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Home My WebLink AboutMCKINLEY HEIGHTS #1 BLK 7 LT 8A (2) - II / tunicipalitYof Anchorage P.O. BOX 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWLES, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES March 24, 1987 Joal Babb % S & S Engineering SRB 196X Eagle River, Alaska 99577 Subject: Lot 8 BLock 7 Mc Kinley Heights Subdivision On-site Sewer Permit #860075 Upgrade A permit issued by this Department for an individual well and/or on-site sewer system has expired as of March 20, 1987. Your permit expired on the date of issue basis by authority of Municipal Ordinance existing at that time. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. The new permit will come under the calendar expiration date as per the new Wastewater Ordinance (effective May 20, 1986). If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system the original as-built inspection report (three part form) must be sent to this office for review and approval, and for documentation. If there are any further questions, please call this office at 343-4744. Sincergy, R.~. Rob±nson Program Hanager On-s±te Serv±ces RWR/ljw #7 enc: copy of permit LOT S I ZE: f'c,r'th t::i¥ t.i'",,.,:.~, Mur-i:ic:i. pa].:Jty c,f' Ar'ichc, r'age (MOA) and th,:..:.:. Stat¢.:..~ of' A].aska,, 2. I v.~:i.]]. :i. nstall 'LI":~.~ sy~d:.em :i.n acccn"darv:::e ~.,~:i.'l:.I"t alt MOA ccx::I,:.:.:>:, and and in c,:::m'q:::,].iance v.~:i, th tt"v:, des:i, gn cr,:i.L,::.mia of' 'Lh:i.s 3, i ~,~:i.].1 adher'e 't:.c~ al! MOA and S'La'Lc¢, of' Alaska r, eciu:i.r'eme:.:.>r'rLs -~',:::~i" th<e set'., back d :L s'La. ric:.s f i' :)m any ~.::,::.~ :i. st :L r'ig v,u.::~, l ]., ~,,~aste~,,h,~YL(:.r' d isl::~osa ]. sys'LE, m c,r' pub ]. i... :[ F:'T' S'I'AT :I: CiN :ZS I NS'T'AI...I...iED ]: N Alxl AI::IEA COV!EI::;:iED BY MOA BU ]: I....D :I: I',IG C;ODiES, ( 1 ) AN ELI:~:C'T'R;]: CAI... !:::'EI;:;S"1:1: T Aiq:O :I: IxlSF:'IECT :[ Olxl MUS]" BiE OBTA ]: IqlED i~ C?. ) AS'""BLJ :i: I....TS NOT BI:: AI:::'I:::'ROVED W :I: 'T'HOU]' AN IEI....IE;C;TR :i: CAL ]: hlSI:::'IECT Z C)N RiEF::'C)I::;Ci"; AND (3) THE MUS'T' BIE DONE BY A i....:[CIENSEEO EI....!EC'T'RIC:!:AN,. ' '-" - I ATF:: .... . .............. .... ~,~ ,"",* ?.:/~ ~" , , DATE: Ct..,MPUTATION SHEET DATE: SHEET BY CKD OF PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST S SEAL) PER LEGAL DESCRIPTION: ~,¢~' ~ /'~Z. od-/z: 'r7 /N//C ?~'//~Z.~ ~wnship, Range, Section: ~"/~:~/~/'./,_ ~/~,~/) SLOPE SITE PLAN 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20- WAS GROUND WATER ENCOUNTERED? DEPTH? p E Depth to Waler Alter ~ Monitoring? /'J'~ ~//'-~' Dote: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE -- (mi~t a/inch) PERC HOLE DIAMETER COMMENTS PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72~008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN /' / Municipaiaty of Anchorage P.O. E,,..,X 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWLES, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES June 23, ]986 S & S Engineering SRB 196-X Eagle River, Alaska 99577 ApplicJnt Name: Joal Babb Subject: Lot 8 BLock 7 Mc Kinley Heights Subdivision On-site Sewer Permit #860075 (Upgrade) - Issued March 20, 1986 On May 20, 1986, The Anchorage Assembly approved a new ordinance regulating on-site wastewater disposal systems (septic systems). Ail septic systems constructed after the effective date of this ordinance are snbject to the provisions of this ordinance. Our records show that you currently hold a permit for the installation of a septic system. We strongly urge that you contact this office prior to constructing your system. Any changes in the code that could impact the construction requirements of your septic system will be identified and brought to your attention. Please contact the Environmental Services Division at 264-4720. Thank you for your cooperation. Sincerely, Susan E. Oswalt Program Manager On-site Services SEO/SSM/ljw ~iUNICJ.['/[L['J.'Y L)L" z~,NL;tiCI,R/~.L;i:J Hea" . and I+:nvironmental Pr'o/e: "; Fourth F].oor West / / 825 L Street. J Anchorage, A],aska 9950] 279-2511, x 224, 225 ................... -i~'~CTION REPORI ON-SHE SEWAGE DISPOSAL SEPTIC TANK. ' DISTANCE [:ROM WILl..[ INbl[3[ TILE DRAIN l'.,ll.J M B E ;t OF . COMP/\R ! MEN rs _ . _~z_-_. ti,) ) ilL'PIti ----- I ,()HID ._ I LENGTt-- DI!)~AN(~E [IIOM W[.LL ._[~_L~._[OUNi)AitON . [_ / _ N[.ABI'SI [(.,1 LIN[' OF LINE ~) SQ. [ I I ENGiIt ()[ [.AL:It LIN[- A[]SORPIION AREA ............... ....... ( [)[:Pllt ()1 I IL. II_R DEPIlI,, [()P OF ltLL TO F'INIStl GRAIiL ~ MAI[RIAl [dIqEAIH '1 ILL ~) '")- IN. ABOVE III F' SEEPAGE PIF: DiAME'I [R ...... ()R WID] H ....... LING I H ..... DEPTH Log Crib'" ' _ ...... Rings Crlb~ ' F;].zo' : DIAMI:I F ~ DhPTtt ........ OISTANCE FROM: WELL_ ...... lOlPk Ft [ [CTIV[ BUILDING f OUNO,WI'ION .... NEAR[St t_Ol [ IN[ .... AI~fiORPTiON ARF'A (W/q_L AREA) .............. sq. . [ ...... : .......... ...... F ............................. .SS: ~ Depth: ' / ~ ~ ~I lg: _~ll Sewer Line: -2--"I i I , ~f Bedrooms: F~kJNTCIPAL!tt?Y Ob' ANCNORAGN and Environmer: I: a] 8 2 5 L S t ~ n e Anchor~]ge,, Al.a~ka 279-~251] ~ x 224, i s C .;c Log "" F't~!]:~ff"l I T NO. [)EI:::'RF?."f'MENT ' "HE]::II....TH RNI} EI'.,!V:[RONHENTFtL.' ::~.'.OTEC:'I'ION ~.'.:.~;77.5 "~ .... STREE]"., RNCHOF:,'FtGE, f:lK. '.!!~::. ..iCL ~::::tt P,.4 ........ t':.:i~;;, ::1~:: "IF' lEE: ."J!E;; Ilii~::: tL-.,I1 Hi:E: ii'-~ IF:::" ~: I1::;;~'.: ih"'tl ]E '"'H .... ,:.' 7'?'645 ) PO. Ii'.:.:::'::. THE RtE~Z:!U ]: RED '.~i; I ZE OF "FHE :50 11.... f:IE~$ORPT I ON SYSTEM :1'. :E;: ~Z::,, lliE:: IF::~ ]~'"' IFd! ...... :!E.,:~ L.. Ili~E: Ii"qt ~::::Er~ T' IF"~ ....... ;;.'.:~:~:: :~i5~ ~:]ii E~?. F~t ",,,~ IE< I1 ....... IIZ,:. E: F" 'T iF-at == THE L.ENGTH [)I MEN.'.'~!; I Ohl :[ ~i~ THE L. ENGTH ':: t N FEET ::' OF "['FIE: TRENC:H OR E:,RFI:I: NFI EL.I:,. THE DEPTFI OF Ft TRENCH OR l:::'l'T tS THE D:[~.:,TF'INC:[ii: IE~ETI.,.IE[.'-]",I THE SI..II:~fl:::'I::ICE OF' THE GROUNf.) RhtE:, "r'Hi:~: E,'O'I"TOH OF' THE E',:.:X]:Ft',/I::YFION ':.' IN FEE"F). "I"I-,~ERE I'.!~; NO SET H ]: E:,TH t:'OR 'T'RENCH[E:iii;. ....., .......... P I PE THE .~..I-- , I::.1.... [:,ti!i]::'TH t S THE M ): t'.,t I MUH E. [.:.F, FH OF .:d.~.. - , E:.L 8ETHliEEN THE OUTFFIL. I .... FIt'.,It:::, "I'HE Bcr'I"TOM OF THE E',:-:',CFiVFITI ON ( I N FEET). IF:ii:: lt:!!ii!:: C:i::~ it.....1t ::I1:: iF;~It ~:.'E: liE::, ~iD:; ~:: IF":' '"'IF' ][ ~(Z::: '"'fl"" ~::"tt ~..,~ ~-~-::: ~'iE~,; ][: ;';~i~!'-' EiC: ..... ::::L ;;~jL". ~:.~!i~ ~iD C:~ii ll:..--:ll It........ L... ~::]::~ 1t"-,,1t :!.:.'ii!: BRCKF I L..L I NG OF FIN9 S'.R~i;TEM H I THOLrT' F :1: NFiL.. t N.'E;PECT ]: ON FiND FiPPF:'.O',,,'RL. E:'.r' 'T'H I'.E; .... F:I R E I CER"t' :[ F".r' "['Hr:IT ...... .:,[::.H[:.F.:..:::, FiNI) HliEt....L..S I:::t'..:.:; :!i!;E'T' ::1..: :I: I:::tM FI::iHI!...II::tR HI]"H ]"HE I:;:'[::":~ :rl~'l:::t','EN'"'Ji; t:::'OR ,- F:'i]I~i:"t"H EiPr' "I"t-IE I'"II.JN II]: ]: I::'1:::11... ]: T"r' OF '~ ....H ... F.f" .~[ .. ;~i: I H :[ I..L. :[ NS"i"F:IL..L. THE .:, ~ .:, I l:i' t :[ N Ft ]::(]I]IR[)I::t ",ICE 1.,-1 :[ TH "FHE COl}lES. ::ii:: t I.JN[:,ERS'T'FIN[) THFIT THE ON-:'.-'.::[TE :i~;EHti!i:R :i::.;"r't.:.:.;TEH HFI"r' F~:E(i:!U:[RE ENLRI:~.'.(:~iE:MEN]" IF' THE F?E:~i;i[:'ENCE ~ REMOt:)EI...ED TO ]:I'.,ICL.L.I[:'E MORE ]"HFfiq 4 E:E:[:,ROOMS. Ftt:::'PI "]"'I::It",I'T' []'"N t F: Fl[:i["f" '..' ~'~.2, ~ L~ngdok Date Performed 8/3/77 for Don D~s-'rietion Lot 8, Block 7, McKinley Heights Subdivision 4 8 10 !4 16- 2O Red-brown, sandy silt w/organics (ML) Clean, caving, well graded,} sandy gravel (GW) 85 ft.2/bdrm- ' Total Depth - 15 feet No water table encountered AVERAGE ABSORPTION AREA FROM sOILS LOG = 85 ft.2/bd~n- Date ] Net "' = I D=.p,.h Nel: Drop t~erc~)!iitlon Rate minute ............ .~ -,.. k_ ~. ~ _ CHA~ION DRILLING COMPANY, INC~ M-'W DRILLING, Inc. O. Box 4-1728 · 2811 Dawson A C 907-279-1741 ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner ' 7;':~.,~ ~.?-~, ~-,~ ~- Use of Well Location (address of: Township, Range, Section, ff known; or distance main road Size of casing Depth of Hole :'~ _feet Cased to__,'L2 feet Static water Ieve] ] "'=' ft. (&lS'6q)~) (below) land surface. Finish of well (check one) open end ( Screen ( ); Perforated ( ). :: ); Describe screen or perforation Well pumping test at ~ ~ galIons per (hour) of drawdown from static level. (minute.) for : hours with Date of completion t Aum.,rt 'fY WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 _TO TO_ TO TO_ TO. ___TO_ TO TO~ TO TO_ _TO. __ TO ___ ___TO TO, 3 -- Contractor MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date Z~- GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ~()~d t~ Telephone: Home Applicant Address _ ¢'~,~, ~ /~ ¢,/. ~-'~L¢'/¢ "~ ¢' (C) Applicant is (check on,e): Lending Institution []; Owner/builde Buyer []; Other [] (explain); (d) Lending Institution ' ,/¢2O /'L/~,~'" Telephone Address (e) Real Estate Company and Agent _ Address Telephone (f) Mail the HAA to the following address: SRB 196x Eagle ~iver, Z~lns~ 99571 TYPE OF RESIDENCE Single-Family/~. Multi-Family [] Other Number of Bedrooms WATER SUPPLY Individual Well ~ Community [] Public [] Note: If corn munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite [~ Public [] Community [] Holding Tank [] Note: if community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Page 1 of 2 ENGINEERING FIRM PROVIDh . INSPECTIONS, TESTS, FILE SEARCH, D~,A AND INFORMATION AS certified by my seal affixed hereto and as of the vWidation date shown below, I verify that my investigation of this Health Authority Approval 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 MunicipW and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm $ ~ $ F~j~enHn~, Telephone Address DHEP APPROVAL Approved Disapproved Conditional Terms of Conditional Approval ,~'"J('/~' 7~/"~J ~'' ~,~¢?/¢2 ~-/~ CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their,lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 {11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 J~UNIClPALI'r~ OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MAR 0 6 lg88 264-4720 Legal Des.q, ription: /8 WELL DATA Well Classi ficatio n/~/~"~-¢/~ If A, B, C, D.E.C. Approved (Y~__~ Yield ,~'"'~d"~J~ Well Log Present ( ___ Date Completed Total Depth .¢~Z7~, ' Cased to ¢¢¢-O Depth of Grouting Static Water Level ~-~'~ Pump Set At Sanitary Seal on Casing~)N) Depression Around Wellhead (Y/(~ ! ; On Adjoining Lots ~¢ I ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot Casing Height Above Ground ~.¢z..// ¢ · Electrical Wiring in Conduit (~4~ Separation Distances from Well: To Septic/H, e4~,~-Tank on Lot-/~ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole /,tX /{4- ; Date Water Sample Collected by Water Sample Test Results Oomments :X ! SEPTIC/HOLDING TANK DATA Standpipes~4) Air-tight Cap~(~N) Foundation Cleanout~N) Depression over lank (Y Date Last Pumped 7-~9 t~ Pumping/Maintenance Contract on File (WN) ; for Holding Tank High-Water Alarm (Y/N) Separation Distances from ~S~¢pticR-i-e~mcg Tank: To Water-Supply Well /~¢¢' ~ ~ ! To Property Line ~ To Water Main/Service Line ~) Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/~__.~ Results of Last Adequacy Test Type of System Design Length of Field Z '¢~ Depth of Field Gravel Bed Thickness /7 2. Standpipes Present ~'4) Date of Last Adequacy Test Separation Distance from A~;)~sorption Field: To Water-Supply Well /g ~.~(-~ ' To Building Foundation ,¢'~) 74 Lot _ _ //-/2~.~ ),J- ~ To Water Main/Service Line ~ ¢ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Commen~ ~ ~ ~ ~ ~ ~ ! TO Property Line ,~/'~ ~',~' ,~ 5' To Existing or Abandoned System on ; On Adjoining Lots /(3~ To Cutbank (if present) D, LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N)- Dimensions Manhole/Access (Y/N) "Pump?fl" Level at I / ./Vent (Y/N) Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Date .~ MOA No. Signed ::.:!... ::.:,:~ Receipt No. __~.)'-/ Date of Payment Amount: $ Page 2 of 2 72-026 (H/84) , CHEMICAL & tJiY. OLOGICAL LABORATOR1E,5' OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER [] PUBLIC WATER SYSTEM I.D.# ~ PRIVATE WATER SYSTEM Name Mailing Address City State · Day Year Phone No. Zip Code SAMPLE TYPE: cLUE Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose _) [] Treated Water t~-Untreated Water SAMPLE Time Collected NO. LOCATION Collected 3 I I 4 I I 5 I I TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: (~Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received ~ '~.~/'~-- ? ~' Time Received / ~"¢..~ O Analytical Method: Membrane Filter * No. of colonies/100 mi. Lab Ref. No. Result* 1,~-/~ 2.- BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Membrane Filter:. Direct Count Verification: LTB BGB Final Membrane Filter Resul,~.., Time: TNTC = Too Numberous To Count OB = Other Bacteria Coilform/100rnl = Coilform/100ml p.m. P.O. BO)( 196650 ANCHORAGE, ALASKA 995'19-~6650 (907) 264-4111 TONY KNOWLES, MA YOR DEPARTMENT OF HEALTH & HU~IAN SERVICES November 18, 1986 Lou Butera~ P.E. Eagle River Engineering Services P.O. Box 773294 Eagle River, Alaska 99577 Subject: Lot 8~ Block 7 McKinley Heights Subdivision Waiver Request WR-86-162 Dear Mr. Butera: This department.has reviewed your request for a waiver of the septic system to well separation requirement using the procedures established by the State Department of Environmental Conservation. Your req~lest for a waiver has been denied in this case. This denial is based on information provided about the soils and hydrogeology in this area° This information indicated that the septic system and well are located in an area of shallow bedrock and highly permeable soils° Both of these factors increase the risk of well contamination from pollution sources such as septic systems. This department regrets any hardship placed on your client as a result of this decision° If you have question regarding this matter please call me at 264-4744° Sincerely, Stephen S. Morris civil Engineer On-site Services EAGLE RIVER ENGINEERING SERVICES Lou Butera P.E. P.O. Box 773294 Eagle River, Alaska 99577 Telephone (907) 694-5195 November 7 1986 Mr, Steve Morl?is Civil Engineep, On-..site Services Municipality of Anchorage P.O. Box 196650 Ancho~?age~ At~ 995[[9 Lot 8, Block 7, McKinley tfeights Dear Mr. Morris On behalf of' m~ client~ M:c. Joel Ba, bb~ I am submitting the informa~:Jon necessary for your' determinaqion of a waJ_ve~~ of separation =li~4~ance ....., private well. to septic, tank, to 64:' and well to leachfield of ,o.c the above referenced loL. The ].eaohfJeld was instal led in 1974 by Tim MoGahn and was J nspec. Led and app~'oved 'by' the Munieipal~ ty at that time, as per i~he inspection report enclosed, The permit shows a distance to septic tank of 65~ ai~d the :inspection report shows Lhe well to septic hank distance as 67~ Our :L~ :;].d measurements confirm qbe tank inlet ho be at 64' from the we!l with the leachfield at 74' The enclosed well log shows that the w'-~.:]. ] is dpi]]ed into bedrock at a depth of 24' and ftaps a confined aquifer' at a depth of +..26{ The casing 'is eonti, nuous to 24~ /~' whe~e it is seated into bedrock. A measurement of static water level is ]26' below the top of casing~ The surface topo.~raphy is such thaL. any seepage would be directed away from the well location toward a 2;~>g slope to the south and a 7% slope to the S.E. (see plot plan}. The subsurface soil is a. OW type wiLh a pete. rating of 85. A waher sample fo~' coliform bacLeria was satisfactory. Jh~ a. rea in question has a J. ow population uens]ty. IF there are any questions or if additional 5nformatiori is z~equir',~d, pl~a,_,~, zee]. free to contact me at 594-5193. Thank You ~ ],ou Bu'Lera, P~',. h/IUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION RECEIVED ~-~..., ~.~w ~,-w9 t'~- ..... ;i;~v'2T..)..'~'.~ /?/ ? ~25 _.~ .,',h.~ed thereon are wftlnn'me prop~ thereto, that no npr~ements,o P. I¥ ' ~ t;torero pncroac question and] that thbm are no rouow~'s Enos other visible casements on ~aid..propert~' e~gaPt louis A. gu~om SCALE: ' - 1"~./ ..Br~ : ', ,g '.' ,' 's ' , Phone 694-2,>43 .... CHEMICAL & ~£OLOGICAL LABORATORIt;3' OF ALASI(A, INC. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska g9518 Drinking Water Analysis Report for Total Coliform Bacteria c4¢- PRIVATE WATER SYSTEM Name Mailing Address City SAMPLE DATE: b~ ?'.- z7'77 __ Phone No. State Zip Code . Day Year SAMPLE TYPE: ~%C~eutine [] Check Sample (for routine sa~ple with lab ref, 0 Speoia~ Purpose .) [] Treated Water _~.-Untreated Water SAIVlPLE li~le Collected LOCATION 4 I I TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: (~Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. O Analytical Method: Membrane Filter No. of colonies/100 mi. Lab Re¢, No. Result* [ I ~..q_ l. J I. J J i--~_] BACTERIOLOGICAL WATER ANALYSIS RECORD REAO ~NSTRUCTiONS BEFORE COLLECTING SAMPLE I~]embraoe Fil~er:. Direct Count ___ CellformllOOml Verification: LTB BGB Final rflembrane Filter Results __.~---~ ~ ¢~tlform/lOOml Time: TNTC = Too Numberous To Count OB = Other Bacteria DA~E RECEtVED '~1 INSPECTION APPOINTMENTS ME TIME TIME ,-~ ~.., ~.,..,,,.~ ~. ,~? ~'\' DATE DATE DATE to INSPECTOR INSPECTO~ INSPECTOR DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ~. ~ St.ee.- ~.c~o...e. *.as~....0~ ~CT ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete aH parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROP~RTYOWNER~; ~ /~ ~ ........ ~ PHONE MAILING ADDRESS PROPERTYRESlCENT If different from above) ~ PHONE 2. BUYER .... ~ MAILING ADDRESS 3. EEND~G INSTITUTION ' PHONE 4, REALTOR/AGENT ~ PHONE I MAI LING ADD~,BS~¢ LEGAL DESCRIPTION STR E ET LOCATI ONz~ 6. TYPE OF RESIDENCE 3~ING LE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four ~=~"~wo [] Five [] Three [] Six [] Other 7, WATER SU~I~ ~:]'~ 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** / ~"~'~ YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: T.E ,NSPECT.ON FEE MUST ACCOMPANY PRO ESS'> THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [~ SINGLE FAMILY [Z] ONE [~] THREE [] FIVE [] OTHER [~ MU LI'IPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [~] INDIVIDUAL DEPTH OF WELL [] COMMUNITY -- .. ~ DATE DRILLED [] PUB'~IC UTFLITY '~ LOG RECEIVED Cop~[pection Verified 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER F_~Septic Tank or [] Holding Tank Size:_L~__ ~%~'~) if Tank is homemade SOILS RATING -- give dimensions: TYPE OFTA. NK MANUFACTUREIq.~ . ~. ~ TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area ISewer Line I Nearest Lot Line 1 WELL TO: _ Absorptiorr Area to nearest Lot Lice 5. COMMENTS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY 72 010 (Rev. 6/7!)) SHEET DA'f E: SHEET BY__ CKD OF 10/16/81 ALASKA PACIFIC BANK P.O. BOX 36 CHUGIAK AK 99567 SELLER - PATTY ANKER BgYER- SUBDIVISION-MCKINLEY HEIGHTS BLOCK-7 LOT-8&7 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 348 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACIT~ OF THE SYSTEM IS 250 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FO.R A 4 BEOROOI~ HOME. THE SEPTIC TANK WAS PUMPED ON 10/15/81 SEPTIC TANK ADEQUACY TH;E EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQ'gATE FOR THIS 4 BEDROOM HOUSE. 1220 U Jest 25th Aoenue · Anchoroqe, Alaska 99503 ,, (907) 276-1361 , . CHEMICAL & G~£OGICAL LABORATORIES ~ ~' ALASKA, INC. , TELEPHONE {907)-279-4014 ' ANCHORAGE INDUSTRIALCENTER ~ .......... ~ Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER I.D. NO. Water System Name Phone No. Mailing Address City State Zip Code MO. Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. ::::] Special Purpose [] Treated Water [] Untreated Water SAMPLE NO. I LOCATION Time Collected Collected By TO BE COMPLETED BY LABORATORY Analvs;s snows this Water SAMPLE to be: [] Satisfactory [] Unsatisfactorv [] SamD~etoo ong in transit; sample should not De over 48 hours old at examination to ndicate reliable results, Please send new sample. Date Received Time Received Analytical Method: [] Fermentation Tube [] Membrane Filter Lab Ref. No. Result* Analyst *No of colonies/lO0 mi or NO of Posibve portions READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD Date Collecte<l Source Lab. NO. Presumptive 10mi 10mi 10mi 10mi 10mi 1.0mi O.lml 24 Hours 48 Hours Confirmatory 24 Hours 48 Hours EMB. Broth 24 hours= Multiple Tube Rebort: Membraee Filter: Direct Count Verification: LTB Final Membrane Filter Results Report~J By Broth 48 hours: 1Omi Tubes Positive/Total ].Omi Portlonl Collform/lOOml BGB Date Collform/100ml Timer a.m,