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Home My WebLink AboutMCMAHON #1 BLK 3 LT 7AMcMahon Block Lot 7A #017-042-56 Municipality of Anchorage Development .u~ld~ngServiCeSsafety av~nDepartment On-Site Water and Wastewater Program. 4700 $. Bragaw St. P.O. I~x196650 Anchorage, AK 99519-6650 Page I of.~ www.cLanchomge.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION ~PORT Permit Number: ,SW060002 PID Number: 017-042-56 Paul & Bevedy Lembke Wastewater System: [] New [] Upgrade 12700 Killey Street ABSORPTION FIELD LEGAL DESCRIPTION ~'~ 5.5 1.0 F~. ~ 3'65 F~ ASTM D3034 1 F810 ~ A+ HOME SERVICES FEB g. 2006 SEPARATION DISTANCES E] septic [] Holding [] S.T.E.P. [] Other. Fmm~ Septic Abso~ptio~ I. Iff Holding 'utl~./Pf~ate Tank Field 8ration Tank Se~,~ Une ANCHORAGE TANK 2000 c,~ STEEL 2 ,~'~.w.. 100'+ 100'+ N/A N/A ~ / LIFT STATION Old tank decommissioned in place. Unable to BENCH MARK ! add absorption area to 1978 trench, because [=~'~'~,'~' Top of deck between 3rd & 4th post trench was not in documented location. 1978 from North. trench suitable for 4 bedrooms. Verbal approval .... by Jeff Poet on 6/26/06. Development Services Department Approval ' ~,u,~,~,., Clddy W. Ellis ../.~ ReviewedandAppr°vedb': ~ ~ Date:' ,~ /q'.'~'-' "~ '~ X~~, / .~ / . AS-BUILT Record Dra~ng of~p~c Upgrade Watkins Engineering, Inc Parcel ID Nm 017~42-5e June 27,2~6 Anchorag~ Alaska 99511~443 ~le 1 In~ - 40 ff ~on~ (907) 349-1851, Fa~ (907) 349-1934 ......... A B STI 30.6 87.3 s'r2 44.9 93.8 DCO 47.6 94.1 DV 48.7 93.7 MTI 56.4 95.1 COl 55.8 93.8 MT2 97.4 105.7 CO2 97.2 106.1 CO3 36.7 82.3 FCO STI 97.3.1 / 91.01 Insulation 2000 GALLON STEEL SEPTIC TANK N.T.$. ST2 Divcrter Valve DCO / To Old Drainfield C03 NOTE: REMTIVE DEPTH OF TESTHOLE= 76.28 NO MATER r 82.73 J ~,ITI COl FINIL GR,~DE = 96.07-97.31 FILTER FABRIC 4"0 PIPE SE~'ER ROCK 45.0 TRENCII N.T.S. 91.05 90.70 ~,IT2 C02 -I NOTE: ORICINIL GRADE = 95.63-96.28 AS-BUILT McMahon #1 BIk 3 Lot 7A Record Drawing of SepUc Upgrade ~ OE A~. Beverly & Paul Lembke '~'- TH Parcel ID: 017~42-56 Watkins Engineering, Inc Permit Numbe~ ~060002 ', ........ " ................. :'"'~ Cindy W. Ellis, P.E P.O. Box 110443 0~.".... ...",~ Febua~ 20, 2006 Anchorao~ Alas~ 99511&443 No ~ale Phone {907) 349-1851, Fa~ {907) 349-1934 MUNICIPALITY OF ANCHORAGE Development Services Depar~menl On-Site Water & Wastewater Program 4700 South Brogaw Street P.O. Box lg6650. Anchorage, AK 99519-6650 (907) 343-7g04 ON-SITE WASTEVVATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jan 05, 2006 Expiration Date: Jan 05, 2007 Permit Number: SW060002 Legal Description: MCMAHON #1 BLK 3 LT 7A Design Engineer: 0844 WATKINS ENGINEERING Owner Name: PAUL & BEVERLY LEMBKE Owner Address: 12700 KILLEY ST ANCHORAGE, AK 99516-2862 Parcel ID: 017-042-56 Site Address: 012700 KILLEY ST Lot Size: 46159 SQ. FT. Total Bedrooms: 5 Permit Bedrooms: 5 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail construction must be in accordance with: 1. The attached approved design. 2. Ail 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By:, Issued By:. O~ / Date: Date: //'F/~, Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P,O. Box 196650 Anchorage, Alaska 99519-6650 www.munl.org/onsite (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-042-56 Property owner(s) Paul & Bevedey Lembke Mailing address 12700 Kille~, St., Anchorage, AK Site address 12700 Kille~, St. Legal description (Sub'd., Block & Lot) McMahon #1~ BIk 3~ Lot 7A Legal description (Township, Ra~a.~Section) Lot Size 46,159 /' S(=. Ft. ~/ Number of Bedrooms 5 Day phone ~ £1{~' I~1 Zip Code 99516 Zip Code 99516 THIS APPLICATION IS FOR ([] all that apply): Absorption Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage [] THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of pmp~/t7 owner or authorized agent) Permit/Rush Fees:<:~H 1~O .c::)o Date of Payment: Re~iptNumbe~ ~1~ . (Rev. 11~5) Waiver Fees: Date of Payment: Recetpt Number:. Watkins Engineering, Inc. P.O Box 110443, Anchorage, AK 99511 (907)349-1851 cwellis@gci.net December 29, 2005 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: McMahon #1, BIk 3, Lot 7A Proposed Septic System Upgrade To Whom It May Concern: Attached please find the application and supporting documentation to upgrade the septic system for the referenced 5 bedroom house. The original septic system was installed in 1978, and the drainfield is now surcharged. A portion of the trench encroaches upon the protective well radius; a waiver was granted in 1989. The original septic system was designed for 4 bedrooms, and it is proposed to add a section of trench to upgrade it to 5 bedrooms. The existing septic tank will be abandoned in place. The proposed design is based upon a test hole dug on December 15, 2005. The hole was dug to 20 ft with no water encountered. After a 7 day monitoring period, no water was detected. The proposed drainfield will be installed in a sand layer between 5.5 ft and 14 ft. A pemolation test between 6.5 ft and 7 ft resulted in a rate of 2.3 minutes per inch. An application rate of 1.2 gpd/ft~ is used in the design. The soil log is attached. Proposed Soil Absorption System: 5 Bedrooms x 150 GPD/BR = System Type: Application rate: 750 GPD / 1.2 gpd/ft~ = Maximum Depth: Effective Depth: Proposed Length: Absorption Area: 750 GPD Deep trench 1.2 gpd/· 625 ~ required 14.0 ft 8.5ft 40ft 680 fff Sewer Upgrade Permit Application for McMahon #I, BIk 3, Lot 7A Wa~klns Engineering, Inc.; December29, 2005; page 2 Details on the proposed I bedroom extension on the existing trench ara as follows: System Type: Application rate: I BR x 150 ~/BR= Effective Depth: Reduction Factor: Proposed Length: Absorption Area: Shallow trench 150 ~/BR 150 ~ required 1.5 ft 0.78 24 ft 153 · The trench will be in a Tee configuration connected to the existing trench near the north end. The lateral will be installed at the same elevation as that in the existing trench, with 1.5 ft effective depth. The new section of trench will be greater than 100 ft from the well. There are no surfaco waters or private wells within 100 ft of the proposed septic system. There are no slope cooncoms. A man-made pond is located 85 ft from the proposed trench, but it is lined and is not considered surfaco water. I am not aware of any adverse effect that this upgrade would have on any adjacent properties' water and wastewater traatment needs. Thank you for consideration of this permit application. If you have any questions or need further information, please call me at 349-1851. Yours truly, Cindy W. Ellis, P.E. President Wefts are greater than 200 It f~om the proposed septic system. 1A-1 Grace Christian Church Grace Addn #1 Lot 1A-1 1A-1 I I L 5 McMahon BIk3 Lot 6 J / Proposed Existing Septi~ \ Tank Existing Man-made Uned Pond Cu~ain dr'air ouffall · Well 2 Lot 3 Previously Mc Mahon #1 BIk 3 Lot 36 / / \3 Approx Well Location · McMahon BIk 2 Lot 21 21 20 FURROW / McMahon #1 B,k ~ Lot 9^ 10 9A McMahon #1 / 10' x 20' BIk 3 Lot 38 / 38 33 32 31 Mc Mahon ,fl, BIk 3, Lot 7A ~__._~' OF,~,:~%~.~ Paul~°~sed~ LembkeSeptic U~de- Site nan Watkins Engineering, Inc ~'"' ~=~"~0~ ~rcel IE 017~42-56 ,~.~" 49 ZU~ '?~ ~ , F...~.t*.v...:..:.:~: ...... :...~ I ~*': ............... :....~ Cindy W. Ellis, P.E P.O. Box 110443 ,~. : dND~ W. ELUS ~ ~ December 29, 2005 Anchorage, AK 99511~443 ~ . '...., CE - ~0~ ..'" ~'~ ~., ... ... ,.~ ~le 1' - 100' ~one: [907] 349-1851 Fa~ (907) 349-1934 ~. · .......... .~ ~k~:,.. ...... ~= \ ~~ ~ '~, ~ ~ 5 BR, 750 GPD ~o~ ~ ~ '~ //~ ~~s ~25 ~ ~/ /.~ / ~ Deep Trench ~ ~ ~ //~ / ~m,~.5Eeffective ~ '~ ./ .......... / 40EIong Pm~sed I BR t~nch e~en- / ~ ~. ~ ~ / ~ ~ // ~ % ~ ~ ~ well mdius to be staked 1~5~005 Trench ~~. .~ / ~ ~ / . Proposed Septic UpgradeWatkins Engineering, Inc Paul & Beverley Lembke ~2~?"[,~"~.' ~i~ '7"'~ S~le 1 inch = 30 ff Phone (907) 349-1851, Fa~ (9071 349-1934 - 0.25 - 1.3 - 2.0 - 5.0 5.5 14.0 - 15.5 - Municipality of Anchorage Developraent Services Department Building Safely Division On-Site Water end Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 (9O7) 343*79O4 Soils Log - Percolation Test Perfon,ned For. Paul Lembke Date Pedmmed: Dec 15, 2005 I.egal OescflpUon: Mc Mahon #1BIk 3 Lot 7A Township, Range. Section: Slope Site Plan 1. I.~ 4- 5- 8- 9- 10- 11- 12- 13- 14. 15- I~,,~ 19- COMMENTS WAS GROUND WA~ER ENCOUNTERED? NO 12/22/05 Reading Date Gross Time Net Time Depth lo Water Net Drop 1 12/15105 11:36-11:46 10 rain 6-1.5 4.5" 2 11:48-11:58 10 6-1.75 4.25' 3 11:59-12:09 10 6-1.75 4.25' 4 12:11-12:21 10 6-1.75 4.25' 5 12:22.12:32 10 6-1.75 4.25' 6 12:34.12:44 10 6-1.75 4.25' ? 12:46-12:56 10 6-1.75 4.25' TEST RUN BET~VEEN 6.5 FT ANO7.0 rt PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELII~S IN EFFECT ON THIS DATE. DATE: /~,'' ~ I ~"~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 N-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ,? NAME MAI LING ADDRESS LEGAL DESCRIPTION PHON~ [] UPGRADE Well · Absor[~tion areaf~> Dwelling DISTANCE TO: ] %,.00 Manufacturer j Material ~6~ Inside ,ength--~R~ Width Liq. capacity in gallons [ ,~ u~,,~,~ n~ Manufacturer ~ k ~ Material I Well Foundation Nearest lot line DISTANCE TO: [ ~OO ~ ' [ No. of hnes ] Length of each hne m,t Total length Top of tile to finish grade , ~ I~ Material beneath tile Length Width Depth Type of crib Crib di~e~er~ ~ Crib depth ] DISTANCE TO: Well ~ ~ ~ ~ ~ Building foundation Nearest lot line / ~lass ~ Depth Driller / Building foundation Sewer line Septic tank DISTANCE TO: / NO. OF BEDROOMS PERMIT NO. '-t ~o o,--/.o No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. ~ inches Distance between lines ~ \ ~ inches Total effective abso~_~i~ ~a PERMIT NO. Total effective absorption area Distance to lot line PERMIT NO. '~- ~) O (:~ Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING \~o INSTAILLER REMARKS DATE LEGAL PERMIT NO. APPLICANT HERZOG 2418 EAST 20TH LOCATION FURROW DEREEK ROAD LEGAL LTA B~ MCMAHAN LOT SIZE TYPE OF SOIL ABSORBTION ~_TEM IS: MAXIMUM NUMBER OF BEDROOMS = 4 NU~J I [: I ~ _qL I T'T" OF ~NCH~--RaGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 ~'L~ STREET~ 8NCHORA~E~ AK. 9~50i NONE ~7000 SQUARE FEET SOIL RATING (SO.. FT/BR>= ~_.TEM IS: THE REQUIRED SIZE OF THE SOIL ABSORPTION DEPTH= -~. 5 LE~gGTH= 94 GRR~/EL DEF'TH-----: :1.. THE LENGTH DIMENSION IS THE LENGTH <IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF e TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE G~......_T-I~..~0M OF THE~Xr~ZIRT.~ON (IN FEET). /-~I~E TRE~CH [11 C, TH I~-~ ,5. ~ FEET T . L DEPTH _ iH~OF O~EL ~ETM[EN THE 0UTF~LL PIPE 8ND THE BOTTOM OF THE EXCAVATION <IN FEET). t~.'EC:-'!U IRE[:, SEPT I C T~-~NK S ! ZE= 1250 C.~RLL,3NS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY 8ND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. TPJCI (2) I ~4SPECTIOr-IS RRE RE~i!IJ I REE~ BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION RND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL. AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL~ OR 150 TO ~00 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS 8ND CONSTRUCTION DIAGRAMS 8RE AVAILABLE TO INSURE PROPER INSTALLATION. F'ER£4 I T E>-~P I RES I CERTIFY THAT i: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. APPL I CANT HERZ_~ ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorago, Alaska 99502 276-2221 SOILS LOG- PERCOLATION TEST SOILS LOG PERCOLATION TEST 3 7 1 o I1 12 l 13 1.4 !6 17 18 SOMMENTS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? * ' 'Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN - FT AND (minutes/inch) -- FT :'ERFORMED BY: :2 008 (?~76) CERTIFIED BY:..~///C-~ DRILLED AT THE RATE OF PROPERTY OWNER //bt., LOCATION OF WELL SITE. SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 80 7e.¢_~, ~7~o O0 PER FOOT, g_~ ~L3oc3 2418 &o 20~ A~ /~o~q.~ _ WELL LOG: 0 .... 27' S~ ~ ~. 15~ ~, COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLb.'iION OF' SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF /$14.40o00 THANK YOU VERY MUCH. DATE BERNIE CLAUS OF RAMPART DRILLING WORKS SERVICE ChARGEOF 1'/.o~ P~ MO~TH ~L BE ASSES~D ON PAST DUE ACCOUNTS. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 EImore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. Ol '7 -O~ Z - ~-~' 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address COSA# ~,~ ~-J)(~. Expiration Date: Day phone Day phone Real Estate Agent' Mailing Address Day phone '7 9_7' - 3~ot9 Unless otherwise reqUested, COSA will be hold 2. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class ~ Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding Tank [] [] Community On-site [] [] 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 seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site 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 Fl~C'~-~p Address I ff~':~O ~__c¢~ Engineer's Printed Name "'T-~ ~',~ DSD SIGNATURE ~ Approved for Disapproved. Conditional approval for bedrooms. ~,~ :¢; .~ ¢~ ~,~ ~, .~ ~.. bedrooms, with the following stipul~'~e~[':::::'~:,~:~:; Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory .~. By: (Rev. 11/05) Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage 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 LegalDescription: ~,f ?,4', 0/o¢~-.~ /'-t',-h~,~,o ~'1 'ParcellD: A. WELL DATA Well type. P~{' Date completed Io/t~/?~ Sanitary seal (Y/N)~ Total depth ~ ft. Cased to .~2_~ft. IfA, B, or C provide PWSID #~ FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform ~ colonies/100 mL Nitrate ~,Z~.mg/L g.p.m. Arsenic: _~,..,5_- ug/L date of sample: B. SEPTIC/HOLDING TANK DATA Well Log (Y/N) Wires properly'protected (Y/N) Casing height (above ground) AT INSPECTION ft. S. 3 ~ g.p.m. in. Other bacteria 0 colonies/lO0 mL Collected by: ,~ l,~,f-~/'"/'*~'c~ ~c,'c Tank Type/Material _~?)('~c / ,~'~'~! Tank size ~OOO gal. Number of.Compartments ~ Foundation cleanout (Y/N). '/' Depression over tank (Y/N) Date of pumping II./l"/ /2.0/0' Pumper /ar~ ABSORPTION FIELD DATA Date installed ~/'~/~ ~ Soil rating (g.p.d./ft~ or ft~/bdrm) ~ Length qA'" ft. Width ,3' ft. Total depth I.,R,$" ft. Eft. absorption area'7~&" ft~ Monitoring tube Date of adequacy test ~ { 2.~/~01 ! Results (Pass/Fail) Fluid depth in absorption field before test 7~ in. Water addeclT~l gal. Elapsed Time: ~,5'" min. Final fluid depth~(,.~ in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) Date installed Cleanouts (Y/N) High water alarm System type Gravel below pipe ~, ~' ft. Depression over field For ~- bedrooms New depth ~$, ~in. If yes, give date I~J. ~, D. LIFT STATION j~. ~. Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at .~ in. "Pump off' level at ~ in. High water alarm level at in, Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: SePtic tank/lift station on lot Absorption field on lot Public sewer main J~. Sewer/septic service line Animal containment areas On adjacent lots On adjacent lots '~ 100' Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ~_ ¥ e Property line 1 ~ ' Absorption field ~ I~, ' Water main JU. ~.. water service line -,~ ~:;r'. Surface water ~> ~oO' 'Wells on adjacent lots "~ I~..,~, ~ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Water Service line Curtain drain COMMENTS Building foundation~ ~ '7 ' Water main Surface water ~, ~'~, ' Driveway, parking/vehicle storage Wells on adjacent lots G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name 'T'"~ ~'~, ~__-~o,~' ~.. /-'~,,~ ~ COSA Fee $ z./00 ~ Date of Payment ,~"~ {/~ / J J Receipt Number O~'~' J 0.... (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Nurn6er Municipality of Anchorage Community Development Department Development Services 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 # 111147 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 7A of McMahon subdivision. This inspection revealed a nitrate concentration of 8.22 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. SGS Ref.# 1111561001 Client Name Flattop Technical Srv. Printed Date/Time 05/03/2011 10:32 Project Name/# McMahon S/D #l Collected Date/Time 04/25/2011 14:00 Client Sample ID Lot 7A BLK 3 Received Date/Time 04/26/2011 15:30 Matrix Drinking Water Technical Director Ste0hen C. Ede PWSID 0 Sample Remarks: 4500NO3-F - Total Nitrate/Nitrite - MS recovery is outside of QC criteria. Refer to LCS for accuracy requirements. Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Hardness as CaCO3 290 5.00 mg/L SM20 2340B C 04/28/11 05/02/11 NRB Waters Department Total Nitrate/Nitrite-N 8.22 0.100 mg/L SM20 4500NO3-F B 04/28/11 AYC Microbiology Laboratory Colony Count 0 Fecal Coliform 0 Total Coliform 0 col/100mL SM20 9222B A (<200) 04/26/11 DLC col/100mL SM20 9222B A (<1) 04/26/11 DLC col/100mL SM20 9222B A (<l) 04/26/11 DLC Private Individual Analysis Alkalinity Aluminum Antimony Arsenic Barium Cadmium Calcium Chloride Chromium CO3 Alkalinity Conductivity Copper Fluoride HCO3 Alkalinity 249 ND ND ND 8.06 ND 81500 44.3 3.46 ND 715 15.7 ND 249 10.0 20.0 1.00 5.00 3.00 0.500 500 0.500 2.00 10.0 1.00 1.00 0.100 10.0 mg/L SM20 2320B D 04/26/11 ATJ ug/L EP200.8 C 04/28/11 05/02/11 NRB ug/L EP200.8 C (<6) 04/28/11 05/02/11 NRB ug/L EP200.8 C (<10) 04/28/11 05/02/11 NRB ug/L EP200.8 C (<2000) 04/28/11 05/02/I1 NRB ug/L EP200.8 C (<5) 04/28/11 05/02/11 NRB ug/L EP200.8 C 04/28/11 05/02/11 NRB mg/L EPA 300.0 D (<250) 04/26/11 04/27/11 LCE ug/L EP200.8 C (<100) 04/28/11 05/02/11 NRB mg/L SM20 2320B D 04/26/11 ATJ umhos/cm SM20 2510B D 04/26/11 ATJ ug/L EP200.8 C (<1300) 04/28/11 05/02/11 NRB mg/L EPA 300.0 D (<2) 04/26/11 04/27/11 LCE mg/L SM20 2320B D 04/26/11 ATJ Lot6 s 15.27' Lot 35 10' UTILITY DRAINAGE F_.ASE'MEI~ Lot 36 Lot 7A 46,159 $.f. / / I AS BUILT X SC. ALE I' ~ 50' ~tD SW 2855 Preleet No, 02-156 Long Reglsfered Land Surveyors (~07) s22-442~ k, nOkmg~y.oom / & Associates, inc. 84/25/2811 17:1'9 8686"78 APLU$ PAGE 81 '~cnl c !40~ A. vcnu¢ Anchorage, Alaska oo¢ 6 12700 Killt, y .~M..OUNT Gallons _.~_ Septic ~ Leach Area ___-- Hoidlng Ta~qk ','"'~"', "~ *,~,qFEA -- CALL ¢OR MORE INFORMATION NEEDS TO ~ ~,~,~E~ AGAIN IN 6 M-~NTH$ G_m3d Sh ,a!3e ~, SLudge buildup on bo~om '~-- missing or ~ Cut s~ndpipe to 1' a~ve ground n~ds mpl=c~ng r---~ Floater ~ top i_~' Needs Septictfine MuNiCIPALITY OE ANCHORAGE Department of Health & Human Services : DIVISION OF ENVIRONMENTAL SERVICES ~ 343-4744 - CERTIFICATE OF INSPECTION FOR HEALTH AuTHoRITY ,~,PPRovAL~ OF O~I-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING parcel I.D. # ¢'3\-~ - (~L.\ :E~ ~/--~(z~ . HAA # 1. GENERAL iNFORMATION (Must be completed prior to submittal) - . (a) Legal Description Location (address or directions) /~ 7o(/ [-r,I/~y include lot, block, subdivision, section, township, range) (b) Property owner Mailing Address Telephone: (home) ,'~/5--I~'~ Business (c) Lending Institution /V,,~, Telephone Mailing Address (d) Real Estate Company and Agent Address (e) Telephone ~'~/) - 7~/ ": ' ' Mail the HAA to the following address: (or check here I~, if hold for pick uP.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-Family ~ Number of bedrooms 3. WATER SUPPLY ndividual Well [] Community [] Pub ic [] "';.:~ Note:..?.~ommu~jty~ well system/mUst~have written ~onfirmat on_ from. the State Department .of Environmental.'- :~' C~'h§~i~/~tiO6-:ai~iih'~'tO.ih.'l~'~ii~, ~-~a~-t.~t~J,s!-~:~,~:~:¢"~;,),:.-:,~:~ -,::~,~-~.~;::,--;:,:'. ~ ..~.._,.::,:_:~?~,:..~ ....... :¥..,.. ..... ,._....,~:,..:~,. ....... .:~.... :. 4. ;~ ':"¢ ' -'; - ; · · ;: ,: ' .. (,. · .... ]., . .:,.-,-,.-,~-~,.};,-,' "' .._ 'Yg~',:,~ '" ' ' :' ':)? ? ' ;. On-site ~;~ ~.--, Public Q :~ ' Community B-:~¢F: Holding Tank ~ .'" U~t~-lf:~6~'~' t~.:~ '~y~tom;"m'ugt ~.~0' Writton'bonfir~.tion fro~ tho Stato Depa~mont of.~n~i[~n~??l '~:'.~ Consemat on attest ng to the ega ty and status -. --:- ~,.-,,',~- :,'~ ' . 72425 [Rev, 7/~) page- 1 of 2' ')lJo~ s,Jeeu!bue leUO!SSejoJd eq~, u( 8UO!SS!LUO .10 8JOJJD JOJ elq!suodseJ ~,ou s! el~BJoqouv jo ,9,llBd!o!unlAI eq.L 'penss! s! e~,8o!j!]Jeo e eJo,teq 8],~p eZ,~l~Ue Jo euoBo@dsu! ],onpuoo ~,ou op SHHQ jo se@~old LU=I 's],ueLueJ!nbeJ e~],s pub leJepe~ U!elJeO ,~s!~,ss m, JepJo u! suo!~,n~,Bsu! I~u!puel J!e~, pue SaLUOq JO sJes~qo~nd ol ,~se]Jnoo e se s!q~ seop SHHQ eq.L '~)~selV Jo e~el$ eq~ u! peJe]s!l~e~ Jeeu!bue I~UO!SS@joJd ~,uepued@pu! ue/,q e^oqe ~ qde~l~e~ed u! ue^!5 suop, e]ueseJdeJ eq~, uodn/~lUO peseq leAoJddv Xlpoq],n¥ qllgeH sense! (C3HHC]) SeO!AJGS UBLUnH pub qllgeH ~o ~,ueLu],Jedec] eBeJoqou¥ ~o X],!led!o!unl~ eH.L ! .~ c~'~~)~ MUNICIPALITY OF ANCHORAGE (MOA) .c~;~ . ~"]~,~ Health Authority Approval (HAA) ~'~'~'"'~__~t~ CHECKLIST- FEBRUARY 1984 ~q ~0~' d ~ 343-4744 '~' .... ,~ Legal Description: ~ 7~/ Well Classification ~'~ ~ Well Log Present (Y/N) ~ Date completed IO/~ / ~ Total Depth ~' Cased to ~' Depth of Grouting N,~. Static Water Level ~7' Pump Set At ~ ~) ' Casing Height Above Ground ~" Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Y Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot ~,~' ~ C.~. ; On Adjoining Lots ~ To Nearest Edge of Absorption Field on Lot ~' ~' ~ c' ~, ; On Adjoining Lots To Nearest Public Sewer Line N, ~. To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot ~ ~' Water Sample Collected by ~/~/~f ~ ~¢~ ; Date ~/8 ~ /)~ Water Sample Test Results (~c~;/- ~ ~(~r~ /¢0o~ Comments ~,v~ ~1(~;~ ~7' ~~ ~;~ B. SEPTIC/HOLDING TANK DATA i~tde ~tt c~ff] $.~ no I ~l No. of Compartments Date Installed ~/g~/7,~, Size Standpipes (Y/N) Y' Depression over Tank (Y/N) Air-tight CaPs (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) If A, B, C, D.E.C. Approved (Y/N) /V, 4-, Yield '~ ,j, Foundation Cleanout (Y/N) Date Last Pumped ,¢//b-/~o ; for N. Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well ¢',¢,.~-' .¢',-,,r,, c,¢. To Property Line ~ 30 ' To Water Main/Service Line :~ 8~' ' To Stream, Pond, Lake or Major Drainage Course ~ 4~,o ' Comments ~'¢./¢~,-~,~ ,~,.x,/c_~,oee ¢~-'¢,;~-~,'~ ~,~.~,~/-~_..~ ~/l,//~ To Building Foundation To Disposal Field 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORP'rlON FIELD DATA Soils Rating in Absorption Strata Date Installed ¢~? 29 / 7~ Width of Field S ' [2,er _ce?~c Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test t/~''¢t'~'~ Type of System Design Length of Field /,f Depth of Field ~',5- Gravel Bed Thickness Statndpipes Present (Y/N) Date of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well ¢), ~ ' .4G-o~ To Building Foundation I-~ ~ Lot N, To Water Main/Service Line ~. To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ~e~r'~on ~t.r /-~nce ~'~,~¢' ~,~n /-e,.~ To Property Line I~ ' To Existing or Abandoned System on ; On Adjoining Lots ~ ~'o ' To Cutback (if present) hh4, D. LIFT STATION /~,/)-. Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA gui.d~q~s. Jn effect on the date of this inspection. ~<~-~ ~' ~).~.~; .... ~ .... % ....... ~,.,~ Engineer's Seal Date ~/ MOA No. Receipt No. __ Date of Payrnent Amount: $ 72-026 (Rev. 7/88) Back , Receipt No. / / Waiver Fee: $ Date of Payment Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER [] PRIVATE WATER SYSTEM Name Phone No. Mailing Address City State Zip Code Mo. Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose .) [] Treated Water I~' Untreated Water SAMPLE NO. LOCATION I I/-7~/ ~.. ~ I 4 I 51 Time Collected Collected By I .~:co~',~ g"'f~ TO BE COMPLETED BY LABORATORY ,~/sis shows this Water SAMPLE to be: ~ Satisfactory' [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received Time Received Analytical Method: Membrane Filter * No. of colonies/100 mi. Lab Ref. No. Result* Analyst ~-~ I-Iq rTq READ INSTRUCTIONS BEFORE COLLECTING SAMPLE BACTERIOLOGICAL WATER ANALYSIS RECORD Membrane Filter:. Direct Count Verification: LTB BGB Final Membrane Filter Results Reported By ~- '~-'-' -~ ~Date Time: TNTC = Too Numberous To Count OB = Other Bacteria Collform/lOOml Collform/100ml PART ONE OF TWO REMAINDER TO FOLLOW aomo CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 Date Repozt ?~inted; ~'i 25 90 ~ I1:07 Client Nam : FLATTOP TECIIt~iC~,L SP, V Client Acct: FLA'£YOT P.O.~ l~O)~g [iECEIV.BD 0~ezed By : TED ~,i00gE Chef!ab Ref ~: 901480 Lab Slapi ID: i ~fatrix: WATER Allowable Pa[amete~ Tested lesult Units l,lethod Li~litS ~IT~T~'-~ 2.4 ~,i~/] gPA 353.2 J.0 Sai~ple I~OUTINZ SA~PL~. SA),iP~g COLLECTED BY T, }400gE, Tests ?ezlozmed See Special inst~uctions Above Ul~Unavai!~ble l~one Detected '~ See Sa~ple Remarks lboYe Not Analyzed LT~Less Than, GT,,Gzeatez Than MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING (~_'~\_~ --~'~L~ ~) _-~. HAA# ~:~ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property owner Mailing Address (c) Lending Institution Mailing Addres~ Telephone: (home) ;~¥.C- ¥8,¢Z Business Telephone (d) Real Estate Company and Agent Address ~'00 (~ r-¢¢_,¢ ca Telephone ~7~"- ~?¢/ (e) Mail the HAA to the following address: (or check here ~, if hold for pick up.) List contact person and day phone number below: 'T'e~ t-too,w_ :3' 'f~,-- /3'5'5" TYPE OF RESIDENCE Number of bedrooms Single-Family [] WATER SUPPLY Individual Well ~ 72-025 (Rev. 7/88) Page 1 of 2 Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. SEWAGE DISPOSAL On-site [] Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. ~ ,to ~ efied 'uo!3eedsu! s!q~ ¢o e~ep eq~ uo 3oejje u! suoRelneeJ pue 'seoueu!pJo 'sepoo e3elS pue led!o!un~l lie ql!~ eoUe!ldLuoo u! s! uJe3S/,s lesodsip Je~eMe3SeM Jo/pue/,Iddns Je~eM e~!s-uo eql 'uo!~oedsu! pue uo!3e§RseAu. XuJ uJoJj pue sel!J ee~Joqou¥ ~o /~l!led!o!unlAi eql uJoJj peu!e~qo uoReuJJoju! eq~ uo peseq ~eq~ Xjpe^ Jeqpnj I 'u!eJeq pe~eo!pu! eJmonJ~s jo ed/~l pue SLUOOJpeq JO JequJnu eq~ Joj e)~enbepe pue'leUO!3ounj 'eJes s! uJm, sXs lesods!p Je3e~e~seM Jo/pue Xlddns Je3eM e3!s-uo eq3 leLll S~OqS leAoJddv ~poq3n¥ LllleeH s!q~ Jo uoReeRse^u. XuJ 3eLl~,~j. Je^ I '~oleq u~oqs elep uoRePile^ eq~ jo se pue o~eJeq pex!jce IEeS ~LU Xq Pe!~!3Jeo sv NOIJ. VBIdO,-INI ON'¢ ~"J2ca 'HOH~iS ~'11.-I 'S£S3£ 'eNOI£OtdSNI 9NlOl^Ol=ld INldlJ 9NItJ:B;BNISN3 '9 A. WELL DATA ~ MUNICIPALITY OF ANCHORAGE (MOA) ~ ~'¥ry OF ANC~j~.~uthority Approval (HAA) ~NV~AL SERVtCE~IST- FEBRUARY 1984 343-4744 JUN 9 1989 Legal Description: /..o¢- X/J/ RECEIVED #, Well Classification Well Log Present (Y/N) Total Depth 8¢' Cased to Static Water Level 5' 7' Casing Height Above Ground Electrical Wiring in Conduit(Y/N) ~v' ~u'o~ ~-~ If A, B, C, D.E.C. Approved (Y/N) · ~ $..¢' ~p~ ~ Date Completed IO/I~/ 7~ Yield i~?~t~ ?,¢,' Depth of Grouting N,,~. Pump Set At ~o" Sanitary Seal on Casing (Y/N) P' Depression Around Wellhead (Y/N) Y SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot ~.,,4" ~ c.~. i On Adjoining Lots ~ too · To Nearest Edge of Absorption Field on Lot ~¢' ~ ~ ~ ~ C?. ; On Adjoining Lots To Nearest Public Sewer Line N, A To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot ~ 85" t Water Sample Collected by 'T; F', I"~o o ~-~' ; Date 5'lid'/~ Water Sample Test Results 5'~ff:~c~'~' - ~ ~_~b~r~. /toe~.(~ a. a Comments iz/,~'~ver'~' ~'~-~ ~ ,' B. SEPTIC/HOLDING TANK DATA Date Installed ~/~-~/7~ Size Standpipes (Y/N) Y Air-tight Caps (Y/N) Depression over Tank (Y/N) N Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well 8~'.$ ~-r-o,-, '¢.~,. To Property Line '~'.-.. 3~ To Water Main/Service Line To Stream. Pond, Lake or Major Drainage Course Comments C~'¢~,u¢~ /~e,~,~ ~,~- No. of Compartments F' Foundation Cleanout (Y/N) Date Last Pumped ,E'/IO""/~9 ~'.,v _~"~,~,c..,,' ; for H,,~-. Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 9/8) / ?~' Width of Field ,5" /~ar Type of System Design Length of Field Depth of Field Gravel Bed Thickness I,~ StaXndpipes Present (Y/N) Date of Last Adequacy Test Square Feet of Absortion Area ~'O~. Depression over Field (Y/N) N Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well )~, 8' .¢r,,r. ~¢' To Building Foundation 13' Lot __ To Water Main/Service Line '~ ~ To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments O~'a~er t~,~e~( e¢( :~ r To Property Line To Existing or Abandoned System on ; On Adjoining Lots ~ ..70 To Cutback (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MC)A Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidP_Ji~es in effect on the date of this inspection. Signed ~J'"~ ~ ~ ~ O~'~L~ ,, Date ~7~n¢ ~ I)~ ~ .................. Receipt No. ¢.~ *~// ¢/ Receipt No. Date of Payment ~ ~ ¢-~ ¢ Waiver Fee: $ Amount: $ ~;~. /F¢. ~_~ bate of Payment n-02e (R~v.,/~)e,o~ -~~~~" Page 2 of 2 l~OT ~ Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 L-oT ~c~ cl-z LOT 7A, Bl-Oc~ ~ Fl c IV t~ ~l o N _~1~ .~ [TE PAAN u,c , uec. & ,? ~1~ 4 , Block ~'~ I hereby certify that a survey of Lot Subdivision was made on I.)~C..~ -7 ~ and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent there[o. 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 hereon. )lgated at Anchorage. Alaska, this CONSTRUCTING ENGINEERS, INC. SRA Box 60, Anchorage, Alaska 99507 344-0817 day of Apy~ I 12407 12540 12601 ~4 1::3080 Ji // \, 5A \ 127O0 AVlON ~Z65° -dEROM[ HUFFMAN $~ 12800 ~545 5546 12901 /~ /? ~551 2~x550 13061 I /0 1:5101 Z 3700 3800 I'~0t DOROSHIN AVE 580O 38OO ~ CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. °~°~'~ .... °~ ANALYSIS REPORT BY SAMPLE for Work Order ~ 13355 Date ~epo~t Printed: ~Y 1~ ~9 ~ 08:30 Client Sample ID:LTA, B3 }~CMAHON PWSiD :UA Collected MAY 16 89 8 12:30 hrs. Received I,~Y 16 89 ~ i6:00 hrs. Preserved with :AS REQUIRED Client Name : FLATTOP TECHNICAL SRV Client Acer : FLATTOY P.O,~ NONE REC~D Roq ~ Ordered By : TED MOORE Analysis Completed :MAY 17 89 Send Reports to: Laboratory Supervieo~ :~TEPHEN C. EkE 1)FLATTOP TECHNICAL SRV ? Special Instruct: Chemlab Rei ~: 5311 Lab Smpl iD: 1 Matrix: WATER Allowable Parameter Tested Result/Units Method Limits NITRATE-N 2.2 mR/1 EPA 353.2 10 Sample ROUTINE SAMPLE. Remozke: SAMPLE COLLECTED BY ! Tests Performed * See Special Instructions Above UA-Unavaileble ND~ None Detected '* See Sample Remarks Above )~A= Not Analyzed LT-Lees Than, GT=Grsater Than CI-IEMICAL & GEOLOGICAL LABOtL4TORIES OF ALASK,4, INC. Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER [] PRIVATE WATER SYSTEM Name Phone No. Mailing Address City State Zip Code SAMPLE DATE: Mo. Day Year SAMPLE TYPE: I~ Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose .) [] Treated Water [~ Untreated Water SAMPLE NO. LOCATION 2 I 31 I 4 I I 5 I I Time Collected Collected By t 8:30 ~.~ '7-Fret TO BE COMPLETED BY LABORATORY Date Received Time Received Analytical Method: saSiS shows this Water SAMPLE to be: tisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Membrane Filter * No. of colonies/100 mi. Lab Ref. No. Result* CFi FTq FTq FYI Analyst READ INSTRUCTIONS BACTERIOLOGICAL WATER ANALYSIS RECORD Membrane Filter: Direct Count ~) Oolifor~ 1~00 mi BEFORE COLLECTING SAIVIFLE Verification: LTB BGB Final Membrane Filter Results. ~ Time: Coliform/100 mi ,/~:<D C> a.m. TNTC = Too Numberous To Count OB = Other Bacteria P~r ! OF 2 FLEtC&It',~DER 'TO FOLLOW Tom Fink Mayor Ntunic pality of Anchorage. Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 June 14, 1989 Ted Moore, P.E. Flattop Technical Engineering Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for Lot 7A Block 3 Mc Mahon Subdivision #1 Waiver Request' ~WR890024, HA890209, PID ~017-042-56' Dear Mr. Moore: Your request for waiver of the required 100 foot separation of a septic system to a private well has been approved. The approved separation distance is 87 feet; This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services DJR/ljw96 THEODORE F. MOORE, P.E. PH: (907) 345-1355 C~ & EN~ON~NT~ ENG~EE~G * ENERGY CONSERVA~ON & ~YS~ 14530 ECHO ST. ~CHO~GE, ~KA 99516 June 8, 1989 M.O.A. Dep't. of Health and Human Services P.O. Box 6-650 Anchorage, AK 99519 Dear Sirs: MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION JUN 9 ~989 RECEIVED By means of this letter we are requesting waivers of the required 100 foot separation between a private well and the septic tank down to 87 feet, and the soil absorption drainfield down to 95 feet on Lot 7A, Block 3, McMahon S/D #1, located at 12700 Killey Street. A site plan, a copy of a recent property as-built survey, and other relevant supporting materials are enclosed to assist you in your review of this waiver, as well as the checklist for your subsequent Health Authority App. According to the driller's log, the well was completed in October, 1978 and has a total depth of 80 feet and a yield of 10 gpm. On May 16, 1989 the static water level in the well stood at 57 feet below the top of the casing. To measure the yield of the well I pumped 578 gallons of water from the well at 3.5 gpm. During this period the water level in the well fluctuated between 57 and 59 feet below the top of the casing as the pump cycled on and off, but never drew down any further. Based on this test, I concluded that the total yield of the well is significantly in excess of 3.5 gpm, which is more than adequate for any single family residence. Water samples taken that day were satisfactory, showing 0 coliform colonies per 100 mi., and 2.2 mg/1 of nitrate-N. The soil absorption system was installed in September 1978 and, according to the as-built report, consists of a 1250 gallon, two-compartment septic tank followed by 94 lineal feet of 5 foot wide soil absorption drainfield containing 1.5 feet of sewer gravel beneath the perforated distribution pipe, for a total depth of 6.5 feet. To test the system's adequacy, on May 16 I added 578 gallons of water at 3.5 gpm through the ¢leanout near the beginning of the drairdield while monitoring fluid levels in the sump before, during, and after. This amount of water caused the fluid depth in the sump to rise from 17.5 inches to over 30 inches, and over the ensuing 2.5 hours the Huid depth receded at a rate indicative that the soil absorption system is still adequate for a four bedroom residence. The XO.~raDhy of the lot is rather leve...__~ll with a slight slot~e towards the _west~, which combined with the fact that the house is between the well and the septic system, means that there is no possibility that surfacing effluent from a failing septic system would make its way to the vicinity of the well casing. The following is my analysis of the appropriate waiver point allocation using the DEC's Separation Distance Guidelines. Distance to water table 55'-6.5' = 48.5 feet Soil sorption (37'x4.5 +11 'x6)/48' Permeability (37'x2 +11'x3)/48 Water table gradient (parallel to flat surface) Horizontal separation (87' to tank, 95' to drainfield) 5.19 pts 4.84 2.23 2.9 2.48 2.80 Total (Septic tank, Drainfield) 17.64 17.96 It is my professional opinion that the requested waiver can be granted without concern as to contamination of the well from the septic system on this lot. Please give me a call if you have any questions on this analysis. cc: Sidsel Bergmann, ReMax Properties Ron and Marsha Green Sincerely, Ted Moore, P.E. ~ MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. O? F2,'\LTH & 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENVIRONMENTAL ENGINEERING DIVISION JUN 8197'9 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWA E~Ei~/~ D DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE MAILING~:~?~"~'~e~D-D'R~SS ,~ / PROPERTY R~=SIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3, 'LENDING INSTITUTION . I PHONE I MAILING ADDRESS 4. REALTOR/AGENT I PHONE I MAI LING ADDRESS 5. LEGAL DESCRIPTION ;TR EET LOCATION 6. TYPE OF RESIDENCE [~"~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] One ~]'"-' "Four [] Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL~ [] COMMUNITY [] 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 available.) 8. SEWAGE DISPOSAL SYSTEM . 10~ ~] INDIVI DUAL/ON-SITE** *~lf individual/on-site, give installation date , If system is over two (2) years old an adequacy test is required [] PUBLIC UTI LITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [~] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2, WATER SUPPLY PERMIT NUMBER [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED Fq PUBLIC UTILITY Connection Verified INSTALLER [] Sept~ Tank or [] HoJding Tank '~'~ ~---c-% ' ~-'~ Size: ~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL / 4. DIST,~JCES Septic/Holding Tank Absorption Area Sewer Line (J I Nearest Lot Line WELL TO: Absorptior~'Area to nearest Lot Line 5. [~'~APP RO V E D FOR ~ BEDROOMS CONDITIONAL APPROVAL (letter must accom,~y certificate) LEGAL DESCRIPTION 72-010 (Rev. 3/78) C=~ ~.~EOLO(~I~I,L LABORATORIF-~ OF ALASKA, INC. P.O. BOX 4-1276 ANCHORAGE, ALASKA 99509 4649 BUSINESS PARK BLVD. Drinking Water Anal~/sis Report for Total Coliform Bacteria TELEPHONE (9O7) 279.4014 TO BE COMPLETED BY WATER SUPPLIER Mailing A~ddrasa ~ City State sAMPLE DATE: Mo. Day Year Zip Code SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose [] Treated Water [] Untreated Water SAMPLE NO. 2 3 :4 5 LOCATION Time Collected Collected TO BE COMPLETED BY LABORATORY LABORATORY: NAME ~:. ADDRESS CITY Date Received ~ - ~---~'~ Time Received /,~/~-~ Analytical Method: [] Fermentation Tube [~Membrane Filter Lab Ref. No. L Result* Analyst READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Form No. 18-310 (3-78) 06-1220 (b) Rev. 1978 BACTER IOLOG ICAL WATER ANALYSIS RECORD Date Collecte~ Source 24 Hours 48 Hours confirmatory 24 Hours EMB /Broth 24 hours: Multiple Tube Report: Membrane Filter: Direct Count Verlficat Ion: LTB Broth 48 hours.. 10mi Tubes Positive/Total 10mi Portions