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Home My WebLink AboutSOUTH LAKEWOOD HILLS BLK 1 LT 9/0 NAME ,~IUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 / Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE (-~ ~'NEw [~., ~-~.,_ [] UPGRADE LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS Absorption area Dwe Ing ¢~ ~ PERMIT NO. DISTANCE TO: ~ L~q' ca~aciW in gaU°ns I IF HrOMEMADE' DISTANCETO Well Dwelling PERMITNO. ~ e ~ ~ Top of tiJe to finish grade Mater~al beneath tde _=. /- Total effectl~ a~sorpt~on area ~ ~ ~el~ ' / Building foundation Nearestlotline DISTANCE TO: ~ a~s ~- . ~ Depth Driller Distance to lot ~e PERMIT NO. ~ I Di~TANCETO: Bui~dh~g foundation Sower line I Septic tank I Absorption area(s) OTHER PIPE MATERIALS , SOIL TEST RATING INSTALLER DATE LEGAL PEk::M I T NO. FiP PI.... :[ CfN]' L..OOFf'F I (,'.'iN L..EGI::~L ;;i!:4][: E;E:]=;8 2:5680 S(:!UF:IRE: FE:ET TYPE OF' SOIL FtDSORBTION S;Y$"f'EM IS: "FRENCH MFtXII"IUH NUMBER OF' E:EDROOHS = 4 SOIL. RFITIF,IG ,::SQ F:'T/'BR)= 85 .:,.[~:-E OF TIdE z,_ II... FIEZ5ORF:"l"ION _,'r_,lLIt THE REQU I REE:' ':"" '":' ' ' ' '=' "::'"' ='" I SE;: lC::. E: F:' "T" F...~I :== ~ I1.._ EE ~"~, ~Z~ 'T' V"~ == ~ CFa F~: IFil %." 'I"HE LENG"['H DIMENSION IE; THE LENGTH (IN FEE'r) OF THE TRENCH OR DRFIINF:[E:L.D. THE [)EF:'TH OF F:I TREI'.,It:::H OR PZT ZS THE DIE;TFINCE BETNEE]'.,I THE SURFFICE OF THE GI:;?OIJND FIN[::, THE BOTTOM OF THE E>,:CFI',,,'Ftl"ION (IN FEET). THERE IfS NO SET I.,.IZE:,TH FOR TRENCHES. THE GRFY,/EL.. [)E:PTH I'Z, THE HINIHUH DEPTH OF GRFIVEI._ BE]"klEEN THE OUTFFtL. L PIPE: FINE:, ]]..'IE: BOTTOM OF THE EXCI::I',,,'F':ITION (IN FEET). PERMIT FIPPLICFINT' k.IFIS THE REE:PON'Z';IE:IL. ITY "FO INFORM TF'IIE; ZNE;TFIU...F:ITION INSPEEC:TIONS OF f:INY I,.!ELLS FIDJF:ICENT TC) 'TI-lIE: NIJME:ER OF RESIDENC:EE!: THFt]' THE: WELL 141'EL. SERYE:. DEPI:iRTMENT DURING THE PROPERTY FIND THE L:~F'IC:KF ILL :[ NG OF' FIN¥ E;YE;"rEM 141THOLIT F I NFIL. I NSPEC'T' I ON FIND F:iF'PRO'v'F:IL. DY 'T'H I S [)E~I::'FIR]]',tENT kll'LL. DE E;IJE:JECT TO PROSECUTION. I',IIi',IIMUH DISTf:fl'.,ICE: [~E.:TNEEN 8 FtEL..L F~N[:, FINY ON-SITE SEI,.IFIGE DI:!~::POSFIL SYSTEM :1..6)0 F:'EET FOR Et F'RI',,,'F:ITE I,.IE[...L..; OR :LSE~ TCI 20El F:EET FROM Ft PUBLIC !4ELL. DEPEND :i: NG UPON THE TYF'E OF PUDL. IC: NE::L.[ .... WELL LOGS FiRE REQLIIR[.SI) FII'.4[:, MI..IE;T DE RETURNED TO THE DEPFIR"rMENT t.,.1ZTH]'N ]:E~ [)I:::iYE; OF THE/ I,.IELL COMPLETION. OTHER REQUIREMEENTE; MFIY FIPPI..Y '.E;PEC]:FICf:FFi'ONS FIND CONS"I"RLICTIC~N DIFiGRFIMS FIF~:IE: FIYF:I:[L. FIBLE 'T'C~ ZNSURE PROPER INSTFILLFtT]:ON. EEC EE: ]: ::tl. ...... :::L ::..~;~ ';F;:' ,'E~: I C:ERTIFY THFIT J.: I FIH F'FIM]CL..IFIR WITH THE REQLIIF:'.EMENTS F:'OR ON-.E;ITE :SEI.'.IEERE; Fli",tD 1.4E:[...L..'.:~ RE; E;ET F'Cq:[:]"H E:Y THE MUNICIPFILITY OF FINCHOF~tF:IGE. 2: Z WILL INSTFILL THE SYSTEM ZN F:IC:CORDFINCE 14Z]']q THE CODES. 2: ]: I.JNDE:R%TFIND THFY[' THE (IN-SITE S.!;E],.IEt:~: SYSTEM MFIY REQUIRE: ENL. FIRGEhlENT tF THE F;;:ESIDENCE IS REMODELED TO .~NCLUDE MORE THFIN 4 BEE:,ROC)MS. SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-222'~ SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST · EG^L DESCR,PT,ON: /-.-01 q, BW'~.. I .,,~ L<;~/~<~'~'.-'O.'.:''J A"~t/¢ SLOPE SITE PLAN 2 3 5 6 7 8 10- 11 13¸-- 14- 15- 16- 17- 18- 19- 20- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop TEST RUN BETWEEN FT AND COMMENTS i FT DATE: FOSS DRILLING O 1336 Ingra Street Anchorage, Alaska 99501 ,'.OC*TION ./-,,0¢:9: lXJt.~.,k"l:R,:,:~ I.,,ok'~,t:,,.,.1J"],:.l L~ _K,.J::,¢ ,.:. v ~ g.o 0 SIZE OF CA~ING ~ DEPTH OF HOLE~T. STATIC WATER LEVEL/~__~FT. FEET OF DRAWDOWN. REMARKS DATE COMPLETED 7 ~"~'~" ~ ~ CASED TO YIELD / ~ GAL. PER · MIN · PUMP TO BE SET AT WITH ~'"~ PT. tO t O~ Cerfi i For~a~ .~. Johanl~es Size of casing---~ % I~Oh... Distance towater~02 ~Pet Distance to water while pumping ~_ t07 F~t at rate Desc' pt on of Formatio~ ~]~ &_Gravel Brh[,-' Soft avel ' GI'~~ Hard ~y & Ora~ Dk.C~ Soft $an5 ~ Dk.Orey Med. 2a~ ~av~WJth Water _o, 40 _ 74 , , .__?~ ' .. 114 ~21 121 122 ~2~ i certif~ the above true and correct. FOSS DRILLING ] 336 INGHA PH. 279-2849 ANCHORAGE, ALASKA 99501 We advise you to attach this certificate to your deed. Municipality of Anchorage Development Services Department 'Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. 'P.O.'Box 196650 Anchorage,~AK 99519-6650 www. ci.anch0rage.ak, us (907) 343-'I904 CERTIFICATE OF HEALTH AUTHORITY'APPROVAL FOR A SINGLE FAMILY DWELLING 1, GENERAL INFORMATION Complete legal descripti(~n /--~,~ q~ ~P--.I oq'ol Expiration'Date: ~ -//~) - O ~ LoCation (site address or directions) Current Property owner(s) · Mailing address Day phone Lending agency Day phone e Mailing address Real Estate Agent ..(~ ~ c ~ ['.c/ Mailing Address Unless otherwise requested, HAA wi//be held by DSD for pickup. NUMBER 'OF BEDROOMS: /1/ Day phone .b-b '~- 5-~,,,~.~'"" . e TYPE OF WATER SUPPLY: · Individual Well Individual Water Storage Community Class .~ Well Public water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer [] [] E] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authori,~, Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from. the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.' 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of' the validatioh date shOwn below, I vedfy that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further redly 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. bedrooms. Name of Firm "'~' k'b '~ ~ Address ~ ~ b~/' Engineer's PrintedName DSD SIGNATURE I,/ Approved for Disapproved. Conditional approval for bedrooms, with the following stipulations! : WASTEWATER : Additional comments Attachments: HAA Checklist . Septic System Advisory 'Well Flow Advisory X Maintenance Agreements Supplemental Engineer's RePort Other Original Cedificate Date: (Rev. 01/02) - : ; ~ ' i Municipality of AnChorage Develppment ServiCes Department .. ~ , ~ I~ i ' BUilding Safety DiviSion, i i'~, i ,i-' - on-site water & wastewater Program i , 4700 South Bragaw St. i':: ' i ?' ',.~,i P.O.'Box 196650 AhChorage;AK 99519-6650 , , www.ci.ahChorage.ak. Us · ! : : . i ,--. (907} 343-7904 :: HEALTH AUTHORITY, APPROVAL CHECKLIST , i , ' 'l~.'t ~OVTI~-~ t~,~F--~--..U/.,'~13 ParcellD:"O/5 ;.-::It>""/'-' Legal Description: : J_O'i'~ t t i · ,'" " A. WELL DATA ;~: we, type, ~ 4 : Date completed Total depth ' Date Of test :. Static water level A,B' or C provide PWSID # '1,-!//~ Sanitary seal (Y/N) ~/ Cased to lbo ft. FROM WELL LOG , .,,~,,; Well product, io,n WATER :~,MPLE RESULTS::' ':iColiform ~ ' &lonies/l~00'mL Arsenic: t~. mgJI. - . : B. SEPTIC/HOLDING T.~iK DATA fto g.p.m. Nitrate IXI L~ mg./l. Date of sample: ~/zbA y i r. Tank Type/Material ' J'"~' ~r~- ~, Tank size I~L'cTO .: gal. 'i N'Umber of Compadments .~-. ~ ~ Foundation cleanout (YIN) ~ Depression over tank (Y/N) ~[ Date of pu~ping ;. '~/5"/~'~: Pumper C.' ABSORPTION FIELD DATA ' ' Date installed~ ~/7~' :,Soil rating (g.p.d./ft Length ~, ft. - · Width Total depth J l ;E.' 'Eff~ ~bsomtion area ~ ,._M°nit°ring tube Date of adequacy ~est ~ V Results(Pass/Fail) Fluid depth in abso~tion field before test ~in. Water added ~Ogal. Elapsed Time':~, . ~ ::'~ Final fluid depth I~ in. Any rejuvenation treatment (past 12 mo.) (YiN & ~pe) g~p.m. Other bacteria ~ t.~ Colonies/100 mi. Co,ected by: Cleanouts (Y/N} ~ ' High water alarm (Y/N)" ~ :r',-:/ · System type ~', Gravel below Pipe:.~' i ' .ft. Depression over field I'-. IFor ~'~ Irooms . New ~dePih, ~?/-, in. Absorption rate >= ~·~O ~'. ig.p.d. If yes, give date v~ · AT INSPECTION '1o~' Wires properly protected (Y/N) ' ~ Casing height (above ground) ~·.: .:~..~. in. ;' gallons , Manhole/Access (Y/N) "Pump on" lev . ' "Puml5 o : in. . i High water alarm Datum cie~ te~., : _ ~: .: Meets'ala~ & c,cuit retirements? SEPA~TION DISTANCES FROM ~ELL:0N LOT TO: '. . : ~ ~ '?',.-:' Septictan~lift,station,[ onlot . '1'~~ ' ~.... : On adjacentlots Public sewer main . : ' Public sewer manholelcleanout Sewer/septic se~ice line ~ ~ ~': ' ~. ' Holdin {ank Building foundation ~.~ Propedy line J O T ;. ~ ~sorption field SEPA~TION DISTANCE FROM A~SORPTION FIELD' ON LOT.TO: Propedyline~ [ .~O ~ . Bulld~ngfoundatlon. . ~Watermam .'~ Water Se~ice line ] ~ suffac~water~.'~ :,~ ~ :. Dnveway,:park,ng/vehicle I ce~/fy that I have dete~ined thmugh fie/d ~nspecti?ns and ~' rewew of Municipal records that the ~bove systems are ~n ~ conformance w~h MOA H~ gu/defines m effect on'this date. Engineer's P~inted Name. ~ : ~ Receipt I ReceiptNumbe $G$ Ref,# CIlent Nnme Project Name/t/ Client Sample ID bintrix 1042075001 Tobben Spurkland P.E. L 9, B 1 South Lake Wood Hills L 9, B I South Lake Wood Hills Drinking Water All Dates/times are Alask~ Standnrd Time Printed Date/Time 04/30/2004 11:55 Collected Date/Time 04t26~2004 15:00 Received DatOTIme 04/26f/004 15:07 Technical Director Step]W~. C, Ede Relensed~~ 5amrle Rcm:rks: Allowable Prep A.~ly~is I'~r~'ne:er Results PQL Unit~ lMe~od Container ID Limits Date Date Ir. it Waters Depar~ent Nitrate-N 0.I00 U 0.100 m g,q., EPA 300.0 B (<-10) 04/27/134 JMP Nitrite-N 0.100 U 0.I 00 mg/L EPA 300.0 B (<-l) 04/27/04 JMP Microbiology Lnboratory 'Total Coliform 0 coVi 00mL SMI8 9222B A (<~l) 04/2C~04 DKC D'MALLEY RDAD N BcJ°SCJ'OO"E 17-.6.0D' 0 n THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BE~NEEN iXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL ;TRUCTURES OR FENCELINES. [ASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. NOTE: ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINE OR LOCATE STRUCTURES. ANY PAVING SHOWN MAY BE APPROXIMATE DUE TO SNOW CONDITIONS. NOTE : NO EASEMENTS APPEAR ON THIS LOT ON THE RECORD PLAT. AS-BUILT SURVEY ;CALE: 1' · 40' HERESY CERTIFY THAT I HAVE PERFORMED A VlORTGAGEE'S INSPECTION OF THE FOLLOWING 3ESCRIBED PROPERTY. LOT 9, BLOCK 1. SOUTH LAKEWOOD HILLS SUB. ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND THAT NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE. ALASKA THIS _:~0TH DAY OF ._APRIL 2004~. HOLT LAND SURVEYING 932:~, FBl11-56, GPS TEl- 345-5513 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 264-4720 5-22-86 Application Date GENERAL INFORMATION Legal Description (include lot, block, subdivision, section, township, range) Lot 9~ Bk l, South Lakewood Nills Subd.~ Sec. 2~, T12N~ R3W~ S.M. Location (address or directions) ' 10800 Ridgecrest Dr. (b) Frances Johannes 892-7690 ApplicantName Telephone:Home ~ P.O. Box 520095, Big Lake, AK 99652 ApplicantAddress Business 892-7690 (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [] (explain); (d) 1st Interstate Bank Lendinglnstitution Telephone P.O. Box 87125, Wassilla, AK 99687 Address 376-5338 (e) Real Estate Company and Agent Address Telephone (f) Mailthe HAAtothefollowingaddress: Hold for pickup 2. TYPE OF RESIDENCE Single-Family ~ Multi-Family[] Four Number of Bedrooms Other WATER SUPPLY Individual Well IY-I Community [] Public [] 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 Onsitel'~ Public [] Community [] Holding Tank [] Note: if corn munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 {11/84) Page 1 of 2 5. 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, t 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. Name of Firm Alaska Soil Testin g and ~ngineeri~l~lephone 345-5602 Address p.O. Bo× ~12815.. Anchorage, AK 99511-2815 Date 5-22-86 D.EPAPPROVA' Approved for ,/-~' bedrooms b ~-~ _ Approved v~ 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 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 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) MUNICIPALITY OF ANCHOP. A(~E CHECKLIST - FEBRUARY 1984 DEPT. OF H[:ALTH & ENVIRONMENTAL PROTECTION 264-4720 Lot 9, Bk 1, South Lakewood Legal Description: MAY 2 2 1986 ills Subd,; sso. 23, '121 , WELL DATA R[C [ ~V[D I~di tridual Well Classification Well Log Present (Y/N) Total Depth 162 ft. Cased to 162 ft. Static Water Level lO~ £t o Casing Height Above Ground 12 :inches Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot If A, B, C, D.E.C. Approved (Y/N) Date Completed 7-24-78 Yield Depth of Grouting H/A, Pump Set At 1]+2 ft. Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) gpm Y 106 To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line 1OO+ Cleanout/Manhole 1OO+ ftc ; On Adjoining Lots 100+ ft. 118 ft. ; On Adjoining Lots 100+ ft. To Nearest Public Sewer 46 f~. To Nearest Sewer Service Line on Lot Mark Holum, P.E. 5-20-86 Water Sample Collected by ; Date Water Sample Test Results Satis£actor,y Well yield confirmed at 600 gal/day per 24 hour drawdown test performed Comments 2/2-5/85. B. SEPTIC/HOLDING TANK DATA Date Installed 7-10-78 Standpipes (Y/N) Y Air-tight Caps (Y/N) Depression over Tank (Y/N) N Pumping/Maintenance Contract on File (Y/N) N/A~ Holding Tank High-Water Alarm (Y/N) ~N/Ai Separation Distances from Septic/Holding Tank: 2 Size 12.50 gal No. of Compartments Y Foundation Cleanout (Y/N) Date Last Pumped 2-5-85 ; for Temporary Holding Tank Permit (Y/N) To Water-Supply Well 106 ft. To Property Line 15 ft. To Water Main/Service Line 106 ft. Course 1004- To Building Foundation 75 ft. To Disposal Field 15 ft° To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72 026(11/84) ABSORPTION FIELD DATA Soils Rating in Absorption Strata 85 £t2/bdrm Date Installed r/-10-78 Width of Field ~O inches Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: 118 £t. To Water-Supply Well To Building Foundation Lot ~/A~ To Water Main/Service Line 2 540 ft Type of System Design Ler~gth of Field /4..~ f't. 12 ft. Depth of Field $ Gravel Bed Thickness Y Standpipes Present (Y/N) N Date of Last Adequacy Test 2-5-$5 Satisfactory ( Absorption rate is approximat~ey 1400 gal/day) 118 ft. To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments 15 ft. To Property Line 92 ft. To Existing or Abandoned System on ; On Adjoining Lots 100,- ft. To Cutbank (if present) tO0+ ft. 1OO+ ft. 80 ft. Ad~qquacy test performed 2-~-85. 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, o[ conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~~Date ~ ~k Soil Testing 6 ],~p?~r~... 85-260 Page 2 of 2 72-026 (11/84) ALASKA SOIL TESTING AND ENGINEERING 6100 A Street, Anchorage, Alaska 99502 (907) 561-7453 May 22, 1986 Municipality of Anchorage Environmental Health Division 825 "L" Street Anchorage, AK 99501 Subject: Lot 9, Bk 1, South Lakewood Hills Subd. Gentlemen: The attached checklist with supporting documents is being submitted for your review. The Health Authority approval request is for recertification of a system which was tested and approved during February 1985. The 1985 well flow test and the 1985 adequacy test were not repeated. However, standpipes were verified to be in place and capped. A water sample was found to be satisfactory, and the site was reviewed to determine that no new construction had occurred since the previous tests were performed. Please call if we may provide additional information to aid in this review. Sincerely, Mark Holum, P.E. Manager ALASKA SOIL TESTING AND ENGINEERING 6100 A Street, Anchorage, Alaska 99502 (907) 561-7453 Location: Type: Address: Client: Adequacy Test Lot 9, Bk. 1, South ~kewood Hills Subd. ,Septic TaXI and Seepage Trench, (See installation rpt., attached) 108~O Ridgecrest Dr. F. Johannes, 10800 Ri~gecrest Dr, Anchorage, AK 99516 Date Time Quantity of Water Added to Seepage Trench (Gallons) Depth Below Grade of Water Level in Seepage Trench (Inches) Depth Below Grade of Water Level in Septic Tank (Inches) 2-2-85 11:17 am O 107 66 11:20 9 106 66 1Ii2~ 21 105 1/2 66 11:40 124 105 7/8 66 12:24 pm 239 105 7/8 66 1:O6 407 105 3/4 66 1:28 495 105 3/4 66 1:57 604 105 7/8 66 2:08 642 105 3/4 ~ 66 2:36 705 103 1/8 66 2:56 774 1OO 66 3:23 867 95 7/8 66 3:24 " 96 1/4 66 3:33 " 96 5/8 66 3:39 " 97 1/8 66 3:41 " 97 1/4 66 3:48 " 97 3/4 66 5:05 " lO1 66 2-3-85 . 12:50 pm " 107 66 2-5-85 3:30 pm " ll2 1/2 Comments: The house served by the septic system was occupied prior to and during ~; the adequacy test.~ The septic tank was pumped after completion of the adequacy test. The standpipe, below a depth of 9', appears to be unperforated. Conclusion: The absorption rate of 600 gal/day for the four absorption rate is 97 inches below grade. Performed by: Mark Holum, P. E. the mini MUNICIPALITY OF ANCHOItACE DIVISION OF ENVIRONMENTAL HEALTH DEPAP~lf2 OF ~kLTH AND ENVIRONiIiENTAL PROTECTION ' N APPLtCATI0 FOR t~kLTH AUTHORITY J.PPROVAL CERTIPICATE ..G~/neral information Application Date Legal Description (include lot~ block~ subdivision, section, to%reship, range) 1___o~.~1.2k. 1~ Sou%b t,al~ewood Rills ~4ubd~ See.~--~2~' T12N~ R~W, Location (address or di~?eetions) 10800 Ridgeeres% {b) Applicants NameFraniis .ii. Job~:anes Telephone -- Home-~ .... ~Business · ~ ~ Applicants Address iO~iO0 Nidgecrest Dro: Ancloorage ~ AK 995].6 (c) App~ant is (check one) Lending Institntion (d} Lending institution ~ '~ ~-~ ~ ' Telephone b6~L~lOob Address (e) Real Es.ate Coo & Agent Address Telephone Mail the ~IAA to the following address: }1o..¢~ for . T~y~p.~o~.f Residence Single-Fatal y l~ Number of Bedrooms Water S u=~p~p_lj~ Multi-Family ~ Other (describe) Individual Well .~[ Co~munity [~I Public ~7 Note: ]if community w~ll system~ must have ~i~ten confirmation from the State Department of Enviro~ental Com~e~zation attesting to the legality a~ status~ Sewa~s~ Onsite [7~ P~blic ~ Community ~lll Holding Tank ~l No~e: If co~uni~y well system, mus~ have ~l'itten co~irmation from ~he State Department of Enviro~ental Conservation attesting to the legality and status. [Page 1 of 2] ~n~i_neer. i~irm Provid_ip_g~ Ins~e_ctions, Test,~v~i_~ie Sear~ch_~. Data and Infomnatio~ As certified by my se~ affixed hereto and as of ~he validation date sho~ below, verify that my investigation of this Health Authority Approval sbo~ that the oa~ wa~ar supply and/or wastewater disposal system is smfe~ f~ction~ and ~aquata fc~ che number of bedrooms and type of structure indicated herein.. I furt~her verify based on the i~o~ation ob~gin~ from the ~Rmicipality of ~chorage files and from investigation and inspection~ the on-site %~ter supply and/or ~stewater disposal mystem is in compliance with ~1 ~nicipal and Sta~a codes~ ordinance% and reguta-~ tions in effect on ~he date of this inspectioa. Name of Firm Alaska So~ L ~fes%Jng~ s~d mng~ne~'~n~ Telephone DHEP Approval ~ /' c?' : , ..... ~v,~ ~ Approved, ~ Disapproved Coc~ti~io n~ , Te~s of Cond.~ion~ Approval CA~£IOM THE MUNICIPALITY OF ANCHORAGE DEPARTf~iE~}~ OF HEALTI{ A~ND EN-VIRONM~NTAL PROTECTION (DHEP) ISSUES HEALTtI AUTHORITY APPROV~iL CERTIFICATES BASED SOi~LY UPON THE REPRESENT~ ATIONS GIVEN IN PARAGRAP}! 5 ABOVE BY AN INDEPENDENT 1RIOFESSIO~IIL ENGI~iEER REGISTEF5v~ IN THE STATE OF ALASY~i~ %/{E DREP DOES TI-lIS AS A COLRITESY TO PURCItASERS OF HOMES AND THEIR LEND%NG INSTITI~IONS I~N ORDER TO SATISFY CERTAIN ~EDERAL A~]D STATE REQUIiRE~ MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE k CERTIFICATE IS ISSLIED. THE MUNICIPJOLITY 0)? Af~CHOt~iGE IS NOT RESPONSIBL~ FOR ERRORS 0i% OMISSIONS IN THE. PROFESSIONAL ENGINEER'S WORK° (DHE~' SL~L) RR4/ej/D18 [Page 2 of 2] 7-19'=84 WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description: Lot 9, Bk. 1, South Lakewood ttills Subd., Sec. 23, T12N, R3W, S.M. Well Classification Individual Well Log P~esent (Y/N) Y Total Depth 162 ft. Cased to 162'~/Depth Static Water Level 103 ft. Pum~ Set At Casing Height Above Ground 12 inches Electrical Wiring in Conduit (Y/N) Y Separation Distances f~craWell: To Septic/HoldingTank on Lot 106 ft. If A, B, c~ C, D.E.C. Approved(Y/N) E~te C~mpleted 7-24-78 Yield 15~ , ~rill rpt.~ Depth of G~outing N/A~ -142'(Per installer contract) Sanitary Seal on Casing (Y/N)..~__ Depression Around Wellhead (Y/N) N ; On Adjoining Lots 100+ ft. To Nearest Edge of Absorption Field on Lot 118 ft. ; On Adjoining Lots 100+ ft. To Nearest Public Sewer Line 100~ ft. To Nearest Public Sewer Cleancut/Manhole 100+ ft. To Nearest Sewer Service Line on Lot 46 ft. Water Sample Collected By Mark Holum~ P.E. ; Date 2-5-85 Water Sample Test Results Satisfactory C~t~,=nts Well'yield confirmed at 600~~ gal/day for 24 hour drawdown test. B~ SEPTIC/HOLDING TANK DATA Date Installed 7-10-78 Size 1250 ~al.(I~st. NO. of C~a~t2rents 2 Standpipes (Y/N) Y Air-tight Caps (y/~ft.)y. Foundation Cleanout (Y/N) Y Depression over Tank (Y/N) N Date Last Pumped 2-5-85 (Receipt attached) Pumping/Maintenance Contract on File (Y/N) N/A~ ; for Holding Tank High-Water Alarm (Y/N) N/A~ Temporaz~; Holdir~Tank Permit (Y/N) ~/~ Separation Distances f~c~a Septic/Holding Tank: To Water-Supply Well 106 ft. To Property Line 15 ft. To ~ter Main/Service Line 106 ft. Co%~rse 100+ ft. To Building Foundation 7~ ft. To Disposal Field 15 ft. TO Stream, Pond, Lake, c= Major D~ainage Corar~nts Receipt $ Date Paid: Amount: [page 1 of 2] 2-15-84 Ce Soils Rating in Absorption Strata 85 ft2/bdrm (S°ilT~')of System Design Date .Installed ?-10-78 (lnst. Insp. Rpt.)Length of Field 47 fl, Width of Field ~0 inches (Inst l~rt.) Depth of Field 12 ft. Trench Square Feet of Absorption Al~ea 540 ft2 Depression ove~ Field (Y/N) N Gravel Bed Thick,ess Standpipes P~esent (Y/N) Y Date of Last Ad~quac%, Test 2-p-8~ Results of Lest Adequacy Test Exceeds 600 6al/da~ (Approx. 1~00 gal./flay at water level Separation Distance from A~scarption Field: 9? inches below grde) TO ~kater-Supply Well 1]~ f~, To P~ope~ty Line 15 To Building Foundation 92 ft. To Existing Or Abandoned System cn Lot N/~ ; On Adjoining Lots 100+ ft. To Wate~ Main/Service Line 118 ft. To Cutbark(.if D~esent) N/~ TO Stream/Pond~/~ake/ca~ Major D~ainage Course 100+ ft. To D~iveway, Parking Area, c~Vehicle StOrage A~ea 80 ft. Ccma~nts D. LIFT STATION Date Installed N/A, Size in Gallons "Pump O~" Level at High Water Alarm Level at Tested for Elect2ical Codes(Y/N) Dirre nsions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Cor~aents ** Check Permitted Bedrocra Rating Against HAA Request ** I certify that I have checked, verified, c~ confOrwed to all MOA HAA on the date of this inspection. Signed /~/x~ ~/~ ~__ Date 2-?-$5 Cotl~Dany Alaska Soil Testing and tlngirme~MOA No. ST 8p-260 KB1/di/s [Page 2 of 2] ~n effect 2-15-84 ALASKA SOIL TESTING AND ENGINEERING 6100 A Street, Anchorage, Alaska 99502 (907) 561-7453 Location: Type: Address: Client: Adequacy Test Lot 9, Bk. 1, South Lakewood Hills Subd. Septic Tank and Seepage Trench, (See installation rpt.~ attached) 10800 Ridgecrest Dr. F. dohannes~ 10800 Ridgecrest Dr, Anchorage, AK 99516 Date Time Quantity of Depth Below Water Added to Grade of Water Seepage Trench Level in Seepage Trench 2-2-85 ll:17 am 0 107 ll:20 9 106 11~2} 21 105 1/2 lh40 124 105 7/8 12:24 pm 239 105 7/8 1:06 407 105 3/4 1:28 495 105 3/4 1:57 604 105 7/8 2:08 642 105 3/4 2:36 705 103 1/8 2:56 774 100 3:23 867 95 7/8 3:24 " 96 1/4 3:33 " 96 5/8 3:39 " 97 1/8 3:41 " 97 1/4 3:48 " 97 3/4 5:05 " 101 2-3-85 12:50 pm " 107 2-5-85 3:30 pm " ll2 d/2 Depth Below Grade of Water Level in Septic Tank inches) 66 66 66 66 66 66 66 66 66 66 66 66 66 66 66 66 66 66 66 Comments: The house served by the septic system was occupied prmor to and during ~ the adequacy test. ~ The septic tank was pumped after completion of the adequacy test~ The standpipe~ below a depth of 9', appears to be unperforated. Conclusion: The absorption rate of the trench exceeds the 600 gal/day for the four bedroom sdngle family absorption rate is approximately 1400 gal/day Performed by: Mark ttolum, INSPECTION APPOINTMENTS .~ DATE RE~E~VED TIME TIME TIME DATE DATE DATE ,NSPEOTOR ,NSPECTOR ,NSPECTOR,., MUNICIPAl ~ DEPT. OF i[ /,LTif & MUNIOIPALITY OF ANOHORAGE ~NVtRONME~(T,~L ~, ~ iECTION DEPARTMENT OF HEALTH E ENVI ~ON~ENTAL PROTEOTION 8~5 L Street- A.chorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720RECEIVED REOUEST FOR APP~OVAL OF INDIVIDUAL WATE~ AND SEWE~ FACILITIES DIRECTIONS: Complete aH parts on page 1. Incomplete requests will not be processed. Please allow ten (10) devs for processing. 1. PROPERTY OWNER PHONE ~AILINGADDRESS PROPERTY RESIDENT (If di{ferent f}om above) ' PHONE 2. BUYER PHONE MAILING ADDRESS MAILING ADDRESS 4. REALTOR/AGENT ~ I PHONE I MAILING ADDRESS 5. LEGAL DESCRIPTION TREETLOD i / ' 6. TYPE OF RESIDENCE [~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [~ Four [] Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY J~ INDIVI DUAL* * ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LIVY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [~ INDIVIDUAL/ON-SITE*~ [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72~010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG REGEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] ~NDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []SepticTankor []HoldingTank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer_ Line Nearest Lot Line Absorption Area to nearest Lot Li~e 5. COMMENTS [~[~APP R 0 V E D FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED ~__/.~~ DATE I BY 72 010 (Rev, 6/79)