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Home My WebLink AboutBENBECCA BLK 1 LT 1ABenbecca Block 1 Lot 1 A #051-052-63 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: S'lJ 980 3SY PID Number: D 5/ 'USZ - (, 3 Name: cnn G lin Wastewater System: O New 9 Upgrade Address:2q �22 iZ«s, t CkAtpik,AK ABSORPTION FIELD Phone: No. of Bedrooms: 3 10 Deep Trench >irShailow Trench ❑ Bed ❑ Mound ❑ Other Soil Rating: TotaDepth LEGAL DESCRIPTION leh from original grade: n � ., _ ., Lot: / Block: / ubdivieion: • utju/b . i -t. Depth to pipe bottom from original grade: 1 7 • f- Gravel depth beneath pipe r /N LCC Ft. 7a . Z r — �. T2 Ft. Township: Range: Section: Fill added above original grade: Gravel length: V Ft. e4- d`W , C 4 Jr y. S Ft. WELL: O New O Upgrade Gravel width: r Number of lines: Distancebetweenlines: �lH Classification (Private, A,B,C): Total D Cased To: 'rr)VG eQ , J Ft. Z /0 Ft. Total absorption area: Pipe material: D 303 q FC Ft. Ft. Driller: I Date Drilled: Static Water Level: F Gl0 750' SQ. Fj7a�ed: tS� installer: �J T Ft. / ! A Gc /i,wMn 4"St. Yield: Pump set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ❑ Septic ❑ Holding *.T.E.P. To From Septic Tank Absorption Field Lift Station HoldingPublic/Private Tank Sewer ones/ Manufacturer: L Capacity in gallons: 1.2S v Well /�O �Ob /_� 10014 _ Z r Material: S / 7u Number of Compartments: Surface 1.46'4 LIFT STATION Lot Line l ar /0 / `% �� -- _ Size in g12 allons: Manufacturer. %%/A%C 0 Foundation lot � /0',L t4- "Pump on" level at:�� "Pump off" level at: rr High water alarm at: /r VV �z ye Curtain Drain �--- dome_ eRV&v;j Pump Make d Model 3o ..r/ Electrical Inspections performed by: Yoh h M -eh o Remarks: h lq��,, vc� ly /,'tips BENCH MARK Location and Description: � Assumed Elevation: /OD Ft- ENGINEEB'S SEAL 4 '' ��q�, 00 «...,•�e� Iy1 Inspections performed by. .1kWh 46:h4,l✓oele Dates: is D9 Z o �'' 4.0 . "" ' 4449°° •••• •••• Og Z� 9Z f� 2 ...,....... ..... ...• / Department of Health and Human Services approval �$ r ° Kenneth m. Lw" •."F "j 49049 Reviewed and approved by: Date: % 7s., ,. .. __ AS—BUILT SYSTEM DETAILS/SITE PLAN Permit SW980358 BENBECCA S/D, ❑T 1A, BLOCK 1 PID#051-052-63 0 o I c I --- ------------------------ .9 A -C=12.2' B -C=17 1' A -D=18 3' B -D=15.7' A -E=1193' B -E=98,7' A -F=130,0' B -F=1114' 294.80 WELL O �P f� s� Qui EXISTI R. OUSE MANHOLE CLEANOUT CLEANOUT 0 �L l� o N1250 GAL ti S.T.E.P. 'v cs TANK OF ALS � ,00 * TH* KENNETH M FUS / CE -7 1 a W � sslojWo 'Aw \`qfb _41p, F MT MTS�10 PRIMARY SYSTEM' Lo 1� AIE ° D EXISTING SEPTIC 1250 S,T.E P. SYSTEM SCALA (95-123) FINAL GRADE FILTER SEWER ROCK 93,36 TRENCH 1 54.5' gg 49 FINAL GRADE FILTER FABFABRIC',INSULATION SEWER ROCK TRENCH 2 — 54.5' — PREPARED FOR: BONNIE KING KING REAL ESTATE 24322 REESE RD. CHUGIAK, AK 99567 FIELD BOOKS COMPUTED: BOUNDARY: JOHNSOM DRAIN: KMD STAKING: JOHNSON CHECKED: KMD ASBUILT: JOHNSON DATE: 2/20 DWG. FILE: GRID: NW15E ACAD FILE: 98108.DWG JOB N., 98108 MONITOR MONITOR TUBE SCALE: NTS VARIES 1 0.51T 3.25' VARIES _I 0.5' T 3,32' 88,11 0 84,61 BOM N HJD ENGINEERING 20441 PTARMIGAN BLVD.. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 January 3, 1999 He: Lot 1 A Block 1 Benbecca - Septic Liftstation To Whom it May Concern: 1 installed the electrical equipment for the above mentiohed septic liftstation in compliance with the National Electric Code, as well "a state and local cedes. V' MUNICIPALITY OF ANCHORAGE Q� Department of Health and Human Services ❑ On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SW980358 Legal Description: BENBECCA BLK 1 LT 1A Design Engineer: 0070 KND Engineering Owner Name: Bonnie King Owner Address: 24322 Reese Rd Chugiak , AK 99567-5509 Date Issued: Sep 15, 1998 Expiration Date: Sep 15, 1999 Parcel ID: 051-052-63 Site Address: 024322 REESE RD Lot Size: 78723 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage 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 (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. J-2248 8 Fxisnow, SEiortc T^*vx 13 Nar 4r 74 Or FLSV4TI&V EtiG6K 7H0 As T' rNwl ENG 9C-)eS /NF i,. PP -5/6.V /s 7b oVOpNxrtT/�+& 5eP1/[. T p'A'1< %!NQ COAb5 7 -le U 6 A S• r. e. lo, rANK /u I7s Pip «, Received By: Issued By: I/ L NIZ&l+D Date: Date: 9 -15.7 v KND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 907)696-6111/FAX (907)696-8111 September 2, 1998 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Upgrade Sewer Permit — Benbecca S/D, Block 1 Lot 1A Gentlemen: At the request of the owners, on August 24, 1998, we excavated one testhole for the subject property to upgrade the existing system,Opp which was identified by the owner as in failure. We also installed a monitoring tube and monitored water for one. The results of this test and water monitoring are attached. We propose to install a 5' wide shallow trench. The testhole (98-1) had registered water at 40" from BOH upon on September 2nd. We anticipate additional fill being needed over the system. This lot slopes from the east to west/northwest at approximately 2-7%, which is away from the proposed system. There are no public or private wells within 100' of our proposed system location except as noted. The school to the north is served by public water and a holding tank which do not impact this site. There is neither surface water within 100' nor any known curtain drains 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, �1D) Engineering Kenneth M. Duffus, .E. attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Tests WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLA BENBECCA S/D, LOT 1A, BLOCK 1 O WEM 1A (97-8) 0 m 2 :9-53) I� I I• I 40,030 SF m I I 294.80 I I I I I I I I I I I I I I VZIZ G , I I I I I I I I I I F I I E TH H98-2 - p 750 SQ. FT (750/(5')) X 0.58(RF) (3.0' GRAVEL) = 87 FT, TRENCH USE 2 TRENCHES 43,5'(L) X 5'(W) EX Total depth of system is 4.0' jw N distribution pipe is 3.0' , K D le1 Iu N REQUIRED, INSULATE TANK IF <4' COVER. 2. INSULATE TRENCHES WITH 2' HD Im I 3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK, 4. ADDITIONAL FILL WILL BE ADDED Iv I MIN, 3' COVER IF REQUIRED. 5. CONTRACTOR TO EXCAVATE TANK I� I PREPARED F❑R1 BONNIE KING I� I KING REAL ESTATE Scale: 1'= 100' 24322 REESE RD, I I Iv I CHUGIAK, AK 99567 SHEET 1/2 FIELD BOOKS W '�1 1 F,\ � I' I y ENGINEERING 1E ��SSS�� VVV �:� BOUNDARY: TNH DRAWN: KMD I I Id I STAKING: TNH CHECKED: KMD 2 :9-53) I� I I• I 40,030 SF m I I �ZZi I 1 I I I I TH � PROPOSED RESERVE El I I I I I I I TH H98-2 - p I I I I I I I I I I I I I I I I I I I I NO PUBLIC WELLS WITHIN 200' OF PROPOSED SYSTEM. NO PRIVATE WELLS WITHIN 200' OF PROPOSED SYSTEM EXCEPT AS NOTED. NO SEPTIC SYSTEMS WITHIN 200' OF PROPOSED WELL EXCEPT AS NOTED. ,:ft 7'41-Nk\ *TH* /� / IKENNETH M. FUS I #41k, W tl % ti�G~�� RQFESSI01AD ``_t d PPT E SE PTJC FDOSTING SEPTIC 1000 GAL, S,T� SYSTEM (95-123) 1A 2A 1250 GAL. S.T. O D 30 2 i SE C 98-. sou J p FC I J , SP IT TER .IW� C PROPOSED WEU.I Y 'flROPOSED PRIMAR SYSTEM 01 Q 0,145.16 SF pT" _ LOT 3 4 BDRM _-'mow T. SFD 10' Utl ------------------- ------------------- 0 31 1 3 SEPTIC SEPTIC RACE DR, SEPTIC 35 DESIGN DETAILS 3 BDRM X 150 GPD = 450 GPD 450 GPD/0,6 GPD PER SQ, FT. = 750 SQ. FT (750/(5')) X 0.58(RF) (3.0' GRAVEL) = 87 FT, TRENCH USE 2 TRENCHES 43,5'(L) X 5'(W) X 3'(D) Total depth of system is 4.0' from original grade. Total depth of gravel below distribution pipe is 3.0' , NOTES: 1. USE 1000 GALLON SEPTIC TANK, IF REQUIRED, INSULATE TANK IF <4' COVER. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM.. 3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK, 4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN, 3' COVER IF REQUIRED. 5. CONTRACTOR TO EXCAVATE TANK AND VERIFY INTEGRITY, PREPARED F❑R1 BONNIE KING KING REAL ESTATE Scale: 1'= 100' 24322 REESE RD, CHUGIAK, AK 99567 SHEET 1/2 FIELD BOOKS COMPUTED: '�1 1 F,\ � I' I y ENGINEERING 1E ��SSS�� VVV �:� BOUNDARY: TNH DRAWN: KMD STAKING: TNH CHECKED: KMD 20441 PTARMIGAN BLVD. ASBUILT: DATE: EAGLE RIVER, AK 99577-8736 TNH 9/2/98 DWG. PILE: GRID: N W1561 ACAD FILE: 98108.DWG 1 J011 N° 98108 (907)696-6111/FAX (907)696-8111 WASTEWATER DISP❑SAL SYSTEM DETAILS BENBECCA S/D, LOT 1A, BLOCK 1 r 7 xc'07 C❑ C❑ ED �R DE o MT ; F LO MT T O SPL �T An1E `ter E 1000 GAL, SIT, i �� OF AL4 * 9 TH* KENNETH M. FUS / CE -71 t\ d PftFESSIC�AS, / 0 0 0I SEPTIC PREPARED FOR: BONNIE KING KING REAL ESTATE 24322 REESE RD, CHUGIAK, AK 99567 FIELD BOOKS COMPUTED: BOUNDARY: TNH DRAWN: KMD STAKING: TNH CHECKED: KMD ASBUILL TNH DATE: 9/2/ DWG. FILE: GRID: NW155E ACAD FILE: 98108.DWG IOB No.: 98108 EXISTING SEPTI SYSTEM Scale: 1'= 20' SHEET 2/2 HID ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 OF 14♦ 11 1 J ��M11 J F.NG[NLERING ` � ��•'• ' # 49M 0 20441 PTARMIGAN BLVD. ..... .... ...........................% EAGLE RIVER, AK 99577-8736go ............ ........... ...... 0 ♦ :KENNETH M. D S. Ar % CE 11 i SOILS LOG -PERCOLATION TEST ;;/1 '•F': 1,�nf L_✓1�__-- --- Date Performed: Performed for: U //__ // p Legal Description: Bcln CCCG,, 4_�, TEST HOLE # !8 — Depth (Feet) or leovtma 7` 1- y 2- 3- 4- 5- 6- 7- 8- -3- 4-5-6-s- 4 men s 9- 10- 11- 12- 0-11-12- 13- 14- 15- 16- 17- 18- 19- 20- 13- 14- 15- 16- 17- 18- 19- 20- Comments Comments SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Ground water encountered?__A/0 What depth? Depth to water after monitoring? _ Date __i=zLe Reading Date Gross Time Net Time Depth to Water Net Drop of'N rr (O !� z // M nC_ Percolation Rate to (min/in) Perc Hole Diameter_ Test Run Between "7 feet and �5 feet I, Kenneth M. DUffUS, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES Address FROM TO SEPTIC ABSORPTION WELL TANK FIELD F.O. Lz YrAw=51I WELL 1 I t Phone(s) Permit No. No. of Bedrooms loP�B - 22'I l0 0f30?11%L 3 LEGAL DESCRIPTION LOT LINE T + S Lot i Efock-___1 Subdivision/ ti10 ( 1r -I t 1 j Township, Range, Section FOUNDATION 1.3 /- ssAA AS -BUILT DIAGRAM (Show location o1 well, septic system, property lines, foundation, driveway, water bodies, etc.) TANKS SEPTIC ❑ HOLDING Manufacturer I Caoacitvin callous Gll)LL1�iD9� . REMARKS: c S`& S ENGINEERIN 17034 640 glumcJ Municipal Pite-gDideFTl•6c1 Health Department Approval: Y 72-013 (,3/85) ------ r" q-1 • % r Inspections Perto ed by. Date. I �.15� ea .. C n nc-:, I No. 111 ce that this inspection was performed according to all Date: 114 I bsrt A. ghwkw Nw 16.57.6 Total absorption area-._„ - Distance between lines TYPE OF SYSTEM i o _ ❑ TRENCH ❑ BED W. DRAIN ❑ OTHER ' Number of lines Depth to pipe bottom from - original grade "j- FT Total depth from original grade (RO'< F Fill added above original grade FT Gravel depth beneam pipe 2 rS F JIiii �3v3q' Gravel length - I�`1'FT Gravel width �F Gll)LL1�iD9� . REMARKS: c S`& S ENGINEERIN 17034 640 glumcJ Municipal Pite-gDideFTl•6c1 Health Department Approval: Y 72-013 (,3/85) ------ r" q-1 • % r Inspections Perto ed by. Date. I �.15� ea .. C n nc-:, I No. 111 ce that this inspection was performed according to all Date: 114 I bsrt A. ghwkw Nw 16.57.6 Total absorption area-._„ - Distance between lines 8 f2SO FT i o Number of lines Soil rating Pipe material Z SOFT JIiii �3v3q' InstallerDate Installed &-dss8 So. 1�oP-1� IL' IS �t38 WELLS PRIVATE ❑ ,OTHER ildentifv) Classification (A,B,C) Total Depth Cased to x1I FT Installel- - -I Date Installed: Gll)LL1�iD9� . REMARKS: c S`& S ENGINEERIN 17034 640 glumcJ Municipal Pite-gDideFTl•6c1 Health Department Approval: Y 72-013 (,3/85) ------ r" q-1 • % r Inspections Perto ed by. Date. I �.15� ea .. C n nc-:, I No. 111 ce that this inspection was performed according to all Date: 114 I bsrt A. ghwkw Nw 16.57.6 ~ MUNIClPHLITY OF ANCHORAGE Department of Health & Human Services 825 LStreet, Anchorage, A]aska 99501 343-4 iFRe svw*4j OM - SITE SE.ER & WELL PERMIT Permit Number: 880.242 Date Issued: 10/25/88 Engineer Designed Ow:er Name: BONNIE KING Day Phone: PO BOX 770567 688-2276 EAGLE RIVER, AK 99577 Parcel Id: 451-052-37 Lot Legal: Subdivision: - Lot: - Block: - .Section.3/Township� '15N Range: 1W �� u�.��-u* �e, Lot Size 2,5 A (sq~[t" or acres) Max Bedrooms: This Permit: 3 Total Capacity: 3 GLyTIC TANK: Minimum total septic tank capacity." 1,000 gallons" Each septic- tank eptictank must have at least -2 compartments" Depth to top of septic tank(s) < 4.0 feet requires insulation over tank(s)" WELL: Log must be submitted to Municipality of Anchorage Department of Health and Human Services within 30 days of well completion" INS101.1. PER ENGINEERS ATTACHED DESIGN. NOTIFY DHHS PRIOR TO EACM 1NJ1-1ECTION 1.3,e THE ENGINEER, [HIG PERMIT IS ISSUED FOR THE PRUPO�ED 3 BEDROOM SINGLE FAMILY DWELLING AND EXPIRES ON l C2RTIFY |HAT: _1, i am Familiar with the requirements for on-site sewers and wells as set �orth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. l will install the system in accordance with All MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back ��stances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot" 41, I understand that this permit is valid for a maximum of 3 bedrooms, I also understd th t thecapacity f th total stem is 3 bedrooms and any enI r g e additional permit. SignedDATE: .A (Owner) BONNIE KING IssuedBy: DATE: 0 Y U V it� . 'Z , AV"ry 1 3 I 3lV�S .. e Municipality of Anchorage • •• °'°°°�• DEPARTMENT OF HEALTH & HUMAN SERVICES ................r 825 "L" Street, Anchorage, Alaska 99502-0650 ttiUart A. Ni°'f0t % SOILS LOG — PERCOLATION TEST NO 11,10-6 r'< PERFORMED FOR:firr,, pC.�'1//iN V�t�i -I>�- DATE PERFORMED: l n (Z—�8 LEGAL DESCRIPTION:_VlI61/-1 0( �i0�%( L-o(Z Township Range Section: PTA SLOPE SITE LAN (FLET1 �i�..�i %�Ci - ITT—T-I 1 2- 3- 4- 6 3 4 6 s of 9 Wil. 10 v' / j b 11 �� 12- 13- 14- 15- 16- 17 21314151617 18 19 20 G COMMENTS — WAS GROUND WAl ENCOUNTERED? IF YES, AT WHAT �•-�,� DEPTH? Depth Montt to Waler Ajlar _ Manitorinp7�jJ�i/_0ale: Lo—1—0 11 1i Reading Date Gross Time Net Time Depth to Water Net Drop A- o ( _ g m • �« N PERCOLATION RATE _n__ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN Z5__ FTAND tO FT S & S ENGINetKIN%s PERFORMED BY: CC1��7,,o''+QQ•pptEa�glseeoti�ver® yy00P7 R7oind nr I CERTIFY THAT T IS TET WAS PERFORMED IN ACCORDANCE WrgTRALC'SI7STe1*MU0127AL GUIDELIN M EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE AiL • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Sox 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING1 Parcel I.D. # 051-052-63 HAA # . ' 9 S 1. GENERAL INFORMATION Complete legal description Benbecca S/D, B1, L I A Location (site address or directior'tJ322 Reese Raod, Chugiak, AK 99567 Property owner Bonnie King Day phone 688-2276 Mailing address24399 Reese Road, Chilg•iak., AK 99567 Lending agencyResidential Mortgage Day phone 694-8817 Mailing address Eagle River Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. 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. 4. TYPE OF WASTEWATER DISPOSAL: - Individual on-site Holding tank ❑ Community on-site ❑ Public sewer ❑ NOTE: If community wastewater system, provide written confirmation from Stat6ADEC 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 696-6111 Address 20441 Ptarmigan Blvd., Eagle River, AK 99577 Engineer's signature 6. DHHS SIGNATURE V Approved for Disapproved. T_H9E E bedrooms. Conditional approval for Additional Comments By: aUTM Date G �� q2 OF A 4 �A io• •ir'+Ha...•• r••• r.•s'' t�_w,:;° Kenneth A. t)u x' e C 7116 Fays.'�� bedrooms, with the following stipulations: Date ;2, -eZ' % 2 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 DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. -The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 RECEIVEU ,E Municipality of Anchorage JUN 17 1999 DEPARTMENT OF HEALTH & HUMAN SERVIQWpAury OfANCFin Environmental Services Division vwiRONAENTALsuVj'�E46DIV 825 L Street, Room 502 • Anchorage, Alaska 99501 e (907) 343-4744 Health Authority Approval Checklist Legal Description: Benbecca S/D, B1, L 1 A Parcel I.D.: 051-052-63 A. WELL DATA Well type Ind. If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed UW Total depth 11j31C Cased to 40! }- Casing height (above ground) 24" Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y FROM WELL LOG Date of test Static water level Well production g.p.m. WATER SAMPLE RESULTS: 0 Coliform Date of. sample: 6/11/99 B. SEPTIC/HOLDING TANK DATA AT INSPECTION 6/11/99 165' 3.0+ g.p.m. 5 0 Nitrate Other bacteria Collected by: KND Eng. (Brent) Date installed 9/28/98 Tank size 1250 Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression (Y/N) N High water alarm (Y/N) Y Date of Pumping 9/28/98 Pumper JR's C. ABSORPTION FIELD DATA Date installed 9/28/98 Soil rating (g.p.d./f? or ft2/bdrm) 6 gPd System type S Trench Length 109' Width 5' Gravel thickness below pipe 3.25' Total depth 4.2' Effective absorption area 750 SF Monitoring Tube present (Y/N) Y Depression over field (Y/N) N Date of adequacy test New Results (Pass/Fail) P For 3' bedrooms Fluid depth in absorption field before test (in.); N/A Immediately afterN/A gal. water added (in.): N/A Fluid depth N/A (ins) Minutes later: N/A Absorption rate = N/A a.p.d. Peroxide treatment (past 12 months) (Y/N) N If yes, give date N/A 72-026 (Rev. 3/96)" D. LIFT STATION Date installed 9/28/96 Size in gallons 1250 Manhole/Access (Y/N) Y "Pump on" level at" 44" "Pump off",,level,at* 42" High water alarm level at" 48 "Datum Bottom Cycles tested .5 E. SEPARATION DISTANCES _ SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 100'+ On adjacent lots 1001+ Absorption field on lot 100,+ On adjacent lots 100,+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Lift station 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 5'+ Property line 10'+ Absorption field _10'+ Water main/service line- 10'+ Surface water/drainage 100'+ Wells on adjacentlots :100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line `10'+ Building foundation 10'+ Water main/serv�e line aoUi, _... Surface water 100'"+ Driveway, parking/vehicle storage area, 10'+. Curtain drain No known Wells on adjacent lots I M, F ENGINEER'S CERTIFICATION A, r 1 7. I certify that 1 have determined thru field inspections and review of Municipal rec i�$ie ftr l ms are in conformance with MOA HAA guidelines in effect on this date. ,�.�P •.••'��`�'";" a or Signature * •' . Kenneth M. Du s P.E. �.. Engineers Name �t : Keni%$h $"f Date 6/16/99 �® � % CE 7116 •.•'?t/ HAA Fee $ Waiver Fee $ 7--- %' Date of Payment Date of Payment - 74 ey) 3 Receipt Number 7 tJ _ Receipt Number -= -, 72-026 (Rev. 3/96)* ; ; JUN -17-99 08;23 FROM -CTE ENVIRONMENTAL 5815301 T-889 P.02/03 F-180 CT&E Environmental Services Inc. ,ZAL - CUE Ref.# Client Name Project Namely Client Sample !D Matrix Ordered By PWSfD Parameter Tac$l Coliform Nitrate -N 992639001 KND Fug4=dng Beubcccu SID 81 LIA Benbecca SID 81 L1A Drinking Water 0 Client P()# Noted Date/Time 06/16/99 14:23 Collected Date/Time 06/11/99 09:30 Received Date/Time 06/11/99 16:55 Technical Director: Stephen C. Ede Released By, AtlowaOte Prep Analysis Reaulcs PRL units Method limits Date pace (nit 0 oow00mL 5M18 92226 06/11/99 KAP 0.500 u 0.500 mg/L EPA 300.0 10 max 06/11/99 06/11/99 SCL