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Home My WebLink AboutROBINDALE LT 12Robl'ondale Lot 12 #051-053-14 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231149 PID Number: 051-053-14 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name CHRIS DAVIS & BONNIE KELLEY-HEUSTESS ABSORPTION FIELD ® Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 24119 SUNNYSIDE DRIVE, CHUGIAK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 0.6 GPD/SF 9 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2 Ft. Gravel depth beneath pipe 7 Ft. Subdivision Block Lot ROBINDALE 12 Fill added above original grade VARIES 0.36' — 1.11 Ft. Gravel length 74 Ft. Township Range Section Gravel width 2 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 1036 Ft2 1 NA Ft. Well 100'+ 100'+ 25'+ TANK N Septic N S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1500 Gal. Surface Water 100'+ 100'+ Material HDPE Number of compartments 2 Lot Line 5'+ 10'+ NA Foundation 10'+ 10'+ LIFT STATION Manufacturer GREER / ORENCO Capacity 1500 Gal. Remarks 2" IN SOUTH PORTION OF TRENCH & 4" IN NORTH PORTION OF TRENCH Alarm location FIRST FLOOR Electrical installed by DRS Installer FRS PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Drainfield 3034 Co/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspdection 151 8/14/23 2nd 8/14/23 Location and description 3`d 8/15/23 4" 8/15/23 TOP OF MANHOLE ON -SITE WATER AND WASTEWATER SECTION APPROVAL 4� lit Conditional Approval: Date low ' •: TH .. 4..- ....... l / • • " .... .......... Curtis Huffman � �'•, • � � Septic System Approved - c, Date / Y�Zy �� F�� . CE 128991 s�F�•. 12/15/23 .•��G=� ilF�pROFESSIONA ��.� Note: this approval does not include well permit requirements. 1�'�`11� (Kev uwu2n u) PID:051-053-14 PERMIT: OSP231149 Lot 8 I Lot 9 ( Lot 10 89'56'E 132.00' MT o F 4 INSUL MT 10' UTIL E WOODEN FENCE I 29' TRENCH L i 10' UTILITY 5'+ TO EXISTING FIELD GREENHOUSE EASEMENTS TH23-1Z -10'- x MH MH DECOMMISSIONED f5 DCO E�TTNE D & W i 1GAL HDPE �\ \ STEP TANK 100' WELL ISEPTIC W/ INSIDE RADIUS Z / STEP To OLD FIELD. STAKED FCO AT CONST. G T o 15.t' B 28.1, 51.5' to 2.2' I62, SHEO o O�G �+ -4.1' x 12.5' BALCONY v. p y Lot 11 Lot 13 p 4.1' x 9.0' CANT 48R SHED ON SKIDS WITH STAIRWELL BELOW HOUSE v W/ NO FOUNDATION c ro N Ln 33.4' 36.1' 4.1' x 21.1' BALCONY \ FCO , 91H MH� A—C=42,0' 99.37 B—C=19,1' A—D=40,9' 92.96 B—D=19,5' A—E=63,4' 9z3s 1'HD E STEP TANK B—E=42,3' 0 - � i B—F=56,4' A—G=30,9' B—G=36,3' �J Lot 12 19,074 s.f. ASPHALT S DRIVEWAY ,p0 PROTECT\VE RPD\U rFINAL GRADE MT10026 MT MT / FV— R FINAL GRADE FILTER FABRIC I I W/ 2' INSUL SEPTIC SECTION SCALE, NTS 2, GRG/OL 97.15 SEWER ROCK 90.15 SM-MI/GM DRY - 5/19/23 DRY - 8/14/23 15, - TH23-1 ROBINDALE LOT 12 SUPPORT SERVICES: PREPARED FOR: �� OF ��,� CHRIS DAVIS & BONNIE KELLEY—HEUSTESS 24119 SUNNYSIDE DRIVE * 9 TH ,rr CHUGIAK, AK 99567 0. FIRST WATER CONSULTING DATE: 12/15/23 tis Huffman 13030 SUES WAY SURVEY: KGL CE 128991 DRAWN: FWCS ANCHORAGE, AK 99516 SCALE: 1" = 30 X 12/15/202ivo 907-350-9566 FirstWaterAK@gmail.com i I Lot 8 I --I-- E 2.2' Lot 13 i PIPES / 15,1• SliEO � Lot 9 I Lot 10 I N 89'56'E 132.00' WOODEN FENCE 10' UTILITY GREENHOUSE EASEMENTS MANHOLES B.O. 1 STORY RESIDENCE N WITH DAYLIGHT N BASEMENT 33.4' 36.7 • CHAIN -LINK FENCE ASPHALT DRIVEWAY 51.5' `4.1' x 12.5' BALCONY x 9.0' CANT WITH STAIRWELL BELOW V'.1' x 21.1' BALCONY Lot 12 19,074 s.f. }0o PR0SE0j1"Js �p1U5 WELL S 89'56'W 132.00' SUNNYSIDE DRIVE J Lot 11 IV 'O O PLOT PLAN AS BUILT X SCALE 1 " = 30' GRID NW 1561 Project No. 23-028/A3 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lana & Associatesinc. (907) 522-6476 Phone " ' (907) 522-4625 Fax vvo�'�DOQ� Q Professional Land Surveyors ken®Iangsurvey.com v OF A� �Q jonathanQlongsurvey.com I hereby certify that I have surveyed the following described property: LOT 12, ROBINDALE SUBDIVISION (Plat No. P-591) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the V-W Day of � ' °�'�- , �I , at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49TH�I KENNEtH LAN o .I-S-5202_ . • gJO SSIONN- Q �DOpOoo" AECC963 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231149 Work Type: Septic Upgrade Tax Code Number: 05105314000 Site Legal Address: ROBINDALE LT 12 G:1561 Site Mailing Address: 24119 SUNNYSIDE DR, Chugiak Owner: KELLEY-HEUSTESS BONNIE J & Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: il Ment S 1° l -;:...t 'IN V• Department 6/28/2023 6/27/2024 19074 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with - 1 . ith: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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: A test hole is required prior to construction of the absorption field, in the location shown on the site plan, to confirm minimum separation to impermeable soil and seasonal high groundwater, as well as percolation rate. Construction may proceed at your own risk prior to 7 -day groundwater monitoring. If results require a design change, construction shall stop pending approval of a change order. Please submit results with the inspection report (or change order, if required). } S i=J '-�-rlvC ii Received By: S S uED -f-0 P Issued By: V V v\ 0 F Date: Date: (�2 S zo-Z 3 LI MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-053-14 Property owner(s) Chris Davis & Bonnie Kelly-Huestess Day phone Mailing address 24119 Sunnyside Drive Chugiak, Alaska 99567 Site address 24119 Sunnyside Drive Chugiak, Alaska 99567 Legal description (Sub'd., Block & Lot) ROBINDALE LOT 12 Legal description (Township, Range & Section) Lot Size 19,074 Sq. Ft. Number of Bedrooms In APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ® Initial ❑ Single Family (SF) X❑ Septic Tank X❑ Upgrade X❑ (w/wo AD U) Holding Tank ❑ Renewal ❑ Duplex (D) ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: P-+_701-1 Distance: r I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Si -nat-are-of-property owner or authorized agent) Permit/Rush Fees:A5q 5 Waiver Fees: Date of Payment: {o (2/ LD'L3 Date of Payment: Receipt Number: Y Receipt Number: ``�� Permit No. Z{�2?� / 1 t- � Waiver No. V5 V 2-3 f 033 GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage n. s I)e ha rtine nt P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV231033 PID#: 051-053-14 COSA#: OSP231149 Legal Description: ROBINDALE LT 12 Engineer: Curtis Huffman Your request for a waiver of the required 14 feet horizontal separation between the proposed absorption field and the existing one has been approved. The approved separation distance is 10 feet. This waiver approval applies to the proposed absorption field. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ............................................... IS ............................. ■ 1 Waiver is Granted: X Waiver is not Granted: Date: V 2 v 3 Approved by: 6�� Name of Reviewer **** VARIANCE/WAIVER REVIEW **** FIrst Waler C 0 N S U L T I N G upi fti.1. pfi.Ft °l W" 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com June 8, 2023 Municipalities of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COIVIPUANC On4P239949, Curtis Townsend, 06,28 RE: ROBINDALE LOT 12 - SEPTIC SYSTEM UPGRADE PERMIT W/ WAIVER The property owner has requested we obtain a permit to upgrade the aged septic system of the above referenced lot. We propose to install one deep trench and 1500 -gallon HDPE STEP tank to serve the existing 4 -bedroom residence per the attached design. The design is based on the recent testhole conducted in April -May 2023 and per MOA record test hole data conducted in 1985 by S&S Engineering. Per these testholes, no groundwater was observed at excavation or monitoring. Due to elevations, silty soils with no anticipated effluent transfer, to minimize negative property and area impact, and other reasons a field -to -field waiver of 10' between the existing and proposed trench TED trenches are requested. This waiver is justified with the tighter, silty soils and shows any potential effluent transference or interaction between the existing and proposed fields will be marginal or nonexistence. The property is best served by retaining the original field for future use due to the lot & area characteristics. The mitigating factors of soil type justify the issuance of the waiver and indicate the proposed field will have no effect on the functionality of the existing fields. The slopes are moderate at 1-6% at the proposed upgrade location. The lot and area are served by private or private shared water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. �•� CC�,„„ONSULIINQ SEPVICFS WATER WA RIEWAEER ' SVPP041APIANNIN0 F is[ Water - C O N S U L T I N 1AIfR1INAST FWAIER 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com August 14, 2023 Municipalities of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: ROBINDALE LOT 12 - SEPTIC SYSTEM UPGRADE PERMIT - CHANGE ORDER We contacted Lang & Associates, Inc. to ascertain the existence of any 10' utility easement. Per Ken Lang this easement does exist, and they missed the easement that was vaguely shown on the original plat. Also, the existing septic trench is slightly skewed, and the proposed trench cannot be installed as proposed so the trench layout has been modified. The adjacent septic system on Lot 13 runs parrel to the proposed trench and is 17'+ away. The area slopes are moderate and flat at the proposed septic trench location. The lot and area are served by private or private shared water. Other than the trench layout, there has been no other design changes. The design will not impact any of the neighboring properties. JRs excavation is installing currently and request immediate response. Please contact us if you have any questions. Sincerely, i Curtis Huffman, P.E. Attachments: CO Design & TH23-1 — F�q sEnvicFs 11NEN1WdJIE1111FX c-'oYj DESIGN CALCS: 413R X 150 GPD = 600 GPD 6000 GPD/0.6 GPD/SF = 1000 SF SAS 1000 SF / (2 X 7' ED) = 72 FT. TRENCH USE 1 TRENCH — 72'(L) X 2'(W) X 7'(ED) NO SLOPES >25% WITHIN 501 TOTAL MAX DEPTH FROM EXISTING GRADE: —9' OF PROPOSED FIELD. NOTESi STAKE PROPERTY LINE & WELL RADII PRI❑R TO C❑NSTRUCTI❑N PRESSURIZED DISTR\BUTI❑N1 1/2 F 1 1/4" PVC WITH 3/16"NL ES @ 2,4' SPACING (TYP) A% LOQ APR= Loc APR= Loc. wE,, t > m Lot o Lei 9 / �AR� \ / sErr� ,moi► ' I� �s �o �'3➢IlC /ISA- 9QJIN 1Y DI R'Ot /Svm AREA llla-1 10° urL bMog- NSf/11,5 rrO • d M OSSINO SpA y na "M Dana /m m mmRk.Torl su ,em ix * V, S&S 1985 TH IS SHOWN PER MOA FILE & AN ,,;� , ®M ADDITIONAL PERC TEST WILL BE CONDUCTED a,s TO VERIFY SOILS 2& 4M PRIOR TO CONST. Hata nmwar. , STORY RESIDENCE /FPRv. LOi 11 Loi 18 WTM DAYLIGHT too' m R0.5E/AENT Lot SS4 /eanrcxr 1QX4 d? rtxs \ ElL \ NO WELLS WITHIN 100'OF PROPOSED SUNNYSIDE RIVE \ APPM Loc SEPTIC SYSTEM. A9F'M Loa wELL� I ee wu ROBINDALE LOT 12 SUPPORTeSERVICES: ®®®®® PREPARED FOR: or OF '4,§ CHRIS DAVIS & BONNIE KELLEY—HEUSTESS 24119 SUNNYSIDE DRIVE®* 9 TH i* CHUGIAK, AK 99567 FIRST WATER CONSULTING DATE: 8/14/2023 `is Huffman SURVEY: KGL CE 126991 13030 SUES WAY DRAWN: FWCSOf ANCHORAGE, AK 99516 SCALE: 1" = 60' 4 8/14/2ossiola 3 ®' 907-350-9566 FirstWaterAK@gmail.com PAGE: 1 OF 2 4 DESIGN DETAILS: INSTALL NEW 1500—GAL HDPE STEP TANK. MAINTAIN 10'+ FROM FOUNDATION, 100' TO PRIVATE WELLS, 100' TO SURFACE WATER, 5' TO FIELD & DECK SUPPORTS WITH 4' OF COVER OR INSULATION WITH 721 X 7'ED — 9' ORIGINAL GRADE PRESSURIZED TRENCH WITH 3+' OF COVER OR 2' COVER & 2" OF INSULATION. INSTALL PER AMC 15.65, 15.55, & MASS... TANK BEDDING, SEPARATIONS, MATERIALS,... / Lot B ( Lot 9 _ APPROX. '1 -- SEPTIC AREA 100' WELL SEPTIC AREA I RADII I Lot 10 SEPTIC AREA - TRENCH 12' OFF PL PER IR / / SE TH23-1 I 89'56'E 132 0 ' _ 10' UTIL o CLOSE TO ANCES - INSTALL 10' FROM PL & 10' TO EXISTING FIELD. j STAKE PLs, WELL RADII, EXISTING FIELD RIOR TO CONSTRUCTION. NTRUCTION. -10 - S&S 1985 TH MT 28' of EXISTING SILTY SOILS WI EWAIVER 7 -ED NI ASSUMED I MT 0-37, VACANT ' ExlsnNc FI DIV TO IS 2.5' WIDE GREENHOUSE ixQ H FIELDS a H DECOMMISSION PER DATA - a EXISTING S.T.SHARED WELL & INSTALL NEW 10 ACROSS ACROSS THE (� (� 1500 -GAL HDPE RADIUS STREET SERVED o z / SEPTIC STEP TANK THIS PROPERTY CL FCO W/ DIV. I PREVIOUSLY. Ld t't 51.5' cn v p MT I o 28. t' (n PER DATA - W SHARED WELL ' SNEa N ACROSS THE I 2.2 0 4BR v STREET SERVES ¢ ?' THIS PROPERTY. ¢ 8.0' 1 STORY p \ Lot 13 v' RESIDENCE v APPROX. P Lot 11 `° W TIF o ITH DAYLIGHT 100' WELL CTI cq N N BASEMENT I RADII �_ o 33.4' 36� / ASPHALT PAVEMENT Lot 12 19,074 s.f. \ I-CHAIN-UNKNCE ELL T ROBINDALE LOT 12 SUPPORTOSERVICES: PREPARED FOR: Ar_kq> OF<4S CHRIS DAVIS & BONNIE KELLEY—HEUSTESS .. t'?� 'f- 24119 SUNNYSIDE DRIVE C 9 Tf1 * "� 0 CHUGIAK, AK 99567 FIRST WATER CONSULTING DATE: 8/14/2023is H1fm� SURVEY: KGL CE 128991 13030 SUES WAY DRAWN: FWCS 8/14/2023 ANCHORAGE, AK 99516 SCALE: 1" = 30'sstotz�' 907-350-9566 FirstWaterAK@gmail.com PAGE: 1 of 2 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: ROBINDALE LOT 12 PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 5/22/23 DEPTH FEET OG SOILS 1 ORG/OL 2 3 4 SM-ml/GM 5 6 7 8 9 10 11 12 13 14 15 16 BOH 17 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 5/19/23 30 min 6 1 10/16 30 min 6 1 10/16 30 min 6 1 10/16 PERCOLATION RATE 19 (MIN / INCH) TEST RUN BEWTWEEN 3 & 4 FT PERC HOLE DIAMETER 6 PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: DRY DATE: 5/19/23 TESTHOLE # 23-1 DATE PERFORMED: 4/4/2023 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: CHRIS DAVIS 5/22/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231149, Curtis Townsend, 06/28/23 Lot Lot I L SUNNYSIDE DRIVE II PLOT PLAN ___ AS BUILT _X_ SCALE _ _= 30__ GRID NW 1561 _ Project No. ___ 23=02V 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone op0000�� (907) szz-afizs Fax OF A�p�4 Professional Land Surveyors kenOlongsurvey.com o .. jonothanOlongsurvey.com O�O�•' A •9•S'�On. I hereby certify that I have surveyed the following described property: �-~X'TH LOT 12, ROBINDALE SUBDIVISION (Plat No. P-591) o* : 49— � Anchorage Recording District, Alaska, and that the improvements situated thereon are ' within the property lines and do not encroach onto the property adjacent thereto, that Q no improvements on the property lying adjacent thereto encroach on the surveyed 0'p ' KENNETH NG G. LA premises and that there are no roadways, transmission lines or other visible O �c o easements on said property except as Indicated hereon. Q s�'•, ��(4�29 •.'� Dated this the �� y 2 •LS -5202.•'' agJOG Da of _____ t Anchorage, Alaska Q aR goo 4�n �FfSS10NP& ao It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. .~. MUNICIPALITY OF ANCHORAGE ~~"~'~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAILING ADI~ ESS LEGAL DESC~IPTKON Well Absorption area Dwelling PERMIT NO. DISTANCE TO: ~ I~ ~ ~ ~<~ ~ Manufac ,urer>~ ~,~ .~¢, M~--~_~ No. of compartments Liq. capacity in gallons Inside length Width Liquid depth ~ ~ IF HOMEMADE: .... ~~ ~ ~ DISTANCE TO: Well ~/~ Dwelling PERMIT NO. ~ -- ~ Manufacturer Material Liquid capacity in gallons D Well F~undatio, Nearest lot line wi~ inches Total left,of, lines Distance between lin~/~ ~ ~ ~ Top of ti'e to finish grade ~. Material beneath tile Total effeC~Ve~r~n area ~en~th ~idth Depth PEBMIT ~O. ~ ~ Ty~e of crib Crib diameter Crib depth Total effective absorption area m Well Building foundation Nearest lot line ~ DISTANCE TO: ~ CI Depth Distance to lot line PERMIT NO. ~ ~O~ ~ ~~ ~ ~ ~ Driller ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) PIPE MATERIALS~ t I INSTALLER .~., ~ REMARKS ~ ~;/'.to~:~:%¢,6~;~~ ..~ ~. · MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST [] SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 5 7 8 9 SLOPE ~ITE PLAN 10 11 t WAS GROUND WATER S E IF YES, AT WRAT DEPTH7 13 14 15 16 17, 18- 19- 20- Gross Net Depth to Net Reading Date Time Time Water Drop l~ebert A. sha'~er '~" '~ (minutes/inch) TEST RUN BETWEEN ~ FT~ FT COMMENTS PERFORMED BY:~ ~ ~B}~ CERTIFIE~ ~ DATE: ~H, 694-2979 tIT ' Mirb Dr -thug log r r -.k i t t by DOC Co. dba SULLIVAN WATER WELLS P.O. BOX 272, CHUGIAK, ALASKA 99567 • TELEPHONE 688-2759 OWNER OF LAND ADDRESS LEGAL DESCRIPTION DATE - Started Ended PERMIT NUMBER KIND OF FORMATION: From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. Ft. t�Ft From Ft. to Ft. From_ Ft. to Ft. From Ft. to Ft. From Ft. to Ft.. From Ft. to Ft. Ft. to Ft. From Ft. to Ft. Ft. to Ft. From Ft. to Ft. Ft. to Ft From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. MISCL. INFORMATION: DEPTH OF WELL STATIC LEVEL OF WATER FT DRAW DOWN FT. GALS. PER HR KIND OF CASING From Ft. to Ft. From Ft. to Ft. M�,Mc7A From Ft. to From Ft. to ✓0, q From Ft. to-`jC�,F)t�2� From Ft. t�Ft From Ft. to L_��t From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft DRILLER'S NAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description/___../~ (include/,~O ~' J,~l°t' block, subdivision,j,¢_.///~ se~J/~ township, range) Location (address or directions) (c) Applicant is (check one): Lending Institution []; Owner/builder J~; Buyer []; Other [] (explain); (d) Le n din g I nstit ut,o n ,/~'/~xJ'~¢4:;~ Address Telephone (e) Real Estate Company and Agent Address Telephone (f) -t~rffthe'FtAA to the following address: SRB ~96X EAGLE RIVER, AK 99577 TYPE OF RESIDENCE Single-Family~, Multi-Family [] Number of Bedrooms z~ Other WATER SUPPLY Individual Well~ Community [] Public [] - Note: If community well system, must have written confirmation from the State De attesting to the legality and status. 3artment of Environmental Conservation SEWAGE DISPOSAL Onsitey~ 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 72-025 (11/84) ENGINEERING FIRM PROVlDIN~ INSPECTIONS, TESTS, FILE SEARCH, DA,A 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 regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING Telephone SRB 196X Address Date Engineer's Seal Approved for /-'O~Y--/~ bedrooms by 'Date Approved Terms of Conditional Approval 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 Casing Height Above Ground Electrical Wiring in Conduitt~N) Separation Distances from Well: To Septic/I,,~ Tank on Lot To Nearest Edge of Absorption Field on L~)t To Nearest Public Sewer Line j~'~/~ Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments ~ ..,~ _~4EMUNICIPALITY OF ANCHORAGE (MOA) ALT" AUTHORITY APPROVAL (HAA) .~ O~_~L~~- CHECKLIST- FEBRUARY 1984 ~ ~.~ ¢?~ ~"~.'~ ~:~ 264-4720 WELL DATA ~~ Well Classification ~, ~. If A, B, C, D.E.C..Approved (Y/N) Well Log Presen~N) Date Completed //~-¢ Yield Total Depth ~ ~ ~Cased to /~ ~" Depth of Grouting/ ~ Static Water Level /~ ' Pump Set At ~ ~ Sanitary Seal on Casing (:~/N) Depression Around Wellhead (Y/~ ~. c:~:~ ;On Adjoining Lots ~, I, .~ ~ ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ~'~S ~_..~ (¢~ ~ e~c;("¢.~ r.~ ;Date B. SEPTIC/~ TANK DATA Date Installed Standpipes ~'N) Air-tight Caps./N) Depression over Tank (Y/~) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic¢4.~ Tank: Size !2...~"0 NO. of Compartments ~-- Foundation Cleanoutl~/N) Date Last Pumped /~J~"~ ¢ ; for To Water-Supply Well To Property Line To Water Main/Service Line Course Temporary Holding Tank Permit (Y/N) To Building Foundation ~ ¢''~- To Disposal Field ~ To Stream, Pond, Lake, or Major Drainage Page I of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~- "Z.l.J- ~.~' Width of Field "'~:2~* Square Feet of Absorption Area Depression over Field (Y~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Weld / / ~ To Building Foundation .¢~/~j Lot Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present ~N) ~/~Date of Last Adequacy Test To Water Main/Service Line I ~:2 f '~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutba. nk (if present) LIFT STATION Date Installed · · Size in Gallons "Pump On" Level~t. ' High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at ~ Vent (Y/N) Pumping Cycles during 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. Signec~ ~ ~ ENGINEERING Date /'~"/ SRB 196X MOA No./' Company EAGLE RIVER, AK 99577 Receipt No. ~.~)¢ / ~ ~-- ~ Date of Payment 7//~ Amount: $ ~/~¢-~ , ~ Engineer's Seal Page 2 of 2 72-026 (11/84) A CHEMICAL & GEOLOGICAL LABORATORIES 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 '~PRIVATE WATER SYSTEM Name Mailing Address City SAMPLE DATE: Phone No. State · Day Year ~) ~.~ 77 Zip Code SAMPLE TYPE: ~5~ Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose .) [] Treated Water Untreated Water SAMPLE NO. LOCATION 2 I 31 5 I Time Collected Collected .~ 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 senO new sample via special delivery mail. . I? ,~ i,.-,r Date Received ,to ,t } ~.~ ~' ,.., Time Received / ? "" Analytical Method: Membrane Filter * No. of colonies/100 mi. Lab Ret No,Result* I x7/,? F-Vd Analyst BACTERIOLOGICAL WATER:ANALYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Membrane Filter: Direct Count Verilication: LTB Fin al M embra ne, F~l~}~u!~ ~ / Reported By TNTC = Too Nurnberous To Count BGB Date Time: Coilform/100ml Coilformll00ml a.m. OB = Other Bacteria