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HomeMy WebLinkAboutKNIK HEIGHTS BLK B LT 13 Municipality of Anchorage Page J 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 Wastewater System: ~ New ~ Upgrade Phone: (~ ~+~ 'm~ Nc. of Bedrooms:s ~DeepTrench B ShailowTrench ~ Bed ~ Mound ~ Other "' Total Depth from ~riginal grade: LEGALDESCRIPTION so,, Rating:, ~5 GPD/Sq, Ft. Lot; '" I~ Block: ~ ~Su~div~i°n:~' Depth to pipe~.~_bo~om~xfrom original grade: Ft. Gravel depth beneath pipe~ r ~ Ft. Township: ] Range: Section: ~ Fill added~bove~ ~.~ ~°ri~nal~--g~de: F~. Gravellength: ~ I ~1 Ft. Number of lines: Dis~n~ ~n lin~: ~~ g New D Upgrade Gravelwidth: ~'5 ~ Ft. ~ ~ + Ft. Clarification (Private.~ ' ~T°tal Depth: Ft. Cased To: Ft. Total absorption~area~j ~ ~Q.' ~,~ ~ Ft. ~T~Pipe material: Driller: ~ D '~ Static Water Level:Fl. Installe~l t~ Date~/~.i~stalled: Yield: Pump Set at: Casing Height: TAN K GPM Ft. ... SEPARATION D ISTAN CES ¢Septic D Holding ~ S.T.E.P. TO Septic ALso.lion Lift Holding Public/Pdvate Man. fac~~ T~ CapaciW in gall°ns: From Tank Field Station Tank ~ewer Lines Web /~+ I~'~ ~/A ~/~ ~5~ Material: 5~ee~ Number°fC°mpa"ments: ~, Sudace / Water I~'~ I~'~ I~+ LIFT STATION Lot Line S'~ /0'~ ~O'~ Size in g~llons: ~ Manufa~ Cu&¢ik Pump Make & Model Electrical Insertions peflo~ed by: Remarks: BENCH MARK . Depa~ment of Health and Human Se~ices approvm ~t:~:~;~:~ 72-013 (Rev. 9/91) MOA 25 PERM,, NUM ER: w o, ' AS-BUILT: DRAWING PARGEL ID017--O~,~--,~,-~NUMOER: I NEW DRAINFIELDS 45+ LONG EACH C04 .~TH INSTALLED FLOW'~'<-~,~':! '-, '; ".~ ]: 77:~. SPLICER (FS) ~": ,' , EXISTING DRAINFIELD 'ro BE USED AS A RESERVE SITE. MT2 SUMP2 % DBL1 ...... '~% 10' UTILITY EASEMENT INSTALLED FLOW DIVERTER (FD) NEW 1500 GALLON SEPTIC TANK NOTE: 1. NEW SEWER LINE PASSES OVER TOP OF THE OLD TRENCH. ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 OEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 PHONE: (907) 357-6179/FAX: (907) 338-5246 LEGAL DESCRIPTION: KNIK HEIGHTS SUBDIVISION, LOT 15, BLOCK B tYPE OF WORK: AS-BUILT OF SEPTIC SYSTEM UPGRADE PREPARED FOR: PHONE NUMBER: JAMES AND WILMA SPEARIN (907) 545-0816 DATE:6/16/99 IDRAWN BY:K,D.W. IsCALE'' 1 = 40' IPAGE: 20F5 '~?: A S - B U I LTD R AWl N G / I--5-:-', Mr2 601/6~ ~ldl~ ~ .'// I-'.' WEST TRENCH ~ - l~bO AV~, ~AS~ WATER ~D WASTEWATER CONS~T~TS, ~C. LEGAL DESORIPIION: ~"~'"~ KNIK HEIGHTS SUBDIVISION, LOI 13, BLOCK B . . ....... AS-BUILT PROFILES OF SEPIIC SYSTEM UPGRADE ~[V~[D ~o~: PHONE J~M[S ~NDW~LM~ SP[~mN (907) ~AtE: 6/1 4/9 9 aY: K.D.W. N.T.S. 3 Of 3 MUNICIPALITY OF Deparfment of Health and Human Services On-Site Services Program 825 L Street, Room 502 t P.O. Box 196850, Anchorage, AK 99519-8650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT ~ Upgrade Date Issued: May 28, t999 Expiration Date: May 27, 2000 Permit Number: 8W990113 Legal Description: KNIK HEIGHTS BLK BLT 13 Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: James & Wilma Spearin Owner Address: PO BOX 111726 Anchorage, AK 99511-1726 Parcel ID: 017-033-33 Site Address: 012541 SHELBURNE RD Lot Size: 43500 SQ. FT. Total Bedrooms: 5 Permit Bedrooms: 5 This permit is for the construction of: I¢~ 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 ( 18AACS0 ). 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. Received By: Date: Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B - Anchorage - Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers May 25, 1999 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Upgrade Design for Lot 13, Block B, Knik Heights Subdivision To whom it may concern: The existing 5 bedroom house is served by a private well and septic system. The septic system consists of 1500 gallon septic tank and a 76 feet long trench that was installed on 8/1/78. The existing septic system will not pass an adequacy test and must be upgraded prior to the sale of the house. One test hole was excavated to the west of the existing trench. We propose to have a new 1500 gallon septic tank and a new drainfield installed within the 30 foot radius of the test hole. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached is a log which shows the soil profile, and the percolation test result. The soils beloxv the organic layers are a SM/ML material (with a few SW lenses to 5 feet) to a depth of 18.5 feet (bottom of test hole). No groundwater was encountered during the excavation of the test hole, except for a slight seep at 9 feet. Groundwater monitoring was perfolxned several times over the a two week period and found the monitoring tube to always be dry. A percolation test was performed between the depth of 7.5 feet to 8.0 feet which had a rate of 34.3 minutes/inch. 2. TRENCH DESIGN: a. Percolation Rate: 34.3 minutes/inch b. Allowable Application Rate: 0.45 gallons/day/ft2 c. Number of Bedrooms: 5 d. Design Flow: 750 gallons per day e. Minimum Absorption Area: 1667 ft2 f. Total Depth: 12 feet (max.) g. Effective Depth: 10 feet h. Width: 2.5 feet i. Reduction Factor: N/A i. Minimum Length: 2 ~ 45 feet lon~ each (90 feet total length) j Effective absorption area-- 1800 ft= 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As can be seen on the topography site plan, the average topography of this property is a 20 to 24 percent rulming from approximately east/southeast to west/northwest; in shorts, there are no slope concerns. The trench is to be installed parallel to slope contours. I am unaxvare of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you ~i~r assistance'/~ .. NOTE: Attached is a site plaJ~ drawi~g, a desig~ drawing, a soils log, topography site plan, and a 4 page co~structio~ specificatio~ letter which are ail part of th e design package for this septic system. ~ LOT 2, BLOCK B, LOT 2, BLOCK C, I LOT 15, BLOCK B, KNIK HEIGHTS S/D i ~ESEPTIC AR~ KNIK HEIGHTS S/D ~ KNIK HEIGHTS S/D KNIK HEIGHTS S/D LOT 1~, BLOCK B, ]~ ] KNIK HEIGHTS S/D ~ LOT 3, BLOCK B, ~ ~ ] KNIK HEIGHTS S/D ~PROPOSED SEPTIC UPG~DE ', ~ ~ (SEE D~SIGN, PA6E 2 OF 2). / KNIK HEIGHTS S/D ~ X EXISTING 5  ' X BEOROOM HOUSE ~ ~CA~ ' AR~ ~~ ~ LOT 12, BLOOK B, J KNIK HEIGHTS S/D [ j KNIK HEIGHTS S/D ~ LOT 6, BLOCK B, LOT 6, BLOCK C, [ LOT 11, BLOCK B, ~ " KNIK HEIGHTS S/D KNIK HEIGHTS S/D ,, KNJK HEIGHTS S/O ALAS~ WATER AND WASTEWATER CONS~TANTS, INC. LEGAL DESCRIPTION: ~PE 0F WORK: DATE:5/25/99 J.L.M./K.D.W. 1 100' 1 or 2 ~, PROPOSED DRAINFIELO UPGRADES, EXCAVATE 2 TRENCHES THAT ARE I 12 FEET DEEP (MAX.) BY 2,5 FEET i WIDE BY 45 FEET LONG EACH. ADD i 10 FEET OF CLEAN, WASHED SEWER DRAINROCK. INSTALL TRENCHES , PARALLEL TO ALL SLOPE CONTOUR [ // PROPOSEO ~500 GAJ-LO"~- ~ ' ~ "~' ~o' ~. I \ J ~ ::4 ':::::: ~?" co~ USED ~ A RESERVE SI'E ~ , : . T ~ISTING SEPTI IN~ FCO ABANDONEO COMPL~LY, j X NO~S: 1. THE CONTRACTOR SHALL HAVE THE 100 FOOT WELL RADIUS , ~ F~GGED BY A REGISTERED ~ND SURV~OR PRIOR TO ANY ] ~ CONSTRUCTION. ~ 2, THE CONTRACTOR SHALL FIELD THAT ALL SEPARATION DISTANCES ~ ~ WILL BE M~ PRIOR TO ANY CONSTRUCTION. ALAS~ WATEK AND WASTEWA~R CONS~TANTS, INC. '- LEGALDESCRIPTION: KN~K .~OHTS SU.D~V~S~ON, .OT 1;..~OOK ~ ~.¢...~./ ~PE OF WORK: D~S~N o~ SE.T~C SYSTSM UP~.*DE PREPARED FOR: PHONE NUMBER: WlLMA SPEARIN 545-0816 JA~ES AND :ATE:s/25/99 ~W~ a~: SCALE~ RACE: K.B,W. 1 = 50' 2 OF 2 ALASKA WATER & WASTEWATER CONSULTANTS~ INC. ~ 0F 4/'~.~ 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK. 99504 ~' ~ ....... /- I SOIL LOG - PERCOLATION TEST I .."..*...t DATE PERFORMED: 5/7/99 (/0¢,¢.U. "? ( )E-7953 .'" ~ DEPTH ~ ,':' ~'' ORGANICS T ~ 2-- ~ i SOle C~SSIFICATIONS [SITE PLA~ ~ ~ ~ WITH A FEW '-?'--F FZ~ ~ ~ (SEE DESIGN. PAGE 2 OF 2). , ,~, SW LENSES i!?~ 4~GH CL GROUNDWATER ~ ~'l; SLIGHT SEEP ~ 5/7/99 ~ '~: ~' tI 9' (SEE NOTE) / EXISTING }' i~ DRY 5~2!~99 X 5 BEORO0~~ ' 11 ~ ~ [ DATE READING CLOCK NET TIME WATER LEVEL NET DROP , TIME (MINUTES) READING (INCHES) / ~ SM/ML 12-- ~ !;~ 5/21/99 - PERC, HOLE WAS PRESOAKED 7,5 HOURS PRIOR TO TESTING 19- B.O.H. PERCOLATION RATE 34.3 (MIN,/INCH)/ PERC. HOLE DIA. 6 (INCHES 20-- TEST RUN BETWEEN 7.5 F 8.0 FT. -- PERFORMED BY A~SKA WATER & WASTEWATER I, ~ ~ , CERTI~ THK TH~S WAS PERFORM¢ ~N/ACCORDANCE W~TH ALL STATIC ) GFN~C~DEUNES ~N EFFECT 0N TH~S DEPTH TO DATE GROUNDWATER SLIGHT SEEP © 5/7/99 9' (SEE NOTE) DRY 5/21/99 Armhoragc, A.lask~ 99519-6650 Telephone: (907) Fax No: Rick Mystr, om, Mayor Malford Representative Fred Dyson ~~10h~ Assembt~om~ Alaska Dept. Na~ Resources :'~';';:[}'~}~j~ept.lEn~omental Conse~atmn Alaska DiVot Co~s of En~s. Fish & Omc AK Office Envkom~t~ Prote~on Agency ":: i "J~a!:9;ii:[ ~99 at 7:00PM to discuss the Lower Fire Lake Dam repair/replacement and the "~ 'i~t~n.gl. ~0~ this._ work. The meeting will be held at the Valley River Center, 11901 " : }llus~e~i Boulevard. in the second floor MOA Conference Room. · 'An,,Ap~i [999}Periodic Safety Inspection Report for the Lower Fire Lake Dam has been ' ' :..'.~elved:: :om'the Alaska Department of Natural Resources. Th/s report indicates the dam i.':"~etu~e ~taS deteriorated to the point that some major work is required to keep the dam in 'i'!' ' ..~aSa.~¢i~!meable condition. The scope of this work a_nd how to fu~d these repairs will be : lt.i.i:'.N:~hi¢:ree0mmended thai you attend this public meeting. ::' · ': i' DEP,U.,I'I',M.F.XT OF PUBLIC WORKS i. May 24, 1999 RECEIVED · ' -:i. ~:':i::' : MAY 2 5 1999 :,. : ..,."i~.:' ii.;. ' .. · ' ': : '" ::'" ': M :'. '" ' ,';'~" ..:;.i::', - i; : Oe~?,] c,paluy o~ Anchorage "ii ' 2 ::...~:i':.'..'!'i': J';, ' ' '~'esident m ,~ealth & Human Services :;,. ! '.::., ':"-,:.i::: ' · ' ::i :::.' i'~;'":':::;:if:::i',!:-: ', . :::.. i',; .~ ~e::~ea'(¢~ism~zs^) ~oa~d of Su~e~visors win ~e conaucdn~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAl_ ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 2.64-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME~ 1PFIONE T~~ MAILING ADDRESS LEGAL DESCRIPTION LOCATION I_iq, capacity h~ gallons DISTANCE TO: No. of lines / Top of tile refinish Length of each line~ 1___7(2;' ,cd, Length Type of crib grade DISTANCE TO: lClass DISTANCE TO: Absorption area Inside length Dwelling Total Ich§th of lines Material b~neath tile Width Depth Depth ' ' ' Driller Building foundation Sewer ne OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS Material Nearest I ~j~? Trench wi~ NO. OFBEDROOMS PERMIT NQ. No, of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. . Distance between lines Total effectiv~ absorption area PERMIT NO. Total effective absorption area Nearest lot line Distance to lot line I PERMIT NO, Septic tank L~J~r~n ~'ea(s) APPROVED ~"~ / ,~ DATE 72-013 (Rev, 3~78) LEGAL PEF?.M i~'f' NO. :tP[::'[. i[ I]::[:lt"~"l" ,Jfli'"lE'~'.3 SPEI~IR 2[ J.:lC:Fl'f' 1'. ON S t~~1~:7 F.'.D ..EOif-:]l.. I..fL3: BL.K E: KI',I:iK I.,ITS S,."[::, FYF'[:.' ()F.' 5;0 ]:1.. f:IE;2.1OF.'.I3T )'. ON SYSTEH .1: S: "FI~'.iENCH I.':,[EPFif;:TMEI"~T OF:' I--IEFtL. TI~ Rf.,Ir.:, [:::N',/Z [,~ONI,iENTf:II... F'[;.: :)TE'C:T ~ ON '"""' .... L. '~ STRE:'[~"f' F'iNC':I-IOF;'.Fll3E., [:IK. ':?:)P [~ .i. ,/, ~ ~ g.,,.ll lEE L.. IL,~ F:B Ii%q [1:::. u:':::~ 6~..~.~ ..... ,":.".:i; ~ 'T lis?'=: ~.:!E; ,qF./E &.Il tE F;.-'". II:--::" E: ~-:;?.' Ii'"~ ~ '"'IF' ,' ?'SELS:.::;(~)', .:,[:.H F.:,L. ,.., THE LENGTH D:I:MENS:[ON :[E; THE L..ENGTH ,:::IN FEEl'."* OF THE 'FF.:E;.NCH 01:~'. I:::,RFI):Nf:'.'r. EI...D. 'fl-tiE DEPTH OP' R 'f'RENCH OR PZT ):.S THE I~):STRNCE BETI,.IEEN "f'HE SUF.'.FRCE OP' 'f'HFi GP.:OL.IND RNI3, THE BOTTOH OF THE E>,:CRYK-IT Z ON ,:: .f. N FEEl'.'.'. 'f'HEF,'.E ~S 1'.40 SIE'T' I,I:[I?I'H F:OR TRENCHES. "i'HE GF.'.RYEI... DEPTH I $ "file f,I I N :[ HLlld [:,EPTH OF GRRVEL. BE"I'I,.I[!!:Ei'4 'THE OI. JTI=f'-'ll...I.. F':[ PE FIN[::, THE E~OTTOrq OF' THE EXC:R',,,'WI'ZEIN ,.'. :IN FEE:T). IqL.IME:tEK-: OF F?.L::5;IDENCES THFIT THE HELl.. HI:EL. ' ..... E,P..KF.:[LL:[NG CLF FtNY :', ..... · :4 ': ':~.;UEL.fE:C T TO Pf;.:OSEC:UT :[ ON. t~:,EPR[;'T HI:ENT H :[ I...L OF' THE PIEL.[... C:OHF't_E?'f' :[ I CEI;;:"I" ]~ FY THFIT ::t.: ~. FtI"I [::'F:Ii'"IIL]:FIR H:i'rH THE REL:..!UZF;.':Ei'dENTS FF~IR OI',I-=¥;[TE ':'.:;EHERS I=lf-,l[:, HELI...'...S FtS; 5;ET FOF.:TH P.,Y THE f,tUN l C: I F'I:iL l TY O1=' '- '=1 .... Rr'::CRDRNCE HITH THE COE:,ES. 2:;( H):LL INSTI=ILI.. THE =, ._ rEl~ 3:: )~ UI'.~[>ERSTFII"41) THFIT 'f'HE Of.4-S;~TI:2 SEHER ..~::,lL~:.ft i"IFIY RE';-~ IRE!' EI'.&...~f,...~I£HE. Iq l XF' TI.tI:; I I:': ;r [' E'.'NCF ]: ':; :~'Ef'lf"fl')E'[ [=[') Tf'~ ]' NCL U[:,E ¥"1OI; E THAN 5 F¢:~PI._ :[ C:FII'.4T ..:fI=IHE::_':i SOILS LOG · MUNICIPALITY OF ANCHORAGE  Pouch ~650, Anchorage, Alaska 09502 276-~22~ SOILS LOG - PERCOLATION TEST PERFORMED LEGAL DESCRIPTION: ' ' ' SLOPE SITE PLAN 2 ' 4 . ,. ~ ~ , : , ' 9 ~-, , .~ ~/ · 10 WAS GROUND WATER ~.~ S - ..... 1 1 /v¢ L ENCOUNTERED? P 12 E , IF YES, AT WHAT . . DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop //.~..,./,~ ~ c, 14 1 6 17 18 19 PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN '/-- - FT AND -/ FT 72 008 (7/76) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services 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. # _. ~> / ~ -- I O ~ ~ 1. GENERAl.. INFORMATION Complete legal description HAA # Location (site address or directions) Property owner Mailing address Day phone Lending agency Mailin. g address Day phone 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 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 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 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, t further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ALA$KA WATER & WA$TEWAI'E~ Phone GUNSULTANI~i ~/.,J¢ · Address 6901 DEBARR ROAD, SUITE 2B ANCHORAGE, ALASKA 99504 Date Engineer's signature Alaska Wa~er & Wastewater Consultan~, Jr~ Shall be PAID $/000--- at, or prior to, closing for the Engineering Services Provided. DHH6 SIGNATURE [./" Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health AuthoriW Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesyto purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ?2-O2~(Rev. 1/gl) Back MOA~21 EC, EIVED of Anchorage dUN 1 8 1999Z. Municipality DEPARTMENT OF HEALTH & HUMAN SERVICE~uNicmAUTY OFANCH~ Environmental Services Division ~NVIRONMENTALSERVICE$ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Description: Health Authority Approval Checklist [-~r%~->j bO'T" I~/ .~/¢--.~¢' Parcel I.D.: A. WELL DATA Well type Log present~/N) Total depth Sanitary seal Casing height (above ground) f ~ Wires properly protected (Y/N) ~-~' If A, [3, or C, attach ADEC letter. ADEC water system number Date completed tT//' ~-/r7("~ Cased to 40(+. // FROM WELL LOG AT INSPEC]ION Date of test 7//~,'~ / "7 ~ ._~ O/~ ~:~' Static water level ,/~ ~. / t/ O .~ Well production ~.'~.~ g.p.m. "7, ~ WATER SAMPLE RESU.~: Coliform '-~ . Nitrate Date of sample', ,..~-~/.~/~ c~ B. SEPTIC/HOLDING TANK DATA Date installed ~/~' Tank size Foundation cleanout (Y/N) _ Date of Pumping g.p.m. / ~m_ Other bacteria Collected by: ¢/~-~J~'/~, //'J~-~' Number of Compartments "Z_ Cleanouts (Y/N) _ y Depression (Y/N) ,Aj' High water alarm (Y/N) AJ ~ Pumper ~ C. ABSORPTION FIE~LD,/,,-DATA Date installed . Length ~'! Width 'Z.~ ~: Gravel thickness below pipe Effective absorption area I &C~ ~ -£ Monitoring Tube present (Y/N) Date of adequacy test ~ Results (Pass/Fail) Soil rating (g.p.d./fF or fl¢/bdrm) ,~ ~r~ System type Total depth . Depression over field (Y/N) For Flu~~sorption field before test (in.); Immediately after Fluid depth (ins) Min6te~ ,~i'rem-----------._ Absorption rate = __ gal. water added (in.): Peroxide treatment (past 12 'nontfm) (Y/N) bedrooms g.p.d. If yes, give date -------'"'---'---- -~ 72-026 (Rev. 3/96)* Date installed ---._..~ .._Size in gallons ,, Manhole/Access (Y/N) __ ,,Pumpon~ "Purep off level at* High water alarm level at* *Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ?(:...,~_D Absorption field on lot / 470 Public sewer main ~k/ Sewer/septic service line "'2~"/4- On adjacent lots On adjacent lots Public sewer manhole/cleaneut Lift station ~/,/~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~/Y- ~ Property line Absorption field__ Water main/service line /L~ l.¢.. Surface water/drainage .JO/2 / /OO I /Oo Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /0 Iv..- Surface water / CO r 4- Cudain drain }k/ /,,~¢¢ Building foundation /O / +- Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots ENGINEER'S CERTIFICATION /~ I certify that I h/~ de/f~/rmine/~¢ru ~eld inspections and review of Municipal in con formap wilhj~OA//~A~guidtlines in effect on this date. Signature !~ FngineersName j~J ~U ~'--~'-~'-~'-~/ ~ ' ~:,, Date ms are Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* /_~i~, .~ CT&E Environmental Services Inc. CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID 992279001 AK Water & Wastewater Consultants Inc. Knik Heights, Lot 13 Block B Knik Heights, Lot 13 Block B Drinking Water Sample Remarks: Client PO# Printed Date/Time 05/27/99 14:15 Collected Date/Time 05/25/99 ll:10 Received Date/Time 05/25/99 12:00 Technical Director: Stephen C. Ede Released By~ ~ Parameter ResuLts PQL Units gethod AllowabLe Prep Analysis Limits Date Date Init Total CoLiform 0 col/lOOmL SM18 92228 05/25/99 KAP Nitrate-N 0.970 0.500 mg/L EPA 300,0 10 max 05/26/99 05/25/99 SCL DATE RECEIVED .... INSPECTION APPOINTMENTS Cl~-F'L'(~O~_/~9 , ~']L~L~"\ .%L~. ~C.'... ~D, ~'IME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSP~OR , MUNICIPALITY OF ANCHORAGE MUNIcIPALI~ OF ANCHORAGE  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT 825 L Street - Anchorage, Alaska 99501 bNVI~ONM[:N/',:d. ;. i~CTJON ENVI RONMEN'rAL SANITATION DIVISION M~ Telephone 264-4720 DIrECTIOnS: Complote all parts on page 1. Incomploto roquosts will nol Bo procossod. Please allo~ ten {10) dags for processing. 1. PROPERTY OWNER ' ~ '3 "~'~ MAi liNG ADDRESS '~ , ' PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE " MAI L~ NG ADDRESS I ' ' ' ~ ' I PHONE MAILING ADDRESS 4. REALTOR/AGENT [ PHONE I MAILING ADDRESS 5. LEGAL DESCRIPTION ¢ 6, TYPE OF RESIDENCE ~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four [] Two ~ Five [] Three [] Six [] Other 7, WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A welt 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 E~ INDIVIDUAL/ON-SITF** [] PUBLIC UTILITY 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 [] SINGLE FAMILY [] ONE [] THREE [] 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 F-IINDIVIDUAL/ON -SITE DATE INSTALLED Connection Verified INSTALLER []Septic Tank or []Ho,ding Tank '~L.~ Size: ~.~-'~"OO If Tank is homemade SOILS RATING TYPE OF TANK MANUFACTURER ~_t~ .z m~ .. -~OTAL ABSORPTION AREA MATERIAL '~.- DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line WELL 1'0: I -~bsorption Area to nearest Lot Line 5. COMMENTS [] CONDITIONAL APPROVAL {letter must accompany certificate) [] DISAPPROVED BY~ 72-010 (Rev, 6/79) Wilma L, 0/J~u~e~q l<o Speariu Post ()f[i,c~-~ ]L~ox 10-1726 S'ubj~ct~ Lo'b 1] !~tock b Xnik Heights Subdivision Approval for y~t%r in:~[ividual sewer and w~ter facilities can not be granted until tho following items have been c o~tL~ t e ted; (1) A %~;ell ].og s%lbmi't'ted 'tO t]~i~ depart~,~en't for ouz' (2)~'iTt¢~ water a~l~ltysJ.s 17eport ]>e ,Reti:,/ered to %his ~"~ ~~froa Che.~a La].~ 5633 !~ Street, ',for our review, 5if there are any fur%her questions~ please con'ta,~h this S.[ncerely ,. PiFSt .... t. IOh ~1. ',ank ;.~. An~'horage 'POSh Office ]:}OX 720 995].0