HomeMy WebLinkAboutDRAKE BLK 1 LT 7BON
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MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
E WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Permit Number: SW040301
Legal Description: DRAKE BLK 1 LT 713
Design Engineer: 0014 Anderson Engineering
Owner Name: STEVE STARK
Owner Address: 2751 MERGANSER AVE
ANCHORAGE , AK 99516-2702
Date Issued: Jul 28, 2004
Expiration Date: Jul 28, 2005
Parcel ID: 017-461-03
Site Address: 002751 MERGANSER AVE
Lot Size: 49500 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
(�llUlO� De5(�N �ev,S;on1-Sv.;f4EO F0214 "r-'**'tlHJ�cx S VS7F_.� wi� y n ovn��eq�
aro. THE w%li rje P/PocEo 11v LocA-Tip�j of �x;$yr sysr��
f1CL GPVTga�.,�ruRTcC, a'Mo.7F-2�tfG. 'v�6.L. �E cxfRU+FT�p A"1IU 2e^'+O✓F /y �-,¢iE V?��iZ
Received By:
SAX (NG/�ES QF �`"OV S yS7E�1n 6�1�ST CONS iST Or- ToP SOl C 7r1E Ae0J rl P" vS
84 V`�E7s�T�rp S�JFt�M7� To pld?RVeVT F_iaoSipn/,
71��Lcd'
1l� WvEAort
Date: I— " ' D
Issued By: ,�I� n Date: 7 LZ o c
TO
ALASKA ENVIRONMENTAL CONTROL
SERVICES, INC.
'~ 1~00 W. 33rd Avenue Suite B
ANCHORAGE, ALASKA 99503
(907) 276-1361
JOB NO.
RE:
WE ARE SENDING YOU [] Attached [] Under separate cover via
[] Shop drawings [] Prints [] Plans I
[] Copy of letter [] Change order []
COPIES DATE NO. DESCRIPTD
THESE ARE TRANSMITTED as checked below:
REMARKS
[] For approval
x~For your use
[] As requested
[] For review and comment
[] FOR BIDS DUE
[] Approved as submitted
[] Approved as noted
[] Returned for corrections
[] Resubmit
[] Submit
[] Return
copies for approval
copies for distribution
corrected prints
19__ [] PRINTS RETURNED AFTER LOAN TO US
COPY TO
PRODUCT240-$ ~ In~. Gm~0,, Ma~. 01471.
If enclosures are not as noted, kindly notify us at once.
M
SUBJECT
REPLY
~t~o--~-~® 45 472
REMARKS
SEND PARTS I AND 3 INTACT -
PART 3 WILL BE RETURNED WITH REPLY. POLY PAK (50 SETS) 4P472
TIlE IO'E.I,t) V4ELL i.~; it, lOT /it.,l,
72-013 (Rev. 3~78)
DATE
LEGAL
PERMI'T NO.
[::,EF'FtRTI"iEI'.,tT ~...~.-' HE.:RLTH RN[:' EI'q',,,'IRONI"IENTFIL. ~ F..'OTECTION
'E:25 '" L '" STF.:EE:T., FINC:HORFIGE., RK. 995G±
;.E: (5 ,.1..- 4. 7 2 E~
C, Ih41 ....... ."LE; EE -f" IF_'"E: ::E; EC II..,J~ EC FE:: IU~ F::" uS FET.: F"~ E::, ET. F" lei FE: I'"1 ][. -i-
,' :.E. "ii: .39 E~2: ',
FI F' F:' L 1. CFt N T
L.. 0 C FI T l 0 N
LEGRL
PFIUL. HUNT
L. OT 7E: E,'L.K d.. L':,F;.:RKE SUB
:l.E~4E~57., RNC:HOIRFIGE.,
L O"F S I ;2 E
FIL FI'.E;K FI 349-t502
999999 SQUFIF.'.E FEET
]""r'F'E OF SOIL. FIBSCIF.:F'"I"ION S"r'STEH IS: TF.:ENC:H
I'"IRXIMUM I'-~UMBEF.: OF E:EDRC~OMS = 3
S 01 L F.: FI T I N G ( S L.":! F 'T',.'" 8 R ) = ~
THE REQUIRED SIZE OF 'l-HE SOIL RBSORPTION E;'¢STEM IS:
E::, E: IF:" 31-11.-.11 == ~ IL_ EE 11"..41 ,."2~ 'T IHI == ,:.E~ HZ:-[ F--: Ft %." E: L. [:::, EC F" T H =: (~
THE LEEI'-,iGTH [:,iI"IEN:.E;1.01'-,I IS 'THE LENGTH ,.:IN FEET) OF' ]"HE ]"I;.:ENCH OR DRFItNFIEL[:'.
THE DE:F']"H OF FI TF.:ENCH OF.: PIT IS THE [:,ISTFINCE BETHEEN THE: SUF.:FFICE OF THE
GF.:OUN[':, FtNI:> THE 1'30TTOM OF THE EXC:FI',/RTIOI'4 ,:;IN FEE:T::,.
THERE I2~, NO SET I.,.I1.DTH FOR TF.'.ENCHES.
THE GF:'.Ft',/EL [:,EF'TH IE; THE MI. NIMLIM DEF'TH OF' GF.:FI',,,'EL BETHEEN THE OUTFRLL PIPE
FIND THE BOTTOI'"t OF THE E'XCFI',,,'FITION '.': IN FEET>.
i~: Ei: ,.-.::, L.., EE F-:: EE t[:::, :E; EE F" ']- EE ,.-_':: "IF Fi lb..Il I1<: :SEE
PERM.t. T I=IPPL. if. CFINT HI=tS THE RE:SF'ON'.:.!; 1. B I L. 1. 'TY TO 1' NFORFI TH 1' .':5 E:,EPFIF4.':TFIENT E:,UF4.': 1' NG THE
.I:I'-,ISTFIL. LFIT]:ON i'I",ISF'ECTIONS OF FIIq'¢ HELL. S R[:,JFICEI'4T 'TO THIS PF..'OF'ERT'T' FIND THE:
NUFIBER OF REE;I[':'Et".IC':ES THFIT THE HELL HILL SERVE.
.................. "1- i.dt C_" .:: ;?. ::, ]: it'-.~ E':; F' E C: T' :Il: C, t'-,i ~; F~ F;: E l-;: E'E (;;:.~ lJ ]:: IF;..'. IE E':,
BRCKFIL. L 1.NG OF FIN¥ S¥STEI"/ H ITHOUT F INFtL INSPECT t ON RNE:, FIF'PF.:O',,,'RL E:'¢ THIS
E.,EPRRTi"IEN'I' H:[L.L BE SUE:JECT 'T'O PF-::OSECUT1. 01'4.
HINIMUI"I B, ISTFtNCE E:E"f'HEEN fa HELL FII",I[:, FtI",I¥ ON-...E;I'TE E.-;EHFIGEE [:,IE;POSFIL "2'T'STEM
:LE)E~ FEET FOF.: FI F'F.:i',,,'FITE HELL OF.: :LSE~ TO 20C~ FEET FROM FI PUE:L1.C 1.4ELL DEF'EI"~E:,It"4G
UF'ON ]'HE T'.,.'PE OF PLIBLIC: 1.4ELL..
t"11.NIHUM [:,I':;TFINCE F'F.:OM fa PRI',,,'FITE HEL. L TO FI PRI',/RTE SEHEF.: LINE IS 25 FEET RI'.,I[:,
TO R COHHUN:[T'¢ SEHE:R LINE :i:S '75 FEET.
OTHER REQU:[REi'tEI",I]"S P'IFI'¢ FtPF'L'T'. E;PECIFtCRTIONS FII'.,I[:, CONSTRUCTION [:,IRG'F.:FII'"IS FIF;.'.IE
FI',,,"RIL. FIBLE TO INSURE PF.:OF'ER INE;TRL..LFITION.
i CE:RT I F"," THR]"
::L: :[ I'"":t1"1 FF:II'"IILIFtF.': HITH THE REQUIREI"'IENTS FOF.: OIq-SITE SENE:RS FIND HELLS FIS SET
FORTH B'¢ THE 1'4UNICIPFILIT'¢ OF FINCHOF::RGE.
2: I HILL iI",ISTFILL THE S'¢S'TEM IN RCC:ORDFINCE HITH THE E:O[:,ES.
.'.~.: I UNDERSTRt",tD THFIT THE ON-SITE SEHER S'¢STEt'"t I'"IR'¢ REL.-~UIRE ENLFIRGEI"IENT IF THE
PERFORMED FOR:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
PERCOLATION
TEST
DATE PERFORMED:...
LEGAL DESCRIPTION:
4
?
10
11
~1 f<,
14
15
16
17
18
20
SLOPE SITE PLAN
t-,,.O
PERFORMED BY:
72-008 (6/79)
WAS GROUND WATER S
: ENCOUNTERED? I~5 oL
"iF YES, AT WHAT /}5
DEPTH? .... ·
· Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE .... (minutes/inch)
TEST RUN BETWEEN L :-x.., ,'FT AND ~ ~1_' FT
·"'" ~..,-: .... I
CERTIFIED BY: ".,.,., '., . .].. DATE ://'--'- ./,C~ ' ?'3-
SOl LS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR: /l,k"Z
LEGAL DESCRIPTION:
1
2
3
4
DEPTH
(FEET)
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
DATE PERFORMED: Z ~/ 7~'"'~...
SLOPE
SITE PLAN
WAS GROUND WATER ,v~>~ S
ENCOUNTERED? L
O
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date
Time Time Water Drop
PERCOLATION RATE ~ (minutes/inch)
TEST RUN BETWEEN .3 FT AND ')~- J'~ FT
CERTIFIED B~: NN~ ~ DATE-'.'
72-008 (6/79)
CAMERON SHARICK
LAWYER
FI~)NTIEI~ BUILDING - PENTHOUSE
360~ C STREET SUITE ~428
ANCHORAGE, ALASKA 99503
{907} 563-5811
Chuck Spinelli, Manager
Bowen Quality Construction
Company, Inc.
5520 Lake Otis Parkway, Ste. 101
Anchorage, Alaska 99507
October 15, 1986
Re: My house
Dear Chuck:
Today I received a telephone call from Mr. Robinson at the
Department of Health. (264-4077) ~r. Robinson indicated that my
wells', septic and drain field are not in compliance with the law.
He indicated I must provide him with the following information:
1. The well permit number to relocate the well.
2. The date and method used to abandon the old well.
3. The locatio~, log, casing, depth, production and
permit number on the new well.
4. The soils tests and reports on the elevated mound.
5. The location and depth oi the curtain drain.
6. Soils reports indentifing what soils test was used
to size the bed. The closest hole the health depart-
ment was is test hole number 2 which know about 90
feet north east. Hr. Robertson indicated he doubts
that test hole was used because it was too far away.
7. Identify the type of lift station, describe the lift
station and its location.
6. The soils test and water monitoring test at the bed
site. This needs to be 2 feet deeper then the bed
and have a soils rating and water elevation.
9. A site plan which can be hand written which shows the
location of the house, well, tank, bed, soilS, sites
and bounaary.
Mr. Robinson was very nice. Apparently, he has sent two inspectors
out to my lot today. He indicated he would be glad to work with
Dr. Reid from Environmental Control. You will recall Environmental
Control was hired by Intercoastal to do this wor~, or part of lC,
on my house.
Additionally, Hr. Robinson indicated I needed an on site
system permit', soils log and something else to comply with some
other department's requirements.
CAMERON SHARICK
Chuck Spinelll
October 15', 1986
Page 2
Over the last month, I have tried to straighten this problem
out ~self. However, it just seems to be getting into a bigger
mess. I am really at a loss on what to do. I would appreciate if
you could give me a helping hand. As you knoW, I am trying to sell
my house and without these approvals, I can not tranfer title.
With best regards',
Cameron Sharick
~ ?lW EL L. Z
t~LL
?RO vlo£ Uf
j~ ITi"J
Organics
~0.0
1.0
Silt, trace sand & gravel
(ML)
NOTE:
No water table
Test hole excavated with tractor mounted backhoe.
13.0'
otem R al y
[on of ~esJ~A~Olf~
~n~horage, asKa
Engineering B Geological Consultants Inc.
ANCHORA(iE: FAIRBANKS ALASKA JU.EAU
SCALE Il'-2' OWN aY B.H. CH~<D BY WED
NO. 462086 Jowe No. A-01
~1-W DRILLING, Inc. '
P.O. Box 10-378 * 10300 Old Seward Highway
(907) 349-8535
ANCHORAGE, ALASKA 99511
DRILLING LOG
Well O.wner. . BO~..EN CONST. RUCTION ............ Use of Well
Location (address of: Township, Range, Section, if known; or distance main road
Lot 7B Block= 1 Drake Subdivision __
Domestic
Size of casing 6" Depth of Hole 76 . feet Cased to 74.3 feet
Static water level ground ~ft. (above) (below) land surface. Finish of well (check one) open end ( xx );
Screen ( l~el--- Perforated ( ).
Describe screen or perforation None
Well pumping test at. 10+ gallons per
of drawdown from static level.
Date of completion nct':nh~r 2.5; 1 qg2
Depth in feet from
ground surface
0 TO. 2
2 TO. 4
4 TO 9
9 TO 15
15 TO 22
22 ,TO 30
30 TO 40
(minute) for 1
hours with 100% x~.
WELL LOG
......
Give details of formations penetrated, size o?~~color and hardness
~ravellv s~nd ~ ~ '
Sandy clay gravel
:~. Sand~ clam ~ravel (damp)
.Dry gravelly clay
40 TO 52 =
Clayey grav~l,, ,
57
70
52 TO 57
TO ' 70
.TO 73
73
,TO, 76
TO
,TO
Sandy gravel
Clny~_y grav~] (damp)
Sandy gravel (wet)
Waterbearing gravel
TO
I -- CUSTOMER'
MUNICIPALITY OF ANCHORAGE
cc*`
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
SOILS LOG
I PERCOLATION
TEST
t
PERFORMED FOR: -VoW N %fEW r0%J If 0--p V-01 WOO-() DATE PERFORMED:
LEGAL DESCRIPTION:
SLOPE SITE PLAN W
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
ML
J �
v -
WAS GROUND WATER d f �j S
ENCOUNTERED? O
P
IF YES, AT WHAT E
DEPTH?
r
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
70
2
`��
C�
■ice®�■®��'�®
v -
WAS GROUND WATER d f �j S
ENCOUNTERED? O
P
IF YES, AT WHAT E
DEPTH?
r
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
70
2
`��
C�
20
PERCOLATION RATE (minutes/inch)
TEST RUN BETWEEN FT AND FT L
COMMENTS Vti'fn� L17f- /t' ll. U-11 Z ' 3 r, tf j L G/I.ECi/
� J
PERFORMED BY:
72-008 (6/79)
CERTIFIED BY:
DAT
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVl RONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SQl LS LOG
PERCO.~,ATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
3 /~l
4
5
6
7
8
9
10
~'1 ~
DATE PERFORMED: I ~-- -'~"P- ~
SLOPE SITE PLAN ~ ~
11
12
13
14
15
16
17
18
19
20
COMMENTS
WASG.OUNDWATE.
E.COU.TE.EO, ,
O
P
E
IF YES, AT WHAT
DEPTH?
Reading Date Gross Net Depth to Net
Time Time Water Drop
I
PERCOLATION RATE
TEST RUN BETWEEN
{minutes/inch)
FTAND ~'~" FT
PERFORMED BY:
CERTIFIED BY:
DATE:
72-008 (6/79)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVl RONMENTAL PROTECTION
825 L. ~treet, Aneho~alle, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG,~ .,, '~
PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
:p,C:AK E- ~u8 6'tk
DATE PERFORMED.' 1~ 3,- ~_~
8
9
10
11
12
13
14
15
16
17
20
COMMENTS
SLOPE
SITE PLAN
ENCOUNTERED? O
I P
DEPTH?
Reading Date Gross Net Depth to Net
Time Time Water Drop
,4_.. ii, ~g ;3¢ /1' ,'"~V~ ' '~
PERCOLATION RATE (minutes/inch)
TEST RUN BETWEEN FT AND ~ FT
PERFORMED BY:
CERTIFIED BY:
DATE:
72-008 (6/79)
, MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264~1720
SOILS LOG - PERCOLATION TEST
SOILS LOG
[] PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
4
?
0
~0
14
15
17
18
2O
coMMENTS "J'H _~_
PERFORMED BY:
72-008 (6/79)
SLOPE
DATE PERFORMED:
WAS GROUND WATER S
. ENCOUNTERED? ~5 O
.. ,.,=,.,=s. ~.,- w..~,-,,,..,.., t55.
Po-r- _'7~
SITE PLAN
· Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE ,
TEST RUN BETWEEN ~ ~ ,'I~T AND ~ ¢~. FT
'. '" !..~ _ ,'",1
.... (minutes/inch)
"' ' ' ALASKA ENVIRONMENTAL Jo. ~'/~ ~c/( /~q~r .,
CONTROL SERVICES, INC. s,~,o. / o~
1220 West 25~ Ave~ Suite B
~CHO~, ~S~ 99503 CALCULATED BY ~O" DATE
· CALE ~ ~
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ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
1220 West 25th Avenue Suite B
ANCHORAGE, ALASKA 99503
276-1361 279-2917
S.EE'r.O. ~ O~ ,'~,
CHECKED BY DATE
SCALE
ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
1220 West 25th Avenue Suite B
ANCHORAGE, ALASKA 99503
276-1361 279-2917
~o~ E,~,,k £,'~?,~r ...
SHEET NO ...... ,,~ OF, ~
OA'CU'ATEOS, ~ R.~!A DATE ~-/¢-~? ~
CHECKED BY. DATE
SCALE
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~ ~'-, .e ~ ' ~ : e· ~ ~ ~ ~ · .... . ....
: ~' 'e ~ :' ~ ~ ~ ~ · : ' : ~ '
............. , .............. .~.~..~. ~....,,. :.~..~ ............................................ ~ ............. : ~ ........... ~ ........ ~ ........... ~ .................... ~ ........................ ~ .................................................... ~ ............ ~ .............. ~ ..........
---~~~ ......... ~ ........... ~ ~, ....: .: ........ ~ : ~ .........: ...... ~ ..................... ~ ......... ~ ........... ~ ............ ~ ............. ~ .............. ~ ............ ~ ............ ~ ..........
.... ~ ~ .......... ~. ............. t ............. ~ ......................
Order Tike~ by~.~Tine Scheduled
Ordered by:
Billed To:
Address:
m
Phoue B~ ........
(I) Leiml: Lo~BIk
(2) Loclt~iau of Tdork
..... Zip Code
(3) Descriptiou of gork,
l. Dr:tll~.'ng/Pe~c 4. Adequacy
,7. Consult·
5. Health Auth/l~elI Flow
6. Sever Iuspection
.8. Design
9. Lab/Sieve]
10. I~isc,
Date ' Code ' Start Stop Total, Bra P~ice,. ]]
i ,...,.~.
~ : ~.~ A,. i /2.5'*.
($) dmount to be Billed
(6) Approved' by , ,,
PERMIT NO.
PPL I CENT
DC. BT I ON
:GAL
/
i.iLil'-.! I ']: I F'FtL I T'"r' OF FtNCHORI=IGE
DEF'RRTMENT OF HEFILTH FIND ENVIRONMENTRL PROTECTION
825 "'L" STREET, BNCHORRGE, BK.
0 I<.i-- S:':~E T E SE L.-IEi~: i_1 F- G F.: R [:, E F'EI~-: r'i I T
pRLIL HUNT F'. O. -104057.. RNCHOF.'.BGE, RLFISKB 7.~4D-'1502
.LOT 78 BLK ~:DRRKE SUB 4
LOT SIZE 999999 SQUBRE FEET
i'F'E OF SOIL FtE:SORPTION SYSTEM IS: TRENCH
X IMUM NLIMBEE OF E:E[:,ROOMS = 2
SOIL RBTING (SQ FT?BR)= ;~
EE6!UIRE[:, SIZE OF THE SOIL FtBSORF'TION SYSTEM IS:
.
,EF'TH= ~ I_ E I'-1 ~3 TH = I----I G R I=1'..,' E L
[:, E F' T H = ~-Zl
THE LENGTH [., i HENS I ON IS THE LENGTH '.lIN FEET;:' OF THE TRENCH OR DRBINFIEL[:'.
THE [:,CF'TH OF Ft TREHC:H OR PIT IS THE DISTBNCE BETWEEN THE SUE. FBCE OF THE
GF.:OUN[:' RN[:' THE BOTTOM OF THE EXCB'v'BTION (IN FEET;:,.
THERE IS NO SE'T' WIDTH FOR TRENCHES.
THE GF.:B",.'EL [:,CF'TH IS THE MINIMUM DEPTH OF 6REVEL BETWEEN THE OUTFBLL PIPE
BNE:, THE E:OTTOM OF THE E',,<I]:R'.,,'FITION (IN FEET).
E~;!Li I I~:E[:, '"---;EF'T I L--: TRI"-.il'=:' S I ZE=
EMIT RPPLIC:RNT HRS THE RESPONSI6ILIT'T' TO INFORM THIS DEPRRTMENT DURING THE
ION INSPECTIONS OF BNY WELLS BDJBCENT TO THIS PROPERTY BN[:' THE
OF RESIC'ENC:ES THBT THE WELL 1.4ILL SERVE
TI..,iC~ ( 2 ) I I'-ISPE~2:T I ~]~N$ .RE:E F.:Et_~LI I RE[:,
LLiNG OF RNY S'~:STEI'"i WITHOUT FINRL INSPECTION BN[:, RPPROVRL B'¢ THIS
WILL BE SUBJECT TO PROSECUTION.
DISTRNC:E BETWEEN R WELL END RN'¢ ON-SITE SEWRGE DISPOSRL SYSTEM IS
IFk%}FEET FOE B OR f58 TO 2AC4 FEET FE. OMB F'UBLIC WELL DEPENDING
F'F.'. I VBTE
WELL
'ON THE T'¢F'E OF F'UE:LIC WELL ·
~.If4I[.ll.lr,1 [:,ISTRNC:E FF.:OM R PEIVRTE WELL TO R F'RIVRTE SEWER LINE IS 25 FEET RN[:,
ioB CC~I'"IHUNITY SEWEF.: LINE IS ,.'75 FEET.
THEE REQUIREHENTS MR'r' BPPL'¢. SF'ECIFICRTIONS FIND CONSTRUCTION [:,IRGF.:RI"IS RE.E
,/RILRBLE TO INSURE PROPER INSTRLLRTION.
F'EE:i'I I T E;:-::F" I RE'_=. [:,ECEI'IBEF.: ---.-:-1 .. IL=,.:=:2.:
CERTIFY THRT
: I AM, FRMILIRF.: HITH THE,, RE6.!UIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
]RTH Be THE MUNI F:IPRLIT'T OF RNCHORRGE.
I: t WILL ,INSTFILL THE SYSTEM IN RCCORDRNCE WITH THE CODES.
Iili ! UNDERSTRND THBT THE ON-SITE SEWER SYSTEM MRY REQUIRE
ESIDENCE IS REHAE:,ELE[:, TO INRLUE:,E I"'IF~F.:E THEN _~ E~EE:,ROOMS. ENLRRGEMENT IF THE
MUNICIPALITY OF ANCHORAGE ·
t 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
SAILING ADDRESS
LEGAL DESCRIPTION
LOCATION NO, OF BEDROOMS
~v DISTANCE TO:
~,~ Manufacturer Material ~rtments
Li.. c~.thin gallons IF HOMEMADE: Inside length Width Liquid depth
Well Dwelling PERMIT NO.
I~ v DISTANCE TO:
O Z,~ 'Manufacturer Material Liquid capacity in gallons
C3 Well Foundation Nearest lot line PERMIT NO.
,,~, -r DISTANCE TO:
~.J--'l---O~ ~ 'No. of lines .... Length'of each line Total length of lines Trench width Distance between lines
_ -. inches
~ ~. Top of tile to finish grade Material beneath tile 'Total effective absorption area
CI inches
Length Width Depth PERMIT NO.
~1- Type of Crib diameter Crib depth Total effective absorption area
crib'
u~ Well Building foundation Nearest lot line
m DISTANCE TO:
.j ClaSs Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation' Sewer line Septic tank Absorption area(s)
OTHER ' '
PIPE MATERIALS
' NSTAL;LER ~ J
APPROVED DATE LEGAL
72-013 (Re,;. 3;78)
'. ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
1200 West 33rd Avenue Suite El
ANCHORAGE, ALASKA 99503
Phone 276-1361
t
SHEET NO. / OF
CALCULATED BY DATE ,..
CHECKED BY DATE-
SCALE
PERFORMED FOR: ~.
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
: Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
20
DATE PERFO~
Township, Range, Section:
SLOPE
1
SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH? 7. 5-'--1r-~ ,
Monitoring? :
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
(minutes/inch) PERC HOLE DIAMETER
: TEST RUN BETWEEN __ FTAND __FT
PERFORMED BY: ~l I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL S~ATE AND MUNICIPAl.; GUIDELINES IN EFFECT ON THIS DATE. DATE: . .
72-008 (Rev. 4/85)
Parcel I,D, #
1.
GENERAL INFORMATION
Complete legal descriptiOn
:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. BoX 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
HAA #
Lot 7. Block 1: Drake
Location (Site address or directions)
Property o~ ~ner
Mailing ad(Iress
Lending agency
i
Mai lin. g ad(Iress ,
Agent '1 ~
Address ~,,
Subdivision
2751 Merqanser
Karl & ~ancy Bartholomy
2751 Merganser Anchoraqe~
Day phone
AK 99516
Day phone
345-8569
Day phone
Unless othi~rwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: Three ( 3 )
TYPE OF WATER SUPPLY:
Individual well ×××
Community Well
Public water:
NOTE: If~ommunity welt system, provide written confirmation from State ADEC attest-
ing to the legalitY and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
72-025 (Rev, 1/91) Front ,OAt121
/
; Individual on,site ×xx
~ Holding tank!
Community 6n-site
Public sewer:
If~ommunity wa~tewater system, provide wdtten confirmation from State ADEC
attesting to the legality and status of system.
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm Anderson EnQineering
Address P. 0. Box 240773 Anchoraqe, AK
Engineer's signature 7'~~.~
Phone 522-777~
99524
Date 7/22/99
DHHS SIGNATURE
~ Approved for F'01-~/~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
/// _ / Date
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer reg!stered 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-(]25(Rev. 1/91) Back MOA/~'Z1
f/'~~ ]- i ' ~ i Municipality of Anchorage ~
[~.~J~.~,2)} ~ . ~ D'EPA~ ~EN~OF HEALTH & HUMAN SERVICES ~
~ ~ ~ _: ~ ~Envir~menta Servces Division E I V D
8~ L:Street, R~ m 502~Anchorage, Alaska 99501- (90~343~474~ ~
~ ~ - :- ~ ialth ~thority Approval Checklis~ _ .. .
~ ~ i" ~ ~unicipality Ot AnChOra~.a
- '~- ' ' ~o[ 7 B~oL ~ 1 D=ake ....... Dept. Health&HumanSer'v,ce~
Lega~escnpfion: ~. , .~ ~ . ~, ~ ~ ~. ~uD. ParcelI.U.:
A. WELL DATA ~ ~:-1 -
Log present (Y/N
Total de
Sanitary seal (Y/N
Date of test
Static water level
WelFproduction
WATER SAMPLE
Coliform
Date of sample:
Date installed
Foundation clean,
Date of Pumpin~
31eted 1 0/25/83 -:
~-, 74,3 ' Casing height (above ground) 2 '
properly protected (Y/N) ¥
AT INSPECTION ~
6' BTC
4.08 m, r/L bacteria 0
Collected by: . A. Harala
Number of Compartments 2 Cleanouts (Y/N)
t N Higlh water alarm (Y/N)
Isaac' s
Not
10
Date installed
Len
Effective absorptio
of adequacy' ~st-
16~9,~i
Date
Fluid depth in abs~.'ptio~ field ~fo~
Fluid depth 0i! (ins)-Minut~,
Peroxide treatmentS(pastil2 month~
72-026 (Rev. 3/96)~
~ - Gravel thickness below pipe 6" Total depth 3 5 '
are~ 8~Q ?$~ ~ Monitoring Tube present (Y/N) ¥ Depression over field (Y/N) N
- R~ults (Pass/Fail) Pass For Three
i est(in.~;~:. 0 Immediately after 950gal;Wateradded (in.):, 0
!later: i-~ ~ 1 . Absorption rate =. > 450 g.p,d,
~ ~:~._ - . .
~Y/N) ~,~ · N If yes, give date N/A
bedrooms
D. LIFT STATION - No Post Septic
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot > 1 00 '
'>100'
Absorption field on lot
Public sewer main N/A
Sewer/septic service line > 25 '
Tank Lift Station
Size in gallons
"Pump on" level at*
*Datum
F,
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Lift station > 1 00 '
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation > 5 ' Property line > 5 '
Water main/service line > 1 0 ' Surface water/drainage > 1 o {3 '
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line > 1 0 ' Building foundation > 1 0 '
Surface water > 1 0 0 '
Curtain drain None Noted on Lot
ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review
in conformance with MOA HAA guidelines in effect on this date.
Signature '~--~2~ C~ ~
Engineer's Name M~ha~] R_ Anc]~l".~c~n _ P_ R.
Date 7/21/99 ,
HAA Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
"Pump off" level at*
N/A
>100'
>100'
Waiver Fee $
Date of Payment
Receipt Number
are
Water main/service line > 1 0 '
Driveway, parking/vehicle storage area >. 1 0 '
Wells on adjacent lots > 1 00 '
Absorption field > 5 '
Wells on adjacent lots ~ ! 00 '
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4744
Application Date
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address. or directions)
Pro p erty,~:~r~'/~
Mailing Address
Telep~one/'~: ol.~me '
qC) '~e~di, l~j;:lnstitt~il3n.¢~. ~ Telephone
, ~ing Addre~,~
(d) ~~~y and Agent ~'~
Telephone ~
Mail the ~A~ ~o tho followino addross: or: Chock horo ~ hold for pick up.
Ust contact porson and day phone number bolow.
Business
TYPE OF RESIDENCE
Single-Family~i~
Number of Bedrooms
WATER SUPPLY
Individual Well~i~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 fRev 8/86~ Front
· )lJo~ s,Jeeu!Sue
i~uo!sse~o~d eq~ u! suo!ss!~uo Jo sJo~Je Jo~ elq!suodseJ ~,ou s! e6~oqouv ~o ~,!led!o!unl~ eq.L 'penss! s! eleo!l!peo ~ eJo,teq
~l~p eZXl~U~ Jo suo!~oedsu! ~,onpuoo ~,ou op SHHQ ~o see~olduJ:1 's~UeLUeJ!nbeJ elm, s pu~ I~Jepe,t u!EIJea ~Js!l~s oi JepJo
u! suo!ln~p, su! 5u!puel J!eq~ pu~ se~uoq ,~o sJes~qoJnd o~ ~smJno3 ~ s~ s!ql seop SHHQ eq.L '~IsEIV,tO e~S eql u! peJe~s!§eJ
~eeu!Sue leUO!SSe~oJd ~,uepuedepu! u~ ~q e^oq~ S qdeJ§eJ~d u! ue^!l~ suo!lm, ueseJdeJ eql uodn 41uo peseq
le^o~dd¥ ~poqinv q~,l~eH senss! (SHHQ) seo!^Jes umunH pue q~l~eH ,to lueLu,uedea e~oqouv ,to ~Ul~d!o!unlAI eq.L
NOIJ. nV:3
leAoJddv leUOli!puoo ,~o stuJel
leUOp,!puoo pe^oJddes!a ,~, peAoJddv
'9
el~c]
sseJppv
· uo!loedsu! s!ql
uo toelie u! suo!l~ln§eJ pu~ 'seoueu!pJo 'sepo3 elm, Spue l~d!o!unl~ I1~
Jo/pu~ ~lddns ~el~ m,!s-uo eql 'uo!loedsu! puE uo!l~§!lSe^U! ,~LU LUOJt pU~ Sel!J e§~Joqou¥ to ~l!l~d!o!unlAI eLI1 LUOJJ
peumlqo UO!I~LUJOJU! eql uo peseq 1~LI1 ~t!Ja^ JeLI1JnJ I 'u!e~eq pel~o!pu! e~nlonJts
elenbepe pu~ I~UOp, oun~ 'ai~s s! tum, s~s lesods!p Jel~MelSe~ Jo/pu~ ,{lddns Jm, eM el!s-uo eql t~qt s~oqs I~^oJdd¥ ~lpoqlnv
qll~eH s!ql ~o uo!3e~p, se^u! ~Lu 3~LI1 ~t!Ja^ I '~oleq U~OLIS el~p uo!t~p!l~^ aql to s~ pu~ oleJeq pax!ii~ I~es ~LU/~q peg!lJeO s¥
NOIJ. V~I:IOJNI QN~ vJ.~a 'HOIJ~]S ]]314 '$J.S]J. '$NOI.I.O~IdSNI 9NIOl^O~ld ~lJIJ
.g
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA) /~UG 2 6 ][988
CHECKLIST- FEBRUARY 1984
264-4720
LegalDescription: l,.~7 ?~ ~'t 2) CEIVED
MUNICIPALITY OF ANCI*'tORA{3I~
ENVIRONMENTAL SERVICES DIVISIO
WELL DATA
Well Classification
Well Log Present~N)t
Total Depth 7~'
Static Water Level ~ ~'~,,,K'
Casing Height Above Ground
Electrical Wiring in ConduitON)
Separation Distances from' Well:
;~'~/b/'/~'~'* If A, B, C, D.E.C. Approved (Y/N)
Date Comp/leted /O '~'~ Yield
Cased tO ~ ~ Depth of Grouting
Pump Set At
> / / Sanitary Seal on Casing~N)
Depression Around Wellhead (Y~
To Septic/Holding Tank on Lot /~,O ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot /~' / ; On Adjoining Lots
To Nea..rest Public Sewer Line ,~.~ To Nearest Public Sewer
Cleanout/Manhole ~/~ . To Nearest Sewer Service Line on Lot
Water Sample Collected by ~ ~' ~/~ ; Date ~-/~-~
Water Sample T;st ~esul{s
Comments, ~
B. SEPTIC/HOLDING TANK DATA
Date Installed lO .- '~'° ~'.~ Size /~0'~ . . No. of Compartments
Standpipes~N) Air-tight Caps~N) Foundation Cleanout~N)
Depression over Tank (Y{~) Date Last Pumped ~'"/~
Pumping/Maintenance Contract on File (Y/N) A///I~ ;for
Holding Tank High-Water Alarm (Y/N) ~//~' Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holdin~ Tank:
To Water-Supply Well
To Property Line
; '-_ 'Ye ~{~a~Service Line
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
72-026(11/84)
ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field ~ ·
Square Feet of Absorption Area ~,~'O
Depression over Field (Y{~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot
To Water Main/Service Line ,/~/'~'''
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Type of System Design
Length of Field ~//
Depth of Field ~'
Gravel Bed Thickness ~ ''~' ·
Standpipes Present'N)
Date of Last Adequacy Test
To Property Line 7'-'
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank lif present)
Comments
D. LIFT STATION
Size in
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
~mping Cycles during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I ha~ck/~v~fi~d~Or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed ~/'~"~"'""' Date ~. ~.~,~
Company /~'~ MOA No.
Receipt No. ~, ~,-~' ~' -
Date of Paym'~nt' ~'t~,~-.~o !~[~ - -
Amount: $ !
Page 2 of 2
72-026 (11/84)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
GENERAL INFORMATION
(a)
(b)
(c)
Application Date
Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions).
Applicant Name /~l~J~::::/V ~'~/[/',.~,~' Telephone: Home
Applicant Address
Applicant is (check one): Lending Institution []; Owner/builder.l~; Buyer []; Other []
(explain);
(d) Lending Institution
Address
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA'~o the following address:
~ Telep
TYPE OF RESIDENCE
Single-FamilyJ~' Multi-Family []
Number of Bedrooms
Other
L
WATER SUPPLY
Individual Well [~' Community [] Public []
Note: If community welt system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite ~ Public [] Community [] Holding Tank []
Note: If community welt system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11/84)
ENGINEERING FIRM PROVID, INSPECTIONS, TESTS, FILE SEARCH, [ A AND INFORMATION , ' ,
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this 1~2alth
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
Address /
Date /~,7~/~'
/
Telephone ,,~'/-,~0 C-//0
Approved for i, i ~.., bedrooms by
Approved ~;~ Disapproved
Terms of Conditional Approval
Date
Conditional
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 (11/84)
A. WELL DATA~
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description:
Casing Height Above Ground
Electrical Wiring in Conduit ~)N)
Separation Distances from Well:
Well Classification J'K8 F~' "A, B, C, D._E.C. Approved (Y/N) /{///'77,
Well Log Present ~)N) Date Completed /O/Z.&'-/~'3 = 'Yield /'//,~ ~P/~ ~
Total Depth 7~ / Cased to 7~3 / ' '
Depth of Grouting .~/~
sta io Wate (, ' Pump At
Sanitary Seal on Casing ~N)
Depression Around Wellhead (Y/~
To Septic/Holding Tank on Lot /~_~O / ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot /-'~'- ; On Adjoining Lots / O~ '
To Nearest Public Sewer Line /t~,//~ To Nearest Public Sewer
Cleanout/Manhole /~//,~e To Nearest Sewer Service Line on./7,_L°t
Water Sample Test Results ..~ ~r ~'/~ F/~ 7"~)~ ~
B. SEPTIC/HOLDING TANK DATA
Date Installed ~ Size I 000 No. of Compartments 2..
Stand pipes~N) Air-tight Caps ~N) Foundation Cleanout ~N)
Depression over Tank (Y~) ~f{///~ite Last Pu m ped.
Pumping/Maintenance Contract on File (Y/N) ;for /~/,~
Holding Tank High-Water Alarm (Y/N) /~//J~r'.. Temporary Holding Tank Permit (Y~N) A/'//~'t
separation Distances from Septic/Holding Tank:
To Water-Su pply Well / 2~.{~ /
To Property Line / ~ / ~
TO Water Main/Service Line . .
Course / ~ {~ f-/z'-~/~
To Building Foundation 3,..~ !
To Disposal Field ~;~ '
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y4~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well / ~ /
To Building Foundation
Lot
To Water Main/Service Line
ldo
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Type of System Design
Length of Field ;~
Depth of Field ~
Gravel Bed Thickness ~"~
Standpipes Present (~)N)
Date of Last Adequacy~Test
To Property Line /'7/-~ /
To Existing or Abandoned System on
;On Adjoining Lots ---- ~ /'/'-~/-/'"'
To Cutbank [if present) .
loc '
.5-0
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Electrical Codes (Y/N)
Co m m,.~,.,~,,,,,.,~ ~
Dimensions ~
Manhole/Access (Y/N) ~ .
"Pump Off" Lev.~,-~/
-..~'"~e nt (Y/N)
Pumping Cycles during Adequacy Test· Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I~av,e/c/l~e~7,),~d~,vej'ified,.~r conformed to all MO,~ and H/AA guidelines in effect on the date of this inspection.
Signed ~-"~/~/-.,~/~'~-~--~ Date {~/~//~
· -
Company ..~~ /'/'~---- MOA No. ~'~' ~
Amount: $
Page 2 of 2
72-026 (11/84)
ALASKA e dlROFImeFITAL COFITROL $ Ru Ce$, IFIC.
~nqimrinq $ {{nuir'onmcnlcd $tuclies
03AI333N
NOIIDaIO~Id lVIN]WNO~IAN]
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CHUCK SPINELLI SELLER-
BOWEN CONSTRUCTION
5520 LAKE 0TIS PARKWAY SUITE 101
ANCHORAGE ALASKA 99507
CHUCK SPINELLI
BOWEN CONSTRUCTION
5520 LAKE 0TIS PARKWAY SUITE 101
ANCHORAGE ALASKA 99507
60629
LEGAL:DRAKE SUBDIVISION LOT 7 BLOCK
ADEQUACY TEST FOR SEWER SYSTEM
ADEQUACY TEST DATE-II/25/86
THE TYPE OF ABSORPTION SYSTEM IS A BED WITH AN AREA OF 680 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 682 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
2 BEDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF ].000 IS ADEQUATE FOR
THIS 2 BEDROOM HOUSE.
THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON 1/2/87
THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER
SUPPLY OR WASTEWATER SYSTEM.
FLOW TEST ON WELL
WELL FLOW DATE-ii/25/86
A FLOW TEST WAS PERFORMED ON THE WELL. 682 GALLONS OF WATER WAS
PUMPED AT A RATE OF 4.54 GPM OVER A DURATION OF 2.4 HOURS.
THE DRAWDOWN WAS 10.1 ' WITH A RECOVERY TIME OF ]0 MINUTES
AND THE STATIC WATER LEVEL WAS 6.4 FEET.
THE WELL IS ADEQUATE FOR THIS 2 BEDROOM HOME.
ALASKA ENVIRONMENTAL
CONTROL SERVI¢ :, INC.
12OO West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
~os L 715 81 D?ilKF. ~,
SHEET NO, OF
CAlCUlATED ~¥ a/X DATE
CHECKED BY DATE
SCALE 1% 30 '
December 19, 1986
To Whom It May Concern:
My name is Tom Bowen and I was the superintendent on Lot 7 Blk 1
Drake Subdivision. I am writing this letter to inform you of the
circumstances concerning the septic tank well and curtain drain on
this property.
The curtain drain ran down the East side of the lot and across
the backside running east and west and is about 10' deep. It was
inspected and approved by the city inspector. The septic tank is
on the northeast corner of the house. This work was completed by
Intercoastal Construction.
When work began on the septic tank, the city inspector was
onsite each day until he gave his approval to backfill. At this
same time, we filled the old well with. concrete topping it with
a 16" cap. This also was inspected by the same city inspector.
This whole process took about two weeks time because the inspector
wanted to see if water would seep into the septic tank and drain
field area. It did not, so he gave myself and Jerry Hunt of
Intercoastal Construction, the approval to backfill.
If you have any further questions, please do not hesitate
to contact me.
Sincerely,
Thomas J. Bowen
Construction General Manager
Bowen Homes
TJB: jb
Subscribed and sworn before me this 19th day of December ,1986 by
Thomas 3. Bowen known to be the Construction General Mana§er of Bowen Qua~it~
I~ Commission Expires June 3, 19~1~ ~
My Commission Expires NOT~Y PUBL~ 'U
BOWEN QUALITY CONSTRUCTION COMPANY
BOWEN CORPORATE CENTER · 953 EAST JUANITA AVENUE, SUITE 101
MESA, ARIZONA 85204 · (602) 926-1585