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MCMAHON BLK 3 LT 3
McMahon Block 3 Lot 3 #017-042-03 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: S w cj 5© aS PID Number: if s- Y a- 0 3 Name: S �FFR0 y S -T°/f,v 4. ScHv L- r Z Wastewater System: ❑New ❑Upgrade Y Address: ABSORPTION FIELD I a, g 0 O � uA/2o w Cs@%J,K Ro A1� Phone:3 LI $� _ f g % No. of Bedrooms: L/ I i0beep Trench El Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: � Total Depth from original grade:) • GPD/S . Ft. Lot: Block: Z Subdivision: J Depth to pipe bottom from original grade: 6 Gravel depth beneath pipe M C M,9 PitJ\/0 � Ft. Ft. Township: Range: Section: Fill added above original grade: Gravel length: y y O Ft. Ft. WELL: Eyisr/nG❑ New ❑ Upgrade Gravel width: d• S Number of lines: I Distance between lines: V A4 Ft. Ft. Classification (Private, A,B,C): TotalDepth: Cased To: Total absorption area: p sa Pipe material: ASYi�I D3o3/ (PVC) (fFfuArE D Ft. D3 Ft. SQ. Ft. Driller: }-OSS Date Drilled: Static Water Level: 6`l Installer: 4r2U/+C-C Date installed: URrt-Ldry to/ic/is- Ft. Yield: Pump Set at: Casing Height Above Ground: f� TANK GPM Ft. I- �' Ft. SEPARATION DISTANCES XSeptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: > r 0 From Tank Field Station Tank Sewer Lines A,NClt`o4�'E- 74,viC Well- ,$6/ 113 � C)0 Material: -ST't f L Number of Compartments: r� IGu r loo" - too LIFT STATION WateSurfacer Lot a 3 10 Size in gallons: ufacturer Line , — "Pump on" level at: p o at: High water alarm at: Foundation S Curtain jvon ^""' _ r nc-4, Pump Mak odel I Electrical Inspections performed by: Drain k^'awN K^•o�N K.vGwN BENCH MARK Remarks: Location and Description: pal /V JLitFR'CO- N W CJ2 NE.0 04 Ho (ISE Assumed Elevation: ©O U L eE OF" At ."..�,. S toI� Dates: 1st a 9th � Inspections performed by: s & S ENGINEERING 17034 Eagle River Loop Road No. 204 2nd ? az/1 I) 9 ROBERT C. COWAN River, Alaska Department of Health andEagle man Services approval +�'s♦F�,w,ce.aso1 '\`,����� 'to �J r99577 ..... "; Reviewed and approved by: 72-013 (Rev. 9/91) MOA 25 Permit No. SW950225 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT 3, BLOCK 3, McMAHON S/D PID No.: 01704203 STI ST2 96.5'94.3' /FINAL GRADE_ xrml C04 .... Ate` ROBERT C. COWAN 4.Q SCALE i = ao 1 c CE • 81 2` f.................1 : 72-013 A (1/93)' PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE 1000 DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 �JP� ANCHORAGE, ALASKA 99519-6650 �� L ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW950225 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:SCHULTZ JEFFREY S & JOAN A OWNER ADDRESS:12500 FURROW CREEK RD ANCHORAGE, AK 99516 PARCEL ID:01704203 LEGAL DESCRIPTION: MCMAHON BLK 3 LT 3 LOT SIZE: 37122 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 8/17/95 EXPIRATION DATE: 8/17/96 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: DATE: R- //'% /'/ s - DATE: [ n s&s\ ,-tneeRing August 1, 1995 ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTHAUTHORITY APPROVALS MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 SEWER & WATER MAIN EXTENSIONS REFERENCE: Lot 3; Block 3; McMahon S/D Request you issue a permit to upgrade the septic system SEWER&WATER serving the four bedroom house on the referenced property. INSPECTION A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The approximate location of the test hole is located on the attached site ENGINEERING STUDIES ANDREPORTS plan. At the time of excavation no water was encountered and after seven day ground water monitoring, the monitoring tube was found to be dry. WELL INSPECTION & FLOW TEST Attached is the proposed upgrade design We do not anticipate any adverse effects on neighboring SITE PLANS wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. ROAD DESIGN _ Sincerely, -Aff SOILTEST Robert C. Cowan, P.E. RCC/gk Enclosure PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN d 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 o � w Q \ z UFO i�'> - - ((�(( - `- Mauna A - n O ti d0 {i_. � U U ad xMi lYlOauna .Mi LU o zo IW''o .� tl!G� J x Wawa WU w m � N SX�WU �� • � �O� � � � HWRZU z p - — _w I I QUO zQ�o I > 0 Np 0CL a7 v Z 0p I O O w Z U S O I 0 I Q ~ I Z = QC za0 I N F- I Owur I xw O I UQ �woV, LO wLLJO7�afz � on n I I mQz�w5J y I i 0 o cy 00 viJ���m� jz z m J ,,, a o I 3SnOH V4008 38 I� a o w Uj w m o o w j V ONIISIX3 I I(10 �-Lij (n>L�Nzm I IQ Q Nz� W UJ Owo o j 1f�34 Q j \ N m o NON > N N N Z Z I O I -i- i-� W Q Q o J° I o� 1 `r z wz��mrVi� �� i =� Na i� V) o �i Domes=c v� Q U vzN ~WZ� ° I 0O to Z) cn>�Z a 13HS r NF m r~nc=na �oo� w I a- LJ I ccn Y o Fl Lf) I ° O LLJ W V y> t W o Ci w W o > w H- I Ilj O J o d��``;c� �I�._ c~n I z WOE- O m II N II �w� o I o�� ��.. vri, �' ( II �Ii1 W _ 'D a �gII�! ��LLJ�N I �I �'- ZoI?r zg co o eco C3 Q � r- z o I I W J Q /�qq m J o � �coc d i -)) N< e F �_I I � I o Z =t V)� � �!Q) W ria Qin i�LL O ��W FC------------------1-- - jo F Z �D � �W� 1N3W3SVII ,linlln o l o Oaf � axW W 0 3ltlOS 30vdoin Nd3d 311S Ob = „l SEAL) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST cc 8801 PERFORMED FOR: Ji t S 14 L 'T Z- DATE PERFORfV� %%7 %a I / 3 6Loe 3 /1 SMA//b t)Townshi e, Section: ,;1111\\iy►"� LEGAL DESCRIPTION: La/ P' Range, —I SLOPE SITE PLAN (FEET) I 69C -RN/ G J 1 o 7 W Srt��lr i.v (a 3 4- 5 5 6- 8 SILry j�' I" SM SA j' 9 Vrf,/LY 10 I_ , Net Depth to Time Water Net Drop WAS GROUND WATER ry ENCOUNTERED? — 3.7s-,/ I..I to S 11 ! Il; . IF YES, AT WHAT — P J 6 7. Y.0 `{' DEPTH? P E 11" z' 13 Depth to Water After �R /a5_ � Dale. Monitoring? 14- 15 4 15 16- 17 18-- 19- 20 8 1920 COMMENTS -1I07- 94 L tJu Reading Date Gross Time Net Depth to Time Water Net Drop (� �50g1z 7 a�- 0 — 3.7s-,/ _ to of ro. A) 5, c c" V ]-S' „ J 6 7. Y.0 o.7S-" / 11" 0.-75 PERCOLATION RATE oZ ' 7 (minutes/inch) PERC HOLE DIAMETER G ' TEST RUN BETWEEN / FT AND"� t FT f3 V T W 6If, () 4; x . S & S ENGINEERING PERFORMED BY: I /7` — CERTIFY THAT.THIS TEST WAS PERFORMED IN 17034 Eagle River Loop Road Na 204 3/1 7� 5— ACCORDANCE N'I6tjATAijifi"YIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELL INSPECTION & FLOW TEST MIA;X00E ROADDESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN s&S� ,ineeRrnG ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 3, Block 3, McMahon S/D August 1, 1995 (GENERAL: ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 1. The scope of this project includes the installation of a 1250 gallon septic tank and leachfield trench to serve the four bedroom residence located on the referenced property. The existing septic tank is to be excavated, pumped, crushed, and abandoned in place. The existing leachfield is to be abandoned Svc -i4 i -14,4 -r- 17- -H,4 -r17- MA -1 Ai, to $%y r7 s,v 7 -iii JPW701tL ( 1M SY li 4.G /!/v f.Q Yio sib V41 -vs). 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page Two Lot 3, Block 3, McMahon SID August 1, 1995 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within.2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Lot 3, Block 3, McMahon S/D August 1, 1995 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier. (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Lot 3, Block 3, McMahon SID August 1, 1995 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Lot 3, Block 3, McMahon S/D August 1, 1995 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER GREW' "ANCHORAGE AREA BOR, \`7� Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE D P L SYSTEM NAME?uC ©MAILING ADDRESS (a So PHONE yn , F� LEGAL DESCRIPTION LOCATION +u���"�� -r r SEPTIC TANK: DISTANCE NUMBER OF I FROM WELD MANUFACTURER MATERIALAtJ COMPARTM�ENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY.IwXa"TS_ GALLONS. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL ilii FOUNDATION NEAREST LOT LINE e� OF LINES 4' NUMBER OF LINES f DISTANCE BETWEEN LINES A TRENCH WIDTH IN. TOTAL EFFECTIVE � L'r ABSORPTION AREA ��� SQ. FT. LENGTH OF EACH LINE T DEPTH OF FILTER s DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE ( IN. ABOVE TILE IN. WELL: TYPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE , SEWER LINE , TANK , SYSTEM CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES INSTALLED BY: vel SEWER LINE DEPTH:' v Qui PIPE MATERIAL: 4 T1 '^ l ) Il b^r4 LOT SLOPE: �( REMARKS: Form EQ -032 DIAGRAM OF SYSTEM � Y J �N J � A I DATE -7141-2C APPROVED _ t3G ` G.A.A.B. WATER WELL LOG FOSS DRILLING 1336 Ingra Street Anchorage, Alaska 99501 WELL OWNER � � Ct,�' 1,e,6 \, )cli &&'Q n h USE OF WELL�4n L=�_ LOCATION LOT OL 1) V, ��vb�� ��' ��0pi SIZE OF CASING '' DEPTH OF HOLE F<<9FT. CASED TO 967 / FT. STATIC WATER LEVEL !6wr-(,uvFT. YIELD 'r-- GAL.PER.MIN. WITH 21oW' FEET OF DRAWDOWN. REMARKS �i y DATE COMPLETED D " 7c�J PUMP TO BE SET AT -Lto-L a—j0';u'S0ve2d i) C2ra✓�l 13r r). S `� to /f' L'Lt o.9.0 ato-y—D .?—� to-2ja Ito LIA �LAt o L3 _t o� to_ —to_ t 0— t 0- -t _t o_, 0- 0- 0. _o— o_ 00 GREA '`ANCHORAGE AREA BOF. DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" , REET ANCHORAGE, ALASKA 99503 /J TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT n,, I NAME OF APPLICANT / ! C'G' kLf v - INSTALLATION LOCATION 3 LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH ' SOIL TEST RESULTS COMPLETION DATE ANTICIPATED. fU" MAILING ADDRESS SEEPAGE PIT TO 13E INSTALLED BYf F`a�.•� y �"' �j NOTE J T KNOT VALID PERMIT NO. IL TEST 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 MINIMUM DISTANCES, REQUIREMENTS f FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT f DRAIN 'F# i �" SEPTIC TANK TO SEEPAGE PIT WALL o SEPTIC TANK '^ SEEPAGE PIT DRAIN F4El-' TO NEAREST I%LLO✓T� {(LIN y WELL TO SEPTIC TANf�z-SEEPAGE PIT DRAIN FIELD /6) t ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT ` DRAIN FIELD ICS Ir SEPTIC TANK, L/ SEEPAGE PIT. DRAIN FIELD -. TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFIL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. l G.A.A.B. OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF DESCRIBE D SYSTEM IS IN ACCORDANCE WITH SAID CODE. 2,5 L-5 6 � APPLICANT'S SIGNATURE? l\ F M NO. 0-016 Z TYPE -�-• i - '-yam �� ,/t ` �-�' ��•C�� DIAGRAM p✓FOYSTEM RAGE AREA BOROU9,4 ORDINANCE NO. 28.66 AND THAT THE ABOVE I Fv�� i 4 i I RAGE AREA BOROU9,4 ORDINANCE NO. 28.66 AND THAT THE ABOVE n ALA PAPT LAB 4040 "B" STREET, ANCHORAGE, ALASKA 99503 PHONE: 907-279-2581 1743 q J 0 y 2 5' 1175 ylUuv�J-0/0 y, torfYlSPS BMX 3�5l %�q 54j, � G 7- , L U l 3 �1 � � �( e �G G� o n S°( f� � �eG1v 1�, cl)ae:KS,�,a11;7 1 1 Ufdpi pgav ve e!s� a ye5( pl l �Dl l Gt ve r f V� m 3 S� f"D �,� was Na ev, Thie .7,�n-e wdS D� fo 7D� WGrrhC�jporl_fie� o f/he .�lrl �y .7��.d ldy�v VVhl-&4 Cow es f. 7 � �v�ola/%'0?-7 Va�e Wdd5 w1 1'6 igbe 4m �e v4e- u i VA /2 1,1 S s S� uav� 7ree y��dyov /VU 6 ��v �5 f���5 lo ex�`5 f � o del /� W� o /-5rc�ih�`c�gy� J ESQ' HOLE MELD LOG C�nOaa VEOHL, B 1505 EAST X , . r ANCHORAGE, ALASKA 99001 CLIENT IV O IN �'y . _ _ o 4 . v O Q. - O Q ,• Jai v Q ,. �_ _ FEET G�'� � y " 4 1� � <. PROJECT 3 0 �Pt?�ji4i q�QG G �O O`y rt: �0� ,• . <+ f''� 5, y'0 <S'. •c • <�` 0,,:� r � GO� wo. 17 -1-2 WATER LEVEL WD lar f DATE -- �' S � /� srAnON HOLE NO. It AO DRILL TIME ST_FN- _GR. COVER — NFS , " It 24hP CASING SIZE TECH Q1 — ELEV FROST � jn ' PIEZOMETER YES NO DRILL USED oaf DRILLER...._— — • EPTH A C IV O IN �'y . _ _ o 4 . v O Q. - O Q ,• Jai v Q ,. �_ _ FEET G�'� � y " 4 1� � <. O`' � ,= -.�v O p<� •!- ,Z�, � ��' G y� 4. G� x , '� 0 i-O� 0 ELGY.�., n + 0<r 0 py/�Fl 0<0 �O epO t�V FP '� Ff P \may G C% V G 0 �Pt?�ji4i q�QG G �O O`y rt: �0� ,• . <+ f''� 5, y'0 <S'. •c • <�` 0,,:� r � GO� l + n vi / l 460 to#200 SILTS 8 CLAYS200, COBBLES -3 -B' BOULDERS -12+ GRAVELS NFS , F POOR Y--MDD SW SANDS NFS, F2 WELL GRADED 65 SANDS F21 F4 WELL GRADED GRADED '�T: 4, d (51 NA f l ' 't I' 1 9 4 J r4 -4, d 3 i1 l(SIV oll FRACTION COARSE MED. FINE GRAVEL 3 to l I+ to 318" 318"010 SAND °10 to"3O #30 to''5O 460 to#200 SILTS 8 CLAYS200, COBBLES -3 -B' BOULDERS -12+ GW ORLY GRAVELS NFS, F1 WELL UKAuhu GM GRAVELS F3 WELL GRADED GP GRAVELS NFS , F POOR Y--MDD SW SANDS NFS, F2 WELL GRADED SM SANDS F21 F4 WELL GRADED GRADED SP SANDS NFS, F2 PO MG SILT F �J� rc.vouei ey �� x C GREATER ANCHORAGE AREA BOROI ktA,�;xri )a Department of Environmental Qu,.,.!ty _ �M 3330 C Street �e+L _ 191 ry nP Anchorage, Alaska 99503 Q(iF.PT�EBF PNHUHnUL AREA ^kNPAI, C$U)441Tiry SOILS LOG - PEROLATION TEST Performed for John & Mary Williams Date Performed 6/22/74 Legal Description: Lo ocx _3, TvIcivianon u ivision This form reports: Soils log Yes Percolation test _ Depth Feet 1 _ e ishiTt &Organics v--- 2 - Dry 3 - Grey Sand (SP) 4 - 150 S.F./B.R. 6M 6 - 7 _ Dry B _ Grey Silty Sand (SM) 9 _ 250 S.F./B.R. 14 - Bottom of Test Hole 141 Was ground water encountered? No --- S/0 If yes, at what depth? Reading Date Gross Time Net Time Depth to Water Net Drop Percolation rate m nuke. Proposed installation: Seepage Pit Drain Field Depth of Inlet _, _ Depth to bottom of pit or trench— 0014P?ENTS:No�round__water or bedrock encountered_-»__—_-.—. -___________ Performed By:-Neal_.Hau,s EQ -040 (6/74) Certified [3y: Costu�tiorL_..__�Date.6��/ Test Lab Municipality of Anchorage Development Services Department JBuilding Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsfte (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.017-NI-05 COSA#NAM 0107 Expiration Date:_ 1- 1. GENERAL INFORMATION Complete legal description Lot 3; Block 3; McMahon Subdivision Location (site address) 12500 Furrow Creek Rd. Current Property owner(s) Jeff Schultz Day phone 345-7218 Mailing address 12600 Furrow Creek Rd. Anchorage. AK 99516 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑Q Individual Holding Tank ❑ Community On-sfte ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined in the Certificate of Onsite Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my Investigation and Inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S a S Engineering Address 15861 S. Birchwood loop Rd. Chuglak. AK 99567 Engineer's Printed Name Robert A. Sharer 5. DSD SIGNATURE Approved for 4 bedrooms. Disapproved. Conditional approval for Phone 694-2979 Date L7 ° bedrooms, with the following ON-SITE Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory_ Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: It' (Rw lim) Original Certificate Date: — — 0 Municipality of Anchorage bb.. • Development Services Department <' ; Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: {.v ' 7 3; 3Lee-K 31 de- t�,Iau S/A Parcel ID: Q/%-0����3 A. WELL DATA Well type,�r� If A. B, or C provide PWSID #= Well Log�l N) _ Date completed 1D 11017` Sanitary seal ON) Wires properly protectedON) `S / �Jt Total depth 83 ft. Cased to 83r ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test /&&Z76 _ ah l r � Static water level &r' ft. 53 ft. Well production 7.5 9.p -m. o�o g.p.m. WATER SAMPLE RESULTS: n Coliform colonies/100 mL NitrateQmg/L Other bacteriacolonies/100 mL Arsenic: d ug/L date of sample: H 16 l Collected by: 54 13 B. SEPTIC/HOLDING TANK DATA Tank Type/Material JEPfIG �jTL Date installed Tank size /aso gal. Number of Compartments0? Cleanouts (9N) Foundation cleanout&N) Cf5 Depression over tank (YM 1— o High water alarm (Y® K)o Date of pumping Pumper kbcrnig E np_yrES C. ABSORPTION FIELD DATA �£ 1 �—F Date installed / zjj Soil rating g.p.d./ft or ft2/bdrm) %a2 System type E+�X#{ I � � Length ft. Width o2.5 ft. Gravel below pipe ft. Total depth � � ft. Eff. ab orption area 5af? Monitori� n tube _ Depression over field lk Date of adequacy test al Result Pass Fail) For bedrooms Fluid depth in absorption field before test in. Water addedgal. New depth 56 in. it ,, MM� Elapsed Time: L� min. Final fluid depth if in. A t Absorption rate >_ �y g.p.d. Any rejuvenation treatment (past 12 mo.) (Y®& type) / VO If yes, give date — D. LIFT STATION N' Date installed Size in gallons 'Pump on' level at _ in. 'Pump off Datum Cycles tested • E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot /W r i Absorption field on lot X93 Public sewer main Al%H Sewer /septic service line oZ5 ) Animal containment areas o2S + in. High water alarm level at Meets alarm 8 circuit requirements? On adjacent lots / co 4 r On adjacent lots 619 f Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: r5 Building foundation Property line d3; Absorption field Water main 1JLA _ Water service line Surface water /00 Wells on adjacent lots in. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: 7 r Property line Building foundation 5 Water main /V Water Service line /0 Surface water h� Driveway, parking/vehicle storage /r9 / r Curtain drain AXLE Wells on adjacent lots F. COMMENTS tr C I certify that I have determh review of Municipal records conformance with MOA COS) Engineer's Printed Date COSA Fee $ Date of Payment a� 0 Receipt Number O S S S C (Rev. 11/05) 0- h field inspections and above systems are in Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage .. • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 090107 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 3, Lot 3 of McMahon subdivision. This inspection revealed a nitrate concentration of 9.98 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. wqi SGS ReCO Client Name Project Name/M Client Sample ID Alstriz Sample Remarks: 1091490001 S & S Engineering L 3;B 3;McMahon SID L 3;B 3;McMahon S/D Drinking Watcr rr' g 4 fjf i Printed Datdfime Collected Date/time Received Date/time Technical Director 04242009 16:58 04/162009 16:20 04/162009 16:40 Stephen C. Ede Alloaxblc Prep Analysis Parameter Raults PQL Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) Waters Department Total Nitratc/Nitritc-N 9.98 0.100 mg/l. SM204500NO3-F 13 (<10) Microbiology laboratory Colony Count 0 col/IOOmL SM209222B A (<200) Total Coliform 0 col/IOOmL SM209222B A (<I) Fecal Coliform 0 col/IOOmL SM209222B A (<I) 0420/09 0422/09 NRB 0423/09 JDZ 04/16/09 DLC 04/16/09 DLC 04/16/09 DLC W O ❑ m Z OD OO O S � FWW ga i v •' <L ♦�'. �• W d Z fl � � m Vim'•, � .9 �I w R " • yy0 6x a �' w3 IW°TILIT CA•CMCNT a i v •' <L ♦�'. �• W d Z fl � � m Vim'•, � IW°TILIT CA•CMCNT MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES j Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.# i�l�l-&AQ-r)rQ HAA# 1. GENERAL INFORMATION Complete legal description Lot 3 Block 3, McMahon Location (site address or directions) 12500 r'urroNv Creek Rd., Anchorage Property owner ' Jim.Bunker Day phone 345-3901 Mailing address 12500 Furrow Creek Rd., Anchorage Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well X Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site X 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-M(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 supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify 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 Environmental Address Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments By: bedrooms. Phone (907)562-2580 AK 99518 i -22-15 Date John Earl Simps i(Q_ gJ�., C[-8061 }'� bedrooms, with the following stipulations: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rw.1/91) Back MOA #21 EN IRO\1IENU I\CORPOR.TED August 10, 1993 Ms Susan Oswalt Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, AK 99519-6650 Re: Health Authority Approval for Septic & Well System Lot 3, Blk. 3, McMahon Subdivision Dear Ms Oswalt, RECEIVE® AUG 101993 Municipality of Anchorage Dept. Health & Human Services It is for your information that on 8-9-93, two engineers from EMI went to the site referenced above to measure and supply the information which was requested from your department. After measurements the following information was collected: 1) The elevation difference of the perforated pipe in the absorption field from the 1 st Cleanout is 2.26 inches lower than the Sump pipe on the other end of the absorption field. 2) (a) Surface of water level in the Sump from the top of pipe = 3.87 ft. (b) Depth of perforated pipe from the top of clean out = 4.92 ft. 3) (a) Surface of water level in the Sump pipe from its bottom = 6.75 ft. (b) There was no water In :he 1 st Cleanout. It was found during the measurements, the Sump pipe was not a perforated pipe. Under this circumstances, the measured surface of water level in the Sump pipe was not the actual water level in the absorption field. From the above facts, it appears that the absorption field is working satisfactorily. If you have any questions regarding this job, please do not hesitate to call me at 562- 2580. Sincerely, Environmental Management, Inc. l c,�` Dhruba Neogl ; Project Engineer 907 E. DOWLING, STE. 21 • ANCHORAGE. ALASKA 99518 • (907)562-2580 • FAX (907) 562-1561 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST ~' - Legal Description: Lot 3 Block 3 McMahon _Parcel I.D. A. Well Data Well type Private If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) v Date completed 10-16-75 Driller Foss DriI1;nn Total depth t13 Ft, _Cased to 83 Ft _Casing height 2 f frnm c L Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y FROM WELL LOG AT INSPECTION MUNICIPALITY OF ANCHOkAG,� Date of test 10-16-75 7-21-93 ENVIRONMENTAL SERVICES DIVISION Static water level 64 ft. 48 it. I( 2 3 1993 Well flow 7.5 g'p'm' 6 g�ECEIVED Pump levell 82 ft 82 ft. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 75 ft. ; On adjacent lots 100+ ft. Absorption field on lot 106 ft. ; On adjacent lots 100+ ft Public sewer main N/A Public sewer manhole/cleanout N/A Sewer service line N/A Petroleum tank N/A WATER SAMPLE RESULTS: Coliform 0/100 ml Nitrate 6.02 mg/l Other bacteria Date of sample: 7 --�2/ 13 Collected by: -� ° •Vc?C�QI B. SEPTIC/HOLDING TANK DATA Date installed 7/28/75 Tank size 1250 Compartments Cleanouts (Y/N) Y Foundation cleanout (Y/N) 9 Depression (Y/N) High water alarm (Y/N) N Alarm tested (Y/N) Date of pumping 10-4-92 Pumper Roto -Rooter SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: N Well(s) on lot ' 75 ft On adjacent lots 100+ ft. Foundation 5 ft. To property line 20+ ft. Absorption field 40 ft. Water main/service line N/A Surface water/drainage 100+ ft. 72-026(3/93)• Front CONTINUED ON BACK PAGE C. LIFT STATION N/A P.= i istalled Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pump off" Level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots Surface water Date installed 7/28/75 Soil rating (GPD/Ftz) 128 sq.ft . /BR System type'? ench Length 34 f t. Width 3 ft. Gravel thickness l ft. Total depth 9 ft. Total absorption area 400 sq . f t . Cleanout present (Y/N) Y Depression over field (Y/N) N Date of adequacy test 7-21-93 Results (pass/fail) Pass for 3 Bedrooms Water level in absorption field before test 2 ft. After test No change Peroxide treatment (past 12 months) (Y/N) N If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 106 ft. On adjacent lots 100+ ft. Property line 20+ ft. To building foundation 75 ft. To existing or abandoned system on lot N/A On adjacent lots 7.00+ Cutbank N/A Water main/service line N/A Surface water 100+ Driveway, parking/vehicle storage area 100 ft. Curtain drain N/A E. ENGINEER'S CERTIFICATION /certify that/ have checked, verified, or Signature HAA Fee $ 176 a� Date of Payment :� —1:2 q- 9,3 Receipt Number` 79.n7R !'i/441' Rmnk to a# MDA and HAA guidelines in effa4p�_ O OF Waiver Fee $ Date of Payment Receipt Number. John Earl Simpson CE -8061 pROfESSiCt��•� of this inspection. INVOICE Ooyo�200yga SEWER AND DRAIN`''I ",4w,v,y Ca %uw&ea CLEANING SERVICE Z)0&4va tke Z:)244c.. P.O. BOX 112688 PHONE345.2513 ANCHORAGE, ALASKA 99511-2688 F J A t J m Job Address DATE LES AN �C TERMS- ODAYS CUSTOMERORDERV ROTO -ROOTER SERVICE CALL HRS. @ STEAMTHAWING HRS. @ TRIPCHARGE HRS. @ ❑ JOB NOT GUARANTEr FOR FOLLOWING REASON. OVERTIMECHARGE HRS. @ � 9%Y �� ADDITIONAL LABOR CHARGE HRS. @ PUMPING SERVICE MGi7 (GAL.) HRS. / @ �O I HYDRO -JET SERVICE HRS. @ MATERIALS PLEASE PAY FROM THIS INVOICE TOTAL �d _ TOTAL FOOTAGE CLEANED OR THAWED. BLADES USED PROBABLE CAUSE OF STOP (r V'L. //6w.a'- o�- i-i1dELEAN@D ❑ JOB NOT GUARANTEr FOR FOLLOWING REASON. WORK ACCEPTED BY � 9%Y �� ��� i� n L L COMMERCIAL TESTING & ENGINEERING CO. ENVIRONMENTAL LABORATORY SERVICES °Q REPORT of ANALYSIS 5633 B STREET ,emlab Ref.# :93.3550-1 ANCHORAGE, AK 99518 Client Sample ID :12500 FURROW CREEK RD. TEL: (907) 562.2343 Matrix :WATER FAX: (907) 561-5301 Client Name :ENVIRONMENTAL MGMT INC (EMI) Ordered By Project Name Project# PWSID :UA Parameter Nitrate -N WORK Order :68590 Report Completed :07/26/93 Collected :07/21/93 @ 14:30 hrs. Received :07/21/93 @ 16:25 hrs. Technical Director:S C. EDE Released By :!� " : ROUTINE SAMPLE COLLECTED BY: D. NEOGI. QC Results Qual Units ------------------ 6.02 mg/L Method Allowable Ext. Anal Limits Date Date ---------------------- EPA 353.2/300.0 10 07/23 * See Special Instructions Above UA = Unavailable ** See Sample Remarks Above NA = Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT = Less Than D = Secondary dilution. GT = Greater Than 0 SEMS Member of the SGS Group (Societe Gdndrale cle Surveillance) Init LLH 5. LEGAL DEIPTION SpR - DATE RECEIVED 3 Me 8tk/y INSPECTION APPOINTMENTS TIME lL TIME U TIME DATE ❑ One ❑ Four ❑ Other -DATE DATE ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY INSPECTOR * ATTACH WELL LOG. A well log is required for all wells drilled INSPECTOR INSPECTOR ❑ PUBLIC UTILITY IMINK,IPALITY OF ANCHORAGE 8. SEWAGE DISPOSAL SYSTEM MUNICIPALITY OF ANCHORAGE DEPT. OF ;:-;<,i_T;I & OF HEALTH & ENVIRONMENTAL PROTEC%RQN!NEi-,t);-,- 01 INDIVIDUAL/ON-SITE** DEPARTMENT ;-,-XTION 825 L Street - Anchorage, Alaska 99501 • MAR 2 6 19130 NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 R E C EKY FA 1- REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten 110) days for processing. 1. PROPER.TYOWNER PHONE � � _ C06�. MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE ` 9`tm215 8V &'K 2 3 MAILING ADDRESS a 5-a. s S7- M s/Z A 3 .� baso P;), 3. LENDING INSTIZUZION % "V �} L _ 36-t" L' ��?� PHONE MAILING ADDRESS �—6 r o)-61 / - -367~fP r /JPN/U P_ 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DEIPTION SpR - b -t 3 Me 8tk/y STREET LOCATION V rr lL 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS �1 SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five_ ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY IM INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM 01 INDIVIDUAL/ON-SITE** iet`_CYEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-070 (Rev. 6/79)^ IlNlnv(trJ' 6, 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY l 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED �t INSTALLER ❑Septic Tank or ❑ Holding Tank Size: I S If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER _ ea 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 0 "APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE (o -oo BYa c - 72-010 (Rev. 6/79) Carl Cross SRA Box 1561R Anchorage, Alaska Re: Adequacy Test on Existing Sanitary Sewer System; Lot 3, Block 3, McMahon Subdivision, Anchorage, Alaska Dear Mr. Cross: Per your request of April 3, 1980, we conducted a test of the sanitary sewer system on the above described property. During this test the liquid level in the septic tank was monitored as water was added to the system. The measurements are summarized in the following table: Liquid Level Below Top Total Gallons 4' Carl Cross SRA Box 1561R Anchorage, Alaska Re: Adequacy Test on Existing Sanitary Sewer System; Lot 3, Block 3, McMahon Subdivision, Anchorage, Alaska Dear Mr. Cross: Per your request of April 3, 1980, we conducted a test of the sanitary sewer system on the above described property. During this test the liquid level in the septic tank was monitored as water was added to the system. The measurements are summarized in the following table: The meter used during the test was a Rockwell 5/8" standard water meter which had previously been calibrated by R&M Consultants, Inc. ANCHORAGE FAIRBANKS JUNEAU VALDEZ WASILLA Liquid Level Below Top Total Gallons Time of Standpipe Added 9:45 6.15' 0 9:50 6.08' 30 9:59 6.04' 70 10:09 6.05' 120 10:18 6.05' 170 10:27 6.07' 0 10:37 6.08' 0 The meter used during the test was a Rockwell 5/8" standard water meter which had previously been calibrated by R&M Consultants, Inc. ANCHORAGE FAIRBANKS JUNEAU VALDEZ WASILLA April 8, 1980 h. 1 Carl Cross Page -2- If the 3 bedroom residence on the property is to house 6 people, the average load on the system can be expected to be 450 gallons per day or .31 gallons per minute. During the test, the system accepted 170 gallons in 52 minutes. This indicates an average effluent acceptance rate of approximately 3.3 gallons per minute at the time of the test. Because the house on the lot is occupied, we assume that the leach field was at its normal degree of saturation. We can therefore conclude that the system is disposing of effluent at an adequate rate for a 6 bedroom resi- dence. We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this test or if we can be of additional service. Very truly yours, R&M CONSULTANTS, INC. Ernest R. Rahaim Staff Geologist ERR/JC/dj/AT&SI-L L Janice Cecere Project Manager Carl Cross SRA Box 1561R Anchorage, Alaska Re: Adequacy Test on Existing Sanitary Sewer System; Lot 3, Block 3, McMahon Subdivision, Anchorage, Alaska. For Services Rendered through April 8, 1980. Dear Mr. Cross: The following is our invoice for professional services rendered on the above referenced project. Invoice No. 051001-15 Professional Services Fixed Fee $175.00 Total Invoice No. 15 $175.00 Please note our invoice number on your remittance. Should you have any questions concerning this invoice, please contact me or the Project Manager, Ms. Janice Cecere. Thank you, R&M CONSULTANTS, INC. XV_'00��'Z'4-L -.72� C. J. Parisena Anchorage Office Manager CJP/djj/I1-S ANCHORAGE FAIRBANKS JUNEAU VALDEZ WASILLA �o,rcxo2" TER ANCHORAGE AREA BOROUGH Pik vent of Environmental Quality Anchorage, Alaska 99503 274-4561 Date Received February 19, 1976 Time of Inspection VW IOJC Date of Inspection REQUEST FOR APPROVAL OF 2L - INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval requested by: National Bank of Alaska Mailing Address: Phone: 2. Property Owner: Charles F. Jackson Phone: 344-0461 Mailing Address: Box 1562N Star Route A 3. Legal Description: Lot 3 Block 3 Mc Mahon SA 4. Location: lsthLuQA_`on the right on Furrow Creek Road 5. Type of facility to be inspected Single FAmily' No. of bedrooms 6. Well Data: �. A. Type Individual B. Depth 89 C. Construction D. Bacterial Analysis - F u 7. Sewage Disposal System: on-site system. f)O. t9..cA v Q 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 1 of two pages Page 2 of two pages - Rec r ,t for Approval of Individual S !r & Water Facilities IJ.'Legal Description X Lot 3 Block 3 McMahon Subdivision Comments Approved / Disapproved Date .f Z."! Approval,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality 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) 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: CMRO VAf FHA CONV 2. Property Owner: 4,LL.y 4�L / Mailing Address: f ,.x Day Phone z 3. Name of Buyer: le % y -S'-S Mailing Address: Day Phone 4. Name of Lending Institution: Mailing Address: Phone i i 7�/a/ 5. Name of Realtor or Agent: �/"/ Mailing Address: Phone 6. Legal Description: _ a--3 Location: ['APe�J� OSf<^ 7. Type of Facility to be inspected: S;/1" No. Bdrms. S. Water Supply Type of Supply: Public Utility Individual Id If Individual, number of dwellings presently served If Individual, depth of well t�%l 9. Sewage Disposal System Type of System: Public Utility Individual (on-site)_ If Individual, date of installation EQ -037 (1/74)