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Home My WebLink AboutT15N R1W SEC 8 LT 47A '~'~TER ANCHORAGE AREA BORe., DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: LEOAL DESCR,PT,ONJZ *?~; .-C.~:. ~. 7Zs'.V. ~/~ DISTANCE FROM WELl LIQUID CAPACITY _//2tDf') GALLONS. MATERIAL INSIDE LENGTH NUMBER OF COMPARTMENTS LIQUID INSIDE WIDTH -- DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF FITS ~ OUTSIDE DIAMETER UN,NO MAtER,A, ~X_~f~ NEAREST LOT ~,.e ! OR WIDTH I ~. , tENGTH I ~1 DEPTH . INSTANCE PRO,~ WELL /~ 0~ . BU~LD,NG POUND^T,ON · TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~'~ ~ SQ. FT. TILE DRAIN FIELD: ~'~'~ , FOUNDATION . NEAREST EOT LINE -' DJStAN~C ~T ' ' WEEN LINES TRENCH WIDTH SQ. FT. LENGTH OF EACH TINE EPIH I ~) ~: } DISTANCE FROM WAIER 0 BUILDING FOUNDATION. ~ SAMPLE DISTANCE FROM E'~-~LI NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE .TO FINISH GRADE .... WI::LL: TYPE DUZ"- ~ tOT LINE ,j~ ~.~. ~ ~ NEAREST SEPTIC SEEPAGE ~ . SEWER LINE ~ TANK t~ ~ I , SYSTEM /~ ~ , CESSPOOl .__TOTAL LENGTH IN. T~AL EFFECTIVE IN. ABOVE TILE ., NEAREST OTHER -- SOURCES DISTANCES: DATE GREATEr ANChOrAgE AREA borOUgh DEPARTMENT OF ENVIRONMENTAL QUALITY BSOOTUDOR ROAD POUCH 6-650 RERM T.O. 1 3W' SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT INSTALLATION LOCATION /'~/"'~'~/~/~';/~"/~//~ '//--'~/'"'~ //~'/'~/' .*'~'~ ' INSTALLATION OF: SEPTIC TANK / SEEPAGE PIT ~ DRAIN FIELD OTHER ~PE AND SIZE OF FACILITY TO SE $ERVED ~ ~~/~/ //~/~ .~//~ FINANCED THROUGH ~ TO BE INSTALLED BY ~' SOIL TEST RESULTS /~//~J ~/~./ NOTE; THIS PERMIT IS NOT VALID WITHOUT ~IL COMPLETION DATE ANTICIPATgD FINAL INSPECTION= 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE ~-~"'~ I~"~"~ SEEPAGE TO NEAREST LOT LINE:* / WELL TO SEPTIC TANK /--*'~ O DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER HAIN TO SEPTIC TANK /~ $[EPAGE PIT / 5[~1C TANK. ~/ - SEEPAGE PIT /~ DRAIN CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP DF EXCAVATION B FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FII'TEO WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR LICENSED DESIGNER ~IAGRAM OF CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE HO. SD-B8 AND THAT THE ABOVE LO.G. OF DRIJ~ING by A & L DRILL~JG COMPANY ,TATI¢ L~VEt- OF WATER TT .................................... . DRAW DOWN FT ............... &~....~.... ................................ GAL~. PER HR ................................................................... KIND OF ~A-~,"~ A~..~.O......i ........................ ' KIND OF FORMATION: FaOM ........................ FT. TO .......................... ~ .................... F~OM..._J ................. FT. ~o,.......A ........... ~.,o....Z ............... ~.~ ............. % ......................... · , . ~ ~ ~ .~.o-.1 ................. =. ~o.J. ............... ~ .......................... ~.o. ........................ ~. ,o,..Z..~........~.~o..~.2 ......... ~..~..~ ~ ~,o,...:: .................. ~. ~o,.~./ ............ ~.~o.~..~..~........~..~..~.~.. ~o, ........................ ~. ~o....J..~ ......~. m"~dWw~ ' · o.Z.A.9 ........ ~ .............. Wm ~o. ........................ ~. ..... ~~ FROM ........................ ~. TO ........................~.~ ............................. FROM ........................ ~. MISCL. INFOR~TIONJ TO ........................ FT ................ : .............. TO ........................ FT .............................. TO ........................ FT ............................... NAME Z.~,,. ~...u..ll,'~'l-~Xl 825 "L" Street Rick Mystrom, P.O. BOX 196650 Anchorage, Alaska 99519-6650 Mayor 343-4744 June 9, 1997 Bobby W & Julie A Brown PO Box 670493 Chugiak, Alaska 99567 Subject: TISN Rlw Section 8 Lot 47A Permit ~SW960106, PID ~051-093-27 The subject permit, issued June 7, 1996 by this office for a single family well and/or on-site wastewater system, has expired as of June 7, 1997. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. Ail inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Si~erely, ]~ Pr~.gram Manager On, site Services eric: Copy of Permit MUNICIPALIT~ OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE i OF ON-SITE WELL SYSTEM PERMIT NLrMBER:SW960106 DESIGN ENGINEER: OWNER NAME:BROWN BOBBY W & JULIE A OWNER ADDRESS:20241 BIRCH AVE CHUGIAK, ALASKA 99567 (UPGRADE) PERMIT DATE ISSUED: 6/07/96 EXPIRATION DATE: 6/07/97 PARCEL ID:05109327 LEGAL DESCRIPTION: T15N RlW SEC 8 LT 47A LOT SIZE: 50507 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASRA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED ~ CLOSED ON THE SANE DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. 1 SPECIAL PROVISIONS: 1.) ENSURE 100 FT. OR GREATER SEPARATION BETWEEN PROPSED WELL LOCATION AND NEIGHBORING SEPTIC SYSTEM(S). 2.) SUBMIT WELL LOG TO DEPARTMENT WITHIN 30 DAYS OF WELL INSTALLATION, AND SUBMIT SKETCH SHOWING THE NEW WELL LOCATION. RECEIVED BY: ISSUED BY: DATE :. / ~m info~io, hereon ts for the use of institutions mho~ln8 the re]attonship of It is uot to h used ior ~sltionin8 sddiZionsl s~ctures or [encelines, ,// 'h oorners'set this date Lot &7A,$ec. 8,TI~N.RIW. TELEP.HONE {907) 562-2343 /ANCHORAGE INDUSTRIAL CENTER ~ Drinking WaterAnalysls, Re, pgrt for Total Colifor, m Bacteria , ,.! (_~,,., /,~,/~ ,////~ TO BE COMPLETED.. BY WATER SUPPLIER WATER SYSTEM' ~, LO. NO, ///*, %",, * TO BE COMPLETED BY LABORATORY t Analysis shows this Water SAMPLE to be: ~ Saiisfactor¥ ' [] Ur~atisfactory t ". / ' ~ [] Sample too long in trans,t' sample should · ' not be over 48 hours old at exam nat on" .~, / - i,~ ~ to jnd~cate rehable results. Please send SAMPLE DATE: .- Routine W th ~ ~f ~O. , : , ) :~ ~ ~T~at~ Water .. '," ~, ~ M~mhr. n~ ~llt~r ' S~l Puree ~E . ........ /. ,?i / ' ,%. "TI~;~ ~ '' ~ ~b ~f. ~. Result* A~t 3-1 ,,,.1.,~I .... t,,. _i ~ ' ...... ee-tzt~o ~) ...... BA~CTERIOLO~K~AL. WATER A~LYSlS R~DINSTRUCTIONS ,~ . /' '.~. BEFORE COLLECTING SAMPLE EXCAVATION ROBERT A. SHAFER WORK June 4, 1983 CtVIL ENGINEER 694-2979 Red Carpet/Greatland Realty ATT~TIDIg: Terry Krueger P.O. Box 633 Eagle River, Alaska 99577 Dear Terry, Reference: Lot 47A: Section 8: T15N; R1W A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was charged with 1000 gallons of fresh water and after a period of 24 hours all the water which had been added to the system had percolated away. It can be concluded from this test that the waste water disposal system serving the three bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failure. If we may be of further service, US. please do not hesitate to contact cc: Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA GREATER ANCHORAGE AREA BoROuGH Department of Environmental Quality Date Received July 26, 1976 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: e 4. 5. 6. voao Lomas and Nettleton 4449 Business Park Boulevard Earl Roberts C .hugiakt Alaska Legal Description: T15N R1W Section 8 Lot 47A Location: Phone: 274-7661 Phone: 688-2490 S, Birchwood Loop onkBirch Lane~ 1st house in on the right Type of facility to be inspected Well Data: Individual A. Type C. Construction Single Family No. of bedrooms 3 B. Depth 107' D. Bacterial Analysis Sewage Disposal System: On-site system A. InstalledApprox. 1972 B. Installer 2. Manufacturer C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines ! Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank '~, Absorption area , Other contamination C. Absorption area to nearest lot line 2. Material Sewer Lines , Absorption area EQ-034 (1/74) Page 1 of two pages REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES ' '- · :- Ci;RO 1 Type of-Inspection "· ........ VA'-,~ ....... FHA ........ 2, Property Owner: (~. ~A~_. liailing Address: .~~/~ ~ Day Phone 3 Name of ~uyer, Hailing Address: ~~ ~~/ Day Phone ~-~. 4. ~{ame of Lending institution: ~~ F:a i Ii ~g Add res s:~ ~/~ ~ ~/~/Phone 5. r;ame of Realtor or Age,t': ~~ ~.:a i 1 ing Address: ~ ..... Pi:one CONV ......... -¥: Locction: 7. Type of Facility 8, ~ater '- S.::,~., l.,) be in:.,: ,..: I0 '~n~luidu~l ','Jrt-site) ~ Page 2 of two pages - Rec.X~t for Approval of Individual ~C~r & Water Facilities Legal Description T15N R1W Section 8 Lot 47A Comnents Approved ~_~ . Disapproved Date _ . . Approval ~Valid for one year from date signed Greater Anchorage Ar&a Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Da te EQ-034 (1/74) GREATER AI~ItORAG~ AREA 80RIIUGT1 Department of Envir~ental Quality 3500 ~oT Road, Anc~g~, A1~8~ ~7 ~9~6 Da~e ~cetve~~ Ti~e of Inspection~,_~~___~ Date of Wall Data: A. T~. g,g,~-' 6. D. pt, /O'Z/.' C. Conat~ucttefl D. ~acte~ie] Anal E. Disposal Field: Total ~th of Lines -- Distances= A. Wall To: Septic Tank ., Nearest Lot line/O~ ~ , Other Cont~mtnation Foufldation toSs,tic Tank .~O/ "~ AbaS=ion A~tton A~s to Nearest Lot Li~ Absorption Area_LL('p~__~, Se~er Lines Re'est for Approval of 2 lvidual Sewer & Water Faciltti6 Page Two Comments= Date Approval Valid for One Year From Date Signed Greater Anchorage Area Borough, Department of Environmental Quality D~AGRAU OF SYSTE~( ! certif7 that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities located at: Signed Date EXCAVATION WORK June 4, ROBERT A. SHAFER CIVIL ENGINEER 694-2979 1983 Red Carpet/Greatland Realty ATTENTION: Terry Krueger P.O. Box 633 Eagle River, Alaska 99577 Dear Terry, Reference: Lot 47A~ Section 8; T15N; R1W A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was charged with 1000 gallons of fresh water and after a period of 24 hours all the water which had been added to the system had percolated away. It can be concluded from this test that the waste water disposal serving the three bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failure. system If we may be of further service, please do not hesitate to contact cc: Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER. ALASKA 06.]220(o) Rev. 1973 "ALAs"'~EPARTM£NT OF HEALTH AND SOCIAL SE~-~..S DMSlON OF PUBLIC HEALTH INDIVIDUAL AND S£MI~UBUC BACTERIOLOGICAL WATER AHALYSIS Lab No. OFFICE INDIVIDUAL/[:] / X. NAME /// '- ". ' ~ ADDRESS OF SOURCE REPORT RESULTS TO l~1 Sat;sfactory I-T Un~afid'ado~y r-I Questlonable SANITARIAN'S REMARKS COMPLETE THIS SECTION ONLY IF WATER IS AN INDIVIDUAL SUPPLY DATE COLLECTED ~ ,, ,' ~TIME COLLECTED ~ '" Sample Collec~ed From ~1 K~tc~en Tap ~l 8aihroom Tap / ~ Basemen~ Top LOCATION: PURPOSE OF EXAMINATION: Illfless Suspected? [] Yet [] No READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING ,SAMPLE e~.l~o ~) BACTERIOLOGICAL WATER ANALYSIS RECORD a.m.- DIRECTIONS FOR COLLECTING SAMPLES OF WATER FOR BACTERIOLOGICAL EXAMINATION Read Carefully' and Follow Instructions Exactly Bear in mind that water analysis deals wlth materials present in very minute quantities. The least care- lessness in collecting and handling may give rlse to results which are misleading. Samples are accepted at the regional laboratories in' the early part of the week (Monday-Wednesday) unless there is an emergency or prior arrangements have been made. Arrangements should be made to have the water samples reach the laboratory as quickly as possible and wlthJn 4~ hours after collection. After 48 hours, the significance of the bacteriological analysis is impaired. In collecting samples from TAPS or PUMPS proceed as follows: (a) Thoroughly flush tap or pump by allowing water to run freely for five minutes. (b) Shut off water and flame the outlet with torch or burning paper. The flame should not be merely passed over the outlet but should be applied until fixture shows indication of being hot. Flame should be directed against inside edge. (c) Open fixture so that a small stream flows. (d) Remove bottle from mailing tube. Hold bottle by the lower half in one hand and wlth the other remove the screw cap wlth the fingers, leaving foll protecting cover in place. Fill the bottle to the shoulder. Replace cap with foil cover, screwing firmly inlo place but do not apply pres- sure which will split cap. (e) Pack bottle carefully in mailing tube enclosing thls completed information sheet. DO NOT COLLECT SAMPLES FROM FIRE HYDRANTS, YARD HYDRANTS, DRINKING FOUNTAINS OR SIMILAR OUTLETS WHICH ARE DIFFICULT TO DISINFECT PROPERLY. STERILE WATER SAMPLE BOTTLES ARE AVAILABLE UPON REQUEST FROM: WE SERVE CHUGIAK, AK 688-3199 ~";RILLING CO. ~ P.O. BOX 670042 -- CHUGIAK, ALASKA 99567 OWNER OF LAND ......~.9..h.~y...~X'.q'.,'dD... .................. :. ................................... ADDRESS .......... .~ ...... o.... fi.7.C~.a.9.2 _.C~u-% £ ',~f..~k ................................ WELL - SITE ...._er, c...~...Lo.t_..[i2.~u..Chu~.~..~. ....... .L...; ................... DATE - STARTED ......6..'...~.~..9.Z ........... ~. ................. ; .................................... DATE - ENDED ....... A.=15.=~2. .................................................................. ALLALASKA WASILLA,'AK 376-3199 DEPTll OF WELL ..1...8..O....f...t_~ .......................................................... ~......:... STATIC LEVEL'OF ~TEI~ :I~T..51..~.~., .................................................. DRAW DOWN FT.....1-7.75.[.f...t.,. ....... Z~.;:: ........ ::: ........ , ......................... ~ ...... G 600 Visual E~,tinate ALS. PER HR ................ : .............. ; ........................................................... KIND OF CASING ...[3.0....f.t./,,-..6..!.'.n..:....A.':..5-~:iB-...A..:..S..:.T-.'.~:. .................. KIND OF FORMATION: FROM ................... .0 Fr. TO ~.~ ............... 2. FT....~.l:~..u~. ............... FROM ................~ FT. TO .................~. FT.....~.Y.~.)~...: ............. ' FROM ................ 1%2 FT. TO ............... 15/& FT ...... =~,~..Cm!i ..... FROM ........ ~.:...~.L2! FT. To ........... ~...12.?. FT.....c=.~l ...................... FROM 172 ~r~n IB0,'FT Sandstone FROM ....................... IrT. TO ........................ FF ........................ ... _. ~ FROM ........ ~ ............ FT. To t- ........................ FF.....~_ .......... ; ............. ~ FROM.~ ..............:.....FT. TO~ ...................... FT.; ........................ ~ ..... FROM ....................... FT. TO ........................ FT.~ ................ ~ ............. FROM.~ ..................... FY. To ........................ FT ................................. FROM ....................... FT. TO ....................... FT ............................... FROM ....................... FT. TO ........................ FT ............ ~L...O .......... FROM ....................... FT. TO ........................ FT.., .................... m ...... FROM~ ............ :: ........ Fr.~o ....................... FT .......... ~ .......... ~...~ FROM ....................... FF. TO .......... ; ............ FT ..................... au ~.........s MISCLINFORMATION:o No-warrhhty or no ~rrantiem implied ca~ed fro~ 120 fi: to 180 ft. with 6} Dr26 P.V.C. well ca~lng - APPLICANT FILLS OUT UPPER HA('~ONLY. Phone Landing Instl~flon ~. /1. ~/. ~, ~Slngle Family ~ Other ~ ~mm~ity For wells ~illed prior lo Ih~ date, gfve well depth (attach I~ If evallable). Public ~ility When ~ected to Public.Utility:. NOTE: THE INSPE~ION ~E MUST ACCOMPANY EACH ~E~T BEFORE ~OCES$ING CAN BE INITIATED.. Time Time Date i Dale Inspector Inspector · Field Notes: ( '~ ) APPROVED BEDROOMS ( ) DISAPPROVED , , C D2C"i ¥PROVA'' BY: ~ ~ Inspector JUL 0 8 1983 '?.h:';~:~. dity r(:cd 0;'..:' '" / \"~'"~t. of hea:~l & , 'CONDITIONSOF APPROVAL -- -'" ' Soils Rating Date Sewer Installed Well Log Received - - Septic Tank Blze Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-093-27 1. GENERAL INFORMATION Complete legal description COSA #, Expiration Bate: T15N R1W SEC 8 LOT 47A Location (site address) 20241 WEEPING BIRCH AVE., CHUGIAK, AK 99567 Current Property owner(s) GORDON C. HURLEY Day phone Mailing address Lending agency '~ Mailing address Real Estate Agent Mailing Address 20241 WEEPING BIRCH AVE., CHUGIAK, AK 99567 Day phone Day phone Un/ess otherwise requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: 3 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 E] [] Community On-site E] [] Public Sewer [~ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems 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 COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a pdvate 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 validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems 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 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3792 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 10/24/2011 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levelS that may fluctuate dudng the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. DSD SIGNATURE ~/'"~ Approved for ~.~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: .. ~: ON-SITE ': ,_ . WAI~.tRAND - By: (Rev, 11/05) Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: //(~ - ~ /-// Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: TlSN P,1W SEC 8 LOT A. WELL DATA Well type PRIVATE IfA, B, or C provide P~ID # __ Date completed 6/12/1997 Sanitary seal (Y/N) Y Total depth 180 f. Cased to 130.5 f. FROM WELL LOG Date of test 6/12/1997 Static water level 53 ff. Well Log (Y/N) _~ Parcel ID: 051-093-27 Well production 10 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100mL Nitrate ND mg/L Arsenic: ?.08 .mg/I Date of sample: 10/13/11 SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Wires properly protected (Y/N) Y Casing height (above ground) 24 in. AT INSPECTION 10/17/2011 40 ff. 4.1+ g.p.m. Collected by: ArcTe~ra Date installed 11/1/1971 Tank size 1000 gal. Number of Compartments 1_ Cleanouts (Y/N) _Y Foundation cleanout (Y/N) _Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 10/17/11 Pumper .TRs C. ABSORPTION FIELD DATA Date installed 11/1/1971 Soil rating (g.p.d./ft2 or ft2/bdrm) 8_~_5 System type Pit Length 12 ff.' Width.- 1__~2 ft. Gravel below pipe 6__ft. Total depth 9.__~6 ff. (Measured 10/17/11) Eft. absorption area.288{t2 Monitoring tube Y Depression over field N Date of adequacy test 10/1_?/11 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in. Elapsed Time: 1__ min. Final fluid depth 0 in. Absorption rate >= 450~ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N__lf yes, give date -_~- LIFT STATION Date installed "Pump on" level at__ Datum in. E. SEPARATION DISTANCES Size in gallons~ "Pump off" level at in. Cycles tested Manhole/Access (Y/N) High water alarm level at in. Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot ;tOO'+ Absorption field on lot :tOO'+ Public sewer main Sewer/septic service line 2~'+ Animal containment areas 50'+ On adjacent lots :tOO'+ On adjacent lots :toO'+ Public sewer manhole/cleanout :tOO'+ Holding tank ;tOo'+ Manure/animal excrete storage areas ;tOo'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation $'+ Water main :tO'+ Wells on adjacent lots :tOO'+ Property line $'+ Water service line :tO'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line :tO,+ Building foundation :tO'+ Water Service line :to'+ Surface water :tOo'+ Curtain drain 50'+ (None Knewn) COMMENTS Absorption field 5'+ Surface water 160'+ Water main ;to'+ Driveway, parking/vehicle storage Wells on adjacent lots ;tOO'+ G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Date COSA Fee $490.00 Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number SGS Reft# 1115064001 Client Name ArcTerra Engineering and Surveying Printed Date/Time 10/21/2011 8:41 Project Name/# TISN R1W SEC 8 Lot 47A Collected Date/Time 10/13/2011 15:30 Client Sample ID T1SN R1W SEC 8 LOT 47A Received Date/Time 10/13/2011 16:12 Matrix Drinkin~ Water Technical Director Stephen C. Ede PWSID 0 Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic 7.08 5.00 ug/L EP200.8 C (<10) 10/14/11 10/16/11 NRB Waters Department Total Nitrate/Nitrite-N ND 0. I00 mg/L SM20 4500NO3-F B (<10) 10/18/11 LCE Microbiology Laboratory E. Coli Nezative I 100mL SM20 9223B A 10/13/11 DLC Total Coliform Negative 1 100mL SM20 9223B A 10/13/11 DLC 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.anchorage.ak.us (9O7) 343-79O4 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. Expiration Date: 1. GENERAL INFORMATION Complete legal description .' TI.c~ Location (site address or directions) Current Property owner(s). Mailing address . "'p. o. Lending agency Mailing address Real Estate Agent Mailing Address Lo-[-- q7 ,~ Day phone Day phone ~"/1,'o'~ Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class. Public Water System Well [] [] [] T~PE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank .I-'1 Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority 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 lille (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 validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the 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 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Eagle River Engineering Services lu42t Address F~gl~ Fliv~r. Al<' ~qR77 Engineer's Printed Name 5. DSD SIGNATURE L,'/'' Approved for ~ Disapproved. Conditional approval for Phone bedrooms. bedrooms, with the following stipulations: Additional Comments By: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements ' Supplemental Engineer's Report Other Original Certificate Date: {Rev 01/02) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Legal Description: A. WELL DATA HEALTH AUTHORITY APPROVAL CHECKLIST "r-lS-h/~ ~tNj $Ec3' Lo"r' g-lA ParcellD: Well lype "~'VQ-~. Date completed ~//,,~./'~-'/ Total depth I ~'C~ ft. Date of test Static water level Well production t O WATER SAMPLE RESULTS: Coliform . ~ colonies/100 mi. Arsenic: ~/~. rog.fl. SEPTICIM~&~IN~ TANK DATA IfA, B, or C provide PWSID # Sanitary seal (~) ~ Cased to l~'O.5'ft. FROM WELL LOG l / Z l ft. g.p.m. Well Log (~/N) ,~,-~' Wires properly prbtected (~I~N) Casing height (above ground) ~ q in. AT INSPECTION ~ ft. ~q '~ gp.m. Nitrate k/~ mg./I. Other bacteria ~' colonies/100 mi. Date of sample: ..~/~0/~'~' Collected by: .(~'/1~r'~5 Tank size .i, 000 gal, Number of Compartments Foundation cleanout (~N) ~ Depression over tank (~ Dateofpumping OcT Z. 7~Z,~'" Pumper C. ABSORPTION FIELD DATA Date installed II ./' ! ! ~ I Soil rating (g.p.d./ft~ or~ Length IP- ft. Width !0- ft. Total depth W. ~' ft. Eft. absorption area ,,,3~'~ ft~ Date installed ' Cleanouts ~.~N) High water alarm (Y/~) System lYpe ~ ,,o;*/-- Gravel below pipe f~ ft. Monitoring tube ~ Depression over field Date of adequacy test ~//$~'/o5' Results ~Fail) "F::'~"2,-- For, ~ bedrooms Fluid depth in absorption field before test ,e' in. Water added qS'O gal. New depth .,,Z in. Elapsed Time:. !O min. Final fluid depth ,.E in. Absorption rate >= qS'O g.p.d. Any rejuvenation treatment (past 12 mo.) (Y~& type), ~ f~ o~,J ~ If yes, give date m I ~' D. LIFT STATION Date installed 'Pump on" level at Datum Size in gallons Manhole/Access (Y/N) ~ in. 'Pum~ in. ~....._.----b-~'T~~m & circuit requirements? ~ISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift-st'at~ on lot -t-I OO ' Absorption field on lot ~r J ~O ° Public sewer main + ~' ' Sewer/septic service line '~ ~-~' ' On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/I-I~':B4N~ TANK ON LOT TO: Building foundation ~-c~ ' Property line 'rS' ',, Water main .r to Wells on adjacent lots Water service line SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line · I O' Water Service line 'f I O ' Curtain drain -I- ~'O ' Absorption field Surface water Building foundation Surface water t- · We s on ad.lacent lots Water main .~ I o ' Driveway, parking/vehicle storage lO' F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Date .~ C-~ [c~ r" HAA Fee $ /-'/~"~ Date of Payment t~-/7 '~/J ~' Receipt Number "7-7~ 9 '~ ~1_ (Rev, 12/01) Waiver Fee $ Date of Payment Receipt Number 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.anchorage .ak.us (907) 343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Chris Wood Legal description: .T15N Rlw Section 8 Lot47A The attached paperwork has been reviewed and is being returned for the following reasons: Original signature or stamp missing on Calculation error in design. Additional soils information needed. Water monitoring results inadequate. Discrepancy in information submitted. Topographic information missing or inadequate. Incomplete; missing Status of second well located on survey Incomplete; missing Additional adequacy test information needed. Water sample unacceptable. , Measured/proposed distances/dimensions missing. Locations of all soils, percolation and water monitoring tests not shown. Proposed system too deep for soils information submitted. Well log required . Omission in narrative. Insufficient fill over tank or field. Other. Name of reviewer: Jeff Date: 11/1/2005 Please supply the necessary information and re-submit your request. LEA VE THIS FORM ATTACHED TO THE PAPERWORK Al~ka Distributor 25a-~10 ~ Z[~I'C..~ P.p. Box 770197 Eagle River, Alaska 74,%2510 .-*~ 7 %;~ "*',~ 99577 ; Fax 688-2543 NWWA CERTIFIED PUMP INSTALLER Peyment due on recelpt o! Invoice unless other arrangements made, Address :O~y. Y"'~' "~'' -'' ' Dcsc~lptfon Pi'ice J Amount I I I I I I I I I I · Plea~ pay by I~olce. All ~count Past D~ will ~ Oham led $25 second bill;nc charge THANKYOU ~(X)/-~08'8 ZA:~8 ~ Z~(xv:m) ~NI~IE~I~ ~',I8 ~ 00:Il. (~FU.)SO(O~-8~-AON 10-13-05;14:48 ; ;907 561 5301 # 1/ 1 SGS Environmental Services Inc 200 W. Potter Drive Anchorage. AK 99518 3'el: (907) 562-2343 Fax: (907) 561.5301 SGS Ref. t/: Client Name: Project Name: Client Sample ID: Matrix: F~VSID Sam~e Rerna~s: 1056531 Eaglo Rivor Engineering Services T15N. R1W, Sec 8, Lot 47-A T15N, R1W, Sec 8. Lot 47-A Drinkinct Water All dates/times ere Alaska Stanc~ard Time Printed Date/lime: 10113/05 14:30 Collected Date/Time: 09/30/05 14:00 Received Date/Time: 09/30/05 1.~':54 Technical Director:. ...~t~p.hen EJ~e' J Bacteria Nitrate Results PQL Units 0 OB No Coil ND 0.10 mg/~g Allowable Prep Analysts Method Limits Date Dale Inlt 9222B 09/30/05 09/30/05 tf EPA 300.0 10.00 09/30/05 09/30/05 azs 18/27/2885 11:31 9873449821 iRS SEPTIO PAGE 82 .IRs l'umptng PO Box 773415 Eagl~ River. AX. P9577 (907) 694-6454, Eagle RIv~ EngUlfing 10421 ~ Rd Sle 201 E~gl~ Rtver. AK 99671 Jab Deecflp~lon: 500g P.O. Number: Terms; Net 30 ~ateSt~o: Nt~ole Stepnanla Job CommentS: 2O241 Weeping BIn:h Chuglek. AK 99567' (907) og4-5'm$5 Pipes In front yard ~ taft in Itrnw~r~ bed. ~lngla tc~e~ )nnk Service Agreement Numbs,*: 018~01 O~der Date: 25-Oct-2005 Standce D~te: 27-Oct-2005 12;00 am Tecflfltcian: Butch Job Type Repeat MaD Odd; 25 8irchwood Loop Rd Last servi~ 07112K)4 lO00g .......... ~t~ecked and pumped lank.- levels Iow. house vacant Tax Pm'cent; 0 t 1000 Gallons Actual: . Hose Lenglh: Double Tank: [~ · Pure. S~tem: ~ gafl~es Inlet: Baffles Outlet: L~ ==='=~ NonTaxable Tolal T~xabfe Total Ta~ TMaf Grand To~el Est~maled Charges: $130.00 ~.00 S0.~ ~st~er ~ ~ ~l ~ l~ ~ ~n~ ~ ~ ~ck. THI~ IS A BI~/NQ AGREE~NT. Signature and TI.a o~ Cuolemer RNxeMntaUve 'Date For ~ added Convenience we -c:¢ept American Express, Dlcover, ~qaa and Master Card payments over the Alter 30 Days accouele w~ll be turned over Io collectors. $25.00 Fo~ NSF Checks Returned. [.o% 2'; J "A~BL~TI~t' ~o corners set this date F~E~ZNTS ~)F RECb'~D;' ~m~ "THAN THOSE SHOWN RECORDED PLAT ARE NO~ SHOV~q HEREON. The information hereon is for the use of lending institutions shoving the .relationship of existing structures and platted easements and lot lines. It is not to be used for positioning additional structures or fencelines. DPEX: DMS SCALE: 1"=30' FB: 8_13· I~ATEI ~-4-87 GRID. NN,1356 I hereby cettL~y that ] have performed a Mortagee'e spect|on of the foUowtng described property: Lot 67A,Sec. 8,T15N,R1W, S.M. ~.nchorege ]~cording Precinet..~Llnska, and that the Improve- meot~ situated thereon ere within the property Unes and do 'not'overlap at'encroach on the property lymg adjacent there- to. that no lmprovement~ on property lying edjecent thereto encroach on the premises in question and that there are no roadways, trLqsmL~iofl lines or other %'isible e~emeflt~ on said property except as bertha. Dated, at ~¢horaee, ml~.~' da,),, of' Jtme lg 89 688-45 .SI"-N^P,!?.6 A~SOC[ATES LAND SURVEYING ¢ TER ANCHORAGE AREA BOR¢... ri DEPARTMENT 0r: ENVIRONMENTAL QUALITY 3500 TUDOR ROAr) ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSI'EM LOCATION ]~,'1 ~ SEPTIC TANK: DISTANCE FROM WELL__~5 i _MATERIAl. ~.~'7/~/~ -" NUMBER OF: ~f~/~Z____ C OM PA RTM E NT S _ / LIQUID CAPACITY__/_~.? .... GALLONS. INSIDE LENGTH '-- __INSIDE WIDTH -- LIQUID .DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: i NUMBER 01: PITS. j_ OUTSIDE DIAMETER _OR WIDTH / ~- ~J~] ...... DISTANCE FROM WELL /_~ NEAREST LOT LINI:~(~t_ ?~ ~ ~_~/~. TOTAL EFFECTIVE ABSORPTION AREA (WALL AREAl. LENGTH__ '~*~__, DEPTH_ · BUILDING FDUNDATION~__¢, ___SQ. FT. TILE DRAIN FIELD: DISTANCE FROM ~VELL_ '",~. , FOUNDATION NUMBER OF LINES __DISTANCbxBEfWEEN LINES , NEAREST [Of LINE _TRENCH WIDTH _ TOTAL LENGIH __IN. ABOVE TILE ABSORPTION AREA SQ. FT. I. ENGTH OF EACH LINE DEPTH: tOP OF TILE .TO FINISH GRADE %, DEPTH C)P~T'I~TER MATERIAl. BENEATH TILE_ r - WELL: a[~ ) DISTANCE FROM WATER TYPE J)O~- _ , DEPTH I ~L~., BUILDING FOUNDATION. ~) _SAMPLE NEAREST SEPTIC / SEEPAGE . ; LOT LINE ~0'¢__~ 7~_~_~, SEWER LINE "' ., TANK__~ 3 , SYSTEM___L~ ¢ , CESSPOOl NEAREST OTHER SOURCES DISTANCES: DIAGRAM OF SYSTEM ()ATE /6./2?/ GREATER ANCHORAGE AREA BOROUGH DEPAFITMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME OF APPLICANT ~-~¢'~'/"~/¢¢/~'J' ~;.J~/~"~,*'/~'~/'~'~?~J ~ ' MAILrNG ADDRESS ~/ -~, ~/ ~ PHONE INSTALLATION OF: sePtIC TANK SEEPAGE PIT , DRAIN PIELD , OTHER FINANCED THROUGH ¢*/ TO BE INSTALLED BY ~' ~'~?2 ~F~¢~/ NOTE: THIS PERMIT 18 NOT VALID WITHOtJT SOIL FINAL INSPECTION~ 24 HOUR NOTICI,' REQUIRED, E.~IACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPE(:TION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUSJE~T TO PRO~E~UTIOI~. DRAIN FIELD ALSO CONSIDER AREA WELLS. / WATER ~IAIN TO SEPTIC TANK /~/} --, SEEPAGE PIT . ,~ SePTiC TANK, ~ SEEPAge PIT /~ ., DRAIN fIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CR]B CROSSING GAP OF 4 INCH DIAMETER CAST iRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL [ilACKFILL DIAGRAM OP' ~*Y~TEM [ CERT[FY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA E]OROUG;I ORDINANCE NO. 20-68 AND THAT THB ABOV~ DESCRIBED SYSTEM IS IN ACCORDANCE WITH SA[D CODE, LOG OF IDRI~"' lNG by A G' L DRIL. L""G COMPANY KIND OF FORIVIATION: FROM ........................ FT. TO ......................FT ............................... FROM ........................ FT. TO ....................... FT ............................... FROM ..................... FT. TO ......................FT ............................... FROM ........................ FT. TO ........................ FT ............................... Rick Mystrom, Mayor Mtmicipality of Jh chocage Department of Health and Human Services 825 %" Street P.O, Box 196650 Anchorage, Alaska 99519-6650 343-4744 June 9, 1997 Bobby W & Julie A Brown PO Box 670493 Chugiak, Alaska 99567 Subject: T15N Rlw Section 8 Lot 47A Permit #SW960106, PID #051-093-27 The subject permit:, issued June 7, 1996 by this office for a single family well and/or on-site wastewater system, has expired as of June 7, 1997. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must: be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Siderely' ]~1 pJra~;rS ~Cmr~;~ 'ag eP;~/ O~dsit e Services enc: Copy of Permit PAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW960106 ]DESIGN ENGINEER: OWNER NAME:BROWN BOBBY W & JULIE A OWNER ADDRESS:20241 BIRCH AVE CHUGIAK, ALASKA 99567 DATE ISSUED: 6/07/96 EXPIRATION DATE: ]PARCEL ID:05109327 LEGAL DESCRIPTION: T15N R1W SEC 8 LT 47A LOT SIZE: 50507 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM 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 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AN[) CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. 1 OF 6/07/97 SPECIAL PROVISIONS: 1.) 2.) ENSURE 100 FT. OR GREATER SEPARATION BETWEEN PROPSED WELL LOCATION AND NEIGHBORING SEPTIC SYSTEM(S) . SUBMIT WELL LOG TO DEPARTMENT WITHIN 30 DAYS WELL INSTALLATION, AND SUBMIT SKETCH SHOWING THE NEW WELL LOCATION. ISSUED BY:. ~ DATE: ~/~'~/76~ OF t oorner~ 8ot: thi~ d~,~e The informa~ion hereon is for the use of lending institutions showing the relationship of existing '~n'tre~Ures and']~l~rted easements snd lot lines. It iB not to be used for positioning additional structures or fencelines. D~wp: p~s M J Lot &TArget. 8,T15N,R1W, S.M. SEW;dH) & ASSDCIATES LAND SURVEYING CHEMICAL & Gl TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL CE~ITER · / 5633 B Street orinking vva'ter Anmys)s,r~epcrt for Total Colifor~m Bacteria TO BE COMPLETED, BY WATER SUPPLIER LOGICAL LABORATORIES , ALASKA, INC. WATER SYSTE/IV*,: Mailing Address City State Mo, Dey Code SAMPLE TYPE: [] Routine [] Chsck SBmple (for routine with lab ref, no._ _) : [] Treated Water [] Special Purpose · [] Untreated Water SAMPLE NO. 1 2 4 LOCATION L / j ")' i~J Ii!./[~(.) .-"/%,.L ~ . j , J Time COllege)ed Collected , ~B]~,) '-. / (') :'/ t'~ ~ TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to De ¢ Satisfactory [] Uni;atisfactorv [] Sarr om too long in transit: samole ShOUld not be over 48 hours ale at exammauon to ~nolcate reliable results Please send Date Received Tl,,m~, Received / ,' ' , Analytical Method: ~1~ Fermentation Tube i [~ Membrane Filter '~ '"t%' :i . La~ Ref. ~.,. Result* Analyst ,~"/ 'q*/.I," I ~(.I _ %'~ 06-1220 (b) Rev. 197e BACTERIOLOGICAL WATE .R AI~LYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING,SAMPLE ', '.~..I... Tube Report. ~lOml Tubes Positive/Total Z0ml Portloni EXCAVATION ROBERT A. SHAFER WORK June 4, 1983 CIVIL ENGINEER 694-2979 Red Carpet/Greatland Realty ATT ENT IDI~: Terry Krueger P.O. Box 633 Eagle River, Alaska 99577 Dear Terry, Reference: Lot 47A: Section 8} T15N} R1W A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was charged with 1000 gallons of fresh water and after a period of 24 hours all the water which had been added to the system had ]percolated aw ay. It can be concluded from this test that the waste water disposal system serving the three bedroom residence located on this property is currently functioning adequately. However, the system cannot ]De guaranteed against subsequent :failure. If we may be of further service, US. please do not hesitate to contacl: cc: Municipality of Anchorage Department of Health and Environmental Protection SR6 196X EAGLE RIVER, ALASKA Approval 4. 5. 6. GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Time of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES ~-~Q~ ~. FOR voao requested by: Lomas and Nettleten Mailing Address: Property Owner: Mailing Address: 4449 Business Park BoUlevard Phone: 2'74-7661. Earl Roberts Ph0~e: 688-2490 Ch_~u~ak, Alaska Legal Description: T15N R1W Section 8 Lot 47A Location: S. Birchwood Loop on~LB~rch Lane, 1st house in on the right Type of facility to be inspected SJ.n~le Family No. of bedrooms 3 Well Data: Individual A. Type C. Construction B. Depth 107' D. Bacterial Analysis Sewage Disposal System: A. InstalledApprox. C. Septic Tank: 1. D. Seepage Pit: I. On-site system 1972 B. Installer Size Absorption Area 2. Manufacturer 2. Material E. Disposal Field: Total length of lines Distances:,~:~ A. Well to: Septic tank , Absorption area Nearest lot line , Other contamination B. Foundation to septic tank C. Absorption area to nearest lot line Sewer Lines ___ , Absorption area EQ-034 (1/7~) Page ] of two pages ',~3~J3,]~)i~'C'' St , Archorage, Alaska 99503 74--4561 REQUEST FOR APPROVAl. OF INDIVIDUAL SEWER & WA'FEI{ FACILITIES 3, Type o'F inspection: CMRO ////V/~/_.~._. fHA CONV NanJe of t. endin9 [n~;I;itution: __/].g2~/7/]..~- ~,~¢ 1 ]" /,,dd,' ,, ' : , '[,$,'pe of ;'~ ] t;., l,, b' Page 2 of two pages - Req ~t for Approval of Individual Legal Description T15N R1W Section 8 Lot 47A r & Water Facilities Comments Approved Date '_~ Approval~Valid for one year from date signed Greater Anchorage Ar~a Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) GREATER ^NCHOI~GE ARE^ BOROUGH Departraent of Env~ronnental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-.8686 Date Receive~ Inspection Time of REQUEST F~R APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES Address: ~ ---- .~ ....... 2.Prooertv ~ner: ...... 5. Type of Facility to be Inspected:. Number of Bedrooms~ Well Data: C. Construction Sewage Disoosal System: t spt _ ...... ~Glt D, Bacterial Analysis C. Septic Tank: 1. D. Seepage Pit: ].. E. Disposal Field: Distances: A. Well To: Be Septic Tank_._~.c~____, ^bsorption Area 11%--, Se,ar Lines _~&_____, Nearest Lot Line [.0 ..... , Other Contamination ..... · Foundat~sn ~o Septic Tank 6-0/ "~, fib~orp~ion firea_~P2Z/ Absorption firea to Nearest Lot Line 5~2, ~ ____.' Request for Approval of k xvidual Sewer & Water Facilltie~ Page Two 9. Comments: Approval Valid for One Year From Date Signed Greater Anchorage Area Borough, DeF~artment of ~,nvironmental Quality DIAGR~ OF SYSTHM I certify that the information contained in this request for approval to be a true and accurate representation of the sub.iect sewer and water facilities located 8%: S~gne ~ [)ate EXCAVATION ROBERTA. SHAFER WORK June ].983 CIVIL ENGINEER 694-2979 Red Carpet/Greatland Realty TEN] ION. Terry Krueger P.O. Box 633 Eagle River, Alaska 99577 Dear '~erry, Reference: Lot 47A: Section 8; T15N~ R1W A sewer system ade¢~acy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was charged with 1000 gallons of fresh water and after a period of 24 hours all the water which had been added to 'the system had percolated away. It can be concluded from this test that the waste water disposal system serving the three bedroom residence located on this property is currently functioning adequately. However, 'the system cannot be guaranteed against subsequent failure. If we may be of further US. service, please do not hesitate to contact cc: Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASK/~ ., 06-1220(o) Rev. 1973 DATE ALAS JEPARTMENT (IF HEALTH AND SOCIAL SE[ ,iS DIVISION OF PUBLIC HEALTH INDIVIDUAL AND SEMI-PUBLIC BACTERIOLOGICAL WATER ANALYSIS omcE INDIVIDUAL [] NAME SEMI-PUBLIC E CHLORINE RESIDUAL PPM REPORT RESULTS TO AgDRESS , r CITY__ ZIP CODE ADDRESS OF SOURCE Analysts SJlOWS this Water SAMPLE to be: _~ Satisfactory Unsatlsfaclory QuesHonable [] Sample too rang in transit; sample should not be over 48 hours old al examJnatbn 1o indicate reliable results, Please [] Bottle broker :- Iransit, please send new sample. SANITARIAN'S REMARKS COMPLETE THIS SECTION ONLY IF WATER IS AN INDIVIDUAL SUPPLY SAMPLE COLLECTED BT ' ' LOCATION~ PURPOSE OF EXAMINATION~ Illness Suspected? [] Yes [] No REA[) INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE g6-1220 (b) BACTERIOLOGICAL WATER ANALYSis RECORD Rev, 1973 , 24 Hours 48 Hour~ 48 Hours EMB AGAR DIRECTIONS FOR COLI. ECTING SAMPLES OF WATER FOR BACTERIOLOGICAL EXAMINATION Read Carefully and Follow Instructions Exactly_ Beat' in mind that water analysis deals with materials present in very minute quantities. The least care- lessness in collecting and handling may give rise to results which are misleading. Samples are accepted at the regional laboratories in the early part of the week (Monday-Wednesday) unless there is an emergency or prior arrangements have been made. Arrangements should be made to have the water samples reach the laboratory as quickly as possible and within 48 hours after collection. After 48 hours, the significance of the bacterloJoglcal analysis is impaired. In collecting samples from TAPS or PUMPS proceed as follows: (a) (b) Thoroughly flush tap or pump by allowing water to run freely for five minutes. Shut off water and flame the outlet with torch or burning paper. The flame should not be merely passed over the outlet but should be applied until fixture shows indication of being hot. Flame should be directed against inside edge. (c) Open fixture so that a small stream flows. (d) Remove battle from mailing tube. Hold bottle by the lower half in one hand and with the other remove the screw cap wJlh the fingers, leaving loll protecting cover in place. Fill the botlle to the shoulder. Replace cap with loll cover, screwing firmly inle place but do not c~pply pres- sure which will split cap. (e) Pack bottle carefully in mailing tube enclosing this completed information sheet. DO NOT COLLECT SAMPLES FROM FIRE HYDRANTS, YARD HYDRANTS, DRINKING FOUNTAINS OR SIMILAR OUTLETS WHICH ARE DIFFICULT TO DISINFECT PROPERLY. STERILE WATER SAMPLE BOTTLES ARE AVAILABLE UPON REQUEST FROM: Dept. of Health & Sociul Servlces Southeastern Regional Sanitarian Pouch J Juneau, Alaska 99801 DepL of Health & Social Services Northern Regional Sanitarian 604 8arnelle Streel FaJrhanks, Alaska 99701 Or District Offices in Fairbanks, Juneau, Ketchikan, Kodiah, Nome, p~lrner, Soldotna and Valdez. Consult local telephone directory for R E C E IV E D Anchorage 'nan Servic( APPLIC' NT FILLS OUT UPPERHAI Type of Residence Single Family ~ Multiple Family E] Other Water Suppiy [~ Community [~ Public Utility ONLY. Zip Code zip Code Zip Code No of Bedrooms Zip Code ATTACH WELL LOG. A well Iog Is required for all wells drilled since June 1975. For wells drilled prior to that date, glw] well depth (attach log if available). Sewer Disposal [~ Holding Tank Year Individual Installed: When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Date Date Inspector Inspector Inspector. Field Notes: /~{~.¢ .- ~¢./¢. L.~ L.[ JUL 0 8 1983 L.ZJ 'CONDITIONS OF APPROVAt. ' ' ( '~ ) APPROVED BEDROOMS ) DISAPPROVED ) CON DI~ION,~I~APPROVAL * BY: ~"~ ~ Well To Absorption Area Well to Tank Well Log Reoelved Septic Tank Size