HomeMy WebLinkAboutALPINE VILLAGE BLK 5 LT 7Alp ine Vi'611a 9 e Block 5 Lot 7 #014-132-16 zLi', i� �-.., GREOR ANCHORAGE AREA BOR�H �i� Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION_ REPORT ON-SITE SEWAGE DISPOSAL SYSTEM Y� NAME= V'Iej� MAILING ADDRESS Yd����, aC06- PHONE LOCATION L4 P - Imo{ Z't' LEGAL DESCRIPTION �- S Iq� i!✓L� V 1 (C(. �� v SE DISTANCE NUMBER OF FROM WELL MANUFACTURER - MATERIAL COMPARTMENTS. INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE_ WELL:: TYPE(G IIJ tA CONSTRUCTION DEPT BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION -,LOT LINE , SEWER LINE , TANK -,SYSTEM_ CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED REMARKS TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: SLOPE:LOT REMARKS:.��, .� 10az Form EQ -032 DIAGRAM OF SYSTEM DATE APPROV IN. DISTANCE FROM: fififfl®rl�!" GREATER ANCHORAGE AREA BOROUGH l J31 DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION o 7,- / INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED MAILING ADDRESS' '°' dd "� f �^' l PHONE SEEPAGE PIT , DRAIN FIELD OTHER TO BE INSTALLED BY NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. NK SIZE d b Ll A TYPE S� SEEPAGE AREA SIZE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT , DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK , SEEPAGE PIT , DRAIN FIELD , TO NEAREST LOT LINE. WELL TO SEPTIC TANK — DRAIN FIELD _ SEEPAGE PIT ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD . SEPTIC TANK, , SEEPAGE PIT , DRAIN FIELD , TO RIVER, LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. � T G.A.A.S. OR LICENSED DESIGNER TYPE DIAGRAM OF SYSTEM 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. s f I DATE _ APPLICANT'S SIGNATURE FORM NO. EO -016 h ~' A,~t-I. 4 7o? $o,~ L MINIMUM DISTA?'ICE. BETWEEN H WELL AND ANY ON-SITE SEWAGE DL.F'OSAL SYSTEM Is 100 FEET FOR: A PRIVATE WELL OR: 200 FEET FOR A PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAY_. OF THE WELL COMPLETION, SPECIFICATION_: AND CON=STRUCTION DIAGRAMS ARE AVAILABLE TO IN'=URE PROPER INSTALLATION. P"&- Imo': P-1 1 1- •"1_ 3 C e ®_[ r-.1 F= ` e E FA F Z F F=_ ®_s r-1 3 'S== /_I E_: I CERTIFY THAT 1: 1 HM FAMILIAR WITH THE REQUIREMENTS FOR: ON-SITE SEWERS AND WELLS AS SET FIRTH BY THE MUNICIPALITY OF ANCHORAGE. : I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED !SSUED BY IC:ANT JERALD BRUNNELL F•7 0_O r•a 11._ Y is, f i L_ 1. "1 - w (_i FZ7 F! V4 t_: VA Q f Q FA Ci E_ DEPARTMENT n IEALTH AND ENVIRONMENTAL qlbpECTION 2516 E. POR. RD.: ANCHORAGE, AK. 994F7 ^ i6-2221 PERMIT NO. t: 76479 ) APPLICANT JE.R:ALD BRUNNE 7516 ZURICH 272-8927' LOCATION ZL IR IC:H =T'REET LEGAL Lr B5 AL.PINE. PILLAGE SUB LOT SIZE 8450 SQUARE FEET MINIMUM DISTA?'ICE. BETWEEN H WELL AND ANY ON-SITE SEWAGE DL.F'OSAL SYSTEM Is 100 FEET FOR: A PRIVATE WELL OR: 200 FEET FOR A PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAY_. OF THE WELL COMPLETION, SPECIFICATION_: AND CON=STRUCTION DIAGRAMS ARE AVAILABLE TO IN'=URE PROPER INSTALLATION. P"&- Imo': P-1 1 1- •"1_ 3 C e ®_[ r-.1 F= ` e E FA F Z F F=_ ®_s r-1 3 'S== /_I E_: I CERTIFY THAT 1: 1 HM FAMILIAR WITH THE REQUIREMENTS FOR: ON-SITE SEWERS AND WELLS AS SET FIRTH BY THE MUNICIPALITY OF ANCHORAGE. : I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED !SSUED BY IC:ANT JERALD BRUNNELL -- --------- y y 1 Cl -- i I Municipality of Anchorage - • A Development Services Department jf s Building Safety Division On -Site Water & Wastewater Program r !' 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 01L4--(:3°) I(p— COSA# LflOO110� `"7 1. GENERAL INFORMATION Expiration Date: — 2 �Z _09k Complete legal description ALPINE VILLAGE S/D; BLE)CCK 5, LOT 7 Location (site address) 7516 ZURICH STREET * ANCHORAGE, AK * 99515 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address WASHINGTON MUTUAL Day phone ffi lrti: . C WWI I� �0 =i Day phone TODD MCCORMICK W/ PRUDENTIAL Day phone 3801 CENTERPOINT DRIVE *ANCHORAGE. AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 244-4085 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer to The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER 5. As certified by my seat affixed hereto and as of the validation date shown below, t 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. t 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 Engineer's Comments: JEFFREY A. GARNESS, P.E. 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, groundwater levels 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. Phone 337-6179 Date 11ZO/Dq ON-SITE WATER AND WASTEWATER --- .. Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory bedrooms, with the fllowing stipulations: Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: r (Rev. 1vo5) Municipality of Anchorage .f, q • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: ALPINE VILLAGE S/D; BLOCK 5, LOT 7 Parcel lD:Q/!V—/32-/(o A. WELL DATA *PER NEIGHBORING WELL LOGS Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 8/10/1976 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 129 ft. Cased to *40+ ft. Casing height (above ground) 12+ in. FROM WELL LOG Date of test 8/10/1976 Static water level 79 ft. Well production 10+ g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Arsenic: ND ug./L. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size gal. Number of Compartments Foundation cleanout (YIN) D pcessi vermrb— tank (Y/N) AT INSPECTION 1/6/2009 47 ft, 3.2+ g.p.m. Nitrate ND mg./L. Other bacteria 0 colonies/100 ml. Date of sample: 1/6/2009 Collected by: GEG Ltd. PUBLIC SEWER Pumper Date installed High water alarm (Y/N) C. ABSORPTION FIELD DATA 1PUBLIC SEWER Date installed Soil rating (g.p.d./ft2or ft2/bdrm)_ System type Length ft. Width ft. Gravel below i ft. Total depth ft. Eff. absorption area_ ft' Monitoring tube Depression over field Date of adequacy test Results P ail) For bedrooms Fluid depth in absorption field befor _ in. Water added gal. New depth _in. Elapsed Time: n. Final fluid depth _ in. Absorption rate >= g.p.d. treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "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 NSA On adjacent lots 100'+ Absorption field on lot NSA On adjacent lots 100'+ Public sewer main Sewer /septic service line **10'+ Animal containment areas 50'+ Public sewer manhole/cleanout 100'+ Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorption Water main Water SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Water service line F. COMMENTS *SEE ATTACHED G. ENGINEER'S CERTIFICATION Building foundation Water Surface water Wells on adjacent lots 1 certify that t 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 1I zo/uq Ll COSA Fee $ I q o _°3 Date of Payment tf 0 0,7 Receipt Number. 7 5 (Rev. 11/05) Waiver Fee $ water. PUBLIC SEWER PUBLIC SEWER storage OF ff ... rness:3D .D4 coAo Date of Payment Receipt Number co co /� co 3 O M 0 0 O co r LU CDO 0 F ° 0 co ® O M Pp1 O N t— Q A9E£a E L'bZ B LL Z O �0 r Icep E'EZ m N 0 S m CD m C) LL N 0'bZ J o'tL 110041, L N N L U c w s c Aiimn .04 00`99 ALOOIMON J m Lam' m a W 2+ LOmm O 2a ac 0 0 Q? O`9 N 4 a t o a _m S _C a grn c m mc_ 28dm, mN•f0� ^ 5� 0 y:s 0 Em 0 Q mmcEaE Q m 0> 3m L C tiCO�W6 6 u C O Ill 'q c Qmuc.Q mQEo.q c• >. CC mmWw IL OamCQ9b ¢ c 10 n� c o m m C 02, m m m L e o 0 0 c aEossm� Q w' C E W - m U. Lu cn 00 C) a°° %LL. :fir M¢uzi LU LLJ O CC> zW D I - a �a LO In O J go n CF) W Ca O ¢ o Z �W u�¢ LL LL ULLIQ Z WW F= p V)0 W=z 002 0 OLS Z LWz OFD O LOS LL Z N N 002 \ Lj w < ® Q LUiog F � e:�5Z� C Municipality of Anchorage �ox • Development Services Department Building Safety Division On -Site Water and Wastewater Program s> E r y 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D. HAA# Expiration Date: 1. GENERAL INFORMATION Complete legal description 1//GL,4c,E467- -7 Bla & .S Location. (site address or directions) 75 /G 2f t i Current Property owner(s) /� Fp(�( / j aDay phone Mailing address Lending agency Day phone Mailing address Real Estate Agent 6704 I_O k Eaj Day phone Cs—`%— 7 - Mailing Address P9Lj6e*jn*t_ �r i Unless otherwise requested, NAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well em Individual On-site ❑ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority 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 Address Engineer's Printed Name -57-(5-06 IF&j (; Phone C W- 74e7do Date OF cA�h .......... C 4%1 fC,).-* it � '•z9 5. DSD SIGNATURE 0 F : Steven W. Approved for 3 bedrooms. `des'•. PG 625 el to. Disapproved. �It PROF... 0\oa®9 Conditional approval for bedrooms, with the following. stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By; _ / f Original Certificate Date: Ll - 13- ® 7 (Rev. 01/02) Municipality of Anchorage e° 11111 • Development Services Department ° p p mow_, Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 141—P/N/- i%(4"eE y L OT F 5 Parcel ID: 0 /y— ✓' 3.t A. WELL DATA Well type —R Date completed o!aN o Total depth 12 7 ft. If A. B, or C provide PWSID # Sanitary seal (Y/N) Cased to le r% ft. FROM WELL LOG Date of test 60/7.r Static water level 77 ft. Well production lt/ ¢ g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Arsenic: = mg./l. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size gal. Foundation cleanout O Date of pumping C. ABSORPTION FIELD DATA Date installed Length Total depth ft. Date of adequacy test Fluid depth in absorptj Nitrate (0, L mg./&) Date of sample: 2 2 /oS poes14c. Well Log (Y/N) y Wires properly protected (Y/N) Casing height (above ground) in. AT INSPECTION z as Other bacteria 0 colonies/100 ml. Collected by: r SQ-)t5d — Date installed Number of CompartmentsCleanouts (Y/N) Depression over tank (Y/N) _ High water alarm /N) Pumper PtJBblc. SEwG'dt Soil rating (g.p.d./ft2 or ftz/bdrm) ft. / Width Elapsed Time:--/ min. System type ft. pipe ft. Eff. a orption area ft2 Monitoring tubeDepression over field Results (Pass/Fail) For bedrooms field before test _ in. Water added gal. New depth_ in. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION f; (C $ 64.+5-: � L Date installed Size in gallons "Pump on" level atin. "Pump off' level atn. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main .03 Sewer/septic service line 2•-) F Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. On adjacent lots /a ID, On adjacent lots t3 Public sewer manhole/cleanout 476 176 reyj Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Po gf 1c _XCW5A Building foundation Property line Water main Water servic/in- Wells on adjacent lot SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field Surface water f vBLIC SFv�/L Property line Building foundation Water main Water Service line Surface water Driveway, parking/vehic storage Curtain drain Wells on adjac Tt lots F. COMMENTS G. ENGINEER'S CERTIFICATION �Ar ° •..;�ffgt)( I certify that 1 have determined through field inspections and * 49Y � � review of Municipal records that the above systems are in � "'°•°° 't conformance with MOA HAA guidelines in effect on this date. ..fid. 6•�yr1pyG� StexenrW. Eng/ 4.,! Engineer's Printed Name S (�iEoL6 dt�T•.,• PE 6256 : ° ,� Date & (I s ¢��9Fp°'• •.,••.• � w� �a_pROrcggjG ,,.� HAA Fee $ T Date of Payment a /4✓ Receipt Number &69&14 - (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number 0 0 0 • N �oUf p • • • ,J� moo' JF!wq,�4'] SCS RCtty 1051456002 All Dales/I'imes art Alaska Standard Time Client name NorthRim Engineering Printed Date/time 0325/2005 6:38 Project name/# Various Collected Date/rime 03/172005 16:00 Client Sample 11) Sample (z(ZAMP'=f ALP(IVF V ILLACE Received Date/time 03/182005 11:35 Matrix Drinking Water l--? BS' Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Partuneter Results PQI. Units Method Container ID Limits Date Date [nit Microbiolocry Laboratory Total Coliform 0 coU100mL SN1209222B B (<-1) 03/18/05 TLF J SGS/CTBE ENVIRONMENTAL SERVICES -SQS Drinking Water Analysis Report for Total Coliform Bacteria READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE MUST BE COMPLETED BY WATER SUPPLIER ❑ PUBLIC WATER SYSTEM IW PRIVATE WATER SYSTEM ❑ Sand Results 13 Sand I.. .Y. ifyr. Y.nyCu,P�/ Y.... 2 Y.n• 6 -7oZ� ,....�. o YY,p lWanu - µ WAO-MUG (PIA) RESULTS: xeGe. SAMPLE COLLECTION: Dab:�/ Y 0-S'- /6 Qo AM Location: collector TmnspMad to Lab By: "me as collector Other. ❑ Sand Results 200 W. POTTER DRIVE ANCHORAGE, ALASKA 99518 Tel: 907.582-2343 Fax: 907-5615301 Lab Ref No. ms1asw.tiy Q Sand Imok� SAMPLE TYPE: 13 Routine ❑ Treated Water ❑ Repeat Sample ❑ Untreated Water � VX' 4 G E (refer to lab no. 1 --Z7- ❑ Special Purpose TO BE COMPLETED BY LABORATORY Sample Receiving: Date: 3 ' i os ❑ Sample oear ao hou I old; ❑ RUSH SAMPLE _. . .., Results may W wallable Temp: Phone R: Delivery Method: L� F« toatima Fax 0: Received By: .......... ................................................................................................................................ Bacteriological Water Analysis Record: rnroAOEa WAO-MUG (PIA) RESULTS: ANC FSK JUN - r 'l. Analysis Began: ; /,�/� /L / Tohl Cafdam: tank" Analyst E Call: Sent to pMnt Analytical Method: MEMBRANE FILTER RESULTS:� Dked Count Colm"100m1 Phoned Q Faxed Q Daterrkne: Filter Vedfloatlon: Spoke with: g—lMllembrane MO MUG (P!A) ...c+r.Lam: {aca: A --satisfactory ,.,�.... { EC: ❑ Unsatisfactory Reported By: Datemme:3d neaee oa.oa,.s.aw Forth 0 FW- 0053 12/17/03 SCS ReLH 1050852001 Client Name NorthRim Engineering Project Name/M Alpine Village Client Sample ID Alpine Village L7 B5 Matrix Drinking Water PWSID 0 Sample Remarks: All Dates/rimes are Alaska Standard Time Printed Datelrime 03/02/2005 14:43 Collected Daterrime 02/22/2005 9:00 Received Daterrime 02/22/2005 14:00 Technical Director Stephe C.Ede Released Allowable Prep Analysis parameter Results PQL Units hlclhad ConwinerID limits Date Date Imt Waters Department Nitrate -N 0.100 U 0.100 Microbiology Laboratory Total Coliform 20 OB, No Coli mg/L EPA 300.0 B (<=10) 0222/05 XM COVIOOmL SN1209222B A (<=1) 0222/05 DKC I IAI ��� V 1 ;' �� S �� / r RJ!! WFFFJflD GOVERNOR HEFT'. OF ENVIRONNIENTAL CONSERVATION / r„p o ": Json 274-2533 Adore— 437 "E" Street Suite 200 Anchorage, AK 99501 November 14, 1983 Ms. Vicki L. Sloppy — Assistant Administrator Anchorage water b Wastewater Utilities 3000 Arctic Boulevard Anchorage, AK 99503 RE: Well Radius Waivers Zurich LID 137, 582-12 Bear Ms. Sloppy: Thank you for the engineer's report in request of well distance regulation waivers for the referenced project under your letter of October 19, 1983. The construction of the referenced project will consist of furnishing and installing an estimated 1,950 L.F. of 8 inch ductile iron sanitary sewer line, in portions, north from Lore Road in Bern Street Zurich Street O'Brien Street and Lake Otis Parkway. ' In accordance with Title 18 of the Alaska Administrative Code Chapter 72 (18 AAC 72.021.a). a Mr. Al Sundquist, P.E. and engineering design supervisor for AWMI, submitted a report for ADEC's review and consideration to waive established separation distances to construct, maintain and operate portions of Zurich LID Wo. 137 closer to drinking water sources. More particularly, construction of the referenced project will require a waiver to encroach upon the well radius of 14 wells adjacent to this project. The wells are located along Bern Street, Zurich Street, O'Brien and Lake Otis Parkway from Lore Road to E. 74th Avenue. In recognition of the report and the preliminary plans for the proposed sewer lines, the following separation distances are approved instead of that required in Table A of 18 AAC 72.021. 1. Separation distances of 30 and 24 feet between a private well on Lot 1, Block 4 of Alpine Village Subdivision and proposed sewer line and nearest cleanout respectively. 2. Separation distance of 48 feet between a private well on Lot 12, Block 5 of Alpine Village Subdivision and proposed sewer line. 3. Separation distance of 54 feet between a private well on Lot 13, Block 5 of Alpine Village Subdivision and proposed sewer line. 4. Separation distances of 48 and 60 feet between a private well on Lot 14, Block 5 of Alpine Village Subdivision and proposed sewer line and nearest manhole respectively. • M Ms. V. L. Sloppy rg Well RadlUS Naiverc, cg? -12 November 14, 1983 Page 2 5. Separation distance of 64 feet between a private well on Lot 16, Block 5 of Alpine Village Subdivision and proposed sewer line. 6. Separation distances of 52 and 56 feet between a private well on Lot 18, Block 5 of Alpine Village Subdivision and proposed sewer line and nearest cleanout respectively. 7. Separation distances of 63 and 54 feet between a private water well on Lot 1, Block 5 of Alpine Village Subdivision and proposed sewer line and nearest cleanout respectively. 8. Separation distance of 45 feet between a private water well on Lot 6, Block 5 of Alpine Village Subdivision and proposed sewer line. 9. Separation distance of 23 feet between a private water well on Lot 7, Block 5 of Alpine Village Subdivision and proposed sewer line. 10. Separation distance of 44 feet between a private water well on Lot BA, Block 5 of Alpine Village subdivision and proposed sewer line. 11. Separation distance of 68 feet between a private water well on Lot 4.of Jovon Subdivision and proposed sewer line. 12. Separation distance of 65 feet between a private water well on Lot 5 of Jovon Subdivision and proposed sewer line. 13. Separation distance of 55 feet between a private water well on Lot 6 of Jovon Subdivision and proposed sewer line. 14. Separation distances of 43 feet between a private water well on Lot 7, Block 6 of O'Brien Subdivision and proposed sewer line. The Department finds that the special manhole and cleanouts detailed in the preliminary plans as an acceptable solution to the separation distance problem between maniurle-cleanout and well. Within the special manhole, the sewer lines flanged pipe is mechanically sealedand gasketed to prevent leakage of any sewage into the manhole. with the above in mind and by reviewing the pertinent characteristics of piping materials to be used, the pipe's most feasible alignment and the limited soil information available, this Department finds the above separation distances as adequate protection of the private water sources. Please forward copies of the final plans and specifications when they are available. GM/djf Sincerel, A3-921r— Construction Grants Engineer 11 5. LEGAL DESCRIPTION v DATE RECEIVED L3 INSPECTION APPOINTMENTS - STREET L ATION ; TIME TIME TIME OFBEDROOMS SINGLE FAMILY ` ❑ One Four ❑ Other EDLy" ❑ Two ❑ Five DATE DATE DATE INDIVIDUAL* _ra__ INSPECTOR ❑ COMMUNITY INSPECTOR INSPECT7 ❑ PUBLIC UTILITY depth (attach log if available.) n� , MUNICIPALITY OF ANCHORAGE DEPT. G ' EOINDIVIDUAL/ON-SITE** DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT"-CTION 825 L Street - Anchorage, Alaska 99501 /9 W, YEAR ON-SITE SYSTEM WAS INSTALLED. 22 2 ENVIRONMENTAL SANITATION DIVISION NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Telephone 264-4720 RECEIVED ]ECEi\/ED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PRO RTV OWNER PHONE MAILING ADDRESS PROPERTY RESIDENT different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4. RE TOR/AGENT Zsi -�/ :_(.• / �._Y>�_C, C J'�.<>> [�X-Ld'Ln..:Y ��JA Yi"iJ �< � P7HO'/NE 'j iY� / `�" MAILING A RESS L:L Lc I/ ��-It�_XL.K.t'_c �/ C/LJE: r e 71-1_/_LL% iii; . _. �A� 11 5. LEGAL DESCRIPTION L3 STREET L ATION ; 'LNCLWEn 6. TYPE OFFR/ESIDEN OFBEDROOMS SINGLE FAMILY ❑ One Four ❑ Other EDLy" ❑ Two ❑ Five ❑ MULTIPLE FAMILY ©'Three ❑ Six 7. WATER SUPPLY INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM EOINDIVIDUAL/ON-SITE** /9 W, YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. " 72-010 (Rev. 6/79) \ 1 THIS SIDE FOR OFFICIAL USE ONLY ,. 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED - 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE El PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or El Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS z; E1/APPROVED FOR _ BEDROOM ❑ CONDITIONAL APPROVAL (letter must acco pang certificate) DISAPPROVED DATE BY 72-010 (Rev. 6/79) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received August 5, 1976 CD�S Time of Inspection 9 ,,3Q per, D Date of Inspectionqzlo 122 REQUEST FOR APPROVAL OF �— INDIVIDUAL SEWER & WATER FACILITIES FOR fitecar V.A. 1. Approval requested by: Home Federal Savings & Loan Mailing Address: 535 D Street Phone: n 2. Property Owner: Gerald D. & Jar Jane Brunell Phone. 2 " 2t±La _ p Y Y op�'I�,veo- Mailing Address: 7516 Zurick 3. Legal Description: Lot 7 Block 5 Alpine Village 4. Location: 5. Type of facility to be inspected Single Family No. of bedrooms 3 6. Well Data: Individual A. Type B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: On-site system A. Installed C. Septic Tank: 1. Size B. Installer 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Rust for Approval of Individual *r & Water Facilities ,Legal Description Lot 7 Block 5 Alpine Village Comments jJA A — � Q AC CA- v, -1 19 ... ,_ eo Approved pproved Date v v Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM 1 certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 — 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 'I . Type of Inspection: CMRO VA XXXXGerPAA CONV 2. Property Owner: Gerald D. & Jary Jane Brunell Mailing Address: 7516 Zurich Day Phone 344-6016 3. Jame e` buyer: n/a Mailing Address: Day Phone !. Name of Lending Institution: HOME FEDERAL SAVINGS & LOAN Mailing Address: _ Phone Name of Realtor or Agent: Doris Timberly of Dynamic Realty Mailing Address: Phone S. Legal Description: L7, B5, Ali2ine V; l 1 aP Location: — 7. Type of Facility to be inspected: sinal,-_ Pam; 1 v No. Bdrms. -A Ls. Water Supply Type of Supply: Public Utility Individual xyyg If Individual, number of dwellings presently served If Individual, depth of well 9, Sewage Disposal System Type of System: Public Utility Individual (on-site) If Individual, date of installation valerie august 2, 1976 r Q-037 (1/74) �rtm / ent o 3330 "C° Street, Anchor_a , �.; aka Leyal Description —/ 7�_ 5 lI �f,/ r ' ///%L . _•�%U F,pproved Disapproved App,ova( valid for one year frog*) dc!'.e signed Greater Anchor2ge Area Borough, Depart -melt of,Environment 0 a1ity Vc: u �Y EM !/cLof7 ri/'. -�. ./��.-e • ✓./� tF ��N.c� '„ %-7/, �_ �%✓�/.L'�' �,%'F=yam ;//,w ;.,r T vV/y- i j l3 i ). Ccrtify that the ilnformatlen con talne,- In this accurate representation o; the subject sewer and are operating satisfactorily. SIG PI -D EQ -034 (1/74) recuest forr ap,lr . _ _ tru:= an water facilities -_.,. .�.._ _ Facilities GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received 9-I 76 - Time of Inspec(on ."00/9/%7 Date of Inspect/O — 7- -7 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR GON ✓ 1. Approval requested by: Lai/ern E. t- err A B kP r - Mailing Address: 75/6 z.uriGK- before. Gam Phone: 3qq-38o3 2. Property Owner: Phone: same a.s a our ' r Mailing Address: 3. LegalDescription: Loi-- `7, Block 5, /4 subd 4. Location: _76/16 2urio% o -P Lore nr 76j�h• S. Type of facility to be inspected h om No. of bedrooms �3 B. Well Data: A. Type inali'tJI'd al B. Depth //p C. Construction D. Bacterial Analysis 7' Sewage Disposal System: ori -514-e A. Installed not sCjre, C. Septic Tank: 1. Size B. Installer D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines 8. Distances: 2. Manufacturer 2. Material A. Well to: Septic tank Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank Absorption area C.; -Absorption area to nearest lot line EQ -034 (1174) Page 1 of two pages 4.1 October 10. 1975 tor. Lavern Becker 7516 Zurich Anchorage, Alaska 99507 Subject: Lot 7 Buck 5 Alpine Subdivision Dear Mr. Becker: EueclQsed is a Cepy of a letter sent to you an Octaker 9, 1972. As stated in the letter frump Susan Dickersuo, .your loan raguast cannot be approved until ,your, well is located 1€0 feet away from the house i,vediately to the north of you Any questions regarding this matter, do not hesitate to contact we at 274-4561 extension 134. Sincerely, Robert C. Pratt,, R.S. Sanitarian RCPIljk 1. APPROVAL ADDRESS: 01fork w GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 j)� DATE RECEIVED: /©/- 8/7i INSPECT: TIME: I;t 00 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES FOR FHA 77-Mrd'/F 2. PROPERTY OWNER: 90409 �19,5 PHONE: 3. LEGAL DESCRIPTION: --Z,-4---Z,-4-% .. Alt)ch -5 A16 //w 1%/'1,1`/Qzd, 4. TYPE FACILITY TO BE INSPECTED: .§!/1 l£ /1T STREET: 7S>f6 ,&e,y4 NUMBER OF BEDROOMS: 3 5. WELL DATA: A. TYPE B. DEPTH C. SIZE/�((l D. CONSTRUCTIONtde a E. BACTERIAL ANALYSIS 6. SEWAGE DISPOSAL SYSTEM: A. SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON 1. SIZE 2. AGE 3. MANUFACTURER 4. INSTALLER i Is APPROVAL REQUEST FOR SEWER & WATER FACILITIES PAGE TWO B. SEEPAGE PIT 1. SIZE 2. LINING C. DISPOSAL FIELD 1. NUMBER OF LINES 2. TOTAL LENGTH 7. REQUIRED MEASUREMENTS A. WELL TO SEPTIC TANK B. WELL TO SEEPAGE PIT C. WELL TO SEWER LINE D. WELL TO PROPERTY LINE E. WELL TO OTHER POSSIBLE CONTAMINATION F. FOUNDATION TO SEPTIC TANK G. FOUNDATION TO SEEPAGE PIT H. SEEPAGE PIT TO PROPERTY LINE 8. COMMENTS: APPROVED: DISAPPROVED: ,/�5� 77*-, DATE: DATE: APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY