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HomeMy WebLinkAboutMACBETH BLK 1 LT 1A MUNICIPALITY OF ANCHORAGE DEPARTIV~ENT OF HEALTH & ENVIRONMENTAL PRO'I ECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAILING ADDRESS LEGAL DESCRIPTION /..0'7' LOCATION DISTANCE TO: Manufacturer Liq. capacity in gallons DISTANCE TO: Manufacturer PHONE 27(- g~.o~'l~ Well /oo IF HOMEMADE: Absorption~.~a / Dwelling Material NO. OF BEDROOMS PERMIT NO. No. of compartments Well Dwelling PERMIT NO. ~i~NEW [] UPGRADE DISTANCE TO: Well /~:) .~_ Length of each line No, of lines~, ~g~'/ Top of tile to finish grade 4 / Length Width Type of crib Crib diameter Well DISTANCE TO: Material Liquid capacity in gallons Foundation Nearest lot line PERMIT NO. Total length o~.lines Trench width ~ lines ~;:~4 ,~.~ inches Material beneath tile Total effective absorption area inches Depth PERMIT NO. Crib depth Total effective absorption area Nearest lot line Building foundation Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorpt on area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS APPROVEDY'~~'~ DATE LEGAL -ptcrn be^ ) lcr_K I LO% 72-013 (Rev, 3/78) MUNICIPALITY OF ANCHORAG~o ~~ . Departmental Health and Environment~ ~rotection .]~¥ ~ ~c~ ~' ' 825 ~ Street, Anchorage, AK. 9501 ~ '~.~O ~ 264-4720 * * * HANDWRITTEN PERMIT * * * ~, ~' Permit ~[Dt/]~ WELL AND~0N-SITE SEWER PERMIT 'A Location: ~ Phone Number: ~7~ - ~ g~-~ ¢g7 . Legal Description: L /~ ~ ~ ~dJ~~ Lot Size: $~,d~,~ Type of Soil Absorption System Is: Trench: / Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: ~ -Soil Rating(sq.ft/br) /~ The Required Size of the Soil Absorption System Is: GRAVEL DEPTH · WIDTH DEPTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimtLm depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~--~/~O GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and 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 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install th~ system in accordance with codes. (3) I understan~d~th~/the on-site sewer system may require enlargement if to include more that 3 b~rooms. .-'> t~x/~///m°de 1 ed ~plicant / ~ ~ ~ ~ -F Date: ~ ~ ~'~--~ ~ SWP/024 (1/81) PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 10 12 '14- 17 18 20 COMMENTS MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-222l~ SOILS LOG - PERCOLATION TEST ~ SOILS LOG [] PERCOLATION TEST DATEPERFORM D: 7? SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND , FT 72-008 (7/76) ALASKA 6i,~,RoRm~T^L COrlTROL $t~R,,,.Je$, I~C. PERCOLATION TEST DATA SHEET L /_ CLIENT ~--~-D c:U~.~ ~- DATE ADDRESS ,~'Y~ ~9 GO)< ~0 -~ ~C~ ~ ~' m m ZIP CODE LEGAL LOCATION £o7- /,,~ ~coc/'(. j' /.,4/o,.~ ~ET~ TOTAL DEPTH OF HOLE /.~ ft. ZONE TESTED (~ ft TO ~r~ ft READING # CLOCK TIME NET TIME DEPTH TO NET DROP 'RATE (min/in) DATUM FIliAL PERCOLATION RATE 2.~. ~3 - (min/in) PERFORMED BY 7'0,0 ~4-W DRILLING, Inc. P.O. Box 10-378 · 10300 Old Seward Highway (907) 349-8535 ANCHORAGE, ALASKA 99511 DRILLING LOG Well Owner {~LYDTT HICKOI~' General Contrac%o~,)_~ect Ho West Oam~z- .Use of Well DOnestic Location (address of: Township, Range, Section, if known; or distance main road fat ]a~ Block 1 ~,i~Beth Subdivision Size of casing. Static water level Screen ( ); Describe screen or Well pumping test of drawdown from static .Depth of Hole 115 ft. Perforated ( 172 feet Cased to 171.95 feet (below) land surface. Finish of well (check one) open end ( xxx ); (minute) for 1 hours with lOlL ft. Depth in feet from ground surface 0 .TO. 2 2 iTO. 10 10 .TO. 105 105 .TO. 125 125 TO. 140 140 .TO_ ].55 155 .TO. 165 165 .TO. 172 __TO .TO. TO .TO __.TO. TO TO WELL LOG penetrated, size of material, color and hardness 3--CONTRACTOR Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519,6650 343-4744 ,~. ,,~,. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (site address or directions) 11001Ridgecr~st Drive Anchorage~ Alaska 99516 Property owner H.U.D. C/0 ASSOCIATED BROKERS Day phone Mailing address 640 W. $6th Av~nu~ Anchorage,' AK 99503 563-3333 m Lending agency Mailing address Agent ' A~s o ~'_a~_~.d Bro k~.s: In~. Address 640 W. 36th Avenu~ Anchorage, AK Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3-' TYPE OF WATER SUPPLY: Individual well NOTE: Day phone Day phone 5~$-3333 99503 XXX Community well Public water 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 XXX, Holding tank : ~ ' Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. NOTE: 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 and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my inves.ti_gation 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 ~ '~' ~ ~; ~GINEERING ~ ~ ~3,~ C.~ule River Loop Road No, 204 Engineer's signature~',~ ~iYer, Alasl(a 9~577 Phone -/ // DHHS SIGNATURE Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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 DH HS 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 MOA~21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L-cT Ift /~(./,~(. / /-1/~C/Z6F// --~]~ Parcel I.D. A. Well Data Well type Log present ~'N) Total depth Sanitary seal (~N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~'[/~-/g.~ Driller Cased to /'TJ, f_C' ' Casing height Wires properly protected~N) FROM WELL LOG I g.p.m. AT INSPECTION ENVlRONMENTALSF-RVICES DIVISION /~,'-~ g.p.m. .-- u~ JAN 1 ;5 1994 Date of test Static water level Well flow Pump level1 L//J'C SEPARATION DISTANCES~FROM WELL TO: · 1 Septic,Dm#~ tank on 10~~ Absorption field on lot Public sewer main r~.~ r.j,L Sewer service line "~'- ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank RECEIVED /Od' W WATER SAMPLE RESULTS: Coliform 0 / [00 ~ Date of sample: ///P/~'~t- Nitrate /----~'/'0 //~///~ Other bacteria dZ?///~co/''~''--- Collected by: SE PTIC/NeE. BtNer TANK DATA Date installed Cleanouts~) High water alarm (Y~, Date of pumping SEPARATION DISTANCES FROM ~EPTJ~ ~CLD',NC TANK TO: Well(s) on Iol ~ -/T On ~dj~oenl Iot~ / o To prope~y line Su~8oe w~ter/dminsge Tank size /.~00 ~J'IC/..~J.~ Compartments Foundation cleanout(~N) c/~- Depression (Y~) Alarm tested (Y/N) ,'~'//'~ Pumper //~'/- ~-~ ~'~-/~jr_~..~ / Foundation Water main/service line /0 72-026(3/93)*Front ~-,x~ ~J'/t~//U~"/'"~ /5~.~t/_.~ /4,,"/~' /~'-~' - CONTINUED ON BACK PAGE C. LIFT STATION J~c)~J~~ P/~~-~'~t~J~'--- Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N). "Pump on" level at "Pump off" Level..~-~''~ High water alarm level Cycles te~ Meets MOA electrical codes (Y/N) ~ SEPARATION DISTANCE FRO~J~-iF'I~TATION TO: Well on_~D~~~''~ On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length ~(Jr--/ Total absorption area Width Soil rating (GPD/FF) Z ?-.~' 7/~/'~ System type ~-'~JC/'~ Gravel thickness ~ ~' Total depth //' ! ?~-~ Depression over field (Y/{~ ~ F~z~-r'-b~' -/~'/) for '~"'/"'//~-'-L~ (~) Bedrooms After test (~ Cleanout present'N) Result,~fail) Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: If yes, give date Well on lot /0~ To building foundation On adjacent lots Surface water Curtain drain On adjacent lots / d_~("-) r~.~ Property line To existing or abandoned system on lot Cutbank /t.}O,,(./~~''/P/~747~Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION, s.. 'ii~~ ~.~ I certify that I have checked, verified, ~ed to all MOA and HAA guidelines in ~' ~te of this inspection. Signature ~ ........ Engineer's Nal~34 Eagl~ ~p Road No.~04/ Eagle River,'-Ala~ :a ~577 ./, / _ / - // ~ · Date / ///7' !Tk // ~ ' HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back ~00~ 0© Waiver Fee $  Date of Payment Receipt Number 01,,"11/94 1,'7: 15 C'JTF.;:E EI'4U I RDNMENTRL LRB !3ER;...~ ! CEL=; Drinking Water Analysis Report for- ~" ,' . ~,.' : otax Coliibrm Ba,.,~ ~a ~ST BE CO~LE~D B~WA~gR S~PIJER [ TO BE L~LBORxTORY / ~ P~ATE WATER SYSTEM ' ~ : lo &.~ ~ re.lab,=,.~mu. Please send - ~ ' ~ ' ' ..... dorm, ~' ' ......... ~: ..................... Lab Ref, No. Result* Routine :' " ......... Repeat $~p~ flor r~utlne sample ~ Untreated Water with lab re[ no ...... " Special Pu~oae Time Collected Cii,;nt r~oti~efJ ef uns;~ti:f,~c:oO' results: 8~LE LOCATION Collected By BACTERIOLOGrCAL WATER-~'~YSIS ~COkD 5~IO-~G Re;ult: Total Coliform E. Cog' ............. Membrane ~llter', Direct Count ~ Cok, a;es/lO0 mi Verification: LTB BGB COLIT~M 7.','rc., ro~ .v...~,, Fecal Colifo~ Confimatlon c~ - 0,'~ Final M~mbra~ilter Rasult~ C*lifo~2! 00 ml Commaau: ' ~ " ,:Ax: O0;') PART ONE OF TWO: REMAINDER TO FOLLOW ~CT~E ~ ,im, ENHE ~TAL I AD SERUICE'5 hid ....... D02 COMMERCIAL TESTING ~k ENGINEERING CO. ENVlRONMENTA~ LA[~ORATORY ~ERV'{C~ Chemlab Ref.~ =94.0128-1 client Sample ID ~LtA Matt ix : WA~ Client Na~e o~ered By : R, REPORT of ANALYSIB Report Com~,fi et. ed Collected T-~L: {~07} 562.23~ FAX: (507) 561-~301 :74627 pWSID Sample RemarRs: ROUTINE Sk..J~t,E C-~-~¥~[D BY; $,So Received :01/10/94 Technical Dir~,ct, or:¢TE~Ph%t} C. Allowable Ext., Ansl QC ,, ~;e~( hod ,%i~i t s Date Date In _ _ Resule5 Oual Un~ '' ' '. ....................... pa~e~er ......... ~ ........................... ~ ....l'i[i"~ ....... '0 Of/lO L ............................... 0.10 U mg/L EPA ~5~.~/3UU,U l Nitrate-N .= ...... ============================================ ............. UA = Unavait'.able ===~----= .... ==-- ..... ==.--- -77--i- ~bove 'HA ~ Not AnalYze~ * See Special instr~c~lor,~ a ** See Sample Remart{s Above GT = Greater Tha' U = Undetected, Reported value i~ the oractical quantification lb~it, D = Secondary dilution. . ~' OH'O MARYLAND: WEST V~P3JaA. N~WjE~S~Y ~OUTH ........ ~,~ *,*~A ~3LO~AOO, U~AM ILLINOIS ..... APPLI -NIT FILLS OUT UPPER HA!'- ONLY Buyer Address Zip Code Realty Co. &Agent Phone Address Zip Code Type of Resi~nce ~ingle Family ~ Multiple Family No. of Bedroo~ ~ Other Water SupPly ~dividual A~ACH WELL LOG. A wall log is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility Sewer Disposa~ /~ ~dividual Year Individual Installed: ~ Public Utility When Connected~ to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMP FORE ~OCESSING CAN BE INITIATED, Time Time Time Time Date Date Date inspector In spect e'~. Field Notes: ( ~ APP- 'gED BEDROOMS ( ~;ROVED 72-023 (3182) WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: /;;Z~', ~co ~,=,--.. MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ~NVIP. ONM~:NTAL ~ROTECTION Well Classification Well Log Presen~(~N) Total Depth -- /Tr'~ Cased to / '~'-~ Static Water Level Casing Height Above Ground Electncal Wiring in Condui~)/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot /C~ ("~ ; On Adjoining Lots To Nearest Public Sewer Lie Cleanout/Manhole Water Sample Collected by Water Sample Test Results If A. B. C. D.E.C. Approved (Y/N) Date Completed ~ -t"~'r/' '~'_~' Yield Depth of Grouting Pump Set At ~,f ~,-~ ~'~ Sanitary Seal on Casin ((~_~N) Depression Around Wellhead (YAY- (~- ¢ ~ '-~-~,; On Adjoining Lots ~j/~ TO Nearest Public Sewer To Nearest Sewer Service Line on Lot .~¢'/,~ ~(~, :Date Comments B. SEPTIC/HOLDING TANK DATA Date Installed c~-.2 '~-'~.~ Size Standpipe~N) Air-tight Cap~N) Depression over Tank Pumpmg/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) /(/~ Separation Distances from Septic/Holding Tank: TO Water-S~pply Well ~:2,,~' To Property Line t/~ To Water Main/Service Line Course Comments j-.~,/,~.~.- ~-~ No. of Compartments .I~ Foundation Cleanoui~N) Date Last Pumped ~'~ ~'~- dC) -- OO~ ;for ,~j~ Temporary Holding Tank Permit (Y/N) / To Building Foundation /, To Disposal Field To Stream Pond, Lake. or Major Drainage Page 1 of 2 72-026(11184] C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~-~?- ~' Width of Field ~ Square Feet of Absorption Area Depression over Field (Y~) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present ON) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions ~ Manhote/Acc~ ~Pu m~,p~' Level at __ .,"~'~ Pu::tn(gY~::le--~during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified; or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Receipt No. Date of Payment Amount: $ Date MOA No. Page 2 of 2 72-026 (11/84) : . MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-472O' Application Date ~ GENERAL INFORMATION (a) Legal Description (include lot, blogk, subdivision, section, township, range) s = I ,~ -., ;,,, ' ( Lo~J~on (~dOress O; di}e~t'~gs) ' (b) 'Applicant Name ~ ~.+ Telephone: Home (c) Applicant is (clieck ooe);~.L~,ndlng Institution []; Owner/budder~ Buyer []; Other [] (explain); (d) Lending InStit~ti~''" ~ ~ /~gd( Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family. Multi-Family [] Number of Bedrooms ~. Other WATER SUPPLY Individual Wel~/~ Co_mmunity [] Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the.legality and status. SEWAGE DISPOSAL Onsite/~ Public [] Commum~y [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for 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. N.me of Firm . .,~-~--~'-- ..,~ ~ · Telephone Address /~ ~). , Date DHEP APPROVAL Approved 1~ Disa~l~wd Con~nal lerms of Conditional ~pproval Date 2.. -/.,~ -~'~, CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 unicipalitYof Anchorage P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES February 18, 1986 Dennis Roe Alaska Environmental Control Services, Inc. 1200 West 33 Avenue, Suite B Anchorage, Alaska 99503 Subject: Lot IA Block 1 Mac Beth Subdivision Waiver Request~ WR86-020 Dear Mr. Roe: This Department hereby waives the separation distance requirements stipulated in 18 AAC 72.021. The well to septic tank separation distance requirement has been waived to 94 feet for the subject lot. This waiver is valid for the existing three bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw ALASKA erlUIROFImE FITAL COFITROL SeRUlCl $. ~n§i~¢¢~inq ~- ~nuironm¢~lr~l ~tudies D~PT. OF HEALTH & ENVIRONMENTAL PROTECTION February 10, 1986 i" FL~ ~ 0 ~2 EEEJ ED MUNICIPALITY OF ANCHORAGE Department of Health & Human Services 825 "L" Street Anchorage, Alaska 99502-0650 Attention: Mr. Steve Morris Subject: Well Waiver, Lot iA -- Block 1 MacBeth Dear Steve: During a Health Authority inspection of subject lot on February 6, 1986, it was discovered that the separation distance between the well and septic tank was only 96.5 feet, measured from closest standpipe. The edge of the tank may be as close as 94 feet from the well. The septic tank has caulder couplings on the inlet and outlet pipes. Our office requests a waiver to 94 feet with the following justification. No other septic systems encroach on the 100 foot protective radius around the well. The well is 172 feet deep, and is cased to bottom. The well lot reports clay from 125' to 140', and silty soil from 105 to 125 and 140' to 155'. The static water level was reported at 115 feet. General slopes are less than 10% from the septic tank to the well. However, the house is positioned between them. The soils test hole was dry to -- 15 feet. The first indication of water would be the static water level in the wall. A water sample taken February 7, 1986 was free of coliform bacteria. The waiver of the septic tank distance to 94 feet would not create a health hazard. If you have any questions, please call. Soil S[~entist Approved By: Preside~f 1200 LUcst 33rcl Auenue, $ui1¢ [~* Anchoraq¢, Alaska 99503 ,/907) 561-5040 cmr~c~r · c~,~o~o(;~c~/~ ~o~rom~s or,~,~s/¢,~, ~c. .~"~.,~,_~ TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 ~ . · Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER [] PUBLIC WATER SYSTEM I.D.# [] PRIVATE WATER SYSTEM Name Phone No. ~(~ qo~Fd City State Zip Code MO. Day Year ,~Rou E TYPE: tine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose ) lq/Treated Water _~ Untreated Water SAMPLE NO. ~ I 2 I 31 4 I 5 I Time Collected LOCATION~ I Collected MUNICIPALITY OF AN(J:HORAGF: DEPT. 0.': .~.~.".LT,"J & ENVIRONMENTAL PROjT£CTION .RECEIVED__ TO BE COMPLETED BY LABORATORY Date Received Time Received Analytical Method: An/alysis shows this Water SAMPLE to be: .'~ Sat sfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Pl~,ase send new sample via special delivery mail. Membrane Filter * No. of colonies/100 mi. Lab Ref. No. Result* I 1-1-1 I I-T-t t J-1-1 I I-T-1 Analyst BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Membrane Filter:. Direct Count Verification: LTB BGB Final Membrane Filter Resultsj :/.,-",/'~ ~'', Reported By ~'.. / , · ' Date Time: Collformll00ml Collformll00ml TNTC -- Too Numberous To Count OB -- Other Bacteria CHEMICAL & GI , , INC. Drinking Water Analysis RePort for ~Totai ~olifor; Bact:ria ~ TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: Water System Name I.D. NO, Mailing Address City Day S~A~.E'TY PE: '~D"Routine [] Check Sample (for murine with lab inf. [] Special Purpose State:: Year Zip Code SAMPLE NO. 1 2 3 LOCATION TO BE COMPLETED BY LABORATORY Analys~s sr~ows this Water SAMPLE to be: XSatisfacto~ry [] Unsatisfactory [] Sample too long m transit; sample should not De over 48 ho.urs old at examination To indicate ~re~ults: ..Please send new sam Date Received ime Received tical Method: Fermentation Tube lembrane Filter Result* Analyst READ INSTRUCTIONS BEFORE COLLECTING SAMPLE ~6~1220 Rev. 1978 B~CTER IO~OG I~WATE~iANA L ¥S15 REC~ Date Collected Source Lab. NO. ~esumptlve 10mi 10mi 1Omi 10mi 10mi 1.0mi 0.1mi 24 Hours 48 Hours :onflrmatory 48 Houri EMB. Broth 24 hours: MultiPle Tube Report: Membrane Filter: Direct Count verification: LTB Final Membrane Filter Results ~ ~ Broth 48 hours: ~ /0mi Tubes Positive/Total /Omi Portions Collfomt/100ml BGB Collform/lOOml o,t. //~- ~,~