HomeMy WebLinkAboutROCKHILL BLK 1 LT 5
MUNICIPALITY OF ANCHORAGE
~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL sYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE _~ q~,~. [;~N EW
MAI LING ADDRE~
LEGAL DESCRIPTION
LOCATION NO. OF BEDROO~
0~ ~ ~OTT
Well Absorption ar~ ( Dwelling PERMIT NO.
~ DISTANCE TO:
~ ~ ~ Z Manufacturer ~ ~ Mat~ ( No, of c~partments
Liq. capacity in gallons Is Inside length Width Liquid depth
( ~
~ ~ DISTANCE T~ Well Dwelling PERMIT NO.
=--~OZ< Manufactu¢
D Well Foundation ~ ~ Neares{'lot line~ ~ ~ PERMIT NO.
~ DISTANCE TO:
~ ~r ' Distance between~liBe~ ( s o~
No. of lines Length of each I Total length of line~ Trench w~ inches
~ ~ ~ Top of tile to f~ish grade Material beneath tile rea
~ ~t ~ ~ L~ Total effective ab
Length Width Depth PERMIT NO.
~. %r~ di~ Crib d% ¢ota, effecti
~ ~CE TO; ~ % ~ing foundation ~ine
~ ~ Depth Driller Distance to lot line PERMIT NO.
~ Building foundation Sewer line Septic tank Absorption areals)
~ DISTANCE TO:
OTHER
PIPE MATERIALS
SOIL TEST RATING
I
INSTALLER
REMARKS
APPROVED~ ~~ ~ DATE LEGAL
PERMIT NO.
MIJNICI~ 'RLIT~r' OF Rr~CPr-tRAGE
DEPARTMENT OK HEALTH AND ENVIRONMENTAL ~ROTECTION
825 ~'L"' STREET.. ANCHORAGE, AK. 99501
264-4?20
SEL-IER PERM I T
RF'PLICRNT GOENTZEL BLDG INC.
LOCATION ABBOTT RD.
LEGAL LT~ 5!ROCKHILLS '~D
PO BX i00~8 S. STATION
LOT SIZE
54000 SQUARE'PEET'""'
TYPE OF SOIL ABSORPTION SYSTEM I_. TRENCH
MR×IMUM NUMBER OF BEDROOMS
SOIL RATING
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
DEF'TH= i0 LENGT~-- --?-8 6R;]%¢EL [~EPTH= 5
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>.
RE~2LI I RED SFPT I C T,"~:NK $ I ZE= ~000 t]ALLON$
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 ) I N--c. PECT I Or4S ARE REQU I RED
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION,
MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE'DISPOSAL SYSTEM IS
i00 FEET FOR R PRIVATE WELL OR t50 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO 8 PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PERM I T E~P I RES D ,FL--:EMBFR $1 .. 1~80
I CERTIFY THAT
t: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
21 I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
~ I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS.
V4. 0
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6.650, Am~Ma~e, Ala~a 99602 27~222~
SOILS LOG-- PERCOLATION TEST
[] PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
3
4
5
6
7
8
7-1¥
9
10
11
12
13
14
15
16
17
18
19
2O
SITE PLAN
SLOPE
WAS GROUND WATER /~r0
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
$ ;_
L
0 .... L
P
E
Gross Net Depth to Net
Reading Date
· Time Time Water- Drop
PERCOLATION RATE
, (minutes/inch)
TEST RUN BETWEEN FT AND FT
CERTIEIEDBY ~¢d ~~DATE: :--/~
Box ]~(~9, .._~?AR P~OU?E A ANCHORAGE, ALASKA 99502
SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF
DRillED at tHE RATE Of $19o00 PER fOOT.
ProPErTY OWNer fl~&. Quart J: ~;oen~f.~eZ 344-942£
LOCATION OF WELL SITE
B~
D~ILLE~
WELL LOG:
0 .... 15' 8~.
7~---35' Co~ ~.
35---62' ~ ~ ~
62---110~
110--115'
~ 115 ~
CoaSt o~ 9*JJ. JJ~¢: $19.00 X 115 .~e~L: $2185.00
geJ..L Se. oJ.: $22.50
WRITE CHECK PAYABLE TO RAMPART DRILLINg WORKS FOR THE SUM OF
COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING.
$~:~o7.50
THANK YOU VERY MUCH.
DATE.
BERNIE CLAU~RAMPART DRILLINg. WORKS
MUN ICIPALIT~" OF A~'4C:HORAI3E
DEPARTMENT '~HEALTH AND ENVIRONMENTAL~)OTECTION
825 ~L STREET~ ANCHORAGE, AK.
264-4720
PERMIT NO.' 4 8001~4 )
APPLICANT GOENTZEL BUILDERS
LOCRTION ROCKHILL CIR.
LEGAL :TLOT~i5 BLK i ROCKHILL SUB'
BOX i02~8, ANCH. AK
LOT SIZE
~44-4422
54000 SQUARE FEET
MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSAL SYSTEM IS
t00 FEET FOR R PRIVRTE WELL OR t50 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTRNCE FROM R PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET RND
TO R COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DRYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MRY RPPLY. SPECIFICATIONS RND CONSTRUCTION DIAGRAMS RRE
RVRILRBLE TO INSURE PROPER INSTRLLRTION.
PER~I I T E,-~P I RES DECE[~BER _?,-1.. 1980
I CERTIFY THAT
i: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET
FORTH BY THE MUNICIPALITY OF ANCHORRGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
_ I t~NED ......................
RP 'PL~,~T'OENTZEL BUILDERS
V4. 0
LOC;-tT [ ON ~KHILL O[P~
~ ~ MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
' ,: 343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D.# ~\--~- 1'~-o~)--(~"~ HAA# ~,~-'~(~o~'-~,.~
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include 10t, block, subdivision, section, township, range)
· ' Location (address or directions) '" -"",'° -' '. ~-
(b) Property owner J~l ~'o~-J'~e'~.~,,f/ .............. Telephone.:~(home)~W&'-~
Mailing Address ..... ., .... ~, ~
(c) Lending Institution ~'~'~' ~'~ ~ ~'ff'~'~':~'?";' ', '~ ~ Telephone
(d)
Real Estate Company and Agent
Telephone
(e) Mail the HAA to the following address: (or check here [~, if hold for pick up.)
List contact person and day phone number below:
2. TYPE OF RESIDENCE
Single-Family r~ Number of bedrooms
3. WATER SUPPLY
Individual Well [] Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site ~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-025 (~ev. 7/88) Page 1 of 2
~ ~o ~ e§ed
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MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744
Legal Description:
Reel< I!
WELL DATA
Well Classification
Well Log Present (Y/N)
Total Depth I1~' Cased to
Static Water Level ¥~' '
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Date Completed 5- / ~-,¢ /
II~ Depth of Grouting
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
If A, B, C, D.E.C. Approved (Y/N)
Yield 15'~'~ ~r Io~
/Y
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot iO0" '
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
To Nearest Sewer Service Line on Lot
% c.o. ; On Adjoining Lots ;:. fo~ '
I1~' /-u C.O. ; On Adjoining Lots ~ too '
To Nearest Public Sewer Cleanout/Manhole
Water Sample Collected by 7"./~, /~/. ; Date
Water Sample Test Results $¢d-l.r,,~retry , ¢;~ ~z~(,~,,~ /(~o ~
S~PTIC/HOLDING TkNK DkTk
Date Installed ~/ ~/BO Size IO00a~( No. of Compartments
Standpipes (Y/N) ¥ ~-~ Air-tight Caps (Y/N)
Depression over Tank (Y/N) /~
Pumping/Maintenance Contact on File (Y/N) N,,~.
F o u n d at io n?~elesJ0 o~u~y/N) Y'
Date Last ,umpe~____~/ll//~)'?,)'
; for
Holding Tank H~tC~,~%~i~'.~/N) Itl,~, Temporary Holding Tank Permit (Y/N)
SEPARATIC~,,,~,,~S~T'AI~CES FR~PTIC/HOLDING TANK:
· o Water-~p~y Well;, ',, .,r t.r ~ ~ ~.O. To Building Foundation
~ t~ ' To Disposal Field ~t
To Proper~ L~o , ,
To Water ~ CSe~V c~ L he *~- r' ¢
To Stream. PO~:~L~ke~o[~aj~nage Course ~ ~o '
Comments *"- ~ ~ ,~ ,~ ~
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed .¢'1 ~-o / ~¢,
Width of Field ,1' '
Square Feet of Absortion Area
Depression over Field (Y/N)
/~c.(~',~ Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness ,5-.5"
Sta/(ndpipes Present (Y/N)
Date of Last Adequacy Test
Results of Last Adequacy Test /~E¢"~f'¢ ~oe .~
SEPARATION DISTANCE FROM ABSORPTION FIELD: /.
1,9' .,~0~" C,O. To Property Line ~( Id'
To Water-Supply Well
To Building Foundation yO' To Exi~'-b~-~r~-~r~-c~-~{e~
Lot /~,A. ; On Adjoining Lots ~ ,3'(2
To Water Main/Service L~ne ~. 2_,¢ To Cutback (if present)
To Stream, Pond, Lake, or Major Drainage Course ~. ¢oo '
To Driveway, Parking Area, or Vehicle Storage Area ,~-~
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test.
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guide
inspection.
Signed _¢T-~
Company
Date ~c'/
MOA No.
Receipt No. _,~///
Date of Payment
Amount: $
;liQ.e~j.n_effect on the date of this
*' -- o* in '
~...oo.oo..~.o.ooooooo. J~g eersSeal
Receipt No.
Waiver Fee: $
Date of Payment
72-026 (Rev. 7/88) Back Page 2 of 2
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
TELEPHONE (907) 562-2343 5633 B Street
Anchorage, Alaska 99518
Drinking Water Analysis Report for Total Coliform Bacteria
TQ BE COMPLETED BY WATER SUPPLIER
[] PUBLIC WATER SYSTEM I.D.#
L'¢ PRIVATE WATER SYSTEM
Name P~one No.
Mailing Address
City State Zip Code
SAMPLE DATE:
Mo. Day Year
SAMPLE TYPE:
~ Routine
[] Check Sample (for routine sample
with lab ret. no.
[] Special Purpose
) [] Treated Water
[] Untreated Water
SAMPLE
NO. LOCATION
5 [
Time Collected
Collected By
TO BE COMPLETED BY LABORATORY
,n lysis shows tills Water SAMPLE to be:
/~ Satisfactory
[] Unsatisfactory
[] Sample too long in transit; sample should
not be over 30 hours old at examination
to indicate reliable results. Please send
new sample via special delivery mail.
Date Received
Time Received
Analytical Method: Membrane Filter
* No. of colonies/100 mi.
Lab Ret. No. Result*
J FTq
Analyst
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
BACTERIOLOGICAL WATER ANALYSIS RECORD
Membrane Filter; Direct Count ~
Verification: LTB BGB
Final Membrane Filter Results _ ~)
Time:
Coil for rn/100ml
,/,..~'-~2~ a.m.
TNTC = Too Numberous To Count
OB = Other Bacteria
PART I OF 2 REMAINDER TO FOLLOW
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
FEDERAL TAX ID # 92-0040440
ANALYSIS REPORT BY SAMPLE for Work Order ~ 13207
Date Report Printed: MAY lO 89 @ 14:27
Client Sample ID:LS, BI ROCKHILL
PWSlD :UA
Collected MAY 9 89 ~ 14:00 hrs.
Received MAY 9 89 @ 15:00 hrs.
Preserved with :AS REQUIRED
Client Name : FLATTOP TECHNICAl, SRV
Client Acct : FLATTOT
P.O.~ NONE REC'D
Req ~
Ordered By : TED MOORE
Analysis Completed :MAY 10 89 Send Reports to:
Laboratory Supervisor :STEPHEN C. EDE 1)FLATTOP TECHNICAL SRV
Released By : /'~~ 2)
.;;::::: ............... ................................................................ i ......................
Instruct:
Chemlab Ref ~: 5214 Lab Smpl ID: i Matrix: WATER
Allowable
Parameter Tested Result/Units Method Limits
NITRATE-N 4.2 ms/1 EPA 353.2 lO
Sample ROUTINE SAMPLE.
Remarks: SAMPLE COLLECTED BY T.M.
Tests Performed See Special Instructions Above UA=Unavailable
None Detected "See Sample Remarks Above
Not Analyzed LT-Less Than. GT-Greater Than
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date -~~/~'
1. GENERAL INFORMATION
(a)
(b)
(c)
Legal Description (include tot, block, subdivision, section, township, rancte)
Location (address or directions)
Applicant Name ~- ~ 1~. .Telephone: Home,'~ -/g~ Business ~
Applicant Address ~0~~C~ ~ /[ ~ t '~/~ /
Apptican~ ;s (check one): Lending Institution ~; Owner/builder ~; Buyer ~; Other ~ (explain);
(d) Lending Institution
Address
(e) Real Estate Company and Agent
Address
Telephone
Telephone
(f) Mail the HAA to the following address:
2. TYPE OF RESIDENCE
Single-Family~ Multi~Fa,~,~ly [] Other
Number of Bedrooms __ ,,.,,)
WATER SUPPLY
Individual Wed/~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite/~ Public [] Community [] Holding Tank []
Note: If corn reunify 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, DATA AND M TION
~ As certified by my seal affixed hereto and as of the validation date shown below, t verify theI mY investigation of thi
Authority Approval shows that the on-site water supply and/or wastewater disposal system's safe'fUncti°na/, . 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 ail Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm
Date
Seal
DHEP APPROVAL .
Approved for /,-h/~e~i:~ bedrooms by ; ~' '
Approved )(~ Disapproved Conditional _
Date
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2 '
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
0 8 1{ti5
RECEIVED
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
WELL DATA
Well Classification ~k U~ If A, B~C, D.E.C. Approved (Y/N,
Well Log Present (Y/N) ~ Date~Completed ~ - ~(~ Yield
Casing%M~(&!AbOVe GrOUnd Z¢~ Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
Depression Around Wellhead (Y/N)
/ 0 0 ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot / Oo / +; On Adjoining Lots
To Nearest Public Sewer Line ,A'//O/t'/~ To Nearest Public Sewer
Cleanout/Manhole
Water Sample ColleCted by
Water Sample Test Results
Comments
/~/0 PJZ~ To Nearest Sewer Service Line on Lot .
~'~ W O'w'~-/¢~ 0 ~J ;Date 7/~//
B. SEPTIC/HOLDING TANK DATA
Date Installed I '¢~ ~;~ 0
Standpipes (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well /
To Property Line '~ ~"
TO Water Main/Service Line ~OI
Course /¢~/0/'¢',~' ~O~-r'h
Size { (2 O 0 No. of Compartments ~'-
Air-tight Caps (Y/N) :~/'~---~ ~'~ Foundation Cleanout (Y/N)
Date Last Pumped 7/~//
/t~O ;for
Temporary Holding Tank Permit (Y/N) /V'/,/~
/
To Building Foundation ~/
To Disposal Field 7 '*
(,~"~r' ,-~-~¢'(/;~'~ To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/N) ,,~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well / / ~ ~' ''~'
To Building Foundation
Lot /~ ~ ~J~
To Water Main/Service Line <~' O ~ '~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
~¢co ~" c'[ Type of System Design
Length of Field
Depth of Field '~ ·
Gravel Bed Thickness '~"
Standpipes Present (Y/N) ~F'~ '"z~-" ,.~ //
Date of Last Adequacy Test 7/~//~::~
! ·
To Property Line / 0
To Existing or Abandoned System on
·
; On Adjoining Lots / OO '
To Cutbank (if present)
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
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
Page 2 of 2
72-026 (11/84}
Company MOA No.
Receipt No. "~ ~'/.L~'-~'~
Date of Payment %-
Amount: $ ~5 P~ ~:~¢'~'~'~ Engineer's Seal
~ ~'. . . ..'
~.J0 W. Benson Blvd.
Sutte ~06
PENINSULA ENGINEERING
Anchorage, Alaska 00~03
(9O7) 561-5~07
august 5, 1985
Walt Riley
6240 Rockhill Circle
Anchorage, Alaska
RE: Lot 5 Block 1 Rockhill Subdivision
Adequacy Test & Well Inspection
Dear Mr. Riley:
At your request we have performed an adequacy test on your on-site
sewage disposal system at the above referenced location.
The test was performed by adding 450 gallons of water into the ab-
sortion field and monitoring the levels in the field and the septic
tank for two consecutive days. The system was found to accept the
effluent readily and returned to its initial levels rapidly. The
results are tabulated on a separate sheet and the system is considered
adequate for a 3 bedroom home. The septic tank was pumped on July
31, 1985. The well was found to be in compliance with local codes
and the water analysis was satisfactory.
If I can be of any further assistance please call.
Sincerely,
~en~a n~ .....
Attachments: Test results, Water Analysis, HAA Certificate and Check
~.~.0 W. Benson Blvd.
Suite 206
PENINSUI ENGINEERING
Anchorage, Alaska 99503
(907) ~fll-5107
ADEQUACY TEST RESULTS
5/1 ROCKHILL SUBDIVISION
DATE
TIME SEPTIC C.O. 91 C.O. ~2 WATER TOTAL
TANK START END ADDED WATER
DRAINFLD DRAINFLD (GPM) ADDED
(GALS)
7/31
0 11 " 0 " 67 " 5
t0 11 0 80 5
30 11 0 76.5 5
50 11 0 76.5 2
70 11 0 2
90 11 0 78.5 2
122 11 0 79 7
132 11 0 79 7
0
5O
150
· 5 200
.5 250
.5 300
.5 375
.5 450
s/1
0 22 " 0 " 66.5"
10 22 0 79
20 22 0 79
40 22 0 79.5
60 22 0 77
70 22 0 68.5
75 22 0 67
0
7·5
7.5
7.5
7.5
0
0
0
75
150
3OO
450
450
450
I INSPECTION APPOINTMENTS
NSPECTO INSPECTOR IN~PECTOR
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIONDEPT. OF HEALTH &
825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTECTION
ENVIRONMENTAL SANITATION DIVISION JUL 3 1 1980
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE~"E~'"" ~lLV'r~)
DIRECTIONS: Complete all parts ga page 1, Incomplete requests will not be processed. Please allow ten (10) days for processing,
1. PROPERTYOWNER t PHONE
MAILING ADDRESS
PROPERTY RESIDENT (If different from above) PHONE
2. BUYER PHONE
MAILING ADDRESS
._._.-----
3. LENDING INSTITUTION I PHONE
V~AI LING ADDRESS
4. REALTOR/AGENT [ PHONE
I
MAILING ADDRESS
5. LEGAL DESCRIPTION
STREET LOCATION
6. TYPE OF RESIDENCE
SINGLE FAMILY
[] MULTIPLE FAMILY
7. WATER SUPPLY
I
NDIVIDUAL~
COMMUNITY
[] PUBLIC UTI LITY
NUMBER OF~BEDROOMS
[] One [] Four [] Other~
[] Two [] Five
~] Three [] Six
*ATTACH WELL LOG. Awell log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE~D SPOSAL SYSTEM
/~ INDIVIDUAL/ON-SITE** /~ ~'~ YEAR ON-SITE SYSTEM WAS INSTALLED.
[] PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,
72-010 (Rev. 6/79) ] l ~
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified
INSTALLER
[]Septic Tank or []Holding Tank
Size: l~:) 0 If Tank is homemade SOILS RATING
give dimensio,ns:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank IAbsorption Area Sewer Line I Nearest Lot Line
I
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
[~;]~PP ROVE D FOR _.~ BEDROOMS
[] CONDITION'AL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY