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T12N R3W SEC 33 LT 167
_R ANCHORAGE AREA BOR, Department of Environmental QusJity 3330 C Stree'~ Anchorage, Alaska ggs03 ]NSP[,CI'JC)N R~PoRT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ._/'~&7- 12._O_b'',SO~ _ ~,~,~ ~:~ ~-O. %~ ~q--~ ~ q_ ~,O~ LOCATION ~h~'f C~ ~ ~0~ LEGAL DESCRIPTION j $C SEPTIC TANK: DISTANCE I oO FROM WELl_ _ INSIDE LENGTH ~.4¢L-d~'E) RA I N FIELD: MANUFACTURER'S;~':~¥ MATERIAL NUMBER OF 'X'-- COMPARTMENTS '""'"""-"---~ t IQUID CAPACITY J O4)~)GALLONS. __INSIDE WIDTH / __ LIQUID DEPTH 'FOTAL LENGT j DISTANCE FROiVl WELL LO© 11~ FOUNDATION 3"7 _NEAREST LOT LINE '~.O '~'- _OF LINES g~.,,~,.,,~/~ F', TRENCH ~ IN. TOTAL EFFECTIVE ABSORPFION AREA / 0 ~)C) " ~Q, FT.' LENGTH OF EACH LINE ~ q: ' DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISII GRADE ~ MATERIAL BENEATH 'FIL. E~%O IN. ABOVE TILE ~ IN. BUlL.DING ~O ( NEAREST ~O~ NEAREST FOUNDATION~. , LOT LINE ~ SEWER LINE~ ~_, CESSPOOl_ / OTHER SOURCES DEPTH SEPTIC , ( SEEPAGE TANK}0~:f- SYSTEM DISTANCE FROM: APPROVED _DISAPPROVED-- REMARKS SEWER LINE DEPTII: DIAGRAM OF SYSTEM , D AT E'~.I ~"~ (~.'"~ App R O V E~ May 26, 1977 R&M No. 751167 Mr. Paul Jackson The Drilling Co., Inc. P ~. Box 8718 Anchorage, Alaska 99508 Re: Soils Investigation for Sanitary Sewer System, Judd D. Robinson Property B.L.M. Lot 167, Section 33, T12N R3W SM., Anchorage, Alaska Dear Mr. Jackson: At your request of May 24, 1977, we conducted a subsurface soils investi- gation at the proposed location of the sanitary sewer system on the subject lot. The investigation complied with those procedures required by the Municipality of Anchorage, Department of Health and Environmental Protection. This investigation, which was accomplished on May 24, 1977, consisted of a test hole drilled to a depth of 20 feet below the existing ground surface. The location of the test hole is shown in attached Drawing A-01. Drilling took place with a rotary drill riglusing continuous- flight, solid-stem auger with an outside diameter ~f 6 inches. Samples were taken at the depths shown on the soils log in. attached Drawing A-01. These will be held in storage at our lab for approximately six months. In addition, all material brought to the surface by the augers was continuously monitored by an experienced engineering geologist. The topography at the drilling site is generally horizontal. At the time of the investigation the site had been stripped. The top of the test hole was located at original ground surface. The soils encountered in the bore hole are shown in the test hole log in Drawing A-01. Groundwater was not encountered in %he test hole. Bedrock was not encountered. Subsu~~lons may vary in other ~o- e' ot. - A percolation test was performed within the bore hole at the depth shown in the at~ach~d Table 1. All depths were measuredi from the top of the hole. The data in Table 1 show average infiltration from the depths indicated to the bottom of the hole. The measuredlpercolation rate was 4.4 minutes per inch. May 26, 197'7 The Drilling Co., Inc. Page -2.~ We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this letter. Very truly yours, R & M CONSULTANTS, INC. Stephanie M. Hoag Staff Geologist Jim McCaslin Brown, Ph.D. Head, Earth Science Department SMH:JMB:gld Attachments: Drawings A-01, B-01, B-02, B-03, T~ble 1 xc: Dept. of Health & Environmental Protection PERCOLATION TEST JUDD ROBINSON R & M No. 751167 MAY 25, 1977 TIME 1:30 1:31 1:32 1:33 1:34 1:35 1:36 1:37 1:38 1:39 1:40 1:45 1:50 1:55 2:00 2:10 2:20 2:30 ELAPSED TIME 0 1 2 3 4 5 6 7 8 9 10 15 20 25 30 40 50 60 INCHES 48 48.5 5O 50.5 51 51.25 51.5 52 52.5 52.75 53 54 56 56.5 57 59 6O 61.5 DROP IN INCHES 0 ¼ ¼ ¼ ¼ 1 2 2 1 1% 134 Inch Total Drop 4.4 ~nutes/Inch LOCATION SKETCH B.L.M. Lot 167, Section 33, T12N R3WS.M. Driveway ..~]'5'f Cabin Not To Scale. Distances shown are approximate and have not bgen-~easured by surveying methods. DATE: 5-25-77 SCALE:see above LOG OF TEST NOLE NO. 1 Scale: 1"=3' A A A A ORGANIC ~TERIAL (A) SILTY SAND W~ TRACE GRAVEL (SM) ~ine, Brown, Slightly Moist, Medium Dense 2 SAND W/SO~ SILT, SOME GRAVEL (SM) Brown, Slightly Moist, Medium Dense 5.5I 17.0' GRAVEL AND COBBLES -W~T~0~--aa~D (GW) 18.0' SANDY GRAVEL W/TRACE SILT 4 No Water'Table Encountered This logldepicts subsurface soils observed!within the test hole at location shown. See Drawings B-01 and B-02 for explanation of syn~ols. ~0.0'T.D. LOCATION SKETCH AND ~ ~,n TEST HOLE LOG ,, PROJ. NO JUDD ROBINSON ItOWG. NO. 75]167 A-01 Mr. Paul Jackson ~he Drilling Co., Inc. ~ P.Oo Box 8'718 ' Anchorage, Alaska 99508, - ~-~ ' Re: Soils Investigation for Sanitary Sewer System, ~ ''' = '" ' - Judd D. Rober~son Property BLM I~t 167,'Section'33 T12N R3W SM, Anchorage, Alaska ~ - .-,-., ~ Dear Mr. Jackson~ ~ At your request on May 24, 1977, we conducted a's~bsurfaee-soils inVesti- gation on the s~ject lot. That i ' ' nvest ~gation~ letter ko you of May 24. - In ~hat letter we stated that the percolatiofi rate of 4.4 minutes pe~ inck reflects average infiltration from 4 feet to th~ bOttO~.of the hole. We understand there is some question concerning' the percolatio~ test, since the test hole log' shows SM mauerial ~o a depth-,ofl7 feet, wit]] gravel present between 1.7 and 20 feet. Before the percolation test was done, ~e hole was backfilled with ~%e SM m~terial which ]lad been brought up by the. auger. It. was backfilled to a depth of approximately 16 feet. The percoiation rate of 4.4 s ~f e erage-infil- tration between 4 feet and 16 feet, not to the bottonl of the hole as erroneously indicated in our previous letter.' ~. We apologize for our m~stake and the ~nconvenience it may have caused. - . If you have any further questions please do net hesitate to contact us ~ again. ~... . ~tep?_l~i~ Hoag ' Staff Geologist SH: JMB/sl .... -...~/..,,. ,~.~ " ,, ,.. . ',.. ~i~ McCaslin Brown, ' PhD. ' Head, 'Earth Science Dept. - / ,iM-W DRILLING, Well Owner__ Location DRILLING LOG IN (',. ( Y Use of Well (address of: Township, Range, Section, if known; or istance main road Size of casing Static water level Screen ( Depth of Hole ft. (~8~a) ); Perforated ( "" feet Cased to~[' ' feet (below) land surface. Finish of well (check one ). Describe screen or perforation Well pumping test at i. _gallons per (hour) of drawdown from static level. open end ( ); (minute) for hours with Date of completion WELL LOG Depth in feet from ground surface Give details of formations penetrated, sizelof material, color and hardness ft. ? TO_ TO__ TO TO ~TO TO TO TO TO TO TO ~TO TO _TO .TO 2 -- STAT E MUNICIPALITY OF ANCHORAGE ,f~ DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Serv'ces On-Site Services Section P.O. Box 196650 Anchorage. Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # ~'} / C~' ~g~- (")q HAAt} 1, GENERAL INFORMATION Complete legal description _ Location (site address or directions) ','~ ~:~ Property owner /V~/~' ~'l'/']¢/~-,~Jd4(-/ /~,/~g)~r'.~ _,~(2;2- Day phone Mailing address ~_.,~rt~.L~ O-~Y'azL~'agY~, ~)O~_-x:>'k \~Lb~3LO% ~'~'hC,~f", Lending agency Day phone Mailing address Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAl.: Individual on-site NOTE: State ADEC attest- Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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 -~--? ~'_~) ~-~-¢-'%/¢~'2/'~'¢¢'¢(/~'~,;?~;c' Phone Address ~/-/~ ¢~'[~/'~/~'/~[' ~}~.' ,~'~ Engineer's signatur ~ A ' · ¢ / DHHS SIGNATURE Disapproved. Conditional approval for bedrooms, bedrooms, with the stipulations: Additional Comments Date_ //- 9.. ¢_ ~ .~ The Municipality of Anchorage Department of Health and Human Services (DFIHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DH HS does this as a COd rtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state ~'equirements. Em ployees of DH PIS 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. 724725 (Rev. 1/91) 8ack MOAI~21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST A. Well Data Well type Log present (Y/N) Y / Total depth Sanitary seal (Y/N) FROM WELL LOG Dateoftest '~ ./~./ /','~? Static water level Well flow Pump levelt :l"~iL) ~ '¢'~ If A, B, or C, attach ADEC letter. ADEC water system number Date completed 7/'Z~//'7 7 Driller l~-- Cased to ~- ,~-~- 2 / Casing height Wires properly protected (Y/N) ~;/ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot / /['0 (- Absorption field on lot [/- (~ r Public sewer main /~'/.//~ Sewer service line ~ r<r~ / g.p.m. AT INSPECTION ~.~.~.~ r.NVI[,,OF!MEN I/\L SERx" ICES DIVISION '~ ~ g.,p:m. ~ 199~ t ECEIVF. D ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform (¢~ Nitrate Dateofsample: / ] /('"~/" Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed 7/~--- 7/7 ? Cleanouts (Y/N) / Foundation cieanout (Y/N) High water alarm (Y/N) ~'J Date of pumping /~ ~' /~//' ~h Tank size /0~'h~ Compartments ~--, y _Depression (Y/N) Al Alarm tes!ed (Y/N) umper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot l / (.~ I On adjacent lots '~/~;~): To property line _~ ~2._, £ Absor?tion field / ~--- / Surface water/drainage [~2 ~ 72-026 (3/93)* Front Foundation Water main/service line CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons ~ Manhole/Acc~,ss-(-V/N)--~ Vent (Y/N) "Pump on" level at ~~~mp off" Level at High water alarm level ~ Cycles tested Meets MOA eI~Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D, ABSORPTION FIELD DATA Date installed '7/~-~ ~/~ Length ~).~¢ Total absorption area Date of adequacy test Width Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/Ft2) / ,]~--~-~ ]~ ~-'2// Gravel thickness /(~ / Cleanout present (Y/N) Results (pass/fail) System type ~/~/0(] Total depth Depression over field (Y/N) ~'? ~,> .~']~ for ~ Bedrooms After test ~ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot / /(~ /~ Onadjacentlots -<~ /0(~¢) : Property fine To building foundation ~ ~-- (' To existing or abandoned system on lot On adjacent lots ~:E~ Cutbank ~ ¢/~ ~ Water main/se~ice line Sudace water / ~ ~ (r ¢) Driveway, parking/vehicle storage area ~¢ Cudain drain ~ ~ ~ E, ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines ia.¢~bt dh' the. date of this inspection. Signature H~ Fee $ ~00 ~ Waiver Fee $ Date of Payment //- '~ ~ ~)¢ Date of Payment Receipt Number ¢~¢ ;-~ (~¢*) Receipt Number 72-026 (3/93)* Back NObel HERN TESTING 3930 INDUSTRIAL AVENUE LABORATORIES, FAIRBANKS, ALASKA 99701 ANCHORAGE, ALASKA 99503 INC. 907-456 3116 907 27? 8378 James Sizemore 640 Switzerland Drive Anchorage AK 99516 Attn: - Report Date: 11/i6/93 Date Arrived: 11/09/93 Date Sampled: 11/08/93 Time Sampled: 1045 Collected By: JS MDL = Method Detection Limit Our Lab #: Location/Project: Your Sample ID: Sample Matrix: Comments: F130722 Lo7 167 533 T12 NR3W Water * Flag Definitions B = Below Regulatory Min. H = Above Regulatory Max. Date Date Method Parameter Units Results * MDL Prepared Analyzed EPA 300.0 Nitrate-N mg/1 <MDL 0.03 11/12/93 NO THEf N 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA '39701 (907) 456 3119 · FAX 456 3125 2505 FAIRBANKS SFREET ANCHORAGE, ALASKA 99503 (907) 2/7 8378, FAX 274 9645 DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORM BACTERIA J. Sizmore 6410 Switzerland Dr. Anchorage, AK 99516 Public Water System I.D.~ Date Received: Date Analyzed: Date Reported: Next Sample Due: 11/08/93 Time Received: 11:00 11/09/93 Time Analyzed: 16:30 11/11/93 Time Reported: 15:15 Comments: S = U = POS = ND = Collected by: JS TNTC = Sample Type: CG = Routine HSM = Method of Analysis: Membrane Filtration Comments: SA = Old = Satisfactory Unsatisfactory Positive Test Result None Detected Too Numerous To Count (>200 Colonies) Confluent Growth Heavy Sediment Masking, Results May Not Be Reliable Sample Age >30 Hours But <48 Hours, Results May Not Be Reliable Sample Age >48 Hours, Too Old For Analysis Resample Required NoTest * # Colonies/lO0 mi ** # Colonies/mi Sample Sample Total* Fecal* Other* HPC** Location Date Time Lab# Coliform Coliform Bacteria Result Comments 1 Lot167 533 T12NR3W 11/08/93 10:45 AB2746 0 NT 0 NT S 3612 Sandy Ct.