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HomeMy WebLinkAboutDELUCIA LTS 2A & 3AICl l GREA~'-~ ANCHORAGE AREA BORC""3H Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION MAILING ADDRESS ~r Er g~-%/ i~)Z~ PHONE LEGAL OESCR,PT,ON t,~, 2.z ~, c.~;., %/,. SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURER INSIDE WIDTH S1 - NUMBER OF MATERIAL I~ COMPARTMENTS LIQUID DEPTH_ .LIQUID CAPACITY IZ.~'O GALLONS. SEEPAGE PIT: NUMBER OF PITS t . DIAMETER ~'6' LINING MATERIAL ~¢~ CRIB SIZE: BUILDING FOUNDATION ~i~I NEAREST LOT LINE ABSORPTION AREA (WALL AREA) · . OR WIDTH /~'~ LENGTH /~i DEPTH D~AMETER ~' DEPTH ¢' D~STANCE FROM: WELL Igi' TOTAL EFFECTIVE SQ. FT. ADDITIONAL ABSORPTION WELL: BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION ~:~/171A) ~7~-l"O~lA(~ DEPTH DISTANCE FROM: NEAREST NEAREST SEPTIC ! SEEPAGE ]~i' LOT LINE , SEWER LINE TANK__10L/ SYSTEM OTHER SOURCES DISAPPROVED REMARKS DISTANCES: DIAGRAM Of SYSTEM INSTALLED BY: PIPE MATERIAL: LOT SLOPE: REMARKS: Form No. EQ~031 DATE APPROV/L~[~4 )~' ~f~-~ /~/.g. G.A.A.B. GREATER ANCttOt<N;~ A!~,LA UOR~,)UGi, L~epartment of E~vi roniner~[a] [)ua] i Cy 3330 "C" S/.re~.}t Anchorage, Al as~:a 9~;bi;3 N()II,S 1,()(; I)ER()I,ATI()N 'I'EST Legal Descri lhis form reports' Soi]s log___~_ ................. Percolation ~e~t Dep th Feet 4 - 5- 6- 7- 10- 11 - 12 - 13- 14- Was ground water encountered? ._~lk~___t~ ...... If yes, at w,laL Percolation rate I;11 nute. .Proposed installati~-n-:---~'e-e~-fle Pit Depttl of Inlet Depth to bottom o,F pit or trel~c~, COMMENTS' Porformcd By' ~/~ Cert]f]e~, By: E(~040 (6/74) EXCAVATION ROBERT A. SHAFER WORK May 15, 1983 CIVIL ENGINEER 694-2979 Dynamic Realty ATTENTION: Linda Parker P.O. Box 1796 Eagle River, Alaska 99577 Dear Ms. Parker, MUNICIPALITY OF ANCHORAGE DEPT. OF HZ?,LTil ,"' ENVIRO;",;MENTAL PF, OT.~CHON RECEIVED Reference: Lot 2 and 3: DeLucia Subdivision A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of ~250 gallons. The seepage pit was tested by charging the system with approximately 1400 gallons of fresh water and after a period of P4 hours all the water which had been added to the crib had percolated out. It can be concluded from this test that the waste water disposal system serving the four bedroom residence located on this property is currently functioning adequately, However, the system cannot be guaranteed against subsequent failures. If we may be of further service, please do not hesitate to call. cc: Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA EXCAVATION ROBERT A. SHAFER September 12, 1983 WORK CIVIL ENGINEER 694-2979 Municipality of Anchorage ,~Department of Health and Environmental Protection 825 L~Street Anchorage, Alaska 99501 -RECE!_V ED Reference; Lot 2 and 3: DeLucia Subdivision Upon completion of the modifications to the well this office inspected the well casing and found that it had adequately been repaired and that the well seal on top of the well provided an adequate sanitary, seal. All wires leading from the well casing in to the ground had been placed in conduit. The ground slopes away from the casing and provides adequate drainage. If we may be of further service, please do-not hesitate to contact us. s/s ' . c ttn: Dirk SRB 196X EAGLE RIVER, ALASKA EXCAVATION ROBERT A. SHAFER Dynamic Realty ATTENTION: Linda Parker P.O. Box 1796 Eagle River, Alaska 99577 WORK May 15, 1983 CIVIL ENGINEER 694-2979 MUNICIPALITY OF ANCHORAGE DEPT. OF H=/',LTH 3, RECEIVED Dear Ms. Parker, Reference: Lot 1, 2A, and 3A; DeLucia Subdivision; R1W Section The four bedroom residence located on lqt 2 and 3, DeLucia Subdivision is served by a septic system which has been determined as of this date to be adequate. A building located on lot 1, DeLucia Subdivision is in the process of being converted to a multiple family dwelling six-plex (eight bedrooms). This building is served by a septic system which is only currently adequate for three bedrooms and will require upgrading. Both of these structures are served by a single well located on lot 2 and 3. This well is currently 141 feet from the absorption area serving the four bedroom residence located on lot 2 and 3 and ~pproximately 142 feet from the septic tank serving the proposed six-plex. It is recommended that a waiver to the horizontal distance of 150 feet be granted for the operation of this well to serve both the multiple family dwelling and the single ~amily dwelling located on the referenced property..The septic systems 1-ocated on these : properties pre-date the horizontal distance requirements established by current code. It is felt that the soil conditions in this area will provide adequate purification of the water to allow its return to the water table. If we m_ay be of fur. ther service, A.- / s/ss cc: State Environmental Protection Association ATTENTION: Bruce Erickson please do not hesitate to call. Municipality of Anchorage Department of Hea~th and Environmental Protection SRB 196X EAGLE RIVER, ALASKA ~lee.~8 ),uemnoocI Municipality of Anchorage Page ) of ~ 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 Name: XO~ ~' ~ ~~¢ ~. Wastewater System: 'U New ~pgrade A~~ ~% %~¢~ ~ ~¢~ ABSORPTION FIELD NO. o~rooms: Phone: ~~¢~~ ~ DeepTrench D Shallow Trench '~ed ~Mound ~Other LEGAL DESCRIPTION ~o,, Rating: Total Depth from oriainal grade: / ~ .~GPD/Sq Ft ' Lot ~ Block:~~~l~Subdivi~'°n: Depth to pipe bottom from original~.~ra¢?: Ft Gravel depth beneathpip~ Township: ~ Range: Section: Fill added above original grade: t Gravel length: I ~E[~; D New ~ Upgrade G~a~el width: Number of lines: Distanc* between lines: Classification (Prwate, AB,C): Total Depth Cased To: Total absorption area: ~* Pipe material: ~10 Driller Date Drilled: Stabc Water Level Installer:Ft ~~ rD'//~' Dateinstalle~l ~ ~1 Yield: GPM ~ Pump Set at: Ft ~ o~,.~ ~.~, A~ov~ ~,oun~:~,. TANK i SEPARATION DISTANCES ~ Septic ~ Holding ~.T.E.P. To Septic Absorption Lifl Holding Public,'Pnvate Manufacturer: Capacity in gallons: Well i~l i~/ ~1 ¢~ Material: Number of Compartments: Surface Water I~ j~l~ I¢'~ ~ ~ LIFT STATION I ~ I ~ "Pu~p on .... Pum~ off" leuel aL ~i~h water alarm CurtainDrain ~ ~ (~ ~ ~ O~ ~ _ ~Pump Make&o¢~l*Od,,__l Inspections performed by: Remarks:~~~ ~ ~~~ BENCH MARK Locatio~nd Descriptio~ ~ Assumed Elevation: ~ ~ ~. ENGINEER'S SEAL 170~EB eRtverLoopRoad, N ~ [~~ ~ ~ " Inspections performed by: ¢ ~: 1st ] . Department of Health a~d H~man Services approval ~;~.>; ,. N~:~f~ .... ..'/*:'C:~L~;: Reviewed and approved by: ~'~ Date: 72-013 [Rev 9/91) MOA 25 Permit No. ~-~::::J ~!q ~ Page ~ of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description:"[::~ ~¢: L..,LAC~'t J~- ,~--~~[~/|'~d;>t~, (~Cr~ ~ PID No.: I RECEIVED OCT 1 9 1992 Municipality of Anchorage Dept. Health & Human Services 72-013 A (Rev. 9/91 ) MOA 25 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 PAGE 1 OF PERMIT NUMBER:SW920198 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:WAGNER JOHN W JR OWNER ADDRESS:2440 East Tudor Rd. No. 956 Anchorage Ak. 99507 DATE ISSUED: 7/27/92 EXPIRATION DATE: 7/27/93 PARCEL ID:05114147 LEGAL DESCRIPTION: DELUCIA LT 5 LOT SIZE: 70132 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: SYSTEM IS DESIGNED AS A PRESSURIZED BED. ENGINEER MUST NOTIFY DHHS AT LEAST TWO HOURS PRIOR TO EACH INSPECTION. RECEIVED BY: ISSUED BY: -.JC,~ ~'F~iWd DATE HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN ROBERT SHAFER, P.E. ROGER SHAFER, P.E. July 3, 1992 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99501 REFERENCE: Delucia Subdivision, Lot 5 Request you issue a permit to upgrade the septic system serving the referenced property. An adequacy test was performed on the existing system and the absorption capacity of the existing trench was found to be inadequate. A test hole was excavated and a percolation test was performed in the area of the proposed upgrade. During excavation of the test hole water was encountered at 7', and after seven day ground water monitoring water was at 7'. Attached is an upgrade design which shows the location of the proposed distribution system. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic upgrade. If you have any questions or require additional information for your review, please contact us. Sincerely, RJS/lsu 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 I"= 40' SCALE JUPGRADE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCR,PT,ON.' ~'~J~L.-'L/[ ~-------' l ~. ~-~ L.~TT'~shjp, Range, Section: SLOPE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS SITE PLAN WAS GROUND WATER ENCOUNTERED? ~ _ S L IF YES, AT WHAT ~'~ / O DEPTH? P E Del]t, 10 Water Alter.~( ( Monitoring? Date: , Gross Net Depth to Net Reading Date Time Time Water Drop ,," : t " PERCOLATIONRATE~ ] [m~nutes,qnchi PERCHOLEDtAMETER __ ~" FT AND ~ FT S & S ENGINEERING 104~ ~/~/ CERTIFY THAT THIS TEST WAS PERFORMED iN PERFORMED BY: 17034 Eagle River Loop Roacl No, 2 ACCORDANCE WITH ALP,~]j~e'~ ~[I~J~iQ~J~UIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) UJ F- O F- 350 300 OSl © 1990 250 200 150 100 50 0 00Sl 15 HH - 11 Stage ii:.iiiiiii;ii[il "i ....... :'"~ ........ ! .......... i. ...... :.--!--.i .......... ~i..--i---!.- 20 OSi HH ' : ~ · i ' ! : ; ' ' ......... ~= ........ ~.--~ ....... ~....; ...... :-..~ ............. ~.--;-.-~---i ......... ~ ....... :-..i---~ ........ ~, ........ i ......... ~..--:: .......... ~ ....... ...... ....... ....... .... ............ ............... ...... ....... .............. ................ ....~...~ ....................................... ~ : ?:. :.:..~.:-.-..-.: .....- .-...-..:..................-...-...-.......-...'.-~: ...... '.;... ~.':.-.'.-:..-..'...:..'..:.'.'.'~:'.'.'.'.'.-.'.'.'.'.:.'.'. /.'.'/..~j.:..':.'.'.-..'.'.:.:.-.~:'..~..:'.'.'.: ......-.-.-.'.-..:.....:..-..-.:.-:.:'.:~.:..-.-.-:.'.-.:. ....:.. 20 3O 4O 50 60 i0 NET DISCHARGE, GPM 2826 Colonial Road Roseburg,OR 97470 5031673-0165 Compliance Inspection Report Note: Reports of Final and Repair Compliance Inspections left at site always require reviewer's signature to be Official. Consult mortgagee for official reports. U.S. Department of Housing ~' ~ '~ and Urban Development lr Office of Housing Federal Housing Commissioner OMB No. 2502 0189 Builder's Name and Address Mortgagee's Name and Address a. [] Report not left at site. b. j~ Report not official without reviewer's signature. Property Address I. Inspection of On-Site Improvements Reveals: FHA Case Number Date of Inspection ConstructionU was, ~ was not begun prior to the date of mortgage insdrance approval shown on the commitment, statement of appraised value or "Early Start" letter. (Applies to the initial report on new construction) 2 L~ Builde~ other than named in application. 3 [] Uuable to make inspection. (Explain below) 4 ~ Accepted construction exhibits not available at site 5.L J Individual Sewage disposal system; [] Individual Water supply system L__J No noncompliance, ~ Correction essential as explained below. [~ Submit Health Department letter or form HUD-92573 6.~ Correction req'd by rprt. dated not acceptably completed 7.~ Repairs required by form HUD-928OO. EB not acceptably completed. 8.~ Correction essential as explained below: ~ a. Will examine at next inspection. [~ b. Do not conceal until reinspected. Acceptable variations as described below IRequest fo~ Change form HUD-92577, may be submitted) Extensive noncompliance as exp!ained below ¢see certification that mortgagee's inspectiors rb*,eals s:~tmf;~ct? v completion of all items !isted below below, complelion of which is delayed by conditions beyoe I control of the builder (see IV.B below!. On site ~mprovements acceptably completcd. Off-site improvements: ] a. Correction/Completion essential as explained belnw ] b. Completion assured by escrow agreement or governing authority. 9,[] No noncompliance observed. II. Explanation of statements checked in Parts I and III [] Initial Inspection [] Framing Inspection ~i Final Inspection ~ Other (explain) No, No. ] c. AcceDtably_ com~pleted. .... ~-I~spection~sp Numbe~ [] Repair hrspection [[, ? Certification: I certify that I have carefully inspected this property on this date. I have no personal interest, present or prospective, in the property, applicant, or proceeds of the mortgage. To the best of my knowledge I have reported all noncompliance, work requiring correction, and unacceptable work Signat-.~ ~' Date [] Fee Inspector [] Appraiser X '~,'"~],.,,¢_~.,,~./~ ~;;;~ . , ~"~ ~/ "~'"~"~' [] DE Staff Inspector [] HUD Inspector III. ~Sl~e~ci~c"~ondifiSn-C'Required by the HUD-92800.SB, Not Requiring Field Inspection 16.~"_jubmit[~l '/' --'l/'LCenrs or resubmit incomplete 17.[]Acceptable Compliance with all specific 18.[] Submit Termite Soil [] None items as noted above. conditions not requinng field inspection. Treatment Guarantee. Approved: ] as modified by me. Signature Date ] Direct Endorsement Underwriter X [] Chief Architect [] Deputy ID Number IV. To Mortgagee: When signed below, refer to the statement on the back corresponding to the designation checked. [] A. Noncompliance [] B. Compliance -- Incomplete Items. "Mortgagee's [] C. FinalAcceptance. Closing papers ] (a) Variations from exhibits. Assurance of Completion", HUD 92300, may be submitted, may be submitted provided mortgage credit analysis is acceptable. ] (b) Unacceptable construction, for completion ] (c) Premature construction. $ not later than: Signature Date ID Number ] Direct Endorsement Underwriter x LJ Director of Housing Development L~ Deputy For HUD Use Only for concurrence of Direct Endorsement Processing Signature of HUD Authorized Agent Date of this Compliance Inspection Report. If signed, this final report is considered processed by HUD and, thereby, convertible to the Veterans Administration. X Previous editions are obsolete form HUD 92051 (7/871 VMPMORTGAGE FORMS · (313)293 8100 · (800)521 7291 ref. HB 4145.1, 4190.1 ~,.-413 ~s8o~, PAGE 1 OF 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 WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:$W930064 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:WAGNER JOHN W JR OWNER ADDRESS:19722 JASMINE RD CHUGIAK, AK 99567 DATE ISSUED: 4/22/93 EXPIRATION DATE: 4/22/94 PARCEL ID:05114147 LEGAL DESCRIPTION: DELUCIA LT 5 LOT SIZE: 85000 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 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 PROVi / RECEIVED ' DATE: DATE: I"= 40' SCALE UPGRADE 0 ~D 0 0 0 0 0 ~ ~ 0 0 ~ 0 ~I.~IV~D GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRON,MENTAL QUALITY Case # I.(. >,, ,.j 19/td ~ 3330 "C" Street ANCHORAGE, ALASKA 99503 O~AT~ ANCHORAGE AREA BOROUGH Performed For ........ ~ .... , .......... Legal Descr~p¢~on: LoC ; Block SubdJvJsJon ThJs Form ReporCs So~ls Log ~ ~PercolaCJon Tes~ - So~1 Tes~ Hus¢ Be Logged To 4' Below Proposed Seepage SysCem - Depth Feet 1-- 2-- 3-- 4-- 8-- 9-- 11-- 12-- 13-- Soil Characteristics Dated Performed Was Ground Water Encountered?_L,,~,,=~ If Yes, At What Depth? Reading Date Gross Time Net Time Depth to H20 Net DropI Percolation Rate Minute Proposed Installation: Seepage Pit Drain Field __ Depth of Inlet Depth to Bottom of Pit Or Trench COMMENTS: -: ~-, £ Test Performed BY -'~:;,--~-c3~.-( Date Certified BY' Date: if'*L Time fnspector Field Notes: PrOperty Owner ~,ddress ,~ BUyer Address Lending institution Address Realty Co. & Agent Address Legal Description [. Type of Residence ,~ Single Family ~ Multiple Family ~ Other Water Supply ~ Individua~ munity Utility Sewer DiSposal 'J~ Individual blic Utility Iding Tank ) APPROVED BEDROOMs ) DISAPPROVED ) CONDITIONAL APPROVAL* BY: APPLIC' NT FILLS OUT UPPER HAl ONLY Phone Eip Code .._Zip Code _Zip Code One Phone No. of Bedrooms~ .~~WELL LOG. A we/I log is required for all Wells drilled Since June 1975. ritled prior to that date, give Well depth (attach log if available). Year Individual Installed: When Connected to Publi~ NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Date Inspector Inspeclor Time Date 'CONDITIONs OF APPROVAL r Installed 72-023 (3/82} ~tion Area Well to Tank Well Log_~_~Received Septic Tank Size CItEMIC4L& Gl. i -- O~.I~4L L.4BOR~4 TORIE$ ~4L~4SK.4, INC. 274 3364 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteri~ TO BE COMPLETED BY WATER SUPPLIER o TO BE COMPLETED BY LABORATORY WATER SYSTEM: Water System Name Mailing Address City SAMPLE DATE: I.D. NO. State Mo. Day Year SAMPLE TYPE: [] Routine [] Check Sample (for with lab ref. no._ [] Special Purpose LOCATION Phone No. SAMPLE NO. L routine sample [] Treated Water [] Untreated Water Zip Code Analysis shows this Water SAMPLE to be: [] Satisfactory ~ Unsatisfactory [] Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample. Date Received Time Received Analytical Method: [] Fermentation Tube [] Membrane Filter Time Collected Collected READ INSTRUCTIONS 06-1220 Rev, 1978 Date Colla:te(I Lab Ref. No. Result* Analyst BACTERIOLOGICAL WATER ANALYSIS RECORD Source_ BEFORE ~ -'"' ,~l ~,,,, O.Zm~ COLLECTING SAMPLE EM,=~ ~ ~ Multiple Tube ReDort~'-~ Broth 24 hour~=~Broth 48 houri=_ Membrane FIIter~ Direr Count ZOml Tubes P~tlm~otaI J~l Verification= LTB Final Membrane Filter Results Repor tecl By~ - BG8 Collform/i0Oml Collfoml/] 00mi Date Time=_. ~ EXCAVATION ROBERT A. SHAFER CIVIL ENGINEER 694-2979 August 15, 1982 ENV!, ~., ; /:,. : ,0 :Z ; J WORK Cheryl Langworthy SR 1 Box 1227 Chugiak, Alaska 99 567 R Dear Mrs. Langworthy Reference: Lot 5; DeLucia Subdivision A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The drain field was tested by a continuous flow of water over a period of 24 hours without any adverse effect on the system. It can be concluded from this test that the waste water disposal system serving the three bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failure. As requested by the Municipality the system was excavated to determine the type of system and its proximity to Peter's Creek. The attached sketch shows the approximate location of the system with respect to the creek, the residential well and dwelling located on this property. It has been determined that the system was installed in accordance with ordinance No. 28-68, Section 9-71, Paragraph 7 of table 5 and is considered to be adequate at this time. If we may be of further assistance, to call. please do not hesitate ¢s/ss cc: Municipality of Anchorage Department of Health and Environmental Protection SR8 196X EAGLE RIVER, ALASKA  MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services ' On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4'744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # C.L~'/ -- / ~-/.- '~7 1. GENERAL INFORMATION Complete legal description ______~;~-- ~ Location (site address or directions) _ Mailing address ~~ p,~,~_. Lending agency ----__ Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLy: Individual well Community well Public water NOTE: Day phone Day phone Day phone If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91J Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Engineer's signature Phone DHHS SIGNATURE Approved -for .~)'~'~ ~_? bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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 indepenu~nt 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. 1/91) Back MOA ~21 Legal Description: Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST A. WELL DATA We, type Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. Y ADEC water system number Date completed %~i~ Z_y",/~- Driller Cased to i 7...~' ~ Casing height Wires properly protected (Y/N) FROM WELL LOG Date of test ,~.~1¢1-- iq;i z_ Static water level Well flow Pump level AT INSPECTION Y SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: / / B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) Y' High water alarm (Y/N) Date of pumping Nitrate Collected by: Other bacteria Tank size ~ z. ¢ Compartments ~ Foundation cleanout (Y/N) ~' Depression (Y/N) ~Y' Alarm tested (Y/N) ~ ~Y~ ,~'?~'7 Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot io57' On adjacent lots To property line Jg"f' Absorption field Foundation I Water main/service line Surface water/drainage 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer / Manhole/Access (Y/N) ~;-, ~'~ "Pump off" level at Cycles tested ~-~ Meets MOA electrical codes (Y/N) ~' SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot ! o~,- ' On adjacent lots I oo +-- Surface water D. ABSORPTION FIELD DATA Date installed Length ;~¢' Width Total absorption area Depression over field (Y/N) Soil rating ¢): ? q~'J/'~¢ System type "~z~'~"~/~ /Z." Gravel thickness ~- ~- ~ Total depth :~' ~" ~ ~,'~ Cleanouts present (Y/N) /(.."/~:' Date of adequacy test //~/~'-' Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) for bedrooms --,,I., ' If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots i Surface water Curtain drain On adjacent lots i ot'~, -~- Property line J ~ '~- To existing or abandoned system on lot Cutbank iC ?,,-o ~,- Water main/service line Driveway, parking/vehicle storage area J E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name Date Davkl R. Dayton P.E. 20210 Donalar St. Chu~iak, Alaska 99567 HAAFee$ /'7 Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev 3/91) Back MOA 21 D. R. DAYTON, P.E., R.L.S. 1~[~7~x~ Chugiak, Alaska 99567 20210 Donalar St. (907)~1~~~ April 13, 1993 WELL FLOW TEST Legal Description: Lot 5, Delucia Subdivision Date of Test: April 8, 1993 Well Depth: 125' Static Water Level: 108.3' Driller: Penn Jersey Drilling Requirements: 3 bedroom - 450 gallons per. day Test: The well was pumped with the existing pump through an outside hose bib. Volume, time and drawdown were monitored during the pumping. The well produced 720 gallons in 2 hrs. 5 min. for an average pumping rate of 5.8 gallons per minute. The maximum drawdown was 4.2'. The drawdown completely recovered in 2 min. 45 sec. Results: The well is currently producing adequately for a 3 bedroom home. CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99516 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 Member of the SGS Group (Soc,*,* G*n*rale de Surveillance) TELEPHONE (907) 562-2343 5,333 B Street Anchorage, A~aska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER [] PUBLIC WATER SYSTEM I.D. # i~"~,PRIVATE WATER SYSTEM 20210 Donalar Se. Phor~e h,o. Coy State SMVlPLE DATE: qJ ? } ¢ _s Mo. Day Year SAM, PLE TYPE: ?,~Routine Check Sample (for routine sample with lab ref. no. Special Purpose ) [] Treated Water ,~ Untreated Water SAMPLE Time Collected No. LOCATION Collected By si I TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: '~- Satisfa~ory [] Unsatisfactory [] Sample too long in transit; sample shou',d not be ovsr 30 hours oid at examination to indicate reliable results. Please send new sarnple via special delivery mail. Date Received Time Received __j / ,,-,, Analytical M, ethod: Membrane Filter * No. of colonies/100 mi. I ~,1~ ~,-,¢ ~-~- Result* 73,1430 - -~ READ INSTRUCTIONS Membrane Filler: Direct Count A~t Coliforrr¢100 mi BEFORE Verification: LSB BGS Fecal Coliform Confirmation COLLECTING SAMPLE Final Membrane Filter Results v',/ Coliform/100 mi TNTC : Too Numerous To Count~ ~ .... { ~O ..~_ OB = Other Bacteria Member of the SGS Group (So c OF TWO ~::iIAINDE~ TO F'OLLO¥t