HomeMy WebLinkAboutKASILOF HILLS BLK 7 LT 19 MUNICIPALITY OF ANCHORAGE Hea 'l and Environmental Prote( Fourth Floor West 825 L Streot Anchorage, Alaska 99501 279-2511, x 224, 225 INSPECTION REPORT ON-SITE f;EWAGf! DISPOSAL SYSYEh'i .~Ef lC 'TAt"JK: DISTANCE/I.~U"nm { ~ , ~'. ~ NUMBER OF FROM WI_EL,/-.:_ ...... MANUFAC]URFR _ tvlA FFi~IAI.. ~/~_~ COMPARTMENT~ INSI[)[i LENGfH ........ INSI[)E ~¢l[)lll . _ [ I()tJli) [)[:PI'H ....... ~ [QUID CAPACIT . GAJ_I~OfgS. TILE DRAIN FIELD: · ,~ / { ~ i TOTAL LENGT~I .. j [)1.,I ANCL IJ[IWiLEN I..IN[..~ . _ TNI{FICtl Wll)T IN. TOTAL. I.FI"ECI I'/[ AFJ',SORPrlON AREA ............ SQ. FT. L [_NGFII OF EACtl LINE ..... I)EPTII: TOP OF TiLl: 10 [-INISII ORAOE~ __ .... MATT:RIAl [Ir. NCATlt TIt_E ¢ ~AJ~OVE TILE ..... I[ . SEEPAGE PI'T= DI/\M E'F [iR ........ OR WID'FH .... I. E FIGTtl .... [3EPI'I t Log Crib Rings/CRIB SIZE: I)IAMETFR ..... DEP1 H .... DISTANCE FROM: WELL ]OTAL El FECTIVF' i~tJILDING FOLJNDAqION ....... NEAR[-_SI' LOF I INF ....... AI4SORPTION ARF'A (WAI_L AREA) .......... SQ. Fl'. Bldg: Z~ t4 Sower Line: /D ~/ ' ' ' ~ : ~ Pipe Ha~Zs: ~ ~~ ~ ,~. ~ '. .... o' ~ # of Bedrooms: ~ ..... 71' i 16'u' Installer: ~h--~-7 Remarks: --'------- - July 22, 1977 R&M No. 751200 Jim Dennington Box 567 Anchorage, Alaska 99510 Subject: Soil Investigation for Sanitary Sewer System, Lot 19, Block 7, Kasilof Hills Subdivision, Anchorage, Alaska Dear Mr. Dennington: At your request of July 22, 1977, we conducted a subsurface soils J_nvestigation at the proposed location of the sanitary sewer system on the subject lot. The investigation complied with those procedures required by the Municipality of Anchorage Department of Health and Environmental Protection. This investigation, which was accomplished on July 22, 1977, was conducted within a backhoe trench excavated to a depth of 12 feet below the existing ground surface. The test hole was sited according to your instructions and its location is shown in attached Drawing A-01. A sample was taken at the depth shown on the soils log in Drawing A-01. The sample will be held in storage at our lab for approximately six months. In addition, ali_ material excavated was monitored by an experienced engineering geologist. The topography at the excavation site is generally gently-sloping to the West. At the time of the investigation the site had original..vegetation c~nsisting of grass and low shrubs. The soils encountered in the excavation are shown in the test hole log in Drawing A-01. The symbols used in Drawing A-01 are explained in Drawings B-01, and B-02. This log displays specific conditions encounter- ed at the test location. However, subsurface conditions may vary in other parts of the lot without any apparent surficial evidence of the change. Groundwater was not encountered. Bedrock was not encountered. At the time the hole was excavated seasonal frost was not present. Permafrost was not encountered. ~ A hole approximately 8" in diameter was excavated to a depth of 1.5 feet within the trench for a percolation test. The top of the hole was 6' below the original ground surface. A percolation test was performed within the bore hole at the depth shown in the attached Table 1. All depths were measured from the top of the July 22, 1977 Mr. Dennington: Page -2- hole. The data in Table 1 show average infiltration from the depths indicated to the bottom of the hole. The measured percolation rate was 6.3 minutes per inch. We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this letter of if we can be of additional service. Very truly yours, R & M CONSULTANTS, INC. Staff Geologist Jim McCaslin Brown, Ph.D. Head, Earth Science Department Attachments: Drawings A-01, B-01,.B-02, Table 1 Lot 150 ' 19 Backhoe Trench Not to Scale. Distances shown are approximate and have not been measured by survey methods. T,H. 1 7-22-77 SANDY SILT w/ ORGANICS, TRACE GRAVEL (OL) GPJ%VELLY SAND w/ SOME SILT 1 Grey, Moist (SH) 2I 12'T.D. This log represents subsurface soil conditions within the backhoe trench at the location shown. KO: SMH riTE: 7-22-77 See Drawings B-01 and B-02 for explanation of symbols. TREHCH LOG AND LOCATIOH DIAGRAM JIM DENNTNC~TOM TI~, _~E 9:33 9:34 9:35 9:36 9:37 9:38 9:39 9:40 9:41 9:42 9:43 9:48 9:53 9:58 i0:03 10:13 10:23 10:33 ELAPSED TIME 2 3 4 5 6 7 8 9 10 15 2O 25 3O 4O 5O 6O TABLE 1 PERCOLATION TEST JIM DENN INGTON R & M NO. 751200 INCHES 3 1/2 3 3/4 4 4 1/4 4 1/2 5 5 1/4 5 3./2 5 3/4 6 1/4 7 8 1/2 9 10 11 1/2 12 1/2 13 DROP IN INCHES 0 1/4 1/4 1/4 .]_/4 1/2 ~/~ 1/a 1/4 1/4 3/4 i ]./2 1 1/2 9 1/2 ZNCHES TOTAL DROP OR 6.3 MINUTES/~NCH d> ~ ,~-,~,_./ ~ ~'-- SOILS CLASSIFICATION: CONSISTENCY AND SYMBOLS CLASSIFICATION: Identification and class{fication of the soil is accomplished in accordance with the Unified SoLl Classification System. Normally, the grain size distribution determines classLflcat{on of the soil. 7~e soil is defined according to major and minor constituents with the minor elements serving as mod{fiefs of the major elements. For cohesive soils, the clay becomes the principal noun with the other major soLl constituents used as modifier; i.e. silty clay, when the clay particles are such that the clay dominates soil properties. Minor soil constituents may be added to the classLfication breakdown ~ accordance with the particle size proportion listed below; {.e. sandy silt w/some gravel, trace clay. no call - 0 - 3% trace - 3 - 12% some - 13 - 30% SOIL CONSISTENCY- CRITERIA: Soil consistency as defined below and determined by normal field and laboratory methods applies only to non-frozen mater{al'. For these materials, the influence of such factors as soil structure, i.e. fissure systems, shrinkage cracks, slickensides, etc., must be taken into consideration in making any correlation with the cor/sistency values listed below. In permafrost zones, the consistency mid strength of frozen soils may vary significantly and unexplainably with ice content, thermal regime and soil type. Cohesionless N*(blows/ft) Relative Density Loose 0 - 10 0 to 40% Medium Dense 10- ~0 40 to 70% Dense 30- 60 70 to 90% Very Dense - 60 90 to 100% *Standard Penetration "N": Blows per foot of a 140-pound hammer falling 30 inches on a 2-{nch OD split-spoon except where noted. Cohesive T- (tsf) Very Soft Soft Stiff Firm Very Firm Hard 0 - 0.25 0.25 - 0.$ 0.5 - 1.0 1.0 -2.0 2.0 -4.0 -4.0 DRILLING SYA4B OLS WQ: Wash Out WD: While Drfllh~g WL: Water Level BCR: Before Casing Removal WCi: Wet Cave In AC}{: After Casing Removal DCI: Dry Cave In AB: After Boring WS: While Sampling TD: Tot~ Depth Note: Water levels indicated on the boring logs are the levels measured in the boring at the times indicated. In pervious unfrozen soils, the indicated elevations are considered to represent actual ground water conditions. ~ hnperv{ous and frozen soils, accurate determinations of ground water elevations cannot be obtained w{thin a lhnited period of observation and other evidence on ground water elevations and conditions are required. Engineering 8, Geological Coneultants Inc. A~C.O.~,~E ~^,.0~,~s ALASKA ~u.~u ~- I - 7'2 ]SCALE N /A GENERAL NOTES STANDARD_ SYMB SILT SANDSTONE ICE, MASSIVE ' ' SCATTERED COBBLES (ROCK FRAGMENTS) SAND MUDSTONE ICE-SILT 8, SANOY GRAVEL GRAVEL LIMESTONE ORGANIC SILT SILTY CLAY w/TH. SAND SI ..... 1,4" SPLIT Ss ..... 1.4" SPLIT SI ..... 25" SPLIT Sh ..... 25" SPLIT Sx ..... 2.0" SPLIT Sz ,' .... 1.4" SPLIT Sp ..... 2.5" SPLIT Hs ..... 1.4" SPLIT SAMPLER TYPE SYMBOLS SPOON WITH 47~ HAMMER SPOON WITH 140~ HAMMER SPOON WITH 140# HAMMER SPOON WITH 340# HAMMER SPOON WITH 140# itAMMER SPOON WITH 340# HAMMER SPOON, PUSHED SPOON DRIVEN WITH AIR HAMMER Ts .... SHELBY TUBE Tm .... MODIFIED SHELBY TUBE Pb .... PITCHER BARREL Cs .... CORE BARREL WITH SINGLE TUBE Cd .... CORE BARREL WITH DOUBLE TUBE Bs .... BULK SAMPLE A ..... AUGER SAMPLE G ..... GRAB SAMPLE HI ..... 2.5" SPLIT SPOON DRIVEN WITH AIR HAMMER NOTE: SAMPLER TYPES ARE EITHER NOTED ABOVE THE BORING LOG OR ADJACENT TO IT AT THE RESPECTIVE SAMPLE DEPTH. TYPICAL BORING LOG M 80[¢/NG NUMSE/?-.,,...E H. 30- 15 DATE D,-?/LLED-.~iO- ~1- 70 SAMPLE/? TFPE.~. Ss .4FTE/~ BO. RING \ 9'A. WA TER WHILE D/tILLING''f Ss F/~OZEN Elev ~74 6 '"*J ELEVA?/ON /N FEET All Somples Ss''°~- SxtMPt-E/¢ TYPE O' ;- MATERIAL I' Cons~d Vis~blelce ICE-I-ML ICE -SILT Eslim(]le 65% Visible Ice (~) 90, 56.2°/o,80.SpcfN-, ML4' -~'STtqATA CHANGE SANDY SI LT ~./ APPt~OXIMA?-E S TFtATA CHANGE  ~ 5~.loJ~, ~.~, ~ ~ (CO~PS OF ENGINEERS METHOD) ~ ~ ~ ~ ~UNIFI~D 0~ F~A CtASSIFICATION ~ 'X X --TEMPERATURE, °F ~ ~ D~Y DENSITY ~ WATE~ CONTENT Bt 0 WS/FO0 T SAMPLE NUMBE~ . SANDY GRAVEL Cd 95 SCHIST ~GENENA~IZED SOIL OR ROCE DESCRIPTION E ~OCATION ~0' ~ D~ItL DEPTH ~ WEIGHTED AVENAGE · ADDITIONAL DATA AVAILABLE ON SUPPLEMENTAL LAB SHEETS CONSULTANTS, INC. EXPLANATION OF SELECTED SYMBOLS . ~RL/\TER ANCHORAGE AREA BOROUGH . ,T~;;.~ARTMENT OF ENVIRONMI.:NTAL QUALITY ~"~ ki~\ 3330 "C" Street \~ r], \~A ANCHORAGE, ALASKA 99503 Performed F~o~eS~awyer Legal Descr~p~i'on':--I.~-t '19'"B'l'ocE This Form Reports Soils Log Depth Fee t lO-- ll-- 12~ 13-- Case # Dated Performed_May 1~,~ 1974 7 Subdivision Kasi[off Hills Percolation Test Soil Test Must Be Logged To 4' Below Proposed Seepage System - Soil Characteristics _ , Clays CH Medium gravel & sand SW-SM Coarse-to-medium gravel with sand GW Was Ground Water Encountered? No ¢4m~ If Yes, At What Depth? Reading Date Gross Time Net Ti me Depth to H20 Net Drop~ Percolation Rate Minute Proposed Installation: Seepage Pit X Drain Field Depth of Inlet Depth to Bottom of--Pit or Trench ~6' COMMENTS: We recommend 120 sq, ft. per bedroom based on Borough recommendations and requirements. Test Performed BY_ ,].__Jameson Date Certified BY: J'UL 1£ '94 16:04 UR STATE,!~IDE~,~,53'~87 Jul. 12,94 15:52 F'.(P.i/1 DRILLINO LO~ Well Owner I~'~'~.~_~'E'p,~.eSx~TL_/~OCC ~ff~ess Use of Well Local, ton (add/'os0 o~ ToYt~h]p, Range, ~etion, if k~*own; ,or dJsLanee r~atn road,__ Size o~ oa~lng~~Depth ut Flole_.B_5_.~_~eet Cued to. Static w~ter leveL. 2.C[0_._Jt, (~ ' ~low) lanrJ. 8urt~,e. Ftr, i:sh ~reen ~( ); Per~orated ( ~ ), De,cfi~ sofia or pe~'foratio~-,'~ .................. Well pumping te~t ~t 1 -ga~lg~ ~ (~ (~inu~e) ~or~__hour~ wl.~h~6 ~. rt~t. t, -. : . WELL LOG Depthinf~et~rorn ~ . ., .. · . ground ~fa~ Oi~ det~i~ of formations t~netr~ted, size of m~teria), color ~nd hardnes~ ~q:-' :..' ...., . ,. .:. . ~. . .... ... · ?~-,.~. ':..:.. _ , ,, . ,. ., . ~ ~;, .~ ~'.: .,.., . :. ' / :.. - ..... · .~,,,.,.:. , .. ..... ,.;,~ . ,:, . · . · ... ..'.: :. .,.....'$< .5~.'[ .. Certificate No'$, 814 & 973 CUSTOMER SIX INCH WATER WELL DRILLED AND CA~ED OUT TO THE DEPTH Of 20.% feet. DRILLED AT THE RATE OP" ¢18,00 PER FOOT. PROPERTY OWNER _J~h~~~m~ 272*8006_ LOCATION OF WELL SITE D R I L L E R __~Bcrn.ic~Olaus~z.¢ · ' ' Works o _ WELL LOG: 0 ..... 15' Sandy gravel with 20~ cl~y~b_inder. _ ___.L5---35' SilSy_ cl~v and gravel, ~--~5' Clay with 20% gravel. _ 5~--1~5' Bedrock. A sedimentary rock. _ 13~_-141' A granular rock showing some signs o~ water. i41-185' Sedimentary rock. 185-187' Granular rock showing more yield of water° i87-205' Sedimentary rock, A yield of water showing 2 1/2 GPM or 3600 gals per day casing of over 150 feeto bp should be installed ten feet off bottom. with a recovery in the Cost of Drilling: $3600°00 Paid in full by ~. Jim Denndngton per this date, COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF THANK YOU VERY MUCH. DATE BERNIE CLAUS OF RAMPART DRILLING WORKS , Ju v SERVICE CHARGE OF I'/2% PER MONTH WILL BE ASSESSED ON PAST DUE ACCOUNTS, 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. HAA # 1. GENERAL INFORMATION Complete legal description Lot 19; Block 7; Kasilof~ Hills Location (site address or directions) 10101Stroganoff Priv6 Anchorag6, AK Property owner Mailing address Lending agency Mailing address Agent Address Mar~'. 10101 Stroqanof f Anchoraq~, Day phone AK 99516 346-1455 786-7766 (w) Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: XXX 'If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 {Rev. 1/91) Front MOA ~21 .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 s8pply 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 ~ Phone ~ Address · s & EngineeCs signat~ .~¢~ ~lv~ ~. R~~ DHHS SIGNATURE ~pproved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: '-'-'~-;, ,. .... 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 ,~ 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 and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: /._o~ /~' A, Well Data Well type Log present(~) Total depth "-~"~- Sanitary seal (~N) ~"~-~ ,~L,~' ? K'~S~LoF/~lu_,~ Parcel I.D. If A, B, or C, attach ADEC letter. ADEC water system number Date completed ?/z4-177 ~ Driller Cased to ~0~-'/"""""""""~'~ Casing height Wires properly protect,ed ~Y~N) ¥'Q..~ 7-o ~S' fSY f~-~ LP~cc/roC~ o~ ?/Il/a/H FROM WELL LOG AT INSPECTION Date of test Static water level ZOO Well flow p level1 SEPARATION DISTANCES FROM WELL TO: Septic/hetd~tank on lot /OO / Absorption field on lot Public sewer main '~- Sewer service line g.p.m. /Z ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout / Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate O'(-'¢/ '/~./Z Other bacteria O/~/o°~ Collec~e/d by: ~' %-~- ~Y/-JG//,-JE~-,~//,,) ~¢ B1 SEPTIC/H~LD{NG-TANK DATA Date installed Cleanouts ~/N) r.~ High water alarm (Y~_~ ~ Date of pumping Tank size Foundation cleanout(~)N) Compartments '~ Depression (V~ /Jo Alarm tested (Y/N) /t,///'~ SEPARATION DISTANCES FROM SEPTIC/FE~.-D-~ TANK TO: Well(s) on lot /O~f On adjacent lots To property line /~ (7'-~ Absorption field Surface water/drainage ("(_.~/¢"- ,/00 re_ Foundation /CO Water main/service line. ,/O 72-026 (3/93)'Front CONTINUED ON BACK PAGE c. L,FTSTAT O. e" Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) ~ SEPARATION DISTA..tCSE~OM LIFT STATION TO: We~l~m-lof'~/~' On adjacent lots Manufacturer Manhole/Access (.~.~ ~ ..~---'"~ump off" Level at . ~es tested Sudace water D. ABSORPTION FIELD DATA Date installed ~/f ~/~ 7 Length z~F~'~ / Width Total absorption area Date of adequacy test ,~,/~o Water level in absorption field before test Soil rating (GPD/Ft / Gravel thickness Cleanout present ~)N) ~'~-~ Results ,~)'fail) '/~""~r System type . '7'-/g~McH _ Total depth /// Depression over field ('Y~ ,/O~ for ~u~ (~L) Bedrooms Aftertest ~//" ~ Peroxide treatment (past 12 months) (Y/N) APO AYe- /.~ A_O,~Pd/--~ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: ~ 5 ~E~ ~, ~ ~o~ Well on lot_/(:~0 r To building foundation /('~ On adjacent lots ..~O Sudace water /OO On adjacent lots / C~O /?L- Property line To existing or abandoned system on lot Cutbank "'" Z-O/~ Water main/service line Driveway, parking/vehicle storage area / © Curtain drain .-~,~,NEpJ Co~T~ucTTo~J E. ENGINEER'S CERTIFICATION IZ'-ZO/ F~¢~°~ LoT-I? ~or conform( I cern'fy that I have checked, verified, OA and HAA Signature,- ._ , _.~ ._ _,~,~ ~,~ e . . ~~,x~ ~nglneers Nar~e , " Date ~agre~m'"~'~XT~~ HAA Fee $ ~,~06~ - ~./7~ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number CT&E Re[',// Clien! gample Matrix Commercial Testing & Engineering Co. Environmental Laboratory Services ~~-'~r~a~'j~'~j~'~r~e'-~ LABORATORY ANALYSIS REPORT 94,360%1 I,OT 19 B LK 7 KASILOi? l[ll_l S W^TER ClicntNt~tne S Cc 8 EN'GlZXIEERiN(.~ WORK Order 80471 Ordered By RJ'S Printed Date (17/20/94 (~} 08:42 [,rs, Collected L~4t c 07/18/94 ~) 07:15 h.ru, Pro, ieet Name Recejvedlhte 07/18/94 ~¢(),q:15 hrs. Projeut# PWSII) JlA Technical Director STEFI.LEN C. R¢le.(lsed By: ~ - _ ........ --~,,¢T;-i'~;Sf;---'25-i~t,: S^m'LF~CO~,~,~CT~r) ~¥: SS. QC A!lowt~ble Ext Anal Jearame.ter Results Qual Units Metimd I.in~i'..s Date Date hilt ........................................................................ ~ ......................... ;--%~ .... --~]~ .............. 0.6~ ,ng~ EPA 353.2/3000 1,,, 07/18194 C~{ * See Special Instructions Above UA = Unavailable '* * See Sanlp I e Remarks Ab o v e NA. = Not Analyzed U = lh~tcctcd, R~ort ed val~ is th c practical ~,~mtificat~on I imit. LT=' ~ss D = 8cconchry c~h~ion. OW = Greater 5633 I~ Street, Anchorage, AK 99[ii 8.1 600 -- Tel: {907) 562-2343 Fax: ¢07) 1561-5301 .... ~,~x/mmsl[,tl:f, JTAI FACILITIES IN ALASKA, COLORADO. FLORIOA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAh'4, WEST VIRGINtA 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 GENERAL INFORMATION Complete legal description Lot 19; Block 7; Kasilof Hills Subdivision Location (site address or directions) 10101 S/¢~oganof D/~v6 Property owner Mailing address Day phone Lending agency Mailing address Day phone Agent GcrJ4g~.J~c_~E~y JACK WHITE C~PANF Day phone Address 3204 C S¢~4¢6-t ¢LI-OJ A~.6horage, AZ. cJ~h~J)_9503 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: 563-5500 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system, TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system, 79-025(Rev. 1/91) Fronl MOAP21 5. STATEMEN'r 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 _ s ;,;. :,; ......... ilL, Phone Address Engineer's signature DHHS SIGNA'I'URI-' _~ . Approved for /z~.. bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: By: 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. 72q325 {Rev. 1191) Back MOA  Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lo--r tot ~:,t_,~l \/~A~,~::~: ~,~.~,% ICParcel I.D. A. WELL DATA Well type Log present (~'N) Total depth If A, B. or C, attach ADEC letter. Sanitary seal (~/N) ADEC water system number Date completed Cased to Casing height Wires properly protected ~Y,,~N) AT INSPECTION EN¥1R~,NMENM, L FROM WELL LOG Date of test '1 - ~,~ -"]-~ Static water level OhgV-~©¥~,~, Well flow ~2_, ~' Pump level / ~'~ ~ g.p.m. MAY 1 6 199:[ RECEIVED g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Public sewer Service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform (~ Date of sample: ~'- -~ ~ '~ / B. SEPTIC/HOLDING TANK DATA Date installed ¢'- Cleanouts~N) High water alarm (Y/~ Date of pumping ~'"~ Nitrate Collected by: Other bacteria /,,/o/,./F_ Ill & lit i~NGINEEEING ~tlo Rlwr, Alaska 99577 Tank size / ?-,'~'~~ Compartments Foundation cleanout (~N) y Depression (Y/~ /,J Alarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /00 On adjacent lots / CO To property line / c~ Absorption field Surface water/drainage /z2 c, Foundation Water main/service line 72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) Manufacturer "Pump on" level at High water alarm level .------"~ Cycles tested Meets MOA electri~ SE ANCE FROM LIFT STATION TO: ~¢e1'1 on lot On adjacent lots Manhole/Access (Y/N) ~ _ .~--~P'd~p off" level at Surface water D. ABSORPTION FIELD DATA Date installed ~" J~ -7'~ Soil rating I~"~E)~¢/~ System type Length ~¢r'~~ Width ~L~" Gravel thickness Total depth / / Total absorption area ~O2- ~ Cleanouts present ~:~N) Depression over field (Y/~:~ ,'~ Date of adequacy test -~- '~ ~ ~ / Results ,~;~'fail) ~' for ~o~ 6"¢) bedrooms Peroxide treatment (past 12 months) (Y~:) L.'~J//~/4'~ ~J ~,J If yes, give date /"//~- SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /¢~ To building foundation On adjacent lots Cutban k Water main/service line Surface water Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. -7.,~.~',' ' ;t:;gle River Loop Road No. 204 Signature Engineer's Name HAA Fee $ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING 5633 B STREET ANCHORAGE, ALASKA99518 TELEPHONE (907)562-2343 ANALYSIS REPORT BY SAMPLE for WORKorder# 34067 Date Report Printed: MAY 10 91 @ 15:45 FAX: (907) 561-5301 Client Sample ID:LI9 87. KASILOF HILLS PWSID :UA Collected MAY ? 91 ~ 15:45 hre. Received MAY 8 91 @ 13:10 Ea. Preeerved with :AS REQUIRED Client Name :S & S ENGINEERING Client Aoct :SNSENGP BPO ~ PO ~ NONE RECEIVED Req ~ Ordered By :R. SHAPER Analyele Completed :MAY 10 91 Send Reports to: Laboratory SupoI. vls~r iSTE~E}I C. EDE I)S & S ENGINEERING Releaeed By: /~ ~/~~ 2) Chemlab Ref ~: 911886 Lab Smpl ID: I Matrix: WATER Allowable Parameter Tested Result Unite Method Limits NITRATE-N ND(O.IO) r~/1 EPA 353.2 lO Sample ROUTINE SAMPLE COLLECTED BY: RAY. Remarke: 1 Teete Performed ' See Special Inetructions Above Uk~Unavallable ND= None Detected *' See Sample Remarke Above NA- Not Analyzed LT-Less Than, GT-Greater Then ROBERT SHAFER, P.E. ROGER SHAFER May 13, 1991 CIVIL ENGINEERS (907) 694-2979 FAX 094-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAiN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOiL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSALSYSTEM DESIGN Mr. George Mc Coy JACK WHITE COMPANY 3201 C Street Suite 100 Anchorage, Alaska 99503 REFERENCE: Lot 19; Block 7~ Kasilof Hills Subdivision; D~ar Mr. Mc Coy, At your request a flow test was performed on the well serving the referenced property on May 8, 1991. The static water level was measured in the well at 66' below the top of the w~l casing. A m~ter was connected to thc water system and the flow turned on full. After 35 minutes the water level was drawn down to the pump (195'). The pump was then shut off and the water level was allowed to recover for approximately fifteen minutes. At that time the pump was turned on again and the water level drawn back down to the pump while the water quantity was metered. This process was repeated five tim~s with consistent results. From this test we have found the well to currently produce approx~'~ately 28.2 gallons per hour (GPH). This flow rate is not guaranteed to remain constant, subsequent variatio~ ~n occur. This flow rate is co~id~red to be adequate to meet the Municipal daily flow rcquirement~ for a four (4) bedroom house. Although there is no requirements placed upon instantaneous flow rates, the State Department of Enviro~ent~ Conservation recommend a water system be capable of supplying 8 GPM over a 20 minute period for a single family house. There is approximately 180 gallons of water storage within the well casing (as measured during the flow test). This storage will enable the water system to deliver the r~commended instantaneous flow rate of 8 GPM for 20 minutes. It should be noted that even though this well and water system meet current requirements and polices, there is no guaranty of a continued adequate supply of water. A~t~al performance of the system will depend upon water use habits of the occupants. If we may_.b~of furth~ service, please conta~ us. ~/~F~ 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE DEPARTMENT~)F/i4EALTH 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 GENERAL INFORMATION (a) Legal Description (include lot, block, su,bdivision, section, township, range) Location (address or directions) (b) Applicant Name ~fie ~Or~ e/ Telephone: Home ~.~ ~18 ~7 __ Business' Applicant is (check one): Lending Institution []; Owner/builder [~'; Buyer []; Other [] (explain); (c) (d) Lending Institution ~;¢/-1¢,4,¢g( ~_.__,[4~ Address C' f~/'- ~-' lq', ¢,,~ h~' (e) Real Estate Company and Agent Address Telephone Telephone (t) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family [] Multi-Family [] Number of Bedrooms ~' Other WATER SUPPLY Individuai Well [] Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite ~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status, Page t of 2 72-025 01/84) 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 for tile 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 disposaJ system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm ~l~ ~c~¢;c~/ ~e¢¢~ Telephone 3~- ~3¢~ v Engineer's Seal 6. DHEPAPPROVAL ~or ,~q~)bedrooms by '~ Disapproved Terms of Conditional Approval Conditional CAUTION The Muncipality of Anchorage Department of Health and Ehvironmental 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 [)HEP do not conduct inspections or analyze data before a certificate is issued. The Municipality ol Anchorag~ is'"~ot responsible for errors or omissions in the professional engineer's work. MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Descriptio.~n: WELL DATA Well Classification Well Log Present (Y/N) ¥' Total Depth ;~ OL5~ Cased to Static Water Level '~- Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot ! 0 ~./t j.~ C, ~, To Nearest Edge of Absorption Field on Lot ' ,~u/-£C/./ON 'Yiv _/ ,C) R£C£1VED Gloc('~ 7 If A, B, C, D.E.C. ApprOved (Y/N) t'V,/$. Depth of Grouting iN,A-, Pump Set At 12~~ Sanitary Seal oniCas~ng (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ;Date ~'/i? To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~'-/'Y / 77 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 I 0 ¢'~ .~"¢z,~ ¢.~.'. To Property Line '~ ~ (-;' To Water Main/Service Line Size i~"~¢.~~1 No. of Compartments Air-tight Caps (Y/N) )"' Foundation Cleanout (Y/N) Date Last ~umped ~f ,~' ; for ~/. N,/l-. Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field Course ';~ IO0 T!o Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~/q / 7 ? Width of Field ~-t, Square Feet of Absorption Area lC'E) ~ Depression over Field (Y/N) /~l Results of Last Adequacy Test ~,~'~'f4.~ .~' Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line ! t7 D'/Bd.~r-~ Type of System Design Length of Field ~ Depth of Field II Gravel Bed Thickness 7~ Standpipes Present (Y/N) Date of Last Adequacy Test To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments V To Property Line To Existing or Abandoned System on ; On Adjoining Lots '~. ~PO ~ To Cutbank (if present) Nt D, LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~¢j'~'~~ ~ ~ Date ~'/i~ {'~' MOA No. Company Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal DATE RECEIVED INSPECTION APPOINTMENTS c'¢J~.C~. ~.z~.)~ .((. (',' \.__ CZ-/; TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR I NSP ECTO~3 MUNICIPALITY OF ANCHORAGE J~UNICIPALITY OF ANCHORAGE  DEPARTMENT OF REALTN & ENVIRONMENTAL PROTECIIONDEP'f' 825 L Street - Anchorage, Alaska 99501 i EN~/IROI~bAE~41' ':'; ~ ''~ LCT[ON  ENVIRONMENTAL SANITATION DIVISION APR ~) 1980 Telephone 264-4720 DIFIECTIONS: Completo all parts on pa§e 1. In¢omplota requests will not ba proaessad. Plaase allow tea {19) days for processin§. 1. PROP, ERTYOWNER I PHONE MAILING ADDRESS PROPERTY RESIDENT {If different from above) PHONE PHONE MAILING ADDRESS / LENDI ,NST,TU'r,ON PHONE MAILING ADDRESS 4, REALTOR/AGEN.r I PHONE I MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [~ Four ,,,.~' SINGLE FAMILY [] Two r-] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY  I NDIVIDUAL~ COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well Icg is required for all wells ddlled since June 1975. For wells drilled prior to that date, gwe well depth (attach Icg if available,) 8, SEWAGE DISPOSAL SYS.rEM t~ INDIVIDUAL/ON-SITE~ [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAE BE INITIATED. 72-010 (Rev. 6/79) 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 [] ~NDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified iNSTALLER [~]Septic Tank or []Holding Tank Size: ~o~.~'''~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES Sewer Line ine WELLTO: /OD' I I DO Absorption Area to nearest Lot Line 5, COMMENTS [~-~-~APP R OV E D FOR '~ BEDROOMS [] CONDITIONAL APPROVAL (letter must acco/~an~)certificate) [] DISAPPROVED A c le ra e 825 "L" STREET ANC}tORAGE, ALASKA 99501 (907) 264-4111 GEORGE M, SULLIVAN, MAYO,~I DEPAIgTMENTOF HEAt. TH AND ENVIRONMENTALPRQTI~CTION April 14, 1980 James G. Dennington Post Office Box 567 Anchorage, Alaska 99510 Subject: Lot 1_9 Block 7 Kasilof }{ills Subdivision Approval for your individual sewer and water facilities can not be granted until the following items have been completed: (1) The water analysis report be delivered to this office from Chem Lab, 5633 B Street, for our review. (2) The septic tank p%~ped with a receipt submitted to this office. If there are any further questions, please contact this office at 264--4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw CC: Alaska Mutual Savings Bank Mortgage ]Loan Department Post Office Box 1].20 99510 9UNICIPALITY OF ANCHORAGF DEPARTMEI~. OF HEALTH AND ENVIRONMENlr~_ PROTECTION 825 L Street, Anchoraa~. Alaska 99501 264-4720 #1: Time --i~_~D~ _ #2: Time Date ~[-I~q~ ~ ~£/ Date In sp ~_~,~_~ Insp Date Received: April 10~ 1978 ~13: Time Date InsD REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER ~ACILITIES~' ' ' ' 1. Lending Institution Request: Mailing Address: Pouch 7-777 99510 2. Property Owner: James G/Judy_C Dennington Mailing Address: Box 56? 99510 g~enrj_%y hlakiQnal Bank Phone: 276-680,0/217 Phone: 344-7471 3. Legal Description: Lot 19 Block 7 Kasilof Hills Subdivision 4: Single Family Residence: (x) Multiple Family Residence: ( ) Number of Bedrooms: Number of Bedrooms: Four Well System: Permit # Construction Individual Well (x) Community/Public System ( ) Depth of Well Well Log on File ( ) Bacterial Analysis e Sewage Disposal System: On-site System (x) Public Utility ( ) R & M Engineering report has been ordered. Permit II Installed Installer Septic Tank Size A;~ Manufacturer Absorption Area _ ~O~5__ Soils Rate . /.~'~) Material ~_~t_~ Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot l~ne Absorption Area to Nearest Lot Line MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: 2. Property Owner: Mailing Address: 3. Name of Buyer: CMRO VA Jarn~.q O. and Judy C_ DenninAton Box 567 Anchorage, Alaska 99510 James G. and Judy C. Dennington FHA CONV X Day Phone 344-'7471 Mailing Address: sa~tte Day Phone sa~e 4.Name of Lending Institution: Security National Bank Mailing Address: Pouch 7-777 Anchorage, AK 99510 5. Name of Realtor or Agent: N/A Mailing Address: Phone Phone 276-6800 (ex. 217) Legal Description: Lot 19, Block 7, Kasilof Hills Subdivision, according to Plat 66-69, filed in the Anchorage Recording District, 3rd Judicial Dist., State of AK Location: NHN Stro~anof Drive Anchorage, Alaska 7. Type of Facility to be inspected: SFR No. Bdrms. four (4) 8. Water Supply Type of Supply: Public Utility Individual X EQ-037 (1/74) If Individual, number of dwellings presently served c~e If Individual, depth of well ? Sewage Disposal System R & I'~ Engineering Report Ordered. Individual (on-site) Type of System: Public Utility If Individual, date of installation MUNICIPALITY OF ANCHORAG~ DEP], OF HEALTH & ENVIRONMENTAL PROI'ECTION RECEIVED Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 19 Block 7 Kasilof Hills Subdivision Comments: Affadavit Attached: ( Disapproved: Letter Attached: ( ) Dahe: Date: Department Worksheet: