HomeMy WebLinkAboutCHRISTOPHER HEIGHTS #1 BLK 1 LT 3E"Aop m 6K4S
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t Municipality of Anchorage Page of -2—
DEPARTMENT OF HEALTH AND HUMAN SERVICES
DEPARTMENT
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: ��Gb3t PID Number: c»�Z�t93
Name,? � �
Gv
Wastewater System: ❑ NewUpgrade
Address: 45)GjS,113
� I �►�IM�-�'f'
ABSORPTION FIELD
Phone:
(DESCRIPTION
No. of Bed: ms:
Ll Deep Trench ❑Shallow Trench 11 Bed Ll Mound ❑Other
LEGAL
Soil Rating:
Total Depth from original grade:
GPD/Sq. Ft.
Lot Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
Ii G
Ft.
Ft.
Township:
Range:,
Section:
Fill added above original grade:
Gravel length:
Ft.
Ft.
WELL: ❑ New ❑ Upgrade
Gravel width:
Number of lines:
Distance between lines:
Ft.
Ft.
Classification (private, A,B,C):
Total Depth:
Cased To:
Total absorption area:
Pipe material: 4-
Ft.
SQ. Ft.
4
Driller:
Driller:
Date Drilled:
Static Water Level:
1n;,taftirl
G
ate instalIV:_
Ft.
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION DISTANCES
❑ Septic Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
Holding
W4,64eWrivate
\ ►/
Mtt
Capacity i gaa s:
From
Tank
Field
Station
Tank
Sewer Lines
/JrF—�V
Well
�•
�i
'��
)/'
v2-
(%��
M��
Number of Compartments: 1
Surface
/
1�}
LIFT STATION
Water
1
Lot
Size in gallons:
Manufacturer:
Line
��
Foundation
�
/
/
� 4,
�
"Pump on" level at:
"Pump off' level at:
High water alarm at:
Curtain
Pump Make &Model
Electrical Inspections performed by:
Drain
BENCH MARK
Remarks:
Location and escri tion: G
2
LST �r—� of Pfz o �of7
�1Li
242
Assumed Elevation:` O
Ft
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17034 Eagle River Loop Road No. 204
Alaska 99577 1st !;LT"7
xru a:.nw ..moo°. �.° •
Inspections performed by: Eagle River, Dates:
2nd to—"►'�
w�
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_
Department of Health and Human Services approval
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Reviewed and approved by: Date:
72-013 (Rev. 9/91) MOA 25
Permit No. ---� 3
Page 2 of 2
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
*i
Legal Description: L -,,r3 '�• Glk��—tS'1 o�� i2-- LS. PID No.:
tj is Nx- ?--15--c. 'r4 An.._.
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72-013 A (Rev. 9/91) MOA 25
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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 WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW930031 DATE ISSUED: 3/18/93
DESIGN ENGINEER:S & S ENGINEERING EXPIRATION DATE: 3/18/94
OWNER NAME:REEVES DAVID AND KELLY
OWNER ADDRESS:8371 SUMMERSET DRIVE
ANCHORAGE, ALASKA 99518
PARCEL ID:01523193
LEGAL DESCRIPTION: CHRISTOPHER HEIGHTS #1 BLK 1
LT 3
LOT SIZE: 41025 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
HOLDING 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 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:
v
ISSUED BY:.
DATE: J ( -7 q-3
DATE: 9 9
March 13, 1993
ROBERT SHAFER. P E
ROGER SHAFER. P.E.
CIVIL ENGINEERS
(907)694-2979
FAX 694-1211
HEALTH AUTHORITY
APPROVALS
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. Box 196650
Anchorage, Alaska 99519-6650
SEWER & WATER
MAIN EXTENSIONS
REFERENCE: Lot 3, Block 1, Christopher Heights Subdivision
Request you issue a permit to install a 2500 gallon
wastewater holding tank to serve the 4 bedroom house located
SEWER&WATER
on the referenced property.
INSPECTION
Soils testing on the property found the soils to be
unsuitable for the installation of a septic system. Refer
to our Wastewater Disposal System Assessment and Soils
ENGINEERING STUDIES
g p Investigation Report attached.
ANDREPORTS
A
The proposed holding tank is to be installed essentially in
the area of the existing septic system. This location is in
excess of 100 feet from any wells in the area.
WELL INSPECTION
8 FLOW TEST
If you have any questions or require additional information
for your review, please contact us.
SITE PLANS Sincerely,
VV
ROAD DESIGN ROGER J. SHAFER, P.E.
SOIL TEST
PERCOLATION
TEST
STRUCTURALS
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
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WASTEWATER DISPOSAL SYSTEM ASSESSMENT
AND
SOILS INVESTIGATION REPORT
LOT 31 BLOCK It CHRISTOPHER HEIGHTS
BY
S & S ENGINEERING
ROGER J. SHA ER, P.E.
SUBMITTED TO
DAVE AND KELLY REEVES
TABLE OF CONTENTS
Purpose 1
Results 1
History 1
Discussion 2
Conclusions 3
Appendix 4
A. As -built Survey 5
B. Soil Logs -Percolation Data 6
C. Photographs 11
D. Grain Size Distribution Report 17
Lot 3, Block 1, Christopher Heights
PURPOSE:
The purpose of this investigation originated as a request for
a Health Authority Approval by Charlene McLean - 2001 Realty
on January 20, 1993. Once problems were detected with the
performance of the existing septic system, soils testing was
performed to determine a suitable wastewater disposal system
for the subject property.
RESULTS:
The existing septic system serving the referenced property was
found to be in a state of failure. Failure is attributed to
the following conditions:
1. The septic leachfield was installed within
impermeable soils.
2. The septic leachfield is encroaching
groundwater and assumed to be within the seasonally
high groundwater table.
Soils investigation has found there is not a location on the
property which supports the installation of a soils absorption
type of wastewater disposal system (septic system).
HISTORY:
The well serving the subject property was installed in June
1985 by ALPINE DRILLING.
The septic system serving the referenced property was
installed 1985-1986 by FEJES DEVELOPMENT and inspections
performed by THOM A. FISCHER, P.E. Municipal approval of the
inspection report was given June 24, 1986.
The type of septic system consists of a 1250 gallon steel
septic tank and a leachfield bed with a total absorption area
of 1860 square feet.
(1)
Lot 3, Block 1, Christopher Heights
DISCUSSION:
On January 22, 1992 we visited the subject property for the
purposes of performing well and septic testing necessary for
obtaining a Health Authority Approval (HAA) from the
Municipality of Anchorage (MOA), Department of Health and
Human Services (DHHS). At that time the following
observations were made:
1. There was a depression over the septic tank
area. The extent of this depression was difficult
to determine due to the amount of snow cover.
2. The liquid levels within the septic tank were
measured at 54 inches indicating a surcharged
condition.
3. The liquid levels within the leachfield ranged
from 19.5 inches to 21.5 inches as opposed to
normal liquid levels of 6 inches or less. This is
also indicative of surcharged conditions.
4. Ice was found within the northwest leachfield
standpipe. There was ice and moisture found around
the northwest end of the leachfield bed also
indicating surcharged conditions with periodic
surfacing effluent.
To further assess the conditions of the leachfield in relation
to its proximity to groundwater levels, a test hole was
excavated near the leachfield bed on February 10, 1993 (Test
Hole C. See Appendix). Within this test hole we found clayey
silts with a visual percolation rating in excess of 120
minutes per inch. Groundwater monitoring found groundwater
levels at 5 ft. below the ground surface verifying a
groundwater encroachment of the existing leachfield.
On March 8, 1993 we excavated 2 additional test holes near the
leachfield bed (Test Holes A and B) and 2 test holes elsewhere
on the property (Test Holes D and E) in search of a
replacement septic site. Percolation tests were performed
within each of these test holes.
(2)
Lot 3, Block 1, Christopher Heights
We found the soils throughout the property to be predominantly
silty clays with some gravel. Sieve analysis performed on
samples collected found the silt/clay content (percent passing
the #200 sieve) to range from 33.2% to 94.1%. Percolation
testing found all the soils to have a percolation rating ii,,
excess of 60 minutes per inch. Soils in excess of 60 minutes
per inch are considered to bay unsuitable for on-site septic
installation. After 3 days of groundwater monitoring,
groundwater levels were found to range between 5 f t . Lnd 9 f t .
below the ground surface. Since this is late winter,
groundwater levels should be at their deepest. We anticipate
the groundwater levels to rise considerably during spring
break-up when groundwater levels reach their seasonally high.
We understand the current occupants/ owners of the property
have not experienced adverse effects from use of the septic
system. Adverse effects include sewage backing -up into the
dwelling. It appears the effluent entering the septic
leachfield has been migrating out of the leachfield between
the organic overburden and underlying silty clay layers.
Given the elevation difference between the septic leachfield
and the house, this condition may exist for several years
without experiencing sewage backing into the house.
Unfortunately, this type of migration of effluent does not
provide the wastewater treatment necessary to assure an
environmentally safe condition. This migration also increases
the potential for daylighting effluent as observed near the
northwest end of the leachfield.
CONCLUSIONS:
Soils located on the subject property are unsuitable to
support the installation of an on-site septic system. We
recommend the installation of a 2500 gallon wastewater holding
tank to serve the 4 bedroom residence located on the property.
(3)
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Municipality of Anchorage 6"0.11®00•.•• E;R =00 •
DEPARTMENT OF HEALTH & HUMAN SERVICES � ,
t••FiC?C •R J. •H825 "L" Street, Anchorage, Alaska 99502-0650 s,
SOILS LOG — PERCOLATION TEST No. e215
PERFORMED FOR: ��-�Citi�l �i� DATE PERFORMED:�,1
LEGAL DESCRIPTION: I��� ��K{��- I
.
Dep
..
WaterMUM
1
r•
2
d v
4-
5
6
7
.
8
9-
o• �+
ownship, Range, Section:
10 WAS GROUND WATER
O-. r ENCOUNTERED?
p ' J
11 'tom.c:'.A.
12-
13-
14-
15-
16-
17
21314151617
81920 18-
19-
20
COMMENTS
IF YES, AT WHAT
DEPTH?
Depth to Water After
Monitoring?
SLOPE
S
L
Gc�S O
P
E
Date:
SITE PLAN
®®MM
Dep
..
WaterMUM
N
PERCOLATION RATE > I2o (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN 21
Z FT AND 3t Z FT
PERFORMED BY: 1c & g EE��_r_tnt(EERING q�I �� CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WIT A? tje Tj yt A04K?t?o IN EFFECT ON THIS DATE. DATE: - 1�" -,9"5
72-008 (Rev. 4/85) EEE AAA��I K 999 (6 )
e Municipality of Anchorage*'!4971H •...«:.•.
DEPARTMENT OF HEALTH & HUMAN SERVICES E` ••
825 "L" Street, Anchorage, Alaska 99502-0650 ,"�� Ru, ,- AF
iHEFR 40
SOILS LOG — PERCOLATION TEST ���;� + No. 8115 •••g
=tea
,%�ROfF9S►0 ..a.
PERFORMED FOR: I"VC� s DATE PERFORMED:
LEGAL DESCRIPTION
E T
F E )
G1k{LtS�oP}�t2 !�i�
6% t-1 -GL-
(N1
13 ----1 'P.> . v. 14-.
14
15
16
17
18
19
Township, Range, Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED? /
S
IF YES, AT WHAT L
O
DEPTH?
P
E
Depth to Water Aller t
Monitoring? Hate: 3'
SITE PLAN
®®MM
Dto
epthWater...
20 I ,4
lul PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER (01
TEST RUN BETWEEN 3t /Z FT AND I 2 FT `
COMMENTS L -4i --tfbt 416! 6t q- VL J^7V/�j��Is(S
PERFORMED BY: S &n 6 ENGINEERING
p �,� 'eIe ` t'` l� CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITHIAL'L35TA'T %4vVJk%V,?tC@OINFL•I*f IN EFFECT ON THIS DATE. DATE:
Eagle River, Alaska 99577
72-008 (Rev. 4/85) ( 7 )
e Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
OF Q
PERFORMED FOR: 4`� DATE PERFORMED 3
LEGAL DESCRIPTION: L�l.-�L• I Township, Range, Section:
G�1STo�1� r.�r� SLOPE SITE PLAN
IXOPFtc,t,
1
ti
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2
3 •� _
4- M L
5
6 gjt_cJ� Gc- t.�N5c5
7
8 �.
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11
12
13
14
15
16
17
18
19
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT
DEPTH? ✓��" P
E
Depth to Water After r
Monitoring? y Date:
Reading Date Gross Net Depth to Net
Time Time Water Drop
20 I� M
PERCOLATION RATE > (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN 2 FT AND FT
COMMENTS—/D�!•1PC.� ►I�GG'�L2f� .4— -:3 �1 —•7f ��'►L��%�y��ycl.�'�l�j .
PERFORMED BY: S C ENGINEERING lI , `` t� CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH�A 3 TAl �A v L11�� f4!d0ftIA" IN EFFECT ON THIS DATE. DATE:
Eag a River, A as a D7777
72-008 (Rev. 4/85) (8,
e Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG - PERCOLATION TEST
PERFORMED FOR:DATE PERF,
LEGAL DESCRIPTION: 3 P.7 LK^ I Township, Range, Section:
DEPTH GIKL1�("oQ}}�it- 1'T 1 �• I SLOPE SITE PLAN
(FEET)
11
12
13
14
15
16
17
18
19
Peir
e
WAS GROUND WATER
t74-;:- 14 ENCOUNTERED?
S
L
IF YES, AT WHAT
DEPTH?
E
Depth to Water After
Monitoring? g Date:
Reading Date
Gross
Time
Net
Time
Depth to Net
Water Drop
! 4z-
tot. v5
.1 fig
20�
PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER ty
G �^ TEST RUN BETWEEN Z FT AND FT
COMMENTS Jb *-'t P1--Ol.i� PC�
PERFORMED BY: S & S ENGINEERING I CERTIFY THAT THIS TEST WAS PERFORMED IN
17034EagleRiver Loop Road No. 204 \ 3 - 12 `13
ACCORDANCE WITH P� gle KIVBAr, RIVM(Y#§�� UIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85) CCB ( 9
Municipality of r49T1�
litf AhZ
• -5496 ••w•nwsa+ws 6°w.�i66 •
DEPARTMENT OF HEALTH & HUMAN SERVICES,
825 "L" Street, Anchorage, Alaska 99502-0650
HAFER : Q,
SOILS LOG — PERCOLATION TEST °�'`s
'•• N ww6 �r i
PERFORMED FOR: �r�'C�V � s DATE PERFORMED:
LEGAL DESCRIPTION: Township, Range, Section:
DEPTH ^Gt cj`o1� {-4v�SSLOPE SITE PLAN
2
3
4-
5 5
6-
7 7
8
9
kt EE,T)
ti
►��
/q �
'o
A,
y
��WAS GROUND WATER
Ar
10 p ENCOUNTERED?
12-
13-
14-
15-
16-
17-
18-
19
213141516171819
201
COMMENTS
IF YES, AT WHAT
DEPTH?
Depth to Water Atter 411
Monitoring?
ENNEE
MENEENEENE
CG ti
PERCOLATION RATE >^ ZO (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN 4 FT AND Z5 FT
PERFORMED BY: 5 & S ENGINEERING I — CERTIFY THAT THIS TEST WAS PERFORMED IN
17034 Eagle River LooRoad No. ��¢
ACCORDANCE WITH L5kg&A(�r� P GUIDELI IN EFFECT ON THIS DATE. DATE.
72-008 (Rev. 4/85) ( 10
17
IY�
% SAND4.3MATERIAL
DESCRIPTION*
SILTY CLAY*
SILTY SAND WITH GRAVEL*
SILTY GRAVEL WITH SANDSAMPLE
DELIVERED TO RPKA
17
GRAIN SIZE DISTRIBUTION TEST DATA Test No.:
-------------------------------------------------------------------------------
Date: 3-10-93
Project No.: 1200B
Project: LOT 3, BLK 1 CRISTOPHER HTS. #1
Sample Data
Location of Sample: TH C, 4'-5'
Sample Description: SILTY CLAY
USCS Class: CL -ML Liquid limit:
AASHTO Class: Plasticity index:
Notes
-------------------------------------------------------
Remarks: SAMPLE DELIVERED TO RPKA BY S & S ENGINEERING
Fig. No..
-------------------------------------------------------------------------------
Mechanical Analysis Data
-------------------------------------------------------------------------------
Initial After wash
Dry sample and tare= 762.50 199.40
Tare = 164.10 164.10
Dry sample weight = 598.40 35.30
Minus #200 from wash= 94.1 %
Tare for cumulative weight retained= 164.1
Sieve Cumul. Wt. Percent
retained finer
0.375 inches 164.10 100.0
# 4 173.70 98.4
# 10 177.60 97.7
# 20 181.50 97.1
# 40 185.00 96.5
# 100 192.90 95.2
# 200 199.40 94.1
-------------------------------------------------------------------------------
Hydrometer Analysis Data
-------------------------------------------------------------------------------
Separation sieve is number 10
Percent -# 10 based on complete sample= 97.7
Weight of hydrometer sample: 50
Calculated biased weight= 51.15
Automatic temperature correction
Composite correction at 20 deg C =-6
Meniscus correction only= 1
Specific gravity of solids= 2.65
Specific gravity correction factor= 1.000
Hydrometer type: 152H Effective depth L= 16.294964 - 0.164 x Rm
Elapsed
Temp,
Actual
Corrected
K
Rm
Eff.
Diameter
Percent
time, min
deg C
reading
reading
depth
mm
finer
1.0
20.0
51.0
45.0
0.0136
52.0
7.8
0.0380
87.9
2.0
20.0
49.5
43.5
0.0136
50.5
8.0
0.0273
85.0
5.0
20.0
46.0
40.0
0.0136
47.0
8.6
0.0179
78.1
15.0
20.0
39.5
33.5
0.0136
40.5
9.7
0.0109
65.4
30.0
19.0
35.0
28.8
0.0138
36.0
10.4
0.0081
56.2
60.0
19.0
29.0
22.8
0.0138
30.0
11.4
0.0060
44.5
1440.0
-------------------------------------------------------------------------------
15.0
12.5
5.4
0.0145
13.5
14.1
0.0014
10.5
-------------------------------------------------------------------------------
Fractional
Components
+ 75mm. =
0.0
GRAVEL = 1.6 $
SAND =
4.3
o FINES = 94.1
D85= 0.03
D60=
0.009
D50= 0.007
D30= 0.0038
D15=
0.00188
(19)
GRAIN SIZE DISTRIBUTION TEST DATA Test No.: 2
-------------------------------------------------------------------------------
Date: 3-10-93
Project No.: 1200B
Project: LOT 3, BLK 1 CRISTOPHER HTS. #1
Sample Data
Location of Sample: TH-D, 2.5'-3.5' SAMPLE #2
Sample Description: SILTY SAND WITH GRAVEL
USCS Class: SM Liquid limit:
AASHTO Class: Plasticity index:
Notes
-------------------------------------------------------
Remarks: SAMPLE DELIVERED TO RPKA BY S & S ENGINEERING
Fig. No.:
-------------------------------------------------------------------------------
2
-------------------------------------------------------------------------------
Mechanical Analysis Data
Initial
After wash
Dry sample and tare=
554.00
428.70
Tare
= 176.40
176.40
Dry sample weight
= 377.60
252.30
Minus #200 from wash=
33.2 %
Tare for cumulative
weight retained= 176.4
Sieve
Cumul. Wt.
Percent
retained
finer
1.5 inches
176.40
100.0
1.5 inches
176.40
100.0
0.5 inches
239.60
83.3
0.375 inches
255.00
79.2
# 4
285.30
71.2
# 10
313.60
63.7
# 20
336.50
57.6
# 40
355.80
52.5
# 100
402.00
40.3
# 200
-------------------------------------------------------------------------------
428.70
33.2
-------------------------------------------------------------------------------
Fractional Componc-,:L
+ 75mm. = 0.0
% GRAVEL =
28.8 % SAND = 38.0
FINES = 33.2
D85= 14.29 D60=
1.202 D50= 0.331
GRAIN SIZE DISTRIBUTION TEST DATA Test No.: 3
-------------------------------------------------------------------------------
Date: 3-10-93
Project No.: 1200B
Project: LOT 3, BLK 1 CRISTOPHER HTS. #1
Sample Data
Location of Sample: TH-B, 3.5'-4.5' SAMPLE #3
Sample Description: SILTY GRAVEL WITH SAND
USCS Class: GM Liquid limit:
AASHTO Class: Plasticity index:
Notes
-------------------------------------------------------
Remarks: SAMPLE DELIVERED TO RPKA BY S & S ENGINEERING
Fig. No.:
3
-------------------------------------------------------------------------------
-------------------------------------------------------------------------------
Mechanical Analysis Data
Initial
After wash
Dry sample and tare=
531.50
370.60
Tare
= 164.30
164.30
Dry sample weight
= 367.20
2:.:.30
Minus #200 from wash=
43.8
Tare for cumulative
weight retained=
164.3
Sieve
Cumul. Wt.
Percent
retained
finer
0.5 inches
164.30
100.0
0.5 inches
164.30
luu.0
# 4
271.50
70.8
# 10
289.00
66.0
# 20
305.50
61.5
# 40
322.60
56.9
# 100
355.50
47.9
' 200
-------------------------------------------------------------------------------
370.60
43.8
-------------------------------------------------------------------------------
Fractional Components
+ 75mm. = 0.0
o GRAVEL
= 29.2 $ SAND = 27.0
o FINES = 43.8
D85= 8.41 D60=
0.646 D50=
0.193
(21)
J:
s ilk.
I pl' h a
34 I v
N*
W, S 40.0V
�r f,�,t`' • �o orf, — 'V
5-0
f a` � 30. � •r/o{0�{.
1
p 1`
l J C`—
u
RECE VED 'i N
FEB 1 1993
Municipality o Anchorage
Dept. Health & H iman Services
As -built Certificate:
I hereby certify that I have surveyed the following de-
scribei property: Lnt 3?���/� < - •;,L;r�,,,._ htJ.
and that no encroachments exist
except as indicated. +�♦``»,,� bJ
o �
.. � of A�q s%, Q
Exclusion Note: V
: �...,��
�r�' 1
It is the responsibility of the owner to determine �t1/'P
the existence of any easements, covenants, or re- y...N... «•'�•.•/
strictions which do not appear on the recorded sub- '0
� �y� •�,•�
division plat. Under no circumstances should any /,�; JchnA.srou•
data hereon be used for construction or for estab- 0 LS627o :-,� •
lichinn Mundary nr fonra linPe +��tJo, ••. °',:]P'✓ ••
S vt SAS OSot.A
aF HO)U-rH 4 H" mA" Svc -
M vt N `c ► P*_ t T`t c5r
G%zz
IRE - Lur 3 sk-or Y., \ cvfv_imPVvo?_ "1-% # t — sit, !SYSIUYA
MS C�st.,o��
_TTlc cA-b 7?zv- c -H Folz- -Tv%s Sep -PC `� `t S7�Yv� �. �� i N ST*�i�
Scr �'M ®� -T'l-} rS New ��� S i S T�'Yh +1� NeK�-1 0
Ti- �-�.�CH _0jZ_JjIN --rj-h- 'V.A,aS CrtST - "Q --r '_T ViC 0%-D
1-ga,c.44 THC: -mmc-- "(1tcz:- -- w
5 -� s- L"W\ N S7iR� > ANU �'�• t^'' �flG�Ft t1.Ea W t71i
THE S ►l voz c- r -w "PA . C IA WT W)pa bot4j", TVtIE
�ZN %mQ-
Tvits N'E� Sm moi = tS 1m, 4wq%lltFF�Qm 1"dis
N�.►i � SY S�'�M . %��� � �. 'Cl -its �fl-+r►n E C � sziv� ►+v
i T wl S c otos. "A ? rl�it-t- C,�,72_ ',n? cTWAV C
THE --T—" zc � S � c� SE�� ►C Kc�c K�
`n-tc
��'i� ► �.15��� tc�t� fqW I 6�6� 'Z Q1n6T� +S „r yt�TH r9ir�r
THOM A. FISCHER /
• CE - 6793 ac��
fir•
WHITEWATER ENGINEERING CONSTR
11600 CANGE ROAD 9 ANCHORAGE, ALASKA • 99516 • PH. 345-7008
MUNICIPALITY OF ANCHORAGE
(0DEPARTMENT 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
NAME
PHONE
W
❑ UPGRADE
MAILING ADDRESS
-7 C01 �iN
LEGAL DESCRIPTION %L
LOCATION
�-4-
NO. OF BEDROOMS
i vQ A
Well (
DISTANCE TO: —.�
Absorption e�
Dwelling i
PERMIT NO.
U y
.
I
'
a Q
Manufacturer �r
Materi
No. of com ents
UJ
N
Liq. capacity in gallons Inside lengthWidth
r�
Z IF HOMEMADE:
-
Liquid depth
7 y
DISTANCE TO: Well Dwelling
PERMIT
Jaz
0Z<
Manufacturer
Liquid capacity in gallons
0
DISTANCE TO:
Well Foundatio Nearest lot line
PERMIT NO.
LU =
Tzl "s—
J LL Z
No. of lines
Length of a ch line Total length of lines Tren width
Distance betw en Jines
F?�
e
c es
cc
Top of tile to finisr grade Zcq"3oyA of Material beneath tile
Total effective absorption area
a
i! 44 S'{ Z �j�C \ZZ, aches
361,'-7t.
w
a
Length Width Depth
PERMIT NO.
F-
Type of crib jameter Cri depth Total effective absorptio
CL
wa
LU
ti
Well Buildin undationest lot line
DISTAN TO:
Class Depth - Driller Distance to lot line
PERMIT NO.
w
Building foundation Sewer line Septic tank
DISTANCE TO:
Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
j'
REMARKS
Lan
.4C
A
L7,
`
5
. :
xy
ylt• •e • e+• yr w .�•t , •�•,
sn
�, THOM A. FISCH
`CE - 6793 q�
APPROV DATE LEGAL
Z
j
/Z -U73 IHev. 3/78)
f�
7
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geologicol a Geophysicol Surveys
Drilling Permit No.
LOCATION OF WELL (Plods* Complete either Iq, Ib or Ic.) A.D. L. No.
la. Borough Sugd iislp of Block Ib. t/sgtrs. Section No. Township N❑ Range E❑ Meridian
—of—of_ot.�
S❑ ry❑
Ic. OISTyNCE �.D-DDI-RECT
Af�!��� y��%
` <
ON F 0 ROAD INTERSECTIONS
L
3. OWNER OF WELL:
/
Address:
f: ?)cx
Street Address and
Area of Well Location "
,• , C :" r
2. WELL LOG
Feet Below
Surface
4. WELL VTH: (final)
Cl
5. DATE OF COI4PLETION
Material Type Top Bottom
/
'1
6. ❑ Cable tool E;rpotory ❑ Driven ❑ Dug
❑ Auger ❑ Jetted ❑ Bored ❑ Other:
�►� -�
/ �<<
��
7. USE: �r Domestic ❑ Public Supply, ❑ Industry
❑ Irrigation ❑ Recharge ❑ commerical
-1-12sk-04 .41-Y uoJ
❑ Test Well ❑Other:
'Lap-r/tr K ��
8. CASING: ❑ Threaded fZ Welded
diam. In. to -7 ft. Depth Weight l lbs./ft.
diem. in. to ff. Depth Stickup it.
(�
t } l . �„ r,.
9. FINISH OF WELL:
Type: :, -'t Diameter:
L
Slot/Mesh Site: Length:
Set between ft. and ft.
i
Backfilling Gravel pack
� f0
10. STATIC WATER LEVEL:_ ft.
❑ Above or A Below land surface Date
Equipment used:
11 . PUMPING LEVEL below land surface and YIELD
Lai ft, after �_hrs. ,.1
pumping g. p. m.
ft. atter Ars. pumping g.p.m.
'
12.GROUTING Well Grouted: ❑ Yes '0 No
Material: ❑ Neat Cement ❑ Other:
ww ���.
t40=
ijj4�3W 4C)
N f40 jiwlvo SIN''
13. PUMP: (if available) HP
Length of Drop Pipe ft. capacity 9 -p -m -
q 511
❑ Subm. ❑ Jet ❑ Centrifical ❑ Other
14. REMARKS:
16. WATER WELL CONTRACTORS CERTIFICATION:
15. Water Temperature a ❑ F ❑ C
This well was drill*
under yy)urisdlclion and this report is true to the my knc l/°ge and belief;
t' � ,.e & '/
�lzsiness
1 i 1
Registered
B ame
t.
Contro t LIC nso Number
Address: ,
C• ^
/
Signed :
—, _ %
f
Date: _i
Authorized •press live
Form 02-WWR (11/81)
Copy Distribution: WHITE-Stote DGGS,
PINK - Driller, CANARY -Customer
January 10, 1986
TO: Permit Applicant
.�.iJX ?.65G
ANCH0,RAGZ. ALAS;,<.; +. t G + r J
9l�! i 264-4111
DEPARTMENT CF HEALTH 3 HUMAN SERVICES
Subject: Permit # 850640 1 A'0'
T12N R3W Section 23 SE�4(Lot 3 Block / Christopher Hts #1)
A permit issued by this Department for an individual well and/or on-site
sewer system has expired as of December 31, 1985.
Permits are issued on a calendar year basis by authority of Municipal
Ordinance. A new permit must be obtained from this Department for any
well and/or on-site sewer system not installed by the expiration date.
If you have drilled the well, a well log needs to be sent to this
Department for documentation of the installation and to close the permit.
If a private engineer inspected the installation of the on-site sewer system
the original as -built inspection report(three part form) must be sent to
this office for review and approval,and for documentation.
If there are any further questions, please call this office at 264-4720.
Sincerely,
Susan E. Oswalt O {/
Program Manager
On-site Services
SEO / l j w
7
enc: Copy of Permit S
WIEMNKWW
WMIMMUM
SV%SATl OSS.,
A.
1 'e v - '-:sk% Sf}^j
41 a -,A)
A s o
TFti .� D fi7� �f �tE S�T� aN
�L .Z Gi-}R ►SAY Hoz f4ocrwjS A'DDN W 1
pf,e> ftlj r> c� vj ej> p(Nz -TVro2!E- A
I -►E i.,, ELL, ► S 1 r a -"T� 11-'h 5 T) rnIE:
OF A4'
�• THOM A. Ft5 ER
0�+��Ea,'•,
CE-6193AV
Qom, O
Ia`Z1/ S�5
L w' 0-- 1
T`
MIV% 500— ►
MCL -13 �t-I c-
lc -T
i
I -s-
--.�.
P.O. BOX 3-4016 9 ANCHORAGE, ALASKA • 99501
PERMIT NO:
DATE iSSUED:
APPLICANT:
ADDRESS:
151 t_J 1%J 1: (0 :1 Fol dcl 1L. :1 -1- " V , EJ F=_ ��A C-.._..` V-4 �::) T"Z lr'� C-3 E7v
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREET, ANCHORAGE, AK 99501
264-4720
C3 04_10 1 1- EE E3 EO LJ EZ FT 1> 94 F.L7 L_ t F: _"����I I
-
nfo
10/01/85
�n ^
CHRIS FEJES
CONTACT PHONE:
8735 CORBIN DRIVE
ANCHORAGE, AK 99507 ' ^
349-8011
LEGAL DESCRIP: SUBDIVISION: NA LOT: NA
SECTION: 23 TOWNSHIP: 12N RANGE: 3W
LOT SIZE: 54208 (SQ.FT. OR ACRES)
LOT LOCATION: WILL BE LOT 3 BLOCK 2 CHRISTOPHER HTS #1
MAX BEDROOMS: 4
/
BLOCK: SE 1/4
Listed below are the options available to you in designing your septic
system. Choose the option that best [its your site.
-------------------------------------/�-
EN EvD.3
DEPTH TO PIPE BOTTOM (FT.) 1.5 ** ~
GRAVEL DEPTH (FT.) 0.5 '
TOTAL DEPTH (FT.) 2.0 - - -
GRAVEL WIDTH (FT.) 31.0 ^-
GRAVEL LENGTH (FT.) 60.0
� ^
GRAVEL VOLUME (CU.YDS.) 68.9
TANK SIZE (GALS) 1,250.0 **
SOIL RATING (SQ.FT./BR) 307
** DEPTH
TO
PIPE
BOTTOM <
2.0 FT. REQUIRES ADDITIONAL GROUND COVER
** DEPTH
TO
PIPE
BOTTOM <
3.5 FT. REQUIRES INSULATION
** DEPTH
TO
PIPE
BOTTOM <
4.0 FT. MAY REQUIRE A LIFT STATION
** TANK
-- - - -
MUST
- -
HAVE
- - -
AT LEAST
- - - -
TWO COMPARTMENTS
- - -
I certify that:
1. I am familiar with the requirements for on-site sewers and wells as set
forth by the MunicipaliLy of Anchorage (MOA) and the State of Alaska.
2._I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
3. I will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
4. I understand that this permit is valid for a maximum of 4 bedrooms and
any enlargement will require an additional permit.
IF A
LIFT STATION IS INSTALLED IN
AN AREA
COVERED BY
MOA BUILDING
CODES,
[HEN
(1) AN ELECTRICAL PERMIT AND
INSPECTION
MUST BE
OBTAINED; (2) AS-BUILTS
WILL
NOT BE APPROVED WITHOUT AN ELECTRICAL
INSPECTION
REPORT;
AND (3) THE
ELECTELECTRICIAN.
SIGNED
DATE:
APPLl
_______________
DATE:
A, 46k��rmLzAWk
v
NE. W . MDRN ERRINGT- T0-
//600 CANGE RD.
ANCHORAGE, AX 995/6
(907) 345-7008
' SOI LS LOG
�y 5���
/c PERCOLATION
TEST
SOILS LOG — PERCOLATION TEST _ /�
PERFORMED FOR: DATE PERFORMED: !thi
LEGAL DESCRIPTION: 'P_ dC ,
SLOPE SITE PLAN
1 r
S 11.:1
2 r, 1M
K7
4
5
a,
7
s
9
10
11 WAS GROUND WATER
ENCOUNTERED?
12 pyo �N+l a v ��� �-alx ES, AT WHAT
lg! DEPTH?
13
14
15
�s
.Al • •' s •
17 A%....* • •'•`,
H
18- •o*$ tr. •..a. •• •..
19 THOM A. FISCHER
CE - 6793
'aid •. .• ,��AP
Reading
Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
tk
Z°
i
47 V4P'
20- 4w
PERCOLATION RATE (minutes/inch)(
TEST RUN BETWEEN V FT AND _ FT
COMMENTS
PERFORMED BY: CERTIFIED BY: DATE:
wA
Municipality
of
Anchorage
September 17, 1985
P.O. BOX 6650
ANCHORAGE, ALASKA 99502-0650
(907)264-4111
TONY KNOWLES,
MAYOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
Mr. Samuel T. Fejes, Jr.
Becharof Construction Corp.
P.O. Box 111294
Anchorage, Alaska 99511
Subject: Permit 4850189 - SE1/4, Section 23, T12N, R3W �4 k-' l
� l z� , ,
4l= �_
Dear Mr. Fejes:
Following an on-site inspection of the sewer installation on the above lot, this
office has revoked your on-site sewer and well permit. The system has been red
tagged for the following reasons:
1. Use of D2729 pipe in system
2. No as -built on file
3. Soil test used for permit is not within ten (10) feet of system
You are hereby ordered not to use this system until written approval is granted
by this office. I would urge you to contact this office as soon as possible.
Sincerely,
Susan E. Oswalt
Acting Program Manager
On -Site Services
SO/dEH5
cc: Kay Larson, Building Safety
Llstaj �glvw li 1 the opliors
T�Ovm UE opnior
1�01 l"Llh to AY
that bcst Ata YEWT 2its.
DEPTH VC PIPH EOTT... " (F-."'
WIMM DEPM
TMAL DERM (F7-'
MOTY
TAINK STM "TALE
SC-L RQTIN; KMF7PV`
1pn of -7 P r To El W Ul TV M 11 1
12.
2
O SOILS LOG
ul • /
1600 CANGE RD. l `7
ANCHORAGE, AK. "5/6 ❑ PERCOLATION
(907) 345 TOOa TEST
SOILS LOG - PERCOLATION TEST
cc FE �� f ,
PERFORMED FOR: `\'f�IM DATE PERFORMED:
1 c3` r. 7�y P/� P 7 060x C Q� k'L 3 A k- i
LEGAL DESCRIPTION:sc �L Ste- Z3 y Z t`—J� Lsm ') - I--#
SLOPE SITE PLAN C_ t T° /
PERT
1I 5u
j TRY Fi me- SAnsD 1(-S f) m
16
17
COMMENTS
CA-V-ftlljeo-' (
(cs^)
S A-N'D`f S I `'T
GT•21/}vcu-Y S o -T
WAS GROUND WATERS
L
ENCOUNTERED? O
E
/ IF YES, AT WHAT
125 9 $gym DEPTH?
OF A4 '144
Ir
••
TH
THOM A. FISCHER
CE - 6793 ' �R�
sP ••• •'••q���
•••.....
5
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
`+
74c>
` 31zi
81z"14 X
4 j I(
+ z�
1
4�,
1 I
S
% .� i
PERCOLATION RATE / `� (minutes/inch
TEST RUN BETWEEN FT AND FT /+
PERFORMED BY I-j�w� i TSG{tCR CERTIFIED BY: DATE:
1
fl,4/1S
•
• Municipality of Anchorage
I� On-Site Water&Wastewater Program •x,t '
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 015-231-93 Expiration Date: I Z^ I?
1. GENERAL INFORMATION
Complete legal description CHRISTOPHER HEIGHTS#1;BLOCK 1,LOT 3
Location(site address) 11932 REGINA CIRCLE*ANCHORAGE,AK 99516
Current Property owner(s) WENDY BROWN Day phone 907-223-9200
Mailing address
Real Estate Agent Day phone
2. TYPE OF DWELLING:
• Single Family(w/wo ADU)
❑ Duplex
❑ Multiple Dwellings(Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well • Individual On-site 0
Individual Water Storage 0 Individual Holding tank U
Community Class Well 0 Community On-site ❑
Public Water System 0 Public Sewer 0
WaverNanance request for N/A Distance: -
Received by: Date:
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee$ S5Z) Waiver Fee$
Date of Payment /17-1A Date of Payment
CJt
Receipt Number n�Qlc' 6)6 Receipt Number
COSA# o�`7/ 06/3 Waiver#
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, 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 tiles 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.
Name of Firm GARNESS ENGINEERING GROUP,Ltd. Phone 337-6179
Address 3701 E.TUDOR ROAD,SUITE 101 'ANCHORAGE,AK,99507
Engineer's Printed Name JEFFREY A.GARNESS,P.E. Date 3/i,Jiq
Engineer's Comments:
In conducting this evaluation,GEG provided an engineering evaluation of the wed and/or septic system in accordance with the 0000�\\1%it
guidelines and regulations established by the Municipality o,Anchorage and industry practices.The reported results describe the 4.• OF a 44
condition of the system's on the date's of the evaluation.Separation distances were measured toreadilyidentifiable feahaes. •.t,1-......••••,
Hidden defeds a encroachments may exist that were not identified during the evaluation.The operational fife of all welts and septic = \. .�.
systems depend on a variety of variables including.but not limled to,soil conditions,groundwater levels(that may fadsate during •' r
the year),quality of construction(materials and workmanship),end the wafausage olthe family Wtinng the system's.These /r *I. 4 �/\ .*#11
conditions can vary,and are outside the control of GEG.Satisfactory fest results do not guarantee future pakrmance of the
system's;therefore.GEG makes no warranty(express or impfied)regarding the Mute performance(ill*wed a septic system.
GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the J� .,. ..,1
current systems fart.The content of this report is la the sole benekt of the persorypary who retained GEG.Reliance upon the 0 r •.Ga rness .
information provided in this report by any other person or party including but not lieded to subsequent property purchasers,is not ♦ c.
authorized In short GEG disavows any legal duty to anyone other than the persov✓party who paid for this report. / C 53 , wr
..• ••.3. VC::
6. DSD SIGNATURE ,,,'qui II i E ....
#AECCS
(" System#1 Approved for bedrooms. LICENSE.
ICENE
84
System#2 Approved for bedrooms. ,
Disapproved. :-)s ` rA(.
ON-SITE G1
Conditional approval for bedrooms,with the following stipulations: WATER AND CO
v WASTEWATER o
PROGRAM o� o
\GS
ti
•-cfiZz- --4
By: k"-----kOriginal Certificate Date:
3 .- 12--I ?
The Municipality or Anchorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only
upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTCHMENTS:
COSA Checklist Nitrate Advisory
Septic System Advisory Arsenic AdvisoC
Well Flow Advisory Other
(Rev.10112112)
V£
COSA Checklist
Legal Description: CHRISTOPHER HEIGHTS#1; BLOCK 1, LOT 3 Parcel ID: 015-231-93
If more than 1 septic system on lot: COSA Checklist# of Structure served by this system_
A. WELL DATA
❑■ Well log is filed with Onsite(or attached) Well production at time of test 2.6+ gpm
Date drilled 824
11995 Water storage tank volume N/A gallons
Total depth 109 ft Well disinfected for coliform test? 0 Yes 0 No
Cased to 71 ft ❑t Coliform bacteria is Negative
0 Sanitary seal is functioning correctly Nitrate 2.t 1 mg/L —�, )
I]Wires are properly protected Arsenic ug/L Arsenic less than MRL(ND)
Casing height(above ground) 12+ in. Collected by GARNESS ENGINEERING GROUP
Date of flow test for COSA 2
/2512019 Date of Sample 21?019
Static water level at beginning of test 16.2 ft.
Comments
B. TANK DATA C. LIFT STATION
Age of tank(s) 26 years 0 Required maintenance completed
Tank type/material STEEL Age of lift station years
❑t Standpipes/foundation cleanout per record drawing Lift station material
Date of pumping HOLDING TANK-SEE ATTACHED Comments:
D. ABSORPTION FIELD DATA
Which system tested(date installed) Adequacy test date
0 ALL standpipes present per record drawing Results ❑Pass For bedrooms
Total measured depth from grade ft(max) Fluid depth prior to test in
Measured depth to pipe invert from grade ft(min) Water added gal
0 N/A—pressurized field New depth in
0 Monitor tubes go to bottom of drainfield. If not, state Elapsed time min
depth into effective
Final fluid depth in
0 Code-required soil cover over field
❑ System presoaked Absorption rate gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months)
date of test) If yes, enter date
Gallons introduced gallons
Comments/Deficiencies:
COSA Checklist yellow sheet
r
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot> 100' Community Sewer Manhole/Cleanout> 100'
0 Yes if No ft 0 Yes if No ft
Neighboring Tank> 100' ZYes if No ft Private Sewer/Septic Line>25' 0Yes if No ft
Absorption Field on Lot> 100' ❑Yes if No N/A ft Holding Tank> 100' ❑✓ Yes if No ft
Neighboring Absorption Fields> 100' Animal Containment> 50' 0 Yes if No ft
0 Yes if No ft
Manure/Animal Excreta Storage> 100'
Community Sewer Main>75' 0 Yes if No ft �,/ Yes if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations> 10' 0 Yes if No ft Surface Water> 100' 0 Yes if No ft
Property Line>5' 0 Yes if No ft Driveway/Parking>0' 0 Yes if No, comment
Absorption Field> 5' 0 Yes if No ft Wells on Adjacent Lots:
Water Main> 10' 0 Yes if No ft Private Wells> 100' OYes if No ft
Water Service Line> 10' 0 Yes if No ft Community Wells>200' ['Yes if No ft
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10' 0 Yes if No ft Driveway/Parking>0' 0 Yes if No, comment
Property Line> 10' 0 Yes if No ft Wells on Adjacent Lots:
Water Main> 10' 0 Yes if No ft Private Wells> 100' 0 Yes if No ft
Water Service Line> 10' 0 Yes if No ft Community Wells>200' 0 Yes if No ft
Surface Water> 100' 0 Yes if No ft
F. ENGINEER'S COMMENTS
26-YEAR OLD STEEL HOLDING TANK MAY BE APPROACHING THE END OF ITS
USEFUL LIFE
00•00N.‘0
G. ENGINEER'S CERTIFICATION v�� OF A 4\\IN
1 certify that I have determined through field inspections and review O �- '.f 0
of Municipal records that the above systems are in conformance with 4 9 H `I ii ''T Opp
MOA COSA guidelines in effect on this date. ; 0
I D
v� ff ,y A. • ess. 4
vh . p. CE 7 53 ..•• OQO
COSA Checklist yellow sheet 00� o f e s sio oma'
#AECC884 DOOOD O
MUNICIPALITY OF ANCHORAGE
,c---------
DEVELOPMENT SERVICES DEPARTMENT 907-343-7904
On-Site Water and Wastewater Section Fax: 343-7997
www.muni.org/onsite \
Septic Tank Advisory
Certificate of On-Site Systems Approval # 0SC191063
Subdivision: Christopher Heights#1 Block:1, Lot: 3
Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for
this property is 26 years old. Typical replacement costs range from $6,000 to $9,000.
This advisory must be attached to all copies of the subject Certificate of On-Site Systems
Approval.
This is an example of what the metal of a 20 year old steel tank MAY look like.
4t,
%.- 6 y ' 1,4 wr I. .t.
, ,,, • f A 4101 .. . ,
r
Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org
Municipality of Anchorage
On -Site Water & Wastewater Program
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 015-231-93 Expiration Date:
1. GENERAL INFORMATION
Complete legal description CHRISTOPHER HEIGHTS #1 • BLOCK 1 LOT 3
Location (site address) 11932 REGINA CIRCLE *ANCHORAGE, AK
Current Property owner(s) ALFRED & MICHELLE MYER Day phone 947-0194
Mailing address 11932 REGINA CIRCLE *ANCHORAGE, AK
Real Estate Agent JAC QUES Day phone 301-2911
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
❑
Individual Water Storage
❑
Individual Holding tank
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance request for: -n/a
Distance:=
Received by: Date: 1 ,�'!
COSA to be released to the engineer, unless etherise requested by the engineer.
COSH Fee $ � j4�. 315 ?gi
Date of Payment -7 14-;-q 115 -
Receipt
15Receipt Number 08-1k3
COSA# ocpCtiS P)TI
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
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, 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.
Name of Firm
Address
GARNESS ENGINEERING GROUP, Ltd.
3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name
JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwaterlevels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
6. DSD SIGNATURE
System #1 Approved for _k— bedrooms.
System #2 Approved for bedrooms.
Disapproved.
Phone
337-6179
Date 7(s
Conditional approval for bedrooms, with the following stipulations:
{lOF1(AIV/1 r
\` Ir
CyrP
`J= ON-SITE
WATER AND
=o WASTEWATER
o^
PROGRAM
Original Certificate Date:
The"ricrpah'(y o[Ahorege Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSH) based only
upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTCHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
(Rev. 11105)
Nitrate Advisory .
Arsenic Advisory
Other
If more than 1 septic system is on the lot:
COSA Checklist # _of_
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: CHRISTOPHER HEIGHTS #1; BLOCK 1, LOT 3 ParcellD: 015-231-93
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) YES
Date completed 6/28/1985 Sanitary seal (Y/N)--L Wires properly protected (YIN) Y_
Total depth 109 ft. Cased to 71 ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 6/28/1985 7/20/2015
Static water level 9 ft. 45 ft.
Well production 6 g.p.m. 3.3+ g,p,m,
WATER SAMPLE RESULTS:
Coliform ff colonies/100 ml. Nitrate M4 mg./L. Collected by: GEC. Ltd.
Arsenic: 0¢ ug./L. Date of sample: 7/15/2015
B. SEPTIC/HOLDING TANK DATA CONDITION OF STEEL HOLDING TANK IS UNKNOWN
Tank Type/Material HOLDING/STEEL Date installed 4/6/1993
Tank size 2500 gal. Number of Compartments 1 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) YES
Date of pumping SEE ATTACHED Pumper ISAAC'S PUMPING
C. ABSORPTION FIELD DATA
Date installed Soil rating (g.p.d./ft�or ftlbdrm)_ System type
Length ft. Width ft. Gravel below ft.
Total depth , ft. Eff. absorption area ft2 Monitoring tube Depression over field
Date of adequacy test Results ail) For bedrooms
Fluid depth in absorption field before _ in. Water added _gal. New depth _in.
Elapsed Time: Final fluid depth _ in. Absorption rate >= g.p.d.
treatment (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at in.
Size in gallons Manhole/Access (YIN
"Pump off" level High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
N/A
On adjacent lots 100'+
Absorption field on lot
N/A
On adjacent lots 100'+
Public sewer main
N/A
Public sewer manhole/cleanout N/A
Sewer /septic service line
25'+
Holding tank 75+
Animal containment areas
50'+
Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING
TANK ON LOT TO:
Building foundation 5'+
Property line
5'+ Absorption field 5'+
Water main N/A
Water service line
10'+ Surface water 100'+
Wells on adjacent lots
100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
Building foundation
Water main
Water service tine
Surface wateray,
parking/vehicle storage
Wells on adjacent
F. COMMENTS
G. ENGINEER'S CERTIFICATION
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 JEFFREY A. GARNESS
Date 7 12 ,4h t'
(Rev. 11105)
OF
'13
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S PNU S' ENGINEERING PAGE 02
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MUNICIPALITY OF ANCHORAGE
• '� DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section erm
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING\
Parcel I.D. # oi5Z 3/9,3 HAA # t WVAtLCCSctj.
1. GENERAL INFORMATION
Complete legal description 6`�
Location (site address or directions) 3:2— /7(E ZAZ4 L//c
Property owner �y/JU��i�S Day phone
Mailing address l =CJ ,�ndj" �3�7�� 44/i/Cdd A/c WG, _-�
Lending agency
Mailing address
Agent
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
Day phone
Day phone
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
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA M21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm Gid off 4 �1_Prs
Address I'60/ /S ozl L Z,�
Engineer's signature
6. DHHS SIGNATURE
By:
G✓.)e--
lX Approved for ECKAK C4) bedrooms.
Disapproved.
Conditional approval for
Additional Comments
Phone c5T 6 —Z000
/q, -)C, iv 41(� 77-5—/,
Date 3
t
c`
��at:T«9iuud�"Ln
bedrooms, with the following stipulations:
WTIC
Tire 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. 1/91) Back MOA N21
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division
825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744
MUNICIPALITY ' GE
ENVIRONMENTAL SERVICES DIVISIOP
Health Authority Approval Checklist t-01AR 1996
11�1-
Legal Description: L 3 /3/ �' f r</Z/Sj O�f/E/Z A/ Parcel I.D.: 13RECFIVED
A. WELL DATA
Well type If A, B, or C. attach ADEC letter. ADEC water system number _
Log present (Y/N) Date completed
or
Total depth Io6 _ Cased to /OG Casing height (above ground)
Sanitary seal (YM)
FROM WELL LOG
Date of test e,— F Z
Static water level '5�9 C
Well production /5 ? /'�'��� g.p.m.
WATER SAMPLE RESULTS: 0 iPE�D G O Gj)
Coliform o Nitrate /.9Z
Wires properly protected (Y/N)
Date of sample: Collected by:
B. SC/HOLDING TANK DATA
Date installed 7-5 Tank size 2500 Number of Compartments / Cleanouts (Y/N)
Foundation cleanout (Y/N) Depression (Y/N) N High water alarm (Y/N) /
i�SiEp 1441J,Q41_ SoaVDS DFF
Date of Pumping .3' �3'% _ Pumper 44C Zv2a /dS 0 /900 0. i'2 /-1 7 /�25e✓r/2r
Good ,
C. ABSORPTION FIELD DATA 0e- r-) 41314A10 /> — 51— 9 3
Date installed _ Soil rating (g.p.d./ft` or ft'/bdrm) System type
AT INSPECTION
�� � �vv•� op �� Si �s
3� g.p.m.
Other bacteria
Length Width _ Gravel thickness below pipe Total depth
Effective absorption area Monitoring Tube present(Y/N) Depression over field (Y/N)
Date of adequacy test
Results (Pass/Fail) For
Fluid depth in absorption field before test (in.);
Fluid depth _ (ins.) Minutes later:
Immediately after gal. water added (in.):
Absorption rate = g.p.d.
Peroxide treatment (past 12 months) (Y/N) If yes, give date
bedrooms
D. LIFT STATION
Date installed
,IvNE 61J a.
Manhole/Access (Y/N)
High water alarm level at*
Cvcles tested
E. SEPARATION DISTANCES
Size in gallons
"Pump on" level at*
*Datum
"Pump off' level at*
SEPARATION DISTANCES FROM WELL ON LOT TO:
Ste€/liolding tank on lot '`/D� : On adjacent lots /oU
Absorption field on lot 4-/°o / 6dnc1vNc.� ; On adjacent lots 10
ie
Public sewer main y` / 00 Public sewer manhole/cleanout
Sewer /septic service line
4-80
Lift station
SEPARATION DISTANCES FROM RENWHOLDING TANK ON LOT TO:
Building foundation 3� — Property line ! ! f Absorption field a 6
Water main/service line 'x/00 Surface water/drainage '`/y0 Wells on adjacent lots 'LAUD
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: A�or c,,Je-D. 54-73
Building foundation Water main/service line
Surface water
Driveway, parking/vehicle storage area
Curtain drain Wells on adjacent lots,
Property line
F. ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review of1funicipal
rec t the, taba sf'sfei %Pe
in conformance with 1vI0A K4l guidelines in effect on this date.
•'r *" aR
Signature
Engineers Name
inA�c}Sl$Ie,
Date 3
HAA Fee $ t,.�� C
Date of Pavment
Receipt Number �� �� LCI, -3 2�
Rev. 8/95 OSS: haa.wk.doc
Waiver Fee $
Date of Payment
Receipt Number
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 p–
Application Date D L
GENERAL INFORMATION � /n
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
(b) Applicant Name 3Af1 1�ESES Telephone: Home 35`%-700 Business�`�" firs
Applicant Address �� orx //o9y )Wd R A'- 915 / – /3g
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ; Buyer ❑ ; Other ❑ (explain);
(d) Lending Institution 111,41 Telephone�/A
Address ��14
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
A
2. TYPE OF RESIDENCE
Single -Family Multi -Family ❑ Other
Number of Bedrooms —
3. WATER SUPPLY
Individual Well Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11/84)
5. ENGINEERING FIRM PROVIDII. _ INSPECTIONS, TESTS, FILE SEARCH, Dr. , A AND INFORMATION
51
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. 7
Name of Firm Cf Telephone ✓�U�-sG 0
Address f7 PfNV176
Date
DHEP APPROVAL Cq)
Approved for f-I2.`-tZ bedrooms by
Approved'IVDisapprove
Terms of Conditional Approval
fG pF As.1 wo
co 49T
•.• • a
' n�IttB� oft
:• 2251
Ole
000404*
� Pr�ession� .
1,4�ar►s®
Date
Conditional
11
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)
144.iiJ 0PALITY Or ANCHORAGE
DEPT. OF HE/14H &
ENVil'CiNMENTAL FrOTrCiION
RECEIVED
A. WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Descrip ion: 40T.3 4eL 4*i1rP'W
1*3 T/z �! c*j see- a-3
Well Classification ""Pte/✓ Ir If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y ) Date Completed 1, -ZT PS Yield �0 6PH
Total Depth X09 Cased to 7�
ni
Static Water Level
Casing Height Above Ground —
Electrical Wiring in Conduit&)
Separation Distances from Well:
S If
Depth of Grouting
Pump Set At W A
Sanitary Seal on Casing(ON) —
Depression Around Wellhead (Ye
To Septic/Holding Tank on Lot /.<7 ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot /7f/ -;On Adjoining Lots —
To Nearest Public Sewer Line To Nearest Public Sewer
oa �
Cleanout/Manhole . � A To Nearest Sewer Service Line on Lot _<-0't
Water Sample Collected by ECS A l��E� ; Date %-Z9
Water Sample Test Results
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed ��'g-�7 Size /LNo. of Compartments
Standpipes ON) Air -tight CapsN) Foundation CleanoutON)
Depression over Tank (YV Date Last Pumped A
Pumping/Maintenance Contract on File (Y/N) AX ; for IWIX
Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water -Supply Well ® /37 r To Building Foundation 7,7
To Property Line 17-4 fi To Disposal Field 1 7 '
i
To Water Main/Service Line 50 To Stream, Pond, Lake, or Major Drainage
s
Course
Comments
Page 1 of 2
72-026(11/84)
1-3 Bi cdc�s�/fie "Y
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
3o7
Type of System Design AEl)
Date Installed gyp_ ? Length of Field
i
Width of Field 3 Depth of Field
Gravel Bed Thickness
Square Feet of Absorption Area g6o Standpipes Present&)
Depression over Field (Y1P Date of Last Adequacy Test
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water -Supply Well 78 To Property Line
J_i
To Building Foundation / 7-y To Existing or Abandoned System on
Lot ; On Adjoining Lots -sd r fi
To Water Main/Service Line t To Cutbank (if present) t44/ A
To Stream/Pond/Lake/or Major Drainage Course /av 't
To Driveway, Parking Area, or Vehicle Storage Area
Comments & 'M 70-
D.
D. LIFT STATION
Date Installe Dimensions
Size in Gallons Manhole/Access (Y/N)
"Pump On" Level at "Pump Off' Level at
High Water Alarm Level at Vent (Y/N)
Tested for Pump cles during Adequacy Test. Meets MOA
Electrical Codes (Y/N)
Comments
** Check Permitted Bedroom Rating Against HAA Request **.
I certify that I ha hed, Je,,ified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
G=—�
. �
7-31
Signed
Date
Company
�i%r MOA No.
4W� QF A
GG•.•���Ott
•e 4
Receipt No.
/
O o 0 O
w �P�sL-�♦
'-r-�:
Date of Payment
— s,� �, � `� �
'
isG** • 4 T �
Amount: $
. ��
0 ng Seal
�j�/'TS O/LL
LEJE7
•.• •• w •.i •• •.•./
:� LER O C. RcID, JR ` Ar
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wit'l� ir�°� �uc,TS
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Page 2 of 2
-
Ik
72-026 (11/84)
ALASKA ENVIRONMENTAL
CONTROL SERVICE" INC.
1200 West 33rd Avenue Suite B
ANCHORAGE, ALASKA 99503
Phone 561.5040
JOB L4" b4e--1-' I 41,elfroAk Al rr 4w /
SHEET NO. Of
i r
CALCULATED BY�Js DATE t�
CHECKED BY DATE_
SCALE-
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LAVATORIES. INC.
7137 OLD SEWARD r';HWAY "ORATORY I.D.
ANCHORAGE, ALASKA 99518
(907)314-8551
"MRIOLOGICAL W1TER ANALYSIS
DATE COLLECTED
MONTH DAY Y
7 _ "I
I.D. N0. (PUBLIC'SYSTEMS)
NAME OF SYSTE
3 B
2_4L,C��sTc,
SYSTEM DDRFss
to BY WATER SUPPLIER i
TIME COLLECTEDTYPE OF SYSTEM
❑PUBLIC10INDIVIDUJIL
CIRCLE CLASS
A N CRel sidentia
4173 4w / TELEPHONE NUMBER
CITY STATE
ZIP CODE.
h
LOCATION WHERE SAMPLE WAS COLLECTED
COLLECTED BY:(SI" ATURE)
i �y
TYPE OF SAMPLE
(CHECK ONLY ONE THIS COLUMN)
DRINKING WATER ❑ CHLORINATED
✓CHECK TREATMENT
❑ FILTERED
❑ RAW SOURCE WATER MNTREATED OR OTHER
❑ NEW CONSTRUCTION OR REPAIRS
j ❑ OTHER(Specify)
IS THIS SAMPLE A CHECK SAMPLE TO A PREVIOUS NON -CONFORMING SAMPLE?
A ❑ YESNp PREVIOUS COLLECTION DATE
ANALYSIS REQUESTED (IF OTHER THAN TOTAL COLIFORM)
SEND REPORT TO:(PRINT FULL NAME,ADDRESS AND ZIP CODE
NAME G S
ADDRESS ILOp GJ
CITY /47tIeA! STATE ZIP
DAIALRIOLOGICAL MATER ANALYSIS RECORD
FOR LAB USE ONLY
TOTAL COLIFORMS
FECAL COLIFORMS
OTHER
❑ RESUBMIT SAMPLE
Sample rejected because:
CHECK ONE OR MORE
❑ Sample too long in transit.
Sample should not be over 30 hours
❑ Sample received too late in week
❑ Not in Proper container
❑ Leaked out
❑ Insufficient information provided.
Please read instructions on form.
❑ Other (Specify)
RECEIVED FROM
RECEIVED BY %7% ..;
ANA
,.TILYTICAL METHOD:
L7 MEMBRANE FILTER
❑ FERMENTATION TUBE
Date b Time Started % .2 -el 60� .3:3o
Date b Time Completed % 9G
LABORAT Y SULTS
Analyst
❑ Other Bacteria
❑ Test unsuitable because:
❑ Confluent Growth
❑ TNTC
SATISFACTORY ID/ UNSATISFACTORY n
Membrane Filter: Direct Count
------__ Col i form/100m1
Verification: LTB
BGB
Final Membrane Filter Results
Coliform/ IOOmI
R
ePorted By
READ SAMPLE COLLECTION INSTRUCTIONS ON BACK OF FORM
Date
Time A. M.
P.M.
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As -built 'Certificate:
I hereby certify that I have surveyed the following de -
bed property: 1-473
AAldi. and that no encroachments exist
except as indicated.
Exclusion Note: �4r.f �. +«...� s,�h
1
It is the responsibility of the owner to determine s * r4 %% *�P,
the existence of any easements, covenants, or re- gOUO *so :•••®
strictions which do not appear on the recorded sub- I�`;
division plat. Under no circumstances should any JohnA.S-
data hereon be used for construction or for estab-
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Date:*/12G/00� Scale: / _4p
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DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
437 'E' STREET, SUITE 303
ANCHORAGE, ALASKA 99501
October 24, 1985
Ms. Susan Oswalt
Municipality of Anchorage
Department of Environmental Health
& Protection
825 IL' Street
BILL SHEFFIELD, GOVERNOR
Telephone: (907)
Address:
274-2533
Anchorage, Alaska 99501
SUBJECT: " .
n l'fs' d ition
##1`, Surface Drainage
—DA -087)
Dear Ms. Oswalt:
This Department has reviewed the subject plans. It is composed
of curtain drains and one enclosed drainage culvert. Approval
is hereby given with the following conditions:
An observation/cleanout manhole must be provided on the
radius of curvature between survey station 16+64 and 18+86.
This manhole must be constructed with proper insulation and
must be accessible.
Manhole construction must be complete by 30 June 1986 with
engineer as—built information.
Appropriate separation from septic systems is required to
curtain drains, groundwater and surface water.
Please call this office for any additional information.
SE:pkk:
Sincerely,
teve Eng, P
District Engineer
�t.o(. '
V4 x S
ALASKA
BILL SHEFFIELD, GOVERNOR
DEPT. OF ENVIRONMENTAL CONSERVATION
r,CH'x%3_=_1 ES" EF_N DISTRICT OFFICE
Z7__S=— , SUITE 303
't�aSXa 99501 274--2533
September 12, 1985
o: anchorage
X25 Street
t_=c:oraze, _Iaska 99501
is ----.-,san Oswalt
MUNICIPALITY QF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
a
SEP
RECEIVED
Cbristopher Heights Addition #1, Creek Re-routing Project
anchorage, Alaska
Ks. Oswalt:
sf the inspection of the subject property on 12 September 1935
t. -.e following:
e 2 -inch corrugated metal pipe (CMP) has not contained the
nn'irety of the old creek flow. Water is still flowing in the
creek bed. 100 -foot septic setbacks will still be required
the old creek bed.
Mater is flowing along most of the road drainage ditches.
=~:is again points to the fact that the 12 -inch CMP pipe
dces not contain all stream water flowing through the area.
JO -foot septic setbacks are required from the flows in the
drainage ditches.
_ =e culvert crossing the roadways have the ends plugged with
fill material. Ponding has developed in some of these areas.
�. T' -.e thaw pipe does not exist as depicted in the plans on the
7 -astern terminus of the 12 -inch CMP.
�. =.s -built plans do not exist showing the depth and details of
t=e 12 -inch CMP.
this attempt to completely contain and reroute the natural
has not worked. The natural flow has been disrupted and is r
err -,ugh several areas across the subdivision. Please contact
f:- an7 additional information.
Sincerely,
P
District Engineer
=- ; kk_
cc: Bruce Erickson