HomeMy WebLinkAboutALPINE VILLAGE BLK 5 LT 14Alpin
Villag
lock
Lot 14
014-
132-23
Jun 07 2104:31 p Anchwage `Ve{i & Punip Ser
9072430742 p.1
UN LIT NCHORAGE
Dcveiepmenr Services Department ' Phone; 907-343-7904
On -Site Water & Wastewater SC_Ction � Fax: 907-343-7097
PumpInstallationLog
6'1.'ell Drilling Permit Number:
Parcel Identification -Number: 01q 2 3
legal Description Block IAt
Irle
Pomp €astallutiun Date,
Date_ of Issue: & . _V__ 2_ f
Property Owner Name & Address:
f- Acs. 6,)w -
Panip Intake Depth _Aplin* Top of Well Casing: � feet
Purnp illanufactureCs `name:
Ptirnp Model: — 42A__
Pump Size. ._ J. hp
.Pidess Adapter Burial Depth: t5— feet
Pirless Adapter -Manufacturer's Name:';srti _
Pitiess :adapter Installer:
Well Disinfected Upon Compioty" :9�$c`es C Na
Method ofDis!nfecti+ra:
Comments:
Pump Installer ANCHORAGE %IVEiL & PUMP SERVICE
7640 K ng Street
Anchorage. ,apt 995 E
Company:____- PH: (407) 243-0740
Maili ag Addre"_ -
City
State: _ Zip:
Attention: The Bump installer shall provide z Gump installation 109.1,0 Ora -site within 30 days of pump tnstallztinn.
GAAB-HD-I
GE TLR ANCHORAGE AREA BOROI H
DI:,,~RTMENT OF ENVIRONMENTAL QUALI,,
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSIEM
LOCATION //')'~_'-:7~',¢g/
SEPTIC TANK:
DISTANCE FROM WELL ~'~-~"
LIQUID CAPACITY.
GALLONS.
~C/ ~''~ /¢',/¢,, (/E~/.=.//¢_~ NUMBER OF
MATERIAL
. COMPARTMENTS
/"~/--'(~//-:' ,'/~,'''''~ ' ~1''g'' 't -~-/'''2 LIQUID
INSIDE LENGTH INSIDE WIDTH DEPTH
SEEPAGE SYSTEM: SEEPAGE PiT:
NUMBER OF PITS_ /
LINING MATERIAL C'~"i[:'/~)~
NEAREST LOT LINE .~' / J"~
OUTSIDE DIAMETER_ '~ OR WIDTH /.~'-
'~,,~,~' __ DISTANCE FROM WELL ~:>_~ '"/~--~.?
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
, LENGTH ~--~'"~'~"'~ , DEPTH
BUILDING FOUNDATION'~/~
-:~ ~ '~ SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL_ FOUNDATION , NEAREST LO1' LINE
NUMBER OF LINES ~NCE BETWEEN~ TRENCH WIDIH
ABSORPTION AREA/ __SQ. FT. LENGTH OF EACH LINE ~
DEPTH: TOP OF TiLE TO FINISH GRADE. DEPTH OF FILTER MATERIAL BEJNEATH TILE
TOTAL LENGTH
, OF LINES /
...~/~TAL EFFECTIVE
IN. ABOVE TILE~
WELL: TYPE/O0'~ r'*~' , DEPTH
NEAREST --
LOT LINE SEWER LINE
DISTANCES:
DISTANCE FROM · WATER
- , BUILDING FOUNDATION ...... SAMPLE
SEPTIC~-:,,~ ,.." SEEPAGE ~ ,
TANK ,,--~' ~?~-~. , SYSTEM ~ '~'"~ /'":~"~, CESSPOOL.
DIAGRAM OF SYSTEM
NEAREST
OTHER
, SOURCES .
APPROVED
/' G.A.A.B.
Greai'Er ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
350'0 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC TANK
TYPe AND SIZE OF FACILITY TO BE serVED
FINANCED THROUGH
COMPLETION DATE ANTICIPATED
(
SEEPAGE PIT ~' DRAIN FIELD OTHER
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
/-~'/)L~ -~ /J _~.~.~-~-2-~ L-~/~.~
~EPTIC TANK size ///'/~" ',~;~'/' . TYPE ('~M),~/'/"'-.,,"~ ..~J"':"~.,'''~ SEEPAGE AREA SIZE~'~'''~j~f~ TYPE
.... . . J ~ i/,.,~.~.~. , -' " ~-~ ....
MINIMUM DISTANCES, REQUIREMENT= DIAGRAM OF SYSTEM
FOUNDATION TO SEPTIC TANK
CAST irON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING gAP Of
£
FOUNDATION TO SEEPage Pit ~ ~/ DRAIN field
SEPTIC Tank TO seePage Pit Wall
SEPTIC Tank ~/, SEePaGE Pit ~-~) /: , Drain field TO NEAREST LOT LINE.
DRAin FIELD ~ ALSO CONSIDER AREA WELLS.
/
/
seePage Pit .----
DRAIN FIELD
SEPTIC TANK,~J//, seEPAGE PIT r/~/~/~/,- ~ DRAIN FIELD TO RIVer, LAKe, STREAM.
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,
HEALTH AUTHORITY
OR
LICenSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER aNC;H.(~RAGE ARea BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBED SYSTEM iS IN ACCORDANCE WITH SAID CODE,
beptb Tc:- H20 Net Drop
Test Per.fo~d By
C. Industrial:
D. Other:
L A USE
PERfIIT
GREATER ANCHORAGE AREA BOROUGH
POST I N A C'ONS P I CUOUS P LA¢£
GRID _ DATE
3. Building Cont~ra tor ' ' . __ ' _
Legal Descr Ipti~n
5. Street Address '~?f~7 ~-~_~.
6. Description of Work~EW ..... ALTEP~TION .... ADDITION___OTHER__
7. Uae of New Structure
A. Res ident ia 1: ~. S ingle-Fami ly___Two-Family___Mu It i_Family
___AcEes sory Building
B. Comme rcial: __Re iai 1-Wholesa le___Of£ice-Profe ssional
__.Combination__Other
___M a nu fac tur ing__S to r ag e__P rotes s ing
I hereby affirm that the above information and that sub-
mitted in application for this permit is true and correct to the
best of my knowledge. I understand that this permit is issued
on the basis of that information and is subject to compliance
with all pertinent codes/~inances of the Greater ~nchor~ge
Area Borough.
Signature of Applicant
THIS PEP~MI~ EXPIRES SIX MONT[IS
FROM DATE OF ISSUE UNLESS CONSTrUCTiON,
AS DEF1,NED IN THE ZONING %~J)I~AN~E,
BECk.
Signature ~ Zoning Officer
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and 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
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 014-132-23
1. GENERAL INFORMATION
Complete legal description
Expiration Date: /! - //-//
ALPINE VILLAGE BLOCK 5 LOT 14
Location (site address) 7447 BERN STREET, ANCHORAGE, AK 99507
Current Property owner(s) STEVE BORCHERDING Day phone
Mailing address
7447 BERN STREET~ ANCHORAGE, AK 99507
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
NUMBEROF'BEDROOMS: 3
TYPE OF WATER SUPPLY:
individual ~Well F~'; []
individual w'ate~ Storage []
Com~unity Class. Well []
publiC Water System []
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding Tank
Community On-site
Public Sewer
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 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 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 ARCTERRA CONSULTING, INC. Phone 868-3792
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 08/08/2011
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The
assessment Of the condition of the well and septic applies on ly to the conditions as of the day tested. The flow
and absorption rates may change due to subsurface conditions that may not be Observed-from the surface,
changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the
water usage of the family being served by the system. The operational life of all well and septic systems are
subject to these various and dynamic characteristics and are outside the control of the
evaluator of the well and septic system. Therefore,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future ~
occupants or can ArcTerra guarantee that no unseen ~.
encroachments, deficiencies or discrepancies exist.
DSD SIGNATURE
~,,/~ Approved for
Disapproved.
bedrooms.
Conditional approval for
bedrooms, with the following stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
X
~ . WATERAND · mc
o:'..
,
Arsenic Advisow
Maintenance Agreements
Supplemental Engineer's Repod
Other
By: ,,,//
(Rev, 11/05)
Original Certificate Date: ~-'~'- //- / /
Municipality of Anchorage
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 BLOCK 5 LOT 14
Well Log(Y/N)
A. WELL DATA
Well tyPe.:P~ATE IfA, B, or C provide PWStD #
Date completed
Total depth UNK ft.
Parcel ID: 01~1-132-23
Sanitary seal (Y/N) Y
Cased to *40 ft.
Wires properly protected (Y/N) __Y
FROM WELL LOG
Date of test UNK
Static water level UNK ft.
Casing height (above ground) 18 in.
Well production UNK g.p.m.
WATER SAMPLE RESULTS:
AT INSPECTION
Coliform Neg colonies/100mL Nitrate 0.51 mg/L
51
7.5+
Arsenic: 7.51 mg/I. Date of sample: 7/27/2011
B. SEPTICIHOLDJNG TANK DATA- PUBLIC SEWER
Tank Type/Material N/A Date installed __
Number of Compartments __ Cleanouts (Y/N)
High water alarm (Y/N) Date of pumping
C. ABSORPTIONFIELD DATA- NIA
Date installed __ Soil rating (g.p.d./ft2 or ft2/bdrm)
Collected by: ArcTe~a
Length __ ft. Width __
Eft. absorption area __
Date of adequacy test
g.p.m.
ft. Gravel below pipe
ft2 Monitoring tube
Fluid depth in absorption field before test __
Elapsed Time: __ min. Final fluid depth __
Any rejuvenation treatment (past 12 mo.) (Y/N & type) __
Tank size __ gal.
Foundation cleanout (Y/N) __ Depression over tank (Y/N) _
Pumper__
System type
ft. Total depth __ ft.
Depression over field
Results (Pass/Fail)~ For bedrooms
in. Water added gal. New depth in.
in. Absorption rate >= g.p.d.
If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at
Datum
Size in gallons
"Pump off" level at
Cycles tested
Manhole/Access (Y/N)
High water alarm level at in.
Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Fo
Septic tank/lift station on lot NIA
Absorption field on lot
Public sewer main *48'
Sewer/septic service line 25'+
Animal containment areas
On adjacent lots N/A
On adjacent lots
Public sewer manhOle/cleanout '60'
Holding tank
Manure/animal ex, Fete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: - N/A
Building foundation N/A
Water main
Wells on adjacent lots
Property line NIA Absorption field... +
Water service line Surface water
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
Water Service line
Curtain drain
COMMENTS
Building foundation ~
Surface water
Wells on adjacent lots
Water main
Driveway. parking/vehicle storage
*ADEC waiver granted to AWWU 10117/1983
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 KENNETH M. DUFFUS
Date 05/08/11_
COSA Fee $490.00
Date of Payment
Receipt Number
(Rev. 11/05)
Waiver Fee $.
Date of Payment
Receipt Number
SGS Ref.# 1113428001
Client Name ArcTerra Engineering and Surveying Printed Date/Time 08/04/2011 10:33
Project Name/# Alpine WOods B5 L14 Collected Date/Time 07/27/2011 15:45
Client Sample ID Alpine Woods B5 L14 Received Date/Time 07/27/2011 16:05
Matrix Drinking Water Technical Director Stephen C. Erie
Saml~le Remarks:
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits Date Date Init
Metals by ICP/MS
Arsenic 7.51 5.00 ug/L EP200.8 C (<10) 07/27/11 07/29/11 NRB
Waters Department
TotalNitrate/Nitrite-N 0.510 0. I00 mg/L SM20 4500NO3-F B (<10) 07/29/11 AYC
Microbiology Laboratory
E. Coli Negative 1 100mL SM20 9223B A 07/27/11 DLC
Total Coliform Neffative 1 100mL SM20 9223B A 07/27/11 DLC
Aug 10 11 08:20a Beau Maxim 19073391985 p.3
Aarow Pump & Well Service LLC
(907)346-9355
Inspection Report
I. ran a camera 55' down the well at 7447 Bern St and did not fred any
lnoles/cracks in the casing or leaking around the pidess.
Beau Maxim
30'
30'
LOT 15
BLK 5
N 89°59'00" Ev v
~)WELL /® ~. 24.0'
RETAINING ~N89'59'OO"E WALL
LOT 1 3
BLK 5
/
30,00' ,,
LOT 1 4 ×
BLK 5
Y Y
130.00'
16.0'
Y ¥ y-
ANCHORAGE RECORDING DISTRICT, ALASKA
AS-BUILT OF:
ALPINE VILLAGE
LOT 14 BLOCK 5 PLAT P-663
SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a
physical survey of this property as shown on this drawing and that thc
improvements situated hereon are within thc property lines and no
enchroachments exist other than noted. Under no circumstance should
any information on this drawing be used for construction of fences,
structures, improvements, or for establishing boundary lincs.
EXCLUSION NOTES: It is thc owners responsibility to determine
thc existence of any casements, covenants, or restrictions which
do not appear on thc recorded subdivision plat.
WORK
ORDER
NUMBER:
JULY 26, 2011 / 1"=30' kndeng~lk.net
DRAWN lay: CHECKED B~:~ GRID NUMBER: BOOK/PAGE:
11--032 JLS/ 2155 110128
I~) = FND 5/8" REBAR
x2.~l., LAND //,b,
*-q'.,'? '%~..2'~ ~.
........ ~.~ ¢ .
...e~ / .... isal Talkeetna Street
~chorage, Alaska 9~508
06~ (907) 227-1455 office
(907) 274-4992 fax
--~ MUNICIPALITY OF ANCHORA, GE ....... ,., .,,. ....
~EPARTMENT oF"Hi~AL~'H"&; H[Ji~IA~I~ §~RVi~;E~ '
, ~,. ,~, ,, . . ~,.~. ~,~ , . of Environmental Se~lces r?~ '.
............... , ~..~ . ,. .,~ ..~ ......
' ' ' . ' ";1~" ' ' ', ~-? ~ ," ,," '
~ P O BoX.196650 ' Anchorag~,,Alaska.' ~51g-66~0
, , ' ~ ' 843-414 ' ' :~.. ,:
'- ..... .... ? '-~'"" :: '~'~ ~'~'~' : ' i ~j) ~j ~1t17~:''~ ~ F":'
~ ;":~ r'; '" CERTIFICATE OF HEALTH AUTHORITY~,
'~ APPROVAL~FOfl A SINGLE FAMILY. DWELLING
Parcel I.D, ff ~/~/~ / ~ ~- HAAff 'm
GENERAL INFORMATION
Complete lega! description
Location (site address or directions)
7 c/~7 /~-/z M
Property owner
Mailing add~:eSs
Lending agency
Mailing address
Agent ~
Address
Day phone
e
Unless otherwise, requested, HAA will be held for pickup. _
NUMBER OF BEDROOMS:
TYPE OF WATER ~UPPLY:
Public water
NOTE: If community well system, provide, writte~ confirmation fro Sta~DEC att~
TYPE OF WASTEWATER DISPOSAL= ~ - ' .................. ' ...... ':' ~. ~'~
NOTE: 't wastewater s stem,~pro~ide'.written qonflrmation from Slate ADEC
(Rev. S.'~11 Ftonl MOA
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 inves.ti_gation 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.
Address ?oC~ E, C///vto,,,J ~ IB ~.ur/.
Engineer's signature ~.-~.~ ~.~.~'"'
Phone ~
Date
DHHS
SIGNATURE
Approved for
Disapproved.
Conditional
bedrooms.
approval for bedrooms, with the following ~tipulations:
Additional Comments
Department of Health and Human Services (DHHS) issues Health Authority
based only upon the representations given in paragraph 5 above by an independent
g~neer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
g 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-O25(Rev. l/91) ~k MOAiI21
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
A. Well Data
Parcel I.D.
Well type t/r) ,~/! u'lc/~A// If A, B, or C, atlach ADEC leUer. ADEC water system number .-
Log present (Y/N) /Uo ~--~) (t~"/'"~J~O~' ~ -- '
Date completed ~:~ Driller (~/4/.-)O~..~/J ~
Totaldepth 15(~' (~ Casedto ~5~c~¢ ~t( Oc/~;;a;ingheight I.~I' ~
Sanitary seal (Y/N) ¥' Wires properly protected (Y/N) y
FROM WELL LOG AT INSPECTION
Date of test
Static water level
Well flow ~ g.p.m. ~ (~
Pump level1
SEPARATION DISTANCES FROM WELL TO:
~*~
7-,
Septic/holding tank on lot /'~,///,'~
Absorption field on lot /'J/A,
Public sewer main ~! ~'
Sewer service line 3.. ~. ~ ~
; On adjacent lots /,,J/A
; On adjacent lots f,.)/A
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform C..) Nitrate C)~
Dale of sample: '7- z~,~. ~.~ Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed ~ ~ Tank size Compadments
Cleanouts (YIN) ~ Foundation cleanout (Y/N) Depression (YIN)
High water ala~ (YIN) .. ~ Alarm tested (Y/N)
Date of pumping ~ * Pumper
SEPARATION DISTANCES ~M ~PTIC/HOLDING TANK TO:
Well(s) on lot ~On a~cent Iols Foundation
Wa,
72-0~6 (~)' Fret
Other bacteria (-~
CONTINUED ON BACK PAGE
C. LIFT STATION
Size in gallons
Vent (Y/N)
High water alarm level
Date installed _~,,.
el al
Meets MOA electrical codes (Y/N) ~
SEPARATION DISTANCE FROM LIFT STATION T
Well on lot On adjacent lots
Manufaclurer
Manhole/Access (Y/N)..
"Pump off" Level at
Cycles leered
Surface water
D. ABSORPT~,,~IELD DATA
Date installed "',,,_
Length. "'~_Widlh
Tolal absorption area ~
Date of adequacy test "~
Water level in absorption field before test~
Soil rating (GPD/FF)
Gravel lhickness
Cleanout present (Y/N)
Results (pass/fail)
System type
Peroxide treatment (past 12 months) (Y/N) '"',,, If yes, give date
SEPARATION DISTANCE FROM ABSORPTION
Well on Iol
On adjacent lots. ",,,,, Property line
To building foundation ~To existing or a"~doned
system
on
Iol
On adjacent lots Cutbank~ ~~Wa't~main/service line
Surface water Driveway, parking/vehicle"' ~storage ama
Curtain drain
Total depth
Depression over field (Y/N) ..
for Bedrooms
After test
E. ENGINEER'S CERTIFICATION ·
I certify th~d-Yra~ecked, verified, or conformed to all MOA and HAA gu/ this inspection.
Signature. '~ ~ ~
_
Engineer's Name i-) ~ ~ ,z./~d~;~-./~. ~ c-~-
Date '7- ~ ~'- ~.~' ' '
HAA Fee $
Date of Payment
Receipt Number
72-026 (3/~3)'
Waiver Fee $
Dale of Payment
Receipt Number
CT&E Environmental Services Inc.
Laboratory Division
,~.~,4-~ Laboratory Analysis Report
]~AT~R '
7%%7 IU~N ST
D H I CONSULTING ~NGIN~B~8 W0~K Order 1~64S
DUSTIN Printed Date 07/2~/9S · i~ hre,
R~ceil,'~d Dat~ 07/26/9S ~ l~t0O hvs.
8ample ~markm; SAMPLe[ C0L~CT~D ~¥: D. ~{~.
QC Allowable Ex~ ~mal
N{trat~-~ 0.10 ~ mg/L ~PA ~,2 lo. ~7/27/95 C](R
200 W. Porter Drive, Anchore~z_AK 99518.1fl05 -- Tel: (907) 662-2343 Fax: (~7) 561-5301
ENVIRONMENTAL FACILITIE~ IN A~S~, CALIFORNIA, FLORIDa, ILLINOIS, MAR~ND, MICHIGAN, MIS~OURL N~W JERSEY, OHIO. W~T VIRGINI~
I'.D. #
RU'~AN SERVICES
Services
CERTIFI
iNFORMATiON '
>lete,legal
i'E°cation (siteaddi
'owner' , ~:: ' A ..... ~ ~'" '::': :Day phone ;~'~'=1 --~t-I ~O
,addreSs
g agency
ling address
Day phone Z..G~ '5-o-/00
,,~tr-- ~ 5-o~- z~) o,
Day phone
i, Address
)F BEDRO
OF WATER SUPPEY:
~ndivid'uaLweiF
communitYwell
Public water, ,~
pickup. -
~yPE'~:oF WA..
IndiVidual
ro~
Commun
PUt
attesting
Front MOA #21
STATEMENT OF INSPECTION BY,:~ENGINEER ~ ~*~' '*'
AS certified by :i' heret0 and as' of the validation ¢ 'ify.that my .~.. '.
.::inVestigation oftt i~)P~)~'~pjrBcati'~)~' watei~ ~uPPly ~'~
and/or waStewater d;~osal system ~s safe, functional and adequate for the number of bedrOoms
and type of structure indiCated herein. I fu~herveri~ that based on the infOrmation obtained from
the Municipality of Anchorage files and frOm my)~veStigation and inspection, the on-site
SUpplY and/or waStewater'~'i~Pos~l' ~Stem: ~:'~ih ;'~iiance,W~t~: all MUniCipal and
Ordinances~ and regul~ti~'~?inef~eCt'~n th~"~a~('~j~:in~p~tion.
Nameof Firm ' ~[ ~SU~TI~~ 'Phone ~-I
Address
Engineer's sig
Approved 'foi~'
Disapproved.
Conditional
apProval:
Additional Comments
By:
Date
//
~r :The Mun cipality of Anchorage Department of Health and Human Services (DHHs) issues Health Authority
. APproval Certificates based only upon the representations given in paragraph' 5 aboVe by an Independent
PrOfessional engineer reg stared in the State of Ala?kai. The DHHS does this as a courtesy to purchasers of homes
and their lending institUtions in °rder t° Satisfycer[~in f~derai and staterequir~me~ts~ EmploYees of DHHSdO not i i i:i
conduct insPections or analYze data lbefore ~,icertificate is: issuedl .The MUniciPality of Anchorage is n°t ~
;.?,'responsible f°'r errOrs or O~iSSi°n~ in the
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: L..
Parcel I.D.
A. Well Data
Well type
Log present (Y/N)
Total depth
Sanitary seal
IA ~ ,~ ~ ~ u ~. c... If A, B, or C, attach ADEC letter. ADEC water system number
Date completed U~ ~-~o~/J Driller U/,J I~o~v~ (~
Cased to A.%s~,,,,,c ~<..c. o~..~r~ (~Casing height I, 4
Wires properly protected (Y/N) ~tE c~ (ID
Date of test
Static water level
Well flow
Pump level
FROM WELL LOG
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main ~/~
g.p.m.
AT INSPECTION
; On adjacent lots ~/'~'
; On adjacent lots
Public sewer manhole/cleanout
Sewer service line Z,4-,,~ ~ d::) Petroleum tank
WATER SAMPLE RESULTS:
Coliform <:~ (~
Date of sample:
Nitrate
~F---~TAE, C E--- (~ Other bacteria
Collected by: ~,~--~-- ~_p~(c(~go~J
B. SEPTIC/HOLDING TANK DATA
Date installed Tank size Compartments
Cleanouts (Y/N) ~'-'--~ Foundation cleanout (Y/N) Depression (Y/N)
High water alarm (Y/N) ~ Alarm tested (Y/N)
Date of pumping ~'"'----P..q.~ ~ J
SEPARATION DISTANC ES FROM SEPTIC/HOLDING~..~ ~
Well(s) on lot ~~ ~On ad?~ __ ~Foundation ~
~ dPra~Pee:~t I~/;r~- ~..~13flo n fie,d ~ ~ Water main/service line ~
(~) W~EASU,~') /o~gf~vC_J3 ~"r ~.1 ~-{~-~ CONTINUED ON BACK PAGE
72~026(~)*Front ~ ~ b~ ~L~S
C. LIFT STATION
Date installed Manufacturer
Size in gallons ~ Manhole/Access (Y/N) ~~'~'
HMi~eht ~va~ eortl; r~i:cVa~ 'codes( *f~~~
SEPARATION DIS~: ~
Well on lot ~ On adjacent lots Surface water ~.
D. ABSORPTION FIELD DATA
Date installed Soil rating (GPD/Ft2) System type
Length '-'~"~/ldth-~., Gravel thickness Total depth
Total absorption area /N)
Date of adequacy test Results (pass/fail) for ~
Water level in absorption field before test ~ After test-'-'~
Peroxide treatment (past 12 months) (Y/N) ~ If yes, give date
Bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot ~_ On adjacent lots Property line
To building foundation __
On adjacent lots Cutbank
To existing or abandoned system on lot ...._
~ne
Surface water _~Ehi~E~ay, parking/vehicle storage area
Curtain drain
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA
Signature~~-'<'~- ~~.~.
Engineer's Name ~- .
Date ~F//~'/~,/
HAA Fee $
Date of Payment
Receipt Number
72-026 (3/93)* Back
Waiver Fee $
Date of Payment
Receipt Number
0472~./~4
CT&g Ref.#
Cl~t Sampl~ ID
Matrix
ClientName
O~lemci By
Proj~tNam~
Project//
Farameter
15:47 CTS,E ENUIRONHENTCL L~B SERUICES ~ 907 ."3_45 ~_Z~3G
NB.428 ~0~
Commemia
Environmental
94.1682-I
7447 BEKN 8T
WATER
D Ifil CONSULTINGJ
UA
Testing & Engineering Co.
aboratory Services --- ~-7~7--~-~---'---------'-
LABORATORY ANALYSIS REPORT
WORK Order 77559
PrMted Date 04f21/94 ~15:33 hrs.
CollectedDate 04118/94 (~ t 7,..~0 hrs,
R~;~ived I,)ate 04119194 (a~08:40
KOI)'I1NE ~ MPLE (
Technical Din,~t or ,t $'I'I~PHKN C. FcA)F.
3LI~CTED BY: M.E,
QC Allowable I.~xt. Ami
Kemd[s Qual Unit'~ M~,hod Limita l)at~ Date Init
0.10 -- U mg/L Ik'PA3~3,~.I300.0 10 04?Z0/94 LLI-I
IJa~4eeted, lh:po~Mvd~z i.~ the praotioal qu~mtification lan. it.
dilution.
IIA = Unavailable
NA = Not Analyzed
LT= I~s lhan
GT= Creater Tlum
5633 B Street. Anchorage, AK 99,518-1 liO0 -- Tel: (907} 562-2343 Fax: (907) 561-5301
ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA. ILLINO!$r MARYLAND, NEW JERSEY, OHIO, UTAH, WE~T VIRGINIA
Tony Knowles
Mayor
3000 Arctic Boulevard
Anchorage, Alaska 99503
(907)
October 17, 1983
Mr. Reford G. Reid
Construction Grants Project Engineer
Alaska Department of Environmental Conservation
437 "E" Street (Second Floor)
Anchorage, AK 99501
Owned by the Municipality
of Anchorage
Re: Zurich LID #137
Dear Mr. Reid:
The Anchorage Water and Wastewater Utility seeks ADEC approval to
construct, maintain and operate portions of the Zurich LID #137
sanitary sewer closer to drinking water sources than established
separation distances specified in State Wastewater Disposal
Regulations. In request of a regulation waiver and in accordance
with Title 18 of the Alaska Administrative Code, Chapter 70 (18
AAC 72.021C), Anchorage Water and Wastewater Utility submits the
following report for your review and consideration.
Well locations
The alignment-of Zurich 5ID ~137 passes close to drinking water
sources (wells) at sixteen locations. These locations are
graphically illustrated on the attached project plan drawing
sheets 3 of 4 and 4 of 4 (Attachment A) and legally described
below.
.Alpine Village Subdivision
Lot 1 Blk 4 - approximate distance between water well and
proposed sewer line is 30 feet, distance to cleanout is 24 feet.
Lot 12 ~Btk-5'- approximate distance between water well and
proposed sewer line is 48 feet.
Lot 13 Blk 5 - approximate distance between~water well and
proposed sewer line is 54 feet.
Lot 14 Blk 5 - approximate distance between water well and
proposed sewer line is 48 feet, distance to manhole is 60 feet.
Lot 16 Blk 5 - approximate distance between water well and
proposed sewer line is 64 feet.
Lot 18 Blk 5 - approximate distance between water well and
proposed sewer line is 52 feet, distance to cleanout is 56 feet.
Lot 1 Blk 5 - approximate distance between water well and
proposed sewer line is 63 feet, distance to cleanout is 54 feet.
Lot 2, Blk 5 - approximate distance between water well and
proposed sewer line is 97 feet,
Lot 3 Blk 5 - approximate distance between water well and
proposed sewer line is 87 feet,
Zurich LID ~137
October 17, 1983
Page 2
Lot 6 Blk 5 - approximate distance between water well and
proposed sewer line is 45 feet,
Lot 7 Blk 5 - approximate distance between water well and
proposed sewer line is 23 feet,
Lot 8A Blk 5 - approximate distance between water well and
proposed sewer line is 44 feet.
Jovon Subdivision ~'~-,~
Lot 4 - approximate distance between water well and proposed
sewer line is 68 feet,
Lot 5 - approximate distance between water well and proposed
sewer line is 65 feet,
Lot 6 - approximate distance between water well and proposed
sewer line is 55 feet.
O'Brien Subdivision
Lot 7 Blk 6 - approximate distance between water well and
proposed sewer line is 43 feet.
Within the subject well radius "waiver" areas, all sewer pipe
will be 8-inch ductile iron pipe Class 50 with a wall thickness
of 0.27. The subject pipe has a working pressure of 350 PSI plus
a surge allowance of 100 PSI. This particular sewer trunk is a
gravity system which will be 0.0 PSI working pressure, making it
.ideal for construction within well radius. On a gravity system
there is more static pressure on the outside of the pipe than on
the inside, thus giving more concern to infiltration than
exfiltration. Ductile iron pipe has a life expectancy greater
than other conduit materials because of its structural strength,
resistance to abuse, abrasive elements and corrosion.
Manholes and cleanouts constructed within the protective well
radii are of special construction (see sheet 2 of 4 for details).
The sewer line, within the manholes, is mechanically sealed and
gasketed-to~-prevent leakage of any sewage into the manhole,
subsequently preventing any leakage of sewage out.of the special
manholes. ~-
We were able to obtain drilling logs for two of the subject wells.
from the Municipal Department of Health and Environmental
Protection. The well log (see attachment B) ~or Lot 7, Block 5,
Alpine Village, indicates the depth of the well at 128 feet. The
well log for Lot 3 Jovon Subdivision indicates the depth of the
well at 129 feet. Both well logs reveal quite extensive layers
of a clay and gravel mixture. The presence of these layers of
clay provides an impermeable layer between the sewer pipe and the
bottom of the subject wells.
Zurich LID 9137
October 17, 1983
Page 3
This essentially completes our request for a waiver. Should you
require any additional information or have any questions
concerning the above information, please contact AWWU at your
convenience.
Sincerely,
· ~PoEo
Enigneering Design Supervisor
Anchorage Water & Wastewater Utility
TK:AES:jmd
attachment(s)
Tony Knowles
Mayor
ANCHO , GE WATER & WASTEWAT R UTILITY
3000 Arctic Boulevard
Anchorage, Alaska 99503
(907)
Owned by the Municipality
of Anchorage
October 19, 1983
Mr. Reford G. Reid
Construction Grants Project Engineer
Alaska Dept. of Environmental Conservation
437 "E" Street, Second Floor
Anchorage, Alaska 99501
SUBJECT:
Zurich, LID ~137
State Grant No. S82(12)3522
Dear Mr. Reid:
Enclosed please find for your review and approval, a
request for a well radius waiver on subject project.
Should you have any questions, please contact this office.
Sincerely,
Assistant_.Administrator
Anchorage Water & Wastewater Utility
VLS:sk
Attachments
DEPT. OF ENVIRONMENTAL CONSERVATION /
November 14, 1983
BILL SHEFFIELD, GOVERNOR
~pho.e: ~o~ 274-2533
Address, 437 "E" Street
Suite 200
Anchorage, AK
99501
Ms. Vicki L. Sloppy
Assistant Administrator
Anchorage Water & Wastewater Utilities
3000 Arctic Boulevard
Anchorage, AK 99503
RE: Well Radius Waivers
Zurich LID 137, S82-12
Dear Ms. S1 oppy:
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. A1Sundquist, P.E. and engineering design supervisor
for AWWU, submitted a report for ADEC's review and consideration to waive
established separation distances to construct, maintain and operate portions
of Zurich LID No. 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.
e
Separation distance of 48 feet between a private well on Lot 12,
Block 5 of Alpine Village Subdivision and proposed sewer line.
Separation distance of 54 feet between a private well on Lot 13,
Block 5 of Alpine Village Subdivision and proposed sewer line.
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.
,/
¢
Ms. V. L. Sloppy
Well Radius Waivers, S82-12
November 14, 1983
Page 2
Separation distance of 64 feet between a private well on Lot 16,
Block 5 of Alpine Village Subdivision and proposed sewer line.
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.
e
Separation distances of 63 and 54 feet between a private water well
onLot 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
8A, 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 manhole-cleanout and well. Within the special manhole, the
sewer line's flanged pipe is mechanically sealed and gasketed to prevent
leakage of any sewage into the manhole. With the above in mind and by
reviewing the pertinent charaCteristics of pipin~ 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.
Sincerely,
Greg l~age~ v
Construction Grants Engineer
GM/djf
ANCHORAGE WATER & WASTEWATER UTILITY
3000 Arctic Boulevard
Anchorage, Alaska 99503
(907)
Tony Knowles
Mayor
Owned by the Municipality
of Anchorage
May 30, 1984
Mr. Reford G. Reid
Construction Grants Project Engineer
Alaska Dept. of Environmental Conservation
437 "E" Street, Second Floor
Anchorage, Alaska 99501'
Subj ect:
Zurich LID No. 137
State Grant No. S82(12)3522
Dear Mr. Reid:
Enclosed please find for your review and approval plans and
specifications for subject project.
Should you require additional information please contact this
office. '
Sincerely,
Assistant.-Administrator
Anchorage Water and Wastewater Utility
Enclosure
rel/j127
DEPT. OF ENVIRON MENTAL CONSERVATION
.. ..FACILITIES, CONSTRUCTION AND OPERATIONS /
BILL SHEFFIELD, GOVERNOR
~Nphone: ~0~
Address:
274-2533
437 E. Street
Suite 200
Anchorage, Alaska
99501
July 11, 1984
Ms. Ruth S. Eresman
Assistant Admi ni strator
Anchorage Water & Wastewater Utilities
3000 Arctic Boulevard
Anchorage, AK 99503
RE: Plans and Specifications
Zurich LID #137 S82-12 Project #12750
Dear Ms. Eresman:
Thank you for the opportunity to review the referenced documents.
The project consists of some 1470 linear feet of 8 inch DIP with appur-
tenant items (including special manholes for well radius protection)
and other features necessary to assure a properly functioning project.
This project will provide sewer mains north from Lore Road in Bern
Street, Zurich Street and O'Brien Street.
These plans and specifications are approved for matters of concern
to this Department. Please forward copies of bid tabulations, bid
award, signed construction contract and the notice to proceed with
constructi On -~Vhen avai 1 i able.
Sincerely,
Greg ~i~gee// ~
Contruction Grants Engineer
MM T/mint
D. . - RECEIVED
INSPECTION APPOINTMENTS
'~IfVIE TIME TIME
DATE DATE DAT~~!
INSPECTOR
INSPECTOR
INSPECTOR
MUNICIPALITY OF ANCHORAGE [~;i~i ~.F ~' :, : ~:'.
-~. DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~,q~.%);
825 L Street - Anchorage. Alaska 99501
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720
:DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing,
~. PROPERTY OWNER PHONE
MAILING A~DRESS
PROPER'fY RESIDENT (If different from above) PHONE
2~' BUYER PHONE
MAILING ADDRESS
MAI LInG ADDRESS
4, REALTOR/AGENT PHONE
MAILING ADDRESS
5. LEGAL DESCRIPTION
STREET LOCATION n
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
~ One L~ Four
wJ SINGLE FAMILY [_-~ Two ~ Five
[] MULTIPLE FAMILY FV~ Three I~] Six
Other
7. WATER SUPPLY
INDIVIDUAL*
COMMUNITY
PUBLIC UTILITY
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON~SITE**
PUBLIC UTILITY
_q -.,, ":I \
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[].-"'~iNGLE FAMILY [] ONE [] -'ff"[q"REE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] /INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
E~IDIVI DUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified
INSTALLER
[]Septic Tank or [~] Holding Tank
Size: / ¢' ~ ~ If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK / MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
Septic/Holding Tank Absorption Area ~Sewer Line INearest Lot Line
4.
DISTANCES
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
~ CO~ITIO~Ak AP~BOVAk {letter must accompan~ certificate)
~ DISAPPROVED
72-010 (Rev. 6/79)
PENINSULA
ENGINEERING
2820 "C" Street, Suite #3
Anchorage, Alaska 99503
276-4855
November 19, 1981
Gloria Stewart
7447 Bern Street
Anchorage, Alaska
99507
RE: Lot 14, Block 5 Alpine Village Subdivision
Sewer System Adequacy Test
Dear Ms. Stewart:
As per your request, I have performed an adequacy test on sewer
absorption system of the above property.
The system consists of a (1000 gallon) septic tank and an
apparent seepage pit. The septic tank was pumped prior to
testing on November 17, 1981 and water was added (520 gallons)
directly to the absorption area via the standpipe. This
procedure was repeated the second day and the levels monitored
at regular intervals in accordance with the Municipality of
Anchorage recommended procedures. (See attached tabulation.)
A review of the test results indicates that the system is
functioning adequately for a 3 bedroom home.
S incere.ly, .
Wayne ~nderson~, P.E.
WH: sa
PENINSULA
ENGINE:ERING
ADEQUACY T t*;ST
Addross
I,ega I:
Sys rem:
I)A'_j'J'i._
11/17
1981
11/18
1981
1981
Gloria Stewart
7447 Bern Street
Lot 14 Block 5 Alpine Village
Septic Tank and Seepage Pit
flI'lE (rain)
0
Altec pmpg
Start test
10 m£n
20 rain
30 m i n
40 mi n
50 m i n
60
65 rain
rain
m ~ n
() rain
10 :';' 'rain
20 rain
30
40 m iu
50 m i n
60 rain
65
111 .[ I1
m in
1ll i 11
()
SI<PTIC TANK
69"
6"
6"
6"
6"
6"
6"
6"
6"
6"
16"
16"
16"
16"
16"
16"
16"
16"
18"
SI';I.;I'A¢;I'; 1' I.T
5 8~'
5 0"
5 0"
6 4"
8 7"
9 6"
11 0"
11 ' 0"
11 ' 0"
11 ' 0"
7 ' 0Il
8' 6''
11 ' 0"
11 ' 0"
11 ' 2"
0
0
0
8
8
8
8
8
8
8
RAT lC
0
8
8
8
8
8
8
8
TOTAl, WA'I'I.:R
A:l)l)l';l__)__(g a I )
0
0
O'
80
160
24O
320
4oo
480
5204~,?
80
160
24O
52o
4OO
48O
52O
l GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3~30 "C" Street, Anchorage, Alaska 99503
2
e
We
0
i FOR
Conv.
Approval .~que$.ted by:
Idres$:pOst%OfficeBox 270 99510
Mailing
Property (Iwner!.- Daltrice Boehmer
Mailing ~.dres~: 'Box 10223 K.R.R.S.
Legal De ript!on: Lot 14 Block 5 Alpine Village
L°cati°n:I -i 7447 Bern Street
Type of cilfty to be inspected Single Family
Well Datl:[ i Individual
A. Well
Neares
B. Found~
C. Absor
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
Date Received September 29, 1976
Time of Inspection
Date of Inspection
First National Bank of Anchorage
B. Depth 150'
D. Bacterial Analysis
C. Const~ ~ctio~
Sewage D' posal System: On-site system
A. InstaI ed ii.. July, 1,971 B. Installer
C. Septid Tank.! 1. Size 2. Manufacturer
E. Dispo Field Total length of lines
DistanceS:l .
: S~ptic tank y-g~"~, Absorption area
lot!line , Other contamination
2. Material
EQ,034 (1/74
ion to septic tank
:ion area to nearest lot line
Phone: 279-4481
Phone: .......
, Absorption area
No. of bedrooms 3 /~
. ./'/'~2, , ~Sewer Lines
Pa§e 1 of two pages
Page 2 of two pages - Req t for Approval of Individual $ ,r & Water Facilities
Legal Description Lot 14 Block 5 Alpine Villa. ge
Comments
Approved _~~~y~~~ Disapproved Date
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
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 Date
EQ,034 (1/74)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" Street, Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
MUNIc tPALiTT ()F ',/',IC/Ir~2AGE
S£P 2 9
RECEIVED
1. Type of Inspection: CMRO
2. Property Owner: Daltrice Boehmer
VA FHA
CONV X
Mailing Address: Box 10223 K.R.R.S.
3. Name of Buyer: Edward J. & Linda J. Lon~;
Mailing Address: 7447 Bern Street 99507 Day Phone
4. Name of Lending Institution: First National Bank of Anchorago
Mailing Address: P.O.]~ox 720 99510 Phone
5. Name of Realtor or Agent: none
Mailing Address: Phone
Day Phone 777-3163
349-1120
779-4481
Legal Description:
Location:
Lot 14 Blk 5 A]p~no V~ll~co S,,h.
7447 Bern S~ro~t - T.n~ ntis off 72nd
Type of Facility to be inspected: SFD
Water Supply
Type of Supply: Public Utility
If Individual, number of dwellings presently served
If Individual, depth of well
Sewage Disposal System
Type of System:
If Individual, date of installation
150'
Public Utility
July 1971
Individual
orl~
No. Bdrms. ~
Individual (on-site) septic
EQ-037 (1/74)
