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Home My WebLink AboutGLENN VIEW ESTATES LT 16 Municipality of Anchorage Page / of ~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SFRVlCES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ,.¢'VV'~, 0.~,0 RID Number: ~/~2/~ ~ Name: ~ ~¢~ Wastewater System: ~New ~ Upgrade Address: [~o~ g~F~ ~m~ ~ E ~ff~¢¢ ABSORPTION FIELD Phone: 7¢~,~OO No. of Bedroom~ ~DeepTrench ~ Shallow Trench ~Bed ~Mound ~Other L E G A L D E S C R I PTI O N so, Rating:¢,~ GPD/Sq. Ft. Total~ ¢1 ¢¢Depth' from original~xi 7grAde:,~ Lot: /~ Block:~/~ ~Subdiv~ion:~/,~ Depth~¢;~to pipe boltom~l~from~/original grade: Ft. Gravel depth beneath pipe ~ ~ Ft. Township: RAnge: Section: Fill added above original grade: Gravel length: ~ ~t. %¢ ~t. WELL: ~New ~ Upgrade Gravelwidth: ~ Ft. Numbero~ines: Dislance~eenlines: Classificatio, (Private, A.B,C): Total Depth: Cased To: Total absorption a~a~ Pipe material: ~ / ,Driller: Date Drilled: Static Water Level: Installer: ¢//F-- Yield: Pump Set at: Casing Height Above Ground: /~ e~ ~ ~t. ~t. TANK SEPARATION DISTANCES ~Septic U Holding U S.T.E.P. To Septic Absorption LiFt Holding ~ublic/Prival Manufacturer: Capacity in gallons: From Tank Field Station Tank S .... Unes ~,¢~ ~,~ SuCace / Water /OD + /$0 ¢ -- ~ ~ LIFT STATION Line /0 & /0 ~ ~ ~ I "Pump on' level ~"Pump off" level al: ~r alarm at: Foundation /~ ~ /~ + -- -- Drain /~ ~ /~ ~ ~ ~ Remarks: BENCH MARK Locatio, a,d Description: ~~ ~0r ~; // -- Elevation: EN~B'S SEAL Inspections performed by: . Dates: 1,, Healt'~nd Hum~ Services approyal) Department of Reviewed and approved by ~3 ( Date: ~ - -...%%.-- 72 013 (Rev 9/91) MOA 25 AS-BUILT SYSTEM DETAILS/SITE PLAN ?e~'m~t sw96osGo GLENN VIEW S/~ LET 16 PI~f1051-5~l ~6 lO'SLOPE ESMT. . TELCBM ~ELEC, ESBT. 0 c o ,~_4 A-C=al' RESER'/E SYSTEM~~~ ~ / A-D=~7.5' / s-s=s4' / LOT ~5 A-E=58' 3-E=79' LOT ~6 ~ A-F=38,5'~ ~, = 50' S-F=38' KENNETH M.~US . ~,~>~ ~Z.,/~ ~x~ 3044~ P'I-AB~IGAN BI VD 3~~ ~1 ~/,,.~9 ~ REX TURNER ARCTIC DEVCB, iNC. EAGI E RIVER, Al<, 99577 ~OF~sSI0~ ~ P.I], BBX 3489 (907)GgG-61]I/Eax (907)696 8111 ~~' PALMER, Al ASKA 99645 DATE: 6/~3/97 IDRAW]NC, , ~ SCALE: AS NOTED [ 96096 S} by SULLIVAN WATER WELLS P,O. BOX 610272, OHUGIAK. ALASKA gg$01 ' TEL~.PHONE 688.2759 OWNER OF LAND _ DATE- ~ta~ted Ended - PERMIT NUMBER ,'7% j'.:'~-4 :.. '": ''~' ' :"~: ":v' : ' · ~.~t~.,4jb,-~rO~' ~ PEVTt! OF ',','ELL /G / ,, . ~..~tl__c ,,'?__ELO,:,~..~T~., r'r, ~4 -¢'" __ KINI) OF CASING ~ From~Fl. From FI. to~_ From FI. 1o__. FI, From Ft, to_ _FI From Ft. lo_S_ 'Ft,. From Ft, lo--Fl From ._ Ft, to Ft. Fromm_ Ft. From__Ft. iD Fi. From__Ft. lo Fi .... Fl, From Ft,~ FtonL__Ft. lo__~_Ft. From__.Fl, to~F(, , . From F(. to .... Ft From~ Fi. (o__ Fl From Ft. ~o Ft,~ Ftom__Ft, io____Ft._ From. From ¢ E ! VE D JUN 2 7 ]997 Muh.c j.,HI' iy Dopt. Health & Human Services MISCL, INFORMATION: I)RILLER'SNAME ~-,-{,'~f" /V/O C. o77 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 AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960360 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:ARCTIC DEVCO INC., REX TURNER OWNER ADDRESS:P.O. BOX 3489 PALMER, AK. 99645 PARCEL ID:05152126 ~ LEGAL DESCRIPTION: ~/~ T15N R1W SEC 10 SW COR NW4 ~-~ DATE ISSUED:il/05/96 EXPIRATION DATE:il/05/97 LOT SIZE: 40000 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 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: DATE: DATE: K~D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 October 31, 1996 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: New sewer/well permit - Lot 16, Glenn View Estates S/D Gentlemen: On October 30, 1996, we excavated a new testhole for the subject property. There is one previous testhole which was dug during the preliminary plat process, however it was not suitably located for the four bedroom house which is proposed for this lot. There was no water observed in the testhole at the time of excavation and we monitored the existing testhole on October 30th, and found no water, which is consistent with the previous report. The results of these tests and previous water monitoring are attached. We propose to install single deep 2' wide trench. If required, additional fill will be placed over the system to provide a minimum of 3' of cover when complete. There are no public or private wells within 200' of our proposed system location. There is neither surface water within 100' nor any curtain drain within 50'. We do not expect that there will be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, /~,~ 2¥J ~) Engineering Kenneth M. Duffus, P.E. attachments: On-Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test WASTEVATER DISPUSAL SYSTE q/SITE LET 16, GLENN VIEW ESTAT£S PLAN VACANT LDT a :ANT LOT 17 ~ VACANT LUT I6 LET 18 VACANT OTH ff~ VACANT LET ]5 NO PUBLIC WELLS WITHIN BOO' DF PRDPDSED SYSTEM, ND PRIVATE WELLS ~ITH[N 200' DF PROPDSED SYSTEM. E 4 BEDRBBHS X ]50 GAL,/DAY/BEDR[]BH = 600 GPD a, SOILS RAT]NG~ J~ H]N./]NCH APPL, RATE 0.8 GP~/SF 3. 600 GPD/0.8 GPD/SF - 750 SF 4, 750 SF /(~' x 70 53.6'L 5, MIN, DESIGN SIZE I TRENCH 54' LUNG x 8' WIDE x 7,0' DEEP 6. DEPTH DF GRAVEL BELDW PIPE IS 7,0', 7. TBTAL ~EPTH BF SYSTEM IS U.O' FRBH BRIGiNAL GRADE, NQTES', E TIE ~NTD TRENCH aT H~DPB~NT, B, USE ~50 GALLBN SEPTIC TANK, INSULATE T~NK ~F <4' CBVER, 3, INSULATE TRENCHES W~']'FI 8" Fig gUR]AL FDAN IF (3' CBVER, 4, CUNTRACTBR ~LL ENSURE HaX]HUH BX SL_UPE ]NTB SEPTIC TANK, PREPARE]} FBR: REX TURNER ARCTIC DEVC~, INC, P,B, BOX 3489 PALNER, ALASKA 99645 KN9 ENGINEERING a0441PTARNIGAN BLV9 EAGLE RIVER, Al<, 99577 (907)696-6iii/Fax (907)696 8]]1 SCALE~ l' = lO0'] 96096 si Municipalily ol Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Streel, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1"//%-/ Township, Range. Seclion: ,'V'~//~/~'4¢- /'O '/"'/~ N ~ I ~/ 10 SLOPE SITE PLAN '11 12 13 14 15 16 17 19 20 IF YES, AT WHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Waler Drop ~ I ', ~,, V /',dV " '~1/~," ~ _ / ;~/~ ,, -- ~, ~//~' ~ t ', V~ " ~'~" '~" 7 ,/: ~ ~ ,, ~ 77/~"[ ~" ~ ~ ~ ,, ~ ~ '?/~ ,,_ PERCOLATION RA~'E __ ~'ESI RUN BETWEEN · /~" . Immuleshnch) PERC HOLE DIAMETER ~ // 7, 5 FT AND -~, 5 F1 Municipalily ol Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Streel, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTIO :~,'/~'r/)/),Y/¢''' 1 2 3 4 5 6 7 8 9 10 '11 12 SLOPE SITE PLAN GROUND WATER ENCOUNTERED;~ S IF YES, AT WHAT ~ 0 DEPTH? p E Deplh lo Waler Afler Monilorin9? Date: 13 14 15 16 17¸ 19- 20- Reading Date Gross Net Depth to Net Time Time Water Drop m ~o1'~0 i., ~o -- -- x_//~" _ I /:.ti /~1,~ Y~/,¢" ~,/,~" s. 1 ...~., ? ". ,, 77~ ,' ¢ I; ~¢ " 7~¢ 'a/¢" ~ /; ~ 7 " ' " ' TM" PERCOLATION RATE lES1 RUN BETWEEN /, '~ Immules;mch) PERC HOLE OIAMETER ~ /I F~om : KENNETH G LRNG RLS FRX 90? 345 4625 [(~}) DEPARTMENT OF HEALTH & HUMAN SERVICES ~r; ~ : '801LS LOG -- PERCOLATION TEST ~,~ ~, c~-~7~ LEGAL DESCRIPTION; .~b~ ~/~ ~¢~¢¢¢ Township, Range, Section: 2 3 4 5 6 7 8 9 11 12 13 14 15 16 17 19 5/cT'/ COMMENTS SLOPE [lITE PLAN WAS GROUNO WATER ENCOUNTE=RED? IF YES, AT WHAT DEPTH? Reading Date Gross Nat Oe~th to Net Time Time Water Drop PERFORMED BY; ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS OATE. DATE: .. ?~"~Q'~JR~¥ ,1!~,¢4 : PERCOLATION RATE ,.~..'~' ~ (minutes/inch) PERC HOLE DIAMETER ~¢// ~ ~. i¢_,,,~,~, I ~~ CERTIFY THAT'THIS TEST WAS PERFORMED tN MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEAl_TH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1, GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lendin9 agency Mailing address Agent Address Day phone Day phone Day phone NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual welt Community well Public water Unless otherwise requested, HAA will be held for pickup. 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: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 {Rev, 1/91) Front MOA #21 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 KND Engineering Phone Z0441 Ptarmigan Blvd. Address Eagle River, AK ,99577-8736 Engineer's signature ~~ ~' ":~/ Date DHHS SIGNATURE ~ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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. Municipality of Anchorage SED ] I~ 19~,~ DEPARTMENT OF HEALTH & HUMAN SERVICE!SAur~lclw~' ' Environmental Services Division "~"~'" :" ' 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist A. WELL DATA Well type /~/~,'~-~/'~'.~ Log present (Y/N) I Total depth /~ / Sanitary seal (Y/N) If A, B. or C, attach ADEC letter. ADEC wa~ter system number / Date completed _g/~L5/~ ~ Cased to /~, / / _ Casing height (above ground) Y Wires properly protected (Y/N) Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform Date of. sample: ~/~/~,~ SEPTIC/HOLDING TANK DATA FROM WELL LOG /g,l ' g.p.m. Nitrate Collected by: AT INSPECTION Other bacteria ~/~-~//~ ~_ Tank size Date installed /~ ,~ Foundation cleanout (Y/N) _ t Depression (Y/N) ,'~ Date of Pumping' ~,//?/"~. Pumper -~,//~ ~~ / / C. ABsORPTiON FIELD DATA ' Date ~nstalled, '/~h~ Length. ''b~ ~ Width ~ Number of Compartments .~ Cleanouts (Y/N)~_ High water alarm (Y/N) ,"~ _ Soil rating (g.p.d./fF or fF/bdrm) ~, ~ · ~- / Gravel thickness below pipe ~'. !~ g.p.m. System type / _ Total depth Effe'ctive absorption area. Date of adequaqy test : -X~ _/"' Results (Pass/Fail) _._'~ ,,," F-'or ~ ,// bedrooms Fluid depth in absorptio~efore test (in.); ~ _lm~lyafter_~__ gal_~w~(in.): ~ Fluid depth -J~,,/ (ins) Minutes later: -~ ,/ Absorption rate = g.p.d. Peroxide tr~ment (past 12 months) (Y/N) / If yes, give da/ 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at~// *Datum Cycles tested SEPARATION DISTANCES ,,,// Size in gallons ~"Pump on" level at* ~"Pump off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation //~ /Y~ Property line /D ¢~ Absorption field /~:~ Water main/service line ~' '~ Surface water/drainage //DC ~ Wells on adjacent lots c/DO SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property ne Surface water Water main/service line Curtain drain Driveway, parking/vehicle storage area Wells on adjacent lots //D ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records thai in conformance with MOA HAA guidelines in effect on this date. Signature Engineer's Name HAA Fee $. Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* SEP 16 '98 ll:13AM MTL AMCHORA~E P,1/1 NORTHERN TESTING LABORATORIES, INC, 3330 INDU$TRIAL AVENUE FAIRBANKS, ALASKA 99701 (007} 4~6-$116 , FAX 4~6-3'125 ~00~ ~CHOON STREET ANCHORAGE, ALASKA 99518 (80~) 349-1000 , FAX 349.1016 POUCH 340043 PRiJDHOE BAY, ALASKA 99734 1909) ~B9-2145 , FAX 659.21A6 ~o~Dam: ~ Ea~n~d~ Da~ ~: 9/10/98 20441 ~ ~lvd. S~ple Dam: Eagle ~vcr, ~ 9957%3736 S~ple Ti~: 18:00 A~: Colloid By: ~ ** ~nd ** Cliont~: ~t 16 M~ = M~ ClientP~t~: MC~ = M~ ~L~: A1~8135 ~ - S~ple ~x: Wa~r M - M~x H = ~ M~L Dat, Date Mcthml Paz~neter Units Result MRL Prepared Analyzed SM 4500 NO3 E Nltrat~-N mg/L 2.96 0.50 9/1S/98 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # _~5/- 5Z I - ~-~ LOS\- co;3_\- 1. GENERAL INFORMATION Complete legal description Ac1~ /~ Location (site.address or directions) .,A/Z/ (~'~/'/~/q /7{'///("~/'/~¢/~ Property owner Mailing address Lending agency Mailing address Agent Address Day phone Day ~hone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: 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. 1191) Front MOA ~21 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 regt~J~o,[:)s i.n eff.ect on the date of this inspection. r~u ~ng~neermg Name of Firm 20441 Pt~rnigan Blvd. Phone _~ ~ - ~/// Eagle River, AK 99577.8736 Address Engineer's signature DHHS SIGNATURE ' (~"Approved for ~- bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: By: 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 independent professional engineer registered in the State of Alaska. The DH HS 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 ENVIRONMENTAl. SERVICES DIVISION Municipality of Anchorage JUN 2. 5 '1997 DEPARTMENT OF HEALTH & FIUMAN SERVICES Environmental se,¥ices Division R-lC E IV E D 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Description: A. WFLL DATA Log present (Y/N) Total depth Sanitary seal (Y/N) Health Authority Approval Checklist If A, B, or C, attach ADEC letter. ADEC water system number Date completed .~,~,,~-//..~ .7 . Cased to / ~ / / Casing height (above ground) FROM WELL LOG /o/' Wires properly protected (Y/N) Y Date of test _ Static water level Well production ,/(~ WATER SAMPLE RESULTS: Ooliform '~ Nitrate Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed 3/~2~/~.Tanksize Foundation cleanout (Y/N) Date of Pumping ,d/'A. Pumper -- AT INSPECTION g.p.m. .j g.p.m. /:26'O Depression (Y/N) /V/ ~', ¢7 <,/ Other bacteria _ Collected bY: Number of Compartments ~¢ Cleanouts (Y/N) High water alarm (Y/N) /V'A C. ABSORPTION FIELD DATA Date installed ,.~//z//~'7 Length ~'~:~ ' Width Effective absorption area Gravel thickness below pipe Monitoring Tube present (Y/N) / Date of adequacy test ./i//¢ ¢/' Fluid depth in absorption fiel.C~ef ro'~e test (in.);. I~ately afler, gal~,): Fluid depth ..~ns) Minutes later: ~ Absorption rate = g.p.d. Peroxid t (past 12 months) (Y/N) If yes, 72-026 (Rev. 3/96)* Soil rating (g.p.d./ft2 or fF/bdrm). ~), ~ _ SYstem type I~p ?¢-¢~tdJ~L. _Total depth -11, _ Depression over field (Y/N) /to/ _ Results (Pass/Fail)_ ...-/ For /~bedrooms LIFT STATION Date installed .~'J Size in gallons Manhole/Access(Y/N) ~ump on" level at* ~"Pump off" level at*c/ High water alarm level at~.~ *~~, Cycles tested ..~"/' E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ./D~) 'rh Absorption field on lot On adjacent lots On adjacent lots Public sewer main /~(~ ~ Public sewer manhole/cleanout Sewer/septic service line [/)(_~ ~ -t- Lift station A/ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation /D 4- Property line /~) '~ Absorption field Water main/service line ~- '~ Surface water/drainage /Or9 -~ I Wells on adjacent lots /~)~)/'/' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain I Building foundation / D 4- Water main/service line Driveway, parking/vehicle storage area ~5 I I '-P Wells on adjacent lots / 0(--~~L F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal in conformance with MOA HAA guidelines in effect on this date. Signatur~ .'-~~ ~---~..~-~ .5' Engineer s Name Date ~,,,/~ / /' . HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* NORTHERN TESTING LABORATORIES INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99704 (907) 456-31'16 · FAX 456-31 8005 SCMOON STREET ANCHORAGE, ALASKA 99518 (907) 349-1000 ,, FAX 349-1016 KND Engineering 20441 Ptarmigan Blvd, Eagle River, AK 99577 Attn: Ken or Dee Our Lab #: Location/Project: 'Sample Hatrix~ Comments: Lab Number Method A150357 Olenn View ~odt~ Hose ~ib Water Parameter Report Date: Date Arrived: Date Sampled: Time Sampled: Collected Byz 06/30/97 06/25/97 o6/25/9~ 0300 ** Definitions B = Present in Blank H = Above Regulatory Max ~ Estimated Value M = M~tr~_.~p~rference D = Lest to MDL ~ Method Detection Limit Date Date Unite Result * HDL Prepared Analyzed A150357 SM 450OB Nitrate-N mg/L 2.24 [.00 0&/27/97