HomeMy WebLinkAboutHUNDRED HILLS 1ST ADDITION BLK 5 LT 7 · Municipality of Anchorage ?:,.~ _~1 of 3 .. '- DEPARTMENT OF HEALTH AND RUMAN 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: ,':~V'J c::l'~-'OO~'~:) PIDNumber: O'7~- Z ~I '-O'Z. Name:~'"tt~-4~, ~'~e~'l~''Ell'' Wastewater System: ~New D Upgrade ~,m: ~O ~:~O ~ ~s~-~, ABSORPTION FIELD ~o.~: ~¢-~113 · No, o~droo~.: ~De'epTrench D Shallow Trench ~Bed UMound DOlher LEGAl. DESCRIPTI O N Soil Rating: Tolal Deplb from odginal grado: Lot: ~ BIock;~ ~v~Subdtv~l°n:~i~b~ ~[~ ~ Oeplh to pip,j, bollom~ ~lr°m~,°riginal~ ~grads: FL Gr~vel depth~benealh pipe Ft. I /~ Fill added abova origin¢ grade: Gravel lenglh: owm l. ..m m,o.w -,-_ Gravel widlh~ Number o[ linss: [ Disl~nc~tween lines: WELL: ~New D Upgrade ~ T~/ ~. , [___~r* Fi. Classification (Private. A,B,C); Tolal Depth: Cased To: Tolal absorplion area: Pips m~lerial: Date~rilled: Sla,,c Water Lc,el'. installer'. IPump Set al: Casing Helght Above Ground: ~leld: ~ GPM ~ o~ %~ Fi. FL > :~, TANK SEPARATION DISTANCES ~se¢~o ~ Ho~in~ ~ S.T.~.~. To 8epll~ Absorption Lilt Holding ~¢/Pdvale Manufacturer: Capacily in gallons: From " Tank Field Slallon Tank Sewerglnes ~ ' ~' / / Malerial: Number ol Comparlments: su,,Oew.t.r ~/~ > ~ LIFT STATION Line Drain (, ,, ~ ... Remarks: 5o'1~g ~e~/~ me ~ BENCH MARK ' I EiqGINEER'S SEAL Inspections performed by: 0~ ~$ Dates: 1st ~/~ ' "='"' ' Department of Healt~and Human ~i~s approval ' Reviewed and approved by: 7~ate://~2~-F~ 72-013 (Roy. 0101) MOA 25 Permit No, ~vac~~ Page of "'~ -..~ Municipality of Anchorage DEp~-P~MENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION · P.O. Box 196650 · AncXho~age, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disp'osx,al System and/or Well Inspection RePort Legal Description: .\ \ 72-013 A (1/93) · Permit No. otS"OoG 8 ~ ' Page Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN ~dEFIVICES ENVIRONMENTAL SERVICES DIVISION P.O, Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LegalDescription: t.o~-'-/j ¢.y--~;, t4~Jo~ bHcc~ s/.~> PIDNo,: CIo -re CIo ' ~ 4"4, ~uC. ~¢~pE:. L~'~O L~'JZL.~ GF,~oP'~ 72,1113 A (1/93) * 81/29/1998 21:55 9876942141 DIVERSE GRAPHICS PAGE ( erlffie Irilltng SULLIVAN WATER WELLS P,O, BOX §70272, CHUGIAK, ALASKA 90567 · TELEPHONE ^O0~ESS r~ ~? .':70 /~_t~=-;.D__~ s'rw~(' ,~x'~;~., o~ w~n~ ~;r . / 0 0 ......................... DRAW DOWN FT .... oErMIT NUMBER KInl) OF cASJN('; _ .(~ O~ KIND OF FORMATION: F,o,,l,~ I..-le'. '°-f q?. F"--Z~(; '~ '~ c f.S .... _~.~ ~.'( From .... F L Fro~'__ Fl, From.__ Ft. I. ..... Ft. From ....... Fl. ~o __FI. Ft, lo .... Ft. __let Fl, , Fl. From ~__Ft. From .... Ft, to ..... From Fl, to ..... Fi, From ...... Fl, to__Fi From ............. FI. 1o..-- Ft. From~Ft, ~o.~Ft From Ft, to ..... Ft,_ From Ft, to ....... Ft From Ft, From ....... Ft, lo Ft ......... From ........ Ft, to__ FI From Fl. Io Ft, From .... FI. to .... Ft, From FL to Fl, __ From .__ From-- FI, to ......... Fl ..................... ............. MISCL, INFORMATION: FEB 22 1996 Municipal ty of Anchorage Dept, Health & Human Sam ees b)' DOC cO, SULLIVAN WATER P.O, BOX ~70~2, CHUQIAK, ALASKA 9955~ · TEL~PHON E ~B8-2759 Ended' ",!LIMBER _._Ft. to Ft. .Ft. h.L __.Fl ~ Ft. lo~Fl, Fl, Io ...... Fl. Ft. to ........ Ft .......................... ~l~'l, ~o_._ --FI, From .... From ~ Fl, to From .... Ft. ........ Fl, to Ft __ From__ Fl. h)-- __l;'l .... Fl, to Ft .......... Fl, lo_. Ft .... Fl, to Ft, · _Ft, to 'Ft"--"-- .... Fl, to ' Ft.:__ .__Fl, to Ft. ~ Frown .... Fl, (o From_____Ft. to .... 'Fl, From ~.m Fi'. to Mpp. icipalit¥ o~ AncBora~e From ..... Ft.to, D~t. i~'~umaaBervices From ..... Fl. lo ._Fl ......................... ):ORMATION; DRILLER'S NAME .~m .... DIVERSE GRAPHICS PAGE ~ HERED': c?'r;,:,: .T~qAT I HAVE..-RURVEYED THE - ' ' ......... '~'"~'~'~' DA~/ INDIOATED. ~T ~$ TH~ RE$~NSlBILI~ OF THE ~ TO DETERMINE THE ~I3TENOE OF ANY E~EMENT~, COVENANTS, OR RE~TRICTION~ WHI~ DO NOT ~PEAR ~ THE RE~D~ ~BDI- VISION P~T, UNDER NO CIRCUMSTANCES S~ ~Y DATA H~N BE USED FOR CON~T~U~ON ~ FENCE LINEg, OR FOR EgTABLISHINB ~ND- ~~ ARY LIN~. DEAWN~ PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AiND HUMAN SERVICES ~ P.O. BOX 196650, 825 "L" STREET, ROOM 502 ~ ANCHORAGE, ALASKA 99519-6650 ~73_0__~ 0N-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW950068 DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES OWNER NAME:MCGOUGH MICHAEL J & RHONDA L OWNER ADDRESS:9370 HILAND ROAD EAGLE RIVER, ALASKA 99577-9411 DATE ISSUED: 5/01/95 EXPIRATION DATE: 5/01/96 PARCEL ID:07828102 LEGAL DESCRIPTION: HUNDRED HILLS 1ST ADDITION BLK 5 LT 7 LOT SIZE: 106816 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE C~PTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343~4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ~pril 26, 1995 MunicS, pality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Servi¢:es Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Alaska Water & Wastewater Services "Preserving The Last Frontier" Ref: Septic System & Well for Lot 7, Bk 5, Hundred Hil. ls S/O To whom :bt may concern: Attached is the application, site plan, and design drawings for the sub~ect well & septic system. Comments are as follows: i. TRENCH DESIGN: As can be seen f rom reviewing the percolation best results, the soil "perked" faster than 1 minube/~noh at the location proposed for the sysgem. There ~as a ~rge pocket of coarse gravel in 'tH ~l, but it was surrounded by gravelly sandy soil. A sieve analysis '~OLllld the surrounding soil to be c:Lassified as SW. I did not net;ice any large pockets of coarse gravel in TH ~2. A sieve analysis of the soil classified it as SW-SH. Based upon ~his information, I am proposing bo forago the use of ~ sand fil~er, and use an application r~e of 1..2 gpd/f~2. S~.noe ~he proposed home will have 4 bedrooms, ~he total design ~low is 600 gpd. Based upon this, the minimum ameunt of absorption area is 500 ftz. The proposed trench is 27 Sect wide, 4 feel deep and 65 feet long, providing an absorption area of 520 f~2. A 1250 gallon septic bank ~ ~ 1. 1 be iesballed. 2.. GROUNDWATER: GroLIndwater was monit, ored 1t days a'l:ter the percolatien tests were done, and nc) water was encountered. Regardless, ib 5. s my intent. Lo monitor .the groundwat, er immediately prior to construct, ion, during the height of break-up. L~. SURFACE: WATER: The majority of Ehe sS.~.e was covered with snow during my site visi Es, bherefc]re, ib was not possible to verify bha. t there are no surface war. ers. Per the homeowner l;here is no surface waters wi[.hin 100 fee~.. Based upon l;he topography of the site and the porosity of Telephone: (907) 337-6179 · Fax: (907) 338-3246 · 8471 Brookridge Drive · Anchorage, Alaska 99504 ~.he soil I have no reason to ~;uspeot ~.here will surface waters within 100 feet of the proposed system. See the abtaohed photographs. Rega~-d]_ess, fever&fy this during oonsbruo'bion. be any septic I will 4. TOPOGRAPHY: Attached is a topographical survey_ There are no slopes gr'eater than 25~ wit:h.in 50 feet of the proposed septic.- sys'be~. All of the adjacent properties are undeveloped at this time. I am unaware of any negative impaots that this installation would ~mpose on future adjacent, wells, or septic syst~ms. If you have any question, please call me a 3~7-6!79. Si rice rel P.E., Owl-J~d/( ~nsu],tant McGuffl.WPS Lo'T' & D,K. '2oo' oF u P(:::~ I oo"I~ 'v,,, ~.~ .~,o. LoCA-q"tOr4 of::: C.b~.J:~,Q-OtaT.~' ~ PERFORMED FOR= LEGAL DESCRIPTION: 1' 'Municipality of Anchorage · '/'~DEPAR,T,,MENT.OF HEALTH & HUMAN $ERVIOES · 825 ' L Street, Anchorage, Alaska 9950.)-0650 sOiLS LOG -- PERCOLATION ,rEST WAS GROUND WATER · i~.:..N, CGUNTER ED ? IF YES, AT WHAT ' ~t DEPTH? ~ Deplh b Waler Alter N.I ,~- i~onllorlng? · Dale: SITE pLAN / Date PERCOLATION RATE , TEST RUN BETWEEN 8 roil line Net Time {minutesJlnch) PERC HOLE DIAMETER ~3 if ,ER"ORM'~D'.OR= LEGAL DESCRIPTION: £ 14 16 17 .18 19 2O ·Municipality of Anchorage ' WAS GROUND WATER · · . I~;.N, CDUNTERED? ,,, DATE PERFORI~. tlon: h4 SITE .PLAN / ;O'MMENTS IF YES, AT WHAT DEPTH? 0eplh to'Water Alter H [ ]~ /~onllorlnl]? Reading I, ' (~rol$ I Net Date ~'lm. ' Time PERCOLATION RATE ~'".___L TESTRUN BETWEEN -- ~ Water ' Drop _. {minule~/Inch) PERC HOLE DIAMETER _ , . FT AND ~ ~' ,, FT. ' ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIOEL NES IN EFFECT ON TtlS [~ATE, 7'2.ooo (nov. .. CERTIFY THAT THIS TES~, WAS PERFORMED IN PROJECT NAME: PROJECT NO,: 5186 CLIENT: AWWS BORE~OLE/LOCATION: TH,I SAMPLE NO,: 95-S-1 DEPTH: GRAIN SIZE ANALYSIS (ASTM D422) LOT 7, BLIP[, HUNDRED HILLS S/D DATE TESTED: 4/21/9§ TESTED BY: TS REVIEWED BY: RJPC ~ DESCRIPTION: Well Phone: (907} 561-4085 EBA Engineering Inc. 907 East DowllnE Road~ Suite 27~ AnchoraEet Alaska 99518 ,. SIEVE ANALYSIS TEST SIEVE DIAMETER TOTAL % SIZE (mm) PASSING 6" 152.4 4" 100 3" 76.2 2" 50.8 100 1" 28.4 95 3/4" 19 92 1/2" 12.7 87 3/8" 9.5 84 # 4 4,75 71 #10 2 49 # 20 0.85 26 # 40 0.425 13 # 60 0.25 8 #100 0.15 6 #200 0.075 4.8 HYDROMETER TEST ELAPSED DIAMETER TOTAL % TIME (mm} PASSING 0 0.5 1 2 4 8 16 $0 60 250 1440 % GRAVEL: % SAND: % SILT/OLAY: D60- D30- O10- Cc=, USO: FC: % .02 mm Fax: (907} 561-7071 28,9 66.3 4,8 3,24 1,06 O,31 10,7 .1,1 6.7% SW 100.0 90.0 80.0 70.0 60.0 %RNERBY WEK~HT .60.0 40.0 30.0 20.0 10.0 I00 lO GRAVEL #4 GRAIN SIZE DISTRIBUTION U.S. STANDARD SIEVE OPENING8 #10 #20 #40 #$0 #100 #200 1 0.1 0.01 GRAIN SIZE IN MILLIMETERE R~Nn L. 81LT AND CLAY 0.001 DATE PRINTED 4/24/95 REVS.'93 PROJECT NAME: PROJECT NO.: CLIEN.T: BOREHOLE/LOCATION: SAMPLE NO.: DEPTH: GRAIN SIZE ANALYSIS (ASTM D422) LOT 7, BLKJ(, HUNDRED HILLS S/D 5188 AWWS TH-2 95-S-2 DATE TESTED: 4/21/95 TESTED BY: TS. REVIEWED BY: RJPD DESCRIPTION',. Well'grd,~ gravel, Phone: (907~ ,~1-4085 I EBA Engineering Inc ..... I 907 East Dow//nE Road~ Suite 27r AnchoraEe~ Alaska 99~18 'Fax: (9.07~.~61-7071 I SIEVE ANALYSIS TEST SIEVE DIAMETER TOTAL % SIZE (mm) PASSING 6" 152.4 4" 100 3" 76.2 2" $0.8 100 1" 25.4 96 3/4" 1 g 95 1/2" 12.7 84 3/8" 9,8 77 # 4 4.75 59 #10 2 44 ' # 20 0.85 33 # 40 0,425 25 # 60 0.25 20 #100 0,15 16 #200 0.075 11,2 HYDROMETER TEST ELAPSED DIAMETER TOTAL % TIME (mm) PASSING 0 0.8 1 2 4 8 16 30 60 250 1440 % GRAVEL: % SAND= % SILT/OLAY: DS0., D30= D10.. Ou. USO: FO: % .02 mm 40,5 48.3 11.2 4.89 0,70 SW-$M ,T,D u ~,/-I 100.0 00.0 80,0 70,0 00.0 %RNER BY 60.0 WEIGHT 40.0 30.0 20.0 10.0 0.0 100 IIIII I I I lO GRAVEL GRAIN SIZE DISTRIBUTION U.S. STANDARD SIEVE OPENINGS _Ih , 1" -h 1 0.1 0.01 0.001 GRAIN SIZE IN MILLIMETERS ,RAND L 81LT AND OLAY DATE PRINTED 4/24R5 REVS/93 I II. III. IY. Ve INTRODUCTION To fxctlitate platting .and development of 'Hundred 'H.~,lls Subdivision, First Additon, YE] Consultants was retained to complete this soils investigation. The investigation was completed in accordance with Municipality of Anchorage Title 21, as it pertains to developments with on-site water and sewer. FIELD INVESTIGATION ~, Test holes were dug during the peri.od between July'g and July']7, 1987, except for Lot 2, Block 4,. which was.du 6 . I986. All holes were dun w t ~-~*- ,_'.? ~ S.e~t?.ber 24, . t h a ~o~.uu, monitoring :ubes were placed in the test 'holes on each lot and monitoring for groundwater was a~compltshed between July 17 and July 24, 1987. The locations of the test holes a're shown on the attached map., Test"hole logs and results of groundwater m appendix, onitorfng are in the SAMPLING AND TESTING All of the samples were of the "disturbed" type obtained from the wall or the bottom of %he test pits that were dug with a backhoe. Results of all tests are contained in the appendix to the repor$~.~ GENERAL GEOLOGY ., Hundred Hills Subdivision is located the South Fork.¥alley, wNt.ch Is a hanging valley that extends several miles south and ~outheast. from Eagle River Valley. The SoUth Fork of Ea'gle River fl'ows toward the north along the floor of the South Fork Vatle~ ]'he site is ~ ' alptne~ ~lopes range ~rom 5% or ~n~ ~. ~_~ . aract~ed ~as the upperat a 2200-foot elevation and can' be ch , · ' .~ ,n uencn areas, up to '35%~tn reaches which essenttal1~ are the 'slope~ of' the surrounding mOuntains. The site generally has a. southwest exposure to the sun. No evidence of permafrost was found in our investigation. . DISCUSSION Sotls' generally consisted of sand and gravel overlaid by one (1) foot of organic silt topsoil. We found some isolated pockets of s41t and in some a~eas, the slltcontent 6f the gravel was higher. However, percolation tests showed all lots to be suitable for on- site septic systems. . We encountered bedrock in two (2) loCations. One was the steep hill area at the northern ~ortion of Lot 1, Block 5. Bedrock was hit at a dep:h of four (4) feet, and the test hole was relocated to Reference Point No. 310 {shown on attached map). The other encounter with bedrock was at Reference Point No. 306. Rock was VI. found at a depth of 4 feet. A sec, ond test hole was dug at Reference Point ~o, 307 to serve Lot 6, Block 4, and no rock was encountgred at this location. No groundwater was found in any of' the test holes either during original logging or during the secondary monito~ing, e×cept~ as noted below. We believe that the groundwater.was at its high point for the year. This was evidenced "by the seasonal groundwater, spring between Lots 2'and 3 in Block 5, which r~ns approximately one (1) month per year and was runn.ing during our investigation and monitoring period, Additionally, significant rains occurred during the monitoring period. A test hole dug on Lot 2, Block 5 in the vicin'ity of. the .spring did encounter groundwater at approximately 6 ~eet, The test hole was relocated to Reference Point No. 311'on Lot 2' and no groundwater was encountered.. SEPTIC SYSTEMS With the,exception of Test Hole Nos. 202., 209, 2~2, and ..227, soils encountered in the subdivision percolated at rates less tham f (5) mtnu'tes per inch. ~i~ means that sand f~ ........ tye ~ed on most -- ,~:ra will. nave O~e~he ]o~ an equivalent of 125 square f~ per bedroom will required ..... Some of the test holes were given ~ vfs~al rating and subsequent sieve .analyses showed these soils :o ac:u~lly be in the gM range. ' However, similar soils were perc tested in the fteld and found' to percolate at quite rapid rates, tn the classification. . - vtsual Locations of test holes on specific lots are described on the enclosed table titled, "Test Hole Locations, ttundred Hills" and are shown' on the site map included in this report. O0 'S. , '099 MUNICIPAL, Pr C? ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address t~Y__~- '~ P---~'~P~ ~G-~H Day phone Lending agency Mailing address r,J/~_ Agent Address /'J Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer X NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER o 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 inform&tion 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. Alaska Water & Westewater Services Name of Firm,,- .............._ .... Phone Address ~_____~~ ~__.~/~~ //_,~-/~ Engineer's signature "-..J Date /?/? . DHHS SIGNATURE /~/ Approved for z¢ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Mu~i(~ipality 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) aGck MOA ~21 L Legal Description: A. WELL DATA Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division &~C4~ I V 825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907) Health Authority Approval Checklist ~oT' --/3 12,V--, ~5"3 ParcelI.D.: ¢Vu,4~¢.,~--~ ¢Vlt, t..~ ~/~ ~ I ED Well type Log present (Y/N) N ~== Total depth Sauitary seal (Y/N) ~:EB ~.0 1996 MuniciPality o~ Anchorage Oept, Health & Human Services If A, B, or C, attach ADEC letter. ADEC water system number / Date completed ~ I/c~ ~ Cased to '~tO Iq., Casing height (above ground) Wires properly protected (Y/N) Date of test Static water level Well production FROM WELL LOG WATER SAMPLE RESULTS: Coliform ~ [:::> Nitrate Date of sample: 2/l~/qlo ~A B. SE~IC~OLD~G TANKDATA ~~ Date installed ~~ Tal~ size / ~ AT INSPECTION . I ~?f/j~ Other bacteria Collected by: ~,e:,l~J C=5 £ Number of Compartments'~ Foundation clemiout (Y/N) XJ~_,,.q Depressiou (Y/N) tOO High water alarm (Y/Il) Date of Pumping NI ~ Pumper t',,2 ABSORPTION FIELD DATA Date installed ~/~l ~clX' Soil rating (g.p.d./fl Length ~ ~ Width R t_ ~ ! Gravel thickness below pipe Effective absorption area ~"4-Z¥' Monitoring Tube present(Y/N) Date of adequacy test Results (Pass/Fail) ___ Cleanouts (Y/N) V System type ! Total depth -/' Depression over field (Y/N) For -~'~F bedrooms FMd depth /" (ins.) Minutes later: / Absorption rate = / _g.p.d. Peroxide treatment (past 12 months) (Y/N) / If yes, give date Fluid depth in absorption field before test (iii.); / hnmediately ,after.-'""" gal. water added (in.)'/ Date installed .~ Manhole/Access(Y/N). ~...~__..~ le~~lp off' level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ~, I ~ /....~ On adjacent lots Absorption field on lot I ID ~ ~ On adjacent lots Public sewer main tx.) }t~ Public sewer manhole/cleanout Sewer/septic service line ] 0 'q' ~ ''~ Lift station SEPARATION DISTANCES FROM SEtYI'IC/HOLDING TANK ON LOT TO: t Building foundation I ~" 4- Property line ~EE; Absorption field I Water main/service line > I O Surface water/drainage ~' I © O Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation ~ [ '*' Water main/service line ~'~ C) ~ ~ ~-ou~;~ Surface water 2~ }CBC) Driveway, parking/vehicle storage area ~- t._~ , Curtain drain t'4 Wells on adjacent lots '"" ~ I O O Property~ line }O /4-' F. ENGINEER'S CERTIFICATION /[ in con/brma2fce with/~OA,dI, ffA ~eline~ in effect on this date. r ~ ~ / .............. ~ ........................................................................................... HAAFee $ ~C."LD,(DcD Date of Payment Receipt Number Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ Date of Payment Receipt Number CT&E Environmental Services Inc, Laborato~ Division ~,¢'.~.,~,~;,~,-~.~'~;,¢i.~:,~--¢;.~: < , O,,J Drive Drinking Water Analysis Report for Total Coliform Bacteria 200 Arlchomge, AK 99518.150:: READ I. VSTRUCTI03'$ O.V R.~VER~ SfDE BEFOR~ COLLECTLYG 3,43fPLE Tel: (907) 5~2.2343 PRIVATE WATER SYSTEM ~'-;e,,, R.s,,,,.,. ~ .v,,~/m.,,,','e ]~~ C~ ~C;gnd [nvOiCg S.-L,',[P LE DATE: 3[on(h SAMPLE Routine Repe~t Sample (for routine sample wi~h lab reft no, ) Sped~l Purpo[e Y~ar Trented Water Untrea,ted Water Time Collected Collected By Fax: (907) ~6~-3301 TO BE COMPLETED 8',' LABOP~.\TCF.': Analysis shows ~hi~ Ware,~ SAMPLE ~o bo: Sample over 30 hours old, results may be unreliable not b¢over 48 houei old ~( ~xaminafion to Md(care reli~bN resuk~, Plea~ new sample via spe:iai~liv¢9 m~ii, Tlm~ Analysis B~gan ( ~ ~ Analvtieal Method: ' ' ,..,.¢Zt~,Mem o r a ne Filtc:' Number oFcoionies,:100 mi, Client notified of uns~tisfactoC,' results', Time.: BACTERJ'OLOGICA_L WATER .A2q,-~T, Jf$l$ R.ECOR.D MMO-3FUG Result: Totol Coliform ,Membrane Filter: Direct Count 'V'erifi~ation: LT8 Fe¢~l Coliform Confirmntion BGB £, Coil Om m Co(oriies/100 nil CO LIFIR.'.I. ~,~TC ' rot; ,%t,~¢r,,,~. ' Final ~lembrane R~ported Collfq,~m/100 mi CT&E Ref,# Clicm Sample ID Matrix CT&E Environmental Services Inc. Laboratory Division ~,~,~r~rj~_~,~,~r,~xr,~ar~,,~r~r~r~L; ' Laboratory Analysis Report 960452,158i Collected Date 02/08/96 L7 B5 Hund Hills S/Dt0452-01 Drinking Water Technical Director Smnple Rerharks: QO Re*uLts Oua[ cOL Units ,1~8 ,1 .100 U ,I m~/L ~PA 353.?. NO,IN 02110/96 08/10/96 EPA 553,2 NO~/N 0~/12/96 02./12/96 200 W. Potter Drive, AnChorage, AK 99518-1605 -- Tel: (907) 862.2343 Fax: (907) 561-5501