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HOMESTEAD HILLS #1 BLK 3 LT 2
Homestead Hills #1 Block 3 Lot 2 #015-173-24 beve[optnem Services department Building Safety 7ivision t 6 , On -Site 44'cter & wastewater program 4700 Bragaw S reef i PA. Sox -196650 .Mark Aegich .Anchorage, .AK 99519-6650 . Mayor xnxw muni.arvrn/nnsirz (907):43-7904 Pump Installation Log -Well Drilling Permit Number: SW_ Date of Issue: _ Parcel Identification Number:_ Legal Description Property Owuer Name & Address: 0 R 67 p y /k. 5 Pump Installation Date: pump Intake Depth Below Top of Well casing:2/o feet Pump Manufacturer's Name: ?,rd JyafCe Pump Model: CA)s -16 Pump Size 3/,1 hp Pitless Adapter Burial Depth: /b feet pitless Adapter Manufacturer's Name: tw;PA 5�_ Pitless Adapter Installer: N/!4 -vVell Disinfected TJpon Comptedon�Yes ❑ No iAethod of Disin 'on: Comments: Pump Installer Name: G� &)/D5 Attention: The pump installer shall provide a Pump installation log to the DSD within 30 days of pump installation. c�,q Ips I 3 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: PID Number: 4l S 1 i324 Name: ivtp(L7 (Gi4LrC.�NE. Wastewater System: ❑ New KUpgrade Address: 11320 Pa�.A.2PA-t,-3 Ank:GlAK-�it Sero ABSORPTION FIELD Phone: No. or Bedrooms: (p El Deep Trench � FiFoa+Fow Trench 11 Bed ❑Mound O Other LEGAL DESCRIPTION Soil Rating:Total Depth from original grade: .Co GPD/Sq. Ft. /•'�; Lot: Z Block:Subdivision: Nor*SEAP (-�l1_J-S Depth to pipe bottom from original grade: 3.5 Ft. Gravel depth beneath pipe 4.D Ft. Township: Range: Section: Fill added above oninal grade: Gravel length: -75 1 VA'vt15S C> Ft. Ft. WELL: ❑ New ❑ Upgrade Gravel width: J A5 Number of lines: I Distance between lines: N/�i Ft. J FI alion (Private, A, B,C): Total Depth: Cased Total absorption area: Pipe material: ' PdC 5.0t.tl) 11DPEQ�R� Ft. SQ, Ft. Driller: rifled: Static Water Level: Installer: V114 VMIR 5 J cxAVAT(ntC Date installed: 4 ^I I 9 4 - Ft, Yield: Pump Set al a f ht Above Ground: t 1 ' TANK �l GPM Ft. t. N SEPARATION DISTANCES Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding cwwis/Private Manufacturer : . ` Capacity in gallons: 100 From Tank Field Station Tank Sewer Lines Ut-/v)12'tl� 1 Material: Number of Compartments: . Well I o 4 U I Z t .... �" r� ! Z. �j'�' tai l.... 2+ Surface —. LIFT STATION Water _ Lot1 Line ?4 l 13.5 t Siz Ions: Manufacturer: -3t , i "Pump on" level at: " " level at: P High water alarm at: Foundation 2 56 -- D Curtain .--- ..—... ,_� Pump Mak del Electrical In pections performed by: Drain BENCH MARK Remarks: Location and Description: Tp4_sy_- INSP�t t 67 D4`tl 4-g-�t4. tL- A s5L Nra TU Q c co rZ- D cc.k- Assumed Elevation: �1'c4i•4 �3Y Iv"t-VrV4, 5 xc a ,aT t� FL S tl E l SMOM SI -1 c.•? SP IL(NCII; 159 4 . Inspections performed by: '- >°ZAA'tS Dates: 1st `-6'S4 t E Nrt�N 2nd -4-1-94- ® AY�A�ti! P 3R -o 4-)1-94 % % Department of H It a d Hum a ices approval Reviewed and approved by: <� 72-01.3 IRev, 9/91) MOA 25 z / alt Z V) %* �-i !' `/- J 711 Permit No. Sj" S4C�0(oO page 2 of => • Municipality of Anchorage W.O. 94107 Department of Health and Human Services Date 4-13-94 ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 On --Site Wastewater Disposal System/Well Inspection Report Legal Description: LOT 2 BLOCK 3 HOMESTEAD HILLS SUBDIVISION )r�\ PID No. CLEANOUT @ TRENCH INLET INVERT = 89.4 CY CAUTION !! \ ,9o�` U. G. T & E ` _ l y- 92 10' SETBACK �- -. FROM lEOPERTY +.''.. 0��� 00. 0 ��o� �\ f 95 P9Q INST/ALL PVC SWITCH VALVE o (ANCH. TANK & SUPPLY) J� EXISTING 1000 GAL SEPTIC TANK INVERT @ OUT ET = 89.9 0 CLEANOUT @ 2� � � , EXISTING �o TRENCH INLET 0THREE INVERT = 89.4 ti� i ' BEDRQOM �,� �� 61 �• � HOUSE � \ I \`r I61 SCALE: 1" 20' RECORD ►NFOR� MCAT dN 4-1 - 4 TBM CORNER OF DECK ELEV. = 98,00 FAL! Permit No. Sw94 00(00 Page 3 of 3 W.O. 94107 Municipality of Anchorage Date 4-13-94 Department of Health and Human Services ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 On—Site Wastewater Disposal System/Well Inspection Report Legal Description: LOT 2 BLOCK 3 HOMESTEAD HILLS SUBDIVISION " \ PID No. GEOTEXTILE FABRIC SEWER ROCK PER MiNICIPAL SPECS - 72-013 A (2/01) MOA 25 3.5' t COVER 6„ 4" 0 PERF. PVC PIPE INVERT = 89.4 � 5.0' 4"0 MONITOR TUBE W/ AIRTIGHT CAP SLOPE FILL TO DRAIN FINAL GRADING AND SEEDING TO BE COMPLETED BY WHITTER'S EXCAVATING WHEN SITE IS FREE FROM SNOW SPRING 1994 4.0' GRAVEL BELOW PIPE INVERT = 85.4 7'+ BOTTOM OF TEST PIT ELEV = 78t TYPICAL WIDE TRENCH SECTION ;• ••;• ••• " • •• SCALE: NTS #♦ A QENNIS CH CS •••• CE •••• RECORD INFORMATION 4-13-94 It os DATE o ,��r►�o��� PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE a IY1 DEPARTMENT OF HEALTH AND HUMAN SERVICES m P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940060 DATE ISSUED: 3/30/94 DESIGN ENGINEER:DEE HIGH ENGINEERING EXPIRATION DATE: 3/30/95 OWNER NAME:FALCONE JOSEPH C & OWNER ADDRESS:11320 BEARPAW ST ANCHORAGE, AK 99516-1542 PARCEL ID:01517324 LEGAL DESCRIPTION: HOMESTEAD HILLS #1 BLK 3 LT 2 LOT SIZE: 44534 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM 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 343-4744 OR 343-4681 AFTER BUSINESS HOURS 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: THIS UPGRADE WIDE DRAINFIELD WITH THE REVISED ENGINEER'S RECEIVED BY: ISSUED BY: MUST BE INSTALLED IN ACCORDANCE DESIGN DATED 3/30/94. DATE.. 3 /3 t/f(/ DATE: '� a Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST aAL) 7/ '!y fl •i4a F e -X- i „ c ®bTTTT a"B Joh WbaR Y SAL cpnSEPER PERFORMED FOR: DATE FORM L oT- 9. B LA Ck. 3 LEGAL DESCRIPTION: 4CyKfSTf-Ap Fk(,LLS SuiS. Township, Range, Section: SLOPE SITE PLAN DEPTH -- r 10 .e WAS GROUND WATER kin (FEET) Gross Time b12Ct,ars IG.S 1 O sit qA Q�i� 7 24 -co ?JCS Wlth1 (1=1 Y9 " RSgtSA- $"wr') 2 ✓r '-30 Q2EtAntic SLAT 3- b . O DEPTH? P 12 - 6, E 4 4- 3. 3© , 5- 5 3" Depth to Water After 6- 67 Monitoring? Date: 7 8-o . . r 10 .e WAS GROUND WATER kin 14 j 51�-T W� San17� 15 Tr%r PIT. 16 (a t %j ` --,- 17- 18- 19- 20 ►- 17181920 COMMENTS Reading b Gross Time ENCOUNTERED? Depth to Water O sit qA Q�i� 7 24 -co ?JCS Wlth1 (1=1 Y9 " S 11 '-30 IF YES, AT WHAT p 16 u b . O DEPTH? P 12 - 6, E 3" 3. 3© , C�Y 3" Depth to Water After 13 Monitoring? Date: 14 j 51�-T W� San17� 15 Tr%r PIT. 16 (a t %j ` --,- 17- 18- 19- 20 ►- 17181920 COMMENTS Reading Date Gross Time Net Time Depth to Water Net Drop sit qA Q�i� 7 24 -co ?JCS Wlth1 (1=1 Y9 " 3t' '-30 �� 16 u " 04 �� 6, 34 3" 3. 3© , C�Y 3" PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND 10 FT PERFORMED BY: G qlU 7T t4 rhiytS. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT O THS DATE. DATE: 3" y �� 72-008 (Rev. 4/85) Permit' No. Page 1 of 7 Municipality of Anchorage W.O. 94107 34107 Department of Health and Human Services Date _ -31-94 ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 On—Site Wastewater Disposal System/Well Inspection Report Legal Description: LOT 2 BLOCK 3 HOMESTEAD HILLS SUBDIVISION PID No. SITE NARRATIVE MAR 31 1994 Lot 2 Block 3 Homestead Hills Subdivision is bordered byMQu, ttth q%� r pl4ftit have existing houses, wells, and septic systems. Elmore Road, which used to be named Bragaw, borders the west property line, Bear Paw Street borders the east property line. The wells on all three lots are located in the front yards. Lot 2 has an existing house and a failed septic system. The replacement septic system is designed for a three bedroom home. WELLS: The 100 foot protective well radiuses are shown on the drawing. The wells do not affect to the placement of the proposed septic system. WASTEWATER SYSTEMS: The placement of the proposed septic system will have no effect on the septic systems or wells on either of the adjoining lots. Due to the fact that two (2) septic systems have already failed on the lot, a 5' wide trench was designed as per recommendations from DHHS. The system was'also designed for the next slower percolation range under advisement by DHHS. The proposed wide trench system will be placed at least 10 feet away from the failed bed system. DRAINAGE: The lot is fairly flat, and the area of the proposed system drains towards the north property line. All finish grades will be sloped to drain in the direction of natural drainage so that no ponding occurs at or near the drain field. The disturbed soil will receive top soil and seeding to protect from erosion. �'&%Iks, T M3 A (2/91) WA " Permit No._ Page 2 of 7 W.O. 94107 Municipality of Anchorage 3-31-94te Department of Health and Human Services Da-- ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 On—Site Wastewater Disposal System/Well Inspection Report Legal Description: LOT 2 BLOCK 3 HOMESTEAD HILLS SUBDIVISION PID No. < I' LOT 1 I I PROPOSED TRENCH 4' DEEP X 75' LONG \ <� I� � � I Z I 30' =) w LL1 I o w I � rn 1 ® 1 I + Ch RECEIVE ' � ql MAR 3 11994 ' Mu+�ici alit I Dept• Health "man Sices <� CL 1 ea LOT 2 44533 SF I <v LU M 3 BEDROOM 1� TEST i HOUSE + RADIUS 1 �fl0, PR Pow I i `•` �1 SCALE: 1" = 50' I LOT 3 72-013 n f2M) uon 25 �' ��a Permit No. Page 3 of 7 W.O. 94107 Municipality of Anchorage Date 3-31-94 Department of Health and "Human Services ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 ' Anchorage, AK 99519-6650 • Tel: 343-4744 On—Site Wastewater Disposal System/Well Inspection Report Legal Description: LOT 2 BLOCK 3 HOMESTEAD HILLS SUBDIVISION PID No. SYSTEM DESIGN CALCULATIONS RECEIVED MAR 31 1994 1. NO. BEDROOMS = 3 Municipality of Anchorage Dept. Health & Human Services 2. USE 5' WIDE TRENCH AFTER DHHS RECOMMENDATIONS 3, ABSORBTION AREA = (# BEDROOMS)(150 GPD/BR) TRENCH APPLICATION RATE NOTE: USED NEXT SLOWER PERC RANGE AS PER DHHS RECOMMENDATION (3)(150) = 563 SF 0.8* 4. TRENCH AREA = (5')(LENGTH) = 563 SF LENGTH REQUIRED = 150' IF DEPTH OF GRAVEL = 4' THEN REDUCTION FACTOR IS MAXIMUM OF 50% THEN LENGTH OF TRENCH = PERCOLATION RATE PIT & TRENCH APPLICATION RATE (.5)(150') = 75' MOUND & BED APPLICATION RATE MIN/INCH GPD/SF GPD/SF 0-1 NOT SUITABLE NOT SUITABLE 1-5 1.2 0.8 6-15 0.8 0.5 * 16-30 0.6 0.4 31-60 0.45 0.3 GREATER THAN 60 NOT SUITABLE NOT SUITABLE FILTER LAYER 1.0 .7 72-015 A (2M) MOA 25 G. "t W-0 Permit No. Page 4 of 7 W.O. 94107 Municipality of Anchorage Date 3-31-94 Department of Health and Human Services ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 On—Site Wastewater Disposal System/Well Inspection Report Legal Description: LOT 2 BLOCK 3 HOMESTEAD HILLS SUBDIVISION PID No. CLEANOUT @ TRENCH INLET _ R ESC E I V E D INVERT = 89.4 S'a CAUTION H MAR\i 1994 1- U.G. T & E Municipality of Anchorage _ 92 10' SETBACK pmt' malt u an Services 9 FROM INEOPERTY 01 0b` TRENCH INLET INVERT = 89.4 SCALE: 1" = 20' ro� TANK OUTLET INVERT = 89.9 111 0) \\� °°. A \� 95 ` ---INSTALL SWITCH VALVE ��Oi f SEE NOTE 18 ,---EXISTING 1000 GAL SEPTIC TANK SEE NOTE 2\ EXISTING HREE THREE FBEDROOM 1 HOUSE TBM CORNER OF DECK ELEV. = 98.00 I 'AW A'T r 9 T I0#00 ........ .. �♦ ,DENNIS E IGH. ¢i i 9,3 % CE R;t�wf s k DATE 12-03 A (2/81) MOA 25 G Fft 107-4 Permit No. Page 5 of 7 W 0. 94107 Municipality of Anchorage Department of Health and Human Services Date 3-31-94 ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 " Tel: 343-4744 On --Site Wastewater Disposal System/Well Inspection Report Legal Description: LOT 2 BLOCK 3 HOMESTEAD HILLS SUBDIVISION PID No. BACKFILL SEE NOTE 14 GEOTEXTILE FABRIC SEE NOTE 13 / 4"0 MONITOR TUBE W/ AIRTIGHT CAP SLOPE FILL TO DRAIN SEE NOTES 15 & 16 EXISTING GRADE = 93.3t SLOPE TRENCH WALLS AS 3.5' t REQUIRED TO MEET ALL COVER 611 LOCAL1 STATE, AND FEDERAL REGULATIONS 0 0 4" 0 PERF. PVC PIPE 09 036 INVERT = 89.4 SEWER ROCK PER MINICIPAL SPECS SEE NOTE 10 q° 9% 4.0' GRAVEL BELOW PIPE INVERT �p 0 o� BOTTOM OF GRAVEL = 5.0' 7'+ BOTTOM OF TEST PIT ELEV = 78t TYPICAL WIDE TRENCH SECTION SCALE: NTS LLJ LJJ wCie CDA ,E Q� ®9 <E oy ers s,,tl U@ .E Z Q 4 72-013 A (2141) MOA 25 „FPR; 107_5 Page 6 of 7 Permit No. W.O. 94107 Legal Description: LOT 2 BLOCK 3 HOMESTEAD HILLS SUBDIVISION Date 3-31-94 NOTES: ALL CONSTRUCTION SHALL BE IN ACCORDANCE WITH CHAPTER 15.65_ WASTEWATER DISPOSAL REGULATIONS OF THE MUNICIPAL CODE AS CURRENTLY AMENDED. 2 CONTRACTOR TO EXPOSE EXISTING 1000 GALLON SEPTIC TANK FOR ENGINEERS INSPECTION. IF FOUND TO BE UNSATISFACTORY, THE CONTRACTOR SHALL SUBMIT BID FOR REPLACEMENT AND INSTALLATION OF A NEW TANK. 3 SITE TOPOGRAPHIC SURVEY CONDUCTED BY DHI ON 3-2-94. EXISTING STRUCTURES, WELLS AND SEPTIC SYSTEMS OBSERVED WITHIN 200 FT. OF THE PROPOSED SYSTEM SITE ARE SHOWN ON DESIGN DRAWINGS. 4 ANY DEVIATION FROM THE DESIGN MUST BE AUTHORIZED BY THE ENGINEER PRIOR TO ITS INCORPORATION INTO THE SYSTEM. 5 CONTRACTOR TO LOCATE ALL UNDERGROUND UTILITIES, PROPERTY LINES, EXISTING WELLS, WATERWAYS, SURFACE AND SUBSURFACE DRAINAGE FACILITIES, LAKES, PONDS, AND OTHER FACILITIES REQUIRING SEPARATION DISTANCES FROM THE PROPOSED SEPTIC SYSTEM. CONTRACTOR SHALL STAKE PROPOSED SYSTEM PRIOR TO CONSTRUCTION. NOTIFY THE ENGINEER OF ANY OBSERVED CONFLICTS PRIOR TO CONSTRUCTION. 6 CONTRACTOR TO NOTIFY THE ENGINEER AND DHHS 24 HOURS PRIOR TO COMMENCING WITH CONSTRUCTION. A MINIMUM OF THREE INSPECTIONS ARE REQUIRED. THE FIRST INSPECTION SHALL BE OF THE SUBGRADE PRIOR TO PLACING THE SEWER ROCK. THE SECOND INSPECTION SHALL BE AFTER THE PLACEMENT OF GRAVEL, DISTRIBUTION PIPING, STANDPIPES, TANK, AND OTHER COMPONENTS AS SPECIFIED. THE THIRD INSPECTION SHALL BE AFTER THE WORK IS COMPLETED. 7 CONTRACTOR SHALL DELIVER TO THE ENGINEER A SET OF RED—LINED, AS—BUILT DRAWINGS SHOWING ALL DATA AS SPECIFIED IN SEC. 15.65.F.2, 3, 4, 5, 6 OF MUNICIPAL WASTEWATER DISPOSAL CODE WITHIN FIVE DAYS OF THE FINAL INSPECTION. INVERTS AND SWING TIE LOCATES SHALL BE TO THE NEAREST TENTH OF A FOOT. THESE AS—BUILTS SHALL BE USED BY THE ENGINEER TO PREPARE AND SUBMIT RECORD DRAWINGS TO DHHS, 8 ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE ENGINEER IF ACTUAL FIELD CONDITIONS VARY FROM THOSE USED TO PREPARE THE DESIGN. 9 EXCAVATE THE ABSORPTION TRENCH. BOTTOM OF EXCAVATION SHALL BE LEVEL AND SCARIFIED. RECORD ELEVATIONS AT BEGINNING, MIDDLE, AND END OF TRENCH BOTTOM. CONSTRUCTION EQUIPMENT SHALL NOT OPERATE ON THE FLOOR OF THE EXCAVATION. ANY MATERIAL COMPACTED BY THE OPERATION OF CONSTRUCTION EQUIPMENT SHALL BE REMOVED AND REPLACED WITH UNCOMPACTED MATERIAL. 10 PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE SEWER ROCK WITH NATIVE MATERIAL OR SPOILS FROM EXCAVATION. LEVEL ROCK SURFACE TO t 1" PRIOR TO INSTALLING THE PERFORATED PIPE. 11 ALL PIPE SHALL BE PVC CONFORMING TO ASTM D3034 OR ENGINEER—APPROVED EQUAL. MINIMUM SOIL COVER SHALL BE 3 FEET OVER THE PIPE AND 4 FEET OVER THE SEPTIC TANK. ONE INCH OF INSULATION MAY BE SUBSTITUTED FOR 1 FOOT OF SOIL COVER. (SEE NOTE 12) 12 ALL INSULATION BOARD SHALL BE 2" THICK DOW HI -35 INSULBOARD OR ENGINEER—APPROVED EQUAL. CENTER INSULBOARD WIDTH OVER SEPTIC TANK. 13 GEOTEXTILE SHALL BE MIRAFI 1405 OR ENGINEER —APPROVED EQUAL, LAP ALL JOINTS 2' MIN. 14 COVER THE DISTRIBUTION PIPE WITH MIN 2" SEWER ROCK, AND COVER WITH GEOTEXTILE BEFORE PLACING INSULATION AND BACKFILL. 15 MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS. 16 SLOPE ALL FILL MATERIAL TO DRAIN AT 2% MIN. SLOPE, AND 3:1 MAX SLOPE, AND IN SUCH A MANNER THAT PONDING AT OR NEAR THE DRAIN FIELD DOES NOT OCCUR. THE FILL SHALL BE LEFT AT 6" HIGHER THAN SHOWN TO ALLOW FOR SETTLEMENT. SEED SURFACE AFTER COMPLETING INSTALLATION AS PER MUNICIPAL SPECS. 17 RECORD THE FINISH GROUND ELEVATION OVER THE BEGINNING, MIDDLE, AND END OF THE TRENCH. 18 CONTRACTOR TO INSTALL ORENCO SYSTEMS SINGLE CHAMBER ALTERNATOR KIT OR ENGINEER—APPROVED EQUAL SO THE EXISTING BED MAY BE PUT BACK INTO USE IF IT REJUVINATES AND BEGINS FUNCTIONING PROPERLY IN THE FUTURE. VALVE CONTROL MUST BE ACCESSABLE FROM ABOVE GROUND. M—ma A fvol) MOA 25 6: Ph:: +.07-0 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & ENVIRONMFNTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ❑ NEW _ L ° G � +,_ ; UPGRADE MAILING ADDRESS �c5 W 33' el A1(,1orr I 9q576-3 5 U� r dy LEGAL DESCRIPTION �m z T—e / L c' : 2 LOCATION NO. OF BEDROOMS Well r Absorption area _ Dwelling PERMIT NO. 'f Uy DISTANCE TO: V 1 . 3 P, q ZZ a W I,_ Manufacturer G Flt Material �' 2ti SEL No. of cora rtments G. NLiq,f rapacity in gallons Inside length Width Liquid depth IF HOMEMADE: JVZ DISTANCE TO: Well Dwelling -. PERMIT NO. 2 Z Manufacturer Material Liquid capacity in gallons Well Foundation Nearest lot lin •� _. PERMIT NO. w2 DISTANCE TO: - No. of Tines Length of each line Total length of lines Trench width Distance between lines J LL Z z w .inches � F Top of the to finish grade Material beneath the Total effective absorption area ® - inches w Length 1,s 2 Width 'Z. C3 I Depth S? PER IT NO % � , 0 aYy Type of crib Crib diameter Crib depth Total effective absorption area 90c) w .�.. w (n Well Building foundatikn Nearest lot ling t DISTANCE TO: J Clan,VAT� RR Depth Driller Distance to lot line PERMIT NO. LU Building foundation Sewer line Septic tank O ♦ Absorption area(s) DISTANCE TO: j 1 V, , OTHER �/� ,�/ PIPE MATERIALS 10 a 30 14,t9 SOIL TEST RATING r INSTALLER p) y e4- 6 � �Jij REMARKS N tAJSu4_A1T4oyV AJ E O o'�u Z 3' P XSJt;c QuF_9 BE0 4MOA S /JY 7 net ._ 1,Aj S PEe-riE 1 9 ,, �N; r, .rl:c 7ti1 m ;. APPROVED DATELEGAL dFFFFFF � 1 qq y �f /� / ` SIA/ % L_ / ev / M % / /�//TIL J /1 /.r �/ PERMIT NQ: DATE ISSUED: APPLICANT: ADDRESS: CONTACT PHONE: ' ^ ���J I E��������� ��� �������������".T � v DEPARTMENT OF HEALTA AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 99501 264~4720 10 HNJ_~!E:5,�~- EEr: EE14 E---'. F:Z F.*.",, E-A'4i: 11-11 1r", ' 840793 -~ � 09/18/84 AECS 1200 W 33RD SUITE B ANCHORAGE, AK 99503-- 561-50-41 9503561-5041 LEGAL DESCRIP: SUBDIVISION: HOMESTEAD HILLS LOT: 2 BLOCK: 3 SECTION: 22 TOWNSHIP: 12M RANGE": 3W L8T SIZE: 55000 (SQ"FT" OR ACRES) LOT LOCATI8N: BEARPAW MAX BEDROOMS: 3 Listed below are the options available to you in designing your septic system. Choose the option that�best ... .... .... ... fits your site. ... .... ..... �..... EZ P�-11 C"'K~11 D�: k. K* 1: D", ... ....�������� ID/��� ][�� DEPTH TO PIPE BOTTOM (FT") 4"0 4"5 4.0 GRAVEL. DEPTH (FT") 3"0 0"5 2.0 TOTAL DEPTH (FT") 7"0 5"O 6"O GRAVEL WIDTH (FT") 2"5 2"0� 5.0 GRAVEL LE MGTH (FT") 89"0 ** 40"0 75"0 GRAVEL VOLUME <CU,YDS"> 2Q"9 29,7 34"8 TANK SIZE (8AL(-;) ` 1,000"0 ** 1,000"0 ** 1,0O8"0 ** SOIL RATING (SQ.FT"/BR) 177 ' 177 177 ** GRAVEL LENGTH > 75 FT" REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH) ** TANK MUST HAVE AT LEAST �-�-.... - .... --�~- - -.1~ TWO COMPARTMENTS .... 1-~^ .... ~..... .... .... ...... ... -~�~~~~~-~�r I certifY that: 1. I am familiar with the requirements for on. -site sewers, and wells as set forth by the Municipality Anchorage (MOA) and the State of' Alaska" 2" I will install the systemin accordance with all MOA codes and regulations, and iO compliance with the design criteria of this permit., ` 3. I will adhere to all MOA and State of Alaska ;equirements for the set back ` distances from any existing well, waistewater disposal system or public sewe,�?rage system on this or any adjacent or nearby lot, 4" I understand that this permit is valid for a maximum of Z bedrooms and any enlargement will require an additional permit" IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION UST BE OBTAINED; (2) AS~BUILTS WILL. 'NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. �SIGNED ' DATE APPLICANT; A E CS ISSUED BY -4/ DATE: � SOILS LOG C) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION 825 L, Street, Anchorage, Alaska 99501 264-4720 / SOILS LOG — PERCOLATION TEST PERFORMED FOR:JF C� S DATE PERFORMED:�� / L% LEGAL DESCRIPTION: G D / I7/oC �d�,51,x+' /T,�/S S� ��e2tpra, $ime�� SLOPE SITE PLAN D E H to -71 1 �0R;-7 d 2-1�I � saw 7 3 5 D S //7(/. �GM) 6 $ Si I7` (AIZ) 9 s, Jf )te' d 7Lo /0 0/at/°P- 10 Y-0 11 12 13 14 15 16 +0 k. 17 18 '5`' 4°F, ---- 10Nk" 1s WAS GROUND WATER ENCOUNTERED? L) _ IF YES, AT WHAT DEPTH? 'If z jl Reading Date Gross Time Net Time Depth is Water Net Drop(�7�) �z f % 3 D 19 PERCOLATION RATE D .38 0112 3 5� �.7'i /e/� � / s'i i o 40, ? 0.08 o� �'rr•�J / a } Iz a/ /0 0. 49-02 DATE:? JL �/ O 0.1-0 .9 8 / /O S o o� /o �. z �/ a.yz o.o� 20 ii /i1z Z 3 O O.q O D (minufps/xcli) PERCOLATION RATE TEST RUN BETWEEN � - � T AND S FT / ZC,O�MMENTS z !/� �.7'i /e/� � O rY �� � � �a O�° 2 i% A I n SJ p /� c. �7�ro,f7` r4rJf "L J!o G-u.wi � e..+ ci o� �'rr•�J /�v J�J�/ y } PERFORMED BY: �.2:� CERTIFIED BY: DATE:? - 72-008. (6/79) :. MUNICIPALITY OF ANCHORAGE C7`) / 0 7 � 7 • DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION jj f 7 ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL_ SYSTEM AND/OR WELL INSPECTION REPORT NAME PH EENYEW ❑UPGRADE MAI LING ADDR LEGAL DESCRIPTION LOCATION NO. OF 2DROOMS U Y TO: Well soron ara Dwellin�DISTANCE Pd),(;s i< UJ F Manufacturer p���� K ` Mater �e� (� No. of corry�rtments c�L. y Liq. cap achy in gallons IF HOMEMADE: Inside length Width Liquid depth _j0 DISTANC ell Dwelling . PERMIT X. Z G 2—F Manu urer Materia id capacity in gallons LU DISTANCE TO: Well Foundation Foundation 1391 Nearest lot line ( /6 f PERMIT N0. P �i0�.. J Z z H Z cc No. of lines ` [ Length%o�eych line Total„Lenalh of lines o(,(r' ! Trenoh�viZ9 O� (�! inches Distances b en lines /�hA F cc¢ p Top of tile to finish grade i Material beneath tile C6 inches Totalof ctiya Sa ption area xs l.� r LU C7 Length Width Depth PERMIT NO. QI- as W Type of crib Crib diameter Crib depth Total effective absorption area W DISTANCE TO: Well Building foundation Nearest lot line J J Class I Depth Driller �� Distance 'ne PERMIT N?IOZ,6 J� W DISTANCE TO: Building foundation Sewer line I ` r N Septic tan 1/0 C C Absorption area(s) OTHER PIPE MAT RI �S •� +//J\ 3o �J SOIL TEST RA ING INSTALLER I REMARKS e r � r e TrI L APPR ED DATE LEGAL 4 -4 iJ _, 7116-lel MAXIMUM NUMBER OF BEDROOMS = 2 SOIL RATING (SQ FT/BR)85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: CoF—=F:w-lF"= :9 1.__EENff7d-F"— --1 *5 0 FZ n V EE 0 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF' A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN 'THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). . F --" F—= 91! Ul I F -" F= EN "H. F= F=` -F T #Z= _I".1=1 f -J t` :F- 3: 27 F:l L_ L_ t @ r_j PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. "r [4 CA -C � > I r_4 � F.- lF__ IZ- -r I C-3 r -A "E.- 9=11 ."E 1� EF 0 L) I F -!.EF. IW -m — — — BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS 1�3n BE DEPARTMENT 'HEALTH AND ENVIRONMENTAL )TECTION j 825 'L' STREET, ANCHORAGE., AK 99501 q -g I 264-4720 -r* 1 11 L_ f--1 r-4 C -a K_-1 r -A —"=-. I 1= F= t4 EF_ F;r--' F::` FR t-1:17 E-7 F '-J PERMIT 'NO. &l.0268 ) JaL APPLICANT ROBERT MILBY BOX 3114 PALMER 745-5230 LOCATION LE13AL L2B3 HOMESTEAD HILLS LOT SIZE 55000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 2 SOIL RATING (SQ FT/BR)85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: CoF—=F:w-lF"= :9 1.__EENff7d-F"— --1 *5 0 FZ n V EE 0 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF' A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN 'THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). . F --" F—= 91! Ul I F -" F= EN "H. F= F=` -F T #Z= _I".1=1 f -J t` :F- 3: 27 F:l L_ L_ t @ r_j PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. "r [4 CA -C � > I r_4 � F.- lF__ IZ- -r I C-3 r -A "E.- 9=11 ."E 1� EF 0 L) I F -!.EF. IW -m — — — BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS :100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING .UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F"-" F= P.: ® I -r FEE X F:=" I P? E -E.' S_:- 04 F= ff:_- FE Irl E3 F= Fic :3. -1 - -1 -1 I CERTIFY THAT 1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FIND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: 1 UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RE'S IE"l-INCE IS REMODELED TO INCLUDE MORE mf3N 3 BEDROOMS. S I I.-iNED: APPLICANT ROBERT MIEBY ISSUED DATE-..--,. V4. 0 ❑ SOILS LOG L,UNICIPALITY OF ANCHORAGE ,PERCOLATION ..r . DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST I, Pouch 6.650, Anchorage, Alaska 99502 276-2221 SOILS LOG - PERCOLATION TEST PERFORMED FOR:, 30.0 MIL -1 3 Y DATE PERFORMED: 1-2 A P R 61 LEGAL DESCRIPTION: (,MES -MAP VI L L L bT OC. I%3,;1 DEPTH (�SLLO�PE�'(�� SITE PLAN (FEET) 1 2 3 4 5 6 7 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS PERFORMED r THOMAS K. SM ee 2248-E . h—de•soo.aebe eee WAS GROUND WATER A S ENCOUNTERED?(�_ L O P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TCCT of 11,1 acTAICCAI �&A, �/._Sd��� Set pump is.producg Lallons of water per hour m @.midfeet. Lk4 �., c3rnX ThLs well INVOICE INVOICE NO• MOON DRILLING DATE?~ BOX 3370 YOUR P. O. NUMBER --- PALMER, ALASKA 9%45 TERMS --- TELEPHONE 745-4071 Sub.'! �Sri7� WELL LOG SALESMAN _glk�3 L DEPTH CABIN FORMATION DEPTH CA 91N FORMATION DEPTH IN PT. CASIN FORMATION IN FT. IN IT. n .101 '�" '201 202 1 a 102 _ l0a '• 203 204 a -• 4 �� 104 .. 106 _�._.. - 200 206 ..��,._.. -. 6 4 106 ......+. 107 - _ Z07 . •206 . 7 • 106 -too— ..209. 210 -210 9.. 10 130 111 211 -212- 11 2 312 113::213- _• 214- 19 14 114 116 216 .... 21g 16 _- 116 -217- 219- 219 19 -19--- O 129 111 ,__.. 221 " 222., 21 22 122 123- 22a 224 - 20 14 121 126 226 ~ 226 26 26 126 127 227 22B 27 26 128 129 229 480 29 a0 190 131 281 292- 31 a1 132 _ 133 299 434 33-134:-293 54 136 296 36 46 - 138 197 ... 297 238 87 as 138 ls9-240— .. - 239 $9_ 40.. _. ... 140 __...-241- Ul ....._ ,._ .. ..242 41 _. .... 42 ..... 141... ....:.. 149 mow- - - 249 .. .. - 244 as 44 144. 146 .r*,'^ .�.«.,,. �,..,......�.,...+..,.-- _ 246 46 46 -- L48 -247 147 248 47 46 149 149 249 260- 49 -_,.. 5'a 160 --261- 161 262 61 62 161-253- 168 268 -254- 53 64- --164- ••• 166 255- 6664166 266 66 __- N •_ •• 168 167 261 268 67 69 169 169-- 269 -260-r� 69 60 160 161 261 262�, o ry 61 62 lag 163 �..- sea 264 ... 6a-164--266- 64145- -- 6664186 268 66=--168 86-167-- 261- 816616T 266 67 as 166 169 269 270 69 TO 170 171 271 I 272 --� 71 77-173-y 174 Ta 74-176--,- 17t -275- Z76 7a376 7e _ 197 277 --' 278 - 77 79 17S •— iio- �. 2T9' ._ —200 260 79 Igo— 191 231 2B2 81 a1 a2 94 132 16J 263 294 N 96 164 1B6 tae 286 266 ... __ . 9e __ _ __�� 67 99 -.-.IV _ la9 -- z6T Zee 269 as 90 lag 190 191 s00 291 91 92 192 193 297 293 93-104--2B4 94 196 296 96 96 196 296 297 9T193 Y6 19D L 299 299 PLEASE PAY FROM THIS INVOICE 9.r toot AMOUNT a Municipality of Anchorage Development Services Department t Building.Safety Division ` s�'r. On-Site Water & Wastewater Program 4700 Bragaw Street A P.O. Box 196650 ; Anchorage, AK 99519-6650 www.muni.org/onsite % (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLEFAMILY DWELLING Parcel I.D. 015-173-24 COSA# CSC('61fe",?- 1. GENERAL INFORMATION Expiration Date: 7 ` (ice Complete legal description HOMESTEAD HILLS S/D #1; BLOCK 3, LOT 2 Location (site address) 11320 BEARPAW STREET * ANCHORAGE, AK * 99516 Current Property owner(s) PATRICK WILLIAMS Day phone 830-5371 Mailing address Lending agency Mailing address 11320 BEARPAW STREET * ANCHORAGE, AK * 99516 Day phone Real Estate Agent MIKE MESSICK W/ REMAX PROPERTIES Day phone 276-2761 Mailing address 110 W. 38TH AVE, #100, * ANCHORAGE, AK * 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well N Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑. Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal of fixed hereto and as of the validation date shown below, l verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party isnot authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Phone 337-6179 Date L13 o)20) t> OF .......... -'i I ', df re A. me s. Q 9� CE -7953o UU ORn'Qrofess/ion o� I V0 .�k0jiiIt,,, OFJ Ax 01 � . r J? " ON-SITE Disapproved, WATER ANQ ; R'= WASTEWATER Conditional approval for bedrooms, with the fllowing stipulations: a PROGRAM 1Soll )))I9v Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsen plc Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: 7%V1 (Rev. 11/05) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: HOMESTEAD HILLS S/D #1; BLOCK 3, LOT 2 Parcel ID: 0/251 /-79-a / A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 7/15/1981 Sanitary seal (Y/N) YES Total depth 221 ft. Cased to 222 ft. FROM WELL LOG Date of test 7/15/1981 Static water level UNSPECIFIED ft. Well production 7 g.p.m. WATER SAMPLE RESULTS: Colifor _ ' colonies/100 ml. Arseni g./L. B. SEPTIC/HOLDING TANK DATA Nit--Mg./L. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 6/23/2010 171 ft. 5.5+ g..p.m. Other bacte olonies/100 ml. Date of sample: 6/23/20.10 Collected by: GEG Ltd. Tank Type/Material SEPTIC/STEEL Date installed 10/4/1984 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 6/23/2010 Pumper ISAACS PUMPING C. ABSORPTION FIELDDATA *BELow ExIsTING GRADE 10/4/1984/ 175 Fre/BDRM BED/ Date installed 4/9-11/1994 Soil rating (g.p.d./ft2or ft2/bdrm) 0.6 GPD/Fr2 System type TRENCH 0.5/ Length 47� ft. Width 25/ ft. Gravel below pipe 4 ft. *4.25/900 Total depth *8:6 ft. Eff. absorption area -it ft 2 Monitoring tube YES Depression over field NO Date of adequacy test **6/23/2010 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test DRY in. Water added 650 gal. New depth DRY in. Elapsed Time: — min. Final fluid depth DRY in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — **NOTE: TESTED 1994 TRENCH ONLY. 1984 BED WAS NOT IN. USE AND DRY. D. LIFT STATION Date installed Size in gallons "Pump on" level at in. "Pump off' E. SEPARATION DISTANCES Manhole/Access h water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION: DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Buildingfoundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water, 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation 10,+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION OF A I certify that l have determined through field inspections and p g H review of Municipal records that the above systems are in 0 conformance with MOA COSA guidelines in effect on this Q date. a Gams.. Engineer's Printed. Name JEFFREY A. GARNESS QQ C 7 Date@ o 0\ �d �� l �� 0fessio�o 0 COSA Fee Q -SIO Waiver Fee $ Date of Payment fy Date of Payment Receipt Number 67 S OS Receipt Number (Rev. 11105) ° 0ry0119 p° ,� mciy0C �o moo'm cr o g;� 0 0p map p m1tD1 R 0 m � �m`QA ..p'm p p �wrb 0 00C -° sr'cl ems+ ��D. �! Fpm p1 m m CL. ° tr 4 0 sn rb m p� rr meCDibG I °O t�q GY d o �. cr °mp 9�gga;� pm:;!;10p. pmraMo�rnm 5y�tl ��.:y g 0 m m m 0 m 0 p, p, 0 z rm*i r z p C) m cw vo a a C7 to 'm to 0 E 3 3 rn 0 N 00 00 Ln w m A m m rn rn z C') m vmm w D m r N c0 N L4 M p W w w v A • mm mz me m zoxmm O mm voory mx?Zn r� v,m rn b U - Z m m� �m II o z \ M // o O o>�°xx zmrn� ® / \ m -r1 Q mm --i r O o* n 0 I i m m N t (A Ny -n n �O � cn D� I / O 0) x O:9 0-0wC ODS \ -i m tcn-m ,1 m0�� ucR V >0 28 V) -V Co - o- 28NV)-V N _ z rm*i r z p C) m cw vo a a C7 to 'm to 0 E 3 3 rn 0 N 00 00 Ln w m A m m rn rn z C') m vmm w D m r N c0 N L4 M p W w w N • mm mz me m zoxmm rr �o mm voory mx?Zn r� v,m 00? D� -{-.-� o co =�rl m2 �m 0�ocm z m aa� _x m-< o O o>�°xx zmrn� ® z o m zx Q zoz O o* �omz Q r-imi?z z m 0No;'T , o m Ny -n n �O i �moor D� rn D m < O 0) x O:9 0-0wC ODS -i m tcn-m z m0�� ucR V >0 28 V) -V Co - o- 28NV)-V N _ O <DN w mzAz moom v w C z SIE 0 ®® m oO D' rn Orn Cn rn o (� p rn m i= z g rr Z D r 0 g' � o t� z1 0 m i Z D m m O A. z z 11 m X m rori m ; x r rn ELMORE ROAD 10' T&E EASEMENT_ _ m o ^, -------- - --D N o �20' GAS EASEMENT �20' CEA TRANS. UNE EASEMENT ^ _ 1» � m N z m r� z � m z -*1 0 z rn n m °tn 0 0 0 ° _u 0C) �z C7 m;v ZE] m m O C7 N T X °7 N 0 v -._ 4- m 07 W ON O qm o O 00 z cn 'D co z z 0 5O m aa� o O NO ® z o °f 0 ND O Z7 X rr� - (;Az, 34.2. to v IN w rn D m < O 0) x O c N -i m tcn-m 0 12.0 v m 0 0 0 ° _u 0C) �z C7 m;v ZE] m m O C7 N T X °7 N 0 v -._ 4- m 07 W ED z A xm m aa� o O ® 03 v O - N v rn cO10 rn D m < 0) x o v 80.10 N 00.06'19° W 165.35 BEARPAW STREET w 0 m v SGS Ref.# 1103010001 Client Name Garness Engineering Group, Ltd Project Name/# Homestead Hills 41 B3 L2 Client Sample ID Homestead Hills 41 B3 L2 Matrix Drinking Water Printed Date/Time 06/30/2010 13:52 Collected Date/Time 06/23/2010 13:10 Received Date/Time 06/23/2010 15:35 Technical Director Stephen C. Ede Sample Remarks: 450ONO3 - Total Nitrate/ Nitrite - MS did not meet QC criteria, biased low. LCS meets QC criteria. Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date ]nit Metals by ICP/Ms Arsenic ND 5.00 ug/L EP200.8 B (<10) 06/25/10 06/30/10 NRB Waters Department Total Nitrate/Nitrite-N 1.77 0.100 mg/L SM20 450ONO3-F C (<10) 06/24/10 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM20 9223B A 06/23/10 DLC Total Coliform Negative 1 100mL SM20 9223B A 06/23/10 DLC i'�NL� r ft -k._ '9 t to _.h ° age Department of Health The Municipality of Ancf1'or hand Human Services:(DHHS) (sues Health Authority, Approval Certificates based only upon the representations given in paragraph 5 above by an independent r !PL`if 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. 4 '. 72-025(Ru.1/91) Beck MOAM21 ' ' 5.: STATEMENT OF INSPECTION BY ENGINEER• E ` 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 ti 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 kf ,^ 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 �� t CtNSQI.TI N1Gt t�.nSGIn Er2S Phone 345-13 35 Address Po to n� ;. Engi'neer's ` Date Y2- ,I • , �p 'IYi 15 6. DHHS SIGNATURE Approved for 3 bedrooms. '. Disapproved. -- Conditional' approval for bedrooms; with'the following stipulations: S ° , IN I +5 4. Additional Comments ' Date 4 — 2__J-_-94 By _.h ° age Department of Health The Municipality of Ancf1'or hand Human Services:(DHHS) (sues Health Authority, Approval Certificates based only upon the representations given in paragraph 5 above by an independent r !PL`if 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. 4 '. 72-025(Ru.1/91) Beck MOAM21 ' ' Municipality of Anchorage aL Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L �Z IS 3 Ovqi,(-STEAD MCLS Parcel I.D. v�f�ivtSio� �\ A. Well Data Well type W014 % OyAL- If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) *(V Date completed ?- -( S- 84 Driller Unslu3ti�a t i Total depth 2-22` (S) Cased to 221 i C2-) Casing height 1 Sanitary seal (Y/N) 1�elg ':�(D Wires properly protected (Y/N) YCS FROM WELL LOG Date of test ?-tS-t54 W Static water level up"Owt.JW Well flow -7 GO -9-P.M. Pump levels Vii Q? `t41 o -7 AT INSPECTION 2'I -114 (D MUNICIPALITY OFANCHOKAGE ENVIRONMENTAL SERVICES DIVISION Ilo2 i ` b ..Nrl 7 3 1994 g.p.m. UN�cNow�� RECEIVED SEPARATION DISTANCES FROM WELL TO: i Septictholding tank on lot 1041 ; On adjacent lots 1 Absorption field on lot X2--9 ; On adjacent lots _ >12JD1(D ? IZoI Q Public sewer main N/ Public sewer manhole/cleanout N/A Sewer service line .7Z) Petroleum tank 1051Q - 'IX Q iQAPL (v WATER SAMPLE RESULTS: /cow Y rac bhc Coliform axz- 0Nitrate •��T0OtherbacteriaQ arsl.dJ �R�s urs Date of sample: © Collected by: CD B. SEPTIC/HOLDING TANK DATA 2. 2 Date installed . -7 %I Tank size IQ� ' Compartments ` Cleanouts (Y/N) fY Q Foundation cleanout (Y/N) til! S Depression (Y/N) N�a� High water alarm (Y/N) 1� 1/i Alarm tested (Y/N) �J/A Date of pumping % �(v 1 �} �/ �a Pumper V:Lh ('< CciE int SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot �04i On adjacent lots 171 Foundation 2 To property line 74 o Q Absorption field �,1 1 lt�, Water main/service line 13b�', Surface water/drainage p3LNc 1) U 1066C4,6W10 BY DkA I CONTINUED ON BACK PAGE 72-026 (3/93)' Front Q fy24> ^ 00�*S C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump High water alarm level Meets MOA electrical codes (Y/N) _ SEPARATION DISTANCE FRO Well on lot D. ABSORPTION FIELD DATA Manhole/Access (Y/N) "Pump off" ATION TO: On adjacent lots Surface water Date installed .4— q- q,+ Soil rating (GPD/Ft2) s L' System type W I DC NI-C^JUA 1 1 I o Length % 45i —Width �� Gravel thickness Total depth 1 Total absorption area SU' �> Cleanout present (Y/N) YCs Depression over field (Y/N) kc) Date of adequacy test N& AS6J r3ltSi1 wk Results (pass/fail) for - Bedrooms Water level in absorption field before test N%AN After test Peroxide treatment (past 12 months) (Y/N) N/,A. If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot RfI On adjacent lots > � CAO, � Property line To building foundation�� I ® To existing or abandoned system on lot t I On adjacent lots N1P- Cutbank NONE_ Water main/service line NV^ Surface water O'DOC- Driveway, parking/vehicle storage area 1001 } 01 Curtain drain t3Df4" E. ENGINEER'S CERTIFICATION 1 certify that l have checked, verified, or conformed to all MOA and HAA Signature Engineer's Name Date v HAA Fee $ _ Waiver Fee $ Date of Payment x-13- 9 v/ Date of Payment Receipt Number cz,2 SY // Receipt Number. nspection. MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE. 1. General Information Application Date /d / (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicants Name 3W _511cov Telephone - Home Business Applicants Address 1 20 - (c) Applicant is (check one) Lending Institution � er/lder Buyer ;'Othgr (explaj.n); (d) Lending Institution Telephone r Address (e) Real Estate Co.' & Agent Address Telephone (f) Mail the HAA to the following address: 2. ape of Residence Single -Family Multi -Family Other (describe Number of Bedrooms 73 3. Water -Supply - Individual Well Community Public Note: If community 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. [Page 1 of 2] 5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information 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 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 regula- tions in effect on the date of this inspection. Name of Firm 4V Date (ENGINEER j2, Telephone_ l �dY4 6. DHEP Approval %` •Ler C. RSeiid Jr1.6 AP Approved for _ edrooms By t Approved Disapproved Conditional Terms of Conditional Approval__ CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS 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 REQUIRE- MENTS. 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. (DHEP SEAL) RR4/ej/Dl8 [Page 2 of 2] 7-19•-84 A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 titu1 JCi10 ,i_nv or nNcH0.1AGr c� '1 & �+5 Legal Description: /.a 3-:3 / M&5rf/ .b #/4-4-5 — Well Classification If A, B, or C, D.E.C. Approved(YM) Well Log Present (Y ) _ Date Completed /S Yield 5%6 .ri Total Depth `z 1 2/ Cased to Z"z--I / Depth of Grouting - Static Water Level 1894D i Pump Set At all/ Casing Height Above Ground Sanitary Seal on Casing(Y ) Electrical Wiring in Conduit) Depression Around Wellhead ( ) Separation Distances from Well: To Septic/Holding Tank on Lot On Adjoining Lots fi-/00 f To Nearest Edge of Absorption Field on Lot -/AB "JIM ; On Adjoining Lots /E�o To Nearest Public Sewer Line To Nearest Public Sewer Cleancut/Manhole )lt± To Nearest Sewer Service Line on Lot /ZI) -Ir Water Sample Collected By JIP/" ' ; Date dt " Water Sample Test Results 4611f r45 nyey Cc ments 'P lopp l �Kt �� 1,011W w ���✓� 7, 41r m lrezi- thio catj j-w.m." J O nasi. 1,953/ ao �fi,, �:i�¢ ® Ak B. SEPTIC/HOLDING TANK DATA Date Installed = j 1 Size /ee>O' No. of Compartments - Standpipes Y ) Air -tight Caps ,A� ") Foundation Cleanout/Nm) Depression over Tank (Y ) Date Last Pumped Pumping/Maintenance Contract on File (YM) ; for Holding Tank High -Water Alarm (YM) A: b Temporary Holding. Tank Permit (YM) Separation Distances from Septic/Holding Tank: To Water -Supply Well /M/-- g To Building Foundation r To Property Line /f% 14— To Disposal Field To Water Main/Service Line -k-,2,7 �fl To Stream, Pond, Lake, cr Major Drainage Course 00 (Page l of 21 0 2-15-84 /a 83 / OVF:57!V,*>1%44; C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Gf Type of System Design e4EAP Date Installed of Field y,S Width of Field 2D Depth of Field S;y� Gravel Bed Thickness Square Feet of Absorption Area Standpipes Present(�1) Depression over Field (Y Date of Last Adequacy Zest ,26La Results of Last Adequacy lost AJ 6-0 Separation Distance from Absorption Field: To Water -Supply Well I/?/ To Property Line Z�! To Building Foundation[/ To Existing or Abandoned System on Lot On Adjoining Lots -/- ; To Water Main/Service Line ,t- q/ To Cutbank(if present) P)/t To Stream/pond/Lake/cr Major Drainage Course ��DO To Driveway, Parking Area, or Vehicle Storage Area Coninents 4 /moil T D. LIFT STATION Date Installed Dimensions Size in Gallons /Access (YM) "Pump On" Travel at "Pump Off" Level at High Water Alarm Level a Vent (YM) Tested for Pumping Cycles during Adequacy 'lest. Meets MOA Electrical C s(YM) Comment Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conforired to all MOA HAA Guidelines in effect on the date of this inspection. Signed Company KB1/d5/s (Page 2 of 21 Date MOA No. D� IOIN aaa+o.�.N6&RS d f.�® i iy C. Nrd, Jr. No. 22514 2-15-84 S � 5. LEGAL DESCRIPTION O 7���©� ! DATE RECEIVED INSPECTION APPOINTMENTS 4 TIME TIME TIME E:1 One ❑ Four El Other [ SINGLE FAMILY ❑ Two ❑ Five DATE DATE DATE PKr INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled INSPECTOR INSPECTOR INSPECTOR RrIAA . MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE & ENVIRONMENTAL PROTECTION DEPT. OF HEALTiI & DEPARTMENT OF HEALTH ENVIRONMENTAL P OTECTION 825 L Street - Anchorage, Alaska 99501 • ENVIRONMENTAL SANITATION DIVISION 9 1981 Telephone 264-4720 (('' FF Ly'- REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW�F�ICiIw) DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER o /& PHONE MAILING ADDRESS,�12p 0 PROPERTY RESIDE (if different from a ove) PHONE 2. BUYER {� PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAI LING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS,.,/ Y 5. LEGAL DESCRIPTION O 7���©� ! n� STREET LOCATION STREET l2 `L'A CA 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS E:1 One ❑ Four El Other [ SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY PKr INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE**y / YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) /1 AW r 0._ ;). V a n THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED YL—o 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑SeptticTank c�or 1:1 Holding Tank Size:. TaIf Tank is homemade give dimensions: SOILS RATING TYPE OF TANK. MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS 1� APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE �✓ ��^' 6/ BY ( /L./460 825 "L" STREE*1 ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEAI_11-i AMI) 6 NVIRONMENTAI_ PROTECTION October 26, 1981 Robert Milby Post Office Box 3114 Palmer, Alaska 99645 Subject: Lot 2 Block 3 Homestead Hills Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) A well log submitted to this office for our files and review. (2) The water analysis report needs to be submitted to this office from the Chem Lab,'5633 B Street, for our review. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw