HomeMy WebLinkAboutLAKE O THE HILLS EAST BLK 3 LT 6 /2o// Pn! MUNICIPALITY OF ANCHORAGE On-Site Water& Wastewater Program PO Box 196650 4700 Elmore Road ; • Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http://www.muni.orgionsite Drpartimmt 4 'CHOP p' On-Site Wastewater Disposal System Permit Permit Number: OSP191108 Effective Date: 4/19/2019 Work Type: SepticTank Upgrade Expiration Date: 4/18/2020 Tax Code Number: 01533316000 Site Legal Address: LAKE 0 THE HILLS EAST BLK 3 LT 6 G:2639 Site Mailing Address: 7101 LAKE 0'THE HILLS CIR, Anchorage Owner: JORDAN VM FAMILY TRUST Lot Size in Sq Ft: 40110 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field El Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: If deck supports have to be relocated to provide the 5 ft separation to the tank, a structural permit will be required. Received By: 1 i ����10 !/� Date: .0'. Issued By: I 1 a Date: 471 RUSK r MUNICIPALITY OF ANCHORAGE • Development Services Department \ '' Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-333-16 Property owner(s) MICHAEL JORDAN Day phone Mailing address 7101 LAKE 0' THE HILLS CIR Site address SAME Legal description (Sub'd., Block & Lot) LAKE 0 THE HILLS EAST BLK 3 LT 6 Legal description (Township, Range & Section) Lot Size 40,110 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑ (w/wo ADU) Septic Tank Q Upgrade 0 0 r plex(D) . ❑ Holding Tank ❑ Renewal ❑ 4)° ale Dwellings ❑ Privy ❑ N (SF and/or D) Private Well ❑ Water Storage ❑ ,°5THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: ��' g Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 3(,06 Waiver Fees: Date of Payment: q hie(iq Date of Payment: Receipt Number: t /0?51 Receipt Number: Permit No. 05/919 1/62 Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc April 15,2019 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: New septic tank permit Legal: LAKE 0 THE HILLS EAST BLK 3 LT 6 To Whom it may concern: This is a request for a septic tank permit on the above referenced lot. This tank replacement will not impact any of the neighbors or encroach on any wells,septic or open water issues. The lot has a community water system therefore no wells to be concerned about. Sincerely m_ Michael N. Anderson, P.E. 4661 Natrona Anch,Ak 99516 Ph 727-8864 ` I I — - - - rS I \(-'----------"----... I_ \ " , -- \ \1 A 200'CLASS A / \ \ WELL RADIUS / \ \ / \ \ -k \ \ 1 p`,t�E e a,, *►+, , \ �. \ \ \ V _�ii \ R&R 1000 GALLON PROPERTY LINE •------------- ., . ' SEPTIC TANK W/ + PLASTIC TANK,PER \ ++ O UPC \ 44" 11 � i+ EXISTI \\ \\ LAKE O THE HILLS EAST TCO M NOUS. BLOCK 3.LOT 5 CS \ \ VACANT lir \ \ \ \ \ LAKE 0 THE HILLS EAS BLOCK 3.LOT 6 �V \ COMM.WATER 1�Go� \ � -� V – - / SERVICE4" C . 4-v+71� . – _ 0� 'b1 E NII.LS C1RCl.E- -LAJ---E O'TF1 _ 1 – f I / 4-an Lc. 4.0 — Al? d, c �ztw 5t4 Septic Tank Replacement .001 \\i,, MICHAEL JORDAN .•-N\ OF q��,-•...;.),/n. , -,. ar LAKE O' THE HILLS EAST, BLOCK 3, LOT 6 �,.•'• �1:milk , ••••.7 *i4 Anchorage, Alaska %• 49TH /\ % • .• Michael N. Anderson, P.E. DATE: 4/16/2019 O ..MICHAEL N. ANDERSON; 4601 NATRONA AVE •4- No. CE 9 69 i ' DRAWN: DJR ♦s4;'•. {��i ANCHORAGE ALASKA 99516 �� �Zj'• (/ ''�� `J (907) 727-8864/FAX: (907) 345-1391 SCALE: 1"=50' 141 SSS\C 4. NAME /) i ADDR~ LEaL D~CRIPTIO~ LOCATION MUNICIPALITY OF ANCHORAGE ' , DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT IPHONE | ~'I~Ew Inside length Dwe ng Dwelling M at e~l~ ~.~.,~ W dth F°undati°.nO (.~ ~' Total~.g~l~ of lines Material beneath tile ' Depth Crib depth NO, OF BE~S No. of,~ar~ments Well ~ DISTANCE TO: L ,~ ~ /.~ Manufactur~ -,~ ~ DISTANCE TO: Well Manufacturer IWell~ No. of hnes~ Lengt~J ea~h~ne To oftilstofinish grade ~ Type of crib Crib diameter Well DISTANCE TO: icl s Depth 8u Idin~ foundation DISTA~C~ TO: Liquid depth PERMIT NO, Material Liquid capacity in gallons Nearest I~ne~ ~.. Trench ~zidth (~L inches Total effective .absorption area PERMIT NO. Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line PERMIT NO. Sewer line Septic tank Absorption area(s) OTHER 72-~¢'(Rev, 3/78) DATE LEGAL !iPI"I~.,I THE "" *'r'" 0i::: :' ~' '*'"" ~:'~ "r'Fi R ......... *' ~ ~.-r,.,., "~:' ~:'~", 'i ,4F ]"::: ":'*~: FEET. ..... ::: -- E ....[ - ¢.... I-.! .~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVl RONNIENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O SLOPE DATE PERFORMED: June SITE PLAN ENCOUNTERED? P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop 2:2.5 o .q:O/ o ~,5,~2 ~:5o to 1.'~7 ,~:O~ /o I:Y3 . ,o~ ~ : /3 o I.'Ri k/ .5,'1~' i0 /,'7¢ COMMENTS ® Iqn RUN"ETWEEN i ~-oo~ ~/~> PERCOLATION RATE ~_ - ~ . ~ -' ~ [m.nutes/mcnl F~"AND FT rV~-W DRILLING, Inc. ~,~.~/ P.O. Box4-1224 * 1310C International Airport Road (907) 274-461] ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner im,',in~ !iYv~:~x~?wtr? (',0. UseofWell Location (address of: Tg.~/~hip, Range, Section, if known; or distance main road Size of casing_ Static water level Screen ( Depth of Hole I ),, feet Cased to .... z. feet ft. (above) (below) land surface. Finish of well (check one) open end ); ' Perforated ( ). Describe screen or perforation Johnson 304 We!l pumping test at_;,.Z© gallons per (1-/ottr) (minute) for of drawdown from static level· Date of completion 'u-I v' ,L,. 1.!)31 ); ].56 "; ' ~-". ft. WELL LOG DepLh in £eet from ground surface Give details of formations penetrated, size of material, color and hardness Cas :LnF, ,s t.iclu~p _TO _TO TO _TO _TO TO. .TO. TO_ TO TO TO_ TO_ _TO TO_ Y/> 1 ()r;Td. nic s Gravelly fi]_}. Ciayev £<ravei Sa_n. dv f. rave]: wc'-2 Si]_Lv clay, stightJy f;r~veily Qraveilv hardoan 3--CONTRACTOR M-VV DRILLING, Inc. ,,.~/ P.O. Box4-1224 * 1310C InternationalAirport Road (907) 274-461 ] ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner : Ld;c>r! l'~!'..rc:'r-:tvw'r~l- (]c~ Use of Well .- Location /!aSSress of: Tol~/d~, Range, Section, if known; or distance main road Size of casing Static water level Depth of Hole~ feet Cased to ~' ' : feet ~ ft. (above) (below) land surface. Finish of well (check one) open end Screen ( 7. ); Perforated ( ). Describe screen o~p~Lforation ,YOhn$O!~ 30/[ :_~.'.:ain!erJs st,a'e]. 0,l(.',.'.) siC{:: Well pumping test .'t~gAllons per (J~'-) (minute) for ,, ~., hours with 70, Y of drawdown fr&h-~'htiC level. Date of completion '~'~ ~ :~mLer ,::/4 , 1931 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness TO TO TO __ TO TO TO TO _TO TO~ _TO_ .TO. .920 .TO. ); ft. Grave]. fill Or ~l~nic s C~'erl:[fic:atc No'x. 814 & ~3 3--CONTRACTOR MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Lot 6: Block 3: Bake O' C[h~ R~,~',~ ~.~ CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Location (address or directions) (b) Property owner ~ ~ Teleph°n~"~Om~e 8586 Mailing Address 7101 rake O' ~a Ri11,~ C~L'cle /~ch, AfO~- ~16 (c) Lending Institution ~ ~ o~ Aia~ Telephone Mailing Address p,o. Business (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or chieck here~, if hold'for pick up.) List contact person and day phone number below: 17034 Eagle 2. TYPE OF RESIDENCE Single-Family;~D Number of bedrooms 3. WATE. R SUPPLY Individual Well [] Community [] Public [] Pablic f~ate~: S~st6m I.D. 23.3603 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL "' On-site;E] Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72~025 (Rev. 7/88) Page 1 of 2 5. EN(~INEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, [ verify that my investigatioQ of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional ~nd 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 Telephone Address Date S & S ENGINEERING Eagle Rlver~ Alaska 99577 6. DHHS APPROVALi Approved for -~ bedrooms by Approved c/~ Disapproved Terms of Conditional Approval Conditional Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before'a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 A. WELL DATA Well Classificatioh Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION 'DISTANCES FROM WELL: MUNICIPALITY OF ANCHORAGE (MOA) ~ Health Authority Approval (HAA) cHECKLIST - FEBRUARY 1984 MUN!~IPAIlTY ©~ ANCH~4,~;4744 ENVIR©NMI~NTAL ~ERVIC~ DIVISION LegsI Description: ~ g SEP 2 7 1988 REglVED D~te Gompl~t~d D~pth o¢ ~routin~ Pump 8~t At Sanitary 8~al on O~in~ (Y/N) ' D~pmssion Around W~llh~d (Y/N) If A, B, C, D.E.C. Approved((.~) Yield To Septic/Holding Tank on Lot To Nearest Edge Of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments ¢~'~' ~' I~ '~ "~ ~ "~ ~'~:~"'~-~ "~¢~c2 14' ; on Adjoining Lots '~ ~-k ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ; Date B. SEPTIC/HOLDING TANK DATA Date Installed '~-/ZJ.~ ~-'Size Standpipes~TN) "-// Depression over Tank (Y~ Air-tight Caps ~N) To Water-Supply Well To Property Line To Water Main/Service Line Pumping/Maintenance Contact on File (Y/N) ,/ Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTI~NG TANK: '"Z.-~c;~ I.-f- To Building Foundation ~. ~ ~ar To Disposal Field To Stream, Pond, Lake or Major Drainage Course No. of Compartments '--/ Foundation Cleanout (Y~ D~tte Last Pumped ~ -'7~-'~ F'5/~ ' ;for Temporary Holding Tank Permit (Y/N) 72-026 (Rev. 7/88) Front Page I of 2 C, ABSORPTION FIELD DATA Soils Rating in Absorption Strata \~ C::> ~//'.¢-¢'p,~ Type of System Design ~-~ Date Installed '~7""~'~L~ "" ~'~'~- Length of Field ~ / Width of Field '"~'~ Depth of Field / I ~ Gravel Bed Thickness '~7 Square Feet of Absortion Area "'7 ~.4-' ~' Sta, tndpipes Present~::~N) Depression over Field (Y/~P r---k Date of Last Adequacy Test Results of Last Adequacy Test ~ % ~:¢'~/ ~ % ~ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well ~ ¢ g' To Building Foundation ~ I Lot ~'~/~ To Water Main/Service Line ~,_ ~ I~ To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area ,¢ To Property Line ~ ~'~- To Existing or Abandoned System on ; On Adjoining Lots To Cutback (if present) ~_b/,~,_ Comments Date Installed Size in Gallons Dimensions Manhole/Access (Y/N) "Pump On" Level at High Water Alarm Level at Tested for ~'~'~'~ff" Level at Vent Pumping C~y Test. Meets MOA Electrical Codes (Y/N) Comments **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 dE inspection. Signed Company Date MOA No. 17034 Ea~lle River Loop Road No. 204 Receipt No. Date of Payment Amount: 72-026 (Rev. 7/88) Back of this Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 3601 C STREET. SUITE 1334 ANCHORAGE, ALASKA 99503 STEVE COWPER, GOVERNOR 563-6775 DATE: PWSIO #: To Whom It May Concern: Accordinq to the records on file in this of?ice the 7/ z/ //. _,c- ..c,/ !~ ._~<.£Z'__A~,'l_ ........... Water System is in compliance uith the State o? Alaska Orinking Water Regulations° RSK:sa Sincerely. Ronald S. Klein Environmental Field Officer "' APPLi , NT FILLS OUT UPPER ONLY Property Owner '~ .~ i~ / /~'¢' !v,i L-: X~ ',~}' ~ / /_T- iL:~ 7- _}: ./.~/ ~ . Phone Mailing Addre~ ["'t~ J:)' '::' Buyer Address Zip Code Lending Institution ~ , ~:~ ~:~ Phone Realty Co, & Agent Phone Address -~ Zip Code Ty~ Resi~nce ~ Single Family D Multiple Family No. of Bedrooms ~ Other Water Supply odiVidual A~ACH WELL LOG, A w~l Icg is required for all wells drilled since June 1975. mmunity For wells drilled prior to that date, give well depth (attach Icg if available), ~ Public Ulility Sewer Disposal ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time Date Date Date Date ('~ Inspector Inspector Inspector Inspector Field Notes: (~.(C ~uL'~''~ .~1~- ~ ( ~ROVED BEDROOMS ~ * CONDITIONS OF APPROVAL ( } CONDITIONAL APPROVAL* Soils Rating Date ~wer Installed_ Well To Absorption Area Well Log Received ~ ~ 72-023 (3/82) Z NV ?~to ~D~ ~'~£AL HEALTH ~ ~OTECTION ~PROV~ CERT~ICA~ Application DaCe ~ ...; _' ........ ~..~k subdivision, section, township, range,)~ ' AppXt~ ~:{n:'i~ ::~/~(~/(?'~'IJ Telephone - Home ~lda 6p~-~a~[: !~ ~ '~ ..... ~, one) Lending Institution B~yer ~.~...j ~ Otn~.~ ~:.~ (explain); Re~I g~ta~e Co, & Agen~ T~lephone M~il the ~ ~o ~he follo~n6 e Type of Residence Single-Family ~ Multi-Family Number of Bedrooms_ ~A/ Other (describe) Water Sup 1~ Individual Well~ Cozmunity ~ 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 ~ Comm'mit:'~'~[/,' Holdi,g Tank Note: If community ,,ell syste., must have Wr~'~en '?nfi~r~a~t_i~°~n.f[~m_~)e.S.~ut Department of Envlro~ental Conse~a~i~ .aC~esuing ~o ~me z~ [Page i of 2] !!Sl :Engineering Firm Providing Inspections, Tests) File Search, Data and Informatio~ ~,,": As, certified by my seal affixed hereto and as of the validation date shown below, I 'L~ , ve:i y that my investigation of- this Health Authority Approval shows that the on-st=e Water supply and/or wmstewater disposal system is safe, functional and adequate for t:7 : the 'number of bedrooms and ~ype 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 w~ter supply and/or was~ewater disposal · : system is in compliance with all Municipal and State codes) ordinances~ amd regula~ tions in effect on the date of this inspection. DHEP Approval Approved for Approved ~/ Terms of Conditional Approval CAt,lION TEIE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF H~ALTH A_ND ENVIRONMENTAL PROTECTION (DHEP) ISSUES ~IRALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESEb~r~ ATiONS GIVEN IN PARAGRAPR 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGI~NEER 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 REQUIRE- MENTS, 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] (DHEP, SE L) ,~\ ~/ / Il, I)tt~ 7-19-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AU% ORITy APPROVAL (HAA) l,bT, 0 !:, I285- Legal Description: Well Well Log P~esent (Y~L ~'] Date Completed "14 Yield ~-~~ d to Total Depth Case ~ P ' .. Static Water Level ~~-~t Casing Height Above Ground~ . _ Sanitary Seal on Casing (Y~__~_~ ~ Depression A~ound Wellhead (Y/N~ Electrical Wiring in Conduit (Y/N) Separation Distances f~om Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot ~2D~' TQ Nearest Public Sewer Line Cleanest/Manhole Water Sample Collected By Water sample Test Results ; On Adjoining Lots , ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot SEPTIC/HOLDING TANK DATA Date Installed ~/~'~ Standpipes ~'~'N ) Size /~0 Air-tight Caps ~/N) No. of Ca,i~a~hrents -~ Foundation Cleanout (Y~ Depression over Tank (Y~ Date Last Pumped Pumping/Maintenance Contract on File (Y/N) /t//~; for Holding Tank High-Water Alarm (Y/N) /~,/~-~fempora~y Holding Tank Pe~.it (Y/N)/L/~ Separation Distances f~am Septic/Holding Tank: To Water-Supply Well ~ z~D' To Building Foundation /~/ To Property Line ../-10/ TO Water Main/Service Lir~ n~l ~- To Disposal Field ~n ~) ~> To Stream, Pond, Lake, c~ Major D~ainage [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date .Installed ~/~ Width of Field_ ~ ~ Square Feet of Absorption A~ea Depression over Field (Y~ /~ ~ Type of System Design Length of Field ~// ' Depth of Field . //~ c- ' Gravel Bed Thickness 2- ~/ ~ ~/~ ~) ~' Standpipes Present _~N) Date of Last A~d?quacy Test A/~,/F, jv Results of Last Adequacy Test _~ -b--~~x_~ Separation Distance f~om A~sorption Field: To Water-Supply Well ~-~ ~ ~/ To Property Line To Building Foundation /~' ~ To Existing or' Abandoned System Lot ,~)i 6 ; On Adjoining Lots ~ ~ z ~_ To Water Main/Service Line ~ /~ '~- To Cutbank( if present) To Stream/Pond/Lake/c~ Major Drainage Course 7~/D~ ~ ~- To D~iveway, Parkin~ Area, o~ Vehicle Storage Area ~ /~ LIFT STATION Date Installed { Dimnsions "PUl~p On" Lave 1 at High Water Alarm Level at Vent (Y/N)-- ~ ' Tested fo~ w-/ Pumping Cycles du~ing Adequacy Test. Meets MOA Electrical Codes Co~nts ** Check Permitted Bedroom Rating A~ainst HAA Request I certify that I have checked, verified, or confomred to all MOA HAA Guidelines in effect on the da: ti%is inspecticn. No. KB1/dL/s [Page 2 of 2] 2-15-84 ALASKA Ih' iJIROFImeI3TA COFITI OL SI TjICi S, InC. 2/20/85 LINDA REYNOLDS P O BOX 8026 WALNUT CREEK CALIFORNIA 99596 SELLER - FRED WAGNER BUYER - SUBDIVISION - EDGEWOOD ESTATE BLOCK - 3 'LOT - 14 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH ~AN AREA OF 714 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 975 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 2/26/85 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. 1200 114sI 33rd Auenu¢, SuiI¢ B o Anchora§e, Alaska 99503 , (907] 561-5040 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA g9501 BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 £15Lob.5 To Whom it May Concern: to records on file in this office the~O~ ~)'~ ~ A~ng Water System is in compliance-with the State Drinking Water Regulations Sincerely, WAT E RWELL TEST PUMP REPORT Conducted By F~ -'X/NJ ~ ~-~JLLIN~. ddress Well Information: Ttl. Depthl~~'' -/~ Depth of Casing. Screen From Casing Size ~" Screen Diam {~ 5creenSlot Remarks Pump Information: Intake Oepthi4¢~'O~' PumpSize.~ h? ~?>C) V ~Air Line Depth ~//~ Static Water Level ~4~T Ay. Discharge Z C~ GPM Max Drawdown Pump On: ZimeJ® _ Date--// ~> Pump Off:~ Time. ) C~ q ,~- Date WATER PIEZO- FLOW WATER PIEZO- FLOW TIME LEVEL TUBE GPM REMARKS TIME LEVEL TUBE GPM REMARKS ~i~ o 04,C j1¢7q j ZO jingo ~ jpzz ~R,~ ~7~ ~ 9q zo J~qq~ q7 Zo WATERWELL -TEST PUM,R,EPJDRT Owner /~z,cz,E',-~/-J . Address Well Information: Ttl. Depth~~-~c~ ~' Depth of Casing ,/,.~9 ' Screen From To Casing Size ?~_Z~J_._Screen Diem Screen Slot Remarks Pump Information: Intake Depth~.~Pump Size ~2~:3 ,A,"p .,,/,,~:) f Static Water Level ~ ~;~ ! Ay. Discharge ,/~:~ : '~" Date .,¢/~¢/~/ Pump Off: Pump On: ' Time //.' Air Line GPM Max. Drawdown Time / ~ ~'"~' Date WATER PIEZO- FLOW WATER PIEZO- FLOW "' '".; TIME LEVEL TUBE GPM REMARKS TIME LEVEL TUBE GPM REMARKS ~,, /~,'/~ ~.1 ~" /~ ..... .~ ,. TEST~ ~' P UMP~EPORT Conducted By- ~.C/- ,~ ~ ~,~ ,'~ ~ Well Information: Ttl, Depth Depth of Casing Screen From/ To Casing Size Screen Diam Screen Slot. , Pump Information: Int~keDepth PumR~ize. Air Line Depth. Static Water Level c~ Ay. Discharge GPM, Max. Drawdown PumpOn: Time~// ~ Date Pump Off: Time Date Sheet__ ~. Date:. WATERWELL - of WATER : PIEZO- FLOW WATER PIEZO- FLOW TIME LEVEL TUBE GPM REMARKS TIME LEVEL TUBE GPM REMARKS y/vo ~7 ~'~, ...~:.' , ~.