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Home My WebLink AboutBUBBLING BROOK LT 7lB lin 'Br, lc -.7 015 - Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report ~~ ~ ~ ~ ~c~u~ Wastewater System: D New ~Upgrade Address: Phone: I NO. of Bedims: ~ Deep Trench ~hallow Trench ~ Bed ~ Mound ~ Other LEGAL DESCRIPTI ON soi~ Rating: Total Dept~ frompriginal grade: Lot: Block: Subdiv~ion: Depth to pipe bo~o~ fro~original grade: Gravel depth ~eath pipe Township: I.~.~e: I S~"on: Fill added above original grade: Gravel I~ngth: __ Gravel width:~ Number of lines: Distance ~tw~n lin~: WELL: D New D Upgrade ~ ' -- Ft. ~ / ~ Ft. Classification (Private, A,B,C): Total De~ ~To: Total absorption area: Pipe material:/ ' ' Date Drilled: Static Water Level:Ft. Inst~e~m~ ~ ~ Dateinstall~d:/~/~ I ICasing Height A've GrOund: TANK ~ GPM Ft. Ft. SEPARATION DISTANCES ~SepUc ~ Ho~ing ~ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~~~ Material: Number of Compa~ments: Sudace LIFT STATION Lot Size in gallons: Manufacturer: ~ "Pump on' Iovol at ~ at: '~ Foundation J~ ~& ~ ~ Cu~ainDrain ~ ~ /~ ~ -- -- ~ IElectrical Inspecti°nsped°rmeo by: Remarks: ~ ~S~ ~~t~b ~ W~E BENCH MARK Location and Description: I Assumed Elevation: Depa~ment of Health and Human Se~ices approval Reviewed and approved by:-- .~~/~ ~_ Date:/~-2~' ~ 72-013 (Rev. 9/91) MOA 25 PERMIT ND, ~W98039i ~] Tei~ I, El~c Eswl; .., / ~ ...... >"',~ :"',:" \ BUBBL/i/NG BROOK Cir .................. ' ...... ,-, ....... '---., .......... ,,,,,..-' [XIS T'O Fm:~ ../ ' ............ ~':''':'¥ ...... / ....... . '':'' ' ................ . ............ ~;; NEV ~EPTIC~YSTE" !VER [ . ... ...... ~~/T~ ~ ~ NEW 1250 g I / '~'":- ......................... ~ ?' .,"~ ~ / I ~ / : ....... ~ / ~ ;' ~ ~ ~ ~ / EXIST'G DRW' SYSTEM I~ / ~ .,?~ ~/ : .......... .... / ,. 83.8 ~ · % TI 1 -/' DC ~,1 31,7 ........... i.:~ ......... \ ' ..,,,' ........ M: / ~8.?77,~ ..... ~'~ ...................... Ca/m.~ ' 88.3 107.9 ~-- ~[ .... I' ~ - ~ ' P~EPARE9 Doug ~ Lynn Wot ve I *~'"..~u'~ ...... '" ~-~Y'- Anchoma~e, AK 99516 /I / / / / DESIGN PERC RATE, 60 MIN/INCH ~[]IL RATD 333 87,0 ii3,7 38.4 83,5 3~BR HOUSE I000 SF REQUIRED 3 5-WIDE TRENCHE~ 2' EFF, 60' LONG EACH, R,F,= 0,70 PANNDNE ENG, ,~VC P, D, BDX i420~'5 ' ANCHDRAGE, ALASKA 99514 272-8218 Phone & Fax I)A, ~, 10-,u-98 AS-BUILT SCALE, 1'=50' , Wootiver Circle P,I,D. ND, 015-492-11 AS- UILT DETAILS WASTEWATER ABSORPTION SYSTEM LOT 7 BUBBLING BROOK S/I) PERMIT NO, SW980391 I Z m.m 3Eni BOIINOW 3Agra B31B3^IE iflO-N¥392 lno-N¥]n3 lnON¥390 lnDNV390 £nON~393 NOIi¥~NnOJ PANNDNE ENG, SVC, P, D, BOX 142025 ANCHORAGE, ALASKA 99514 274-0308, 272-8218 FAX IIATE~ 10-10-98 I ~iOT TO SCALE AS-BUILT MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 02, 1998 Expiration Date: Oct 02, 1999 Permit Number: SW980391 Legal Description: BUBBLING BROOK LT 7 Design Engineer: 0062 Steven R. Pannone, P.E. Owner Name: Doug & Lynn Wooliver Owner Address: 6250 Bubbling Brook Circle Anchorage, AK 99516-1834 Parcel ID: 015-492-11 Site Address: 006350 BUBBLING BROOK CIR Lot Size: 48989 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By:'''-~:~~ Date: Steven R. Pannone, P.E. Consulting Engineer (907) 272-8218 P.O. Box 142025 Anchorage, Alaska, 99514 (907)272-8218 Fax September 27, 1998 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519 Subject: Lot 7 Bubbling Brook Subdivision, Emergency Septic upgrade System Permit Gentlemen: My firm was contacted to test the existing septic system for the referenced lot. The liquid level was found to be 4 inches deep in the foundation clean-out, and above the lateral pipe of the field. We conducted a single test hole on September 23, 1998 for a the upgrade system design. The soils report and a percolation test results are attached. No ground water was encountered, however damp soils were found 13 feet below the surface. No bedrock was encountered in the test hole. The lot is approximately 1.1 acres in size. Lot 7 slopes to the southwest at a rate of approximately 5-6 percent. The north eastern portion of the lot rises approximately 5 feet and then levels off. The proposed installation will be located on the northern portion of the lot. The existing 1,000 gallon septic tank will be verified for integrity, and reused if found compitent. The existing field will be reused. A diverter valve will be installed after the tank to control the direction of the effluent flow. Double clean-outs will be installed after the tank and diverter valve. The proposed location is greater than 100 feet away from the existing well serving this property and 25 feet from the water service lines. The surrounding wells are located greater than 100 feet from the proposed installation. The proposed installation will not affect the future development of the surrounding or existing lots. See the attached design. Please contact me at 272-8218 or 227-3522-g-~.(~¢ have any.questiQns~ahotat-~h,e proposed installation. :~::.;,:,..,~,,;~.' · . - Sincerely, ~ne, P.E. Attachments: C:\WORK\7BubblingBrook.001.~Pd ~Steven R. Pannone~ ~;.i.~'i~c~ ~t....~;- ':'....'.~..'~'.~.....:S,SL;..S '*'--,..,. ": BU~ING BROOK Cir ~' ~z~_ ::.'.'.~ ,, ...... . ......... ¢.;4 5-~I~E TRENCHE~ / '-~ · ~ELL ....... -"~ ~ ~H · j~: ~ ~ f'" t~ -: ..................................... / : ~:~ ~ :~ ~ ~ ~ ........... ~ '/~ . " ~' ~k ~ ...~ 'TIC TANK / ~. >]~ [. .: ~ ~ '"~ IEE[FY [NTEGE[TY / '~. ~ ~ ,~ ~:~'- ~.. . ......../ ~' ~ :.... .: ::._. ................. : / ,, /: / ~ /~....~ ./ ~ ',, / / ~.-":: ..... ~'C..~.:: ................... .,':' / ...... ,,,,, / ::::::::::::::::::::::::::: .. ~.. ~ ~~ / .......... / ........................ · ",'~~ , / .: ~/ ~PERC RATE, 60 MIN/INCH ~ :- ~[ ~SDIL RATE, 333 SF/BR ~ ~ ...... = ~ 3 ~-VIgE TRENCHES ~ ~t :-'-" ~' ... 8' EFF, 60' LONG EACH, ~ , / .'""~ R,F,= 0,70 , ~ ~ ~ ....... / 1,EB6 SF TOTAL ~ 49~ - C,j,_,ork~/P. ~~ a' TOTAL ~EPTH PREPARE9 FOR' PANNONE ENG, SVC Doug & Lynn Woollver 6520 Bubbtlng Brook Circle Anchorage, AK 99516 346-1129 P. 0. BDX 142025 ANCHDRAGE, ALASKA 99514 272-8218 Phone & Fax DATE, 9-87-98 [ DESIGN SCALEml'=I~/e~:>' I P,I.D, Nh, n15-492-11 DESIGN DETAILS WASTEWATER ABSORPTIDN SYSTEM LOT 7 BUBBLING BROOK PERMIT Nh, SW980 T Z W n~ p- 'I- Z z 3Efli ~n/IN[~ lflO-N~3q3 lnDN¥390 m-" lnON¥390 inDNV39J l~ll]N4r~90 inON~390 PANNONE ENG, SVC, P, O, BOX 148085 ANCHORAGE, ALASKA 99514 874-0308, 878-8818 FAX )ATE, 9-87-98 I gOT TO SCALEI DESIGN Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED LEGAL DESCR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS '-'7-"~"(-'/'~0/.. ~ L) DATE PER FORI~ Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT I O DEPTH.;' i"~ p E Monitoring? ~ i',,~ '"'/ Date: Gross Net Depth ~'~' Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER ET AND '~ ET PERFORMED BY: ~ ' 'IC'".X'--~,/'L) ~.) c9''''~f'~ ' I ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: !~~ _ 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 ~NEW LEGAL DESCRIPTION ] Welt [ Absorption area D~elling PERMII NO. DISTANCE TO: I I Manufacturer Material . No. of compartments Liq. c~pacity in gallons Inside length Width Liquid depth / ~ ~ O IF HOMEMADE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons ~ Well Foundation Nearest lot line PERMIT NO. ~ ~ ~ ~o. of lines ken,th of each line Total length o~ lines Trench ~idth Distance between lines -- ~ ~, ?~ .~6 ~O inches ~ ~ ~ Top of tile to finish grade Material beneath tile Total effective absorption area O 2 --¢ / Z ~ inches ~O 0 Length Width Depth PERMIT NO. < ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER ~. &O~ ~.~ PIPE MATERIALS /ear xz.o ., / REMARKS , APPROVED DATE LEGAL 72-013 (Rev. 3/78) PER. MIT NO. I'-lldl'-~ ir C: 1' ~ :iL 1' T'-r' IDF- RI'-.I~-:H F-:RISE DEPHRTMENT' - 0~' HERLTH RN[:, EN',,,'IRC~NMENTRL F~:OTEC:TION 825 '"L'" STREET., RNCHORRGE.. RK. 264-472E1 I~--IEbb F-~l'-4r:, r~l--.t--".=% I Ti SEI.,.IEF..: F'EI~:I"! I < 81062L=: ) RPF'L I C:RNT LOC:RT I ON LEGRL C:OLON I RL ENTERPR I SES E:UBBLING BROOK C:IRCLE L7 B'l BUBBLING BROOK 4325 LRUREL ST #230 LOT SIZE 60000 SQLIRRE FEET TYPE OF SOIL RBSORF'TIL-IN SYSTEM IS: TRENCH MR>,',IMUM HUME:ER OF BEDRC~OMS = x.: SOIL RRTING (SQ FT/'BR)= 320 'THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS: [:, E F' T H == :1. 2 L E I%i ~3 T H = 7 2 C~ F-: R "-.-' E L [:, E I=' T H = :.~: THE LENGTH DIMENSION IS THE LENGTH (IN FEET:.', OF THE TRENCH OR DRRINFIELD. THE DEF'TH OF FI TRENCH OR PIT IS THE D ISTRNCE BETWEEN THE SURFFIC:E OF THE GR. OUN[:, RND THE BOTTOM OF THE E'XC:FIVFITION (IN FEET;). ]'HERE I'=; NO SET WIDTH FOR TRENCHES. THE GRFI'v'EL DEPTH IS THE MINIMLIM DEPTH OF GF.'.R',,,'EL BETHEEN THE OUTFFILL PIPE FIND THE BOTTOM OF THE E::<CFIVFITION (IN FEET.'.,. F=: F_' C::! LI I F-:E[:, SEF'T I C: TR~-~c: '=; I ZE= l~Z~£1LZ~ PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTRLLRTION INSPECTIONS OF RN¥ WELLS R[:,JRCENT TO THIS PROPERTY RND THE .NUMBEF.: OF RESIDENCES THRT THE WELL HILL SERVE TL..iC~ ,:: 2 ) I [-~'_=.PEC:I- I C~[-4S IR~:E I;~:E,:-:! L, I I~:E[:, 8RCKFILLING OF RN'T' SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL B'¢ THIS DEPRRTMENT HILL BE SUBJECT TO PROSEE:UTION MINIMIJM DISTRNCE BETWEEN R HELL RND RN'¢ ON-SITE SEWRGE DISPOSRL S'T'STEM IS t00 FEET FOF.'. R PR I ',,,'RTE HELL OR ±50 TO 200 FEET FROM R PUBLIC' WELL DEPENDING UPON THE TYPE OF F'USLIC HELL MINIMUM DISTRNCE FROM R PRIVFITE HELL TO R PF.:IVRTE SEWEF.'. LINE IS 25 FEET FIN[:, TO R C:OMMUNIT'T' SEHER LINE IS 75 FEET. P.IELL LOGS RRE REQUIRE[:, RN[:, MUST BE RETURNED TO THE DEPRRTMENT WITHIN 30 DRYS OF THE HELL COMPLETION. OTHEF.: REQUIREMENTS MR'¢ RPPL'¢. SPECIFIE:RTIONS RND CONSTRUE:TION [:,IRGRRMS RRE R'./'RILRBLE TO INSURE PROPER IN'--;TRLLRTION. F'EF:I'-I I T E ::-::F' I F-: E'_::. E.:,EF:EI'.IBEF-: _---::1.. 19E:1 I CERTIF;T' THRT I: I FIM FRMILIFtR WITH THE REQUIREMENTS FOR ON-SITE SEWER'=; FIND HELLS RS SET FORTH B'¢ THE MUNICIPRLIT'¢ OF RNCHORRGE 2: I HILL INSTRLL THE SYSTEM IN RCCORDRNCE HITH THE CODES. 3:' I ~Rz, THN[. THHT THE~JN-z, ITE =,_PIE. :.Tz. TEM flHm REQUIRE ENLRRGEMENT ~'ESID~~REM~[:' T~ INCLLI[:,E MORE THRN 3: E:E[:,ROOMS. , / ? , . - ./ - - / / , IF THE V4. 0 · ~" . -'50I L5 · . .LOG PROJECT Bubbltnq Brook Subd. .. TEST HOLE NO. 7 ELEV. TOP OF HOLE 700 · DATE '11/15/77 CLIENT Buster Newton W.O. 77886 Peat, PT:.' Damp,'brown, gravelly sandy silt, ML '- .. Damp, brown sandy silt, ML .:. Grey lenses, traces of gravel Damp, brown, sandy silt, ML : -. (some small gravel) "' 6ottom Ot HOle NOTE: 1. No ground water table at time of drilling. 2. Field perculation test results - 60 min/inch. UNWIF'- SCHEBEN · RY N TA CONSULTING ENGIREERS AND SURVEYORS - 2515 A ST., ANCHORAGE 99503 (907) 276-4245 December 5, 1977 Mr. Buster Newton "~' '- 411' East 36th Avenue .' Anchorage, Alaska 99503 Re: Proposed Bubbling Brook Subdivision Subsurface Soils Investigation Dear Mr. Newton: This report presents the results of our soils investigation for the proposed subdivision of a l0 acre tract located east of Birch Road and just west of ' Ravenwood Subdivision. The investigation was:conducted on November 15 and 16, 1977. The results of this investigation are included in this report as follows: Vicinity Map Test Hole Location Sketch Test Hole Logs (Sheets 1 through 9) Standard Explanatory Information Drilling was accomplished utilizing a mobile drill B-50 mounted on a flex track Nodwel vehicle, owned and operated by Denali Drilling, Inc. Test holes were logged and perculation tests conducted by our firm. The purpose of the investigation was to provide soils data and perculation tests for establishing the feasibility of on-site disposal of sanitary wastes using seepage pits. To accomplish this, we drilled 9 borings distributed across the site with 1 test hole on each lot at the probable septic system location. The test hole locations are shown on the attached location sketch. All borings were drilled to a depth of 16 feet. During the drilling, our engineer was present to log the materials encountered and obtain grab samples of the soil types. All soils were visually classified in the field in accord- ance with the unified soil classification system as described in the standard explanatory information attached herewith. Since the site is fairly small and readily accessible from both sides, per- culation tests were conducted in all holes at the completion of the drilling and logging. The perculation tests were conducted from the 6 to 12 foot levels in each of the holes in accordance with the Manual For Septic Tank Practice published by the PHS. A ground water table was encountered in test hole Number g at the 12 foot level. Therefore, the perculation test in this hole was conducted between the 4 to 8 foot level. ~NWIN, P.E. LEO SCHEBEN, JR., P.E., L.S. EARL O. KORYNTA, E E. Hr. Buster Newton December 5, 1977 Page Two SITE AND SOIL CONDITIONS The site is a660 foot.~quare parRel havi.ng access from Rockridge Drive on the east and 'Ravenwood Subd)visidn on the south. The site is dissected in a southeasterly/northwesterly 'direction by a fork of the Little Campbell Creek. 'The parcel slopes uniformly from southeast to northwest at an approximate 6% to 8% average slope. A small knoll is located in the southeasterly corner. T'here are no areas with slopes in excess of 25%. The parcel may be divided into two very distinct soil map units for purposes of identifying perculation characteristics. A 300 to 400 foot wide band centered.on the creek channel is characteristic of old alluvial deposits and consists primarily of well graded sands and gravels with good perculation characteristics. Test holes 2, 8 and g are typical of this deposit. Beyond this band, the materials are much siltier and tighter as demonstrated by test holes l, 3, 5, 6 and 7. CONCLUSIONS The minimum perculation rates observed in-the field for the. following holes are: Test Hole Number 1 - 30 minutes per inch Test Hole Number 2 - 13 minutes per inch Test Hole Number 3 - 30 minutes per inch Test Hole Number 5 - 35 minutes per inch Test Hole Number 6 - 45 minutes per inch Test Hole Number 7 - 60 minutes per inch Test Hole Number 8 - 5 minutes per inch Test Hole Number 9 - 5 minutes per inch On-site waste disposal systems appear feasible on all lots. An aerated package plant or other treatment process is advisable for the lots with high percula- tion rates. We hope this is sufficient for your present needs. If we can offer further clarification, please do not hesitate.to contact us. Very truly yours, Earl D.~ Korynta, P.E. Attachments EDK/cl r .~ o - 0 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 Parcel I.D. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description /..~"-r- ~Z--~-"~'-~'~L./,,u~,~'~I~o//_, ~,/~-,~ Location (site address or directions) Property oWner Mailing address Lending agency Mailing addreSs ,~' Day phone ~ ~¢ -//~- c~ Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Agent A d d ress'--~ ~..,,~ ~ tc Unless otherwise requested, HAA will be held for pickup. NOTE: Day phone '~ Individual well Community well Public water If community well system, provide written confirmation from State AD£C attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site ~: 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 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/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 FirmC-~Ck,~/¢ Address Engineer's signatur~ SIGNATURE Approved for J~ Disapproved. Conditional approval for bedrooms. DHHS Phone '~ ~--¢.~ ~'~ 9 ~ 5'/~f 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 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 engineeCs work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage ~Cf DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 34,:~.~/~L 825"L" Street, Room 502 · Anchorage, Alaska 99501· (907) - Legal Description: A. WELL DATA Bo Co Health Authority Approval Checklist Well type'-'~F2 ~.~1 A-'r-~- Log present (Y/N) 'Wv Total depth [ '~"Q ! Sanitary seal (Y/N) Date of test Static water level Well production If A. B. or C. attach ADEC letter. ADEC water system number Date completed Cased to ~ ~ '+ FROM WELL LOG Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION / ~2> g.p.m d-/ . c~ g.p.m ~'. j F[~ L¢ Other bacteria Collected by: ~ ¢'~ ~') WATER SAMPLE RESULTS: Coliform ~ O~ ~ Nitrate Date of sample: / SEPTIC/HOLDING TANK DATA Date installed /O /~3 tt~ ~ Tank size Foundation cleanout iY/N) Date of Pumping . ABSORPTION FIELD DATA Date insialled Length /~ t Width /2,~C:> Number of Compartments ,:::' Cleanouts (Y/N) ~ Depression (Y/N) ~ High water alarm (Y/N) ,A. Jf~ Pumper /k.] ~'(-4-) Soil rating (g.p.d./fl: or fi:/bdrm) d>..~,b'- System Gravel thickness below pipe EffectN~ absorption area /.g,g {:> Monitoring Tube present(Y/N) Date of adequacy test l o let[ ~ ~ tOc_aqJ Results (Pass/Fail) ~--'~ Fluid depth in absorption field before test (in.): dxJt:,a~,--aImmediately ,'ffter ~ gal. water added (in.): Fluid depth '' (ius.) Minutes later: ~ Absorption rate = ~ g.p.d. Peroxide treatment (past 12 mol~ths) (Y/N) ~ If yes. give date ~. o__ Total depth __ Depression over field (Y/N) For ~ bedrooms Do LIFT STATION Dale installed Manhole/Access (Y/N) .~;P4~nl~n' level at* "Pump off' level at* ~ , t *Datum High water alarm le55eA-~W~ E. SEPARATION DISTANCES Absorption field on lot Public sewer main Sewer/septic service line SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot / · On adjacent lots · On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation / CP Property line ::~ '~ ! Absorption field Water main/service line "~O~ Surface water/drainage / OO* Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation ~, ~, Water main/service line Surface water / ~0-f + Curtain drain / ~'~'/- Wells on adjacent lots / o o Driveway, parking/vehicle storage area Property line /~. F. ENGINEER'S CERTIFICATION ! certify that i have determined thrufield inspections and review of~[]unicipal recor~~rns are ~,,,., ~,o~ .~ ~,~,,.~ ,,, ~c, o. ,~,s ~,~,~. in cot~FmaHce Date /~ [~O~ .__,~._,~~ .... .................... ¢ ........... ............................................. :_:__ ..... HAA Fee $ ~~ ~ ' Waiver Fee $ Date of Payment ~/~~ ~ Date of Payment Rev. 8/95 OSS: haa.wk.doc 0CT-15-~8 20:2~ I:R~-CI~ ENVIRC)NHENTAL ~ CT&E IEnvlmnm~t~! Gervi~ In;. T-031 P.0Z/03 Client ]Fl'Jnted ])nte/~ime 10/15/9S ] 1:23 CotleeTed Dnte/Time 10/11/98 15:30 Received Date/Time 10/12/~)8 ]0:~0 T~clmical Director. ~epben C. Ede Pa~mmtmr Rm~oT~$ PO~ NiTriCe-N 0,100 U ToTaL CoLftaro', 209' 06/100 #L 0.100 mg/~ EPA 300.0 ~0 max 10/12/98 1~/17./98 GCP ~18 g22~ I0/I~/9D CAP 0CT-29-1998 16: l? CTgE ESI ANCHORAGE 9075615~! P.05×05 CT&E EnvironmenUd Sen~oe~ lnG. 200 W. Potter Driw: Ddnking Watc~ Analysis Report for Tot_n_] Coliform Bacteria~,l:'~"°'n*.(~) ~-~.~^~ ItE/~D [Nx~UL~TiO~V$ ON ~BF~.~R sug n~t~O.m~ cor. r~C'IZNO SAMPi,~ , F, ~c (~07) 661 -- MUST BE COMPLETED BY WATI~I~ SUPPL[~ I TO B~ CO. Lc r~D BY LAB0~,~ TORY ~ PmVATE WATER aYS~M , I' n ~ Q ~d~,~ ~ St~i~ D ~ie~3Oho~o~uhsmaY SAMPLE DATE: SAMPLE TYPE: Mon~ Day Y~u' n Tr~med Wmr ' Numl~ of e. olo~i~/t O~ mi. J?~tllt* Altalyst 981 31 0 Fued 0 Routi~ Repot Smpb (for routi~'~anp~e wtth lab ref. rm. ) U~ W~m. BAC'r~RIOLOGICAL WATER A~ALYSIS RECORD MMO-MUG Pa~i~ T~81 C~il~rm ..... ~ MembFIne lqRer: D4re~ Count ~ ColonM/1M mi Vlrlllcatl~u: LTB BGB FeM ColEorm Conflrnm~,~ Coliform/lO~ mi -230 [] Fued TOTAL P, ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (ad,dress or directions) (b) Prope~y Owner P~ ~ ~;~ ~elephone: Home Business Mailing Address (C) Lending Institution ~4,~.,UU'~ .~';l/'~¢ Mailing Address Telephone (d) Real Estate Company and Agent Address (e) Telephone ~'"-~ ~ - / Mail the HAA to the followino address: or: Check here ~ if hold for p.,i~k List contact person and day phone number below. up. TYPE OF RESIDENCE Single-Family,S]. Number of Bedroom~ WATER SUPPLY Individual Well ¢~. Community [] 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 [] 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. Page I of 2 72-025 (Rev 8/86~ Front ENGINEERING FIRM PROVIDING INSPECTIONS, 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 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 ins~;L~G,t~n. Name of Firm Address Date ,,,~ '.-%-o ; '. ~ ,,- ~ -';~,,',.'.:,..,-,;, .'. , .,', . Engineer's Seal DHHS APPROVAL Approved for ~'"~/~ ~o~?bedr00ms by Approved ~ Disapproved Terms of Conditional Approval Conditional CAUTION The Municipality of Anchorage Department of Health and Human Services IDHHS) 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 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. Page 2 of 2 72-025 fRev 8/86~ Back ~% O~%xl\G~'~ MUNICIPALITY OF ANCHORAGE (MOA) ×C..x~ ~"'; ,~.~.5~ _ HEALTH AUTHORITY APPROVAL (HAA) x4x~O~t-~ .~ ~ CHECKLIST-FEBRUARY 1984 ~ ~ ~ ~ 264-4744 WELL DATA d15- PYz- // Well Classification ~"~--,~ Well Log Present (Y/N) Y Total Depth 1,),~..~ Cased to Static Water Level I ~Q~ c~ Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot I I~, If A, B, C, D.E.C. Approved (Y/N) Date Completed Cl/l"/-[~ I Yield 10 ~,~,'~ cji Depth of Grouting I~d 0~'4 Pump Set At ~ o '~,,'~'~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) · On Adjoining Lots To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results N Comments /,~ f.,4~., ~ J ~ O ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) 'T',,~'o Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course I Size /~::~O-¢_~ No. of Compartments T Air-tight Caps (Y/N) ~',/~ Foundation Cleanout.(Y/N) j~/ '/ Date Last Pumped Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field ~ To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026 fRev 8/861 Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed J~o V/ Width of Field 5 Square Feet of Absorption Area ~O-.o Depression over Field (Y/N) !%( Results of Last Adequacy Test Separation Distance from Absorption Field: /'~o To Water-Supply Well To Building Foundation Lot To Water Main/Service Line ~ I ~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) y o Date of Last Adequacy Test ~/Y/_~ ~ To Property Line / To Existing or Abandoned System on /~.~ · On Adjoining Lots To Cutbank (if present) Comments D. LIFT STATION 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 ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed "~ .-~ ~u4/~-~A,~ _ Date ~/.~_/~",~ Company f · MOA No Date of Payment ~ -//-~ ~ Amount:$ //~ ~ ,' ,t..4C~D t...[ ,~.~ Engineer's Seal Page 2 of 2 .'. 72-026 (Rev 8/86~ Back CONSULTING ENGINEER 203 W 15th AVE C' SUtTE ANCHORAGE. ALASKA TELEPHONE !907) 2?9 LEGAL: LOCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM ADEQUACY TEST .,,. '~-% ,:-,. ...... Lot 7, Block 1, Bubbling Brooks..."~":..-' ' 6250 Bubbling Brooks Frank Shields Single Family, Three Bedrooms On Site SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: Three Bedroom System TANK: Greer Steel, Two Comp, 1000 gal ABSORPTION SYSTEM: Trench ABSORPTION AREA: 400 sq. ft. SOIL RATING: 100 INSTALLATION DATE: Nov.1981 DATE OF LAST PUMPING: August 6th. 1988 Isaacs DATE OF TEST: August 4th, 1988 TEST PROCEDURE: System was inspected and measured. Tank was found with 2 feet of cover and 51 inches of liquid. Cleanout ko ~ed was 3 feet deep and had water in the Jmv~rt.~ ~m~, tO bed ANCHORAG[' TELEPHONE (907! op RESIDENTIAL WELL INSPECTION LEGAL: Lot 7, Block 1, Bubbling Brooks LOCATION: 6250 Bubbling Brooks OWNER: Frank Shields TYPE OF WELL: Residential Single Family WELL LOG AVAILABLE: Yes INSTALLATION REQUIREMENTS MET:Yes WELL YIELD FROM WELL LOG: 10 gpm PUMP YIELD FROM TEST: 6.5 gpm DATE OF INSPECTION: August 4, 1988 TEST PROCEDURE: Well was pumped at a constant rate while the drawdown was monitored with an acoustic probe. At the beginning of the test water level was found at 129 feet below top of casing. At a pumping rate of 6.5 gallons per minute the water level dropped to 160 feet after 45 minutes of pumping and remained at that level for the remainder of the test, 30 minutes. A total of 500 gallons were pumped. The well recovery rate was monitored for 15 minutes. The well recover to 141 feet during this period, a 61% recovery. TEST FOR E.COLI AND TOTAL NITROGEN: Water was tested for E.Coli and total nitrates on August 4, 1988 /Coli tn{c Total Nitrates ND mg/1. Max. allowable Total Nitrates 10mg/1. Well was disinfected on August 12,1988 and retested on the 15th. This time no E.Coli was found. TEST RESULTS: This well meets the requirements Municipality of Anchorage. of the THIS WELL WILL PRODUCE MORE THAN 3 GALLONS PER MINUTE FOR MORE THAN FOUR HOURS The Municipal requirement for well flow is 150 gallons of water per bedroom per day. This well exceed this requirement. The assessment of the condition of the well applies only to the conditions as of the day tested. The flow rate may change due to subsurface conditions that may not be observed from the surface, and changes in the land use and other factors that may impact the aquifer feeding the well. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICA'rE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY Application Date _ / / GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name _~~¢-~- ............. Telephop. e~-Hcrme- Business (c) Applicant is (check one): Lending !ns~itution b-] ' Owner/build~,~3uyer [] ' Other [] (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address (f) Te!ephone Mail the HAA to the following address: TYPE OF RESIDENCE Singte-Fami!y-"~ Multi-Family [] Number of Bedrooms .... ..~ Other WATER SUPPLY We!l ~L Community [] Public E'] Individual f 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[] Holding Tank[] Note: If community welt system, must have written confirmation from the State Department of Environmental Conservation attest n9 to the legality and status. ~-o25 Page 1 of 2 5o ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by rny seal affixed hereto and as of the validation date shown below, I verify that my investigation oi'~is Hea~h Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequ~te for the number of bedrooms and type of structure indicated herein. I fu~her verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply ~nd/or w~tewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations i~ effect on the date of th~s inspection. Name of Firm ~(S 2 ~C Telephone ~%~g / Date ApF. ro,;ed ~or Approved bedrooms by _ ate ......Disapproved Terms of Conditional Approva! CAUTION The M~r.,c pahty of Anchorage Department of Health and Environmentai Protection (DHEP) issues Health Authority Apr/o,al cert. dmates based solely upon the representations given in paragraph 5 above by an independent professional eng"~eer regi.ttered ~n the State of Alaska. The DPIEP does this as a courtesy to purchasers of homes and their iendmg ir~st;t.,tfor~, ~r' order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or ar~a~yze data before a certificate is ~ssued The Mu~icipality of Anchorage is not responsible for errors or omissions in the profess, o¢~a; e'~gineer'5 work Page 2 of 2 A. WELL DATA Well Classification /~¢'v~ ~ ,~¢~ell Log Present~N) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: ,L~7'- :7- If A, B, C, D.E.C. Approved (Y/N) Date Completed ~///7/~"/ Yield Total Depth /"~ '~' f Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit/~) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments (¢) ~ ?'~::~,/~/'¢~' Depth of Grouting .,'~"/-~:~ Pump Set At Sanitary Seal on Casingt~lN) Depression Around Wellhead (Y"~_ · On Adjoining Lots · On Adjoining Lots /--/~ B. SEPTIC/HOLDING TANK DATA :~/.~ To Nearest Public Sewer /t~4-'~ To Nearest Sewer Service Line on Lot ! I / Date Installed / {//~ Standpipes ~q) Depression over Tank (Y./~)//) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well I To Property Line To Water Main/Service Line '~-/¢/~'~ Course Comments Size / t~)O No. of Compartments Air-tight Caps') Foundation Cleanou(~)N.) . Date Last Pumped .~4- 'for ~emporary Holding Tank Permit (Y/N) To Building Foundation ~ / To Disposal Field ~ / To Stream, 'Pond, Lake, or Major Drainage Page I of 2 72-026(11,84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y(~ ",~TResults of Last Adequacy Test Length of Field Depth of Field Gravel Bed Thickness ~ /' ~ Standpipes Present(~N) Date of Last Adequacy Test Type of System Design ~ ~.~C~-~ Separation Distance from Absorption Field: To Water-Supply Well //,.~¢7/ To Building Foundation ,~ ! / ~ Lot To Water Main/Service Line 1~ ~ ~'~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Stor,~e Area Comments ~~_-~'],-z~-~,,~_' _~2~ To Property Line /~-~ To Existing or Abandoned System on · On Adjoining Lots ¢- ;~'~:) To Cutbank (if present) D. LIFT STATION Date Installed ~ Dimensions Size in Gallons / /~¢~' M~____- "Pump On" Level at / I¢ ! ~ "Pump Off" Level at High Water Alarm Level at A_/~''''~ Vent(Y/N)--~~ ~ Pumping Cycles during Adequacy Test. Meets MOA Tested for Electrical G o~-'~ ) Comm~ Page 2 of 2 ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I hav/e:?,hecked, ve.~d, or conformed to all M/O/an,¢ HAA guidelines in effect on the date of this inspection· Signed //¢¢¢"/~ -~:~/~Date 0~'¢'/~"/'~' ~'~ Receipt No. ~ ~ O% ~._.~.;,.~ ,. Amount: $ ~ CO "'~' '*' "'"'~ """"'; ' ' ¢¢~'_,,' ~:.~ '%~- bngmeers Seal Time ime Date Date Date Inspector Inspector Inspector Comments Conditional Approval (5) Approved Bedrooms ( ) Disapproved ( ) Conditional Approval Date Sewer Installed ~,~_~.~ Permit No. Septic Tank Size //~ ~( Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner ~ ~ ~/~ Phone Lending Institution ~/4~ ~g Phone Type~f Residence ~ Single Family ~ Multiple Family No. of Bedrooms ~ Other Wat~upply ~ Individual A~ACH WELL LOG. A well log is required for all wells drilled since June ~ Community 1975. For wells drilled prior to that date, give well depth (attach log if ~ Public Utility available.) Sew~e Disposal /~/ ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holdin~ Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ALASKA 6 IUIROFImI FITAL COFITROL $1 R[11C65, IRC. ~nqin¢cHnq $ (~nuironmental Studies EDGER SHIELDS 6250 BUBBLING BROOK ANCHORAGE ALASKA 99516 SELLER-SAME AUGUST 5 1985 EDGER SHIELDS 6250 BUBBLING BROOK ANCHORAGE ALASKA 99516 50489 LEGAL:BUBBLING BROOK BLOCK 1 LOT 7 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE-AUGUST 2 1985 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 400 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 682 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON AUGUST 2 1985 . FLOW TEST ON WELL WELL FLOW DATE-AUGUST 2 1985 A FLOW TEST WAS PERFORMED ON THE WELL. 682 GALLONS OF WATER WAS PUMPED AT A RATE OF 5.2 GPM OVER A DURATION OF 2.1 HOURS. THE DRAWDOWN WAS 26 ' WITH A RECOVERY TIME OF 70 MINUTES AND THE STATIC WATER LEVEL WAS 125 FEET. THE WELL IS ADEQUATE FOR THIS 3 BEDROOM HOME. 1200 ~¢st 33rd Aucnu¢. Sufl6 E~, Anc~oraq¢. Alosko 99503 ,[907) 561-5040