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HomeMy WebLinkAboutSUNSET HILLS BLK B LT 11 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 Permit Number: ~s',-~ ~tH oH ~8 PID Number: O~E~D.O~ 50 N.me:h.~,~.~o~ ~, N~'~ Wastewater System: B New ~ Upgrade Address: t~ o~ ~,~ A~. ABSORPTION FIELD Phone: ~-- O~ [ND. of Bedrooms: ~ ~DeepTrench ~ Shallow Trench ~Bed ~Mound ~Other LEGAL DESCRIPTION so, Rating: Total Depth from original grade: O.~ GPD/Sq. Ft. Lot: Block: Subdiv~ion: 3epth t0 pipe bottom from original grade: Gravel depth beneath pipe Township: [ Range: [ Section: Fill added above original grade: Gravel length: Gravel width: Number of lines: ~ Distance between Hnes: WELL: New Upgrade Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Driller: Date Drilled: St~[icWater Level: installer: Date installed: Yield: ~ Pump Set at: ~ Casing Height Above Ground: , TANK TO Septic Absorption LiS Holding 3ublic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~ J ~ Number of Compartments: S.rf.o~ LIFT STATION "Pump on" level at: J"~; High water alarm at: Foundation Curtain Drain ' ~O~'~ ~, '~ -- ~~lElectdcallnspecti°nsperf°rmedby: Remarks: BENCH MARK Location snd Description: I Assumed Elevation: EN~AL Inspections performed~lemver, Alaska~57~ Dates: 1st_ ~.,~.~ Department of Healt~ Hum~rwces approvpl / Reviewed and approved by: Date: ) 72-013 (Rev. 9/91} MOA 25 Permit No. SW940418 Page 2 of 2 Municipality of Anchorage 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 LOT 11 BLOCK B SUNSET HELLS S/D 01820150 Legal Description: PID No.: COl :: co2 9~.:.~.' ~g'~.c~ ......... 99. 92 ~EXIST. i ~ INSU ,A rION ~-~_~ 2 ~i 98~O~ Ig°°° 9ALi I k97.8' ~- ~ j ISSPTlC 'i'4N~S -- ' ~ 4 9' 86.9'/ i WELL EXIST.i 4 BDRM · 8~.9' NO W,~TER FOUND A B 13' 24' 25' 27' i26' 28' i36' 33' i68' 72' ~67' 71 ' 88' 76' 89' 77' NEW TRENCH MUNICIPALITY OF ANCHOP3iGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940418 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:HOCKING MARJORIE I OWNER ADDRESS:14000 SPECKING AVE ANCHORAGE, ALASKA 99515 DATE ISSUED:Il/01/94 EXPIRATION DATE:il/01/95 PARCEL ID:01820130 LEGAL DESCRIPTION: SUNSET HILLS BLK BLT 11 LOT SIZE: 15954 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. TME ATTACMED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 DJqD 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 343-4744 (24 HOURS) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL ROBERT SHAFER, P.E. ROGER SHAFER, P.E. 0ctob~[ 14, 1994 CIVIL ENGINEERS (90'7) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESZGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS MUNICIPALITY OF ANCHORAGE Department of H~alth and Human S~viees P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 11; Block B; Sunset Hills Subdivision RequeSt you issue a pe,'u~it to replace the 6ept~c system 6~rving the fou.~ bedroom hou6e on :tJae re.{em, eneed A test hole was excavated and a percolation t~st performed. The approximate location of the test hole is located on the attached sit~ plan. The monitoring tube within the test hole has been checked and found to be dry. An adequacy test p~rformed on the existing system for H~alth Author~y Approv~ purposes found the absorption capacity of the system to be inadequate. Attached is the proposed upgrade design. adverse effects on neighboring properti~ proposed septic system. We do not anticipate any by the installation of the If you have any questions, or require additional infoJu~ation for your review, please contact us. Sincerely, RCC/gk ENCLOSURES ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP · SUITE 204 , EAGLE RIVER, ALASKA 99577 3d¥SOdn I ,Og = ,,!. ROBERT SHAFER, P.E. ROGER SHAFER, P.E. ON-S~TE WASTE~ATER ~]$POSA£ SYSTEM eONSTRU~TION PRACTICES MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER &WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SO]LTEST PERCOI-~TION TEST STRUCTURAL& MECHANICAL INSPECTIONS REFERENCE: Lot 11; Block B; Sunset Hi~ Subdivision GENERA L: The scope of this project includes the insta~ation of a 1250 gallon septic tank and two absorption trcnche~ to s~rve the four bedroom residence located on the referenced property. The existing septic system is to be abandoned completely in accordance with Municipality of Anchorage ordinance. Const~uction shall be in accordance with the approved site plan and design drawings, Mu~cipal permit with any special provisions or conditions, and all applicable State and Municipal W~tewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground ut~ty locates. U~less specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil setting. Contractors installing wastewater disposal systems muSt be certified by the Municipal Heath Department for system installations. Owners insta~ing their own systems must also receive prior approval from the Municipal HeaZth Department. SE~IC TA~K INSTALLATION: I. A septic tank is to be constructed by a c~£tified septic tank manuf, acturer. Construction shall include two 4" cleanouts for p~mprng access. 2. The septic tank shall be sufficiently bedded to prevent settlin~ or shifting of the tank. 3. All standpipes on the septic tank shall extend a mi~mum of 12 inches above final grade. ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA99677 Page Two Lot 11; Block B; Sunset Hil~ Subdivision October 14, 1994 Septic tanks installed with less than 4' of cover shall be insulated. A foundation cleanout shc~l be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent ~anouts (unless an effluent pumping system exists within the septic tank). These clcano~s shall be located on undisturbed soil not more than 10' from the tank· The first ¢leanout, in line, shall be to clean toward the leachfi~ld. The second ¢leanout shall be to ~lean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORFFION TRENCH/~)P. AINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shat~ be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (roughed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimu~ of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before pla~ing backfill. o Monitor tubes shall be of four (4) inch diameter and installed approximately in the locations shown on the design. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel ~ noted on the design. Backfill over the final gravcl layer must not be less than twenty-four (24) inches. Ins~ation mu~t be installed when the backfill depth is less than thirty-six (36) inches. The finch grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATER/AL SPECIFICATIONS: I. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. Page Three Lot 11; Block B; Sunset Hilt~ subdivision October 14, 1994 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe ~erforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. I~u~at~on sha~l be at least 2" thick extruded direc~ burial polystyrene (Dow Ch~mica~ Company Styrofoam HI or equal). Septic tank inlets and outl~t~ shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt bar~i~r (Typar 3401, Mirafi 140/N, or equal) must be installed between the final leachfi~Id gravel layer and the native soil backfill. All leachfi~ld grave~ (s~wer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is b~ing used as a filter material, its gradation specifications must confoJ~ to current M.O.A. or D.E.C. requirementS. I~SPECTIONS: Typically there will be a mind,am of three (3) inspections required during the installation of the wast~ter disposal system. These inspeetio~ will occur us follows: I. The first inspection must be conducted after the excavation of ditches, pits, trenches, or bed~ and before the i~tallation of any gravel. A septic tank may be set in place, but may not be backfilled before th~ inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanout~, and insulation, but before the placement of any other backfill. Page Four Lot 11; Block B; SunSet Hill~ Subdivision October 14, 1994 3. The final inSpection is to occur upon fina~ grading of the property. Often there will be more than these 3 inSpectionS required, ~speeially with the inStallation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspectin~ engineer is to be contacted at least 24 hours prior to the start o~ conStruction. If necessary, a pre-construction meeting will take place on-site. The inSpecting engineer will not coordinate, direct or control in any way the contractor's activities. The owner shall contract with the contractor to perform the work outlined in these spe~fications and plans and in accordance with the attached M.0.A. permit. There will be no contractual arrangement existin~ between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inSpect thc work a~ stated above to document the con~ruetor'~ activities. Final acceptance o~ the contractor's work rests with the owner and the M.0.A. S & S Engineering shall have no liability to the owner or to others for a~ts or omissionS of the contractor or any other persons performing work on th~ project or the failure of the contractor to carry out the work in accordance with these conStruction documents. S & S Engineering 's inspecting engineer will not be responSible for the conStruction m~ans, m~thods, techniques, sequence, procedures or the safety precautions incide~ to this project. CONTRACTOR/INSTALLER Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG --. PERCOLATION TEST PERPORMED FOR: DATE PERFOR SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9- 10- 11 WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT /~j///~ ~) DEPTH? p E ~onitoring? Date: '1 13- 14- 15- 16- 17- 18- 19- 20- Gross Net Depth to Net Reading Date Time Time Water Drop ~ ~ ,. ~ '~ ~,, COMMENTS ~""¢-r~/' ~'Z'C.~/~,t~ ~ ~*~-- THAT~IS TE~ WAS PERFORMED PERFORMED BY: ..~e~ ~0~;~ ~ver Loop Road NO. 204 I CERTIFY ACCORDANCE W~T~AL GUIDELINES IN EFFECT ON THIS DATE. DATE: PERCOLATION RATE [,.~ (m~nutes/~nch) PERC HOLE DIAMETER TEST RUN BETWEEN ~.~Z~ FT AND ~,"~- FT ~N 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. 8ox 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# 1. GENERAL INFORMATION Complete legal description Lot 11 ... Block B; Su'nS~t Hi~s Subdivision Location (site address or directions) 14000 Spe¢~in~ Avenue Anchorage, AK Property owner Mailing address Lending agency Mailing address Agent Address Marjorie I. Hoehin~ 14000 Sp~.~i,g Au~.. Day phone Anchorage, AK 99515 Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: 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 Public sewer NOTE: XXX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my inves.tLgation 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 S & s ENGINEERING 17034 Eagle River Loop Road No. 204 Address Eagle River. Alaska ~7'/ Engineer's signature -'~/J~. Phone Date J" "/~'~'/~ DHHS SIGNATURE Approved for bedrooms. ' ......... / Disapproved. Conditional approval for bedrooms, with the following stipulations: 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 engineer's work. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST A. Well Data Well type Log present Total depth Sanitary seal~/N) \/~.~, If A, B, or C, attach ADEC letter. ADEC water system number Date completed L)/F-. Driller Cased to H0¢+ Casing height Wires properly protected (~/N) "/¢ FROM WELL LOG Date of test Static water level J \o Well flow g.p.m. ~u~. Pump level1 ~ ',J/t< ~-J ~_~ SEPARATION DISTANCES FROM WELL TO: AT INSPECTION Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots ,Public sewer manhole/cleanout .Petroleum tank WATER SAMPLE RESULTS: Coliform o ~ ~o ~..~s/~ co ,,~,. Nitrate Date of sample: 9.5o.~{ B. SEPTIC/HOLDING TANK DATA Date instalie~d' [c(~, ~ Cleanouts ~_~) High water alarm (Y/~ Date of pumping I.%~. "~'¢1/~' Other bacteria ~:~ Collected by: ~J~t~rr-A~,,~r-~, ~(=. F:,~ ~, ~ ~,T~ ~ ~'~1 ~,~'WI~/ c'p~, SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Tank size ~ I~) ~'q4.. Compartments Foundation cleanout Y~N) ~.~ Depression (Y/~.) ~/~ Alarm tested (Y~ .~ ~l~ ~ Pumper Well(s) on lot :~/o0 To property line Sudace water/drainage On adjacent lots 10o Li- Foundation I o~-~ Absorption field I© 'J' 'J- Water main/service line I 0 72-026 (~93)* Front CONTINUED ON BACK PAGE Manufacturer O. ABSORPTION FIELD DATA Date installed .~ [[~ Size in gallons % Manhole/Access (Y/N) Vent (Y/N) ."Pump on'~........ _ ~el at ~iegeht sW~rAale~ re crnt Id~lco d e s (Y/N) SEPARATIO~ATION TO: Well op3Jet~- On adjacent lcts Sudace water '"----. Soil rating (GPD/FF) (~,~ System type Length ~3 ToT~C Width ~z.,~' Gravelthickness ~' Totaldepth Total absorption area ~ ~ C~eanout present ~) ~ Depression over field (Y/~ Date of adequacy ,e..1~- ~ ~ Results (.as~fa,l) ~' ~ ~ for Water level in abso~tion field before test ~/~ ~ After test Peroxide treatment (past 12 months) (Y/~ ~ ~ If yes, g~e date Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot (0o ' ~ To building foundation On adjacent lots ~-Uo '~ Surface water I oo Curtain drain ~./1~ On adjacent lots [00 ~ Property line IO 'J To existing or abandoned system on lot Cutbank )~/~, Water main/service line ' ~ Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, venfied, or conformed to all MOA and HAA guidelines/n effect o..~.4jle~. ~this/nspec'~on. 4, ' ..... Date HAA Fee $ Waiver Fee $ Date of Payment Receipt Number Date of Payment Receipt Number 72-026 (3/93)° Back ,: :(~ ~: DEPARTMENT OF HEALTH & HUMAN SERVICES "~ ~'.,. , .~ , \~,~-~.~/. , :) v s on of Env r0nmenta Services . :., .:., ~, , .,On-S te Serv cas Sect on ':- ~:: ~ h~;.~ . ~',,.:.. CERTIFICATE OF HEALTH AUTHORITY ' APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# ..~,.~.0 I ~ ~-Ol 3~ .1. GENERAL INFORMATION ;Complete legal descrlptlon Location (site adi:lr~ss or directions).' ? ?' Pro~erty owner '' Mar,/'or~& I, Hoekin,q ~.'.,. ,~ . ~:~...~.,~, ...... , ,, ~', Ma~llngaddress; 14000 Sp~e~n~ Av~. ~'/ ~-Le'hdlng agency' ~' :~ '. _ . ~ :~'~ Unless othe~lse mquested,~ 14000S~¢ekin~ Avcnu~ '- Anchorage, AK Day phone ~n~hora~, AK 99515 Day phone Day phone pickup, ....~.' 3.~ :;TYPE OF WATER'SUPPLY: .'. ~ ii" . Individual wel .......... ~ XXX Community well..~-. ~ Pu bile water ........ NOTE:i tf community well system, provide written confirmation from State ADEC attest- lng to the legality and status Of system. TYPE OF WASTEWATER DISPOSAL; XXX attesting to the legality and status of system. confirmation from State' ADEC STATEMENT OF INSPECTION BY ENGINEERrf~. As certified bY my seal affixed heret0'an ~ tt'{ ~'va I atlon date shown below, I verify that m~ investigation of this Health Authority App.r0,v~al ~,~Pll~at'lor~ shows that the on-site water supply and/or wastewater disposal system is safe,,~nc~10n~ end adequatefor the number of bedrooms and ~pe of structure indicated herein. I ~u~her.veri~ that based on the information obtained from the Munlcipali~ of Anchorage files and from my invee~atlon and Inspection, supply and/or wastewater dispo~l system'is In compliance with all.Municipal ~nd state C0des,':~;. ordinances, and regulations In effect 0n th~"d~{e~of this inspection. Name of Firm Address Engineer's signature S & S ENGINEERING 17034 Eagle River Loop Road Date REQUEST YOU ISSUE A CONDITIONAL HEALTH"AUTHORITY APPROVAL.- SEPTIC'SYSTEM WILL BE UPGRADED WITH CONSTRUCTION BEGINNING NO LATER THAN JUNE..I, 19 6. DHHS SIGNATURE Approved for bedrooms,- Disapproved. - .... Conditional approval for' '~'"/,'.",i bedr0oms~ with'the followlng':stipulations: Additional Comments '-.'Y'~ ,~ , , · . /~ . ..-: .... The Municipality of Anchorage Department of Hea th and.Human Servlces(DHHS) issues Health Authority .... .' ·: Approval Certificates based only upon the rsPros'sntatlOns giv~q n paragre~h'~$ above by an'indepand~nt,' ,' ~ ''::rt profess!onal engineer registered in the State of AlbS~i The DHH$'desa th i as a c'0~rtesy to purchasers of homes~'L~ ' and the r end ng nst tut ons n order to sat sfy ~erta n fedem and State requ reme~t~ Emp oyees Of DHHS do not' ':' conduct nspect ons or analyze data before a cert, iflcat~. Is issued. The~Municlpahty',o,f'Anchorage,Js not ,' responsible for errors or omissions in ~he'pr0fessionAi ~ng'l~?S ~0rk'.::" * ~'!'"~ ;" .! ;:." '~ [ a ~: ~; : ' ~ ' :~ i ' a r ' a~ a Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~u/JC'e-7- ////~' ,~'o/~D.,, ,~/¢c/c ~/ /¢~-// Parcel I.D. A, Well Data Well type Log present (Y~ /'J Total depth Sanitary seal (~'N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed L,' (//~ Driller Cased to ~/o -A Casing height Wires properly protected 0/N) ~/ FROM WELL LOG Date of test Static water level Well flow Pump leveL1 SEPARATION DISTANOES FROM WELL TO: Septio/l~tdff~ tank on lot /,¢;1 ¢ Absorption field on lot /Od ~ g,p.m. Public sewer main Sewer service line AT INSPECTION / MUNICIPALI1Y OF ENVIRONMENTAL SERVICES BIVISION !: %/~ d~)&1994 %.p. ECEIVED ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout /c,d 'c-- Petroleum tank A//,g ,-- WATER SAMPLE RESULTS: Coliform O ~',-,),/d',n?e~//~/,'~// / Date of sample: ~ -~0 -~ Nitrate /..~ ,~//Z. Other bacteria / Collected by: B. SEPTIC/~TANK DATA Date installed ~ -/- ?E' 44- ~f Tank size Cleanouts ~N) High water alarm (Y~ Date of pumping /~¢¢ -¢-,4.c. Compartments Foundation cleanout (~IN) y,~.~ Depression (Y~) /V'O Alarm tested (Y~ NEW T/qcq& _Pumper .~,/,,.¢ SEPARATION DISTANCES FROM SEPTIC/F4~t~-~q~it TANK TO: Well(s) on lot /4:~ / On adjacent lots /¢¢ '-," Foundation To property line /~/ Absorption field 5'~ Water main/service line Surface water/drainage /~d ~-~ 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) / SEPARATION DIST~TATION TO: Well on lot ~_// On adjacent lots D. ABSORPTION FIELD DATA Manufacturer / Manhole/~__ .---'""~Cycles teste/''''- "dPump off" Level at Surface water Date installed ' ¢ - / - ~'5 Length ~ '7 ~ Width Total absorption area 7-52. Date of adequacy test ,,V,/,~ /w'W Sv:~/'~,~-~-Results (pass/fail) / for Water level in absorption field before test ,~ After test Peroxide treatment (past 12 months)(~.~ ~ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Soil rating (GPD/Ft2) O.~ System type PEeP Gravel thickness ~ / Total depth /2. Cleanout present (~N) ~/&s Depression over field (YI~ Bedrooms Well on lot /J¢ To building foundation On adjacent lots Surface water On adjacent lots /~/2 '¢ Property line /~" To existing or abandoned system on lot /d' ~ Cutbank EO ' '~ Water main/service line /4) '~ Driveway, parking/vehicle storage area /¢ ' Curtain drain ,gONE' E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name Date Date of Payment Receipt Number 72-026 (3/93)* Back ROBERT CE - 8801 . ,"? .-' ?/ Waiver Fee $ Date of Payment Receipt Number HEALTHAUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER &WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOWTEST ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAl& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN ROBERT C, COWAN, RE. ROBERT A. SHAFER, RE. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 May 22, 1995 MUNICIPALITY OF ANCHORAGE Department of H~th and Human S~rvic~s P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 11; Block~; Sun~t Hills A Conditional H~alth Authority Approval (HAA) was issued on 12/2/94 for the referenced property. All work req~red for the Conditional HAA h~ been completed. Ple~eissue a full H~lth Authority Approval at this ~. If you require additional information, please contact us. Sinc¢~y, Rob~t C. Cowan, P.E. RCC/gk 17034 NO RTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 11-14-1994 07:48PM FROM WRIGHT-ALASKA ENG. SUCS. TO 8941211 Commercial Testing & Engineering Co. Environmental Laboratory Services LABORATORY ANALYSIS REPORT 94,5024-1 LOT WATER BOB WORK Order Prin!ed Date Coll~¢tedI~te KeceivedDate 8266[6 1010~1194 ~20:57 09/3~/94 (~ ] 5:43 h~$. 09/30/94 ~ 16:00 ~s.. t $1'F2I-It~ C. pa~ar~eter Nitrate.N Qc Results qu~l Units 1.38 rag& EPA 353.2/300.0 10 Allowable Ext. Method Limits. iDate 10/03/94 .-,, : .'-- . ~--- .... ~._______------~?.~ . ------ * · $~eSpic, iallasth~tion~Abc/v¢ · UA=Unavailable ** See S6~nple Remafl~ Above NA =Not Aaalyze~ ./ U = Ua&t acted, R~ptxt ed value is !he praetic,//quantification limit. LT = L~ss 'lh~'t -~ D ~ Seeo~da~ dilution~ GT= Oreater 'I'h~n ....... ~?.~3.B..$treet, Aneh¢~'age, AK 99518-1600 -- Tel: i907) 562-2343 Fax: (907) 561-530,1 EN~/IRONM~NTAL ffACliriTIES IN ALASKa. COLORAOO, FLORIDA. ILLINOIS, MARYLANO, NEW JERSEY, OHIO, U//~H, WEST VIRGINIA