No preview available
HomeMy WebLinkAboutKASILOF HILLS BLK 9 LT 3 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? XX Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME ~"~C~ MAILING ADDRESS /YiLINICTIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF I TALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMEN],: ,..- J-ECTION ENVIRONMENTAL ENGINEERING DIVISION 825 LStreet-Anchorage, Alaska 99501 Telephone264-4720 JAN ~ 8 1980 LEGAL DESCRIPTION LOCATION IWell ~ DISTANCE TO: ~'j .~,~ / Manuf~ctu rer Liq, { DISTANCE TO: Absorption area Inside length IF HOMEMADE: Well Dwelling DISTANCE TO: We I ~/' ....,2.,_ ~.~ I No, of lines Length of each line Top of tile to finish grade ~ Width Length Foundation Total length of lines Material beneath tile Depth Type of crib Crib diameter Crib depth Well Building foundation DISTANCE TO: Class Depth Driller Sewer line DISTANCE TO: Building foun~lation OTHER PIPE MATERIALS NO, OF BEDROOMS 'Dwelliq9 / PERMIT NO, I Ma~iaJ.d-.. No. of compartments { Liquid depth --[ Materia) / Trenc~w~idth inches PERMIT NO. Liquid capacity in gallons PERMIT NC), Distance between lines Total effeqtive absorption area inches ___..~_~~~ PERMIT NO. Total effective absorption area Nearest lot line Distance to lot line PERMIT NO, Absorption area (s) SOIL TEST RATING LER REMARKS APPROVED DATE LEGAL FI F:' I::'1.. :1: C: F:It",I T L ()C: FI T ]i 0 N L.. E: C!il:::l L.. I FI:. CIF' '.E;O]:I. F:IE:v:~;CF;?EEI"[Cfl'.,I ':'~;'/!STE:I"I ]i'."~;' I"IFI::.::]:I'"IL.IH J'.,ILli'"IE:[!:I:~: OF' IE:EDFbZu:)h'I~; .... :l. 'THE: L. EN(:TI'I~I D :1: r'lE:l",t~!i; :[ ON :1: Y':'; THE: L.I~:N(!iTH ':: :[ i",1 F'E:ET ::' OF' 'TH[i: TF:E:NC:I'I CJI::~: I:::'l:;i:l::l Z I",E:' ]: !i~:l .[::'. THE: [)[i:PTH "IF' t::1 'I'Fi:EI"4CH O1~: F::' ~ T .T. ?~:; TI'"IE~ [::' :1: ~i;TI:::II",ICE: [.i:li:!:']"l.,.ll:~:l:i!:l",l TH[ii: 5:;t ff;i:l:::',l:::l(:::l!i: I" I:::' TI"II~!: (i~[~'.CIUI"4[:' I:::ll",l[::' THE: E:CFf"IT'OH OF' 'THE: E. t..O1",! ':: ]:i"4 I:':' E: E: T ::' . .... iF' ~"'"1~ IE:i:: 'T' II::;;L" lEE: ~"°,,I] C: 11'"4! il... IJ :1i.~ IIZ::" "~' IF'"~ :If: ::~:~i!.:. "' ............... II::::" ItiiE: ICC THE: EiI:;itI:::I',,"E:I..: [:'[F.F'TH ]: '5 'l"l"lEii: H ~ I",l I I'"IIJH I:::'E~I::'TH 151J:::' I[~[,~:1::1 ,,, E:L E:EJ'T'HE:':[ii:N THE: I"'1 rI'F:'F:IL.I... F' :[ Pti!: F:ff.,ID 'THE: I::: C T'TOH OF:' THE: F..:::.::CFI',,,'FI'F ]; ON ,:: :[ I'.,I I:.:I:.:.:ET I:::'E]::~ff'1:1: ~1" I:::II::'F'I.... ;[ CI::II'.,I"I" Hl::l:i::.; THE[ I:;?.lii?.iSl::U31'.,ffE; J: E: J: I.... :[ T"r' TC ]: I",IF:'OF~ff'I "I"H ]: ti::; 151:ii:F'F:II:;;'.'T'HI~:?',IT I::,I..IR: ]: t'.,t('!i '1'I"1[!!: :[ I",I?i;TI:'IL.L.I:::FI' :[ Oi'.,I :[ iqt31:::'E)::?T ]: OI'.,IL:; Cfi::: I:;:tl'.,l"/ !-,.IIL::I..L::~; F:ID..)'FICI'EHT '1" "t TH :[ :'5 F:'F~?ZIF:'[ZI';CI'"r' I:':ll",l[) 'THE!: I',]I...IJ"][!',EI'~ OF fii:[!:::3:[[::'EI",ICE~i; 'T'HI::IT THE HEZ.L. M ]: I",1 :[ I'"IUP1 D :[ '~!;TI:Ii",IC:E EtE"F,L,.IF.:EI",I t::/ I.,.IE:LL. FIl"d5 F:IN"r' OI",I'""E!; ] 'I'I:E FSE:I.,tF:IGE :tOO FEi:ET I::'O1'~: I':1 F'F.:J:'v'F:FI"L:: I.,.I[~:L.L...~ ::1. !:!;O -['O 200 F'E:[E"F I:::F;40 H FI F:'t.J [~J!.. ][ C: I.,.I E L. L [::, E I::' E NJ:.', :1:I",1C:i ~ J F'O f.,I "!'t iii:: T"r'F' E O F:' F::'I_I F:,'I. ~[ I:[: H [ii:l. I .... I,.IE:IA~. LCu]~; F:II~:E [;'::[~:gfl..I ]: F::E:[::' FIND HIJ:E;T [3[Z [~'.[~.'['t.l[~ff',lE[::, 'TO THE: CIF' 'T'I 'IE HF:L.I... C:CiPIF'I..E:T :[ Ot",1. O'I"HEF: Fi'.E:I::!L.I ]: I:;~:El'l[i:l",F[":i; Pll::l"r' I::tF:'F'L'T'. :ii;l:'[:.:'C :1: F:' :[ C:F:IT :[ CIl",l:i!i; F:IN[::, C:C~N!!i;'I"I,~II..I(:::T I:::I'v'F:I]:I.I:::I[3[.E: "I'CI ]:l",l:[:;I...IFi'.[i!: F'f~:OF:'EFi: ]: C:E:I,UF:t:F:"T' ']"HRT ::1..: ]: I:::d"l I:::'FIf"I:I:L.]:I':II~i'. I.,.I]:TH THE: [?.[~:g!(..I/[I:;?.EH[[NT'_:.:; I:::'OFi: OI"~--::::;ZTE: !!!i[~':HE:I:~i'.:!~; F'CIFii"FH E?d TH[i!: HI. JI",I]:C::[FT-'IL]:']""r' CIF ;:::: :[ I.,.IZI..I.... ]:I',t!:i;TFILI... THE ~5"r'%T[::.'H :IN FICCO~:[::'Fff',ICli![ H]:"FH THE: ::J:: :[ t..II',I[:,[Zrq~i;TF~ND THI::IT THE ©N-...~:;:rT[ii: :!i;[:_'l.,.l[i:F'. :iii;"r'!i;T[i[M Pll::l"d F~'.E:g!LI:[F~'.I~i: lii:NL. FII:;i:GF:HFi:I'.,!T ]:1:::' '1'1-'1[~: l'~:l::i::!~:;]:l)l:.~:l'.,IC[ii: ]:~:.:; F?.EI'"IOD[~L. EI)TO ]:}'.,IC:L.I..I[)[~: t"'IC~F;;:F' TI...IFff.,I ,:-I- [!:F~t::,F;b3OH:~:L ~/(L~ F:IF'F:'I.. :[ ~,,I.:I' I'.,tCff.~ff"ll:::ll'4 · '" ' - ' ¢ ,.,]' d::: i:'q::!l;:':, 't I'.1;:i". i I'f ]'].,1 I:;:I1::' ';:;! !1::?,. i I::11; '!' 'I !"1 !:'1:;i'?1':;:;i:;'1' ;t !'1' '!' !]ti',!. :' ' ::'l' ~"' ' 'i'!ll::il f'l!?.,! i' i' I' I::'!:;I I ~ ~ ]i i,.i)'i.!..'.!'~;i;'!'l !i ._ i'lli:]i '::i ","':!: ' !' l ~?! ',;i'J .:::lE:(:(!r;?,Fd',,!!":l:; I,,!.( 7!'1 i":'ii:: !'i.ff ':i' 'i I i' 'l:'l:":;"l' ' i'~ .... !', ,::,':. ;, ~ ! I!',1 'il-IF! I ............ Fi. Ii::: ~' i'. , '::; I'!:1' ';::1: . i1:;:'~:, .:,'", : , 1', ',, ivh::?~, l;;'!;:i:l! ! I' ;':;' ,'_ ;[',!i ]':::!;:;(;!i!:' i'!i;;i'! ! _,i' !;, ' !;;:]: ':;. ",l:;i',l;;' ::] i;':; !:;;'i:i!'"!l'l!)~!;! I; i;' !'l~ '.,I ": I i":,::- i"!07;;;I::; i-I Il:If,! ':!- !?,l!:'(;:q;'(!~.~i'"! :: December 31, 1979 Norlnal: York Post Office Box 608? .}M~chorage, Alaska 995(}2 Permit !~ 790465 Subject: Lot 3 Block 9 Kasilof Hills Subdivision A permit issued by this department for well and/or sewer system has expired. Pe}mlits are issued on a calendar year basis, as stated on the permit, by authority of Muni¢:ipal ordinance. if you have drilled the well, a we]_l log should be sen%: to this department to document the installation date. If an engineer has inspected ti~e installation of the on-site sewer system, please i%ave them send us the as-bui!ts for our files, If there are any further questions, please contact: this office at 264-4720. Sincerely, Senior En~iro[,~en~i[ ' Speci LNB/1 j w eric: Copy of Permit: Dece~ber 29, 1978 ~780882 J. Arnesen 555 West Northern Lights Boulevard I1202 ~chorage, Alaska 99503 Subject: Lot 3 Block 9 Kasilof Hills Subdivision A permit issued by this department for well and/or sewer system has expired° permits are issued on a calendar year basis, as s-~ated on the permit, by authority of Municipal ordinance° If you have drilled the well, a well log should be sent te this department to document the installation date. If 'there are any further questions, please contact this office at 264-4720o Sincerely, Les No Buchholz. R. So Senior Environmental Specialist If~B/1 jw enc: copy of permit MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-2221 SOILS LOG - PERCOLATION TEST [] SOILS LOG PERCOLATION TEST PERFORMED FOR: ~%'~ ~'-~ l',/\ t '~_\ ( LEGAL DESCRIPTION: SLOPE DATE PERFORMED; ILI~ ::.L /~ t'-J c-t \,: ¢;? f';, c,~ SITE PLAN 3 4 5 6 7 8 9 10 11 12 13 14- 15- 16 17 18 19 20 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE '"~;' (') (minutes/inch) ~ ' ~' FT TE8T RUN BETWEEN ~'~ FT AND COMMENTS PERFORMED BY:'~-~ [%f~ C'¢%~-0 ~.::&),l '-~' ~[~J'~ ~', CERTIFIED BY: , ~z~ ' DATE: 72-008 (7/76) f BORING NUMBER i Dote Completed: 9-5-?8 ' LOCATION 'SKETCH No Scole ~ i o~-~'~ ~,u'~'~:~7-~" SOIL DESCRIPTION ~__ SILTY S~D W/ ' ' OR~ICS ~ . 2.5' ;'0, , .~ .:.... ~ D 160 __ "~; ~ gray-brown, slightly · , %. moist, dense-very dense '~O ~'-- 10'0~ NOTE: OlSTANCES SHOWN ARE APPROXIMATE ANO HAVE  NOT BEEN MEASUREO BY SURVEYING METHODS. J -- s~n~ S~D W/SO~  GI~L (SM) EXPLANATION '-- many cobbles '_.~u~o~ ~ou~ I  I ~ ~ ~ ORGANIC MATERIAL '-- -- 13.0 ' ~ Little Visible Ice 0:~0' Vx d,' " I ~A.8. ~ICF OESCRIPTION :.:0' SILTY S~D W/SO~~.'o~ ~ SS~ 72, 5l I°/o~ 85.~ ~, ~ 15.0' s / ~atows/roor ~ SAMPLER TYPF ~'~ ~-~O. WATER TABL~ SILTY SAND W/SO~'~--9~ -%~0~ STRATA CHAN~ __ many cobbles ~FROZEN GROUND ~-Wfll&F TYPICAL SOILS LOG ] A.B-A~FR BORING ~ ~8,0 ~ ~ 1~ "SP&IT SPOON WITH I~0 ~ HAMMER No Gro~dwater Enco~tered T.D. s z 1.4"SPLIT SPOON WlTH340 LB. HAMMER Sh ES" SPRIT SPOON WITH 340 t~ ~ ~ 2.~" SPLIT SPOON, PUSHED A AUG~R SAMPLE T~ SHFABY TU3E -ZO. Tm MODIFIED 8H~LBY -- SAMPLER T~PE SYMBOLS I ~ SOIL SYMBOLS I -' ~"' ORGANic MATERIAL "Little Visible Ice O:dO' Vx -~-,.A.B. t---/CF DESCRIPTION (~Ss, 72, 5Z I°/o, 85.9 pcf i~ --r---'~pRoz SrRArA CHA/VaE  ] ~O~OWS/FOOT ~ SAMPtER TYPS KD. TE. ALE. R~.IV] CONSULTANTS, INC. SOILS LOG Lot 3, Block 9, Kasilof Hills Subdivision Anchorage, Alaska /PR04. N0.851144 [OWe. NO A-01 TIME PERCOLATION TEST TABLE 1 R & M NO. 851144 SEPT. 6, 1978 ELAPSED TIME FEET DROP IN INCHES 10:27 0 4.65 -- 10:29 2 4.83 2.16 10:31 4 5.00 2.04 10:32 5 5.05 0.60 10:42 15 5.37 3.84 10:57 30 5.85 6.00 11:07 40 6.13 3.36 11:17 50 6.33 2.40 11:27 60 6.56 2.76 (0.71 ft) 8.52 inches in 30 n~nutes 3.52 minutes per inch September 8, 1978 R&MNo. 851144 Mr. Donald Buell c/o Real Estate Corner of Alaska 555 West Northern Lights, Suite 202 Anchorage, Alaska 99503 Subject: Soil Investigation for Sanitary Sewer System, Kasilof Hills Subdivision, Anchorage, Alaska Dear Mr. Buell: Lot 3, Block 9, At your request of September 1, 1978, we conducted a subsurface soils inves- tigation 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 September 5, 1978, consisted of a test hole drilled to a depth of 18 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. Drilling was accomplished with a rotary drill rig using continuous flight solid-stem auger with an outside diameter of 6 inches. A sample was taken taken at the depths shown on the soils log in Drawing A-O1. The sample will be held in storage at our lab for approxi- mately six months. In addition, all material brought to the surface by the augers was continuously monitored by an experienced engineering geologist. The topography at the drilling site is generally steeply-sloping to the west. At the time of the investigation the site was cleared and grown up in grasses and brush. The top of the test hole was located at original ground surface. The soils encountered in the bore hole are shown in the test hole log in Drawing A-01. This log displays specific conditions encountered 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 drilled seasonal frost was not present and permafrost was not encountered. 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 hole. The data in Table 1 show average infiltration from the depths indicated to the bottom of the hole. The measured percolation rate was 3.52 minutes per inch. September 9, 1978 Mr. Donald Buell c/o Real Estate Corner of Alaska Page -2- We appreciated this opportunity to be of service to you. Please contact us if you have any questions concerning this letter or if we can be of addi- tional service. Very truly yours, R&M CONSULTANTS, INC. Senior Geolog±st GS:/kah/12-Q SHEET NO .... OF__ : SIX INCH WATER WELL DRILLED AND CASED OUT TO TIdE DEPTH OF $~8.00 DRILLED AT TIdE RATE OF PER FOOT, PROPERTY OWNER_ //~, /2OA/T~ ~O/Lk, 3 3 ~ -~.~0.~ [~ ~2 ~i~~ LOCATION OF WELL SlTE_/~L, DRILLER L3e/6n/L6 CJxzu~ WELL, LOG: 315-317~ /-~ po,tou.,o rock, q.,/.eJz/~. 1/2 317-3 25~ S exl2~etz,f, avzaj. 7o~oJ, ~oo~,~q.e ~ 333 ~o Mm ,Lop I~a Ch~qj~e, ~o4 8 ~oo£ go Chz~e ~o,~ U~LL SecvL. To,fx~ Cha,~Fe..~o:a ~75 7ee,L, g18o00 pe.,a ~oo~ X Z?5 Fee_Z., ~4950, O0 COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING, WRITE CHECK PAYABLE "FO RAMPART DRILLING WORKS FOR THE SUM OF ~'/¢~.~0e00 THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS SERVICE CHARGEOF I~% PER MONTH WILL SE ASSESSED ON PAST DUE ACCOUNTS. Parcel I.D. # 1, GENERAL INFORMATION Complete'legal description L '5 r~j Location (site eddress or directions) MUNICIPALITY OF ANCHORAGE , - DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services P.O. Box 196650 Anchorage, Alaska 99519-6650~.~ 343-4744 CERTIFICATE OF HEALTH AUTHORITY- APPROVAL FOR A SINGLE FAMILY DWELLING l{,A.$ I UOF IJrl t.L, 5 /~J Property owner 1'2 o rU h.~ ~1 10 O (~ ~<... Mailing address~ IO(~F~[ ~'~(~Os~'~_C'Y ,'~. Mailing address '[1'~..~,2,. ~'.~;~.~ ~/c~. Agent ~ Address Day phone , Day phone Day phone Unless otherwise requested, HAA will be held for pickup. 2, NUMBER OF BEDROOMS: T'u~J~ TYPE OF WATER SUPPLY: Individual welt Community well Public water NOTE: If community wel!~system, provide written confirmation from State ADEC attest- lng 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. . 72.02~(Rev. 1/g1) Front MOA~I STATEMENT OF, INSPECTION BY ENGINEER As certified by mylseal affixed hereto and asof the validation date shown below, verify that r~y 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 ' CovtsJr~'~.'c-Jc'v~ E:v~ m.c.,,.v.S Address ~,o( ~v~L.y' L,L).~%¢.~, "~/, ~vlc.~./ Engineer's signature ' '/~-'/Y~- '/~ ~&)~/- ~ Phor~e Date o DHHS SIGNATURE ~ Approved for __ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Depa~ment 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 satisfl/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 omi~ions in the professional engineer's work. 72~(Rev. 1/91) Beck MOA~21 <tCEIVEb Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SEP, VICES Environmental Services Division 825"L_" Street, Room 502 · Anchorage, Alaska 99501 · (907) 34t3N~A4LiT¥ ENVIRONMENTAL SERVICES DIVISION Health Authority Approval Checklist LcgalDescription: L.~ '~1 1<,&SIL, eF (41Lb5 Parcdl. P.: A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well production I, WATER SAMPLE RESULTS: Coliform 0 Date of sample: G , L ~/ , c~ If A, B. or C. attach ADEC letter. ADEC water system number Date completed Cased to t' O FROM WELL LOG 15- g,p.m. Nitrate [, ~' ~ Collected by: Casing height (above ground) _ '/' /Z Wires properly protected (Y/N) ~ to ,~ ~>~ g.p.m. Other bacteria ~ ce' B. SEPTIC/HOLDING TANK DATA Date installed 7 ¢' . Tank size Foundation cleanout (Y/N) t'J Date of Pumping /¢ '/7, *] ~ C. ABSORPTION FIELD DATA Date installed ~ ~ Length c} "LJ Width Effective absorption area S' S 'L.- Date of adequacy test ¢0 '5, q'~ Fluid depth itl absorption field before test (in.); Fhdd depth O (ins.) Minutes later: Peroxide treatlnent (past 12 months) (Y/N) I 7.50 Nuinber Of Comparttnents 7..- Cleanouts (y/N).__ Depression (Y/N) /kd High water alarm (y/N) Pumper 'ZT5/d('/~ Soil rating (-gep~or fl2/bdrm) i I / 5~ Gravet thickness below pipe ~., ~" Total depth ~, _..c* Monitoring Tube preseat(Y/N) ~/ Depression over field (Y/N) tO Results (Pass/Fail) ~ For tu° 0 (.9 lnmmdiately after$~5"gal, water added (in.): O Ifyes, give date bedromns O Absorption rate = + '500 g.p.d. D. LIFT STATION t..d O T' C) .~ ~_~ D. Date installed Manhole/Access (Y/N) High water alarm level at* Size ill gallons "Pump off' level at* *Datum "Pump off' level at* Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tm~k on lot -P' / o o Absorption field on lot 4- I 00 t Public sewer main -t- / o O ' Sewer/septic service line + 5,-0 ; On adjacent lots 4- t o O ; On adjacent lots -b t o O ' Public sewer ]nanhole/cleanout % 'L. O O t Lift station + I o O SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation q' 50 Property line t a~ O Absorption field Water main/service line '~ 5'0 Surface water/drainage q'/ O Wells on adjaceat lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation Surface water -l- Curtain drain ~ Water main/service line + .~ O Driveway, parking/vehicle storage area F. ENGINEER'S CERTIFICATION Wells on adjacent lots Property. line I certify that I have determined thru field inspections and review of Municipal m conformance with MOA H/L4 guidelines in effect on this date. Engineer's Name I-f, !4, tot O$otOj c2ot05'['/,~Mg)I&3 Date 7~ o~q ~ HAA Fee $ Waiver Fee $ Date of Payment ~7-- ~?--~ ,~.53r DateofPayment Receipt Number O ,~L~77 ('"" ) Receipt Number ,/' . Rev. 8/95 DSS: haa.wk.doc JUL 15 '99 01:14PM NTL ANCHORAGE P.1/1 NOR' 3330 IN DUS'I'RI~,I. 8005 SCHOON STF POUCH 3,10O43 7671 Post-it' Fax Note ~hone ~ Phone !S, INC. 456-3116 - FAX 456-3125 349-1000 · FAX 34,9-1016 §5g-2145 , FAX 6~9-2146 DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORM BACTERIA Constructing Engineers 9601 Buddy Werner Dr. Anchorage, AK 99516 Phone Number: Fax Number: Collected by: HW Sample Type: Private water Systems Method of Analysis: Membrane Filtration (SM 92ZZ E~) Comments: Date Received: 7/14/99 Date Analyzed: 7/14/99 Date Reported: 7/15/99 Next Sample Due: Comments S = U = POS = ND = TNTC = CG = HSM [] Old R NT ' # Colonie,s/lO0 mi Time Received: 11:50 Time Analyzed: 15:00 Time Reported: 13:53 Satisfactory Unsatisfactory Positive Test Result None Detected Too Numerous To Count (>2.00 Colonies) Confluent GroWth Heavy Sediment Masking, Results May Not Be Reliable Sample Age >30 Hours But <48 Hours, Results May Not Be Reliable Sample Age >48 Hours, Too Old For Analysis Resample Required No Test *' # Colonies/mi Sample Sample Total* Fecal Other* HPC*' Date Time Coliform Coliform Bacteria Result Lab~ Location Comments 7/~4/99 07:00 0 ND 0 NT AC12148 L3B9, KASILOF HILLS. Satisfactory HOSE BIB Sherd L. Trask Envffonmental Analyst No~hern Testing Laboratories, Inc Anchorage, AK 7/15/99 RISCEIVED JUL '15 1999 Municipality ol AnChorage Oept, Health & Human Services E4, ._:,bFf'l I"tTL ANCH(')RC/6;E F', 1/1 JLIL 0_-; '9'9 7,i ,~--, NORTHE 3330 INDLISTRIAL AVENUE 8005 SCHOON STREET i"O L.~C?I 34004~, RN TESTING LABORATORIES, INC. SAIRSANK$, ALASKA 99781 [3071 456-3] 16 · F/',X 456-7,125 ANCHOFtAGE, ALASKA 998'~8 1907) 349-1000 · FAX 349-1816 PRUDHOE BAY, ALASKA 99?24 (907) 659.2 h'15 · FAX 6,~9-2'id6 ConstmctLug Engineers 960i Buddy Wemer DrNe Anchorage, M( 99516 Arm: Hern"y Wilson Client ID: L3, B9 Client Project #: Source: Kasilof Hills Hose Bib NTL Lab#: ,Al 61752 Sample Matrix: Water [Method Pa2amet~r Units Kesutt Report Date: 7/8/99 Date Arrived: 6/29/99 Sample Date; 6/29/99 Sample Time: 7:00 Colleeted By: HW ** Legend. ** = Me.od ~,¢por~ Level MCL = Max, M ~ Ma~x ~teff~ce = A~ve MCL D = Log To Dfluhon Date Date ~ Prep~ ~alyzed . SM 4500 NO3 B Ni~rate-N mg/L 1 1,25 7/8/99 Chemist~/Su~erc-sor !UL E~8 '99 C~7:i:3AH HTL ,qHCHC)RAGE F',i.."I NORTHE 873OlND!.{' ~A AV¥~t)E ~;r~o5 SC;HQOFJ STREET POUCH 2-10 C)~ '-,' RN TESTING LABORATORIES, INC, FAIR~AN~K$, ALASKA 99701 (907) 456-3116, FAX ,t56-3125 ANCHORAGE, ALASKA 995~8 {907) 349.1000, FAX $49-1016 PRUDHOE BAY, ALASKA 9,~7~4 (,907) 655'-2145 · FAX 6~9-2146 DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORM BACTERIA Constructing Engineers 9601 Buddy Wemer Dr. Anchorage, AK 99516 Date Received: 6129199 Time Received: 12:10 Date Analyzed: 6/30199 Time Analyzed: 12:00 Bate Reported: 7/3/99 Time Reported: 16:25 Next Sample Due: Comments Phone Number: S Fax Number: U PO8 = Colle~ed by: HW ND TNTC = ,~arnpie 'Type: Private water Systems CG [] Method of Analysis: Membrane Filtration (SM 9222 HSM [] B) SA Comments: Satisfactory Unsatisfactory Positive Test Result None Detected Too Numerous To Count (>200 Colonies) Confluent Growth Heavy Sediment Masking, Results May Not Be Reliable Sample Age >$0 Hours But <48 Hours, Results May Not Be Reliable Sample Age >48 Hours, Too Old For Analysis Resample Required Cid NT = No Test * # Colonies/100 mi ** # Colonies/mi Sample Sample Total* Fecal Other* HPC*'* Date Time Coliform Coliform Bacteria Result Lab¢ Location Comments 6/29/99 07:00 0 ElD 33 NT A011603 KASILOF HILLS L3 89, Satisfactory HOSE BIB Sherrl L Trask Environmental Analyst 7/3/9g TEST PUMP REPORT Conduc~.ed by: Aarow PureE & Well Svc. LLC :}h'im~ Wille Casing Size: .... {~ .... Screen I)iam: ......... 5 m-ee~ ~i~: Remarks: Pump lnformalion S~a~ic Wah:r Leveh .~ ....... Ay. Discharge: ......... Gl'M, Mad Drawdwm Pump On Time: ......... J~a~c: ~:.~.87.99 Pump OfF: Time: .D~H:e: 06-28~99 Time I Water Flow Remm'l{s i Leve~ GPM 00 ~ I P O: umD (ill 3:38,0 ~ Pmnped a total of 3/6.00 gati(ms li}r a produc/ion tale o[3.00 fi:IS.(} ' ] ~ Pulnped~ }}fla] o'f266.75 gallons afte~;'dlis period gallons of",vater i~h> Se well for hydro.-fracin~t well te~{ wag done rifler ti~e well had cleaned ' 'the well produces 2.75 (XP~Oas lested i j ,~hereon, ..Dated at Anchorage, Alaska, this //O CONSTRUCTING ENGINEERS, INC. ~t~,~, Anchorage, Alaska ~ I hereby c. ert. i, Jy that a survey of Lot -~ , Block Subdivision was made on ~"~-,'¢"T 7? and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ~,,~ SCS Member of ihe SGS Group (Soci6t~ G~n~rale de Surveillance) ['7' .... D/~TE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE I N S P EC/T-O R INSPECTOR INSPECTOR DEPT, OF I~'ALTH & ~UNIOIPALITYOFANOHO~AgE ~ ,RONMENT'~ ~, ~ECTION  D[PA~T~GNT OF HEALTH ~ ENVIflON~ENTAL ENVl RONMENTAL SANITATION DIVISION Telephone 264-4720 .RECEIVED ~EQUEST FO~ APPROVAL OF INDIVIDUAL WATER AND 8E~E~ FAOILITIES DIR[OTIONS: OompJete all parts on page J, Inoompleto reqtl~Sts will not be pro~essed, Please allow ten (~0) days for processing. J,' PROPerTY OWNER PHONE PROPERTY RESIDENT (If different from abeve) PHONE ~ BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION ] PHONE I ~AI LING ADDRESS 4. REALTOR/AGENT ~ PHONE MAILING ADDRESS 5, LEGAL. DESCRIPTION STREET LOCATION S. TYPE OF RESIDENCE '~,, SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [~ One [] Four [] Two [] Five [] Three E:] Six [] Other 7. WATER ~UPPLY '~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM ~ INDIVI DUAL/ON-SITE*~ [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if availa, ble.) '~-~'~' YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. (,,v. /Te), .? THIS SIDE FOR OFFICIAL USE ONLY = 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY D 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 [] I NDIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER E~]Septic Tank or [] Holding Tank Size:. If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS [~],-'~'APPROV ED FOR , BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED //~ DATE BY January 17, .108{~ R'ornlan/oonna Lo York Star Roui;e A Box 2152 fu~chorage, Alaska 99507 Subject~ Lot 3 ~%lock 9 Kasi],of U. iil;~; Subdivision Approw~l for your i.u. dividu.~l sewc, r and water facilities ~,,zo_~ o.~ delivered to .... ' '- ~"' ,:ro~ ..... ~.,, 5d33 B ,.,trc.et~ for oiir revJ. ew. (3) YOt.n:' permit for the installation of an on.~site sewer system has oxNirerl as of December 31, 1979, l';'e have not rcceive<[ the as',.bui!ts of the instai[L:.ttion in this office~ If a.n et~gineer inspocted the syste:{tb please s(:~n~! US 'the report for our review and files. If there are any furl:her questions, pl:.~ase oc~rrhact this office at 264-4720. S I{obert C~, Prath~ Y%.S. Associate Specialist Alaska Sta%ebank 310 ?.~st 7'{ortherh Light's 99503