HomeMy WebLinkAboutKASILOF HILLS BLK 4 LT 10Kasl'o I of H I* I I s
Block 4
Lot 10
#015�131�22
Municipality of Anchorage Page 1 of 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW990239 PID Number: 015-131-22
Name; CAROLYN JONES
Wastewater System: 0 New 0 Upgrade
Address:
2211 E. NORTHERN LTS, ANCHORAGE, AK 99504
ABSORPTION FIELD
Phone!
No. of BedZoms:
(907) 440-9140
[]Deep Trench 13 Shallow Trench 0 Bed 0 Mound 0 Other
LEGAL DESCRIPTION
Sall Rating:
0.5 & 0.8 *GPD/Sq.
Total Depth train original grade:
SEE ATTACHED DErAJL
Ft. DRAWING, PAGE 3 OF 3
Lot: Blocic Subdivision;
Depth to pipe bottom from original grade:
Cronvel depth bereoth pipe:
10 4 KASILOF HILLS
SEE ATTACHED DETAIL
DRAWING, PAGE 3 OF 3
Ft. 0.5 Ft.
Township:
Range:
Section:
Fill added above original grade:
G.1 length:
SEE ATTACHED DETAIL
DRAWING, PAGE 3 OF 3 Ft.
64 Ft.
WELL: 0 New El Upgrade
Gravel BrIdth:
16
Number of linew
3
IDIt.n. between lines:
5.33
PL
Pt,
Cl..Ifi..ff.n (Private. A.B,C): Total Depth'
Ca.ad To:
Total absorption am:
Pipe material:
Sj�(:� Ft.
R.
Static Water Level;
1024 sa.Ptl
Install.r.
A+ HOME SERVICES
ASTM D -3034/F-810
Dote In
Driller. Data Drilled:
1 7�99 — 8/23/99
Ft.
I
Set At.
Pump 7Ft
Bing Height Above around:
TANK
GPM
Ft.
SEPARATION
DISTANCES
0 Septic 0 Holding 0 S.T.E.P.
TO
I
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
Public/prw.t.
Sewer Lines
Manufacturer.
ANCHORAGE TANK
CRY 1. 9.11cm.
1250
From
Well
100,+
100,+
—
25'+
Material: STEEL
Number of compartment@: 2
Surface
Water
100'+
100,+
—
—
LIFT STATION
Lot
5'+
10,+
Sir. In gallons:
M.naf.ctu.
Line
Foundation
5'+
1 10'+
"Pump a., level at:
High eater alarm ob
1
Curtain
NONE
KNOWN
Pump Make
Electrical linspeclJons performed br.
Drain
I
----L— - - --
Remarks: SOILS UNDER OLD PORTION OF BED WERE RATED AT
BENCH MARK
location and Description:
10 MIN./INCH BY WAYNE HENDERSON, P.E. AVERAGE APPUCATION
CONCRETE THRESHOLD OF DOUBLE MAN
RATE (0.5 + 0.8)/2 .65
DOORS IN BACK OF HOUSE.
Assumed Elevation: 100.00
ENGINEEWS87
AWWC, INC.
Inspections performed by: Dates: 1St 8/17/99
... : . . . .. ... ...... .......
2nd 8/20/99
3rd 8/ 20/99
.....
A. S. -
8/u/99
Department of Health and Human Services approval
—7953
Reviewed and a proved by: q/ Date: -2-29-19
Professlo
72-013 (Rev. 9/91 ) mcA 2� C/ ol
PeRMIT NUMBER: PARCEL ID NUMBER:
SW990239 AS -BUILT DRAWING 015-131-22
C04
Col
CO21
0
TH0+2 01
FCO I
WELL
�—MT4
I �TH#1
DBL2
DBL1 LLJ
ST2
STI
FC03
RE -BUILT I I
SEPTIC BED MT2 A
03 N_
NEW 1250 GALLON
SEPTIC TANK
*--CURTAIN DRAIN OUTTALL PIPE.
DISSIPATES APPROX. 20' FROM
OUTFALL. INSPECTED BY MOA,
DHHS, DONNA MEARS.
n
03
m
ST1 39.7 50�O 1 —
ST2 46.2 50.91 —
_ __1
DBL1 49.0 52.11 — for of f" top a f"
D_8_L2 50.0 53.2 — Af [Uf - 915� At aa�f - 91.49
NE I A,
3 L
C 1 7—
�l C01 68.7 2.3
CO2 68.0 72.1
CO3
_503 52.1 73.5
C
_G0_4 -0-1 _=_ _�_0_6
M M 1
T1 52.5 73.9 — NM 1250 6&ON
MT2 61.6 81.5 —
AT Wgf - 9099 5�FTIC TAW , hw0FD"
MT3 897 — 69.7 AfMf-90."
k�:J__i� — 60.2
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
6901 DERARR ROAD, SUITE 28. ANCHORAGE, AK. 99504
A� ........
PHONE: (907) 337-6179/FAX: (907) 338-3246 1�1
LEGAL DESCRIPTION:
KASILOF HILLS SUBDIVISION, LOT 10, BLOCK 4
.. . ............
TYPE OF WORK:
AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE . . . . .
1. * f
PREPARED FOR: PHONE NUMBER: y A. a e I.-
CAROLYN JONES (907) 440-9140 7953
DATE: DRAWN BY: SCALE: PAGE:
9/14/99 A.C.G. 1 = 30' 2 OF 3 Prof ess�ot,0
PeRMIT NUMBER: PARCEL ID NUMBER:
SW990239 AS -BUILT DFAWING 015-131-22 1
MYWOGV Pffl�k W/ V15QLfIrl\
WNIN6 ALON6 f1f FA5f, NOM,
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WfE: 50M �W OF 01,19 LtL? WA5 fOO CL05F fO LWOCK
MP VIIZM�Y NO ACCWTIN6 5OL AFTM COWAMINIAtP
5AN19 WA5 WMOVtV 9P W6 MMI? fO TH� NOM fO
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(AWM�)
m ol I 1 0
;e
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ALON6 NOkfM5f POUON
OF fl e ff t9- 60.95 - 6�.14
FILtR FAMC
�XGAVAW TO CaM 5MP
Af 500t�ff �NP 9 9P
- 8�.-* (APkOX)
9t2WCK a 50MA5f �NV
OF MP - 825�
OklQN& Fl[,� 6M @ NOMA9r
W OF mp - 54.92
PO'MOM OF �XAVAION - 61.94
(�':t fofh, mpfH).
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
KASILOF HILLS SUBDIVISION, LOT 10, BLOCK 4
TYPE OF WORK:
PROFILE AS -BUILT OF SEPTIC SYSTEM UPGRADE .....
CAROLYN JONES
9/14/99
A.C.G. I N.T.S.
440-9140
3 OF 3
-/9bJ
. Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2-B — Anchorage — Alaska 99504
Phone (907) 337-6179 — Fax (907) 338-3246
September 11, 1999
Municipality of Anchorage
Department of Health & Human Services
Division of Environinental Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Attn: Donna Mears
Subject: Kasilof Hills, Lot 10, Bk 4. 10500 Kasilof Blvd. As -built Documentation
Dear Ms. Mears:
Attached is the as -built package for the subject septic system installation. The system design was
modified after obtaining your verbal approval. The bed was shifted flirther to the north and
additional sand filter material was placed so as to ensure there was a 6 foot separation to bedrock
(see page 3 of 3 in the as -built drawings). As you saw during our site visit, the outfall of a curtain
drain was discovered when excavating out the old bed. It ran over the top of the old bed and
discharged on the west side of the lot. As discussed, the runoff associated with this curtain drain
was never noted during any of our previous site visits. As you saw during our site visit, the
curtain drain now discharges below the southwest end of the bed and dissipates within about 20
feet (even after the heavy rains which occurred in August of 1999). After the area revegetates
and the rainfall subsides, the discharge will probably dissipate in the immediate vicinity of the
outfall.
As discussed during our site visit A+ Home Services placed additional fill in the vicinity of the
northwest comer of the bed. Rather then placing fill at the toe of the slope (as you requested)
they just moved the entire slope out about 7 or 8 feet. The slope remained relatively stable, even
after heavy rains. It is expected that over time some of the additional fill that was placed will
move towards the toe of the slope until the bank stabilizes. 1 am recommending that the buyers or
sellers place some geofitbric over the slope so as to minimize erosion and hasten natural
revegetation.
� can be of further assistance, please contact us at 337-6179.
MUNICIPALITY OF ANCHORAGE
Department of Heaith and Human Services
On -Site Services Program —
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
-17 -99, YlOcA
!A L_� 0��
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT -A � 1
Upgrade
Date lssued� u ;01a�q
Expiration Date: Aug 01, 2000
Permit Number: SW990239
Legal Description: KASILOF HILLS BILK 4 LT 10
Design Engineer: 0041 AK Water & Wastewater Consulta
Owner Name: Carolyn Jones
Owner Address: 2211 E Northern Lights
Anchorage , AK 99504-0000
Parcel ID: 015-131-22
Site Address: 010500 KASILOF BLVD
Lot Size: 34000 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[?] Disposal Field 7 Septic Tank E] Holding Tank E] Privy
All construction must be in accordance with:
1. The attached approved design.
0 Private Well F] Water Storage
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
tA04
719
Received By:
Date: R _.� _C�q
Issued By:
Date:
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2B — Anchorage — Alaska 99504
(907) 337-6179 — Fax (907) 338-3246
Consulting Engineers
July 20, 1999
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref. Septic System Upgrade for Lot 10, Block 4, Kasilof Hills Subdivision
To whom it may concern:
The existing 4 bedroom house is served by an onsite septic system, and a private well. The
existing bed is surcharged and must be upgraded prior to the sale of the house. Comments
regarding the proposed upgrade are summarized as follows:
1. GENERAL: Two test holes were excavated adjacent to the existing bed for the purpose of
determining the percolation rate of the soils underneath it. The intent is to rebuild the existing
bed so that a gravity flow could be utilized. Based upon the percolation rate, it appears that a new
conventional bed would require at least 750 ft2 of absorption area. The existing bed, which is 64
feet long by 16 feet wide, has a absorption area of 1024 ft2. We are proposing that all piping,
filter fabric, contaminated sewer drainrock and sand filter, etc., be removed completely and all
new materials be installed. The new bed elevation is to be equal to or higher than the existing bed
elevation.
2. SOILS: On June 1, 1999, two test holes were excavated and percolation tests were
performed next to the existing bed. As can be seen from the attached logs, the soil below the
organic & loamy material is a GW/GM material to a depth of 5.5 feet. At 5.5 feet, bedrock was
encountered in both test holes (bottom of test holes). No ground water was encountered at the
time of excavation. In test hole #1, a percolation test was performed between 3.5 feet to 4.0 feet,
and determined the rate to be at 4.44 minute/inch. In test hole 92, a percolation test was
performed between 3.5 feet to 4.0 feet, and determined the rate to be at 4.0 minute/inch. The
existing bed is mounded and was documented to be 6 feet above bedrock.
3; TRENCH DESIGN:
a. Percolation Rate: 4.4 & 4.0 minutes/inch
b. Allowable Application Rate for bed with sand filter: .7 gallons/day/ft2
c. Number of Bedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 857 ft2
f. Effective Depth: 0.5 feet
g. Width: 16 feet
h. Length: 64 feet.
i. Effective absorption area = 1024 f12
4. SURFACE WATERS: There is no surface water within 100 feet of the proposed septic
upgrade.
5. TOPOGRAPHY: As can be seen on the attached topography site plan, the average slope
runs from east/southeast to west/northwest at approximately a 20 to 25 percent. This drawing
was taken from the M.O.A. grid maps and the topography has been altered since this topography
information was taken. At this time, there is a shelf in the area of the existing bed and than the
slope gradually increases downhill from the bed. We do not anticipate any slope concerns or
adverse impacts associated with the rebuilding of the existing bed, given the fact that it
performed adequately for almost 14 years..
6. CLOSING: I am open to any suggestions from your department, which would be an
improvement to the proposed design. I am unaware of any adverse impacts this installation
would have on adjacent wells or septic systems. If you have any questions, please contact meat
337-6179. Thank you for your assistance.
P.E., M.S.
LOT 12, BLOCK 4
KASILOF HILLS S/D
Q,
LOT 13, BLOCK 4
KASILOF HILLS S/D
':ZACAN��-)
LOT 14, BLOCK 4
KASILOF HILLS S/D
LOT 15, BLOCK 4
KASILOF HILLS S/D
10
�-n
LOT 11. BLOCK 4
KASILOF HILLS S/D
TH#2 +
TH#1 +
LOT 5, BLOCK 6
KASILOF HILLS SID
/ 0
ST 2 BLOCK 6
ILO�, HIL2S S/D
KALSILOF HILLS S/D
LOT 8. BLOCK 4
KASILOF HILLS S/D
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
KASILOF HILLS SUBDIVISION; LOT 10, BLOCK 4
1��
P
LOT 1, BLOCK 6
KASILOF HILLS S/D
SITE PLAN FOR SEPTIC UPGRADE .. .7
A
PARED FOR: PHONE NUMBER:
CAROLYN JONES (907) 441-9240 -T fEE -
DRAWN BY. SCALE: rltj*�161" ev p ..........
J. L. M. 1 = loo, PAGE: 1 0 1 ss�lorl
7/17/99 F 3 lkll r f
-7
xl�
;EXISTING
SEP -PC SYSTEM2)
(SEE DESIGN, PAGE 2 OF
0
LOT 9, BLOCK
KASILOF HILLS S/D
IUD
LOT 8. BLOCK 4
KASILOF HILLS S/D
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
KASILOF HILLS SUBDIVISION; LOT 10, BLOCK 4
1��
P
LOT 1, BLOCK 6
KASILOF HILLS S/D
SITE PLAN FOR SEPTIC UPGRADE .. .7
A
PARED FOR: PHONE NUMBER:
CAROLYN JONES (907) 441-9240 -T fEE -
DRAWN BY. SCALE: rltj*�161" ev p ..........
J. L. M. 1 = loo, PAGE: 1 0 1 ss�lorl
7/17/99 F 3 lkll r f
-7
cL
TH#+2
EXISTIN y
16 FEET WIDE). -THE BED IS TO BE
EXCAVATED AND ALL CONTAMINATED
MATERIAL IS TO BE REMOVED. ALL
NEW SAND FILTER, SEWER DRAINROCK,
PIPING. FILTER FABRIC, ETC., IS TO BE
INSTALLED. SEE DETAIL, PAGE 3 OF 3.
*TH#1
c MT
GO CO
Illiel
C)
�'o t'j
9� la�
co C)
co
M M 0
0 EXISTING SEPTIC TANK TO
BE ABANDONED COMPLETELY
(-n
0
n
I
INSTALL DBL CO -i �INSTALL DEL CO
0
PROPOSUED 1250 GALLON
SEPTIC TANK
NOTE: THE CONTRACTOR SHALL VERIFY THAT
ALL SEPARATION DISTANCES WILL BE MEr
PRIOR TO ANY CONSTRUCTION.
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD SUITE 2B, ANCHORAGE, AK 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
KASILOF HILLS SUBDIVISION; LOT 10, BLOCK 4,
TYPE OF WORK:
DESIGN FOR SEPTIC SYSTEM UPGRADE
CAROLYN JONES
/17/99
J. L. M.
441-9240
I = 30'
2 OF 3
T -T_7� .....
A'.
ess
E-7953 �g
MOM 12�O 6UON 5�M fANK
r— — — — — — — — — — — — — — — - — — — — — — — — — — — — — — —
vc) I co
T-
0
mf 0
co
co
Mf
mf.
I co I
L------------------------------- J—
OVIC41N&
NM: XAVAZ All COWAMINV912 5MV ROCK,
5ANP FILTM, PIPIN6, I'MIZ FAMIC, N51AIOW, M.,
ANP ITMOV� COMMY, T�f MW 5ANI? FILSR/
POMOM OF %Vgk WANIZOCK NMTION 15 fio PF
FOLM CR HICKIZ TI -M ff �4511W rl�WATIOW.
PLAN VIEW
FIR
NJ
PROFILE VIEW
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
KASILOF HILLS SUBDIVISION; LOT 10, BLOCK 4,
DETAIL OF PROFILE AND PLAN
PREPARED FOR: PHONE NUMBER:
CAROLYN JONES (907) 441-9240
7/17/99 1 J. L. M. I N.T.S.
3 OF 3
FAMIC
A. Garnessi
—7 9 53
........... e
ASTEWATER
I SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: KASILOF HILLS S/D; LOT 10, BLOCK 4
PERFORMED FOR: CAROLYN JONES
DATE PERFORMED: 6/1/99
DEPTHF-----1
(feet) ITEST HOLE #1]
1
SOIL CLASSIFICATIONS
2 —
3 . .........
LOAMY MATERIAL
4-1
GW/GM
5—
BEDROCK
7
10
11
12
13
15-
16-
17-
18-
19-
20
COMMENTS:
PERFOMED BY ALASKA
THIS WAS PERFOR?ED
DATE. DATE:
DEPTH TO
GW
GROUNDWATER
ORG
WATER LEVEL
READING
GP
DRY
ML
G M
CL
GC
SID
2
OL
MH
CH
10
2-7/8"
3-1/8"
-------------
Sm
OH
2:56
SC
4
DEPTH TO
DATE
GROUNDWATER
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
DRY
S ITE PLAN
1" 100'
TH#2+
LTH#l+
A
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
2
2:56
10
2-7/8"
3-1/8"
-------------
3
2:56
4
3:06
10
3-1/8"
2-7/8"
5
3:06
6"
6
3:16
10
3-1/4"
2-3/4"
7
3:16
--------- -
6"
8
3 2 6
10
--------- ----
3-1/2"
9
—
3:26
—
10
3:36
10
3-1/2"
2-1/2"
3:36
6"
12
3:46
10
3-1/2"
2-1/2"
PERCOLATION RATE 4.44 (MINJINCH) i PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 3.5 FT. WAN/ FT,
TJ�4SO
0
PERG. HOLE WAS PRESOAKED 4*--t(OUF?Ai PX TO TESTING
rER & WASTEWATER 1,
ACCORDANCE WITH ALL
7� , CERTIFY THAT
PAL GUIDELINES IN EFftCT ON THIS
I ALASKA WATER & WASTEWATER CONSULTANTS. INC.
I SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: KASILOF HILLS S/D; LOT 10, BLOCK 4
PERFORMED FOR: CAROLYN JONES
DATE PERFORMED: 6/1/99
DEPTH
(feet) TEST HOLE
2— SOIL CLASSIFICATIONS
5
6
7
8
9
10
11
12
13
14
15-
16-
17-
1 " L
19
20
COMMENTS:
PERFOMED BY ALASKA
THIS WAS PERFOR D
DATE. DATE: :2 -1-c
DEPTH TO
DATE
GW
NET TIME
(MINUTES)
ORG
LOAMY MATERIAL
—DRY __'_6/1/99__
DRY
----------- I ----- - I ----
GP
1
ML
6"
GM
CIL
2
2:58
GC
2-7/8"
OL
GW/GM
SW
3
MH
I
- -----
6'
t�lo�
SID
CH
BEDROCK
10
sm
2-7/8"
OH
5
3:08
sc
6"
PERFOMED BY ALASKA
THIS WAS PERFOR D
DATE. DATE: :2 -1-c
DEPTH TO
DATE
GROUNDWATER
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
—DRY __'_6/1/99__
DRY
----------- I ----- - I ----
6/8/99
----------
------- ------
TE PLAN
1" 100'
TH#2+
TH#l+
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
6/2/99
1
2:48
6"
2
2:58
10
2-7/8"
3-1/8"
3
2:58
--------- - - ----
- -----
6'
4
3:08
10
3-1/8"
2-7/8"
5
3:08
6"
10
3-1/4"
2--3/4"
—
— — —
— —
7
3:18
—
61,
—
8
3:28
10
-- ---------
3-1/2"
2-1/2"
9
3:28
— ------
------ - __ ------
6'
10
3:38
10
3-1/2"
2-1/2"
11
3:38
6'
12
3:48
10
3-1/2"
2-1/2"
PERCOLATION RATE 4.0 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 3.5 FT. :
AN TIT 4SO FT,
0 —
PERC. HOLE WAS PRESOAKED 4+-TitQA7 PR T TESTING
rER & WASTEWATER 1,
AC ORDANCE WITH ALL
CERTIFY THAT
'T ON THIS
daMUNICIPALITY OF ANCHORAGE
RTMENT OF HEALTH AND HUMAN SEIWES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name It DISTANCES
C -Ir
Address 0t - & '_c� SEPTIC ABSORPTION WELL
1 FROM TANK FIELD
6-00
WELLS
K lot btv
1:1 OTHER (Ideil
Classification (A B,C)
0 Depth
417—
Pho"(S)
-Fil
Permit No
No. a
WELL
OD
14
7-768
1
9�r0l&-2_3
1 __14
[LOTLINE
—
LEGAL DESCRIPTION
III
i
'-3 C>
Lot
Block
lscn;�10� hw-'-
FOUNDATION
1
17-1
Township, Range Section
AS -BUILT DIAGRAM (Show location of Wer
Septic SySter, property lines fourmatic
I'
I
driveway, water bodies, etc)
I
TANKS
I
i I
_T_T_T_T_&T
X SEPTIC D HOLDING
manwactme, capacity in gallons
(gr � ei– / _2�5_c;`
Material No. of Comp.mments;
EI TRENCH
Depth to pipe bottom fro
original grade
0 - -1
i added above original
6—' C. /
C2
Gravel length
6 'e
Total absorption area
/ o
- of
Number lines
installer
TYR III I ID
TYPE OF SYSTEM
'X BED El W. DRAIN El OTHER
Total depth tram original grade
If 6ckvi FT 3�-S"
add Gravel depth beneath pipe
FT
FT Gravel wonn
IDistance between lin es
SO FTj I'll
.11 rating
material
Pl�!;fi C,
-J _# ;q 4; 0
Date. V q /3 0/9 15--
I'Aj rLi certify that this inspection was pearporinned according to all
Municipal and State Q --5—
guidelines in ellect on this date: Y7/--3
C-1
G K.
A A4
Health Department Approval: Date..,K/ --qj ----
72-013 (3/85)
N
M
WELLS
PRIVATE
1:1 OTHER (Ideil
Classification (A B,C)
0 Depth
417—
Cased to
12–
-Fil
FT1
FT
Installer
jDar"
rrJow
'C )171
REMARKS:
-J _# ;q 4; 0
Date. V q /3 0/9 15--
I'Aj rLi certify that this inspection was pearporinned according to all
Municipal and State Q --5—
guidelines in ellect on this date: Y7/--3
C-1
G K.
A A4
Health Department Approval: Date..,K/ --qj ----
72-013 (3/85)
N
M
C
RMI I- NO:
�TE ISSUED:
LICANT:
DRESS:
ACT
��
�� �� ��
�� ��
M IJ PA I t-, I P"gc�k L__ I I - N� C] F=7 ice tvi (0 41 tQ Fv 40 (a I=
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREET, ANCHORAGE;
AK 99501
264-4720
C-) Iq_E3 I Ew E3 E= pq EFE FR F� FE FR M I 'r
850623 ENGINEERED DESIGN
09/24/85
PYRAMID EXCAVATING
1048 W INTL AIRPORT
ANCHORAGE, AK 99502
561-2484
L DESCRIP: SUBDIVISION: KASILOF HILLS LOT: 10 BLOCK: 4
SECTION: 13 TOWNSHIP: 12N RANGE: 3N
SIZE: 34000 (SQ.FT. OR ACRES)
certify that:
I. T am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska
. I will instal] the system in accordance with.all MOA codes and regulations
and in compliance with the design criteria of this permit" ,
" I will adhere to all MOA and State' of Alaska requirements for the set back
distances from any existing well, wastewater disposal system or public
| sewerage system on this or any adjacent or nearby lot.
LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
|LN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
�LL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN"
'
GNED '
DATE:
----------
PLICANT: QUID EXCAyATING
SUED BY �
^ DATE: '?-w�~_����
-----`---^---~
/ \4
VV
VV `
\��*e�� ���
. /
- *"' M'_ of
�/ SHEET NO . ...... / ...... OF .... 17
,34 3 -�k
........ DATE 119�*k SU qMT ..... /P ..
--.x.1 . -) 0 _nJ
CHKD'. BY .............. DATE ............... .... AT e.f ...... llkZo ............... ... JOB NO.
......................................................... ........................ ��*icws .......... v . ........ ................ .....................................
4P F,5RFr AOL- -tl/
0
g") 'VV jo*
bRAW n;,fv,
'S = e7 76 /2/ jot
1 00
I*AJO 4"C -0-
J#. -S74" vbv- Pei
PIPE w mf
(fovr-R
4, be/�w
Air Coil
A T�'
10 ........ A ........
0
AV
I
I
I,-- IT.S 6iC7
6-74 Ab
N
Ki
4 4>0
729-C oF
km
Dc, /
lt�/ �02�
A/
70'
2,
15:s -/e -A Led"*, -
vvicL.4-
llp
Izi
........ DATE SUAB 4 .............. 0 SHEET NO......:;;� .... OF..:a
CHKD. BY ............. DATE ............... ...... ........ e... JOB NO . ......
................ ........................................ ...... ....... ....... alao.,-0,94 ......................................................
/YJATEA�14L w ITI.� C 4 p
W-17714 C4P
Bo7H END 6pr F!j5L">
PIPE
co,
/7-:570&AjLL0au 5.Eo�2-jc-
-rWO
vv I T-14 7- - -4" e-, 0. CAP -5.
4-K) FiAlisH GRADE
be,
204- 4-F, 4" ?E-,eFaR4-r-j6D
zw,Ow PiPE 15,C-7- 1-,i5vCL Vtly �bE bal9mr
I
6,Ee 11 :5ArE-T Pet
/Ar gacK
7-"A-2,a,/e ;e'941C140
,�;RAVEL (,5M)
Cli�&-Afthc, R�A-r
W I TJ4 NA -TV R4 L
IAE56t7'47-io�V r-OVEP-
W,5'1-z DRAi"I"6- �SAJbY 6,kAVEL (csw)
ALL oize,4ouie- Fewr
COVOR 5,C-1 o �V 2>
A"t, -5�—�ARlr-r
X SOILS LOG
MUNICIPALITY OF ANCHORAGE PERCOLATION
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720 TEST
SOILS LOG - PERCOLATION TEST
PERFORMED FOR:
Date Gross .
Time In'ij
Net
Time Mim,
Depth to
Water
Q C>oj'E6
DATE PERFORMED:
C/
31,
0
7-
'&'EA'f1v0
415-
LEGAL DESCRIPTION:
1-07,10
234clr
Alr'lA, :5�"4jw
L MEN
RZ12 "Y" -'01 No
GKORL. KENN
Milkoll
MILIMM
ORLIN
EMILIO
MERE
MME11
100111
M L
EN I
M L
EN I
2 - V 4 . ,
k 0
3-
4 - Ili
S
6
7
8
9
10
soje-ock
'a WAS GROUND WATER S
ENCOUNTERED? L
U
Ar P
IF YES, AT WHAT
DEPTH
01)
....... ... All,
Ay f O�RSON
8 .
:�, J&� 4
C
& U
16 -ql1li
17-
18-
19-
20-4
COMMENTS
PERFORMED BY:—
z
11
Reading
Date Gross .
Time In'ij
Net
Time Mim,
Depth to
Water
Net
Drop
0
0
31,
0
7-
415-
D
PERCOLATION RATE M1 VjiJC6 (minutes/inch)
TEST RUN BETWEEN FT AND d4 IFT
I.— CERTIFIED BY: DA
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 11 PERCOLATION
825 L. Street, Anchorage, Alaska 99501 264-4720 TEST
SOILS LOG - PERCOLATION TEST
DATE PERFORMED:
PERFORMED FOR: 2 0
. - It I/
LEGAL DESCRIPTION: 1-7' ALM�
ORGrOlIfff- COVOR
ARb 4M
2—V
'SANtOY 'S/J. SM)
SANIOr '51,Lrr &RAVEL
T"" BED RUCK
5 —
6 —
12
13
14
15
16
17
18
19
20
COMMENTS
PERFORMED BY:
" '-0 A
SLOPE
WAS GROUND WATER
ENCOUNTERED? "o
IF YES, AT WHAT
DEPTH?
111
Reading
Date
TE, . =�N'
me
. 1.
T m
Depth to
Water
Net
Drop
497"
I
it 10.
AYN
ER.ox
41
E
488
12
13
14
15
16
17
18
19
20
COMMENTS
PERFORMED BY:
" '-0 A
SLOPE
WAS GROUND WATER
ENCOUNTERED? "o
IF YES, AT WHAT
DEPTH?
111
Reading
Date
TE, . =�N'
me
. 1.
T m
Depth to
Water
Net
Drop
I
PERCOLATION RATE
TEST RUN BETWEEN — FT AND
Z' CERTIFIEDBY:
(minutes/inch)
— FT
FROM : RLRSKA WATER & WASTEWATER PHONE NO. : 9073393246 May. 25 1999 11:40RM P2
X SOILS LOr
MUNICIPALITY OF ANCHORAGF 0 PERCOLATION
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST
925 L. 80"t. Anchovage, AiAIINA 99501 2444?20
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: &A= OATC PERFQAMGD!_!7 I /I 1 /9
/' /- jj
LEGAL,
DEPTH
olt"J�lc. Covog
2
1plewr 4 Pot)
4
7 -
13
ld
15
1 IS
17
is
is
20
COMMENTS
dF,l L&i�"
PERFORMED By
WAS GRQIJNQ vVATEVI S
ENCOuNTeRRO? OL
P -7
IF YES, AT WHAT E H-1 I
DEPTH? m t t -F' -I fi-
PERG04ATION FIATA —4ml"wt.G11m.h)
TEST HVN BETWEEN — PT AND � FT
PIED
Z4
orwi
TIM
N6t
TIm.
Depth Ip
weter
PERG04ATION FIATA —4ml"wt.G11m.h)
TEST HVN BETWEEN — PT AND � FT
PIED
Z4
NAME
LOCATION
GREjrR ANCHORAGE AREA BOr GH
Cjj
1 Departmento, LFivironmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
�> �y
MAILING ADDRESS 91WO Cr -g, - PHONE ";W_5�-
- LEGAL DESCRIPTION Xt� TIC i214� '� IfW-5'10 Or 136AS -1--$�?Q
SEPTIC TANK:
DISTANCE NUMBER OF
FROM WELL -SO MANUFACTURER 5>41TS61 MATERIAL IPIAA Ze__ COMPARTMENTS
INSIDE LENGTH— INSIDE WIDTH— LIQUID DEPTH —LIQUID CAPACITYA�re GALLONS.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELL — FOUNDATION —NEAREST LOT LINE—OF LINES
NUMBER OF LINES— DISTANCE BETWEEN LINES —TRENCH WIDTH— IN. TOTAL EFFECTIVE
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
WELL:
TYPE -
SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER
—MATERIAL BENEATH TILE
UCTION
IN, ABOVE TILE—IN.
H —DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION—, LOT LINE—, SEWER LINE—, TANK—, SYSTEM -
CESSPOOL
APPROVED
DISTANCES�
INSTALLED BY
SEWER LINE DEPTH:
PIPE MATERIAL
LOT SLOPE:
REMARKS:
Form EQ -032
OTHER SOURCES
DISAPPROVED —REMARKS
DIAGRAM OF SYSTEM
v
DATECn A' ZSAPPROVED
G.A.A.B.
GRE R ANCHORAGE AREA BO GH
0 # bid
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503 T -
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE
TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD -
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK, /L � ' , SEEPAGE PIT
TO RIVER, LAKE, STREAM.
SEEPAGE AREA SIZE I Al TYPE
DRAIN FIELD
- DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
- DRAIN FIELD
CAST [RON INTO AND OUT OF SEPTIC TANK AND INTO CRIS CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST [RON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS+
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G.A.A.B.
OR
LICENSED VES1 GNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATEF
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
' I
DATE ZZ APPLICANT'S SIGNATURE, -1
FORM NO. CO -01 6
DIAGRAM OF SYSTEM
V
NAME OF APPLICANT
L
H A- /;f t W
MAILING ADDRESS
PHONE
INSTALLATION LOCATION
LEGAL DESCRIPTION
T
INSTALLATION OF: SEPTIC TANK
--L7L-2
SEE/A8�14 4�
DRAIN FIELD
OTHER
TYPE AND SIZE OF FACILITY TO BE
SERVED
FINANCED THROUGH
TO BE INSTALLED BY
SOIL TEST RESULTS
NOTE: THIS
PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE
TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD -
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK, /L � ' , SEEPAGE PIT
TO RIVER, LAKE, STREAM.
SEEPAGE AREA SIZE I Al TYPE
DRAIN FIELD
- DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
- DRAIN FIELD
CAST [RON INTO AND OUT OF SEPTIC TANK AND INTO CRIS CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST [RON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS+
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G.A.A.B.
OR
LICENSED VES1 GNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATEF
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
' I
DATE ZZ APPLICANT'S SIGNATURE, -1
FORM NO. CO -01 6
DIAGRAM OF SYSTEM
AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
L
L
H A- /;f t W
T
i-4
i 1 1 Tl-'--� 1 7
AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
L
CWTER ANCHORAGE AREA BORO&H
'Ic ' HEALTH DEPARTMENT NO* 629
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
7 7--'2 —
DISTANCE FROM WELL NUMBER OF
—MATERIAL —COMPARTMENTS
p 51 LIQUID
LIQUID CAPACITY. -2-10. GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF
LINING
WIDTH—, LENGTH , DEPTH I
FOUNDATION—,
NEAREST LOT LINE .. TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT.
TILE DRAIN FIELD:
I - / - TOTAL LENGTH
DISTANCE FROM WELL 'Fo FOUNDATION— A'�6 NEAREST LOT LINE 13 t� Id , OF LINES 1-74
NUMBER OF LINES 4
DISTANCE BETWEEN LINES TRENCH WIDTH —N. TOTAL EFFECTIVE
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE '5--1 '6--l-" 34 /' 3�
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE—IN. ABOVE TILE
WELL:
DISTANCE FROM 14 j& "' WATER
TY E DedleQ DEPTH /196 -BUILDING FOUNDATION.— SAMPLE NEAREST
AREST SEPTIC SEEPAGE OTHER
LOT LINE SEWER LINE--ZV- TANK y SYSTIEZ YO CESSPOOL SOURCES
DIAGRAM OF SYSTEM
DISTANCES:
DATE IP/ 7/ APPROVED HEALTH AUTHORITY
GAAB-11D-2 GREATE#ANCHORAGE AREAfOROUGH Case No.
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
2 � 7—
NAME OF APPLICANTL4)l AV'M 0 PCi MAILING ADDRESA' PHONE NO.
RESIDENCE ADDRESS �Z �Oi A/C k�( C LOCATION OF INSTALLATION
LEGAL DESCRIPTION Z't 10 d� 1�a.OWF H/&
APPLICATION TO INSTALL: SEPTIC TANK SEEPAGE PIT BY41N FIELD—, OTHER
TO SERVE THE FOLLOWING FACILITY bdrm �rll =n
z
FINANCED THROUGH TO BE INSULLED BY �5 e I
PERCOLATIO9YE6`T/ RtEeS6tLTS ANTICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE As A, /Jy,. _51II,- Y�� 5 PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
_7�_o f'OoLek't4
SEPTIC TANK SIZE. TYPE SEEPAGE AREA —TYPE
DIAGRAM OF SYSTEM
PIC 15
D I STAVC EY: I
lvefl to rc'�Ik 5-c.0
kletl 7-a
5�,plql*z
cwi�,(
1-0
),9t )'",? Zvi
_1(1eJ Poav'04
ela6zk;ve"O'll�;
bqCA ('X '-4
�'pz.
'� /�� —/,'c -,e
EALTH AU"
OR
UCENSED DESIGNER
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code tl-d w moq
DATE APPLI CANI S SIGNATU RE
EA 1 A;
T
3 E ii
AJ'lC�l0RAl.'!H%. Al-le:KA
7<�
Th i F, f
Depth -i i -on
OCQILF�n
Was Ground Water
AT �epTl�,
5 1 t 7'
IV/
M"l E 1 "'7S Of Pit Jr '�venclh
cc
,rest
Da�:a Certified By,
Date
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
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. # 015-131-:22 HAA # LAkn 2L
1. GENERAL INFORMATION
Lot 10; Block 4; Kasilof Hills
Complete legal description
Location (site address or directions) 10500 Kasilof Blvd.
Anchorage, AK
Property owner Leland & Carolyn Jones Dayphone 441-9240
Mailing address CIO Paragon Properties
Lending agency Day phone
Mailing address
Agent Kris Abegg/Paragon Properties Day phone 349-1200
Address ' 3111 "C" St. Suite 555 Anchorage, AX 99503
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual well
Community well
XX
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system. I
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site XX
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(Rw.1J91) Front MOA921
5. STATEMENT OF INSPECTION BY ENGINEER
Ascertified bymyseal affixed heretoand asof thevalication clateshown below, I verifythat 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 effectA75499 VReo�r inspection.
-:-, 2 -7 — (ol 7Q
Name of Firm Was&wat ant 1rh- Phone
Address
Suite
Engineer's signature
AjaSK-a Wafer A
Wastewater Consultants, Inc. f
Shall be PAID $ 111g6 K
or prior to, closing for the
Engineering Services Providedi
6. DHHS SIGNATURE
0
Approved for E0 L) R bedrooms.
Disapproved.
Date 911.319
— Conditional approval for — bedrooms, with the following stipulations:
Note: The well for this property meets existing State and Municipal Codes.
There are nitrates present. It is suggested that periodic testinz be
performed to insure the wells continued suitability. Current nitrate
concPnt-rnt-jnn iQ 7 ';R R/J FR4 =�Xim"M IR 10 0 Mg/1
More information on nitrates is available from the On-site Services Program,
DEHS. 343 4744.
Additional Comments
�)� Date 17 - ;2- 19 - q Ct
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 theStateof Alaska. The DHHS does this as a courtesyto purchasers of homes
andtheirlending institutionsin order to satisfy certain federal and state requirements. Employeesof DHHSdonot
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.
72-025(Rw.1/91) a=k MOA021
Municipality of Anchorage AL
� D
DEPARTMENT OF HEALTH & HUMAN SERVIMC E IV
Environmental Services Division
825 L Street, Room 502 - Anchorage, Alaska 99501 - (90n�b-4�&'
Municipality 01 "chorage
Health Authority Approval Checkli9jelpt. Health & services
Legal Description: KASILOF HILLSa LOT 10. BLOCK 4 Parcel I.D.:_ 015-131-22
A. WELL DATA PER 1985 INSPECTION REPORT WAYNE HENDERSON P.E.. CASING
DEPTH IS QUESTIONABLE GIVEN SHALLOW BEDROCK DEPTH.
Well type PRIVATE If A, B, or C, attach ADEC letter. ADEC water system number N/A
Log present (Y/N) NO — Date completed 1971 (ESTIMATED)
Total depth *92' Cased to *92' Casing height (above ground)
Sanitary seal (Y/N)
FROM WELL LOG
Date of test
Static water level
Well production Z 9 -P.M.
WATER SAMPLE RESULTS:
NO CHLORINATION
12"+
Wires properly protected (Y/N) YES
AT INSPECTION
g.p.rn.
4.8 G.P.M. FOR 125 MINUTES
WITH DRAWDOWN TO 60 FEET BTC.
Coliform Nitrate 7�58 mg/L Other bacteria
Date of sample: 8/25/99 & 8/313199 Collected by: A.W.W.C., INC.
B. SEPTIC/HOLDING TANK DATA
Date installed A/QQ Tank size 1 9.c;n Number of Compartments 9 Cleanouts (Y/N)YES
Foundation cleanout (Y/N) YES Depression (Y/N) Nn High water alarm (Y/N) N/A
Date of Pumping NEW Pumper NEW
C. ABSORPTION FIELD DATA * TO TOP OF SAND
Date installed R /qq - Soil rating (g.p.d./ft' or ft2/bdrm) n r,-; Ayr System type BED
Length ... lfi±_Width 64+ Gravel thickness below pipe n sil Total depth *3.5'+/ -
Effective absorption area 1024+ so Fr Monitoring Tube present (YIN) YES Depression over field (Y/N) No
Date of adequacy test NEW Results (Pass/Fall) NFw For 4 —bedrooms
Fluid depth in absorption field before test (in.);
Fluid depth
72-026 (Rev. 3/96)*
(ins)
(past 12 months) (Y/N)
Immediately
Absorption rate =
If yes, give date
D. LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level
*Daturn
Size in gallons--�
,I at* "Pump off " level at*
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot 1 CO'+ — On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main N/A Public sewer manhole/cleanout N/A
Sewer /septic service line 25*+ Lift station N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation 5'+ Property line 5,+ Absorption field 5'+
Water main/servioe line 10'+ Surface water/drainage 100'+ Wells on adjacent lots 100,+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 100+ Building foundation 10'+ Water main/service line 10,+
Surface water in(),+ — Driveway, parking/vehicle storage area 50,+
Curtain drain *50'+ —Wells on adjacent lots 100,+
F. ENGINEER'S CERTIFICATION SEE COVER LETFER REGARDING WTFALL
terns are
I certify t I inspections and review of Municipal r&
. A , . �F , . � te
101�
in n gu * efines in effect on this date. A
Signature.
Engineer's
Date
HAA Fee
Date of Payment —
Receipt Number_
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
A7G-26-02 TK" s 40 ,
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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) Legal Description (include lot, block, subdivision,
/,7-74 io Bloc_k- -4
Location (address or directions)
10 /V
(b) Applicant Name J0"!46 Telephone: Home 344 -2-716'S Business ZH_-ViFig
Applicant Address 10 --roc) altl!d' e��z 2�&
V
(c) Applicant is (check one): Lending lnstitutionA:9;DuiIder 0 ; Buyer El ; Other El (explain);
(d) Lending Institution
46'�;epi PACl/��C i2dAlk--
Telephone
4-6 2-- 610
Address je))
�, &�AlSdlll �L 1/ 13 4AIC'ViN4146e�-,
'4'�t
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
0—, U Q
0h(,�7-14k-(AN W AHT S 41ilvb 14 f�'
duci,(mq6c , X(4S,-_-tq !� jg�
2. TYPE OF RESIDENCE
Single-Familvg Multi-FamilyO Other
Number of Bedrooms
3. WATER SUPPLY
Individual Welix CommunityO PublicO
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE LJ1bFUbAL
OnsitA Public El Community 0 Holding Tank El
Note: If community well system, must have written confirmation fromthe State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11/84)
I
0 0
5. , ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe. functional and adequate
forthe numberof bedroomsand 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. I
Name of Firm ?�� A,','A,', oC Z� Telephone (/-.57e-0 7
Address 17�
aX., 1�
Date — /0
6. DHEPAPPROVY.
Approved for 7—' 4— bedrooms
Approved Disapproved — ConditionaY—
Terms of Conditional Approval
Engineer's Seal
OF
491
Date ZO —//, 9 6'
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
App . roval 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
72-01 , , %
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720 RIV,Vf I
_. / / 0 r-, t /' 4_.6
Legal ion: / �<__ &
ZV51 h
A. WELL DATA
Well Classification cc, V-� � a If A R r,. n r r, iviki�
Well Log Present (Y/N) M2 Date Completed 46r2t /f 7/ Yield
Total Depth — '?'Z� —, Cased to 2-" — Depth of Grouting 6�z
Static Water Level — / ;z.'- — Pump Set At —5-1ZL_
Casing Height Above Ground /1 Sanitary Seal on Casing (Y/N) Kzf .5
Electrical Wiring in Conduit (Y/N) �Depression Around Wellhead (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot /00 4- On Adjoining Lots Zoe)
To Nearest Edge of Absorption Field on Lot ZOO / +' -, On Adjoining Lots :5-0
To Nearest Public Sewer Line To Nearest Public Sewer
Cleanout/Man hole C> To Nearest Sewer Service Line on Lot
Water Sample Collected by CL Date
Water Sample Test Results
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed 0 06�Size J 2- t�_O No. of Compartments -17
0 S1
Standpipes (Y/N!) �F'85� Air -tight Caps (Y/N) K45 Foundation Cleanout (Y/N)
Depression over Tank (Y/N) A.)4> e v 7_AA/,<
Date Last Pumped &A-1
Pumping/Maintenance Contract on File (Y/N) — ; for
Holding Tank High -Water Alarm (Y/N) /J Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water -Supply Well 1 Do +-_ To Building Foundation z &
To Property Line
TO Viatei&40aWe/Service Line
Course Alb�je_
Comments
Page 1 of 2
72-026(11/84)
To Disposal Field
/Vo
To Stream, Pond, Lake, or Major Drainage
9
C. ABSORPTION FIELD DATA
0
Soils Rating in Absorption Strata
Type of System Design CJ/
Date Installed Z -3 C, zk!�;-
Length of Field
Width
— Depth of Field
Gravel Bed Thickness
Square Feet of Absorption Area
_` Standpipes Present (Y/N)
Depression over Field (Y/N)
Date of Last Adequacy Test A�je_Lo :;,(d57
A
.-I- J I J 12 - / / --J,4- ?3—
Results of Last Adequacy Test
V - v r --e- a -TS c7�_
Separation Distance from Absorption Field:
To Water -Supply Well / To Property Linezo�- -_;�o
To Building Foundation -Sc." To Existing or Abandoned System on
Lot 'a; 4- On Adjoining Lots / D�>' 4 -
To Water Main/Service Line To Cutbank (if present) /L/D �Jfr
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area /Do/
Comments 15� Ll I A) 9=1
;7/� __ - 'J M_ Z"), A � -, 7 4#.e�_o Z,:
D. LIFT STATION
Date Installed Dimensions
Size in Gallons —
"Pump On" Level at —
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments —
Manhole/Arcess (Y/N)
"Pump Off" Level at
** Check Permitted Bedroom Rating Against HAA Request **
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
I certify that I;have I a formed to all MOA and HAA guidelines in effect on the date of this inspection.
,Vie con
Sig Date A!� �5
Company MOA No.
'56L
Receipt No. 1
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
I . Type of Inspection: CMRO VA FHA CONV xxxx
2. Property Owner: Dr. Barry L. Mendelsohn
Mailing Address: Kasilof Blvd. Day Phone (H) 344-4232_
3. Name of Buyer: Dr. Leland Jones
Mailing Address: 2211 Northern Lights Day Phone (H) 279-2988
4. Name of Lending Institution: 1st National Bank of Anchorage
Mailing Address: 640 W. 36th Ave Phone
5. Name of Realtor or Agent: Jack White Co. Mr. Clair_J. Ramsey
Mailing Address: 3201 C St. Anchorage Phone 277-1553
6. Legal Description: Lot 10, Blk 4, Kasilof Hills
Location: Kasilof Blvd.
7. Type of Facility to be inspected: House No. Bdrms.3
8. Water Supply
Type of Supply: Public Utility Individual _X
If Individual, number of dwellings presently served
If Individual, depth of well 1091
9. Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
EQ -037 (1/74)
Individual (on-site) X
0- 1 L0,1b
)/1-7
GR TER AN ORAGE AFAEABOROUGH COW
Depa tment of Environmental Quality
3330oX' Street, Anchorage, Alaska 99503 274-4561
A
- L� Date Received September 15, 1976
tj b, WX-E/-
I ime OT inspection Aal
Date of Inspection
REQUEST FOR APPROVAL OF 1011 (LDhay-7
INDIVIDUAL SEWER & WATER FACILITIES
FOR nla�"
36,c-
Conv.
1. Approval requested by: First National BAnk of Anchorage
Mailing Address: 640 West 36th Avenue Phone:
2.
Property Owner:
Barry L.
Mendelsohn Phone: 279-0461/344-4232
Mailing Address:
Kasilof
Boulevard
3.
Legal Description:
Lot 10 Block 4 Kasilof Hills
4.
Location:
Kasilof
Boulevard, see map attached
5.
Type of facility to
be inspected
single Family No. of bedrooms 3
6. Well Data: Individual
A. Type
C. Construction
B. Depth
D. Bacterial Analysis
7. Sewage Disposal System: on-site system
A. Installed B. Installer
C. Septic Tank: 1. Size
D. Seepage Pit: 1. Absorption Area
E. Disposal Field: Total length of lines
8. Distances:
2. Manufacturer
2. Material
109,
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 (1174) Page 1 of two pages
Page 2 of two pages - Re t for Approval of Individual r & Water Facilities
:Legal Description Lot 10 Block 4 Kasilof Hills Subdivision
Comments
Approved Disapproved Date
Approval,Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certifv that the information contained in this reauest for aDDroval to be a true anc
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ -034 (1/74)
0-�'
R & M CONSULTANTS, INC. U49 BABY 01 SM AV A- - BOX B007 - ANCHORAOR, AK.VD602 P.�� 807 E70 U430 - TLY. OBO-RO380
October 18, 1976
Mr. Claire Ramsey
Jack White Company
3201 C Street
Anchorage, Alaska 99503
R & M No. 653134
Re: Percolation Test on Existing Disposal System
Lot 10, Block 4, Kasilof Hills Subdivision
Dear Mr. Ramsey:
on October 15, 1976, at your request, our office conducted a percolation
test on the above described lot.
The following table represents the level of liquid in the tank. The
liquid level was measured from the top of the stand pipe.
SUMMARY OF
Level of Liquid
Time In Septic Tank
0:00 6.15'
0:36 5.95'
4-58 5.951
Meter Reading
In Gallons
856.9 (initial)
956.9
1244.0
Remarks
Fill Storage
Start Test
287.1 Gallons
or 1.1 gpm
- End Test -
The meter used during the test was a Neptune 5/8" standard water meter,
which was borrowed from the Anchorage Water Utility. The meter had
previously been calibrated and approved for installation by the utility
company.
Since the house on the lot was occupied, it can be assumed that the
leach field in question was at its normal degree of saturation. To
further insure normal saturation and to fill any possible storage in the
system, 100 gallons of water were added to the tank before beginning the
percolation test.
If it is assumed that the existing residence will house five people, the
average daily load on the disposal system can be expected to be 375
gallons per day. The maximum hourly load on the system would be about
0.75 gallons per minute (gpm).
ANCHORArE FAIRBANKS JUI\IrAu
Mr. Claire Ramsey
October 18, 1976
- Page 2 -
Since the existing disposal system accepted 287 gallons in 4.4 hours or
1.1 gpm without a level rise, I would conclude that the leach field is
presently performing in a satisfactory manner for a private residence.
If you have any questions concerning this test or this letter, please do
not hesitate to call.
Very truly yours,
R & M CONSULTANTS, INC.
-<'� A;"O�
Stephanie Hoag
Junior Geologist
SH/sc
Xc: Municipality of Anchorage,
Department of Environmental Quality
7� 2,-7- 7 -5 --
GREATER ANCHORAGE ARLA BOROUGH
Department of 1:nvironmental Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
Type of Inspection: CMRO VA FHA CONV xx
2. Property Owner: Barry L. Mendelsohn and Jacqueline Z. Mendelsohn
Mailing Address: SRA 39-B, Anchorage, Alaska 995CIYay Phone 279-0461 (His)
344-4232 (Home)
3. Name of Buyer: N/A
flailing Address: Day Phone
4. Name of Lending Institution: The First National Bank of Anchorage
Mail ing Address :P.O. Box 720, Anch., Ak. 99510 Phone 279-4481 X 376
5. Name of Realtor or Agent: N/A
Mailing Address: Phone
6. Legal Description: Lot 10, Block 4, Kasilof Hills Subdivision
Location: NHN Kasilof Blvd. Anchorage, Alaska 99507
7. Type of Facility to be inspected: Single Family No. Bdrms. 3
8. Water Supply
Type of Supply: Public Utility Individual xx
If Individual, number of dwellings presently served 1
If Individual, depth of well
9. Sewage Disposal System
Type o-1 System: Public Utility Individual (on-site) RX
If Individual, date of installation 6/16/75 New Septic Tankwas installed
(date work coiip�leted)
i1r.
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received ;Y- 'Z A - 'IT
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1 . Approval requested by: x4t�� �' e
Mailing Address: Agr)6 zed Aone: oZ 7 9 - el ;./-,e
2. Property Owner: Phone: .2757-00-6/
OF
Mailing Address: -51-106109. %if- 6
3. Legal Description: Z51�� /0
4. Location:
5. Type of facility to be inspected No. of bedrooms
6. Well Data:
A. Type B. Depth
C. Construction D. Bacterial Analysis
7. Sewage Disposal System: d14--14 -3
A. Installed 6-14,0* 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 0
Nearest lot line Other contamination
B. Foundation to septic tank , Absorption area
C. Absorption area to nearest lot line
EQ -034 (1/74) Page I of two pages
Page 2 of,two pages,- ReSsi: for Approval of Individual &Water Facilities
Leg4j%pesicriptiop'
IL
Approve
m
Greater Anchor#ge
7 —Disapproved DateZ,9�z, 7,.5
Valid for one yeay�,.from-date signed
a BoroUgh, Department of Environmental Quality
DIAGRAM OF'W�EM.,
i cerZlTy znaT tne inTOrmation containea in tnis request Tor approvai to De a true ano
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ -034 (1/74)
--s -
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES May 1, 1975
1. Type of Inspection: CMRO — VA FHA CONV x
2. Property Owner: James M. Henry, Jr.
Mailing Address: NHN Kasilof Blvd. Day Phone 274-1645
3. Name of Buyer: Barry L. Mendelsohn
Mai ling Address: D ay Phone
4. Name of Lending Institution: The First National Bank of Anchorage
Mailing Address: P. 0. Box 720, Anchorage Phone 279-4481 ext. 270
5. Name of Realtor or Agent: Jack White Co.
Mailing Address: Phone 277-1553
6. Legal Description
Location:
*4'j
Lot 10, Block 4, KASILOF't/D
IvHIV )6j", A/ "4
I P —
7. Type of Facility to be inspected: Single Family No. Bdrms. 3
8. Water Supply
Type of Supply: Public Utility Individual X
If Individual, number of dwellings presently served
If Individual, depth of well
9. Sewage Disposal System
Type of System: Public Utility Individual (on-site) x
If Individual, date of installation
EQ -037 (1/74)
r
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
Street, Anchorage, Alaska 99503 274-4561
Date Received
Time of Inspection 3 o 1017).
Date of Inspection 5-- 7 - 7 -Sr
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
I . Approval requested by: Y—L,� 4�L�
Mailing Address: g -2V
Phone:
2. Property Owner: >27 Phone: a 7v— /4� 4---5
Mailing Address: X 5
3. Legal Description: 0 '�Z
4. Location: AJ11 /L/
5. Type of facility to be inspected PIP No. of bedrooms
6. Well Data: 5&ve-e 64v';��
A. Type B. Depth
C. Construction D. Bacterial Analysis 0—, k�
7. Sewage Disposal System: e--7� A
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 I of two pages
Page.2 of two pages - RelWt for Approval of Individual *r & Water Facilities
Lo?gal Description
Approved Disapproved Date -7
Appaval,Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
k, DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ -034 (1/74)
Time
APPL1jjNT FILLS
OUT UPPER HAf ONLY
Property Owner
/-L--- L A AJ i.j �JL
/V
Phone
Date
Date
Mailing.Address
Inspector
Zip Code
4Z
Buyer
Inspector
Field Notes:
( t--,3
N
\1--
Address
Zip Code
Lending Institution
i /J-�) 7�
Phone
Address
*CONDITIONS OF APPROVAL
7`)k� Zip Code
Realty Co. & Agent
I CONDITIONAL APPROVAL -
Phone
Address
Zip Code
BY:
Legal Description
F IV
Street Location
rV S F /P
Well To Absorption Area
T p of Residence
Single Family
Well Log Received
'70 Multiple Family
No. of Bedroorn,-*�
Well to Tank
El Other
Septic Tank Size
W I Supply
Individual
FCommunity
ACH W:LL LOG. A well log is required for all wells drilled since June 1975.
IF
_,If, drFiled prior to that date, give well depth (attach log if available).
El Public Utility
Sewer Disposal
/U Individual
Year Individual Installed:
E) Public Utility
When Connected to Public Utility:
1-1 Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Tim
Time
Da%,�
Date
Date
Date
Inspector
Inspector
Inspector
Inspector
Field Notes:
( t--,3
N
\1--
P1 APPROVED BEDROOMS_3
*CONDITIONS OF APPROVAL
I DISAPPROVED
I CONDITIONAL APPROVAL -
DAT
BY:
Soils Rating
Date
Well To Absorption Area
Well Log Received
-�7
Well to Tank
Septic Tank Size
in (Wmj