HomeMy WebLinkAboutPANORAMA TERRACE BLK 2 LT 3Panorama
Terrace
Block 2
Lot 3
#015-092-45
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION , ov
11
ENVIRONMENTAL ENGINEERING DIVISION
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825 L Street - Anchorage, Alaska 99501
Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
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PHONE
NEW
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BOB 6 1
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CpiUPGRADE
MAILING
ADDRESS
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LEGAL DESCRIPTION
d, o7 3 2 T A NJ 0 t-
0P P
A C
LOCATION
NO. OF BEDROOMS
L?3 o ET -I_� TO 1\1
z
Well
Absorption area
Dwelling
PERMIT NO.
DISTANCE TO:
UY
F Z
Manufacturer
Material
No. of compartments
aQ
WF
N
Liq. capacity in gallons
Inside length
Width
Liquid depth
IF HOMEMADE:
Well
Dwelling
PERMIT NO.
G Y
DISTANCE TO:
O z Q
Manufacturer
Material
Liquid capacity in gallons
2 H
p
w= DISTANCE
TO:
Well
00
Foundation
Nearest lot line
PERMIT NO.
AIAND ND 'W TT
Uj Z Z
No. of lines
Length of each line
Total len th of lines
Trench w"' h
Distance between lines
2 LU
~
��
To p of tile to finish grade ,r
Material beneath tile
�Z
Total eff c,nttiv�ee absorption area
7�/
o
a�
inches
Length
Width
Depth
PERMIT NO.
Lu
f7Total
i F
Type of crib
Crib diameter
Crib depth
effective absor tion area
P
Wa
W
Well
Building foundation
Nearest lot line
rn
DISTANCE TO:
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
J
W
Building foundation
Sewer line
Septic tank
Absorption area(s)
DISTANCE TO:
OTHER
L_
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
REMARKS
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2225-E �4rr
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UNE 25 1971 ' 4.QOW
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APPROVED ATE LEGAL
72-013 (Rev. 3/78)
ALASKA ChARMSTAL COnTROL
6ngineerinq & 6nuironmental Studies
sekb`Os, Inc.
September 8, 1983
Department of Health and Environmental Protection
825 L. Street
Anchorage, Alaska 99501
Attn: Robbie Robinson
Dear Robbie:
`Y-1PAUTY OF ANCHORAGE
r,_ p . CSP HEALTH &
i ivvl Oi%IM'NTAL PROTECTION;
Z y�w3�i
RECEIVED.
At your request on Wednesday the 7th of September 1983, I visited a lot
on Nettleton Drive. The legal location is Panorama Terrace Lot 3 Block
2. On arriving at the site the excavator, Larry Smart; the engineer,
Tobin Spurkland; and your inspector; Lynn Lynquist was present. There
was a hole approximately 13 x 13 x 12 feet deep dug in the yard to
remove the old crib. It appears that they had removed all of the old
crib and the black material except for a few small spots along the wall
which I considered to be insignificant. The excavation appeared to
destroy approximately 72 square feet of the _field. The soils from
approximately 3 to 12 feet bed is a blue silty material, probably a
GM/SM. The soils above had been disturbed so the original
classification could not be determined.
It was impossible for me to tell if the system had been properly
constructed according to the amount of gravel underneath the pipe. The
assumption is that it was properly constructed. However, I do note that
the lot is quite small. There has apparently has been several problems
with the sewer system in the past.
In the vicinity where the excavator pointed out an old crib, I noted an
old pipe coming out of the bank and crossing the road. It appeared to
be a culvert but was not connected to a road ditch. I could not detect
any sewage coming out of this pipe. It appears that part of this pipe
was cut out and crushed.
The placement of the well makes it nearly impossible to install a system
anywhere on that lot that has not been disturbed. There is a question
whether the area to the south of the drive way is adequate for future
use. The drive way itself could be used if the part of the system is
insulated and the soils are acceptable. The percolation test apparently
was run on the NE corner of the system. The material at the south end
of the system appears to be gley.
Another problem I see is that the system was built without the 1.5
multiplying factor as spelled out in the UPC. I think this is something
that you may need to address, because if any system needs to built
larger than necessary, it would appear to be this one. It will be very
difficult to get a replacement system on this lot. Probably the only
future method of improving the drainage will be to treat the system with
Hydrogen Peroxide on a 2-3 year schedule.
I would like to recommend the following actions be taken:
1) I believe that refilling the hole under the bed with pit
run sand or gravel will allow some leaching to occur in the
lower levels as the side wall areas will be greatly
1200 lest 33rd Auenue, Suite B • Anchorage, Alaska 99503 • (907) 276-1361
enlarged. It is probably sufficient to replace that area of
the field which was destroyed in digging out the crib.
2) The system be restored to the original construction,
3) a percolation test should be run in the southern section
of the system where the gley is located to determine the
percolation rate there. Lynn told me that someone else had
tested that area at 80 minutes/inch or about 360
sqft/bedroom. Since there is not room for another system on
this lot this value could be averaged with the one Tobin
found and the system be enlarged accordingly. I realize
that 325 sqft/bedroom is the cut off but in this case a
special exception could be made. I would recommend that if
possible the system should also be enlarged by 50% per the
UPC. I believe that there is approximately 9 foot of area
available between the existing system and the road. The
system may have to be extended into the parking area.
I would like to reiterate that this is one of those cases where the lot
was poorly laid out in relationship to the well and septic system.
Someone has a previously installed an additional crib system in the
gley material which obviously would not work. There are not a lot of
options left for this lot.
If you have any questions please let me know.
Sincerely,
Leroy C. R id Jr.,D PE
President
POUCH 6-650
ANCHORAGE, ALASKA 99502-0650
(907)264-4111
TONY KNOWLES,
M') YO R
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
September 1, 1983
Ms. Cynthia M. Hora and
Mr. John W. Smith
9301 Nettleton
SRA Box 2262
Anchorage, AK 99516
RE: On -Site Sewer System Repair
Lot 3, Block 2, Panorama Terrace Subdivision
Dear Ms. Hora and Mr. Smith:
Subsequent to our meeting in this office on August 25, 1983, we
met with Mr. Tobben Spurkland concerning your on-site disposal
system. During the above referenced meeting, we discussed the
probable cause of the system failure, and reached an
understanding with Mr. Spurkland concerning the method by which
the system will be restored. This office will have an inspector
on-site during the excavation work, and during the drainfield
restoration. Basically the repair procedure which Mr. Spurkland
will follow is as follows:
1.
Excavate the old log crib area. All of the old
logs will be
removed, and the black saturated soils will be
removed.
2.
Backfill the excavated area to a depth of 4' below
ground
level which is the bottom depth of the recently
constructed
absorption bed. The backfill material must be
good quality
"pit -run" gravel. Compaction of the backfill can
be
accomplished with the bucket of the backhoe and
should be
performed at each 2' increment of fill.
3.
That portion of the absorption bed disturbed by
the above
referenced excavating must be reinstalled so as
to conform
with the originally installed bed. (Reference:
On -Site Sewer
Permit #830536)
4.
With 15 days following completion of the above
steps, an
adequacy test must be performed on the new bed
so as to
determine if any enlargement of the absorption
bed will be
required.
Ms. Cynthia
Mr. John W.
September 1,
Page 2
M. Hora and
Smith
1983
5. The surface area disturbed during the above defined repair
operation must be returned to its original condition. In
view of the lateness of the summer season, re -seeding of the
disturbed lawn area must be done after break-up in early
1984.
These procedures and conditions have been thoroughly discussed
with Mr. Tobben Spurkland. It is understood by Mr. Spurkland and
this office that owner/residents will not be burdened with any of
the costs related to the herein described repair procedures.
Ver truly yours
Robbie Robinson
Environmental Engineering Manager
RR/ej/D6
cc: Caldwell Banker/Jack White Co.
Attn: Elliot Lawson
3201 C Street
Anchorage, AK 99503
Larry le Smart/Smart Excavating
615, Lynnwood Drive
Anchorage, AK 99502
Robert P. and Jane K. Gray
SRA Box 2052C
Anchorage, AK 99516
Tobben Spurkland
203 West 15th Avenue
Anchorage, AK 99501
Alaska Bank of Commerce
Attn: Cheryl Noll
4791 Business Park Blvd., South
Anchorage, AK 99503
MUNICIPALITY OF ANCHORAGE
DEPT, OF HEALTH (;
ENVIRONMENTAL PROTECTION
AUG 2 6 1983
mm
Robert Robinson, P.E.
Engineering Program Supervisor
Department of Health & Environmental Protection
Municipality of Anchorage
Pouch 6-650
Anchorage, AK 99502-0650
25 August 1983
Re: Panorama Terrace, Lot 3, Block 2
Septic System Installed by T. Spurkland in July 1983
Dear Mr. Robinson:
This is to confirm our morning meeting with you and
Mr. Larry Montgomery on 25 August 1983 concerning the septic
system installed by T. Spurkland at Panorama Terrace, Lot 3,
BlockAs we explained, there is a large hole in the front
yard of�the property over the area of the new leachfield. As
of this date, it is approximately 5 feet in diameter and 1 to
1-1/2 feet deep. We expect the size of the hole to increase
with the passage of time and precipitation. We consider this
to be a hazard to our health and safety. Therefore, we are
formally requesting that your department do everything within
its power to rectify this problem as soon as possible.
The following background information was provided at
the 25 August meeting. On 31 March 1983, we accepted a
counter-offer by Robert and Jane Gray to purchase the property
at Panorama Terrace, Lot 3, Block 2. In early June, we were
informed that the then existing septic system had failed an
adequacy test and that a new system would have to be installed.
Subsequently, we were told that T. Spuurrkland had designed a new
system. On 15 June 1983, the Municipality of Anchorage issued
T. Spurkland a permit to install a new septic system.
T. Spurkland installed the system and filed an inspection
report with the Municipality on 6 July 1983.
Sometime between 8:00 P.M. on 19 August 1983 and 7:00
p.m. on 21 August 1983, a portion of the new leachfield caved
in. At that time, the hole was approximately 3 feet in diam-
eter and 1 foot in depth. As of this date, it is approximately
5 feet in diameter and 1 to 1-1/2 feet deep. The ground around
the hole is subsiding into the hole. We expect that this
process will continue and that the size of the hole will
increase over time.
Robert Robinson
-2-
25 August 1983
The hole is approximately 32 feet from the house and
30 feet from the northern property line. Reference to a survey
prepared by Franz Kildonen (Registered No. 1308-S) on 11 April
1983 reveals that the hole is in the exact position as a drain
pipe of the septic system which existed on that date. We
believe that there was a log crib from the old system at that
location.
Reference to the inspection report filed by
T. Spurkland on 6 July 1983 indicates that a portion of the new
leachfield is built over that area occupied by the old log
crib. We believe that this is improper and that the old log
crib was not properly abandoned.
It is our understanding that in order to comply with
the current municipal code, the following steps, at a minimum,
are necessar
/. a / /os /�/sc��....�rc�ro./ -kV al�,�O 8q
r/l✓6� a�� (1) Excavate an area 20' x 20' around the hole.
./ (2) Remove all contaminated material in that area to
a depth of 9 feet.
/., (3) Fill the excavated area with pit run gravel
u hich is 2 inch minus.
(4) Compact the filled area t 85° maximum density.
�. (5) Enlarge the current leach field to make up for
the lost area of the new leachfield caused by the
I�xcavation.
"'dG �y
�O�Paf As the Depart ent of Health & Environmental Protec-
tion has b
een delegated the responsibility of supervising and
authorizing the installation of adequate septic systems, we are
asking that the Department take any and all steps necessary to
assure that a septic system which meets all current and appli-
cable municipal code provisions is installed as soon as
possible.
At this time, T. Spurkland proposes to simply
backfill the area occupied by the old log crib. This, however,
is unacceptable. Even if done properly, it would substantially
reduce the effective absorption area of the new leachfield,
thereby limiting the expected life span. Moreover, the
remaining leachfield would not comply with the Municipal Code's
requirements for a three-bedroom home.
If you have any questions or require additional
information or documentation, please feel free to contact
Robert Robinson -3- 25 August 1983
either of us. During the day, John Smith can be reached at
265-5547; Cynthia Hora can be reached at 279-7424.
Your prompt attention to this matter is sincerely
appreciated.
Sincerely,
pzhia Hora
on WX. Smith
cc: T. Spurkland
Elliot Lawson, Coldwell Banker/Jack'White Co.
Robert and Jane Gray
Smart Excavating
Cheryl Noll, Alaska Bank of Commerce
Larry Montgomery, Department of Health &
Environmental Protection
LI/7 � � �.� t aA-
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AWSKkBWM<
of CO Y ■MERLE
MAIN OFFICE. VOUCH 7012, ANCHORAGE, ALASKA 99510
June 20, 1983
John W. Smith and Cynthia M. Hora
Re: Lot 3 Block 2 Panorama Terrace S/D
The undersigned hereby certify that they are aware that the fence located
on the above referenced lot is encroaching onto the utility easement
located on the rear of the property.
They agree to hold Alaska Bank of Commerce, its successors and assigns
and/or Safeco Title Agency, Inc. harmless should any loss occur to said
encroachments.
John W. Smith
i
6 nthia M. Hora
i
As Built
No Corners- Set This Date . Book No. _ Page NO•F/LF
I hereby certify that I have surveyed the following described property, Lot -F Block Z
PA/1pp/1N Tom! PACE 5015-D. Anchorage recording Precinct, Alaska, and that
the improvements situated thereon are within the property lines and do not -overlap or --
-encroach on the property lying adjacent thereto, that no improvements on property
--lying adjacent thereto encroach on the premises in question and that there are no roadways, -
transmission lines or other visible easements on said property except as indicated here
!/ -
Anchorage, Alaska APR.
-
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,r� t
•arow•a•ecoaooaocoacwaa°r•°
n•••NG°ea•••a•• ••a•aw•<a ••
hunts Kildoner, ; r
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P sr No. 130" •• ! j
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MUNICIPALITY OF ANCHORAGE
Department; Health and Environmental 'rotection
825 Street, Anchorage, AK. �=ij501
264-4720
Permit ?DbS S(p # # # HANDWRITTEN PERMIT # # #
ON-SITE SEWER PERMIT
Applicant: FDb02 _ Mailing Address: 213DL
Location: Phone Number:
Legal Description: CQ� ��uO'��mgLot Size: /A _
Type of Soil Absorption System Is:
Trench: Drainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:'
6 'r
DEPTH LENGTH X l�_ GRAVEL DEPTH WIDTH
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).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = dti� GALLONS # #
'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. `
* # * TWO(2) INSPECTIONS ARE REQUIRED # #
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 this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may r uire enlargement if
the residence is e odeled to include more that 3 be rooms.
SigneZ[: S Issued by -
Applica �r ��
Date:
SWP/024(1/81)
I SOILS LOG
r 3 �u✓ � �
•
✓ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION x PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: ��%Y? YAM DATE PERFORMED:
LL,,C% I �� t� . a ? 4No tGmAA Te •�-`�rco` E
LEGAL DESCRIPTION:
1
ENCOUNTERED?
S L
O
2
P
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SAN t)
3
7
a
4•
i `
•
i
Tj
4
6
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11
12-
13
14
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250 1971 •: t4���
18
Z %� .
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9
19-
20
20
COMMENTS H61*— F.,
PERFORMED
;11'i
WAS GROUND WATER
ENCOUNTERED?
S L
O
P
IF YES, AT WHAT
/� E
DEPTH?
®®MM
,to
a�
7
PERCOLATION RATE fJ•°'® (minutes/inch)
TEST RUN BETWEEN FT AND —A4— FT
a
72-008 (6/79)i7
CERTIFIED BY:
DATE:
❑ SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
• �.e TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: F' U N 1 C IPA W f V D C A C{ 1 DATE PERFORMED: q I til I la
LEGAL DESCRIPTION: L.CJ 1
DEPTH ��GA N
1 .1.1.. .
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
x o LE
MEN
�MNo
��
■MEN
MEMO
M■EM
WAS GROUND WATER S
ENCOUNTERED? L
O
P
IF YES, AT WHAT E
DEPTH?
SITE PLAN
0119"W"WERMIN
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
$ VAL
*:491-H
�• r'
t
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2225-E '
„Eq .
J NE 25, 1971 R+
00
■MM
MEN
�MNo
��
■MEN
MEMO
M■EM
WAS GROUND WATER S
ENCOUNTERED? L
O
P
IF YES, AT WHAT E
DEPTH?
SITE PLAN
0119"W"WERMIN
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
$ VAL
MENEMERMEN
t
3®
3 %Z
MEMNON
NOIDEZR
MENNEWENNIN
■MM
2:0
■
1�
it) 06.00
4,2
rmm■Nmmli■
EMEMMEMEM
NOWNWOMMEN
EEEMEEEEEMENOMENNEE
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
$ VAL
t
3®
3 %Z
qµ5
1�
it) 06.00
4,2
2010LA O I7 :1 i5 iy /z
PERCOLATION RATE (minutes/inch)
TTE�ST UN BETWEEN 1" FT AND � FT
COMMENTS � CL!'""— h^ DRE'.yIdos A441A
V'r. W ti
PERFORMED BY: . S CERTIFIED BY: DATE:
72-008(6179)
:.SAAB -HD 11 GR TER ANCHORAGE AREA BOROI' 4
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME 10119 11r, eayll
MAILING ca
ADDRESS `7VX
PHON`EJS' " ,,'p6
LOCATION #Q' `'e/ rms C;N kOO 4
LEGAL DESCRIPTION
l r� ! 3 1-71 K :2
SEPTIC TANK:
_1NUMBER
`-` Lily" a ./ "
OF
J
L
DISTANCE FROM WELL 7
MATERIAL
COMPARTMENTS
C� !
r LIQUID r
LIQUID CAPACITY %C%C%O GALLONS.
INSIDE LENGTH `
INSIDE WIDTH�DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH LENGTH ( DEPTH / T�
J I
LINING MATERIAL L-C�S . DISTANCE FROM WELL / / BUILDING FOUNDATION.5�_,
NEAREST LOT LINE
c� C.� ' TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) �� ��� SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM
NUMBER OF LIN
ABSORPTION AREA
TOTAL LENGTH
FOUNDATION NEAREST LOT LINE OF LINES
ISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE
SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OFFILTERMATERIAL BENEATH TILE. IN. ABOVE TILE
WELL:// DISTANCE FROM WATER
TYPE 41 ///P �, DEPTH 130 BUILDING FOUNDATION. SAMPLE NEAREST
NEAREST SEPTIC SEEPAGE OTHER
LOT LINE , SEWER LINE-, TANK , SYSTEM CESSPOOL , SOURCES_
DISTANCES:
r
DIAGRAM OF SYSTEM
DATE
Htaun
w
SAAB -HD -2 GREATER -;-ANCHORAGE AREA!,)ROUGH Case No.
NEA.pH DEPARTMENT
` 327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APP LI CANT 10( Aid Z� ehlwll S MAILING ADDRESS &t A;%L4GH,GP H 0 N E NO.,311"
RESIDENCE ADDRESS ELLI Eti/ y rE? Q,_ LOCATION OF INSTALLATION OZE /& L S/i)e pe
LEGAL DESCRIPTION �� L K -, 2-07
APPLICATION TO INSTALL: SEPTIC TANK, SEEPAGE PIT , DRAIN FIELD _, OTHER
TO SERVE THE FOLLOWING FACILITY ' ISt-wouy"' rte
FINANCED THROUGH TO BE INSTALLED BY
PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS �l "'�y� s PERMIT TO INSTALL A J�S��
AS DESCRIB
SEPTIC TANK SIZE 1
lv,61-L - /3c)
DISTANCES:
11411V, �ISTAwCC fiQgn)
WTz) 5r'14#r_
Pl fi /OD
7) 640,q1 6U6 L (_
Tt c .
`AO 5410 77&V4
Health Authority
I certify that I am familiar with the requirements of Greater Anchorage A� Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code. �,z4x=aaq
DATE � APPLICANTS SIGNATURE'
MUNICIPALITY OF ANCHORAGE
• '� DEPARTMENT OF HEALTH & HUMAN SERVICES M
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # r_�l 21 - Y')�i�- L_I_�) -
1. GENERAL INFORMATION
HAA# 0Q )nLIORL
Complete legal description L D I 13 2
I��rND2�MA i I^P"ZAC�
Location (site address or directions) 43y I N i- I! LE 1-0 N
Property owner J L4H �1.1.u� I'+�eyvi��la Ho1ra% Day phone 3 Y3 —4 7 y y
NJ
Mailing address
Lending agency
Day phone
Mailing address
Agent iii eA T�1 owra 5 f oY �"v' 4?_ Day phone
Address
Unless otherwise requested, HAA will beheld for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE: if community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL: ✓
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: if community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21
S. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. 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 > o�%�'^ �Pvr kl�ka4� l= Phone 97q-101'6
Address
Engineer's signature ���'r"y"K'' Date '9112101Z-
6.
91!2 ! 0/Z.
6. DSIGNATURE
tK
Approved for bedrooms.
By
Disapproved.
Conditional approval for
Additional Comments
3ea9. ]90 i.aoeu.a nOa ee _ _._�
ti:� cin a T..:.
Q'> c 7�''0 r \�
bedrooms, with the following stipulations:
1t
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineers work.
72-025 (Rev. 1191) Back MOA 1721
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: L 3/
S P, _1- ` `z vt p _e` b"4 °' 1'ei r Parcel 1.D.
A. WELL DATA
Well type 2
If A, B, or C, attach ADEC letter.
ADEC water system number
P /&
Log present (Y/N)
pq Date completed
113& 9 Driller
No i 12t,0V_' r
Total depth 13o Cased to J 1016 Casing height fa it
Sanitary seal (Y/N)
Wires properly protected (Y/N)
FROM WELL LOG
AT INSPECTION
9/2q 9 Z
O Z
o v
Date of test
Static water level
) o ?
rri
�a
flow
O
m '^
E Z
Well g•p•m•
g•p•
y
Pump level
I o b
r7'S
0 70
C�
N G,1,
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot 67
; On adjacent lots
> /07
Absorption field on lot 93
Public sewer main WIA
Sewer service line 6-0
WATER SAMPLE RESULTS:
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank N10
t -t
CU
Coliform Nitrate Other bacteria N p
Date of sample: q�Z R Z Collected by: t� e +*amu r
B. SEPTIC/HOLDING TANK DATA
Date installed 918! �� Tank size j0-&-0 Compartments
Cleanouts (Y/N) Foundation cleanout (Y/N) N Depression (Y/N)
High water alarm (Y/N) N�A Alarm tested (Y/N)��
Date of pumping y' z(D . Z Pumper X OY, 14,1 t
61L �_D AL� dc, h c a .4 m
SEPARATION DISTANCES F'RO SEPTIC/HOLDING TANK TO:
Well(s) on lot R 7 On adjacent lots i /P --G Foundation ti
To property line % / Absorption field fl Water main/service line > 5 0
Surface water/drainage N I d
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION N/
�t
Date installed
Size in gallons
Vent(Y/N)
High water alarm level
"Pump on" level at
Meets MOA electrical codes (Y/N)
Manufacturer
Manhole/Access (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
D. ABSORPTION FIELD DATA
On adjacent lots
"Pump off' level at
Cycles tested
Surface water _
Date installed/(o��� Soil rating as System type C�
Length 41C) Width 16 Gravel thickness iz Total depth 0.5
Total absorption area 7Av
Depression over field (Y/N) N
Results (pass/fail)
Peroxide treatment (past 12 months) (Y/N)
Cleanouts present(Y/N)
Date of adequacy test 9L?- 9� Z
for
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
3
If yes, give date
Wel Ion lot 93 On adjacent lots -;7 A�.6 Property line_
To building foundation To existing or abandoned system on lot
On adjacent lots i 5D Cutbank NZ4 Water main/service line.
Surface water N
Curtain drain N
E. ENGINEER'S CERTIFICATION
Driveway, parking/vehicle storage area
bedrooms
/ C7
5a
I certify that i have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signature rr �%
Engineer's Name b Y I t
Date 0 l 01 2 -
HAA
HAA Fee $
Date of Payment
Receipt Number ` `���
72-026 (Rev. 3/91) Back MOA 21
Waiver Fee: $
Date of Payment r 7
Receipt Number J %�
Municipality of Anchorage
Department of Health and Human Services dhh5
825 "L" Street
Tom Fink,
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
October 15, 1992
Tobben Spurkland, P. E.
203 West 15th Avenue #206
Anchorage, Alaska 99501
Subject: Waiver Request for Lot 3 Block 2 Panorama Terrace SD
Waiver Request #WR920063, PID #015-092-45, HA920685
Dear Mr. Spurkland:
Your request for waiver(s) of the required 100 foot horizontal
separation of a septic system to a private well has been approved.
The approved separation distance(s) are a private well to the
leachfield - 93 feet.
This waiver approval applies to the existing septic system to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this department.
Sincere y,
Robert W. Robinson
Civil Engineer
On-site Services
RWR/ljm
Concur•
Ir
Lee Browning, P. E.
Manager
Environmental Services
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review worksheet
WR# WR920063 PID# 015-092-45 HA# HA920685 Permit #
Date Received: October 12, 1992
Legal Description: Lot 3 Block 2 Panorama Terrace Subdivision
Engineer: Tobben Spurkland, P. E.
203 West 15th Avenue #206 Anchorage, Alaska 99501
Applicant: John Smith/Cynthia Hora
Waiver Requested: Well to leachfield - 93 feet
Criteria: 1. Geology:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Points•
C tJ
Waiver is Granted: / \ Waiver is NOT Granted:
List Conditions or Reasons for above:
rra i
Date:
Rec #: 24149/4377
ame o
Amount: $ 590.00
r
Date Paid: Oct 12, 1992
I
675�N.0MON00LV�.
ANCH0RAG[.ALASK�YY502~J9�4
(Y07)24R^5095
Municipality of Anchorage
Divis�on of 1-:. Health
Deoartment of Health and Social Servi'
820 L Street
Anchorage, Alaska 99501
MUNICIPALITY OFANOHORAQE
-
ENVIRONMENTAL SERVICES DIVISION
OCT 12 1992
��
���������
October l�, �9��
Subject: REQUEST FOR WAIVER OF SEPARATION DISTANCES FOR
PRIVATE WELL TO DRAINFIELD
LOT 3, BLOCK 2� PANORAMA TERRACE
Gcntlemen;
We are submitting a request for waivers from the separation
distances stated in Title 18� Alaska Administrative Code� Chapter
S0.020.
During an Health Authoritit was
discovered that the separation between the well on subject
property and the drainfield was less than the required 100 �eet
an� that a waiver is required.
The attached siteplan shows the approximate layout of the septic
system.. The tank was installed in 1969 and meets the require-
ments at that time. T�e actual location of the drainfield can not
be determined without excavating the site. One monitor tube has
been found� it is assumed that this monitor is located in one
corner of the bed.
.... can be seen the ground slopes away from the well. Any surface
discharge of septic effluent will flow towards the road ditch�
away from the well.
The well log for Lot 2 Block 2 has been used to evaluate the
contamination potential for this well.
By going through the DEC's procodure of analyzing the poLential
for contam�nation I arrive at the following points:
Ground Water
Soil Sorption
Permeability
Gradient
Separation
( SilL;Sand, Clay) 5.0
Away from well 4.0
Total 21.0
AOPPROX LD
DRAIN FIELD
15 0 15 3F 45 • 1✓ 75
SCALE, 1' = 30 FT,
TOBBEN SPURKLAND P,E, LOT 3 BLOCK 2 PANORAMA TERRACE I I SEPTIC SYSTEM ASBUILT I
203 W 15TH, AVENUE DATE, OCT, 12,19N
ANCH, AK, 99501 SEC 13 T12N BR
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MUNICIPALITY OF ANCHORAGE "_i
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
k DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date March 25, 1986
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 3. Block 2, Panorama Terrace
Location (address or directions)
9301 Nettleton Drive - North off Hillside Drive
(b) Applicant Name John Smith Telephone: Home 346-2227 Business 564-2753
Applicant Address 9301 Nettleton Drive, Anchorage, AK 99516
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ® ; Buyer ® ; Other ❑ (explain);
Applicant needs DHEP approval in order to refinance house loan
(d) Lending Institution Westland Mortgage Telephone 563-5150
Address 400 .West Tudor Road
(e) Real Estate Company and Agent N
Address
Telephone
(f) Mail the HAA to the following address:
2. TYPE OF RESIDENCE
Single -Family M Multi -Family ❑ Other
Number of Bedrooms
3. WATER SUPPLY
Individual Well EX Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department ofl=nvironmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite)Q 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)
5. ENGINEERING FIRM PROVIDING 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 A. W. Murfitt Company Telephone 349-7531
Address 8010 King Street Anchora9e AK 99518
Date March 25, 1986
�. •e a �a.A:.1� tt
CO"jt; b,��•�° Engineer's Seal
G°l°ee...° e. u.lf.i.�. •3
Allan W. Murfitt %
�•,°
No. 4977-E ,l
�9�0 a•°o. eo sae••°e•l��V
8tl PR0FESStON"�^a1
6. DHEP APPROVAL
Approved for -�) bedrooms by . _-�/1�—> •� e - `y
Approved Disapproved Conditional
Terms of Conditional Approval
cJhep
CAUTION
A
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 (11184)
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
MUNICIPALITY OF ANCHORAGE (MO� ENVIRONMENTAL PROTECTION
HEALTH AUTHORITY APPROVAL (HAA) Q�
CHECKLIST - FEBRUARY 1984 MAR 2 �
5 *
264-4720
Legal Description: Lot 3, Block 2, PbFfaHVFe
Anchorage, Alaska
A. WELL DATA
Well Classification Singe Family DOmestiClf A, B, C, D.E.C. Approved (Y/N) N/A
Well Log Present (Y/N) NO Date ,o3meI d 1968 1969 Yield 10 Spm
Total Depth 130' Cased to CJJ�{ �i-- epth o Grouting -6m� �YZA W''Zq.
Static Water Level R&M 58", Pump Set At unknown
Casing Height Above Ground 12 11 Sanitary Seal on Casing (Y/N) Yes
Electrical Wiring in Conduit (Y/N) Yes Depression Around Wellhead (Y/N) NO
Separation Distances from Well:
To Septic/Holding Tank on Lot 85 ; On Adjoining Lots 100+'
To Nearest Edge of Absorption Field on Lot 100' ; On Adjoining Lots 100+'
To Nearest Public Sewer Line 3/4 mi 1 e To Nearest Public Sewer
Cteanout/Manhole
3/4 mile Barest Sewer Service Line on Lot 3/4 mile
Water Sample Collected by John Smith ✓" —;Date March 21, 1986
Water Sample Test Results Satisfactory - See Attached Lab Report
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed 1966 Size 1000 No. of Compartments
Standpipes (Y/N) yes Air -tight Caps (Y/N) yes Foundation Cleanout (Y/N)
Depression over Tank (Y/N) NO Date Last Pumped July 1985
Pumping/Maintenance Contract on File (Y/N) N/A ; for N/A
Holding Tank High -Water Alarm (Y/N) no Temporary Holding Tank Permit (Y/N) n0
Separation Distances from Septic/Holding Tank:
To Water -Supply Well 85' To Building Foundation 171
To Property Line 20' To Disposal Field 15'
To Water Main/Service Line 3/4 mile To Stream, Pond, Lake, or Major Drainage
Course 1 mile
Comments *House built in 1966 *As -built drawings show clean out 5 feet from
foundation -- Flower bed and walkway currently exist at as -built location of
clean out -- no attempt was made to excavate and search for the clean out.
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata 165 to 220 ft2/bdrm Type of System Design Seepage Bed
Date Installed New absorption system June 19N*ngth of Field 40'
Width of Field 18 Depth of Field 4
Gravel Bed Thickness 12"
Square Feet of Absorption Area 720 ft2 Standpipes Present (Y/N) Yes
Depression over Field (Y/N) no Date of Last Adequacy Test March 22, 23, 1936
Results of Last Adequacy Test Satisfactory for 3 bedroom ( see attached data)
Separation Distance from Absorption Field:
To Water -Supply Well 100' To Property Line 20
To Building Foundation 171 To Existing or Abandoned System on
Lot N/A ; On Adjoining Lots 100
'+
To Water Main/Service Line 3/4 mile To Cutbank (if present) N/A
To Stream/Pond/Lake/or Major Drainage Course 1 mile
To Driveway, Parking Area, or Vehicle Storage Area 10'
Comments * See information DHEP file.
D. LIFT STATION N/A
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
— Dimensions
Manhole/Access (Y/N)
"Pump Off' Level at
— Vent(Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
** 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.
Signed Date
Company MOA No.
Receipt No.
Date of Payments
Amount: $ 4!5—
Page 2 of 2
72-026 (11/84)
.a
�J9" ;'.`s✓ "V -0' Engineer's Seal
u.
��e�P°dax•7F,C�ia'� e
Allan W. Murfii
'°° No. 4977-E`•
�F���Op••aeeooc` `���:
� �'ORO F'E55'tp
h+`
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
TELEPHONE (907) 562-2343 5633 B Street
Anchorage, Alaska 99518
��^•ro^°° Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
❑ PUBLIC WATER SYSTEM I.D.#
9 PRIVATE WATER SYSTEM
-- tOH t"( Srm t-rl-+
Name Phone No.
� 3 0 t IN -)ET -FL o tom. V 2, 6 r; 4 z'7s3
Mailing Address
4 Nc (J JQ lC 2a�A<
City State Zip Code
SAMPLE DATE: Fol -3-1 Z Fe -7-6-1
Mo. Day Year
SAMPLE TYPE:
❑ Routine
❑ Check Sample (for routine sample
with lab ref. no. ) ❑ Treated Water
❑ Special Purpose Untreated Water
SAMPLE Time Collected
NO. LOCATION Collected By
1 I L(5 -i-3 Eck P4,.rda.A,AA4 mw I 71,oDM 3LALu:
2 I MUNICIPALITY
D�
3 I I ENVIRONMENTA
MAR 2
4
5 I I RE.0 E
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
kSatisfactory
❑ 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 ✓ Al — 9 G
Time Received r= 0
Analytical Method: Membrane Filter
* No. of colonies/100 ml.
Lab Ref. No. Result*
Analyst
'94 Fn
BACTERIOLOGICAL WATER ANALYSIS RECORD
Membrane Filter. Direct Count
Collform1100ml
Verification: LTB BGB
Final Membrane Filte Results Collform/1100ml
Reportedy Date
Time: / 7 4�U a.m.
p.m.
TNTC = Too Numberous To Count
OB = Other Bacteria
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- �nUNICIPALiTY OF
�)T.4L 'Czf�( CANrj PUWIPErD :=
ANCHC gAO
Sz7C� DEPT. OF HE„ L,.7
a
AMIRONMENTAL Pa' ' L i SON
MAR � 3 W
kECEIVED
L W. MURFITT COMPANY
A116 W. 11urfil,, P c.
349-751"
T i
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MUNICIPALITY OF
ANCHORAGE
DEPT. OF HEALTH & A. W. MURFITT COMPANY
ENVIRONMENTAL PROTECTION Allan W. Muffitt, P.E.
MAR 2 516
RECEIVED
8-010 King Street
Anchorage, Alaska 995112
(907) 349-7531
Time
APPLIC VT FILLS OUT UPPER HAL, ;ONLY
Time
Time __II __ 11
�(_i�L �FCe t7
Pro{ierty °Winer
Robert P. and Jane -K. Gray
Phone
Date
344-4752
Mailing Address
SRA BOX 2052C , Anchorage, AK Zip Code 99507
Buyer
John W. Smith and Cynthia M. Hora '
Inspec(rt�\)r �\1
Field Notes:
3307 Boniface Pkwy, Space 94, AnchorageZfp�Code 99504
MUN 11
DEPT. OF i-!�{,LTii
Address
PRO-,ECIION
Lending Institution
Alaska Bank of Commerce -
Phone
Address 4791
Business Park Blvd ... Suite 1r'#4 Anchorage ziP Code 99503
264-5435
Realty Co. & Agent
Coldwell Banker/Jack White Co..Phone
Q ' ����`� ��
iRE
BEDROOMS
277-1553
Address 3201
C Street, Anchorage Zip Code rj
Legal Description
Lot 3, Block 2, Panorama Terrace
Street location
NetfijetonAEhOtt °rnspin�o°�iill aft gills"d a k..big
tur t
Type of Residence
coming in on lert after big turn) ...Has blue/white for
sale sign
a Single Family
three
front.
--- -❑ Multiple Family
.. -:.• - No. -of -Bedrooms..::. ;_(3)
Well To Absorption Area
❑ Other
Septic Tank Size 06 i�
Water Supply
lfR Individual --
-
ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975.
❑ Community.
For wells drilled prior to that date, give well depth (attach log
if available).
❑ Public Utility
not available— -unknown jnfn-rmation
Sewer Disposal
Note. system "Approved" 6-26-1981 -
R Individual
- - Year Individual Installed: uI wn
-
❑ Public Utility
When Connected to Public Utility:
-
❑ Holding Tank
-
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
-
Time
Time
Time
Time __II __ 11
�(_i�L �FCe t7
Date
Date
Date
Date-
�.`
Inspector -
Inspector
Inspector
Inspec(rt�\)r �\1
Field Notes:
MUN 11
DEPT. OF i-!�{,LTii
PRO-,ECIION
14elENVIROti&AINTAL-
-
A R
j �,.1-
C E iV
iRE
BEDROOMS
)VAL
(3) APPROVED
( ) DISAPPROVED
( ) CONDITIO IAL AR VAL'
JJ
DATE
BY:
Soils Rating
Date Sewer Installed
Well To Absorption Area
Well Log Received
Septic Tank Size 06 i�
'
Well to Tank T
72-023 (3182)
Ut
April 12, 1983
1_ Obert P. and iJc7nO K.. l i:ay
sp,j), 'Box 20520
�t1Cl1 C)Y'cl iii ." y e -k 99'
},Gt 3e ;31ock 2, PanOxa:;i« Terrace
,mptproval for the individual sower and viater facilities cannot
be granted until the following items have }Dec -B cOnPleteC1 «
Tile water
analysis report needs to beStUl�Tti7 ttE C t0 t li:i
office frol-ti the Cheri Lab, 5633 B Street, for Our review-
° t'Iir,' SE'. -t 3.c tank }%lt^:"t#�F:c pith a receipt subi13-tted to this
/ dej)artm nt.
t o .- r t {'.<J :)E' jJCrr-o_mc i Gil the c::.`' is 3.T1_`
An t. l��E.C�1,ii71.'��% test ne(_"ds � r_� � n- c e,� c"
leaching area [1ST t.'�.s :dill CiC4EY'11n. S� the ti t l 1ti
r. de,(uate according to Hat,ional ii tandatus. �1 a.'nt.111`1 e7L
�ypriv.>.te firj s perfori- ng the test is enclosed This re}port
! needs to be `3uj),,Aitte(j to tlli.s office Loi' our rcvieW.
1�1 d;s 11Gtiiy tili`s ]�1ep art:;lent f01" reinspection When ilc
noted r ifGtCc c}i`�crej>�:incies have b��'cEl corrected. there, are any
1:u- tlle_r �_.iuestions, i;'lc-ciSL: c:al1 th15 C3i1,:1C$ at 2�74s^".t%2(?.
L, tic losur(.
<P7.1/ei/El
SincerelY,
lwbert �'. Pratt
Associate Environmental S-Peciaiist
�L
��,° ,s
CHEMICAL & GL,,LOGICAL LABORATORIES ._J ALASKA, INC. NOE,ENo
OF'
� r
TELEPHONE (907)-2794014 ANCHORAGE INDUSTRIAL CENTER®-
274.3364 5633 B Street j I
— o
a A
em`
Ve
^�roR1e8 Drinking Water Analysis Report for Total Coliform Bacteria o
TO BE COMPLETED BY WATER SUPPLIER
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
WATER SYSTEM:
NO
I.D. .
EISatisfactory
j y
t...J 1, J.%..�
.
❑ Unsatisfactory
- -
❑ Sample too long in transit; sample should
Water System Name r Phone: No.
r_
not be over 48 hours old at examination
to indicate reliable results. Please send
Mailing Address
new sample.
-
- City -.. State Zip Code -
Date Received
SAMPLE DATE:
Mo. Day Year
Time Received
SAMPLE TYPE:
Analytical Method:
❑ Routine
❑ Check Sample (for routine sample-
❑Fermentation Tube
.
with lab ref. no. 1 ❑Treated Water
11 Membrane Filter
❑ Special Purpose ❑ Untreated Water
SAMPLE Time collected
Lab Ref. No. Result* Analyst
NO. LOCATION Collected By
I I-
2
3
I I
I m
4
I I
I I m
5
-
*No. of colonies/100 ml. or No. of Positive portions.
06-1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD
Rev. 197e
Date
READ INSTRUCTIONS
BEFORE
Collected - - Source
EMB Broth 24 hours: Broth 48 hours:
COLLECTING SAMPLE - Multiple Tube Report: - - 20ml Tubes- Positive/Total 10ml Portions
Membrane Filter: Direct Count Collform/100ml
Verification: LTB - - - BGB
Final Membrane Filter Results Collform/100ml
Reported By - - Date `
Time•- a.m.
p.m.
INVOICE #
Robert Gray
SR Box 2052C
Anchorage, Ak
ADEQUACY TEST
�' ll�
ENGINEERING INNOVATION iN THE FAR NORTH
ARCTIC ENGINEERS, INC.
ENGINEERING S-WDIES � DESIGN a Cors�1'RucTION IVIANAe_mEw e 9(JRVEY,NC,
99507
AEI 83-013-11
May 27, 1983
THE FOLLOWING AMOUNT IS BILLED FOR THE
SERVICES RENDERED:
Engineering Services $235.00
Pumping Service 95.00
TOTAL AMOUNT DUE $330.00
TOTAL AMOUNT BILLED TO DATE: $330.00
THIS INVOICE AND SUPPORTING DOCUMENTATION APPROVED FOR SUBMITTAL TO
CLIENT. PLEASE REFERENCE OUR INVOICE NUMBER ON YOUR REMITTANCE.
THANK YOU.
chi* 455
�����ENGINEERS, INC. 150_6 Vil. 36iii AvENUE - ANCHORAGF, ALASKA 99503_ � 90112'1748593
390 f ATRIGA LANE ANCHORAGE. AI AS <A 99504 a 907/333-9428 (A--cr)UN I ING)
May 27, 1983
E=NGINEERING INNOVATION INTwE FAR MOR -11
ARCTIC ENGINEERS, INC.
ENGINEERING SMMES - DESIGN a CONSTRUCTION MANAGEW-W a SW7,VEvlhr;
Mr. Robert Gray
SR Box 2052 C
Anchorage, Alaska 99507
SEPTIC SYSTEM ADEQUACY TEST
LEGAL: Lot 3, Block 2, Panorama Terrace
OWNER: Robert Gray
HOUSE TYPE: 2 -Story, 2 Bedroom, Single Family
WATER: On -Site well.
SEPTIC
SYSTEM: From owner's records
Tank: 1000 gallons, 1 compartment
Absorption - 1
System: C2-10'xlO' Log Crib
Absorption
Area:
Soil:
Approval Date: Adequacy Test, June 26, 1981
TEST DATE: May 21, 1983
PROCEDURE: The test began by attempting to dump water from a tank truck
into the cribs. Each standpipe at the cribs had a constriction
where it met the logs, and dumping could not be slowed enough
to prevent over -flowing at the standpipe. A total of 130
gallons was added by that method, with a resultant rise of
ARCTIC ENGINEERS, INC.1506 K 36iii AVENUE 9AFjc�,ORAGF.,ALASs�dtW503 UGrt rr s � _.
3909 PATRICIA I..4NE ANCtiofzAGE. ALz,SxA 9;5Q� p J011. 33 9Fz13 ( cco }vTIMIG)
Robert Gray Adequacy Test
May 27, 1983 -2-
PROCEDURE: 23.6 gallons per inch.
(Cont'd.)
To achieve more accurate results, it was then decided to input
water from a slower source, at an average rate of 6 gallons per
minute. An additional 180 gallons was added by that method
when the cribs became full. Total rise for that method was
7.75 inches, which corresponds to a rate of rise of 23.2
gallons per inch.
Absorption monitoring was then carried out for a period of 2.5
hours. A plot of absorption vs. time was prepared using the
average absorption rate of 23.4 gallons per inch of drop in
liquid level. The plot of abosrption vs. time is attached.
The septic tank was pumped at the conclusion of the filling
stage of the test. The pumping receipt is attached.
RESULTS: The attached plot of absorption vs. time yielded an extrapolated
daily absorption capacity of 230 gallons per day. The
Municipality of Anchorage minimum abosrption capacity required
for a 2 -bedroom house is 300 gallons per day. The system fails
to meet MOA requirements.
ENCLOSURES:
Pumping Receipt
Original Graph
Failure Report
Excavator List
ISAACS PUMPING SERVICE
(Norm Tibbetts, Owner)
6218 Quinhagak Street
ANCHORAGE, ALASKA 99507
Phone 344-0114 663.3300
CUSTOMER'S ORDER NO.
PHONE
DATE / 193
NAME
i
ADDRESS
.'CASH
I C.OA.
I CHARGE
V
ON ACCT:
I MDSE.RET'D.
I PAID OUT
A
r
/ TAX j
VED BY
LV I
All claims and returned goods MUST be
33 accompanied by this bill.
`Ihank`You
PRODUCT GC9 Hees I'z, Groton, hies 01471.
,y}G4 anC%04AGC AgFA
ti dpP `�
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
g.
9j .:3330 "C" Street, Anchorage, Alaska 99503 274-4561
°ererAnucy ..
Date _Received July 8, 1976
Time of Inspection 3:30 p.m.
Date of Inspection 7-8-76
Neale Thursday
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Conv.
1. Approval requested by: National Bank of Alaska
Mailing Address: Post Office Box 600 Phone: 279-2506
2. Property Owner: James H. Shaw Phone: 344-7385
Mailing Address: Box 52C Star Route A 99507
3. Legal Description: Lot 3 Block 2 Panorma Terrace
-4. Location: Nettleton Drive, see map on back
5. Type of facility to be inspected Single F ami ly No. of bedrooms 3
6. Well Data: Individual
A. Type B. Depth
C. Construction D. Bacterial Analysis
7. Sewage Disposal System: on-site system
A. Installed B. Installer
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank Absorption area Sewer Lines ,
Nearest lot line Other contamination
B. Foundation to septic tank Absorption area
C. Absorption area to nearest lot line
EQ -034 (1/74) Page 1 of two pages
9
Page 2 of two pages - Reo,1st for Approval of Individual S"ir & Water Facilities
-.Legal Description Lot 3 Block 2 Panorma Terrace
Approved & sapprovea uaLe ; — i
Approval;Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
i
accurate representation of the subject sewer and water facilities and these taciiities
are operating satisfactorily.
SIGNED Date
EQ -034 (1/74)
I
tS� 0,41A�
P�� CP- � I
7dt
it A-'kAf/f IJV --W (
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
7. Type of Inspection: CMRO VA FHA
CONY
2. Property Owner: °
Mailing Address: s C `S Day Phone:
3
El
A
7
Name of Buyer:
Mailing Address: a "�`(J� Day Phone:
Name of Lending Institution:
Mailing Address: 5 ���`�'�,�t �`�_Phone:
Name of Realtor or Agent: _,4L��4 R'
Mailing Address: 4-v
Legal Description: _ - '`:
Location:
Phone: 77— 3,� G'
Type of Facility to be Inspected: No. Bdrms.
S. Water Supply
Type of Supply: Public Utility Individual
If Individual, number of dwellings presently served 1
If Individual, depth of well 1,2-C)
x'
9. Sewage Disposal System \ '
Type of System: Public Utility Individual (on-site)
If Individual, date of installation / 9 6 C�
72-003(3/76)
E
GREATER ANCHORAGE AREA BOROUGH`;
HEALTH DEPARTMENT
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
279-2511
INSPECT: c
/7/
TIME: ,1 ( T(5
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWAGE AND WATER FACILITIES tii(i+tr�_.
yFOR T_HAro%
1. Approval Requested By
Addres
Phone 1 ') 7 7 —
2. Property Owner
3. Legal Description
Phone 6�%--/,? :/;�'�_ .
4. Type of Facility to be Insp cted / �U
Y
Number of Bedrooms
S. Well Data: /%
A. Type �l.t.w_el_�
B. Depth %Q
C. Size
D. Construction
E. Bacterial Analysis
6.. Sewage Disposal System:
/
A. -Septic Tank (If homemade, show diagram �f `on back) / / _I
1. Size 1 oll-eD /"
2. Age56
3. Manufacturer
4. Installer L
Approval Re nest for Sge & Water Facilities L
Page Two
B. Seepage Pit
1. Size iC j(
2. Lining
C. Disposal Field
1. Number of Lines �l/f
2. Total Length M/01
7. Required Measurements
A. Well to Septic Tank
B. Well to Seepage Pit '�7 /
i
C. Well to Sewer Line
D. Well to Property Line
E. Well to Other Possible Contamination
S /
F. Foundation to Septic Tank
G. Foundation to Seepage Pit -S /
H. Seepage Pit to Property Line
8. COMMENTS:
APPROVED. ��-/ DISAPPROVED:
DATE : �` , — 71 DATE:
APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT
ED1170
REPORT OF INSPECTION -INDIVIDUAL SEWAGE -DISPOSAL SYSTEM
PRIMARY TREATMENT consists of ❑ Septic tank. ❑ Cesspool.
Septic Tank:
Distance from well, feet. Material, Number of compartments
Total liquid capacity, gallons. Capacity inlet compartment,
Inside length,— feet. Inside width, feet- Liquid depth, feet.
Cesspool:
Distance from: Well, feet; foundation, _feet; nearest lot line at ❑ front, ❑ side, ❑ rear,
Inside diameter, feet. Depth, feet. Liquid capacity, gallons. Lining material —
SECONDARY TREATMENT consists of ❑ Tile disposal field. ❑ Seepage pits. Other
-
Tilo Disposal Field:
Distance from: Well, feet; foundation, feet; nearest lot line at ❑ front, ❑ side, ❑ rear,
Total length of the lines,— - -feet. -Number of lines,—. Distance between lines,_
Trench width, _inches. Total effective absorption area in bottom of trenches,
Length of each line, feet. Depth, top of tile to finish grade,
Type of filter material: ❑ Gravel. ❑ Broken stone. Other_
Depth of filter material beneath tile, inches. Depth of filter material over tile,
Seepage Pits:
feet.
feet.
- - -- ---
feet.-
-square feet.
inches.
inches.
Number of pits_ . Outside diameter, feet. Depth, feet. Lining material
Distance from: Well, feet; building foundation, feet; nearest lot line at ❑ front, p side, ❑ rear, feet.
Inspection mads by: ❑ State. ❑ County. ❑ Local Health Authority.
Inspected by
Date of inspection
19_
(TITLE)
REPORT OF INSPECTION -INDIVIDUAL WATER -SUPPLY SYSTEM
Distance to nearest public water main,_.—feet. Size of main, inches.
Individual wells ❑ are ❑ arenotcustomary in neighbgrhood.
Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water
Properties in neighborhood ❑ are ❑ are not being developed with both individual water -supply and sewage -disposal systems.
Lot size: feet wide --feet deep. Dwelling ser back from front property line, feet.
Individual water supply from: ❑ Drilled well. ❑ Driven well. ❑ Dug well. ❑ Bored well.
Distance of well from:
Building foundation, —feet; nearest lot line at ❑ front, ❑ side, ❑ rear, feet,
cast iron sewer, feet, tile sewer,_ feet septic tank, feet, disposal field, feet;
seepage pit,— —feet, cesspool, feet, other sources or possible pollution, feet.
Well constroctlon:
Diameter, inches. Total depth, feet. Type of casing, Depth of casing, feet.
Approximate depth to pumping level of water in well, feet. Approximate yield, gallons per minute.
Sealed watertight to depth of feet.
Exterior space around casing sealed with: ❑ Cement grout. ❑ Puddled clay. ❑ Ordinary backfill.
Well cover: ❑ Concrete. ❑ Wood. ❑ Metal. Openings in well cover watertight: ❑ Yes. p No.
Pump; ❑ Shallow well. ❑ Deep well. Length of drop pipe, feet. Pump capacity, gallons per minute.
Located in: ❑ Basement. ❑ Pumproom off basement. ❑ Pumphouse above ground. ❑ Pump pit.
Pumproom properly drained: ❑ Yes. ❑ No. Pump mounting watertight: ❑ Yes. ❑ No.
Type of storage: ❑ Pressure. ❑ Gravity. Capacity, gallons.
Has bacteriological examination of water been made? ❑ Yes. ❑ No. If answer is "yes," give date 19_,
Quality of water ❑ is ❑ is not satisfactory for human consumption.
Installation ❑ does ❑ does not comply with approved exhibits, if any.
Inspection made by: ❑ State. ❑ County. ❑ Local Health Authority.
Inspected by
Date of inspection
19_
GPO 889-088
'
F
V
19_
GPO 889-088