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HomeMy WebLinkAboutLATTA LT 5 GRE^. R ANCHORAGE AREA BOR Department of Environmental Quality 3330 O Street Anchorage, Alaska 99503 !GH INSPL:CTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION /--- MAILING ADDRESS LEGAL DESCRIPTION PHONE -~/~"~ ~ 3~'~7 / SEPTIC TANK: DISTANCE ~ FROM WELL"F~'"'~)~%~--~) MANUFACTURER S INSIDE LENGTH INSIDE WIDTH MATERIAL ~")l I'~'"i'l '~ NUMBER OF COMPARTMENTS "~)~- LIQUID DEPTH LIQUID CAPACITY ~'30 GALLONS. '"I~]~L~D RAIN ~..'TP,,,~ n,;.,~- DISTANCE FROM WELL~)~OI~s":~_~"FOUNDATION NUMBER OF LINES "~ DISTANCE BETWEEN LINES ABSORPTION ARE,~ ~ SQ. FT. DEP-FH: TOP OF TILE TO FINISH GRADE'~(~tr TOTAL LENGTH NEAREST LOT LINE "1/"~O _OF LINES -~'- /~. I TRENCH WIDTH,,~ (f-~ IN. TOTAL EFFECTIVE LENGTH OF EACH LINE ~'3 t .~ DEPTH OF FILTER MATERIAL BENEATH -FILE__~__/''~ '~F~. ABOVE TILE IN. WELL: TYPE~(~)~0 _____CONSTRUCTION BUILDING NEAREST NEAREST FOUNDATION__ LOT LINE____, SEWER LINE__ DEPTH SEPTIC SEEPAGE TANK SYSTEM DISTANCE FROM: CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: ~ K DIAGRAM OF SYSTEM INSTAL. LED BY: SEWER LINE DEPTH: piPE MATERiAL:~'~ LOT SLOPE:~ ................ . REMARKS: Form EQ-032 LEGf~L L. 5 L, RTTFq SURD (~J~( LOT SIZE 'F'¢PE OF SOIL FiE,'SORB'T'ION S~'STEM IS: TRENCH MWXIMUM NUMBER OF BEDROOMS SOIL. RR'r'ING (5;~ FI',-'"E,'F.:)= THE F.'.EQUIREB SI2E OF THIS SOIL. ABSORPTIOH S'¢STE:M IS: THE L. ENGTH DIMENSION IS THE: LENGTH (IN FEET) OF 'I"HE 'FF.'.ENCH OR DF.:RINFrIEI...P. THE DEPTH OF R TRENC:H OR PIT ~$ THE D~STRNCE BETHEEN 'rile SURFFICE OF THE GROUI'IB RND THE BOTTOM OF THE E',,(OFIVRT[ON (~N FEET). TIlERE IS NO SET WIE:,TH FOR 'TRENCHES. THE GRRVEL DEPTH IS TFIE MINIMUM DEPTI4 OF GE'.FIVEL. BETI41EEN '['HE OUTF'FILL. PIPE RND 'rile BOTTOH OF THE EXCRVRTION (IN FEET). 8RCKFILLING OF RN"r' Sb'STEM WITHOUT FINRL INSPECTION RNE:' RPPROVFIL.. B"r' ]"HIS DEF't'~RTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DIS';TRNCE BETWEEN FI WELl_ RNB RN'¢ ON-SITE SENFtGE I)I.S';POSRI_ S'¢S'1'E3'1 IS; :bgE~ FEET FOR R PRI",,'RTE WELL OF.'. 20e3 FEET FOR l':l PUBLIC t.,.IEL.L. SPEC:IFTC.'RTIONS RNB CONSTRUCTION BZRGRFIMS RF.'.E R\,'FtILRE~L.E "f'O INSUF.:E F'ROF'EI~: I NSTRLL. RT ~ ON. I CERT I I"'~r' THRT ~L: I RM FRMILIFIR WITH THE RE6!UIREMEN'TS FOR ON-SITE SEWERS RN[:' PJELL.% I::lE; SIET F"ORTH B~r' THE: HUNICIPRLIT"r' OF RNCHORRGE. 2: I WILL INSTRLL THE S"r'STEM IN RCC'ORB'RNCE WITH THE C.'ODES. ~i:: I UNDERSTRND THRT THE ON-L:~;ITE SEP.IER S'¢STEM F.'.ESIDENCE IS REMOBELEB TO INCLLIBE MORE THAN ]: I~;Er)F,'OOt,'IS. ............................. ~' RPF~E I C:FtNT ROH [)OTSOI'.~ I. ,--,.- ,=.~,L i:.r~ .... : .. , ................ ~,,~,"r~.: .~..¢_. MUNICIPALITY OF ANCHORAGE Department of Health and Environmental Protection 6 SOILS LOG PERCOLATION TEST Performed for Rom DoPsun Legal Description Lot 5, Latta Subdivision fO Date Performed 5/18-19/76 (See back for hole location) Gray-brown, silty, sandy gravel (GM) with lense of clean, sandy gravel (GW) between 2.5' and 3.5' Perc rate - 205 ft.2/bdrm. Gray-brown, silty sand with some gravel (SP) Perc rate = 250 ft.2/bdrm. Gray-brown, silty, sandy gravel (GM) Perc rate - 225 ft.2/bdrm. No water table encountered. AVERAGE PERC RATE FROM SOILS LOG = 227 ft.2/bdrm. Date .. Net Time DePth Net Drop 5/~9/76 9 min. 12 in. 5 in. 5/19/76 19 min. 20 in. 13 in. 5~19/76 29 min. 24 in ..... 17 in. .~/19/76 44 min~ 27..5 in. 20.5 in. . .5/19~76 iLO4 min. 35 in_ .~/19/76 154 min, 37 ~ . . 3Q in. Percolation Rate 5.1 minute/inch = 140 ft.2/bdrm.* Performed By ALASKA GEOLOGICAL CONSULTANTS, INC. ~~ ~_~ _ k/ 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 HAA # 1. GENERAL INFORMATION Complete legal description LOT Location (site address or directions) I1~ 40 L/~TT/~ CIRCLE Property owner Mailing address Lending agency ~ ~/t C.. Mailing address ffGo tv'. TuDor¢. Agent L~£ ~'A~.~P.. C OLb ~L~ /~NcH PrK Day phone Day phone 5'(~2-2/$~ Day phone Address ~5°/ TuDoR Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: '~ TYPE OF WATER SUPPLY: Individual well ~ Community well NOTE: Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1t91) Front MOA #21 5, STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/orwastewater disposal system is safe, functional and adequate for the number of bedrooms and typeofstructureindicated herein. I furtherverifythatbased 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 FI. AT'FOP 'TEch' $/¢ S Phone 3 ~',5- -/~J.S'..E'- Address I ~J 5-30 ECHo 5T /)~VeAl Ak: Engineer's signature -'~~ :~, ~ ' Date DHHS SIGNATURE Approved for Disapproved. Conditional approval for 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 th is 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 MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A, WELL DATA Parcel I.D. Well type ~I~Ik'C~TE Log present (Y/N) N Total depth (¢' .5- ~ Sanitary seal (Y/N) "/ Date completed uNk:, Driller Cased to ',~ bo ' Casing height Wires properly protected (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number N/~ U'NK , 22 FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot -7o 'fo ¢,o. Absorption field on lot 85' 70 g.p.m. AT INSPECTION "'7.0 M~NICIPAL'TY OF ANCHORAGE ENVIR~,,NMENTAL SERVICES DiViSiON 2 1991. RECEIVED ; On adjacent lots ~ /oo' ;Onadjacentlots IIq 70 C.o. Public sewer main Public sewer service line WATER SAMPLE RESULTS: Coliform ¢/~0o~ £ Date of sample: IO0 Nitrate Public sewer manhole/cleanout ~, [00' Petroleum tank NoNE Other bacteria Collected by: F [a[./o? ~ec,~, B. SEPTIC/HOLDING TANK DATA Date installed (~ / 7/¢ Cleanouts (Y/N) "/ High water alarm (Y/N) Tank size /000 d/Ct. Compartments C- Foundation cleanout (Y/N) Y' Depression (Y/N) ,~l, Alarm tested (Y/N) N,/~ . Date of pumping '7/~1 (~t ~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot '70 Fee~ C,O? Onadjacentlots >/°°¢ Foundation Topropertyline ~-2.5' Absorption field 16' C.o. 'to C,o, Water main/service line Surface water/drainage :~ IOo~ 72-026 (Rev. 3/91) Front MOA 21 F~o~ C.O. CONTINUED ON BACK PAGE C. LIFT STATION /q, ,zj., Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length q$ 4- 2:Z Width Total absorption area 55o F'r~- Depression over field (Y/N) N. Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Soil rating [Ho FTz/8D&'t~ System type Gravel thickness 5 Total depth Cleanouts present (Y/N) Date of adequacy test -//3 ojqt for 3 bedrooms ~,lo,~¢. I~nc, r-~,,1 If yes, give date N,,~. SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot 9£¢ F~o~ To building foundation On adjacent lots ¢~5o Surface water Curtain drain ~1~ o6~r=~vEb E. ENGINEER'S CERTIFICATION Onadjacentlots ~, /0~3' Propertyline ~ 15 53 FE~r~ C.~. To existing or abandoned system on lot N.A · Cutbank ~.A, Water main/service line ~ Y-~ Driveway, parking/vehicle storage area I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature ~~ ,~. ~ ~?q"* --/[~ '*:'~x'¢9 Engineer's Name %4 ~o~ ~ ~oo~ ~' .............., ....... :,..~ ~ / ~1~1 Date HAA Fee $ / "~ ~) 0''~ Date of Payment ~.. ~ ~c~ / Receipt Number c~ ;~c/ ~ -- 72-026 (Rev. 3t91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561%301 : iJI,~.TYO? '.i?',Cl!lli (iA!. : lq,M"(Orj' [ I. I. otmbt o Member of the SGS Group (Soci~t6 G~n~rale de Surveillance MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEAl. TH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAl. HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 ~- Application Date 1, GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ~-,~u~(A'l,x'') ~t~..~.'¢-~ Telephone: Home Business Applicant Address I i,.q' ~_/ 0 o/c~ .¢ I,~ (c) Applicant is (check one): Lending Institution []; Owner/builder I~ Buyer []; Other D (explain); _ (d) (e) Lending Institution Telephone Address Real Estate Company and Agent Address (f) "FEI6 r)hone Mail tne HAA to the following address: TYPE OF RESIDENCE Single-.Family ~ MuFti-Family D Nurnber of Bedrooms ~ffT) Other WATER SUPPLY Individual Well ~ Community [] Public El Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4, SEWAGE DISPOSAL Onsite~ Public [] Community [] Hoiding 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-~25 (11184) ENGINEERING FIRM PROVIDING INSPEC'rlONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 I~erein. 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. NameofFirm ~~ ~~¢~__Telephone ~2~~¢~ Address .... ~ ~ ~ l ~ Date ~ ~~ Approved for /~¢~e-'~(LC2/bedrooms by Approved _. '_:_/'~ Disapproved Conditional Terms of Conditional Approval 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 restitutions in order to satisfy certain federal and state requirements. Ernployees of DHFP do eot 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 ~'2-025 [11/84~ WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: /.O'T MUNICIPALITY OF ANCFIORAGE DEPT. OF HEALTH & ENVIRONMEN'rAL PROTF. CTION 28 1985' % -. ECEIVED Well Classification -R~ Well Log Present (Y/N) Total Depth lO~ Cased to Static Water Level /~O ¢ Casing Height Above Ground __ Electrical Wiring in Conduit (Y/N) If A, i3, C. D.E.C. Approved (Y/N) Date Completed (,,) ~.~t,.~c~..,.,v~ Yield '7 ~0 Depth of Grouting I'N 0 N ~ Pump Set At 'i~oT'Ko ,,~, /../ i,' Sanitary Seal on Casing (Y/N) Y ,Depression Around Wellhead (Y/N) Separation Distances from Welh To Septic/Holding 'rank on Lot (~ .~ -~: , .; On Adjoining Lots To Nearest Edge of Absorption Field on Lot g Lots To Nearest Public Sewer Line N 0 ~ '~ To Neb. rest~Public Sewer Cleanout/Manhole I,,t mj~ ~ To Nearest Sewer Service Line on Lot Water Sample Collected by ~ .~' ; Date Water Sample Test Results ~--~ e,',.,-'Jc i ~ i ~'~.--~ c, Comments N ,~ t o-r3 B. SEPTIC/HOLDING TANK DATA Date Installed ~/'7~ _ Size I f,'"~O'CP No. of Compartments _ "~ Standpipes (Y/N) ON'~ Air-tight Caps (Y/N) ~"' Foundation Cleanout (Y/N) Depression over Tank (Y/N) ~ Date Last Pumped '~/~o/~ Pumping/Maintenance Contract on File (Y/N) f'///-~ ; for Holding Tank High-Water Alarm (Y/N) I~/,~. _ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course b~ N oNIE To Building Foundation /'7 To Disposal Field /~;; To Stream. Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 'J I'~1~ Date Installed "~ ~'~ I'~ ~-,. ~, ~I ,~ Width of Field 550 Square Feet of Absorption Area Depression over Field (Y/N) /~ Results of Last Adequacy Test Separation Distance from Absorption F!e.ld:._ Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test 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 To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) N. ~ N /,~ D. LIFT STATION l¢'"¢ O/~/~'' Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test, Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** IsiC~rntief~ t h a~..~a.~c~h~.~, or conf~)ratTd t ~,~.~/~/~;?._d HAA guidelines in effect on the date of this inspection. Receipt No. g~ 4 · ~ .... Date of Payment ~'~'~ ~F~ ()~' /~ t ~ Amount: $ ~,~ ~ ~%~;"' ~ " ;'~(~ Engineer's Seal 72-026 (11/84) ~f ~ o.~ ~t-~ '~, 203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 RESIDENTIAL WELL INSPECTION LEGAL: LOT 5, LATTA SUBDIVISION LOCATION: 11840 LATTA CIRCLE OWNER: BRADFORD SMITH TYPE OF WELL: RESIDENTIAL WELL LOG AVAILABLE: NO INSTALLATION REQUIREMENTS MET: WELL TOO CLOSE TO SEPTIC TANK AND LEACH FIELD WELL YIELD FROM WELL LOG: PUMP YIELD: 8 GALLONS PER MINUTE AT 30 FEET DRAWDOWN DATE OF INSPECTION: AUGUST 27, 1985 TEST PROCEDURE: WELL PUMP WAS RUN AT A CONSTANT DISCHARGE OF 8 GPM. WATER LEVEL IN WELL WAS MONITORED, TOTAL WELL DEPTH IS 105 FEET WITH STATIC WATER LEVEL AT ~60/FEET. AFTER 70 MINUTES OF PUMPING WATER LEVEL HAD STABILIZED AT 90 FEET. TEST FOR COLIFORMS: A SAMPLE WAS ANALYSED FOR COLIFORM. TERST WAS NEGATIVE. TEST RESULT: THIS WELL DOES NOT MEET THE MINIMUM SEPARATION DISTANCES FROM THE SEPTIC SYSTEM. DISTANCE BETWEEN WELL AND SEPTIC TANK WAS 65 FEET, AND BETWEEN WELL AND LEACH FIELD 80 FEET. THE MINIMUM DISTANCE IN BOTH CASES IS 100 FEET. THE WELL DOES MEET THE WATER REQUIUREMENT OF THE MUNICIPALITY. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours. This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. 203 W. 15~h AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOCATION: OWNER: RESIDENCE: WATER SYSTEM: SEPTIC SYSTEM: DATE OF PUMPING: DATE OF TEST: TEST PROCEDURE: TEST RESULT: LOT 5. LATTA SUBDIVISION 11840 LATTA CIRCLE BRADFORD SMITH SINGLE FAMILY, THREE BEDROOMS ON SITE WELL FROM MUNICIPAL RECORDS: TANK: SUNSET PLASTIC, TWO COMP., 1000 GAL ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: !550 SQ. FT. SOIL RATING: 140 INSTALLATION DATE: JUNE 1976 MIDNIGHT PUMPING, MAY 30, 1985 AUGUST 27, 1985 WATER WAS ADDED TO THE DRAINFIELD AT A CONSTANT RATE OF 8 GPM. WATER LEVEL IN TANK AND DRAINFIELD WERE MONITORED. EVERY 100 GALLONS CAUSED A RISE IN THE DRAINFIELD OF 3.5 INCHES. THE WATER LEVEL IN THE TANK DID NOT CHANGE. A TOTAL OF 450 GALLONS WERE ADDED. AFTER 4 HOURS REST THE WATER LEVES WERE CHECKED AGAIN. A DROPP OF 3.5 INCHES WERE MEASURED IN THE DRAINFIELD. THIS SYSTEM ABSORBED APPROXIMATELY 102 GALLONS IN 4 HOURS. THIS IS EQUIVALENT TO 600 GALLONS PER DAY. THIS SYSTEM MEETS THE MUNISIPAL REQUIREMENTS The operational life of aiL1 septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requirements of the Municipality and State. 203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 6.-6650 ANCHORAGE, ALASKA 99501 Mu. AUGUST 27, 1985 NICIPALITY OF ANCHORAGF: DEPT. O1: HEALTFI & ENVIRONMEN[AL PROTECTION RECEIVED SUBJECT: REQUEST FOR WAIVER OF SEPARATION DISTANCES FOR PRIVATE WELL. LOT 5, LATTA Gentlemen; We are resubmitting a request for waivers from the separation distances stated in Title 18, Alaska Administrative Code Chapter 80.020 This submittal follows the format outlined in a Memorandum dated January 3, 1985 on the subject of "Separation Distance Waiver Guidelines for SCRO", prepared by Mr. Bruce Erickson, District Office Coordinator. This Memorandum outlines a procedure to be used in the evaluation of waiver requests by assigning number values to geological features addressed in the waiver request. In this request I have followed your procedure and assigned values to the pertinent features as follows: 1. Vertical Distance Between Sewage System and Ground Water. No well log exist for this well,:' Measurements taken on August 27, 1985 shows the well to be 105,feet deep and with a static water surface in the casing of 60?~ feet. Both distances measured from the top of casing which is 2 feet above ground surface. The well logs from the wells on lots 4, 6, and 7 will be used to evaluate the geological features of the sub surface. The well depths are all similar for the four wells. Two of the well logs shows 100 feet to water bearing the third log ShoWs 75 feet. Point valUe assigned 6.0 sands, 2. Soil Absorption. The three well logs are ali. similar in that they show sandy clay, gravely clay or hardpan from 4 feet to the water bearing sands. Point value assigned 4.0 ,, Tobben Spurkland P.E. Waiver Request Lot 5, Latta August 27, 1985 page 2 3. Permability: The material described in the well logs has rate larger than 50 min/inch. a percolation Point value assigned 3.0 4. Water Table Gradient. This is a confined aquifer with 50 feet of pressure head. At maximum drawdown the gradient of the water table will be 0%. At less than maximum drawdown the gradient will be positive. Point value assigned 3.0 5. Horizontal Separation From well to septic tank 65 ft. From well to leach field 85 ft. Point values assigned For septic tank For drain field 1.5 2.5 TOTAL POINTS For septic tank 17.5 For drain field 18.5 Both of these totals shows that no bacteriological contamination is possible and that chemical contamination is unlikely . Cast iron was used in the construction of the system. Septic tank .has water ~ight c~u~ ki~g~ i Water sample taken during the %-operation of the system have not shown any contamination. I request that a waiver be issued for this property. , ,, ,~,_~, 0 . ~L~ , -.,'/' ~.. ~:w '.'~,~ Anchorage P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TO:*,~Y KN©WLE$. MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES September 19, 1985 Mr. Tobben Spurkland 203 West 15 Avenue "C" Suite 203 Anchorage, Alaska 99501 Subject: Lot 5 Latta Subdivision, WR85-016 Dear Mr. Spurkland, This Department hereby grants a waiver to 65 feet and 80 feet for the separation distances from the well to septic tank and from the well to absorption area, respectively. This waiver is valid for a three bedroom single family dwelling onlyo Sincerely, Susan 0swalt Acting Program Manager On-site Services $O/lj~* APPLI¢' ',NT FILLS OUT UPPER HA' ONLY Mailing Address Zip CodeC.) "-,) ~ 'J 7 Buyer _~,r~_~ /( ~_/.~///¢~.~ ~ , ~ .... ~- ~ Address ~"¢ ~ °~ /-//I ~4 t:~'~o~ "~>/¢/ y~' Zip Code Lending Institution Phone Address ¢ 0 / ~"; ~ ~. / ~/*; /~ Zip Code ;~ 7 ~ ~ "¢ Q / Legal Oescriplion ~ ... / d'- ~,, //~ /,_ ~ ~. </ .... ' i,' Ty~ of Residence Sin~l~ Family ~ MulHplo Family ~o. of ~o~roo~. ~ Othor Wator Suppl~ ~ Individual V~¢~ LCD~ ~(~¢o g'~o(~ ATTACH WELL LOG. A well Icg is required for all wells drilled since gune 1975. . ~ -- ~ For wells drilled prior to that date, give well depth (attach log if available). Community ~ Public Utility ~% ~¢%*~, Sewer Disposal  Individual Year Individual Installed: Public Utility When Connected to Public Utility: g Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Insp6ctor Field No~es/ ( "~ ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' BY: Boils Rating Date ~wer Installed Well To Absorption Area Well Log Received 72 023 (3182) A_B A P llUlI onmeF1TAL COFITF OL $1 l dICe $, IBC. JANUARY 3 1983 RON DOTSON 11840 LATCA CIRCLE ANCHORAGE AK SELLER - RON DOTSON BUYER-BRAD SMITH SUBDIVIS ION-LA'iTA BLOCK- LOT--5 ADEQUACY TEST FOR ShTNER SYSTMM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN ARF_A OF 550 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GAT,¥~DNS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 800 GALLONS. BASED [~20N THE TEST DATA THE SYSTMM IS ACCF]~ABLE F~-R A ~ 3 BEDROC(~I HOME. THE SEPTIC TANK WAS PUMPED ON 4-8--82 . SEPTIC TANK ADEQUACY THE E~ISTING SEFPIC TANK VOLUME OF THIS 3 BF. DR00M HC~3SE. 1000 IS AD~QUA~E FOR ~200 W¢$l 33rd J~ucnu¢, ~uil¢ [~ · Anchorc~§¢, J~laska 99503 · (907) 276-1361 DEPARTME~825 Time In sp ~l ...... MUNICIPALITY OF ANCHORAGE OF HEALTtt AND ENVIRONMENT PROTECTION L Street, Anchorage, Alaska -9950.]. 279-2511, exu. 224 or 225 Date Received Time ~ 3: Time Date Date Insp Insp REQUEST ]FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: First National Bank of Anchorage Mailing Address: Post Office Box 4-2090 99509 Phone: 274-1521 2. Property Owner: Ronald L. Dotson Phone: 344-3771 her w Mailing Address: Star Route A Box 1648 99507 Lot ~ Blockl ~ Latta Subdivision Legal Description: Single Family Residence: ( Multiple Family Residence: Number of Bedrooms: Number of Bedrooms: Well System: Permit # Construction Individual well (x) Conm~unity/Public Sysnem ( ) Depth of Well Well ]hog on File ( ) Bacterial Analysis Sewage Disposal System: Permit It Septic Tank Size Absorption Area On-site System ~) Public Utility ( ) Installed Installer Manufacturer Soils Rate Material 7. Distances: Well to Septic Tank to Absorption Area to Sewer LJ. ne Nearest Lot line Absorp~ion Area to Nearest ]Lot. Line Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 1 Block 5 Latta Subdivision Coraments: Affadavit Attached~' (i) Approved: l'~j('-, ?,'UY- Disapproved: Letter Attached: ( ) Date: Date: ~epartment Worksheet: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Stree-E, Anchorage, Alaska 99501 279-2511, ext. 224, 225 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: VA FHA __CONV_ XX 2. Property Owner:· Ronald L. Dotson Mailing Address: SPA Box 1648, Anchorage DayPhone:_(wife'_s work #) 344-3771 3. Name of Buyer: Ronald L. Dotson Mailing Address: 4. Name of Lending Institution: Mailing Address:_ ?. 0. 5, Name of Realtor or Agent: Mailing Address: 6. Legal Description: same Day Phone:.. First National Bank of Anchorage Box 4-2090, Anchorage (09~hone: NONE 274-1521 Phone:, _ g,jbdivJ g J_O~______ Location: T,a~ra Cite] e 7. Type of Facility to be Inspected: w~] 1 & 8. Water Supply Type of Supply: Public Utility. If Individual, number of dwellings presently served If Individual, depth of welt 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation _No. Bdrms._ 2 .Individual __ XX .... Individual (on-site) XX 72-003(3/16~