verified, or conformed to all MOA and HAA guidelines in e~f~.~,[h,e date of this inspection. "~ Fee $ ~_~ ~ O ~ Waiver Fee $ Date of Payme~ ~ ~A~ ~-~ F ,% Date of Payment Receipt Numar ~ ? ~'' :~) Receipt Number 72-028 (~)' ~ck .- CT&E Ref.# Client Sample ID Matrix Client Name Ordered By Project Name Project# PWSID Sample Remarks: Commercial Testing & Engineering Co. Environmental Laboratory Services ~~;~z~-,47,~z~ LABORATORY ANALYSIS REPORT 94.4260-1 LOT 7BK 1 MTNPARKEST WATER DOUGLAS KENLEY, P.E. WORK Order DOUGLAS KENLEY PrintedDate Collected Date Receiv ed Date UA Technical Director 81512 08/23/94 ~ 15:51 hrs. 08/18/94 ~21:30 hrs. 08/19/94 ~ 13:20 hrs. STEPHEN C. EDE Released By: ROUTINE SAMPLECOLLECTED BY: E. KENLEY. Parameter QC Allowable Ext. Anal Results Qual Units Method Limits Date Date lidt Nitrate-N 1.17 mg/L EPA 353.2/300.0 10 08/22/94 CIvlR * See Special Instractions Above ** See Sample Remarks Ab ove U = Undetected, Reportedvalue is thepractical quantification limit. D = Secondary dilution. UA = Unavailable NA = Not Analyzed LT= Less Than GT = Greater Than 5633 B Street, Anchorage, AK 99518-1600 -- Tel: (907) 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACiLiTIES iN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA 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 I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ~)\'-~ _ _~c-'~ \ _ \~ HAA# GENERAL INFORMATION Complete legal description Location (site address or directions) ~/~ ~;~"~ & ~J ~.P ~ ;w~,!t~,-~- Property owner ~'~'~"~ ~-~ Mailing address /~' ~ ¢~' Day phone Lending agency Mailing address Day phone Agent Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ " TYPE OF WATER SUPPLY: NOTE: Day phone ~-'~' 2. - I'Z..'7.-.'Z-, Individual well Community well 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: Individual on-site Holding tank Community on-site Public sewer NOTE: If community Wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. Well Data Well type ?~ Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number ,v'~- ~ Date completed -~" ~ / ~/~'/-7/ Driller Cased to /~g ,'~;'~ Casing height Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level Well flow /' Pump level1 Absorption field on lot Public sewer main Sewer service line SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot /~ .g.p.m. AT INSPECTION MUNICIPALITY OF ANCHO~G~ ENVIRONMENTAL SERVICES DIVISION: g.p.r~)AY 2 G 199~ RECEIVED ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform: ~ Nitrate Date of sample: Collected by: Other bacteria SEPTIC/HOLDING TANK DATA Date installed / Cleanouts (Y/N) ~/'~ High water alarm (Y/N) Date-o~pumping Tank size /.C~, ~ ~'. ,~ ~ Compartments Foundation cleanout (Y/N) /~,~ Depression (Y/N) W'/~ Alarm tested (Y/N) ~/~,.~/V/_ J~ .~'h Pumper Well(s) on lot To property line Surface watc,~'~'~ainage SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: On adjacent lots Absorption field ~!,-~,~ Foundation Water main/service line ~2-o26 (3~93)' Fro~t CONTINUED ON BACK PAGE F~o~ : flLP]NE DRILL 90? 345 0202 F1ag. 24.$994 07:55 PH POi CI~F,~t:# Commercial Testing & Engin fing Co. LABORATORY ANALYSIS REPORT 94-1857-1 L7 BLKI M'Jlq PARK lk~T WATER WORK O:det 77810 Pgintcd Dale 0q189{94 ~}11:38 i)ra. Colleoled IX41e 0~1/26194 ~ 14:00 }Its, 1;teeelvMBate 04/26194 ~ 17:25 1~. 1Ntmical llire~or STF. PHEN i~. EDE ROIJ'i]NE ~MPLEC(fl.I.ECTED Il'F: D.I,.]-]. QC Allowable ]~xl. Anal Results Qmti Units Method Limits Dale 1)a1¢ 1,06 ~g/L EPA 353.2t300,0 l0 04/2,Pd94 Ir.f= L~'ltmn (Il'= {.k*.:~d¢~ 'lhml 5033 B Slroet, Anahorafle. AK 99518-1600 -- Tel; {907) 562-2343 Fax: (907) 5(11-5301 ~.NVJRONI~ENTAL FAC/LI'I'IE~ IN ALASKA, COLORADO, FLORIDA, It I INOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, ~¥EST VIROINtA & ~ ~ DA'~E RECEIVED .... INSPECTION APPOINTMENTS TIME' - TIME ~ ~ TIME DEPT 0~ ':"LT;' & MUNICIPALITY OF ANCHORAGE E' IR ' , ', ' '' ' I DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT O 825 L Street - Anchorage, Alaska 99501 (~) ENVI RONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED REOUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be proce~ed, Please allow ten (10) days for processing. 1. PROPERTY OWNER --, ~ i PHONE . ~ / PHONE PROPERTY ~ESIDENT (If different from above) . MAILING ADDRESS 3, LENDING INSTITUTION ~ ~ . . PHONE MAILING ADDRESS ~ , 4. REALTOR/AGENT / ~ PHONE MAILING ADDRESS / 5. LEGAL DESCRIPTION STREET LOCATION . .-. 6. TYPE OF RESIDENCE- [~'~SI NG LE FAMILY [] MULTIPLE FAMILY 7. WATER SUPPLY ~i~DIvIDUAL* [] COMMUNITY [~] PUBLIC UTILITY NUMBER OF~BEDROOMS [] One _,.~our [] Other wo [] Five hree [] Six * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM ~]'"~i N DI VI D UA L/ON-SITE** [] PUBLIC UTI LITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS F-I SINGLE FAMILY ~ ONE I~ THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY ~ ---~'~ ~'~ Connection Verified INSTALLER []Septic Tank or [] Holding Tank (~'~ , Size: / O(Do If Tank is homemade SOILS RATING give dimensions: ~ ~:~'0 TYPE OF TANK MANUFACTURER ~._~ TOTAL ABSORPTION AREA MATERIAL 4, DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS [Z~/i~PPROVED FOR . ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must acc~o.~pany certificate) [] DISAPPROVED DATE (~z~ ~ /-~--¥L) BY 72-010 (Rev. 6/79) 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 2(34 4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAl_ PROTECTION May 12, 1980 Tom Stewart 8420 Williwa Circle Anchorage, Alaska 995~ Subject: Lot 1 Block 7 Mountain Park Estates Subdivision Approval for your individual sewer and water facilities can not be granted until the following items have been completed: (1) The water analysis report be delivered to this department from Chem Lab[ 5633 B Street, for our review. (2) Your application shows the number of bedrooms exceeds the number the sewer system was originally designed for. The system was designed for a three(3) bedmoom only. In order for this department to approve it for a four(4) bedroom, an upgrade of the system would be required. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw CC: 1st National Bank of Anchorage Mortgage Loan Department Post Office Box 3128 99501