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PRATOR BLK 1 LT 1
Prator Block 1 Lot 1 #017-091-55 Municipality of Anchorage Page —Lof 2 -- DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: �►�� Z`�� PID Number: /_�/ laq /SSS Name Wastewater System: ❑ New XUpgrade Address: G'��t>L- (o i5' �f�S6iT �� ABSORPTION FIELD Phone: No. of Bedrooms: --Deep Trench El Shallow Trench ❑Bed El Mound El Other LEGAL DESCRIPTION Soil Rating: / Z- Total Depth from original grade, b !3— GPD/Sq.Ft. Lot: Block:Subdivision: _ Depth to pipe bottom from original grade: Gravel depth beneath pipe fq P�rzfr,��-- Ft. Ft. Township: Range: Section: Fill added above original grades., Gravel length: Ft. Ft. WELL: ❑ New ❑ Upgrade Gravel width: / 3 Numberoflines: Distance between lines: I Ft. I01 -A. Ft. CI ication (Private, A,B, ): Total Depth: Cased To: Total absorption area: Pipe material: �$ /0 Fkr-r /i� E/1ST Ft. Ft. 5M SQ. Ft. /"rs � 7p Driller: Date Drilled: Static Water Level: Installgr: CIZ5 GPU C Date installedley / 5 Ft. Yield: Pump Set at: Casing Height Above Ground: TANK GPM FL Ft. SEPARATION DISTANCES 4septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer:Capacity in gallons: T 5j From Tank Field Station Tank Sewer Lines /Tn/G../'7/'��f (y-�/y / Z V Well X� 146/ _, — 2S Material, --.- Number of Compartments: ✓ I C_ Surfa `oi y6�� LIFT STATION watce Lot Line ��/ ---, Size in gallons: Manufacturer: Foundation ��.A� -TT�3 "Pump on" level at: "Pump off' level at: High water alarm at: Curtain O . /G 9/� / / Pump Ma Model Electrical Inspections performed by: Drain _/Aj NG /'vii P`F BENCH MARK Remarks: Location and Description: rjczri.L Assumed Elevation. C�O ENGGllI &,ff.§j AL 'A Oct Road, No. 204 17034 Eagle River LOOP Inspections performed by: E,agleRimmer,Alaska "577 Dates: 1st 2nd : ,A Ft t!. ost3. i4JP r Department of Healt anHu vices app)ro al. i eJ oos l L'i%l�""i Reviewed and approved b �` Date:I 'N_».-Z� 72-013 (Rev. 9/91) MOA 25 Permit No. SW930254 Page 2 of 9 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: PRATOR SUBDIVISION, BLOCK 1, LOT 1 _ PID Nog 1709155 C01 915' NEW 1250 GAL S.T. CO2 85.4' FINAL GRADE 85.3'- FCO 39.5 2.6 COI 68.5 39.4 CO2 75.3 47.4 DV 81.2 53.8 CO3 96.8 71.5 C04 89.0 86.0 MT 89.61-85.5 MT C04 10' UTIL ESMT. C04 MT KNEW TR NCH G G TH 100, A 10' X 20' ANCHOR ESMT.DIVEALVERTER G V DBL col 1 1 CO3 co __+_J. NEW 1250 GAL. SEPTIC TANK I EXISTING CRIB ABANDONED 1 SUCH THAT IT MAY BE USED Y I IN THE FUTURE 0 < S ALE I I" = 40' 4 BDRM HOUSE I DRIVE WELL ENGINEER'S SEAL MIM, A, 145 4, 7 PAVE 1 VY 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON—SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930254 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:COWAN ROBERT C & OWNER ADDRESS:6915 RABBIT CREEK RD ANCHORAGE AK 99516 PARCEL ID:01709155 LEGAL DESCRIPTION: PRATOR BLK 1 LT 1 \ LOT SIZE: 62029 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 7/27/93 EXPIRATION DATE: 7/27/94 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 343-4329 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: RECEIVED BY: ISSUED BY: DATE: 7 2 7 DATE: -7 /?,-1 h3 M rn� 7 3� ROBERT SHAFER, P.E ROGER SHAFER, P.E. 1993 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, AK 99519-6650 SEWER & WATER MAIN EXTENSIONS : Prator Subdivision, Block 1, Lot 1 SEWER & WATER INSPECTION He request you issue a permit to upgrade the septic system serving the four bedroom house on the referenced property. Owner reports existing septic system is in a state of ENGINEERING STUDIES failure. ANDREPORTS test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attachedWELLINSPECsite plan. The monitoring tube within the test hole &FLOW TESTTION as been checked and found to be dry. We do not anticipate any adverse effects on neighboring roperties by the installation of the proposed septic system. SITE PLANS If you have any questions, or require additional information for your review, please contact us. ROAD DESIGN incer3�Ik r SOILTEST ,'/Xgbfrt -A. Shafer, P.E. TEST PERCOLATION / S/LSU/lsu STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTE WATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 1" 40' UPGRADE SCALE PRATOR STREET ti z��Dm am`Sym On�o� NAmmIZ M OZQp A.Z ., m VIm�A z -i mw.P,. tj 00 o—w If�n Ln N 00o 0 0 00 b �O 0 ill 0 0 (�o -ice 0Z;-)0 D V) N z2 -i D C L � OC Lr ZA zrn� -J o () o 0;0 EU ."LIQ—I z H n 'T'xH O >C Nt] I o z m '� " e _ ODDm -ri--iN r 0cn 13 01-3 M H 0 to O a _ 7r —1 0 z C� �doH cii co m a 0 o cw C Ccnm p � �t-j r fel N c d iU w wm 0 bi UI 4] H �„ � yyo Ilix0� H a DDfmj tj 0 WO bi m x Dm� �L-j de C- 00�Zo 0 rob ty T V n o I H zm� tq d y mem Al 0 ti z��Dm am`Sym On�o� NAmmIZ M OZQp A.Z ., m VIm�A z -i mw.P,. tj 00 o—w If�n Ln N 00o 0 0 00 b �O 0 ill 0 0 (�o -ice 0Z;-)0 D V) N z2 -i D C �Zm� OC Lr ZA () h'10: 0 s br z m � = e _ ODDm -ri--iN lr._.r C Z(n� ° o m -O _ mN cw C Ccnm p � v m x Amin D D' tD C- 00�Zo w C rc ZD;u zm� mem mm= r*m -tmz N = p__ Ln m O O � A> �K o 060 ZZ -[i z m (10 z RAgg`� ROAD CREEK O D e Lr h'10: 0 s br �•r' 4 � = e _ lr._.r Municipality of Anchorage 4 DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Il:C�Q cc��r-' DATE I LEGAL DESCRIPTION: 70IL La7� S/ &k / Township, Range, Section: /i l. DEPTH SLOPE SITE PLAN (FEET) 2ll 3 4 5 6 7 / S(Liy Sc oy Clza� C7b&SaMF_ SP LENSES (/ !4"D FEW CAy CE,stii� S W - w/t=L(- 6i4; Sago i i i F1 WAS GROUND WATER ENCOUNTERED? RE COMMENTS IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? deo s L O P E Date: PERCOLATION RATE (minutes/incgh) PERC HOLE DIAMETER D TEST RUN BETWEEN T AND 9, S FT PERFORMED B Eagfe River, Alaska 995" ACCORDANCE WITH ALL STATE AND MUNICIPAL G 72-008 (Rev. 4/85) 1110 N (,- 4Z Z -,C CERTIFY THAT THIS TEST WAS PERFORMED IN INE ECT ON THIS DATE. DATE: ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Prator Subdivision, Block 1, Lot 1 GENERAL: 1. The scope of this project includes the installation of a 1250 gallon septic tank and leachfield trench to serve the four bedroom residence located on the referenced property. The existing septic tank is to be excavated, pumped, crushed, and abandoned in place 2. 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 Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. 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. 5. Contractors installing wastewater 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. SEPTIC TANK INSTALLATION: 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. Page Two Prator Subdivision, Block 1, Lot 1 July 7, 1993 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. 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 ft. 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. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: 1. 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 (ruffed - up) before gravel (sewer rock) placement. 2. 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. 3. 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. 4. 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 Prator Subdivision, July 7, 1993 Block 1, Lot 1 5. 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. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: 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. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, it's gradation specifications must conform to AMC 15.65.060D. Page Four Prator Subdivision, Block 1, Lot 1 July 7, 1993 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: 1. 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. 2. 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. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: &17' cowrir' DATE LEGAL DESCRIPTION:rVJ57-C DEPTH (FEET) 2 C St�tY SQrwOy Cry 4 ] I (& I'''/ �atMF�L P LENSEs CCAy CEN& 5 0 7 COMMENTS PERFORMED 13f'91' River, Alaska 99577 ACCORDANCE WITH ALL STATE AND MUNICIPAL 72-008 (Rev, 4/85) ), Range, Section: SLOPE WAS GROUND WATER F-NCOUNTERED? S IF YES, AT WHAT t" O DEPTH? — P E Depth In Water AI /� Monil°ring7 UC- E..� SITE PLAN LR7eaate G"Oi$ TT:a Net Time Depth to Water Net Drop Ie IiIiDY� 011E 1�" 3 ILI Q S PERCOLATION RATE (minutes/inch) rPERC HOLE DIAMETER TEST RUN BETWEEN T AND 9, S FT CLOW (YtlN r}% �L USE /Z r f%CP %I �C6fLUNC- CERTIFY THAT THIS TEST WAS PERFORMED IN N E ECT ON THIS DATE. DATE: .►�i«J�hp\ MA HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELLINSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Septembers. 23, 1993 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 RECEIVED MUNICIPALITY UP ANCHORAGE SEP 2 3 1993 Department o4 Heatth and Human Se v i ce,6 Attn: John Smith Municipality of Anchorage P.U. Box 196650 Dept. Health & Human Services Anchorage, AK 99519 RERERENCE: Lot 5D; Btock 2; Ditake Subdivision, PID #017-461-14 Dean Mn. Smith, I was in4orsmed by the homeowner that they had eompteted the nepa.ivus which you addressed in yowl tetter dated August 26 ,1993. 1 .%anapeeted the property on 9122/93 and am prov.idi.i.ng you the 4ottow.ing .in4ormation re.ea ive to each o4 the 4,i.ve .items addreased .in your tetter. 1. The owners o4 this property and a neighbor each upgraded their septic systems at the same time. Mr. Pottard's septic system was designed by Ftat Top Techniciat Services white the neighbors septic system wat designed by S 9 S Engineering. Mn. Pottard and his neighbor jo.intty rented the necessary excavation equipment to .in,staPt the k systems. It .is my understanding that they had dveussed .insta ting thein systems with a teptLezenta.tive o6 yours o44-i.ce. 2. Your. comments on this item ane in error. The design stiputated east .iron pipe 4rom the house to the septic tank and not 4rom the septic tank to the teaeh4.ietd. The asbuitt drawing has been corrected to .indicate where the cast ikon pipe was .instaPted. 3. Etevation6 taken upon reinspection ver.i4-te6 that the absorption t)Lench contains 4 400t di44eAenee .in elevation beam the bottom o4 the ctean out to the bottom o4 the monitoring tube. 4. Stand pipes and monitorsi.ng tubes have been repaiAed and eurrentty plumbed. F.inat grading has et minted aP,2 depressions. 5. A copy o4 the wett tog is attached. 14 we may be_94-,4urther sexv.ice, please contact us. A. SHAFER, P.E. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 OGRF ;.R ANCHORAGE AREA BO'- IGH Department of Environmental Quality m 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM h/L �} NAME Q%! MAILING ADDRESS 5,414 �x / 1 31 PHONE�7 ' 2 LOCATION LEGAL DESCRIPTION ►^��' Y71IC� Pv�tor s/� SEPTIC TANK: DISTANCE �ad' e�1liil NUMBER OF FROM WELL ANUFACTURER MqC� '5/e'elMATERIALCOMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY f Z�� GALLONS. SEEPAGE PIT: NUMBER OF PITS-!—. DIAMETER OR WIDTH", LENGTHIJ, DEPTH / �^ LINING MATERIA L`�C CRIB SIZE: DIAMETER—DEPTH % 62 DISTANCE FROM: ,^ec?ulee GG��jj��, / BUILDING FOUNA`TI'ON� -/W/ NEAREST LOT NE 80 TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) 7'w2 SQ. FT. ADDITIONAL ABSORPTION WELL: ✓mat in G71 %ir» P D �n��fC�011 TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED FRI&IFA►[41261 INSTALLED BY: `-971aE/QV PIPE MATERIAL: l Ca ;10;� LOT SLOPE: REMARKS: 4vt3A 1 19-5— ��'n'l Form No. EQ -031 NEAREST SEWER LINE REMARKS DEPTH// DI_STANCE FROM: TAN I /!%D y�l1l�TE DIAGRAM OF SYSTEM GREATER ANCHORAGE AREA BOROUGH 9�cffll PERMIT NO. DEPARTMENT OF ENVIRONMENTAL QUALITY3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT y� [' S 3 f�'t-5Z90 y/� NAME OF APPLICANT _/y� e » f / 7 19:b MAILING ADDRESS �" + / PHONE INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK v SEEPAGE PIT DRAIN FIELD , OTHER TYPE AND SIZE OF FACILITY TO BE SERVED ���''��" • - FINANCED THROUGH �y �^ / TO BE INSTALLED BY SOIL TEST RESULTS T77 S�< ` �/" l NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE S4 TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK 5 - FOUNDATION FOUNDATION TO SEEPAGE PIT 2D DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL 1-5t SEPTIC TANK Z�-, SEEPAGE PIT �. DRAIN FIELD TO NEAREST LOT LINE. / WELL TO SEPTIC TANK f!/, O O / SEEPAGE PIT DRAIN FIELD ! ` ALSO CONSIDER AREA WELLS. r r WATER MAIN TO SEPTIC TPNK /p SEEPAGE PIT �O DRAIN FIELD to SEPTIC TANK, DO r , SEEPAGE PIT [ Oe P DRAIN FIELD/O 4:517 TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER SIZE / S / 2' k) &'Cef E DIAGRAM OF SYSTEM 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE APPLICANT'S SIGNATURE Cf1 PJM mn FO -111 A ORDINANCE NO. 28-68 AND THAT THE ABOVE -a= 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE APPLICANT'S SIGNATURE Cf1 PJM mn FO -111 A ORDINANCE NO. 28-68 AND THAT THE ABOVE Performed for G1 Legal Description: This form reports: Depth Feet i- 2- 3 Inlet SM 250 4 5 6 - GW 85 7- g - -. ME Department of Environmental Qlity 3330 "C" Street Anchorage, Alaska 99503 SOILS LOG - PEROLATION TEST Excavating Block 1 Prator Subdivision s log Yes Percolation 13 - 14 - 151 Bottom of Zest Hole Was ground water encountered? No S/'OpP x'' hh o AUG - 1974 PM GREATER ANCHORAGE AREA BOROUGH DEPT. OF 9P; FNTAL QUALITY Date Performed 7/27/74 If yes, at what depth? Reading Date Gross Time Net Time Depth to Water Net Drop Percolation rate III IIU I.C. Proposed installation: Seepage Pit Yes Drain Fie _ Depth of Inlet Depth to bottom of pi t or trench COMMENTS: -Io g.rouH-1 water or bedrock encountered Performed By: Neal.�_Iia��a _._____Certified By: �tr,T�rt�on_Te UaCe:_ a EQ -040 (6/74) E 545,000 E 54215001 ' vi00 --945/ �- /8/61 -- A0�\ ' / v 0 e09_\ 1 I �I. III. I /, g5/ O e07 / j O /\886 i l/ / BBx- „ 827 Box ALPINE 906 /,i EL. 979.10 x996 985 �i l X 772 1 O S 958 945 _ A• _ �� ��, ��� lac �\ �� � � P/pA7*0R I� \K'-- GRE 'TER ANCHORAGE AREA BOVIUGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM L3�-�zqb NAMEA �� (N `�tUI�1S'U MAILING ADDRESS SRPHONE iL�"q��I� LOCATION )i C CEA, kA (11 Ark �L LEGAL DESCRIPTIO C CA V- &I o SEPTIC TANK: DISTANCE / / i NUMBER OF FROM WELL MANUFACTURER YCC- Y MATERIAL SAG r- 1 COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH — LIQUID CAPACITY 1030 GALLONS. SEEPAGE PIT: 0 NUMBER OF PITS. DIAMETER OR WIDTH, LENGTH, DEPTH % `� y`AU C 1 LINING MATERIA CCRIB SIZE: DIAMETER—DEPTH (� DISTANCE FROM: WELL ii I TOTAL EFFECTIVE BUILDING FOUNDATION, NEAREST LOT LINE . ABSORPTION AREA (WALL AREA) 49 _SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE '% VAi ' t CONSTRUCTIONk-S) 11 KS1 N) DEPTH ��S 5 DISTANCE FROM: BUILDING (� I NEAREST i. NEAREST 1 SEPTIC I SEEPAGE FOUNDATION -1—, LOT LINE, SEWER LINE-��f , TANK , SYSTEM 5 CESSPOOL APPROVED , OTHER SOURCES DISAPPROVED REMAR DISTANCES: S il©wk1 DIAGRAM OF SYSTEM INSTALLED BYbAVC. 1=><t S -i iP PIPE MATERIAL: K 1itt 1 4 fl SSA D�c�'' H o� ; ► a°� a„� f iC LOTgs\ OPE: ✓a <0 REMAR S: ck W N DATE i0 APPROVED Form No. EQ -031 VAI h ,�••xON,pF 4 GREATER ANCHORAGE AREA BOROUGH i= °y DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. ` 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANTMA�1 NG ADDRESS -,�T kA X� PHONE _5Q X3 INSTALLATION LOC, LEGAL DESCRIPTIO INSTALLATION OF: SEPTIC TANK l� SEEPAGE PIT— , DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH '�� TO BE INSTALLED BY SOIL TEST RESULTS NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST hzCOMPLETION DATE ANTICIPATED i FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE "I'��1 TYPE � � KQ- SEEPAGE AREA SIZE ul/AiL //&G.L�� TYPE MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM FOUNDATION TO SEPTIC TANK cJ 1 FOUNDATION TO SEEPAGE PIT �O DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL l � SEPTIC TANK *� SEEPAGE PIT �� DRAIN FIELD TO NEAREST LOT LINE. _ ^� �` WELL TO SEPTIC TANK L`/ Imo' EPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT /0 DRAIN FIELD 1Cg<i SEPTIC TANK. �, SEEPAGE PIT DRAIN FIELD i . TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM 1' IS IN ACCORDANCE WITH SAID CODE. DATE ] � �l�/� /�73 APPLICANT'S SIGNATURE FORM NO. L0-016 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY Case # 3330 "C" Street ANCHORAGE, ALASKA 99503 Performed For %� �e��; ,cru Dated Performed—�� Legal Description: Lot Block �_Subdivision� �T This Form Reports Soils Log Percolation Test - Soil Test Must Be Logged To 4' Below Proposed Seepage System Depth Feet Soil Characteristics 1- 2- 3- 4- 5- 6 — FS 7- 8- 9- 10- 11- 12— 13- 14— Was Ground Water Encountered? 1r If Yes, At What Depth? S� opF _j_I Reading Date Gross Time Net Time Depth to H2O i Net Drop Percolation Rate Minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth to Bottom &fPit Trench COMMENTS: BJ `f OK I� �Ac "/% Gf Sof'/ _ Test Performed BY /�r��u �. z2��Q Date Certified BY: Date: Municipality of Anchorage Development Services Department Y}- Building Safety Division / On -Site Water and Wastewater Program �, 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 614-iXII-55 COSA# MnA�S,�t, Expiration Date: 0 — 3 — D 7 1. GENERAL INFORMATION •Complete legal description &-Alcor SID D)�k 1 L,} 1 Location (site address) - Gl is RAbbit Creelb_ Roxc� Current Property owner(s) Bob Cp%.oar\ Day phone 571- 2-919 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address &9 IC RaUi+ Creel- Ro;kX Day phone Day phone Unless otherwise requested, COSA will be held by DSD for pickup. �► � i1 i j l • 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [� Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Individual On-site El Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of 'title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Nameof Firm $Pl1W AmD ENGIN6C.Qtl1!(r Phone 239-39tt. Address Engineer's Printed Name 5. DSD SIGNATURE Date F O1" AZ.4 11, LARSE.SFURKLAtiD:� !e"� Approved for bedrooms. Disapproved. '+(1IE` __- Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: � Original Certificate Date: 7 /3-07 (Rw.. 11105) Municipality of Anchorage • Development Services Department Building Safety Division a ' On -Site Water& Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Prator S)D 1310-k I Lo} 1 Parcel ID: 0 %-o 91-5 - A. WELL DATA Well type Res If A. B, or C provide PWSID # = Well Log (YIN) v Date completed (1a'413 Sanitary seal (YIN) _y_ Wires properly protected (YIN) Y Total depth ,32Q_ft. Cased to > YO ft. FROM WELL LOG Date of test 11 y 93 Static water level Well production -4-N ft. Casing height (above ground) +12- in. AT INSPECTION G20 O g.p.m. OAOR g.p.m. WATER SAMPLE RESULTS: Coliform ,_colonies/100 mL Nitrate 1.713 mg/L Arsenic: NDr L5 _ ug/L date of sample: o'_ B. SEPTICIHOLDING TANK DATA TankType/Material &Lc qi+ IznA¢. Slee( Tank size 1250 gal. Number of Compartments Z Other bacteria --O--colonies/100 mL Collected by: Lars S41a.Cl" Date installed 9L/ 93 Cleanouts (YIN) y Foundation cleanout (YIN) -I— Depression over tank (YIN) _6L High water alarm (YIN) IV Date of pumping /4 o Pumper A+ iioone ,SeW iced C. ABSORPTION FIELD DATA Date installed 9 / 9 Soil rating (..d./ft r ft'/bdrm) L 2 System type "`Sp Tfenc)-% Length So ft. Width 3 ft. Gravel below pipe 5 ft. Total depth A ft. Eff. absorption area 52 _ft2 Monitoring tube Y Depression over field N Date of adequacy test 2 o Results (Pass/Fail) P453 For _L bedrooms Fluid depth in absorption field before test 4 in. Water added 650 gal. New depth 20 in. Elapsed Time: '271 min. Final fluid depth 15 in. Absorption rate >= GOO g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) None knowe% If yes, give date "'- D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pumpon' Iev _ in. 'Pump off level a in. High water alarm level at in. Datu Cycles t d Meets alarm & requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100 + Absorption field on lot 1007+ Public sewer main 1001 i' Sewer /septic service line Jn a 25 ` L.S, Animal containment areas 50+ On adjacent lots loo+ On adjacent lots 100,+ Public sewer manhole/cleanout /",+ Holding tank N1 -A Manure/animal excrete storage areas 100.{ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: I , Building foundation S f Property line 5 + Absorption field 5+ Water main l0+ Wells on adjacent lots loo r Water service line 101t Surface water 100.{ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 101 r Building foundation 108+ Water main 10+ Water Service line 101+ Surface water 1001t Driveway, parking/vehicle storage 10 14 Curtain drain At. O. Wells on adjacent lots loo + F. COMMENTS - e G. ENGINEER'S CERTIFICATION G. 4gTH4� 9 + i I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name ars SDu���a�� t1l l` ' ;3 "r Date -+I iloq COSA Fee $ 1430 Date of Payment Receipt Number 9 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage ,.. . • �' Development Services Department Building Safety Division ��?•� '-s�;..; On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Nater Well Advisory Health Authority Approval # 070232 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block 1, Lot 1 of Prator subdivision, the well's productivity was determined to be 0.68 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4 -bedroom residence is 0.42 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. ,29.061 i pp �g3 I 9� �31,Sp39 ra+ i cA EWA N ix I I `q, FER M o/ �x/* � X Un! N 0 0 J Q Z 0 �SnOH AH\ (RD Z O W W Q W W O W1 • �N O {— p c b F@ $ o `�•: °'tea Nq ` J 3 x s" N yy�l ,29.061 i pp �g3 I 9� �31,Sp39 ra+ i cA EWA N ix I I `q, FER M o/ �x/* � X Un! N 0 0 J Q Z 0 �SnOH AH\ (RD Z O W W Q W W O W1 • s"�r-1 __— — — — — — — ----------~+ 1N3W—V3 kina1,Oy O M 133�:I1S M "00,£0.00 S o M ?JOIVd Jd �N O {— p c b F@ $ o s"�r-1 __— — — — — — — ----------~+ 1N3W—V3 kina1,Oy O M 133�:I1S M "00,£0.00 S o M ?JOIVd Jd �N J p c b F@ $ o CO 00� Nq 41 3 x s" N yy�l U'8°o m P.".F iPOO r opEp �0 2 RE � a' �n Z Z 0v: s• � a"ass ,LL•ll LA _3 "a a O Z �jOr •l�C�Cb —v o "fi 1 C Q s o P V a .cPa.•d���, o.c 4: S s��g rc$mac Co�Ooh a�wP u O n C N C � 0 0. < 0 M o U 'O i i i 0 m M O N N O W 0 ►� 3 o J v s p 00 0 S s Z LLiLA 40 Z N 1 Z�� W .... r v x V) 04 Wa s"�r-1 __— — — — — — — ----------~+ 1N3W—V3 kina1,Oy O M 133�:I1S M "00,£0.00 S o M ?JOIVd Jd �N J O I o CO Nq Zit O u0 U'8°o ]m (Y o V1 0 Z 0v: m _3 J MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES 66 Division of Environmental Services On -Site Services Section LAXIEd P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D. # 1-1-iC�°11- �� 1 I1(� HAA # "RA'i n 1. GENERAL INFORMATION Complete legal description Lot 1;.:8tock 1; Prator Subdivizion Location (site address or directions) 6915 Rabbit Creek Road Property owner Bob Cowan Day phone 345-1729 Mailing address 6915 Rabbit Creek Road Anchorage, AK 99516 Lending agency Mailing address Agent AAA�o Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 \f 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water Day phone Day phone 1: - ¢° NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX 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 MOAN21 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 iii effect on the date of this igspection. Name of Firm Address 17034 Eagle River Loop Road Engineer's signat T, 6. DHHS SIGNATURE Approved for I bedrooms. Disapproved. Conditional approval for Additional Comments Z Phone Date /0 bedrooms, with the following stipulations: Date //- 15-- �.3 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1191) Back MOA M21 Municipality of Anchorage Department of Health and Human Services0 z HEALTH AUTHORITY APPROVAL CHECKLIST m z� t.3 m y tmEs11 C Legal Description: �of���D'2-S�r' Parcel I.D. rt' A. Well Data Well type P9 -%\t 5� If A, B, or C, attach ADEC letter. ADEC water system number lt� Z;)R Log present O/N) Total depth Date completed Driller 300' Cased to Casing height 12 Sanitary seal ®/N) Date of test Static water level FROM WELL LOG Wires properly protected &N) Well flow \ . d g•p•m Pump levell 7,00, SEPARATION DISTANCES FROM WELL TO: AT INSPECTION SSS TY\a.-! 9.p -m. Septic/holding tank on lot \ o 5' _;On adjacent lots 1 •oo\ Absorption field on lot 11-Yk�; On adjacent lots \00 Public sewer main '� `!� Public sewer manhole/cleanout Sewer service line Petroleum tank 1.6- WATER S WATER SAMPLE RESULTS: Coliform D Nitrate Other bacteria b 5 &5 Eft sl!P13�Pa Date of sample: 3 Collected by: _l 3Fa lgaalu Riur Loop Road k10 204 Eagle (fiver, Alaska 99577 B. SEPTIC/HOLDING TANK DATA Date installed `" -\ '`\ Tank size \25o Compartments 2 Cleanouts ON) _Foundation cleanout(Qd'/N) Depression (YQ r1 High water alarm (Y& -� `` Alarm tested (Y/N) Date of pumping \-� Y� Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot \ OffOn adjacent lots t y- To property line got Absorption field Surface water/drainage \ O 1c> Foundation 44 Water main/service line I CONTINUED ON BACK PAGE 72-026 (3/93)' Front C. LIFT STATION Date installed Size in gallons— Vent (Y/N) allonsVent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y SEPARATION D1.S-T-A CE FROM LIFT STATION TO: on lot D. ABSORPTION FIELD DATA Date installed CI- 1-1�13 Length 4: D Width rer Manhole/Access (Y/N) off" Level at Cycles tested On adjacent lots Surface water _Soil rating (GPD/Ft) \.I- SEPARATION Z type �[ 3 Gravel thickness 5 Total depth /-31 Total absorption area Som Cleanout present&N) _Depression over field (YA6� i-/ Date of adequacy test rl/a - /�� u / Results (pass/fail) for — Bedrooms Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot On adjacent lots To building foundation 7 s / To existing or abandoned system on lot On adjacent lots 3ti ~ Cutbank �� Water main/service line _After test If yes, give date line ale r Surface water 1 0�> A Driveway, parking/vehicle storage area Curtain drain �lo/l6-: iG�jo�Jnf E. ENGINEER'S CERTIFICATION /certify that I have checked, verifie or conformed to all MOA and HAA guidelines in effect on h Lck:l -of, this inspection. •i 1 J Signature x AIM Engineer's Nam JEERING Date 17 4 Eagle River Loop Road No. 204�� ag a RIver, Alaska 9907179 HAA Fee $ Je%) ` �� Waiver Fee $ Date of Payment l�J J .�_c Date of Payment _ Receipt NumberJ �f /Y- Receipt Number 72-026 (3/93)' Back WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO. IPVMLSa During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Lot �_ Block _L of a07 -0R SUS Subdivision, the well's productivity was determined to be 1.0 gallons per minute. The minimum well productivity required by this department (AMC 15.55) for a 4 bedroom residence is .42 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of noncritical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. 4. . Well Log Alaska Now—!dell/Verttoa brilill"O 12241 Avion Anchorage, Afasks 99516 W& I f Owner 007) s-11;-4417 Bob & Carol Cowan._��___.� AA3327 691. Rabbit Ck Rd. _ Location or wall -----... __.... -W EL EF'ERMIT � WELL DEEPENi"JG Borough Subdivision Lot ownship N I?ansa E� Mcf din Anchorape ...... - Prater 1 _. 1 �� 5 JW Well Log Motarial T Well Booth of 120'0 start of drill about 1/4gpm Ob 120" level I+t, Below Surrace Top Bottorn 1� 12 Iru3ty brown rock�� 12G ib0 lgray rock 150 i65 well was drilled under my ized Representative . Nowell - Well Depth (ft) �3Q0 Drilling Method ratarY Rate or Completion �/tA/93 Use dOme'stlG Ci.eilt i pe Diameter (ir,:) Depth (ft.) Weight (lbs/ft) wit0 Finish of Wali ape _w Dlameter openhole Static Water Level Level (ft..) Date �741 8/14/931 Pumping Level Below T of C (ft.' After (hrs) Rumaim (g,v.m) Grouting Yrs _Material No Pi Pump M.P. Capacity Type 3/4hp �� 7 pm submers� ibis Setting (ft) E265' T - Remarks on and this report is true to the best or my knowledge and belief. p�ate�� MUNICIPALITY OF ANCHORAGE Department of Health & Human Services ptr j • DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # C)0 L)9 ) — {� HAA # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Prez fc/ Location (address or directions) 69iS Babb( -t Creel, RoaoC (b) Property owner 6:e2r e Telephone: (home) Business Mailing Address 69/S Rcta bit Ck, Rcl. At7ctiarce F Ak 99S/6 (c) Lending Institution Telephone S6 2 - 2 16/ Mailing Address x/60 w Tuc�oi- Rd nCho��gP, �4-k 99.503 J (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here 63, if hold for pick up.) List contact person and day phone number below: 17csa� 2. TYPE OF RESIDENCE Single -Family CZ 3. WATER SUPPLY Number of bedrooms 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 DISPOSAL On-site 19 Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION L As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm r (aTelephone Address (W530 A/1 CA0r'cni Date 2l ,STN -- Engineer's Seal THECD02E F. 50025 ,• ti7 Cc - 3539 ttil 1v DHHS APPROVA Approved for bedrooms by —IIate Approved Disapproved Conditional Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 aG�\ORPGE MUNICIPALITY OF ANCHORAGE (MOA) pF P` \�Esow • '� Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: Pr S /b A. WELaMr Well Classification rrivr,( If A, B, C, D.E.C. Approved (Y/N) N' A'• Well Log Present (Y/N) N Date Completed 19 7y Yield 0. mem "I""A99 Total Depth i ZD' Cased to 71' Depth of Grouting Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Y Pump Set At f [5 Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot 96, 2' 16 U• ; On Adjoining Lots > «'0 To Nearest Edge of Absorption Field on Lot / 26 ' 16 C. U• ; On Adjoining Lots > [oo ' To Nearest Public Sewer Line N,A. To Nearest Public Sewer Cleanout/Manhole N• A• To Nearest Sewer Service Line on Lot > 2S' Water Sample Collected by Fla f{aT ech S L,cf ; Date [ 2 Water Sample Test Results Sr fzs ec {c%ry O Coll /inrmItoo^ e v Comments w It has 200 a rejerae bei e been � �lu.np ir,�uhe Gye[I um,� �1nsJ4c%rcC by ��Cvyd/e" B. SEPTIC/HOLDING TANK DATA Date Installed 6/ [ / 7y SizeII Z09,P/ No. of Compartments e' Standpipes (Y/N) r Air -tight Caps (Y/N) r Foundation Cleanout (Y/N) Y Depression over Tank (Y/N) N Date Last Pumped (( / 3o /89 by R 1&rl7oc¢er Pumping/Maintenance Contact on File (Y/N) N' A ; for 144 - Holding Tank High -Water Alarm (Y/N) N• A. Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well 9G, 2 ' 4;''n 6C. To Building Foundation To Property Line To Water Main/Service Line To Disposal Field 17. S Ifs ' To Stream, Pond, Lake or Major Drainage Course > [00' Comments W,291"cr �J4eoPcrie �o/ Lue1/ - st arc �an1T SC�arQh�� 72-026 (Rev. 7/88) Front Page 1 of 2 All ,4. C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed B // / 7 Y Width of Field 0, lacerY) Type of System Design S'eeg! qe P,f Length of Field 19 Depth of Field 12 / Gravel Bed Thickness 6 Square Feet of Absortion Area 116-2 Statndpipes Present (Y/N) Y ( repa rreoC ,2/9/69 Depression over Field (Y/N) Al Date of Last Adequacy Test / 2112 / 69 Results of Last Adequacy Test /4e�gomciAe {ar y bearcomf SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well 12 c5 ' �r o C V, To Property Line &o Sye/7c 01 To Building Foundation Lot N. A. To Existing or Abandoned System on On Adjoining Lots 7 36 To Water Main/Service Line > 2.5'' To Cutback (if present) Al. A To Stream, Pond, Lake, or Major Drainage Course > !ao To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION M,,4. Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAAgui"ilm�q effect on the date of this inspection. [)° Al Signed �yL • �K S'� ° �� V Company_%'la�g lechi)iru/ Sul ° ! \ �'!� %" •° , ,' tib °°°°°°°°'°''°°"`°°'°°""tif Engineer's Seal Date Dec r3_ /969.°�.-°..,°°�a MOA No. 9 'OS"2 iHEOD&: E F. 'Aoc)RE ..Fl '. Cc - 3539 r� r1 Receipt No. �/� �✓ 017 1 R( 06 Date of Payment �� Waiver Fee: $ h G� Amount: $ ` 7� — U D Date of Payment _ 72-026 (Rev. 7/88) Back Page 2 of 2 Municipality of Anchorage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 February 22, 1990 Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for Lot 1 Block 1 Prator Subdivision Waiver Request #WR900004, PID #017-091-55 Dear Mr. Moore: Your request for waiver of the required 100 foot separation of a septic system to a private well has been approved. The approved separation distance is 94 feet from well to septic tank. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Robert W. Robinson Civil Engineer On-site Services ljm:#6 Concur: h Smith, P.E. ogram Manager n -site Services t r*rc F �x � c r r CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. February 1, 1990 14530 ECHO ST. PH: (907) 345-1355 MUN1C1PW1WWMNCHQRA0&SKA 99516 DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION M.O.A. Dep't of Health and Human Services P.O. Bog 19-6650 rr" 1 ia909 Anchorage, AK 99519 RECEIVED Dear Sirs: By means of this letter I am requesting a waiver of the required 100 foot separation distance between the well and the septic tank on Lot 1, Block 1, Prator S/D to allow the existing 94 foot separation distance to be approved. Along with the HAA forms, I am enclosing a site plan, well and septic system adequacy test information, and nearby well logs to assist you in your review. According to the septic system as -built inspection report on file at your office, the wastewater disposal system was installed in August 1974, and consists of a 1250 gallon steel septic tank followed by a 12 foot deep concrete ring seepage pit providing 462 square feet of absorption area. Despite the fact that a Health Authority Approval certificate prepared and approved by the Municipality in 1977 indicates the septic tank to be 100 feet from the well, in the course of my adequacy testing on 12/12/89 I measured the actual separation distance between the well and the septic tank cleanout to be 96.2 feet. The 94 foot separation distance being requested is to allow for an assumed underground projection of the tank. I conducted an adequacy test of the septic system by metering water into the septic tank while monitoring fluid levels there and in the seepage pit. The addition of 166 gallons of water caused the fluid level in the seepage pit to rise 66 inches, after which point it began to back up into the septic tank. This indicates that the system has a surge capacity of 166 gallons, and that the primary absorption mode is out through the top of the absorption pit, Over the next four hours I measured the absorption rate to be adequate for a four bedroom residence. No well log exists for the subject well, however it was undoubtedly installed in 1974 also, and the 1977 HAA indicates that it has a total depth of 120 feet. On December 12 the static water level was 60 feet below the top of the casing. During the flow test I was able to track the drawdown only as far as 71 feet, indicating to me that the casing extends to approximately 71 feet, below which level fractured bedrock surfaces caused the acoustic sounder to give unreliable data. After 208 gallons of water was drawn from the well, a low level pump control caused the pump to shut off. I then monitored the production over the next 5 hours, and determined the well yield to be 0.5 gpm, which is adequate for this 4 bedroom residence. Water samples taken that day were satisfactory, indicating 0 coliform or other bacteria per 100 ml., and 1.2 mg/l of nitrate -N. Two logs of nearby wells are enclosed. The log for the well on the east one-half of Block 2, Prator S/D, located northeast of the subject well, shows gravel overlying bedrock at 16 feet and a total well depth of 225 feet, with a production of 5 gpm and a 10 foot static water level. The log for the well on Lot 1 of Karianne S/D, located a comparable distance to the southwest of the subject well, shows cemented hardpan to 130 feet and a total depth of 135 feet with no bedrock, and a yield of 8 gpm with a 70 foot static water level. These two logs bear little resemblance to each other, or to the subject well, but the available data does indicate the bedrock surface to be sloping steeply towards the southwest with the overlying strata becoming thicker and less permeable. The subject well appears to represent a midpoint between the other two well logs. Several factors support the granting of this small waiver request. The surface topography slopes down from the well to the septic tank and the house is between, making it impossible for surfacing effluent from a failing septic system to flow towards the well. The above well log confirms that the bedrock surface also slopes in the same direction, indicating that subsurface groundwater flow paths would also be away from the well. The considerable depth to the static water level should provide for good filtration of effluent as it percolates downward. Finally, the water samples indicate that there is no measurable contamination at the present time, and one can infer from the relatively low nitrate level that the aquifer being tapped is down in the bedrock, which of course provides excellent protection from contamination. The points applicable to D.E.C.'s separation distance waiver guidelines could be assigned as follows, making appropriate assumptions about subsurface conditions: Distance to Water Table (60' - 20' = 40') 5.0 Soil Sorption (assume slightly silty gravel) 2.5 Permeability 1.5 Water Table Gradient (+10%) 6.0 Horizontal Setuaration (94') 2.8 Total 17.8 Please give me a call if you have any questions on this analysis. Sincerely, Ted Moore, P.E. cc: George Patterson Rf3� Ro A� Ii r QLQ n� r r IZ zi 3 o - �O M 1 � � q � o � � j do�i 265 (9) COPYRIGHT 1985 JMR 255 264 y 266 273 G R. 3039 DeArmoun Area Reference Map—P14 TFr-� L(, sl, P13ATo R '91D bul+I v C-1? R ECv"5-C7 To Po ,q -/v,4/ -Y sl1 Sint a -f%e d,rec /torn e it % {fie s�frc nh f're4/-0,- t5 est enizuy etc cu f!( ori tcrn er�ara/� (Gtuf +e rct(fal4rruc /0 slolpe �n of d,rec iron orf Y-l3os eP� oi1 fh�s s/a/�c� 7e S�teCLA 7%u74 6 0 sh�aruc 5e c�ttrrnigr �o� Ctiake,-- 4ble q-" ,,ell[ �/ f� P. 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Kenneth M. Dennison 1116 Mila 99504 Phone: Phone. 337-7311 1.7 -� 3. Legal Description: Lot 1 Block 1 Prator Subdivision 4. Single Family Residence: (XX Number of Bedrooms: 4 Multiple Family Residence: ( ) Number of Bedrooms: — tio� 5. Well Data: Type Individual Depth 120' Well Log Filed�Q�j Construction ` Bacterial Analysis 6. Sewage Disposal System: On-site system (X) Public Utility ) Permit # Installed 1974 Installer 6" Ci/moi Septic Tank Size �j_O ' ManufacturerT%y�G'�� Absorption Area Soils Rate �' _ Material 7. Distances: Well to Septic Tank /Z2&-2 to Absorption Area le�'0 to Sewer Lines Nearest Lot Line Absorption Area to Nearest Lot Line Page ^Pcao Department of Health`and Environmental Protection Request for.'Approval of Individual Sewer and Water Facilities Legal Description: Lot 1 Block 1 Prator Subdivision Comments : C'�—��•F%v ��t! �c.e � yy1/Z ��a2�il c� �� �. Affadavit Attached: ( ) Approved: Disapproved: Department Worksheet: Letter Attached: ( ) Date: Date: i MUNICIPALITY OF ANCHORAG Department of lle'alth and Environmental- 825 nvironmental 825 `'L Street, Anchorage, Alaska 99501 279-2511, est. 224, 225 MAR quest for Approval of Individual Sewer and wa3aes 1. Property Owner: AA01 t b( rvi _)!PA2 ,11 seN kd Mailing Address: 1 /((p M / IA 4AIC1, 41e5'01/ Phone: 2. 3. VAM Name of Buyer: Mailing Address: Lending Institution: Mailing Address: Realtor/Agent: Mailing Address: 5. Legal Description: Lcs2� 4 461! Street Location: Phone: Phone: Phone: 6. Single Family Residence: (r-)" Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: 7. water Supply: *Individual well ( Public/Community System ( } If Individual well, well depth 1.2-o' If Community System, name of system 8. Sewage Disposal System: On-site System Public System ( } If On-site System, date of installation: *NOTE: A well log is required on ALL wells drilled since 6/75. 3/77 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Date Received S- I L� - 1 3 Time of Inspection 0 Date of Inspecti on S " 15 `1 3 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & 'MATER FACILITIES FOR 1. Approval Requested By: 2 Address: ,.�. e�O ✓�� N� \� ��9 s� s Phone a� '��i •.� S�� N�4oiY� �J Phone Property Owner: $ L4 3. Legal Des 4. Location: 5. Type of F Number of Bedrooms: 6. Well Data: A. Tvpe C. ' Construction It CGv c�a B. Depth D. Bacterial Analysis_ /, J/' �� �� 7. Sewage Disposal System: A. Installed �n-13 B• C. -Septic Tank: 1. Size 2. D. Seepage Pit: '1. Size V�7_ 2. Installer Manufacturer Mate rial�j�j�� E. Disposal Field: Total. Length of Lines 8. Distances: A. Well To: Septic Tank -5 )__j Absorption Area 1�Cj� Sewer Lines 1 j Nearest Lot Line Q Other Contamination N Otl B. Foundation to Septic Tanks; Absorption Area «� C. Absorption Area to Nearest Lot Line �.o( +- -��--- Request for Approval of a_--jividual Sewer & Water Facilities, Page Two' 9. Comments: P.onrove��N�p Disapproved Date�Q—�'I Approval Valid for One Year From Date Signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subiect sewer and 'water facilities located at: Signed Date