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HomeMy WebLinkAboutTURNAGAIN BLK 2 LT 2O IQ--1 9,- 0-ooo ADEC ACTIVITY REPORT Lot 2 BK 2 Turnagain SID m service area: AN project #: 502 rev type: DW / WW Fee exempt: project location city/town/village: JAnchorage pwsid: 21859fi pws class: C legal desc: ILT 2 BK 2 Turnagain S/D dwrileno: latitude/longitude: owner's information: company: I 61 2181 149.9003 wwfileno: name: INathan L. Claus street: 1201 Ramona St city/st/zip: Anchorage AK 99515-3D15 phone: (907)344-7714 fax email: submitter's id 'GARN company: Alaska Water & Wastewater name: Mr. Jeffrey A. Garness street: 7320 E. Chester Heights Cir. city/st/zip: JAncliorage AK 99504- phone: (907)337-6179 fax: (907)3 88-3246 email: date 31.18/99 date submittal �^ staff assigned received: complete: comments: I Sep. dist. Waiver & request for Op. Approval. check back date: I reason for checkback: DW ACTIVITY Brieth act. no. I act. id start date I end date review comments 01 R[`' Y 3/22/99I 62 G-SD 3/22/99 V22/99IFinal Operation Approval W22/99 Sep dist wvr-75' to 65' WW ACTIVITY Invoice no. amount date: project completion date: F 3122199 120044 $430.00 3/19/99 Total Invoice: $I30J)o Find A First Next Previous Add a I Print Delete Save Exit Record I Record Record Record Record Record Record Record J # SERVICE CONNE *PWSID # *SYSTEM NAME STATE OF ALASKA DEPT. OF ENVIRONMENTAL CONSERVATION PUBLIC WATER SYSTEM SANITARY SURVEY AND INVENTORY UPDATE FORM 0`77- 502 " Indicates Required Response OE_ C I D *CLASS (A,B,C) *RESIDENT POPULATION *NON-RESIDENT POPULATION h O'TT 2 LEGAL DESCRIPTION (LOT, B ADDRESS 1. G L O C-K 2 T K, SUBDIVISION NAME) 126 1 1_iAM61JA ST O C HORAG L CITY t JA TPA S OWNER NAME ADDRESS CITY /�I OPERATOR ALAsKA STATE � MA06fifl SA"IE- STATE #4A R6ARE'r 13 ERNI E OR RESPONSIBLE AGENT 5AMr OPERATOR ADDRESS PHONE # '9 j j -451 ZIP CODE G1-4.A05 ZIP CODE , I- _ 7'7 OPERATOR PHONE # LONGITUDE: ? :±,9 ' h ` LATITUDE: 1 SEASONAL OPERATION: PRODUCTION 1GAL/DAY1 Is System in Operation? Yes No Avg Daily: 06 C ]�__ Operation Dates: f L).4 to 3 t Vt-�C (MM1DD) Max Daily: 1-dE�c3n G 0 f� Days Open Per Year; 36,— 346 Storage: 3 2- Ca.?),I NS Is System Permanently Closed? Yes No _ If YES, Closure Dates: FACILITY TYPE (CIRCLE ALL THAT APPLY): FS Food Service BR Bar SC School CG Campground SAD Subdivision RS Residential MU Municipal SF Seafood Processor AK State of Alaska WH Water Hauler V3 Military, Government LC Logging Camp MH Mobile Home Park DC Daycare Preschool Residential Care PA Public Accommodation: Hotel, Motel, Showers, Toilets IF Industrial Facility: Drill Rigs, Pump Station, Construction Camps, Mining Camps PF Public Facility: Food Processors, Stores; Markets, Barber/Beauty Shops, Dairy Bed and Breakfast (Glass C) � x Other, Specify p (,�r-`) , F X SOI)RC:FS: ((:IR(:I F ONF) —rd Groundwater Surface Water C Combination Surface & Growidw.Aw PG Purchased PS Purchased PC Purchased Combination Groundwater Surface Water k ' fIf Purchased, PWSID & Name of system providing water: PWSID NAME: TREATMENT USED (CIRCLE ALL THAT APPLY) AR Aeration CO Coagulation SF Sedimentation CL Chlorination DI Disinfection FL Fluoridation FI Filtration SF Softening Agent FV Iron & Manganese AC Activated Carbon TO Taste & Odor Control ID Iodination LV Ultraviolet Light XX Other, Specify NO None WELL DATA: Number Date Size Total Depth Depth Well Pump or Name Drilled (in.) Depth Of Of Yield Capacity (i/ Casing MAL9k (❑ (g 3 pm] I F ! ' aGrout SURFACE WATER DATA: Source Name Location Type of Intake Structure Pump Capacity (gpm) Plan Rvw. DateJ23q'� roval Date:—/ /_ Type of Approval: Construction_Int. Operation_Fin. Operation Engineer: COMMENTS: COMPLETED BY: (Name & Title) RECEIVED BY: g:\awdo\forms\invupdte DATE: DATE: STATE OF ALASKA DRINKING WATER PLAN REVIEW FEE Department of Environmental Conservation INVOICE #: 12Qotr f PAYMENT IS EXPECTED AT TIME OF SUBMITTAL Plan Review Number: So--2— Make check payable to: DEC Contact:i State of Alaska Phone: 555 Cordova St. Anch., AK 99501 Applicant name, address and phone number: IIVI MANT: 1 2 CD , 2 ��" , 1. Please reference invoice number on your check. 9 0195 15 2. Submit form original of this with your payment. Engineer/Project Contact: Facility/Project Name: �� PO�` �i�—d nG �"V—\ _n D Itemized Amount REFERENCE CATEGORY Fee Amount Due 80.030 REVIEW OF REQUEST FOR WAIVER(S) (h)(1) DP Individual on -site system, includes multiple waivers or modifications $230 Z30 (h)(2) DQ First five waivers or modifications submitted for a project $230/waiver (h)(3) DR Waiver or modification submitted for a project, after first 5 waivers $175/waiver NOTE: FEES are NONREFUNDABLE if a waiver is denied. 80.355 PLAN REVIEW FEES (a)(1)(A) DA Class A 25-50 people $250 (a)(1)(B) DB Class A 51-150 people: $250 plus $25 for every 10 persons over 50 (a)(1)(C) DC Class A 151-300 people: $500 plus $20 for every 10 persons over 150 (a)(1)(D) DD Class A 301-1000 people: $800 plus $20 for every 20 persons over 301 (a)(1)(E) DE Class A >1000 people: $1,500 plus $20 for every 40 persons over 1000, max $10,000 (a)(2) DF Class B public water system: 75% of Class A but not less than $200 (a)(3) D i Class C public water system $2002,00 (a)(4) DH For a surface water source add $400 (b) DI Fee reduction of 10% if simultaneous submittal of 18 AAC 72 plans < ©(l) DJ Modification <20% change to facilities, 20% of fee in (a)(1), (2) or (3) ©(2) DK Modification 2 1 % to 50% change: fee is percentage change x (times) [(a)(1),(2) or (3)] ©(3) DL Modification >50% change; fee is 100% of fee in (a)(1), (2) or (3) (d)(1) DM Main replacement or extension: < 1000 feet $100 (d)(2) DN Main replacement or extension: 1000'<5000', $100 plus $75/1000' over first 1000' (d)(3) DO Main replacement or extension: >5000', $400 plus $50/2000' or less, max $2,000 Paid: 0 Cash ,,gyp 1 �� Check 4 TOTAL AMOUNT PAID: To legally construct, install, modify, or operate any part of a public drinking water system in Alaska, ownersloperators are required to pay a plan review fee pursuant to AS44. Please check rma[ion on this f If there are any qucs[ions, lease contact your local 3�(4 ADEC office. 1 Sign re & it)F of DEC Contact Date COPY DISTRIBUTION: REMITTANCE (ORIGINAL); APPLICANT, FISCAL, FILE (COPIES) I E. 112th AVENUE I tiQ fi� SEWER CONNECTION LOCATION PER A.W.W.U. RECORDS. ASSUMED LOCATION OF SERVICE LINE TO HOUSE. 0 R EN STREET Lil Lu ti• eV ti ti Ld of U + ISO. -WELL RAQIUS it ROMONA STREET J,I i NOTE: ALL ItIL SHOWN PROPERTIES TO THE SOUTH OF ROMONA STREET ARE SERVED BY PRIVATE WELLS AND A PUBLIC SEWER LINE THAT RUNS ALONG THE SOUTH PROPERTY LINES OF THESE LOTS. L - _� I I ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 LEGAL DESCRIPTION: TURNAGAIN SUBDIVISION, LOT 2, BLOCK 2 TYPE OF WORK: SITE PLAN ❑ ..... .r........ PREPARED FOR: PHONE NUMBER: UII e r A. Garness; MARGARET CLAUS 344-7714 V��sh� '• -7953 .,•'gip DATE: DRAWN BY. SCALE: PAC€ „0.-eof '"•""' O, �f. d 3/18/99 A.C.G./J.L.M. 1 = 100, 1 OF 2 Van rafessln'` SEWER CONNECTION LOCATION PER A.W.W.U. RECORDS. MANHOLE ASSUMED LOCATION OF MANHOLE SERVICE LINE TO HOUSE.-% 1 i 'y ti0�4 r. 61 50' WFII RADIUS SEWER S II EUNE--\ 11 EXISTING .,O ti DtJPLFX `�XiS'11NG _ r CUSS "C" 1 RAMONA STREET WELL NOTE: ALL THE SHOWN PROPERTIES TO THE SOUTH OF RAMONA STREET ARE SERVED BY PRIVATE WELLS AND A PUBLIC SEWER LINE THAT RUNS ALONG THE SOUTH PROPERTY LINES OF THESE LOTS. r �� ALASHA WATER AND WASTEWATER CONSULTANTS, INC. 44ao 6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 �4 .• l DESCRIPTION: TURNAGIAN SUBDIVISION, LOT 2, BLOCK 2, .... y ...... '1 1. OF WORK: WAIVER REQUEST FROM CLASS "C" WELL TO SEWER SERVICE LINE ..... ...... PArK D FOR: PHONE NUMBER: ef r De9 i s pp MARGARET CLAUS 344-7714 7953•• �p a SCALE: PAGE: BY: P. • • • • • • �o 3/18/99 J.L.M. I 1 = 50' 1 OF 2 Rfes o FIXTURE NO. OF FIXTURES FIXTURE VALUE FIXTURE COUNT SM. SINK 2 1 2 TUB/SHOWER 2 2 4 TOILET (FLUSH) 2 3 6 DISHWASHER 2 2 4 HOSE BIB 2 3 6 KITCHEN INK 2 2 4 PER UNIFORM PLUMBING CODE, 1991 FD__2AQE_1fil C1.-Mf-A-3. FIXTURE COUNT OF 26, PEAK DEMAND=18 GPM WELL YIELD FROM FLOW TEST (2/26/99)= 7.5 GPM INSTANTANEOUS DEMAND: (18-7.5 GPM)(20 MIN)= 210 GALLONS STORAGE R=IIREi1: STORAGE WITHIN WELL CASING= (110'-28')(1.46 GAL/FT. OF CASING)= 121 GALLONS. STORAGE WITHIN PRESSURE TANK(WX-203)= 32 GALLONS TOTAL AVAILABLE STORAGE= 121+32= 153 GALLONS ADDITIONAL STORAGE REQUIRED= 210-153= 57 GALLONS mollim milmlin TOTAL FIXTURE COUNT=26 PRESSURE GAUGE--\ PR SSURE SW1 -CH 40-60 PSI) CONCRETE SLAB--\ WX-203 PRESSURE TANK 48" X 16" 0 WELL X-TROL HOSE BIB - 3/4" COPPER LINE ALASHA WATER AND WASTEWATER CONSULTANT'S, INC. F 6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 PHONE: (907) 337-6179/FAX: (907) 336-3246 . ��❑Qh S1 LEGAL DESCRIPTION: TURNAGAIN SUBDIVISION. LOT 2. BLOCK 2 TYPE OF WORK: SCHEMATIC OF WATER SYSTEM ......... PREPARED FOR: PHONE NUMBER: /} VA p r A. C e59,� MARGARET CLAUS 344-7714 V���g� ' . C 7953 ��e'�qp "' o� F o� p��Qoaaa� (DATE: DRAWN BY: SCALE: PAGE: 3/18/99 A.C.G. 1 = 100' 1 OF 1 FROM : ALASKA WATER & WASTEWATER. PHONE NO. : 9073383246 Mar. 22 1999 10:49AM P1 ALASKA WATER AND WA4L5Tt;WA.T,t;m CONSULTANTS, INC. From ALASKA WATER WASTEWATER CONSULTANTS, INC. `' jeffre'S' A. Gayness, P.E.; M.S. 03/22/99 14:10 FAX 9072697650 DEC DW&WW IM001 TX REPORT Ne�k�esk�k**�*N�:kxesk*�&xe�ksk** TRANSMISSION OK TX/RX NO CONNECTION TEL SUBADDRESS CONNECTION ID ST, TIME USAGE T e Oa QI TONY KNOWLES, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION -. .)K317z19 g cp DIVISION OF ENVIRONMENTAL HEALTH DRINKING WATER and WASTEWATER PROGRAM 555 CORDOVA STREET Telephone: (907) 269-7519 ANCHORAGE, AK 99501 Fax. (907) '269-7650 htL-//www.8tate_ak_us/der,/Iiome/httn March 22, 1999 1VIr. Jeffrey A. Garness P.E. Alaska Water & Wastewater 7320 E. Chester HeightsCir. ,Anchorage, Alaska 99504 Re: Lot 2, Block 2,Turnagain Subdivision ADEC # 9921-DW-077-502 Dear Mr. Garness: I have reviewed your submittal that included a separation distance waiver request between the sewer and water service lines for the Class "C" water system on Lot 2, Block 2, Turnagain Subdivision. I find that the waiver can be granted from 75' to 65' and the use of the water system may continue. Should complaints of decreased water supply be made, the additional sixty -gallon storage at the home should be provided. This recommendation is made based on the provided engineering computations submitted. T1le submitted information did not identify the present condition of the well head, but your letter did not indicate this to be a problem_ Enclosed is a portion of the regulations that address this concern. Please correct or address any deficient items. DEPT. OF ENVIRONMENTAL CONSERVATION DIVISION OF ENVIRONMENTAL HEALTH DRINKING WATER and WASTEWATER PROGRAM 555 CORDOVA STREET ANCHORAGE, AK 99501 http://www.state.ak.us/dee/hon3e/htin March 22, 1999 Mr. Jeffrey A. Garness P.E. Alaska Water & Wastewater 7320 E. Chester Heights Cir. Anchorage, Alaska 99504 Re: Lot 2, Block 2,Turnagain Subdivision ADEC # 9921-DW-077-502 Dear Mr. Gamess: TONY KNOWLES, GOVERNOR FAX 3lzzl9g c,F Telephone: (907) 269-7519 Fax: (907) 269-7650 FILE COPY I have reviewed your submittal that included a separation distance waiver request between the sewer and water service lines for the Class "C" water system on Lot 2, Block 2, Turnagain Subdivision. I find that the waiver can be granted from 75' to 65' and the use of the water system may continue. Should complaints of decreased water supply be made, the additional sixty -gallon storage at the home should be provided. This recommendation is made based on the provided engineering computations submitted. The submitted information did not identify the present condition of the well head, but your letter did not indicate this to be a problem. Enclosed is a portion of the regulations that address this concern. Please correct or address any deficient items. The Public Water System Identification number is 218596 please use this number when submitting sampling results to the lab. Your Final Operation Approval is attached. Respectfully, William R. Rieth, P.E. Environmental Engineer WRR/cf Enclosures: As Stated STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION CONSTRUCTION AND OPERATION CERTIFICATE FOR PUBLIC 'WATER SYSTEMS Api.c-4t- 9921-17O o77-5a2 A. APPROVAL TO CONSTRUCT p R 1 0lCl lli � 1•y1�'`1'�YZ �1.t9 ��% 1=01� �} Plans for the ��x 4 + } ���]� !�-�� �16111 5_t public water system located in C7 , Alaska, submitted in accordance with 18 AAC 80.300 by AcJ��F'��Y �' 1'�►U ` 55 approved. conditionally approved (see attached conditions). BY TITLE have been reviewed and are DATE If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. B. APPROVED CHANGE ORDERS Change (contract order number or descriptive reference): Approved by: Date: C. APPROVAL TO OPERATE The "APPROVAL TO OPERATE" section must be completed and signed by the Department before this system is made available for use. The construction of the W r- L ki public water system was completed on Y 26 1197 (date). The system is hereby granted interim approval to operate for 90 days following the completion date. 71 26 Emits NG I MAY BY TITLE DATE As-buililre,cord drawings; submitted to the Department, or an inspection by the Department, have confirmed that the system was constructed according to the approved plans. The system is hereby granted final approval to operate. 9Y TITLE DATE Distribution: 1. Retain original for project file 2. Make copies for distribution Alaska Water & Wastewater Consultants, Inc. BAR 9g 6901 Debarr Road, Suite 2B — Anchorage — Alaska 99504 _ .Nr Phone (907) 337-6179 — Fax (907) 338-3246 �� March 18, 1999 Alaska Department of Environmental Conservation Drinking Water & Wastewater Program 555 Cordova St. Anchorage, AK 99501 REFERENCE: Lot 2; Block 2; Turnagain Subdivision Request for Class "C" Certificate to Operate � ' nUFE55►"' Request you issue a Certificate to Operate on the well located on the referenced property which serves a 5 bedroom duplex. The flow test was performed on February 26, 1999, and it was determined that the yield was 7.5 gallons per minute. Water samples were taken and submitted to CTE Environmental Services for analysis of total coliform, bacteria and nitrates. The results were satisfactory, see attached. As can be seen from the attached site plan there are no sources of contamination within the 150 ft. protective well radius, other than the sewer service line serving the duplex which is located approximately 65 feet from the well at its closest point. The well was drilled in the Spring of 1971, and the sewer service line was installed in 1989 when the house was connected to AWWU sewer. At the time of the connection, the house was a single family dwelling. Now that it is a duplex, the required separation distance from the well to the service line is 75 feet. The only way to mitigate any contamination potential would be to encase all joints (within 75 feet of the well) in concrete. Based on recent water analysis, there has been no adverse effect to water quality since installation, consequently, modifications to the construction are probably not justifiable. Thus, we request that your department waive the required separation distance between the well and private sewer line to 65 feet. Attached is a check for $230.00 to cover the ADEC waiver review fee. Based upon our calculations, the peak 20 minute flow demand (UPC method) is approximate 210 gallons, and the system deficiency is approximately 60 gallons. According to the property owner, the existing system has functioned adequately in its current configuration, therefore we are requesting that your department waive the need for any modifications. Page Two Lot 2; Block 2; Turnagain Subdivision We request you issue a Certificate to Operate based upon the submitted well log, water sample results, well yield test results, as well as the asbuilt plans and specifications detailing the existing water system. If you require additiorAl information, please contact me at 337-6179. M.S. FROM,: ALASKA WATER & WASTEWAT-,--� PHONE NO. : 9073383246 CT&F- Environroental Services Inc. CT&E Ref 990744001 Client Name AK Water & Wastewater Consultants Inc. Project Name/# L 2 B 2 Turnagain S/D Client Sample ID L2 B2 Turnagain S/D Matrix Drinking Water Ordered By PWSID 0 �arnple Remarks: —_Y — Parameter Total Coliform Nitrate•N Mar. 22 1999 10:49AM P2 Client PO# Printed Date/Time 03/05/99 11:21 Collected Date/Time 02/26/99 16:01 Received Date/Time 02/26/99 16:30 Technical Director: Stephen C. Ede Released ByAA4-"46" Allowable Prep Analysis Results PGL Units__ Method Limits Date Date ]nit 0 col/100mL SM18 9222E 02/26/99 KAP 0.100 U 0.100 mg/L EPA 300.0 10 may 02/26/99 02/26/99 SCL FROH ALASKA WATER & WASTEWAT PHONE NO. : 9073383246 l Mar. 22 1999 10:50AN P3 CT&E Environmental Services Inc. ',94� Laboratory Division s;,s�.�,+�rwsrr�����'r�s«srsr�I�r�rt�..►.r.�trEr+r�r�.. 200 W Potter Drive Drinking Water Analysis Report for Total Coliform Bacteria Anchorage' AK 99518-1605 Te;- {907j 582-2343 READ INSTiRUCTIONS ON I(EVER,SI: S1'DE BLcFORE COLLECTING SAMPLE BE COMPLETEf BY LABORATORY MUST BE C,OMPj-ETED BY W.�TER SUPPLIES Analysis shows this Water SAMPLE to br ❑ PUBLIC WATER SYSTEM I.D• d Satisfactory PRIVATE WATER SYSTEM' Results p Send Invoice /J-_ Send Res r�s i� Send Invoice I ongmy Name Iln1[ A SAMPLE DATE: Month Day Year SAMPLE TYPE: Routine ❑ Repeat Sample (for routine sample with lab ref. no. ) ❑ Special Purpose SAMPLE LOCATION S Comments: ❑ Treated WAter ❑ , Untreated Water Time Collected Collected By AP. ,vim Pi" Priu ❑ Unsatisfactory ❑ Sample over 30 hours old, results may be unreliable O Sample too Itutlt in transit; sample should not be ova 48 hours old at examination to indicate reliable results, Please send new sample kria spec 11deli Qry mail. Date Received r � c Time Received Analysis Began _ ��---=�-- Analytical Method: �Filter �MUO • Number of colo-aies/100 ml. Icsult• Analyst �J Fbks Jun 111 p'azcu Date; - _ - _ Timc: notified bj unsatisfactory Client: results � 3 -- Phoned Spoke with Ford Date; Time; BACTERIOLOGICAL WATER ANALYSIS RECORD MMO-MUG Result: Total Coi;form Membrane Filter: Direct Count _-. -`r—)- - Verification: LTB 13GB E. Cali ColonieV100 rni COLIFIRM TNIV - Too Npm,—x To Co — ON — Other Bach - Fecal Conform Confirmation Final Membrane Filter Results Colifortn/10p ml Repotted By Date A C�. Time - L � �y h I� r Member of the sGS Group {SoeiAtA GbnBrale de Surveillance) ` - •• • •-•—•- •-....r .— J1rrU'1111I aAICCfII Inl WFW .IFRSEY OHIO. WEST VIRGIr:; O U 0 J m. u1 w w U) w ax U oC p0 Z Z lbOd3a N01103dSNI 83M3S U), 0 Z w U � w � J WO Y = cn Z w Z '-1 J w0 Um > z WO cc LL wd w0 (n� 0 3 _ 1 C� �l _J Ilnn W; n� �I � � 1 � i-- w w F r� Q U w z Z O _z Q b Q W Z IL w 0 H w z O U �I z 2 w o_ � z ~ O F U O m J (%j p Q w w C) z w w z N O O Un U U Z INDICATE NORTH n 0) O N z m z K m a Z r O z a d z m n O � n m D m � z v vn o' Z1 N Air > v a O m v " o � r m ` C 1 U) c 03 v O z a) O r 0 AL a 130X 1?,"UTE A ANCUORAGE9, ALASn.A )0e502 344-7` 14 SIX INCH WATER WELL DRILLED AND CASED OUT TO THP' DEPTH OF I 1 0 Feet DRILLED AT THE RATE OF $16.00 PER FOOT. PROPERTY OWNER Height Construction LOCATION OF WELL SITE i.t.. 2 DRILLER — Bernie Claus of Ram WELL LOG: 0---- 22' Fine gravel 22 --- 78' Coarse gravel Blk. 2 Sub. Turns ain rt Drilling Works 78 --- 97' Silty Coarse gravel 97--110' Sandy wet gravel going into a goad coarse water bearing gravel at 110 feet 9 making 8 GPM The ua t of - q�.� ii �' --- — water appears very good. Water recovery back up to within 40 feet of surface. Cost of drilling: $16.00 per foot x 110 feet: $1,760.00 COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF $1 , 0 _ n,0 __ THANK YOU VERY MUCH. -% "\ " C BERNIE CLAUS OF RAMPART DRILLING WORKS DATEMay 96,-19_71 SERVICE CHARGE 0 F I Y,% PER MONTH WILL BE ASSESSED ON PAST DUE ACCOUNTS. 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ANCHORAGE, ALASKA 99501 279-2511 N? 68 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ADDRESS ,EGAL DESCR,PT,O. SEPTIC TANK: DISTANCE FROM WELL. MATERIAL C~ ~ ~ ~//q .~' NUMBER OF COMPARTMENTS LIQUID CAPACITY /~-~) ~ ~ GALLONS. INSIDE LENGTH INSIDE WIDTH PHONE_ LIQUID DEPTH__ SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAl NEAREST LOT LINE SEEPAGE PIT: J _OUTSIDE DIAMETER OR WIDTHJ~/ , C~.Y/Cpffg~c F ~ I')~/(~ . DISTANCE FROM WELl 7~ ~' ] TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) LENGTH 2-2 / ~--~ · , DEPTH · BUILDING FOUNDATION ~ / 9-9- so. FT. TILE DRAIN FIELD: DISTANCE FROM WELL , FOUNDATION ABSORPTION AREA SQ. FT. TOTAL LENGTH ~T L~ , OF LINES TRENCH WIDTH ~i LENGTH OF EACH LINE EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE WELL: ..~.~.. ,,,~,/~ ~),c"f]g]C/4'¢)l/~,.~l TYPE /~-t/ ~b~.O~4 . DEPTH /~' ~ LOT LINE / ~ ' NEAREST in/ SEPTIC ., SEWER LINE~/~ ,TANK. .DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE DISTANCE FROM .~C-~/ WATER ~ , BUILDING FOUNDATION. SAMPLE NEAREST / /~ SEEPAGE I ~L~' ! OTHER , SYSTEM , CESSPOOl ~ , SOURCES ~ DISTANCES: .7 / DIAGRAM OF SYSTEM APPROVED HEALTH AUTHORITY GREATER',i iNCHORAGE AREA -')ROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT '~ ,' : · MAILING ADDRESS ' 'i'. RESIDENCE ADDRESS ' "~ '=' LOCATION OF INSTALLATION LEGAL DESCRIPTION :' ~ ,' APPLICATION TO INSTALL: SEPTIC TANK , SEEPAGE PIT ,DRAIN FIELD TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH ·: ~ .,TO BEINSTALLEb BY. ' PERCOLATION TEST RESULTS ~ i ,,',: :! , ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT PHONE NO ,OTHER. THIS IS TO SERVE AS "':!"~ , PERMIT TO INSTALL A ' "" ' AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED ' · SEPTIC TANK SIZE ': TYPE "' ""' ' SEEPAGE AREA · DIAGRAM OF SYSTEM TYPE DISTANCES: HEALTH AUTHORITY OR LICENSED DESIGNER I certify that i am familiar with the requirements of Greater Anchorage Area Borough Ordh~ance No. 28-68 and that the above described system is in accordance with said code. DATE APPLI CANTS SIG NATU R E EAGLE STREET A~{CHOR~0E, /~LASKA 99501 CAS?: Pe**foPmed For Buck Hight ' This Form RepoPYs a; S...,.~; Depth 1-- 2-- 3~ 4--~ 9~ 10--~ tau sandy silt (ML) loose clean sandy fine to medium gravel (GW) loose clean gravelly sand (sw) w/6" silty sand seam 7.5' ~ 8' Was Ground Water EncotmtePed?__/%o if Yos~ At %~hat Depth Date Location Sxe ~ch COH'-!KN TS: ~ ..... ;%~~%~ ~ requzred per bedroo~ Tes~: ~emfo~med b .... . · ~, Natzonal Testln Servzce ....................... ~ ............ S, Inc. R. E, Carlisle