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HomeMy WebLinkAboutLITTLE BEAR BLK 2 LT 1 F'ERHIT NO. ,' ,'e,:-%~ ) RF'PL Z C:RNT LJDCRT I ON LEGRL EE:, F..' I NNE F.'. BRB'¢ BERF.: F'LACE L:L B2 LITTLE BERF..' '-'.~.IE'D., · =:3>]_0 .,,IELL:,LE,r COUF.:T LOT E:471¢3 SQUFIF:E I:::'EE'T MINIMUM DI2;TRNCE BETWEEN R NELL RND RN'T' ON-SITE SEWRGE [:,ISPOSRL 5?S"f'EM 100 FEET FOR R PRIMRTE HELL OR 200 FEET FOR R PUBLIC HELL. HELL LOGS RRE R:E~;~LIIRE[:, RND MUST BE RETURNEr;, TO THE [:,EPRRTMENT HtTHIN ]~E~ DR'CS OF THE I,IEL. I... COMPLETION. -,,,' ...... :,FEC. IF IuHTIUN:, RN[:, CONSTRUCTION DZRGFtR[,1S R~:E H FHIL. HBLE TO ]:f.~;I..l{4:E F~OF'EF~ I NSTALLAT I ON. I CER:TIF'¢ THRT t: I RH F'RHILIRR WITH THE REQLIIREHENTS FOF.: ON-SITE =,EMER_-, FINE:, 1.4EL. LS FI5 ~;ET FORTH B'¢ THE f,IUNZCIPRLITY OF FiNE:HORRGE. . ,-, ,~ ' 1 . I I.,.IILL INSTRLL THE =,T=TEt, ZN RCCORDRNCE P~ITH THE ~:I-IE:'E~ S Z GNED, ................................... HFFLI...HNf ED F:INNER -,--. - [:,EPf:IF;.~"f'MENT: -": F-IE:I::iLTH !::1t'-,I[:, Ei'.,I',,,' I F.'.Oi'.,IHEN'f'FII. "- "'~'.OTEC"I" I ON - 25:]..E~ E. (t...t[:,OR Fi:iA., t::ff.,IC:HORFIIi~E., FIK. P'?'6--222::L 114 iEC: L. L_ IF" EE ( 'F:'E,.'~::L5 ::, t:::,Fa"t"E OF I'S:E;UE 6E"lFT'6 F:fF:i::'L. I CFiI'-,IT i....OC:Ft'1' I ON L..EE~RI..., Eli:, R :[ NNER t_...l E~:;:.' LITTLE 8EIql:;;: SLIE~E:, 8!!::1..~) HEL.LSLE"r' COURT L. 0"1" :E; :[ :;.:.':E 3 4 4 .-. 4 :L 1'_']: :I.. 840E~ SQI_.II::IF..:E FEET I"I:[NiMJH I)t'..E';'I"I::~NCE BIE'I"HE:EN FI I.,.tEL. L RN[:, F"fl"4"r' IiIN-SITE SEI.,.IFIGE [:,t:F.;F'O'i:.';FIL :,T:,tEII ::l..E~(ilt FEE'f' FOR FI F'F.:]:',,,'FITE t4EL..L OR 2EIE~ FEET FIiIR FI I::'IjE~I_:[C kIEL[ .... I.'.IEL. L. LEIG'.5 RF.:E REI:.:.!IJIREI} FIN[:' ML ~-I" E;E RE"t"LtRI"~E[:' T")'THE DEPFIR]"ME.'NT t.4I]'HII",I i:.':l;f.I OF THE HELL IX::OHPt...ETION. SPEC :t1F :]: CR'T' ]: OHS Ri'qB' CI]NSTla:I..ICT I ON B" I RGF4:Ri'"IS FIRE FI',,,'FI ]1LFIE&.E TIll I t",I"SURE F'F. tOF'ER ]: t",IS"f'F~I...L FtT I ON. ]1 CEt:~:]'I F".¢ TI.-IRT :L.: I Ftt"I i::'RP'!ILZF:IR t4I]"H 'T'HE REQUIREHENTS FOR ON-SITE SEI.,.tERS F:II'.41X:, HEI..I...:E; RS :SE']" F:EiRTH 8'~" ]"HE i-'IUNIE::[PFILIT"r' OF F1NCHORRGE. 2: :[ HILL :t:NS]"FILL THE S'¢:.:.'.:,TE:M :iN RCE:CffRI}FIi",ICE HITH THE CO[:'Eg.;. 5 :[ GNE[:,: FIF'PL t C:FtH T El} R I NNEI::..'. Z :5!:.; Ul~i:[) E', "r' .......................................................................................... Dla]"E ]11'.JSF:'E:iE:T 1[ ON H 1[ 9;TOR'?' .... 9';EHEF.: ± 8 ;:.,Eii[,.IE:_'I;~: 2 HIELL.. ]1 i'.,ISP ¢3 iqEL.I..~ L...OC-i bn"rE e DF.'. ! I...LEFi: -- . .UNICIPALITY OF ANCHORAGE ; ~. Department of Health and Environmental Protect~o:h ':. ' ' i~fO~\ 825 L Street~ Anchorage, Alaska 9,9501~'.' ~.~'. '-''~' ,~T~;] 279-2511, ext. 224, 225 '"~ " '*~'- .uest for Approval of Individual Sewer and Water CFaeiL-~ties 1. Property Owner: . &~/~// ' . Mailing Ad¢tress: ~~7. Phone: _ 2. Name of Buyer: .:3. Mailing Address: Phone: Mailing Address: Phone 6. Single Family Residence: (~) Number of Bedrooms: Multiple Family Residence: ( ) Number 6f 'Bedrooms: Water Supply: *Imdividual Well (~) Public/Community System ( ) If Individual Well, well depth ~ If Community System, name of system Sewage Disposal System: On-site System If On-site System, date of installation: ( ) Public System *NOTE: A well log is required on ALL wells drilled since 6/75. 3/77 ParcelI.D.# O1~/- O ro l - -5 ~ 1. GENERAL INFORMATION Complete legal description MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Lot 1; Block 2; Little Bear Subdivision MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISIOI~ MAR 2..5 7998 Location- (site address or directions) P, r0perty Owner '- K'en Foley Mailing address 6740 Baby Bear Drive k£en. dlng agency -: ', M~iling address.' ~ ' Agent .... - 6740.Baby Bear Drive Anchorage, AK Day phone 522-5500 Anchorage, AK 99507 Day phone Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS:- 3 TYPE OF WATER SUPPLY: Individual Well Community well Public water NOTE: NOTE: If community well system, provide writterr confirmation from'State ADEC attest lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank ' Community on-site . - Public sewer ××× If community wastewater system, provide written confirmation from State attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 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 · : ' an~l/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Engineer's signature S & $ ENGINEERING 17034 Ea0ie R~ver Loop Road No. 204 EaclJe Rjr, er, Ala~.Jra~99~77,, Phone Date DHHS SIGNATURE X Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments :;The "' :~: '~:' ' Municipality of An'chorage Department of Health and Human Services (DHHS) iSSues Health Authority Approval Ce'rtificates based only upon the representations given in paragraph 5 above by an independent professional engiqe6~'~egistered 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 (Rev. 1/91) Back MOAIY21 MUNiCIPALiTY OF ANCHORAGE · Municipality of Anchorage ...... /~&~ DEPARTMENT OF HEALTH & HUMAN SERVICES ~v~A~ ~ o ]99~ Environmental Se~ices Division · ~~1 !1 ~) 825 L Street, Room 502 Anchorage, Alaska 99501 (907) 3~4~,=~ ~ Health Authority Approval Checklist LegalDescription: ~o7- / &/.~ ~ z.~-~-7~4 8~.;-¢ 5/O ParcelI.D.: ~ / 5/-0 C/ - ';7 ~' A. WELL DATA Well type ~° /~ ' v /+ 7- ~ Log present (~N) ¥~}~ / Total depth 5'~ ~/ Sanitary seal (~N) Date of test Static water level If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~//3. ~//'7 ? Cased to z./o -/- Well production FROM WELL LOG I0 WATER SAMPLE RESULTS: Coliform CO Nitrate Date of sample: ~, / ~. -¢ / ~ Y B. SEPTIC/HOLDING TANK DATA ~e~, .,v-tV Tank size Casing height (above ground) Wires properly protected (~N) Collected by: alarm (Y/N) AT INSPECTION O . / Other bacteria 6 5 & ~ ENGINEERING Ea~le River, Alaska Number of Compa~ments Date installed Foundation cleanout (Y/N) Date of P~'~"' C. ABSORPTION FIELD DATA Date installed Length Width Effective absorption area Gravel thickness bel~..-~'"-~ta~'depth Monitor/N) Depression over field (Y/N) __ ~Re~ults (Pass/Fail) Pumper Soil rating (g.p.d./ft2 or ft~/bdrm) System type For Immediately after gal. water added (in.): Absorption rate = g.p.d. If yes, give date Date of adequacy test Fluid depth in abso~(in.); Fluid depth ~ (ins) Minutes later: P.~~ment (past 12 months) (Y/N) bedrooms 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) ~ "~ High water alarm level at* .,-.~-~ *Datum "Pump off" level at* E, SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots ~ / 4 On adjacent lots ~/4 Public sewer manhole/cleanout Lift station /¢ ///¢ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation Property line Absorption field Water main/service line Surface water/drainage Well~t lots SEPARATION DISTANCE FROM ABSORPTI~TO: Property line Bu~_iJdirr~oundation Water main/service line Surface water ~ Cu n~tal-h~rai/~n Driveway, parking/vehicle storage area Wells on adjacent lots ..- .: ENGINEER'S CERTIFICATION I certify that l have determined thru field inspections and review of Municipal recocc~l'~C,~'lh'~ a~)t .5 ~s are ui¢~li~ in conformance with MOA HAA g es in effect on this date. ~ ~ / ~:~ ~ ,~ Signature '"~~ Engineer's Name ~0J~,¢~~ ~, ~Ow~,~ --; ' ' Date ~ /~ 5' -. HAA Fee $ '~ © O - ~ O Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* MUNICIPALITY OF AtVCHOF~AGE ENVIRONMENTAL SERVICES DIVISiO~ MAR 2 ~ 1998 CT&E Environmental Services Inc. ~EC~I~/..~ Laboratory Division ~~~~~a )rinking Water Analysis Report for Total Coliform Bacteria t~o w. Po.., o,;,, An~hotaga, AK 9951 tE.4D INSTRUCTIONS ON REFERSE SIDE BEFORE COLLECT/tV(; $,4MP££ 'fei: (9071 56Z-2343 -- MU~T BE CO,~iPLET~b BY WATI~R SUPPLIER' PUBLIC WATER SYSTEM LO. # PRIVATE WATER SYSTEM Xtnd R~ult~ ~ $~ntl ln~tt, S,nd .~.~tt= 0 ' Send/.voit. Day' SAMPLETYPE: Repent Sample (for ma0ae ~mpl~ with I~b ~f, an. , ' ) ' SA~Lg LOCATION, ~ Uutmfnd Writer Time Collected Coll~,tmb ~ex: (90'2) 561-$301 TO RE COMPLE~'D BY L~'~OR.ATORY 7alysiS shovv~ this Water SAIVlPEE tO Satisf~toW _ Um~is~;to~ S~ple ov~ 30 ~ou~ old, ~ul~ ~1~ ~oo Ionff in transit; s~mpl~ ~hould to ind{~tW reliable ff~ulff. PIe~ ~end n~ s~ple v~ S~ial deliv~ mail. Date Reeeiv~~/~. ~ ...... ~mt R~ceived Analy, I, B~an [~ ~ , Annl~cul Method: ~,-~Memb~ne Filter a MMO-MUG Analyst Clleat notified of unsmfisf'~ctory resultS: Phoned - ~p~k~ wills Flied BACTFJIIOLOGICAL W~TER ANALYSIS RIECORD ,~ CT&E Environmental Services Inc. MUNICIPALITY OF ANCI;,~A;;.~' MAtq 2 c, 1998 CT&E Ref,# 98088 i 00:2 Client Name $ & S lZngine~dng Project Name/# N/A CHent Sample ID Li, Blk 2 Little Beat Matrix Driakin§ Water Ordered By PWSID $ m'nple Remarks: Client PO# Printed Date/Time 03/04/98 12:03 Collected Date/Thne 02/27/98 09:30 Received Date/Time 02/27/98 10:50 Technical Director: Stephen C. Ede Attoaabte Prep Anatysfa Method L~mtta Date Oate Init gitra:e-N ~aters Department Anatyaea 0.100 U 0 0.100 coL/~OOmL EPA 300.0 10 max 02/Z?/98 RMV 02/27/98 Page: 1 Document Name: .ENTERPRISE SERVER PARCEL: 014-061-38-000-99 CARD: 01 OF 01 RESIDENTIAL SINGLE FAMILY STATUS: RENUMBERED TO/FROM: - - - 1 LINK GREGORY L & JANE LITTLE BEAR BLK 2 LT 1 6740 BABY BEAR DR 0 ANCHORAGE AK 99507 2204 SITE 6740 BABY BEAR DR LOT SIZE: 9,010 ZONE : R1 TAX DIST: 003 GRID NOTES : ---DATE CHANGED ....... DEED CHANGED .... OWNER : / / BOOK: 0254 PAGE: 0086 ADDRESS: / / DATE: 00/00/00 HRA # : 000000 PLAT: 760181 ................................. -ASSESSMENT HISTORY .......................... ---LAND-- FINAL VALUE 1996: FINAL VALUE 1997: FINAL VALUE 1998: EXEMPT VALUE 1998: --BUILDING .... TOTAL--- 30,000 76,400 106,400 30,000 85,800 115,800 30,000 79,900 109,900 0 0 0 --EXEMPTION--- ..... TYPE ..... STATE EXEMPT 1998: FINAL VALUE 1998: 0 -COMM COUNCIL- 109,900 ABBOTT LOOP Date: 3/25/98 Time: 02:29:22 PM Rick & 'strom,, Departmen of Health and Human Services 825 "L' Street P.O. Box i96650 Anchorage, Alaska 995i9-6650 April 1, 1998 Lynda L. Barber- Wittze Special Projects Manager Anchorage Water & Wastewater Utility 3000 Arctic Boulevard Anchorage, Alaska 99503 Subject: Waiver Request for Lot 1 Block 2 Little Bear Subdivision Waiver Request #WR980012, PID #014-061-38, HA# HA980063 Dear Ms. Barber-Wiltze: Your request for a waiver of the 75 foot horizontal separation~to the community sewer line to a private well has been approved. The approved separation is 69 feet. This waiver approval applies to the existing well and community sewer line only. Any future upgrade will require all separation distances be met or another approval from this department. If there are any further questions or concerns regarding this waiver, please call our office at 343-4744. Sincerely, Dan~el~' J. Roth Civil Engineer On-Site Services cc: Robert C. Cowan, P.E. S & S Engineering MUNICIPALITY OF ANCHORAGi Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR~%~9~fbl~k PID# 014-061-38 HA# HA980063 Date Received: March 27, 1998 Legal Description: Lot 1 Block 2 Little Bear Engineer: Lynda L. Barber-Wiltze, AWWU Permit 3000 Arctic Boulevard, Anchorage, Alaska 99503 Applicant: Waiver Requested: community sewer line Waiver request of 69 feet from a private well to the Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditi 3. Other: Waiver is Granted: List Conditions or Re~ Date: Name o2 ~evlewer Rec #: Amount: $ Date Paid: ~Ytl v£R ~ F~r 2.¢ ANCHORAGE WATER & WASTEWATER UTILITY Rick Mystrom, Mayor Engineering Division 3000 Arctic Boulevard Anchorage, Alaska 99503-3898 March 26, 1998 Otoned by the Municipality of Anchorage Mr. Daniel J. Roth Municipality of Anchorage Department of Health and Human Services 825 L Street Anchorage, Alaska 99501 RE: Well waiver application Lot 1, Block 2, Little Bear Subdivision RECEIVED MAR 2 ? 1998 Munleipalit Dept' Health ~Y~°f,.A__nchora~ Dear Mr. Roth: Pursuant to Alaska Administrative Code 18 AAC 72.015 Separation Distances, the Anchorage Water & Wastewater Utility (AWWU) is seeking approval of a lesser separation distance than that set out in Table A of this regulation as the minimum separation between a private water system and a community sewer line. This waiver application is in consideration of a set of circumstances which have coexisted since1983. Background Information Little Bear Subdivision is a residential development in Southeast Anchorage, north of E. 68th Avenue and west of Spruce Street. 1976: Little Bear Subdivision was platted and recorded as Plat 76-181, attached hereto as Attachment A. Lot 1, Block 2 is at the northwest corner of E. 68th Avenue and Baby Bear Drive. Community sanitary sewer mainline services were extended to all properties in the subdivision. Extending south from the northern boundary of the subdivision, the project terminated with a sanitary sewer cleanout approximately ten feet south of the north property line of Lot 1 (extended) and ten feet west for the centerline of Baby Bear Drive right-of-way. The sewer main size and material is 8-inch diameter ductile iron pipe. Reference attached record drawing labeled Attachment B. 1977: On February 24, 1977, a private well was drilled on Lot 1, Block 2, Little Bear Subdivision approximately sixty-nine feet (69') west of the sanitary sewer main and cleanout. At the time, ADEC regulation required a minimum fifty feet (50') separation between the two facilities. The property site plan showing the well location on the property and its proximity to the community sewer is attached as Attachment C. The drilling log for the well is attached as Attachment D. 1983: Effective December 30, 1982, Wastewater Disposal Regulations 18AAC72 adopted new minimum separation distances. The new minimum separation was seventy-five feet between a private well and a community sewer line. Well waiver application - Lot 1, Block 2, Little Bear Subdivision March 26, 1998 Page 2 In March 1983, AWWU received application from a developer to enter into a sanitary sewer mainline extension agreement to connect to the sanitary sewer main installed in 1976 and extend the collection system to a new development south of E. 68th Avenue. Records indicate AWWU approved the sanitary sewer design in June, and a revised design in August; ADEC approved the design in June. Construction notice-to-proceed was issued September 1983. The sewer main size and material is 8-inch diameter ductile iron pipe. Reference attached record drawing labeled Attachment E. The private well was not shown on the sanitary sewer design plan drawings. 1998: March~ The private well/community sewer line separation distance was identified as not meeting State regulation. The 1983 construction caused the community sewer line to be located sixty-nine feet (69'+) to seventy-five feet (75') from the private well; regulations require seventy-five feet (75') unless a waiver is approved. AWWU is seeking a waiver for approximately 23_+ feet of 8-inch ductile iron community sewer main located within the 75' well radius with the following supporting justification: This waiver revolves around a set of circumstances which has existed for approximately fifteen years. Within the subject well radius waiver area, all sewer pipe is 8-inch ductile iron pipe, minimum Class 50, with a wall thickness of 0.27" and a working pressure of 350 psi plus a surge allowance of 100 psi. As this sewer line is a gravity system, the working pressure will be 0.0 psi (or atmospheric). On a gravity system there is more static pressure on the outside of the pipe than on the inside, thus giving more concern to infiltration than exfiltration. Ductile iron pipe has a life expectancy greater than other conduit materials because of its structural strength and resistance to abuse, abrasive elements, and corrosion. At the time the well was drilled in 1977, that portion of the community sewer line built in 1976 was in conformance with minimum separation distance regulations. The 1983 construction removed a sanitary sewer cleanout and then extended the sewer line, leaving the community sewer line only just inside the seventy-five foot radius. The northern half of the "encroachment" would appear to be grandfathered under prior regulations. This waiver is for the southern half. The community sewer line is approximately 8½ feet below ground surface. The well drilling log for the referenced property, and the well drilling logs for adjacent properties (Lot 1, Block 1, Little Bear Subdivision across Baby Bear Drive and Lot 2, Block 2, Little Bear Subdivision abutting to the north) indicate a layer of hardpan soils which would provide an impermeable layer between the community sewer line and the source aquifer from which these wells draw. The aquifer is generally 54 feet below surface elevation. According to the drilling log, the hardpan layer for the well in question is twenty-seven feet thick. Across Baby Bear Drive, the well serving Lot 1, Block 1 has a sixty-five foot layer of hardpan. (See Attachment F.) From information off municipal topographic maps, the ground surface in the subdivision would appear to drain to the north and west. This is corroborated by the community sewer gravity collection system in the area which, by its nature, tends to generally correspond with surface elevation trends. Comparing soils layers in the three well drilling logs, hardpan appears to consistently show up at the 24- and 25-foot drilling depths. Above the hardpan is an identified layer of "gravel and sticky clay" which may also impede any vertical groundwater movement. Considering the bedding and the trench work associated with the installation of the community Well waiver application - Lot 1, Block 2, Little Bear Subdivision March 26, 1998 Page 3 sewer line, any wastewater which could find a way out of the community sewer line, though improbable, would follow the bedding and disturbed area (the path of least resistance) when considering the characteristics of the surrounding undisturbed soils into which the well casings penetrate. The final piece of information offered is a recent drinking water analysis report dated February 27/28, 1998, pertinent to a sample from the referenced well. No trace of coliform was noted and n itrates-N was reported at 0.100 mg/L. (Reference Attachment G.) This completes our request for a waiver. Should you require any additional information, or have any questions concerning the above information, please contact the undersigned. Lynda U Barber-Wiltse, P.E. Special Projects Manager 564-2751 email: barberwiltselb@ci.anchorage.ak.us Attachments: A: Plat 76-181 B: Record Drawing No. 3625: Sanitary Sewer Main C: Property Site Asbuilt, Lot 1, Block 2, Little Bear Subdivision prepared by S&S Engineering w/AWWU markup D: Drilling Log: Private Well for Lot 1, Block 2, Little Bear Subdivision E: Record Drawing No. 6852: Sanitary Sewer Main F: Additional Drilling Logs for neighboring properties' wells/area topo/sewer collection main locations and flow G: Drinking Water Analysis Report Attachment C . -) TR A S Text Bev usg Bev uss' Text Blocks Text ~ Text Lotnum / lvbal:~,e · Jr'aniSes Attachment G CT&E Environmental Services Inc. Lal~oratory Division r~~J'~~,J'J,J~'~r~'~'~JrJ,~,,~r~r~'~,~~ Drinking Water Analysis Report for Total Coliform Bacteria 2~o w. ~o.or Or~, Anchorage. AK gg$18-1605 ?E.4D ItVSTRUCTION$ ON RE}'ERSE,S/DE BEFORE COLLECTIi¥O $,4MPLE Tel: (907} 562.Z343 MUST BE COMPareD BY WATer sUPPLIER-' puBuICW^Z£rSVStm,.n.# IIII I.._l I' PRIVATE WATER SYSTEM SAMPLE DA'r~ SAMPLETYPE: ~ R_6utlflo ManOr Da)' : Yesr Untruf~d Wiier Repeat Sample (for routine simple, with lab tel no. ') * SABLE LOCATION, '~ Coll~ Collected Fax: (907) $61.S301 alysis shows this Water SAMPLE tO be: Satisf~tow _ U~Uis~;to~ S~ple erg 30 hou~ old. ~ul~ may be unreliable a S~ple too long [n tmnlJl: sample should no[ be over 4~ haum old et exminetion to indlmte tclieble mulu. P~c~ send n~ s~ple vie sp~ieJ deliv~ mail. Date Receiv~ ~ ..... Anel~csl~ethodt ~-~cmb~eFiltcr O MM~MUG ~. ~u~ofaolonie~lO0 mi. Analyst Fd~ed eicon notified of unsa~r,,ctory resultS: i~ · , Pho~d _ SIm~l wi~b · BACTERIOLOGICAL WATER ANALYSIS RECORD .... T~mc ~ C~l Coloni .~'100 mi ..... COLIFIR~r ColIFo_?/. tO0 mL MhIO.MUCRemlt, T~ai Calllbrm .Membrane Flitch D/r~Coua~ ~_. r. al Coll&rm Conflrmaffo~ final Memb~ne ~te~ Ruulu ~ Commenm I~~ mamb~roithiiSGSGroupISKi&PIGin~eladO?,urveilllfl,c') . .: CT&E ReL# 980881002 Client Name $ & S Enginee~ng Project Name/# N/A CUcnt S~mple ~ LI, BJk 2 Li~flc Matr~ Dr~g Water Ordered By PWS~ Sample Remar 'ks: Client PO# Printed Date/Time 03/04/98 12:03 Collected Date/Time 02/27/98 09:30 Received Date/Time 02/27/98 10:S0 Technical Director: Stephen C. Ede Released By ~ ~ Parameter Re~u[t$ PQL Units Attowabte Prep AnaLysis Method L(mits Date Date Init Nitrete-N Waters Department Tota[ CoLiform 0.100 U 0.100 mg/L eoL/loomL EPA 300.0 I0 max 02/27/98 RMV SM18 9222a o2/27/9a T~w "~UNICIPALITY OF ANCHORAGE ,~-~ ,S~_4-b~- DEPARTMEN',: 3F HEALTH AND ENVIRONMENTA. PROTECTION-l'! 264-4720 Date Received: O,':tober 28, 1977 #1: Time 11:00 a.m. #2: Time #3: Time Date 10-31-7/_Monday Date Date Insp ~llar~ ~ ~ Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Alaska National Bank of the North Mailing Address: 3301 C Street, Calais II · Phone: 2. Property Owner: Lawrence J. Sebring Mailing Address: Star Route A Box 1540C 99507 Phone: 344-3069 3. Legal Description: Lot 1 Block 2 Little Bear Subdivision 4: Single Family Residence: (x) Multiple Family Residence: ( ) Number of Bedrooms: Number of Bedrooms: Three o Well System: Individual well (x) Community/Public System ( ) Permit # Depth of Well 80' Well Log on File Construction Bacterial Analysis Sewage Disposal System: Permit # Septic Tank Size Absorption Area On-site System ( ) Public Utility (z) Installed Installer Manufacturer Soils Rate Material 7. Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line P~ge ~WO Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 1 Block 2 Little Bear Subdivision Comments: Affadavit Attached: ( ) Letter Attached: ( ) Disapproved: Date: Department Worksheet: 06-1220(al Rev. 1973 ALA. _, DEPARTMENT OF HEALTH AND SOCIAL., DIVISION OF PUBLIC HEALTH INDIVIDUAL AND SEMI-PUBLIC BACTERIOLOGICAL WATER ADDRESS SEMI PUBLIC [] CHLORINE RESIDUALPPM REPORT RESULTS TO z,P CODF ' i r.,, ~'--7", -] COMPLETE THIS SECTION ONLY IF WATER IS AN INDIVIDUAL SUPPLY DATE COLLECTED . i~ -'} [ ~, ,___IIMECOk[ECFED '~ \ [] Basement 1.ap OFFICE ANALYSIS Anak us sno ~,s this Woler SAMPLE to be: '~(& Satisfactory [] Unsotisfoctor~ Queshonable Sample ~oo ~ong m ronst; sample should not be over 8i' hours o~d ar examination to indicate reliable results Pleosb send new samole. : [] Bottle oroken in transit, please send new sample SANITARIAN'S REMARKS Wel --[] Dug [] Driven [] Drilled [] Bored SOURCE [] Spnng [] C~stern [] Orner Walls [] Wood [] Concrete [] Meto ,'1oo- E Wood [] Concrete [] Meta LOCATION [] r~Bosemenl [] Basement Offset - ~ [] nYard [] Other Buslding Sewer SeDhc DISTANCE TO or Other Drmnage Pioe Feet. Tank Feet. Tile Seepage Cess- Other Possible MATERIAL Building Sewer- [] Cast Iror [] Wood [] Tde [] Rbre [] Asbestos GENERAL Does Water Become Mudd! or Discolored? [] Yes ~] No Diameter of Well Degrn Well Casing Material Diameter Deom Offset in PUMP LOCATION: [] In W( [] Basemenl [] In Bosemenl On Too []Of Well [] Other- READ NSTRUCTIO NS ON REVERSE SIDE BEFORE COLLECTING SAMPLE [] THe Brick or [] Or~enToD [] Concrete [] Jnder House ' ~ Yes ~ No Signo~ure '~-'t ' 06 1220 lb BACTERIOLOGICAL WATER ANALYSIS RECORD Rev 1973 ]/'~ rime Received <~ C ~.?~ Lab. No,.~ Doter ...... d (¢', ~. ~ ~ , , Lactose Broth I 0cc 10cc 10cc 10cc 10cc 1.0cc 1.0cc 24 Hours ' " EMB AGAR Lactose 8rotf 24 hrs 48 nrs. Gram's stain. · ' (Most probable No. per 100cc( Coliform Densit. ~.,:, :~ MF Resuits "~ Re~ortedev ~/~ Dote This anal sis indicates Coliform Organisms ro ge