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HomeMy WebLinkAboutROBIN HILL #3 BLK 3 LT 6Robin Hill #3
Block 3
Lot 6
#017-394-12
On -Site Water System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP131342
Tax Code Number: 01739412000
Work Type: Well
Permit Effective Dates: September 20, 2013 to September 20, 2014
Design Engineer:
Subdivision: ROBIN HILL #3
Site Legal Address: ROBIN HILL #3 BILK 3 LT 6 G:2838
Owner/Address: GOLICK JOHN D
12961 MOUNTAIN PLACE ANCHORAGE AK 995163188
Site Mailing Address: 12961 MOUNTAIN PL, Anchorage
This permit is for the construction of:
N Disposal Field N Septic Tank N Holding Tank N Privy
All construction must be in accordance with:
Lot Size in Sq Ft: 77842
Total Bedrooms: 3
Y Private Well N Water Storage
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 must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received B
Issued By:
MUNICIPALITY OF
Community Development Department
Development Services Division 6
On -Site Water & Wastewater Program
•'.
Phone: 907-343-7904
Fax: 907-343-7997
RUSH! ON-SITE SEWERNUELL PERMIT APPLICATION ,
Parcel I.D. ©n--�ctq- ia l 7 j
Property owner(s) �00Q Day phone
Mailing address
Site address SAM G
Legal description (Sub'd., Block & Lot) LO/ �� B �� -��, Z013W Ola, bL 2
Legal description (Township, Range & Section)
Lot Size I . I q. Ft. Number of Bedrooms
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Single Family (SF)
Absorption Field ❑
Initial ❑
Septic Tank ❑
Upgrade
(w/wo ADU)
Duplex (D)
❑
Holding Tank ❑
Renewal ❑
Multiple Dwellings
❑
Privy ❑
(SF and/or D)
Private Well Pq
Water Storage ❑
THIS APPLICATION INCLUDES
A VARIANCE / WAIVER REQUEST
FOR:
Distance:
I certify that the above information
is correct. I further certify that this is in accordance with
applicable Municipal Codes.
Permit/Rush Fees: d0jb Waiver Fees:
Date of Payment: Ct I I Sd I C&Date of Payment:
l3
Receipt Number: dbF��b Receipt Number:
Permit No. 13t-ka. Waiver No.
Permit App__-:
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Municipality of Anchorage Pana a
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 a Anchorage, Alaska 99519-6650 • Telephone: 3434744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: S49 PID Number:
"'meBQIAnL4Dp
Wastewater System: gNew 0 Upgrade
Address:
ABSORPTION FIELD
PAO"°
of ei0ro°""` 3
0 Deep Trench Shallow Trench 0 Bed 0 Mound 0 cow
LEGAL DESCRIPTION
$°''"""'°
Ta"' DI'': °'r"".'"'"
, i6
Lot:/ Block: 9Subdir
�1��
ppmbraOOUow"sa i49rWt
Gravel OWMber"Mpipe
�.
Ff.
Township:
Range:Section:
FiUadded ewbopraiW.
(irarNlarnpN:
NO1%frFt.%L
WELL: )(New O Upgrade
Gravelwi '' S R.
lry �alirw
k,re
°wane ISFL
Clauificauon (Private. A,B,C):
PJ214*T6
Total Depth:
8/
Caned To:
8a.SFt.
Total abaeption erect:
ZO
Pipe material:
3034 PVCO
Ft.
T
Driller:
M- w
Date 11M.
IV,
$Wc; riaSW
ss
tiaelelter:
Al�ctsr�
OeNklelaMad
9 i
12111 lrJ
9 L
Ft.
Yield:
7
Pump Setal:
Gww 3 t cam:
TANK
GPM
!fa FI
SEPARATION
DISTANCES
Xseptic 13Holdinp 13 STEP.
To
Septic
Absorption
lin
marmucWW.4eri.
�yb" �Zso
From
Tank
F*W
Station
Tank
Sever Line
agar.
Well
/SD'
Ida,
—
—
142
Material: STLCL.
rwtee"etc�.nmarw
Waere
—
—
—
—
—
LIFT STATION–
Lot
N•
I
Size In paawie:
mommclwe:
Line
Foundation
6'
ZZe
P°rr1pWwow at
otrW tar
"tohMOMf' Mat
Curtain
PlesptMiaitim
EMatriealtirpedbnaperbrmWby
Drain
Remarks: OVC25j&iV- PTiiC.
BENCH MARK
N V.LA c t; r
Location and Daaaipuarl:
Tor op FovaDA-+eN
e - T
uJALL a"li 1sr %aaw— OR
Flo usGIFf
a,
41
_I_�
Inspections performed by: M- 4pibeRSoAl Data: 1s 9 �°
9°°
2nd 9/ b°
i$°Michael
E. Anderson +�
a `,
13-
Department of Health d u anrices approval
°°a °°$�°°°°°�
Reviewed and approved by. Date.
72-011911ter.IVatl MOA 25
Permit No. SW&01224
Pape Z. of 3
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: <6 If 3 ledXh //jf5
v
M.
72-013 A (Rev. 9191) MOA 25
0
E
4
M
f CW
/it= SO
PID No.: --el -1!12 /7_
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O
pAGIN991t SEAL
V .,J
.1d ad a�ooa` o
eae �--
s Michael F,. An decso s
A381• c
lk'ePROFessl��•
Permit No.���
3
Papp _3 of 3 r
Municipality of Anchorage
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
Description: LoT-L BL-ocie-3 PoB1f7IwS J
^i PIDNo.:
9
0
$c4C4 AAAft.1L a .100
•'o/ OF lvu4bA710J Wa�"
4oar1 cw- t444a L 0p Foust;
72-013 A IRw. Y91) MOA 25
'ir !% 063 "JO[0H .v l'
-1J EJ/y, V ;�
U p�v,
OD 6
Irl
rte. %
em
e� �cacuao �a000 aOeoE oo��,°�n
,Michael E. Anderson $
o� 4381 - E
0 CO3B08 F.\. ca �0fy�=�ss�o`'r
M -W DRILLING, Inc.
P.O. Box 110378 0 10330 Old Seward Highway
�-'(907) 349-8535
ANCqORAGE, ALASKA 99511
DRILLING LOG.
BRIAN LADDD Domestic
Well Owner I of Well
Location (address of: Township, Range, Section, if, known; or. --'distance main road
Lot 6 Blk. 3 Robin Hills
Size of casing 6 epth of Hole 81 feet Cased to --- U -.5 ---feet
Static water level 58 `ft. (Abliby"I , below) land surface. Finish of well (check one) open end X
a.
'
Screen Perforated ( '#1
Describe screen or perforation
NIA
7 Ot 2 1007,
Well pumping test at OWW) (minute) for __--hours with t.
of drawdown from staticYel
A
nnfn of Auj 7292
Depth in feet from
ground surface
0 TO --L-
2 15
To—
:15 17
To—
17 20
20 60
TO
60 81
To—
TO-
TO-
TO-
-TO-
-TO
WELL LOG
of formations penetrated, size of material, color and hardness
ickUD R ECF I VFn
Bldg a< t NOV 2 1992
4
MU
nlcipala� Ot Anchnrmc1g,
Dept.,; altvalth & HUMan Services
vic
4V :,
Ok Jidl �jes
Nw VV MW
To-
-TO—
TO-
0-
3—CONTRACTOR
M&W DRILLING TEL Nu.907-345-3287 Mar.18,93 5:37 P.01
M -W DRILLING, Inc.
P.O. Box 110378 • 10330 Old Seward Highway r
(907) 349.8535
ANCHORAGE, ALASKA 99511
GRILLING LOG
BRAT`d LAD'Domestic
Well Owner Use of Well
Location (address of: Township, Range, Section, if known; or distance main road
Lot 6 Blk. 3 :"obin hills Subd. j
Size of casing 6 Depth of Hole 22feet Cased to 19 7 feet
Static water level 53 ft. (1&8) below) land surface. Finish of well (check one) open end
Screen ( }_ ); Perforated ( v). i
Describe screen or perforation
—
r'
t� perf'd from 58-63, 83-98, 116-135 v7 4 slots/f�
Well pumping test at 1 lro2gallons pet >(~) (minute) fore hours
of drawdown from static level. `tote: A 4" PVC csg & screen was Inst-alled
Date of completion 05 March 1993 screen from 50•-60' & 145-2001. Annul -L.
packed w/ 3/8 minus pea gravel.
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
-4�__TO E1
Existing Well
of TO 97
Ueaving Sand D (• Ix/
_87 TO .,7
Flardpan
2 2 1995
07 TO 9Q.5
Small. Vater Gravel
`MAK
Dept. Health & Human Services
_@R,5 TO 10y
Hard an
1''16 TO 120
51 ltv Sand • wet
1-?�—TO 13G
c`lavev Gravel broom damp
- 1 3 r" _To S_
'dateg Gravel —
__12_5__TO 170 -
Cl,g ey Nardpan wL small grAvel streaks
--no--To 1q9
CnArse ('ravel
�I C)-, TO 903
[dParhPrej !Pdrnck --
---20-:A TO -22
Rerlrortk • grP;g• 1 ` t-nne:..,q*rgij11Le-.- a few wat-er semis
in sporadic fractures.
_ TO_
TO
TO
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW920026
DESIGN ENGINEER:ANDERSON ENGINEERING
OWNER NAME:LADD BRIAN J & CECILEE
OWNER ADDRESS:7501 SOLARSET
ANCHORAGE, AK 99505
PARCEL ID:01739412
LEGAL DESCRIPTION: ROBIN HILL #3 BLK 3 LT 6
LOT SIZE: 77842 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
PAGE 1 OF 1
DATE ISSUED: 3/10/92
EXPIRATION DATE: 3/10/93
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 FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY:
ISSUED BY
DATE: /yZ
DATE : !7
Dear Technician:
I have reviewed information available on lots adjacent to the subject
property and have conducted an onsite investigation. Lots
immediately adjacent to the property are currently vacant with no
onsite systems. Systems located on other properties in the
neighborhood are more than 200' from the proposed systems on the
subject lot.
The terrain of the lot is fairly flat with the center of 4he lot
somewhat higher than'• the lot lines. In addition, the following
comments pertain to the property:
1. The system, if constructed as designed, will have no adverse
impacts on the wells currently in use or to be placed in the
future on lots located in the area.
2. The •system, if constructed as .designed, will. -have no --adverse
impact on existing septic systems in the area or those to be
constructed in the future.
3. The system, if constructed as designed, will have no adverse
impact on reserved space either surface or subsurface on any
lots located in the area.
4. The system, if constructed as designed, will have no adverse
impact on drainage patterns in the area.
Sincerely,
Michael E. Anderson, P.E.
k�Y-
doe
0'49 TI4
�6 dada„soaea aa,ddaoa oeodoeG�ae e
OaoOd0a,a0ob0 ddo00d Goad oboe, .0
Michael E. Anderson e'
4381 - E ®
TF dd,o d,® ����
Aw
*000000
rn
August 18, 1991
o z
`a
V
Municipality of Anchorage
;V
Dept. of Health & Human Services
g
o
Environmental Services Division
m m
825 "L" Street, Room 502
rm
o
Anchorage, Alaska 99501
Subject: Lot 6, Block 3, Robin Hills
Septic System Design
Impacts to Adjacent Properties
Dear Technician:
I have reviewed information available on lots adjacent to the subject
property and have conducted an onsite investigation. Lots
immediately adjacent to the property are currently vacant with no
onsite systems. Systems located on other properties in the
neighborhood are more than 200' from the proposed systems on the
subject lot.
The terrain of the lot is fairly flat with the center of 4he lot
somewhat higher than'• the lot lines. In addition, the following
comments pertain to the property:
1. The system, if constructed as designed, will have no adverse
impacts on the wells currently in use or to be placed in the
future on lots located in the area.
2. The •system, if constructed as .designed, will. -have no --adverse
impact on existing septic systems in the area or those to be
constructed in the future.
3. The system, if constructed as designed, will have no adverse
impact on reserved space either surface or subsurface on any
lots located in the area.
4. The system, if constructed as designed, will have no adverse
impact on drainage patterns in the area.
Sincerely,
Michael E. Anderson, P.E.
k�Y-
doe
0'49 TI4
�6 dada„soaea aa,ddaoa oeodoeG�ae e
OaoOd0a,a0ob0 ddo00d Goad oboe, .0
Michael E. Anderson e'
4381 - E ®
TF dd,o d,® ����
Aw
*000000
JOB �Or 51,0 G(- 3, pt o 3 to 14I u-,5
SHEETNO. OF
CALCULATED BV DATE
CHECKED BY DATE
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on
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SHEET NO.
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CALCULATED BY
... . ....... . .. . . . ........
DATE
CHECKED BY
DATE
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O�}EN 1�'�S SEAL)
yy✓✓ a 4 a
Municipality of Anchorage
t DEPARTMENT OF HEALTH & HUMAN SERVICES;d' p•i 6
BJP°P 04947 Asaa asCfi° POae°
825 "L" Street, Anchorage, Alaska 99502-0650 1p �t F
SOILS LOG —PERCOLATION TESTP_MtchaeleEn Anderson e+oe
PERFORMED
FOR:
ZAt4 ' G,:,A4
Net
Drop
LEGAL
DESCRIPTION:
��t' 1. ^.'f3ltlj. ��II�V, Township, Range, $e
L
SLOPE
g. S
7,)
07
Dl--PZU
(F EE^TJ)
9. ZS
37
/ !rz
9.L3
8
:17
/0140
.3
/ az
2
3
:2
/.SYP
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4
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t
11-67
-32-
2.
i
6
7
8
v
9
°
16
17
18
19
WAS GROUND WATER
ENCOUNTERED?
S
�— L
0
E
9/17 ✓!
v Ci;% `0oa�0 o°� �G• cJ
D
_ DATE PERF�'Ef7�' ,_
:tion:
SITE PLAN
IF YES, AT WHAT
DEPTH?
Depth to Water After
Monitoring? /y0^/C Date:
Reading Date Gross
Time
20
Net
Time
Depth to
Water
Net
Drop
�� 41 rz:sy---
L
g. S
7,)
07
9. ZS
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11-67
-32-
2.
20 PERCOLATION RATE 1/ ` (minutes/inch) PERC HOLE DIAMETER
( ET jyTEST RUN BETWEEN v FT AND FT
G��T
COMMENTS I�I 1SDLC pi AS PkC-50+4rL-6D PR.1a2
PER GALA -'i 0 JJ 'TA`s 7^17~16. n Q �n
PERFORMED BY:/ I""'"""�' 4��""`°' CER IFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:�� �j- o
0
eye
a Municipality of Anchorage .<
DEPARTMENT OF HEALTH & HUMAN SERVICES e
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: DATE PERF
LEGAL DESCRIPTION: LL/ r" " OXOO W I'1 l �l�<Township, Range, Section
COMMENTS
4 pj f15 .
Di F. A.Iderson
4381-E
SITE PLAN
WAS GROUND WATER I, P
ENCOUNTERED? UP
s
IF YES, AT WHAT L
DEPTH? P
E
Depth to Water Aller , I
Monitoring? �y Date:
DEPTH
(FEET)
I
/�✓
1
..
2
3
4
5
/•
6
b
7
8-
i
9-
10
10-
11
11
,q
12
b'' .
13
14-
4
15-
151s
16
17
s1918-
1 9
20
COMMENTS
4 pj f15 .
Di F. A.Iderson
4381-E
SITE PLAN
WAS GROUND WATER I, P
ENCOUNTERED? UP
s
IF YES, AT WHAT L
DEPTH? P
E
Depth to Water Aller , I
Monitoring? �y Date:
PERCOLATION RATE (minutes/inch) -PERC HOLE DIAMETER 6 y
TEST RUN BETWEEN FT AND —Z— FT
T'. — LLi� ..Ae' 'P3n.- C,-1 A,, I>.?,ne
PERFORMED BY: �/ L-1� I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
Depth to
Water
..
PERCOLATION RATE (minutes/inch) -PERC HOLE DIAMETER 6 y
TEST RUN BETWEEN FT AND —Z— FT
T'. — LLi� ..Ae' 'P3n.- C,-1 A,, I>.?,ne
PERFORMED BY: �/ L-1� I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
SURVEYORS PLANNERS ENGINEERS
TRANSMITTED TO: e z
ATTENTION:
DATE: 9 - /24- - 2 TIME: _
# OF PAGES (INCLUSIVE) SENT BY,-
MESSAGE:
Y: MESSAGE• f % `(_.� t ' •l / �_.5
RECEIVER: PLEASE DELIVER THIS FACSIMILE TRANSMISSION TO THE ABOVE ADDRESSEE. IF YOU
DO NOT RECEIVE ALL OF THE PAGES IN GOOD CONDITION, PLEASE ADVISE THE SENDER AT YOUR
EARLIEST CONVENIENCE, THANK YOU FOR YOUR ASSISTANCE
FAX (907) 561-6626
PHONE 562-5291
440 WEST BENSON, SUITE 1 03
ANCHORAGE, ALASKA JJ503
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTHAND HUMAN SERVICES
MEMORANDUM
DATE:
March
22, 1993
TO:
Leslie
Jordan,
Public Works, Permit Counter
FROM:
Daniel
Bolles,
On -Site Services
SUBJECT:
Lot 6,
Blk 3,
Robin Hills #3, PID #017-394-12
Please be advised that the well and septic system constructed on
the subject lot are now in compliance with the requirements of
AMC 15.55 and AMC 15.65 respectively.
db/205
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTHAND HUMAN SERVICES
MEMORANDUM
DATE: November 18, 1992
TO: Leslie Jordan, Public Works, Permit Counter
FROM: Daniel Bolles, On -Site Services
SUBJECT: Lot 6, Blk 3, Robin Hills #3, PID #017-394-12
Please be advised that the well and septic systems constructed
on the subject lot do not currently meet the requirements of AMC
15.55 and AMC A.65 respectively. C.O. should be withheld until
approval by this department is granted.
db/205
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
FOR A SINGLE AFAMILY DWELLING
Parcel I.D. 01739412
1. GENERAL INFORMATION
COSA# 05G /0 /P.1 a
Expiration Date:
Complete legal description ROBIN HILL #3; BLOCK 3, LOT 6
Location (site address) 12961 MOUNTAIN PLACE *ANCHORAGE, AK
Current Property owner(s) BRIAN LADD Day phone 345-5499
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
12961 MOUNTAIN PLACE *ANCHORAGE, AK
Day phone
BETH SIMPSON W/ KELLER WILLIAMS Day phone 865-6556
101 W. BENSON BLVD. SUITE 503 *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
Individual On-site
Individual Water Storage
❑
i
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 affixed hereto and as of the validation date shown below, I 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 tiles 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
Date
Engineer's Printed Name
Engineer's Comments:
Phone 337-6179
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 own r --4 d b A 1'
..... ...........�
A. G rness;
"V
ofes
/i
"y l� l�
Q'P�\
e �s e a ove. ny re rance upon or use of 1111S report by any 0000 (t , /trrj
other person or party is not authorized, nor will it confer any legal right whatsoever. i 0 r,
DSD SIGNATURE �XV`•' '•,y©F:
ON-SITE
Approved for bedrooms. : '� • WATER AND • K�
WASTEWATER
Disapproved._
PROt;RAM _
Conditional approval for bedrooms, with the fllowing stipulations: �,o'.. .•'�Q``.t��
•
oNT
Attachments:
COSA Checklist �
Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By: % Original Certificate Date: 9
�v
(Rev. 11105)
Municipality of Anchorage
Gh gv
• Development Services Department
Building Safety Division
On -Site Water & Wastewater Program p T.
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: ROBIN HILL #3; BLOCK 3, LOT 6 Parcel ID: 01739412
A. WELL DATA
Well type PRWATE If A, B, or C provide PWSID# N A
Date completed 8/21/1992 Sanitary seal (Y/N) YES
Total depth 229 ft. Cased to 197 ft.
Date of test
Static water level
Well production
FROM WELL LOG
3/5/1993
53 ft.
1.5-2.5
WATER SAMPLE RESULTS:
Coliform 6olonies/100 ml.
Arsenic: ug./L.
B. SEPTIC/HOLDING TANK DATA
Well Log (Y/N) YES
Wires properly protected (Y/N) YES
Casing height (above ground) 12+ in.
AT INSPECTION
7/9/2010
57 ft.
g.p.m. 0.62 g.p.m.
Nitrate ma I mg./L. Other bacteria colonies/100 ml.
Date of sample: 7/9/2010 Collected by: GEG Ltd.
Tank Type/Material SEPTIC/STEEL Date installed 9/17-18/1992
Tank size 1250 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 -V Pumper ISAAC'S PUMPING
C. ABSORPTION FIELD DATA *BELOW ExiSTI cRA�E
Date installed 9/17-18/1992 Soil rating (g.p.d./ft2o /bdr 0.8 System type SHALLOW TRENCH
Length 20 36'=72 ft. Width 5" ft. Gravel below pipe 3 ft.
Total depth *9.58 ft. Eff. absorption area 620 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test **7/9/2010 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 9 in. Water added 626 gal. New depth 23 in.
Elapsed Time: 120 min. Final fluid depth 21 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date -
**WEST TRENCH TESTED ONLY, EAST TRENCH WAS VISUALLY INSPECTED AND FOUND TO BE SURCHARGED.
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N
"Pump on" level at in. "Pump off' level High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
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
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Sewer /septic service line 25'+ Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water,
Wells on adjacent lots 100'+
100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ 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
► certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date 17 h O /) D
COSA Fee $ q 10 Waiver Fee $ _
Date of PaymentTT40 Date of Payment
On
Receipt Number L-/ Receipt Number.
(Rev. 11/05)
Municipality of Anchorage
P.O Box 196550 4700 Elmore Road
Anchorage, Alaska 99519-6650 (907) 343-7904 Fax (907) 343-7997
hftp://www.muni.org/onsite
Planning and Development Services Department
On -Site Water and Wastewater Program
On -Site Sewer/Well Submittal Comment Sheet
Engineer: GARNESS ENGINEERING GROUP LTD 9/24/2010
Legal Description: Robin Hill #3 Blk 3 Lt 6
Permit: OSC101219 WellSeptic Completed By: J.Poet
Report Type: COSA
The attached paperwork has been reviewed and is being returned for the following reasons:
COSA will not be approved. Inspected system on 9-24-10 and found trenches full.
:� l L �l�l�✓�t�lJ✓ �qc ec-
G le,4
l2 -CSX J^ 7-
L/ I
-Vf e
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Cil e 1.1
G
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
September 28, 2010
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907) 343-7904
Attn: Jeff Poet.
Ref: Robin Hill S/D #3; Lot 6, Block 3,
Mr Poet:
Per your request, we re -inspected the septic system on the subject property. A site visit was made on
9/28/2010. Elevation shots were taken to confirm the liquid level in the west trench. It was found that
the trench only had 7 inches of standing water (out of 36 inches effective depth). The cleanout in
question (south cleanout of west trench) appears to have a slight reverse grade in between the tank and the
drainfield. We believe this is a result of poor construction and is the only cause of the standing water in
the cleanout. This is corroborated by the fact that the north cleanout of the same trench is dry. In short,
the drainfield is functioning correctly. We therefore ask you to approve the C.O.S.A. for the subject
property.
If you have any questions, please contact us at 337-6179. Thank you for your assistance.
Sincerely,
r
frey, , ,t(�rne ., M.S.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com
Municipality of Anchorage
• Development Services Department
Building Safety Division
S A E 7 Y
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www. ci. anchorage. ak.us
(907)343-7904
Water Well Advisory
Certificate of On -Site Systems Approval (COSA) # 101219
During a recent COSA on-site inspection and test of the potable water
supply well on Block 3, Lot 6 of Robin Hill #3 subdivision, the well's
productivity was determined to be 0.62 gallons per minute. The minimum
well productivity required by this Department (AMC 15.55) for a 3 -bedroom
residence is 0.31 gallons per minute. Although the subject well currently
exceeds this minimum requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction of non-critical
water uses such as washing cars and watering lawns and gardens may be
required.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
SGS Ref.#
1103369001
LOQ
Units
Client Name
Garness Engineering Group, Ltd
Printed Date/Time
07/13/2010 17:11
Project Name/9
Robin Hills 43 B3,L6
Collected Date/Time
07/09/2010 14:38
Client Sample ID
Robin Hills 43 B3,L6
Received Date/Time
07/09/2010 15:20
Matrix
Drinking Water
Technical Director
Stephen C. Ede
Sample Remarks:
Parameter
Results
LOQ
Units
Method Container ID
Allowable
Limits
Prep Analysis
Date Date
lnit
Metals by ICP/MS
Arsenic
ND
5,00
ug/L
EP200.8
C
(<10)
07/09/10 07/12/10
NRB
Waters Department
Total N itrate/N itrite-N
ND
0.100
mg/L
SM20 4500NO3-F
B
(<10)
07/12/10
AYC
Microbiology Laboratory
E. Coli
Negative
1
I OOmL
SM20 9223B
A
07/09/10
DLC
Total Coliform
Negative
I
I OOmL
SM20 9223B
A
07/09/10
DLC
ISAACS PUMPING SERVWI::Cj
M -w DRILLING, Inc.
P.O. Box 110378 • 10330 Old Seward Highway
(907) 349-8535
ANCHORAGE, ALASKA 99511
DRILLING LOG
Well Owner BRIAN LADD Use of Well Domestic
Location (address of: Township, Range, Section, if known; or distance main road:
Lot 6 Blk. 3 Robin Hills
Size of casing 6" Depth of Hole 81 feet Cased to 80.5 feet
Static water level 58 ft. (awe) (below) land surlface. Finish of well (check cne):
open end ( X ); Screen ( ); Perforated ( )
Describe screen or perforation N/A
Well pumping test at 7 gallons per (hour) (minute) for 2 hours with 100% ft. of drawdown from
static level.
Date of completion: August 21, 1992
WELL LOG
Depth in feet from
ground surface
Give details of formations penetrated, size of material, color and hardness
0 TO
2
CSG Stickup
2 TO
15
Peat
15 TO
17
Mud
17 TO
20
Gravel: Small
20 TO
60
Grey Silty Clay
60 TO
81
Med Gravel: Water Bearing
NWWA Certified Contractor
Certificate No/s, 814 & 978
M -W DRILLING, Inc.
P.O. Box 110378 • 10330 Old Seward Highway
(907) 349-8535
ANCHORAGE, ALASKA 99511
DRILLING LOG
Well Owner BRIAN LADD Use of Well Domestic
Location (address of: Township, Range, Section, if known; or distance main road:
Lot 6 Blk. 3 Robin Hills Subd.
Size of casing 6" Depth of Hole 229 feet Cased to 197 feet
Static water level 53 ft. (above)(below) land surface. Finish of well (check one):
open end ( ); Screen (X); Perforated (X)
Describe screen or perforation: Csg perf d from 58-63, 83-98, 116-135 w/ 4 slots/ft.
Well pumping test at 1.5 to 2.5 gallons per (how)(minute) for 24+ hours with 120 ft. of drawdown from static
level.
Date of completion: 5 March 1993 Note: A 4" PVC csg & screen was installed w/ screen from 50-60' &
145-200'. Annulus packed w/ 3/8 minus pea gravel.
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
0
TO
81
81
TO
87
87
TO
97
97
TO
98.5
98.5
TO
106
106
TO
120
120
TO
130
130
TO
135
135
TO
170
170
TO
192
192
TO
203
203
TO
229
sporadic
fractures.
NWWA Certified Contractor
Certificate No/s, 814 & 978
Existing Well
Heaving Sand
Hardpan
Small Water Gravel
Hardpan
Silty Sand: wet
Clayey Gravel: brown, damp
Water Gravel
Clayey Hardpan w/ small gravel streaks
Coarse Gravel
Weathered Bedrock
Bedrock: grey siltsone argillite, a few water seaps in
MUNICIPALITY OF ANCHORAGE��
• DEPARTMENT OF HEALTH & HUMAN SERVICES dl�j
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. # kp\--) _ .�iI Ll — 1 ra HAA # 0 C�°I ` f-_)-- ?A
1. GENERAL INFORMATION
Complete legal description'
Location (site address or directions) f zq6 l
Aa>� tJ
Mm 41
M0u,0-a--Ajj,9 t'4ACC
'A_%
Property owner 43 i rk LASDay phone 34)q` 109q
Mailing address 7O Z -r "' `1 � ���-- ct
Lending agency
Mailing address.
Agent
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well X
Community well
Public water
Day phone
Day phone
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 3C
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 N21
5. 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 /i,`'f?ice ���,),.J �i�1 �/tJC-L-�,AAJ Phone `Iq-
Address
) l Z-4- 6i`- A -a-
Engineer's signature _121'1161 '116 Date J�
6. DHHS SIGNATURE
_, L Approved for
Disapproved.
Conditional approval for
Additional Comments
W
M
bedrooms.
111Tir
c(•.? ;ICF O£i°a
C1.Rnderso" ,��'
en �{ c'�\°�481 _t °aa1,a4�
fe�FCp °peoyoeo°®q° ����
0 Slti\il\\- az.
IT Z_
bedrooms, with the following stipulations:
Date
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 engineer's work.
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: r.OT zoo &0U(_ S. 2,1)89/4 f7r Parcel.I.D. elf
A. WELL DATA
Well type } RRI VAT'G'
Log present(Y/N)
Total depth
Sanitary seal (Y/N)
If A, B, or C, attach ADEC letter. ADEC water system number
Y
Z -9I
Y
— Date completed 3,& &T Driller IV) _kJ DIZr(-(-fel 6
� 7Z /
Cased to /T 7 Casing height /
3
Wires properly protected (Y/N)
WATER SAMPLE RESULTS:
Coliform o Nitrate Other bacteria D
Date of sample: Collected by:1
B. SEPTIC/HOLDING TANK DATA
9
Date installed '?//'7 19 Z- Tank size 1 L`-�® Compartments Ta
Cleanouts (Y/N) Y Foundation cleanout 'Y/N1 Depression (Y/N) Iq
High water alarm (Y/N)
Alarm tested (Y/N)
Date of pumping N dW left rJ S,Mu cr/0 1,J Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
r
Wei I(s) on lot /SO On adjacentlots '�00 Foundation
AIIA
To property line /IV Absorption field Water main/service line
Surface water/drainage NO A) &-
/D /
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
FROM WELL LOG
AT INSPECTION C7
(D�
c
Date of test
.316
S j
w
rn
Static water level
Xe,g.p.m.
Well flow
g.p.m. c o
roco
---
Pump level
L) 14,N 10yJIQ
00
ca
t'il
C o
c�
SEPARATION DISTANCES FROM WELL TO:
<.(Q
Septic/holding tank on lot
r
On adjacent lots
>/00 N
Absorption field on lot
142-
; On adjacent lots
>/-dD
M( CCI
/A U0
Public sewer main
Public sewer manhole/cleanout
Sewer service line
> 50
Petroleum tank
�DJJ C
WATER SAMPLE RESULTS:
Coliform o Nitrate Other bacteria D
Date of sample: Collected by:1
B. SEPTIC/HOLDING TANK DATA
9
Date installed '?//'7 19 Z- Tank size 1 L`-�® Compartments Ta
Cleanouts (Y/N) Y Foundation cleanout 'Y/N1 Depression (Y/N) Iq
High water alarm (Y/N)
Alarm tested (Y/N)
Date of pumping N dW left rJ S,Mu cr/0 1,J Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
r
Wei I(s) on lot /SO On adjacentlots '�00 Foundation
AIIA
To property line /IV Absorption field Water main/service line
Surface water/drainage NO A) &-
/D /
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION
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
On adjacent lots
"Pump off' level at
Cycles tested
Surface water _
D. ABSORPTION FIELD DATA
Date installed T/17`%
q Z- Soil rating 6191011 =7 System type
Length Width 5 Gravel thickness s Total depth %— /Z'
Total absorption area %ZO f=7' Cleanouts present (Y/N)
Depression over field (Y/N)
Date of adequacy test cw nl sT-Ay c:r,o j
Results (pass/fail) PA $.5`` '� for
Peroxide treatment (past 12 months) (Y/N) /V If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
o /
Well on lot /4 On adjacent lots % 1D� Property line_
To building foundation 71 L To existing or abandoned system on lot
bedrooms
b® /
A10 ni c
On adjacent lots 40 fJ L _ C u t b a n k AJp � C- Water main/service line
r
Surface water 14o JC_ Driveway, parking/vehicle storage area i 5�
Curtain drain ^d0 "'iC
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect PiYhe date of1his; inspection.
p C
Signature
i
a
Engineer's Name 1v` 1C4'1a1-`Z-
1,W,0 C� Uc�
�? cc ;p-• 0 00o c i
Date 3 Z
€ "n _1 0060n0 Aflaoo0on0 Oo0 p r "'n
G r ; ° rn a10Ci . A CIC, o�
HAA Fee $
Date of Payment
Waiver Fee: $
Date of Payment
Receipt Number Receipt Number
Municipality of Anchorage
Department of Health & Human Services _
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:.' �3, /V g%rJ I ILLS Parcel I.D. CIL , Y�/ /2
A. WELL DATA
Well type ����� 41_6' If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
Well flow
Pump level
0/,
_ Date completed €8 1 Z- Driller M' w T)X1 Li4^4b
Cased to 1 0 X_ / Casing height—
Sanitary
eight
Wires properly protected (Y/N)
FROM WELL LOG
lel l C?
9 -p.m
i
AT INSPECTION
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot 150 ; On adjacent lots
Absorption field on lot 41Z ; On adjacent lots
Public sewer main NIlk
Sewer service line
WATER SAMPLE RESULTS:
Coliform
Date of sample:
B. SEPTIC/HOLDING TANK DATA
Date installed 11 9 Z_
Cleanouts(Y/N)
Y
High water alarm (Y/N) —
Date of pumping AJQ7 LAJ
Nitrate
Public sewer manhole/cleanout
Petroleum tank
Collected by: -
> t o o'
til+
1J /A
Other bacteria
Tank size ��� Compartments 0
Foundation cleanout (Y/N) Depression IV/N)
11
Alarm tested (Y/N) /V /A
._L SrAU,A104 Pumper 6f 1A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot /sO On adjacent lots ? /00 Foundation
6 r i
To property line /Id Absorption field Water main/service line }
Surface water/drainage 1400 eE
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
zm
M v
a
<
h'"tM
m 0
C)f
g.p.m<
<„
r
c-
1
00
> t o o'
til+
1J /A
Other bacteria
Tank size ��� Compartments 0
Foundation cleanout (Y/N) Depression IV/N)
11
Alarm tested (Y/N) /V /A
._L SrAU,A104 Pumper 6f 1A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot /sO On adjacent lots ? /00 Foundation
6 r i
To property line /Id Absorption field Water main/service line }
Surface water/drainage 1400 eE
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent(Y/N)
High water alarm level
/Q/A
"Pump on" level at
Meets MOA electrical codes (Y/N)
Manufacturer
Manhole/Access (Y/N)
Cycles
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
D. ABSORPTION FIELD DATA
Date installed/l-7 /q
I
Length 7Z Width
On adjacent lots
"Pump off" level at
Surface water
Soil rating PI) /:1-T Z. System type�Ma
t
Gravel thickness Total depth "7
Total absorption area _ Cleanouts present (Y/N)
Depression over field (Y/N)
Results (pass/fail)
Peroxide treatment (past 12 months) (Y/N)
�r
r �trl(h4
_ Date of adequacy test r`�� `' CK?nJ (r—/?_,Q
forbedrooms
If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
qz /Q+
Well on lot ` On adjacent lots ' loo Property line
To building foundation To existing or abandoned system on lot A
On adjacent lots / Cutbank 1'11A Water main/service line
Surface water 141,4 Driveway,C/O J
parking/vehicle storage area
Curtain drain 1,11A
E. ENGINEER'S CERTIFICATION
certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect plqe date of this inspection.
Signature�f� �a ,6a��_ ri r ��
Engineer's Name "'14 /7— hC-1ZS,)^�
Date ip/e, /I1�
HAA Fee $ /7t?( V d
Date of Payment / b —.'?,0 ` c --- -
Receipt Number
Waiver Fee: $ —
Date of Payment
Receipt Number
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301
Chemlab Ref.# :93.1117-1 REPORT of ANALYSIS
Client Sample ID :L6 B3 ROBBIN HILLS S/D WELL WATER
Matrix : WATER
Client Name :ANDERSON ENGINEERING
Ordered By :A.H.
Project Name
Project#
PWSID :UA
Sample ROUTINE SAMPLE COLLECTED BY: A. HARALA.
Remarks:
QC
Parameter Results Qual. Units
-----------------------------------------------------------
NITRATE-N 0.10 U mg/1
Collected :03/18/93 A 13:46 hrs.
Received :03/18/93 6 16:50 hrs.
WORK Order :64152
Report Completed :03/19/93
Technical Director :S PHEN . `EDEEE
Released By
Allowable Extract Analysis
Method Limits Date Date Init
-------------------------------------------------------------------
EPA 353.2/300.0 10 03/19/93 MCE
RECEIVED
MAR 2 2 1993
muilic.
®ept. Health & Human Services
..................................""----___...--............-.-..__...-.,._........__..._....0.......----------_-_.---.---_
` See Special Instructions Above UA - Unavailable
" See Sample Remarks Above NA = Not Analyzed
U - Undetected, Reported value is the practical quantification limit. IT - Less Than
D - Secondary dilution. GT - Greater Than
1v�L' E3S Member of the SGS Group (Societe Generale de Surveillance)
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301
ANALYSIS RESULTS for INVOICE # 59919
Chemlab Ref.# 92.597.9 Sample n 1 lfatr.i.x:. W WR
Client Sample ID : ROBIN HILLS - SWENSEN Client Name :hh'DERSON ENGINEERING
PI7SID UA Client Acct :ANDENGR
Collected @ hr s. BPO# POn :NONE RECFIVFD
Recaived OCT 22 92 @ 15:30 hrs. Req#
Prsserved with AS REQUIRED Ordered By
Analysis Completed OCT 2.3 92 Send Reports to:
Laboratory Supexvisor STEPHEN C. EDE I)ANDERSON ENGINEERING
Released By
Parnmeteu Results Units Method Allowable Limits
NITRATE -N ND{ 10) my/l EPA 353.2/300.0 10
Semple ROUTTINE SAMPLE COLLECTED BY: UA.
Rorcatks:
saa9�o,_=aLno s _,v=a a................. _ _.. _ _ ........ ........ o._.e_......
7. Tests Pat:foxmad See Special Instructions Above UA-U;savailable
ND- None Dotectea " See Sample Remark's Above
NA- Not Analyzed LT -Less Than, GT Greater Than
IRNl SGS Member of the SGS Groun (Societe Generale de Surveillance)