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Home My WebLink AboutT15N R1W SEC 18 LT 9TISN RIW tion 18 Lot 9 #051 - 171 - 15 Tom Fink, Mayor / un dpality ot Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 January 28, 1993 James A. Henderson PO Box 670127 Chugiak, Alaska 99567-0127 Subject: T15N R1W Section 18 Lot 9 Permit ~SW910369, PID ~051-171-15 The subject permit, issued November 22, 1991 by this office single family well and/or on-site wastewater system, has expired as of November 22, 1992. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. for a 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: $200.00 for an on-site wastewater permit; $75.00 for a well permit and $275.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Sincerely, ,~ , /J~hn Smi~.h~ P. E. ~rogram ~anager On-site Services enc: Copy of Permit PAGE 1 OF 1 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:SW910369 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:HENDERSON JAMES A OWNER ADDRESS:19526 R.R.ACCESS RD CHUGIAK, AK 99567 DATE ISSUED:il/22/91 EXPIRATION DATE:il/22/92 PARCEL ID:05117115 LEGAL DESCRIPTION: T15N R1W SEC 18 LT 9 LOT SIZE: 108900 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: EXISTING WELL TO BE ABANDONED TO CODE REQUIREMENTS. ISSUED BY: ...... DATE: MUNICIPALIT ENVII~ONMENTA NOV IHORAC~E ES DIVISION Oc~,ober 50, 1991 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 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 DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM Lou Campbell ASSOCIATED BROKERS 640 West $6th Avenue S~te #I Anchorage, Alaska 99505 REFERENCE: Lot 91 Sec. 18, TISN, RIW, S.M. 19562 Railroad Acc~S, Chugiak, H.U.D.#111-028985-205 At your requ~t we have continued pumpin~ water from tke w~l serving the referenced DropSy in an effort to al~ar the w~ purs~a~ to our l~r of 0~tober 10, 1991. On October 11, 1991 a ho~e and m~r w~re connected to an ouJ~ide faucet and the flow rate turned on at ~pproxlmat~ly I gallon p~ minute {GPM). The water continued to flow until a power outage shut the w~l pump off on October I$, 1991. Once power was r~tored to the prop~rt~ we r~turned on October 17, 1991 and foun~ 2565 g~on~ had b~n p~p~ from th~ sy~t~. W~ took a ~t~ s~p~ ~ ~ poi~ and co~nu~ ~ flow from th~ w~. Th~ r~ of t~ ~pl~ ~ho~d a ~rbi~y l~v~ of 255 NTU. On O~ob~r 21, 1991 we r~turned to the property and r~sampled the water. At this time an additional 6984 gallo~ of water had be~n pumpe~ from the w~ll. The r~It of this sample was 148 NTU. From thi~ data it app~ar~ the w~ll i~ not ~l~aring with use. In fact, use of the w~ll ma~ tend to keep the si~t particl~ suspended within the water. We recommend ~tker of the following options to obtain satisfactory drinking water for the referenced property. In~tall a water treatment u~t within th~ ho~ to r~ov~ th~ ~i~ par~ ~n the ~ter. For more d~ on ~e t~pe of s~t~ and ~ co~t, a w~ ~ ~p~t ~ho~d b~ co~d. Th~e ~y6t~s ~n b~ eo~y wi~ a f~r ~ou~ of m~nc~ r~q~r~. 2. Drill a n~ w~ on the property. A n~w w~ll may or may not produce the same turbid water. The prop~t~ 'own~ to th~ nor~ s~t~ th~ ~ ~d a ~rbid w~ u~ ~ n~ w~ w~ d~d to a l~ d~pth. Sh~ $~d th~ ~ ~topp~ j~t p~or ~ ~ ~rbid ~r. Sh~ now ~ ~r w~ w~ho~ ~. 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Page two Lot 9; Set. 18, II~N, RIW, S.M. HUD #I11-02898~-205 Oc. tober 50, 1991 Therefore, we recommend the ne~ w~ll be drilled in either the north~6t or the nort~e6t corner6 of the lot. Care 6hould be t~ken to keep the well out of the 33 ft. Patent R.O.W. R~6erve and 100 ft. from any 6ep~ic If you have any qu~6tions or if we may be of further service, please contact Sin~er~y, ROGER J. SHAFE RJS/gm ROBERT SHAFER, P.E. ROGER SHAFER, P.E. O~.tober 10, 1991 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 PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER OISPOSAL SYSTEM DESIGN Lou Campbell ASSOCIATED BROKERS 640 W~t $Sth Avenue Sure #I Anchorage, Al~ka 99503 REFERENCE: Lot 9; Sec. 18, TISN, RIW, S.M. 19562 Railroad Acc~s, Ch~giak H.U.D. #111-028985-205 DP.~r Lou, The r~t~ of the water sampl~ we have taken from the w~ s~rving the referenced property are as follows: TURBIDITY = 11 NTU TOTAL SUSPENDED SOLIDS = 11 mg/1 As can be seen, the turbidity level is still high. Since the w~ll s~rving th~ property i~ n~w, it may be possible that the w~l will ~ar with u~e. At this t~e we understand the n~w owner has run a considerable amoun~ of wat~ from the w~ll. However, we hav~ no data to show wh~th~r or not the w~ll is ~l~aring with use. At th~ poi~ we recommend running the water co~in~ously at a low flow rate such as approximately I g~lon p~r minute (GPM) for 3 days at which poi~ we will r~s~ple and t~st for turbidity. We can then allow the water to run for another 3 days and again sample for tur§idit~. with the r~u~ of thee t~ts we should g~ an indication as to wh~th~ or not the w~ll will continue to cl~r with u. se. If you hav~ any q~estio~ or wish us to proceed with the work d~s~ribed above, pl~se contact us. Sincerely, ROGER J. SHA~ER, P.E. RJS/~m 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Municipality of Anchorage Page / o! 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 Name: ~ ~ ~ Wastewater System: u New ~Upgrade Address: ~ ~ ~ ~ ~v~U~ ~x ~-~ ABSORPTION FIELD Phone: ~No. of B~ooms: ~ Deep Trench ~ Shallow Trench ~ed ~ Mound ~ Other ~ ~ ~ ~ Total Depth from ~rlglnal grade: LEGAL DESCRIPTION Lot: ~ Block: Subdivision: Depth to pipe boitom Irom original grade: Gravel depth beneath p~e ' Fill ~dded above original grade: Gravel length: Number of lines: J ~ Ft, WELL: ~New ~'Upgrade Grave~ J Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Date installed: Driller: gat Drll d: S a icWaterLevel: Installer: J P~mp Set et: I Casing Height Above Ground: TANK 8EPABATION DISTANCES a Septic ~ Holding ~S.T.E.P. Number of Compartments: i Material: Surface /A ~/~ tiff ~/~ LIFT STATION Water Line i "Pump on" level at: J "Pump ofF' level at: High water alarm at: Drain BENCH MARK Location and Description: Assumed Elevation: ENGI~3~AL Reviewed and appr0ved ~~- 72-013 (I/91) MOA 25 Permit No. ~ .~/,.~,~, Page Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION . of ~ P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: ~-',-,~-,,~ ,,~ //-~' 5"~_., /,~ PID No.: West 529.7' septics within 200' .35' R.O.W Easement 2o~ ! / ~,/ / , J Top of bank ~...... ~10X I B~D = 14' WELL L?CAT~O N No surface water +200' No known curtain drams ·: ENGINEER'S SEAL ELEVATIBNS (NOr TO SCALE) FINISHED GRADE @ 98.0' 2-Y odded fill 2' BURIAL FOAM -I ' II ~ (~5 PSO O .......... 1· -- r- · ' .......... "~9/ GRDUND '~",.- ~25.~' ~9/ LEVEL e 95,0' ~- ~/£S~ ]B~_SENENT ViNDJ]V SILL H C]WT @ 89,0' 72-013 A (2/91) MOA 25 PAGE 1 OF 1 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 AND WASTEWATER DISPOSAL SYSTEM PERMIT NUMBER:SW910188 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:SECRETARY OF HUD OWNER ADDRESS:222 W. 8TH AVENUE BOX N-64 ANCHORAGE, ALASKA 99513 (UPGRADE) PERMIT DATE ISSUED: 7/11/91 EXPIRATION DATE: 7/11/92 PARCEL ID:05117115 LEGAL DESCRIPTION: T15N R1W SEC 18 LT 9 LOT SIZE: 108900 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD / 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: 1. TOTAL DEPTH OF SYSTEM MAY NOT EXCEED 0 FEET. 2. PROPERLY ABANDON EXISTING TRENCH AND SEPTIC TANK. RECEIVED BY: ~ DATE: ISSUED BY://~~ ~t~,~ DATE: EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, ALASKA 99577 LETTER Phone 694-5195 TO -~ d'~ ~* Date Subject [] Please reply [] No reply necessary ENViR~,NMENTAL S~RVICE5 DIVISION ,I [J L - 9 1991 RECEIVED AGLE RIVER ENGINEERING SERVICES Leu Bulera, P.E, P.O. Box 773294 Eagle River, Alaska 99577 Telephone (907) 694-519ff November 20, 1990 Mr. John Smith, P.E. Dept of Health & Human Services 825 L Street Anchorage, Ak 99502 RE: Lot 9 T15N R1W, Sec. 18 Narrative Dear Mr. Smith, The probable impacts to adjacent properties of this well and septic system installation are negligible. This is due to tile fact that the lot is 2.5 acres and the required setback distance to well and septic are met on the lot itself. The lot is also fronted on two sides by a 66' road easement. Neighbor wells are +200' distance from the septic system areas and wastewater systems are +200' from our proposed well location. Reserve area is sufficient and drainage will not be affected. The existing system will be abandoned to code. We are requesting a variance from the 15' bed width as allowed by the ordinance. Our bed location provides adequate work area and level work area to accomodate an 18' wide bed reducing the length to fit site conditions. If you have any questions or any further concerns please call me at 694-5195. Sincerely, Louis Butera, P.E. ~.~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street. Anehosage. Alal~kll 99501 264,4720 SOILS LOG -- PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: D^T. F..FORMEO,_ ///~"'/" 2 3 4 5 7- 8 9 SLOPE lO WAS OROUND WATER E.CDUNTE.ED~ IF YES. AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop I I,/~'*~' /~:~-.~.-. ~-...,~ ~;~" PERCOLATION RATE ~--- // (mloutelllnch) TEST RUN BETWEEN "~-"-. FT AND '~ -- FT COMMENTS PERFORMED BY: 12-006 ($179) Eagle River Enal,eerlflg 9ervlcoa Eagle I~lver. P.K 6957? 694-6196 , CERTIFIED BY: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION S26 L. Street, Anchorage, AIBSka 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST pE.EORMEDFO"= DESCRIPTION: ~- ~ ~T~'-/~, ~' /~ ~ LEGAL SLOPE 1 3 4 6 6 7 8 9 10 IS GROUND WATER :OUNTERED? 12 IF YES, AT WHAT EPTH? I?- 18- 19 20- Reading Date PERCOLATION RATE TEST RUN BETWEEN ..DATEPERFORMED: SITE PLAN Gross Net Time Time ~- ,,,~,,~ Depth to Water Net Drop /----- / ,{minutes/Inch) '~-- FT AND 7, J- , FT COMMENTS PERFORMED BY: EBgle River E,glneerl~g SoP/lees Eagle River, AK 99577 694-5195 _CERTIEIEO BY: ' ~-- ~ 12-008 ISI79I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 929 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: '/7/'~f~ ~ DATE PERFORMED: 1 2 3 4- 5- SLOPE SITE PLAN 7- 8 g- 10- 11 12 13 )UND WATER AT WHAT 14 15 16 17 18 20- Gross Net Depth to Net Reading Date Time Time Water Drop ~ '~.,a .,'9 I 'l,,&/4, ..r.,..,,: .ATION RATE ~' / (minutes/inch) TEST RUN BETWEEN ~ FT AND ~ , FT COMMENTS Eagte River Engineering 9orvlco8 ,~ ~ PERFORMED BY: p ri Rnv ?7~BQa CERTIFIED BY: Eagle River, AK 99577 694,-6196 72-009 SPECIFICATIONS FOR OW-SITE SEPTIC SYSTEM LEGAL: LOT 9, T15N RiW, Sec. 18 Ae GENERAL 1. The well and septic plan are for a single family, residence only. 2. The drawing and or site plan shall be a part of this specification. S. All materials and workmanship shall meet the Anchorage Department of Health and State Department Of Environmental Gonservatton requirements. 4. Ail soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. Bm BED 1. The bed is to follow the natural land contour to maintain uniform total depth of the bed bottom. 2. The bottom of the bed shall be level, plus or minus 1.5". 3. The total depth of the bed excavation is to be at ground level. Removing topsoil layer and replacing with 2' sand layer meeting State specifications per 18 AAC 72. 4. The sewer line is to replace the existing sewer line that leads to the existing tank. The existing tank is to be abandoned. 5. The bed gravel is to be covered with typar fabric material. 6. Soil or combination of soil and extruded board insulation to a depth of 4' or equivalent is to be placed over the leachfield. 7. The area over the bed is to be finish graded to prevent ponding of surface water runoff. 8. The septic tank and leachfield must not be closer than 100' to any existing private well, 1.50.' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS TOTAL DEPTH = O' GRAVEL DEPTH = 1' BED LENGTH = 32' BED WIDTH = 18' Soil Rating = 125 (sand material) Bedroom Capacity -- 3 Septic Tank Size = 1250 Anchorage tank with lift station wired by !,lcensed electrician. Sand Filter - 2' depth Remove and replace ~ Insulation = 2" burial foam, 35 p.s.i., over bed No wells, buildings or West 329.7' 3;~' R.O.W, Easement 12o~ ~ ~ Top of bank ~ ~ ~atl~ Trench No su~ace water +200' No known cu~oin drains ~ ~" Well ~ Septic Site Plan LEGAL: T15N, RlW, Sec. 18 Lot 9 EACLE RIVER ENGINEERING SERVICES P.O. Box 77329~ (907) 694-5~95 FAX: (907) 694-8408 RECEIVED ~ ~ ,Munfc,pahty Of Aqchofage] D~pt. H, ealth & Ruman JOHNSON EXCAVATION CON TEL No,go?-$?6-8824 WELL LOG Torn Fink, Mayor January 10, J unicipality o7 Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 1991 Housing and Urban Development 222 West 8th Avenue Box N-64 Anchorage, Alaska 99517 Subject: T15N R1W Section 18 Lot 9 Permit #900374, PID #051-171-15 The subject permit, issued by this office for a single family well and/or on-site wastewater system has expired as of December 31, 1990. 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 needs to be sent to this office for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site wastewater system, the original as-built inspection report (three-part form) 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: $90.00 for an on-site wastewater permit; $50.00 for a well permit; $140.00 a combined on-site wastewater and well permit. for If you have any questions, Since~ ~AA. ~ John~Smith, PI/E. Pr o~/~ am Manag'ceL On-site Service please call this office at 343-4744. JW/ljm:200 eno: Copy of Permit Kids Are Our Future L. crL fi~ :i: i;:! ;i (),'.'i F:/ I K) (iii; q ,, t '1 . clr ai:;; r ~,!~!; ) EAGLE RIVER ENGINEERING SERVICES Lou llulera, PJ~. P.O. Box 773294 Eagl(~ River, Alaska 99577 Telephone (907) 694-5195 November 20, '~ ~ ~4r. John Sm!tN, P.E. Dept of Health & Human Serv:ices 825 ~ Street RE: Lot 9 TI5N RiW, Sec. 18 Narrative The probable impacts to adjacent ~-~ · '~' ~' of ' - ~ _ ope ~ , ~¢:~ kb is we! ..... a~at~o.., ere igible. : - ', is 2 5 acres and oe,ua~, distar..ce '[o we!z a~td septic .... se.,n~L.. Neighbor wells are +200' distance f:?'om ' f~c~e.~{ end dFainage will. lot be .x ....... g system will lie abandoned h} He are requesting a v- 4,., ar.,a.,.,ce from ~he !5' bed width as allowed b'g the ePdizlahce. O12. r bed iocat:[Qn provides ~decaa~e ?,-~ ' ' work area ~o accomodate an .!8' wide bed PedgL,'-{--c 'V~,e length ',, ,~:~- ,~, ~-~ if yo%; have arty q-~es'tions or any fu. rtho:~? at 694- 5!95. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 826 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: "~/'~ '~ DATE PERFORMED: LEGAL DESCRIPTION: ~ ~- ~ ~,.~'-/v' ~' /~/,.~' _~-~ ¢ SLOPE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 - SITE PLAN 17- 18- 19- WAS GROUND WATER ENCOUNTERED? /V~'~ O P / , E IF YES, AT WHAT DEPTH? I It"~ II ~1~1 III III I,~,~1 I I I III IIIIIIIIIII IIIIIIIIII I IIIIIIIIIIII IIIIIIIIIII 20- COMMENTS Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~- ? .(minutes/Inch) TEST RUN BETWEEN ~ , FT AND --~ FT PERFORMED BY: 72-008 (6/79) Eagle River E~glne0dng Service9 Eagle River, AK 9957? 694-5195 CERTIFIED BY: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION E2E L. Street, Anchorage, Alaska 99E01 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLAIION TEST PERFORMED FO.=, /-/' ~, ~, DATE PERFORMED: LEGAL DEECR~PT,ON= /~ r 2 SLOPE 7-// ~ SITE PLAN 1 2 3 4 5 6 7 8 9- 10- 11 13- 14- 15 16 17 18 19 20 ~GROUND WATER ~OUNTERED~ IF YES. AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop ~ ~.4~ /w ...',,..., I IJ~, /~,'~/,,~ ~-~,~ ~ ' ~ ,, ~- /~/~'~,: I1; ~ ~- ~,~ 3 ' + ~ " PERCOLATION RATE ~ / (minutes/Inch) TEST RUN BETWEEN ~ , FT AND T,~ FT COMMENTS Eagle River £noIneorln9 Services ,/_ ~ PERFORMED BY: P, fl Rnx 773Pfl4 CERTIFIED BY: Eagle River, AK 99577 694.-5195 72.00a (6/79) DATE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 82E L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: LEGAL DESCRIPTION: 1 4- 5 6 7 8 9 10 12 ,-~,, ENDO~ IF YES, DEPTH ~ ~T~'%%~ ~ Rea( 13- 14- 15- 16. 17 SLOPE JND WATER ENCOUNTERED? 7'-/-/ ~ AT WHAT PERCOI SITE PLAN r", ,,, I It"t~ III I~1~1 III l 18 19 2O Reading Date Gross Net Depth to Net Time Time Water Drop ..2 I~,z~/~,., I I; ~' ? ~'-~,, .: ..~ '..~- "; .,, ~, ,, COLATION RATE ~' // {minutes/inch) TEST RUN BETWEEN ~' FT AND -~ FT COMMENTS Eagle RW~r E~fneorlng 9erviceg PERFORMED BY: P ~ Rn~ 77~c1~ CERTIFIED BY: Eagle Rlvor, AK 99577 69~5195 72-008 (6/79) SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: LOT 9, Ti§N R1W, Sec. 18 GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department Of Environmental Gonservation requirements. 4. Ail soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. ?. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. BED 1. The bed is to follow the natural land contour to maintain uniform total depth of the bed bottom. 2. The bottom of the bed shall be level, plus or minus 1.5". 3. The total depth of the bed excavation is to be at ground level. Removing topsoil layer and replacing with 2' sand layer meeting State specifications per 18 AAC 72. 4. The sewer line is to replace the existing sewer line that leads to the existing tank. The existing tank is to be abandoned. 5. The bed gravel is to be covered with typar fabric material. 6. Soil or combination of soil and extruded board insulatlon to a depth of 4' or equivalent is to be placed over the leachfield. 7. The area over the bed is to be finish graded to prevent pondtng of surface water runoff. 8. The septic tank and leachfield must not be closer than lO0' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS TOTAL DEPTH = O' GRAVEL DEPTH = 1' BED LENGTH = 32' BED WIDTH = 18' Soil Rating = 125 (sand material) Bedroom Capacity = 3 Septic Tank Size = 1250 Anchorage tank with lift station wired by licensed electrician. Sand Filter = 2' depth Remove and replace existing soil as required Insulation = 2" burial foam, 3§ p.s.i., over bed and all flow lines Municipality of Anchorage Development Services Department Building Safety Division On.Site Water & Wastewater Pmgrgrn · . 4700 South Bragaw SL P:O~ Box 196650 Anchorage, AK 99519-6650 www. cl.anchorage.ak.us (~07) 343-7~04 CERTIFICATE OF HEALTH 'AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.' 051-171-15 1. GENERAL INFORMATION C°~pletelegaldescfiptlon "LOT 9; T15N, R1W, SECTION 18, Location (site address or directions) Current Property owner(s) Mailing address · Lending agency. ~. Mailing address Real Estat~ Agent Mailing address RABIAB LABNONGSANC Day phone.688-5505 19526 CANOE STREL:"r * CHU(;IAK, AK 99567 Dayphone - BROOKE STILTNER w/ REMAX OF E.R. Dayphone 694-4200 16600 CENTERFIELD DRIVE * EAGLE RIVER, AK 99577 Unless othem4se requested, HAA will be held by DSD for pickup. 2. HUMBER OF BEDROOMS: ,.3 3. TYPE OF WATER SUPPLY: Indivldual Well [] Individual ~Nater Storage Community Class Well [] Public Water System TYPE OF WABTEWATER DISPOSAL: Individual On-site Individual Holding tank Commun~ On-site Public Sewer The Munlclpality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an Independent professional civil engineer registered In the State of AJaska. Certficates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certtlcates 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 less than 30 days old. (Cerrtficates may be reissued for a period cf 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 Munlctpelity of Anchorage Is not responsible for errors or omissions In the professional engineer's work. Noto. Alaska Water and Wastowator Consultants, lnc. shall be Fald $ l~ l l at, cr pdor to closing for the englneadng services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As cer~'fied by my seal affixed hereto and as of the validation date shown below, I verify that my Invesb'gation, based on procedures ~utlined In the Health Authodty Approval Guidelines for this application, shows that the on-site water supp~' and/or wastewator disposal system Is(are) safe, functional and adequate for the number of bedrooms and type of s~ucture Indicated heroin. I further vedfy that based on the Informab'on obtained from the Munldpalib/ of Anchorage files and from my Investigation and Inspection, the on-site water suppfy and/or wastowator disposal system Is(arc) In compliance with all applicable Municipal and State codes, ordinances, and r~julations In effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD. SUITE 2B * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. CARNESS. P.E. Date 537-6179 Engineer's Comments: In conducing this evaluation, AWWC, Inc. attempted to provide a thorough, consden#ous engineering anal~ts of ~he system in accocdance ~ ADEC and MOA DSD Guidellnea & Regulations. The reported results described ine performance of the system under the cond~ons encountered at the time of the test, and separation distences measured to readT~y Identifiable features. The operational life of all wells and septic systems depend on the local solls condition, groundwater levels that may fluctu~.to during the year, and the water usage of the family being served by the ~rstem. These conditions are outeide the control of the evalualo¢ of the system. Sallsfactoo/ test results do not guarantee future pedom3ance of the system, nor do they guarantee that there are no hidden defecte or encroachmeate. AWWC, Inc, can lherafore not prm, ide any warranty or future estimate of how Io~ the system v, fll confl'nue to meat the operational requirements of the ADEC or MOA DSD. The content of this report Is for the $ole benefit of the owner Ilsted above. Any reliance upon or use of this report by any other person or party Is not authoc~z, ed, nor ~ It confer any legal right whatsoever. 7953 ..." ~ 5. DSD SIGNATURE Approved for ~ bedrooms. Disapproved. Conditional approv{l for __ bedrooms, with the fllowlng stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: [~ ' '~ j' O J Municipality of Anchorage Development Services Department 8u~ ~;~,Zt Divlekm Or-,-~te Wmer & Wastewater F,mgmm 4700 South emgmv GL P,O. Box 10~650 AllotS, AK~951~ A. WELL DATA Weft type P~'A; HEALTH AUTHORITY APPROVAL CHECKLIST LOT 9; T15Nt R1Wt SECTION '18t ParcellD: 051-171-15 If A, B, or C provide PWSID~ N/A Well Log (Y/N). YES Oatecompleted 6/22/91 Sanlla~eal (Y/N) YES YES Toteldepth~lO3 It. Casedto;~lOl It. 18+ Date of test SlaUc water level Weft production WATER SAMPLE RESULTS: Collfomt o colonies/lO0 mL Oat. of ~ample: e/2O/Ol B. SEPTIC/HOLDING TANK DATA Tank 'P/pa/Material El'EEL "~ 6/22/91 -t- 75 fL Casing height (above ground) AT iNSPECTION e/17/Ol 39 fL 6.7 +/- g.p.m, -.~ 6 g.p.m. Nl~ate 0.5 mg./L. Olherbacteda o CoIllK:te¢:l by:. AWWC, INC. TankMze 1250 gal. NumberofComparlments 2 Foundatlmdeanout(Y/N) '~S Oe _pre~__lonovertenk(Y/N) NO Oate of pumping 8/24./2001 Pumper C. ABSORP11ON REID DATA Oate Installed ?/la/~l Soil rallng ~ ~/'edrm) 0.8 Lenglh ,32 fL Wldlh 18 fL Totaldepth 2.~ fL Eff. ab~area 576 RI Monltedngtube YES Oate of adeClUaCy test 8/17/01 Re~ufts (Pa,~,/FalI) PASS Fluid depth In al~ flald before test 0 In. Water added 609 gal. E]al~ed Time: 5 m~ Flnalfluld depth 0 Any reJuv~nalion trealment (.east 12 mo.) (Y/N & type) In* __ colonies/lO0 mL Date Installed 7/18/91 Cteanoute (Y/N) YES High water alarm (Y/N) YES JR°s PUMPINO System type BED Gravel below pipe 0.5 fL Oepre~alon over field NO For 3 bedrooms Newdepth 6 In. 450+ g.p.d. NONE KNOWN D. UFT STATION Oats Instsltsd 7,//18,/2001 'Pump on' level at 4O In, Datum BOTTOM OF TANK E. SEPARATION DISTANCE8 Size In gallons 1250 'Pump off' level at 4~ In. Cydes teetsd 3 SEPARATION DISTANCES FROM W;I [ ON LOT TO: Sepl]o tant~11~ ~tation on lot, 100% AbeerplJon 11eld on lot 100'+ Pubfio sewer mahl N,/A Sewer/septic eewlce line 25'+ Mantle/Access (Y~) ~s High water alarm level at 46 Jn. Meets alarm & dmult requirements? YES On edjacent lots. lOO'+ Oft adjacent lots, 1 oo'+ Publlo ~ewer manhole/cleenout Holdlng tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: *PER PREVIOUS H.A.A. Absorption field. 5'+ Sur~ce water 100'+ Property Ihle 10'+ Water eewJce Ilne 10'+ Cuflaln drain NONE KNOWN F. COMMENTS Building foundaUofl .5'+ Property fine 5% Water main N/A Wator service Ilne. 10'+ Wells on adjacent Jots 100'+ SEPARATION DISTANCE FROM ABSORPTION FID n ON LOT TO: BuB:llng round,lion 10'+ Surface water 100'+ Welts on adjacent lots. 100'+ Water main N/A Driveway, i~tdng/veh~e storage 20'+ G. ENGINEER'S CERTIFICATION I certify that I have determined Inmugh field Inspections and revlew of Munlc~al records inat ine ebove ~/afems are in cordtxmance with MOA HAA guldellnee tn effect on ~is date. Fee $ Rocelpt Number Waiver Fee $ Date of Payment Receipt Number. AU~-ZZ-Ol 16:25 FROI/~CT&£ ENVII~I, il/ENTAL SRV 90T5515301 T-189 P.OI/OZ F-025 CT&E Environmental Services Inc. Laboratory Divlslon 200 W. Potter Ddve Anchorage, AK 99518 Tel: (907) 562-2343 Fax: (907) 561-5301 CT&E Ref. #: Client Name: Project Name: Client Sample ID: Matrix: PWSID Sample Remarks: 1015480001 AK Water & Wastewater Cons. n/a T15N, RIW, Sec18, Lot9 Drinking Water Client PO#: n/a Pdnted Date/Time: O8/22/01 16:00 Collected Date/Time: O8/20/O1 08:30 Received Date/rime: 08/20/O1 15:25 Technical Director. Stephe~ Ede Parameter Results PQL Units Total Coliform (MF) 0 col/100 mi Nitrate 0.5 U 0.5 mg/L Allowable Prep Analysis Method Umits Date Date Init SM92220 08/20/01 KAP EPA 300 10.O 08/21/O1 SCL Revised 11/15/91 Recertification 8/10/91 ASBU~LT-No CORN£RS sET TH~S DATE. SEWARD & ASSOCTA_T~ LAND Sl.~v~lt~ 688-4566 I HEEE~ C[KIIFY THAT I HAVE SURVEYED THE ~o~O~lN6 DES~IBED PROPERS: 1 "=40' t 9,Sec. 18~T15N.,R1W.,S.M.,~ ...... I~~z~~Ts, ~ ~Ri~i~s -'"-~ zB~ I - MUNICIPALITY OF ANCHORAGE DEPARTMENT Of HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # ' ';~; .... ¢/'- /g~ HAA # ~,~ ~'~. ' \(_c L~ \ ~L- 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address · Lending agency Mailing address Agent Address Day phone Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: Individual well ~ Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: ,/ Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev 1191) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with ail Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Engineer's signature bedrooms. DHHS SIGNATURE X Approved for --~ Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: ~//..~Z~L~ /~. ~ Date 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 & HUMAN SERVICES Environmental Services Division 825%" Street. Room 502 · Anchorage, Alaska 99501· (907) 343-4744 Health Authority Approva~ Checklist Legal Description: Parcel I.D: ,03-/- / 7/' -- / ~ A. WELL DATA Well type ,~z.,~,~.v~-' Log present (Y/N~ fi/ Total depth ,-'~,.¢ ~ Sanita~ seal fYi) ~ IfA. B. otC. attach ADEC letter. ADEC water system number Date completed J~,,~'~ ~'.~) z¢'¢/ Cased to /~ / .,c-/. Casing height fabove ground) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well production WATER SAMPLE RESULTS g.p.m. Coliform ~ Nitrate Date of sample ,,'-'/~,~.~e~¢ /-7/ B. SEPTIC/HOLDING TANK DATA ~' / Other bacteria Collected by: Date installed ~-~¢-'/¢'/ Tank size ×~g~';o,~-t4qumber of Compartments ~ Cleanouts (Y~ Foundation cleanout (Y~) ~ Depression (Y~) ~ High water flarm (Y~) ~ Date of Pumping ~/~ Pumper ~¢~Y~¢~ C. ABSORPTION FIELD DATA Date installed ~///~/9~/' Soil rating (g.p.d./fl: or ft%drmt '¢" '¢ System type ~Y'~-z>' Length ..~.,~3,~/ Width /'~"~-"~, Gravel thickness below p~pe ~'~' 6~-'2~'~ Total depth -~'~'~. Effective absorption area ..4'-7~ ,~? ~vlonitonng Tube present(Y/N) / Depression over field (Y/N) ~ Date ofadequacy test '~//~///¢~ ResuhsIPass/Fail) .~::'~'.~.r' For J bedrooms Fluid depth in absorption field before test (ill.); Fluid depth ,~;z (ins.) Minutes later: ~ Peroxide treatment (past 12 months~ (Y/N) A./ Immediately ',tfter~/~gal. water added (itl.): Absorption rate = .2> 4/,;r'-'e9 g.p.d. If yes, give date LIlT STATION Date installed ../o..~ y' /~¢' /~¥ / Manhole/Access IY/N) High water alarm level at* Cycles tested .zg SEPARATION DISTANCES Size in gallons "Pump on' level at* 4//-/.P',6 *Datum ~'~' ~'~",~,'-'/~,~' SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line : On adjacent lots : On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main/service line SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation .~¢.¢"~z~ Water main/service line Surface water Curtain drain ENGINEER'S CERTIFICATION 1 cert!~ that I have determined thru field inspections and review of Municipal records that tn conjbrmance n ith MOA HAA guidelines in efJkct on this date. Engineer s Nau,e Date '~-O I l °f, [ Date of Payment Receipt Nmnber Rev. 8/95 OSS: haa~wk.doc Driveway, parking/vehicle storage area ~/'7.~'*. Wells on adjacent lots /,..r~ '~r' Property tine Waiver Fee $ Date of Payment Receipt Number HUSTON.XLS Douglas T. Kenley Civil Engineer State of Alaska C.E. 8176 SEPTIC SYSTEM ADEQUACY TEST Legal Description Applicant Date of Test SYSTEM DATA Tank Volume Number of Bedrooms Absorption system Absorption required (1.5 daily flow) TEST DATA rIME FLOW VOL. 'TAN.~ L-EVE'c ,-TJGBE-L-E-VE ~ COMMENTS (gpm) (gels) ~'~v.,~-.,~ ~-,,~, ,~.,..,~,~- ~., - System Passed ~ Sysy[em Failed- Page I HUSTON.XLS Douglas T, Kenley Civil Engineer State of Alaska C.E. 8175 SEPTIC SYSTEM ADEQUACY TEST Legal Description Applicant Date of Test ,SYSTEM DATA Tank Volume Number of Bedrooms Absorption system Absorption required (1,5 daily flow) TEST DATA TIME FLOW VOL. TANK LEVEL .~-..~,~ TUBE LEVEL~-w-,~z~, COMMENTS (gpm) (gals) ~ '~ System Passed ,~',.~_~-~,~/~ Sysytem Failed: Page 1 CT&E Environmental Services Inc. Laboratory Division l-~-~,~,~-~-~'~'~l~-~-~,~-~-~-~,~,~.fj~f~jjj~jjj~j~~ Laboratory Analysis Report CT&E Ref.# 960755.5389 Collected Date 03/04/96 Client Sample ID Ti5 R1W SEC18 L910755-01 Matrix Drinking Water Technical Director Released Sample Remarks: DC Parameter Results Qua[ PQL Units Method Nitrate-N 0.100 U 0.1 mg/L EPA 353.2 Allowable Prep Analysis Limits Date Date Init o~/os/96 ~Mu 200 W. Potter Drive, Anchorage, AK 99518-1605 -- Tel: (907) 562-2343 Fax: (907) 561-5301 3180 Peger Road, Fairbanks, AK 99709-5471 -- Tel: (907) 474-8656 Fax: (907) 474-9685 ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell. D.# ~'~\ - ~1- ~"~ NAA# '~,("~ LI~},[r~ 1. GENERAL INFORMATION Complete legal description Lot 9; Section 18; TI5N; RIW; SM Location (site address or directions) Property owner Mailing address 19526 Ganoe Chu~iakt AK James Henderson Day phone 19526 Ganoe Chugiak, AK 99567 688-6426 384-0981 (w) Lending agency Mailing address Day phone Agent Day phone Address = Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: XXX If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my invest~ation 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 ~,~ ~ f~NGINEEIRING '17034 Eagle ~Jwr Loo~Eoad I~ 204 Phone t~'~' Address Eagle River, Alaska ~'57/7' / Engineer s signature Date DHHS SIGNATURE ~ Approved for '~"'/~"--~-~.~/) bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to pumhasers 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 Legal Description: ~-c' o~ (--~,c,. ~,% ~ "T'(,<~.. iZ,~,,..,~ Parcel I.D. A. Well Data Well type Log present ~/N) Total depth Sanitary seal ~-~) If A, B. or C. attach ADEC letter. ADEC water system number Date completed:>~" \\~ t~-.-=3 \ Driller Cased to ~ ~ ~ Casing height Wires properly protected (~,1) ,~' Date of test Static water level '~/ ~ Well flow "7~, o FROM WELL LOG \\- t%- umpleTI1 '~ ~ EPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot \ Public sewer main Sewer service line .g.p.m. AT INSPECTION MUNICIPALITY OF ANCHORAGI:: ~.NVi~,Di~Nr~AL SERVICES DIVISION ,~.,..s...,~T~o~,.) 'IL 2-/ 1993 ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank E D WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: '"'q -' g.- ~ --c13 B. SEPTIC/HOLDING TANK DATA ale installed -! ~ ~, \ Cleanouts (~N) '~ High water alarm (Y~ Date of pumping Collected by: Other bacteria o $ & S ENGINEERING Eagle River, Alaska 99577 .Tank size I '2-~C) Compartments Foundation cleanout ,~0N) ,../ Depression (Y/~ Alarm tested (Y/N) ""7~ ~ ~'~ Pumper '~,--¢" , SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot \ oc> ~ ~ On adjacent lots \ ,oc, ~' ~ Foundation To property line ~,~ ~ ~e Absorption field '~' ' Water main/service line Sudace water/drainage ~ o o 72-026 (3/93)' Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed ~'/ --~ Size in gallons t,-7..~ Vent ~¢)N) High water alarm level /--//_- Meets MOA electrical codes (~/N) Cycles tested "Pump on" level at Manufacturer ~/~4..~b ~- ~c.~ Manhole/Acoess ~/N) ~J ~ ~ "' "Pump off" Level at SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot [ ~ ~ On adjacent lots Surface water \ ~ ~ "~' D. ABSORPTION FIELD DATA //.., / ~'~?/ Date installed '"7 "~ ~ Length "~ '7.- ~ Total absoq:)tion area Date of adequacy test Width Water level in absorption field before test Peroxide treatment Ipast 12 months) (Y~ Soil rating (GPD/FF) ~, % Gravel thickness Cleanout present ~'/N) Results~/fail) ~ ~ ~'/,-~-I-~ System type ~-~¢~ :5'-" Total depth ~ ~ ' ~ Depression over field (Y/,~!~ ~ for ~ Bedrooms After test If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots .~ Surface water Curtain drain ,r E. ENGINEER'S CERTIFICATION On adjacent lots ! ~ c, ~ '~ Property line /~> ~ ~' To existing or abandoned system on lot Cutbank 5--0 ~ Water main/service line I Driveway, parking/vehicle storage area Signature Engineer's Name Date I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in / / HAAFee$ /7~ o° Waiver Fee $ Date of Payment Receipt Number Date of Payment Receipt Number 72-026 (3/93)* Back . -~-------COMMBRCIAL TESTING & ENGINEERING CO.: ENVIRONMENTAL LABORATORY SERVI~E~ [~0~- Chemlab Ref,# s93.3545-3 Client Sample ID Matrix :WATER ~PORT of ANALYSIS 5633 0 STREET ANCHORAGE, AK 99§18 PAX: (907~ S81-6301 Sample Remarks~ ROU?IN~ SAMPLE COLI~iCTED BY: RAY. Client Name :S & S ~J~GI~ING WORK Order Ordered By :RAY SHA~E Report Completed t07/26/93 P~oJect Name : Collected ,07/21/93 ~ lit40 hfs P=oJect# : Received :07/21/93 PWBID :UA Technical Dlrector~T~PHIl%C. Released By QC Allowable Ext. Anal Parameter Results Qual Units Method limits Date [~te Init Nitrate-N O.i0 U mg/L EPA 353.2/~00.0 Bee special Instructions Above :See 6ample RemarkeiAbove ~ ~ UA == Unavailable - NA= Not analyzed Undetected, Repo~ted value is the practical quantification ltmll;, LT = Less Than iSeo°nd~fYidilutt°~:~" ~ i iGTi'= Greate~ Than NV RONME,~/AL SERVICE~,~N ALASKA, COLORADO, UTAH, ILLINOIS, OHIO, MARYLANQ, WEST VIRGIN[A,'NEW JERSEY, SOUTH CAROLINA MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# ~)~ - ~'-') ~- ~ HAA# 1. GENERAL INFORMATION Complete legal description Lot 9, T15N, R1W, Sec. ~8 Location (site address or directions) 19526 Railroad Access Property owner MJB Day phone 271-4342 Mailing address 222 w. 8th Ave. (Box N-64), A~chorage, Ag: 99513 Lending agency Mailing address Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Agent Sandy Hjelmsted/Associated Brokers Day phone 563-3333 Address 640 W. 36th Ave., Suite 1, Anchoraqe, AK 99503-5807 Unless otherwise requested, HAA will be held for pickup. 3 ~ NOTE: Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site × Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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 investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Eagle River Engineering Services Phone 694-5195 Address P.O. Box 773294, Eagle River, AK 99577 Engineer's signature Date .~"/- ~/ ,~ SIGNATURE · Approved for~---/-. Disapproved. bedrooms. Conditional approval for _ /f t,'q bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to pumhasers 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. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Z~O7~ 4~, "rlS.kl, /~11,0,. .~,t¢'[,. I~ Parcel I.D. A. WELL DATA Well type Log present (Y/N) Y Total depth /~.~ Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~2 L~/¢- ¢'/'2./ Driller Cased to /0/ i Casing height ~" Wires properly protected (Y/N) Date oftest Static waterlevel Wellflow Pump level SEPARATION DISTANCES FROM WELL TO: 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 ~ tank WATER SAMPLE.~SULTS: Coliform Date of sample: ;~/,?,~/'~./ Nitrate ~' / ""~/"~ Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) High water alarm (Y/N) Date of pumping Tank size /..2,¢--,¢ Compartments Foundation cleanout (Y/N) ,Y Depression (Y/N) Alarm tested~N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot //~ ~ On adjacent lots ,'~/'~'~ ~ To property line ,,/?5-x Absorption field ¢;- / Foundation Water main/service line Surface water/drainage 72-026 (Rev, 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed ~ ¢/./~'/~/ Manufacturer Size in gallons ,,/! ~- .~.-0 Manhole/Access (Y/N) Vent (Y/N) .~' "Pump on" level at 2"/'D" "Pump off" level at High water alarm level Z~o" A~g ,~07'17)./.'/ Cycles tested ,'~'/,~ Meets MOA electrical codes (Y/N) ./V'/.~-. ~/,.,~,',-.;~ SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot //4 ' On adjacent lots Surface water D. ABSORPTION FIELD DATA Width Soil rating /~' ~ ~'~Z)/Fr 7"System type Gravelthickness ;~-~-~....,~r Totaldepth Cleanouts present (Y/N) Date of adequacy test. for Date installed : Length ~--~ / Total absorption area · Depression over field (Y/N) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 1 To building foundation On adjacent lots /~ .w,. Surface water Curtain drain /~//~ On adjacent lots P(~, / Property line To existing or abandoned system on lot Cutbank _~-a¢' Water main/service line Driveway, parking/vehicle storage area 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 HAA Fee $ _ Date of Payment Receipt Number 72-026 (Rev, 3/91) Back MOA Waiver Fee: $ Date of Payment Receipt Number MUNICIPALITY OF AN~HoP, AGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIOI~NVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL NOV 06 OF ON-SITE SEWER AND WATER FACILITY 2,.,,20 RECEIVED Application Date October 30, 1985 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 9 Section 18, TWP 15N, R1W Local;on (address or directions) End of Amy's Avenue off Birchwood Loop (b) (c) Applicant Name C_l_a_rk Buswell Telephone: Home 688-3272 Business 688-2133 Applicant Address PO Box 77-0089, Eagle River, Alaska 99577 Applicant ~s (check one): Lending Institution []; Owner/builder I~; Buyer []; Other [] (explain); Lending Institution Q~LI J/'C~(~_Cg434.~2~ Telephone Address (d) (e) Real Estate Company and Agent Address Telephone (f) MailtheHAAtothefollowingaddress: Please contact owner for pickup TYPE OF RESIDENCE Single-Family [~ Multi-Family [] Other Number of Bedrooms ___~3 ........ WATER SUPPLY Individual Well [] Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite [~ Public [] Community E] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72e25 m/84) 5. ' ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As 'certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approvar 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 obtainea from the Municipality of Anchorage flies and from my investigation and inspection, the on-site water supply and/or ;.~a~t~wate[ disposal system is in comptiance with all Municipal and State codes, ordinances, and regulations in effect on the date of th s nspect on. NameofFirm QUADRA Eng~ne~_ring~ Inc. Telephone 276-3770 Address 401 East Fireweed Lane, Anchorage, Alaska 99503 Date October 30, 1985 Engineer's Seal DHEP APPR~_~.,~ .OVAla ~ ~' Disapproved Approved V~ al Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description; DEPT. OF HEAL'IH & ENVIRONMENTAL PROTECTION NOV 0 6 E D TWP 15N R1W Well Classification Class C Well Log Present (Y/N) N Total Depth 12 ' Cased to Static Water Level Casing Height Above Ground 14" Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot If A, B. C. D.E.C. Approved (Y/N) Date Completed 19 66 Yield 12 ' Depth of Grouting None Pump Set At 1~ ' Sanitary Sea on Casing (Y/N) Y Depression Around Wellheaa [Y/N) 150' · On Adlo~ning Lots To Nearest Edge of Absorption Field on Lot 16 0 ' . On Adjoining Lots To Nearest Public Sewer Line None To Nearest Public Sewer Cleanout/Manhole None To Nearest Sewer Service Line on LOt Water Sample Collected by QUADRA Eng'ineerinq : Date September Water Sample Test Results Satisfactory Comments Adequate for Class C system Y 5.3 GPM Y N 153' 157' 150' 25, 1985 per approval by A.D.E.C. B, SEPTIC/HOLDING TANK DATA Date Installed 1966 Size 1250 No, of Compartments Standpipes (Y/N) Y Air-tight Caps (Y/N/ Y . Foundation Cleanout (Y/NJ Y Depression over Tank (Y/N) N Date Last Pumped September 1985 Pumping/Maintenance Contract on File (Y/N) Y : for 85 Holding Tank High-Water Alarm (Y/N) N/A Temporary Holding Tank Permit (Y/N) N/A Separation Distances from Septic/Holding Tank: To Water-Supply Well 150 ' To Building Foundation 15 ' To Property Line 57 ' To Disposa Field 10 ' To Water Main/Service Line 80 ' To Stream. Pond· Lake or Major Drainage Course None Comments Septic tank is adequate. Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installee 1 9 6 6 Width of Field 3 ' Gw 85 Ft2 Square Feet of Absorption Ares 4 9 6 Ft 2 Depression over Field 'Y/N) N Results of Last Adequacy Test Pas sed Separation Distance from Absorption Field: To Water-Supply Well 1 6 0 ' 25' To Building Foundation Lot None To Water Main/Service Line 8 5 ' To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area. or Vehicle Storage Area Comments Absorption field Type of System Design Length of Field 62 ' Depth of Field 4 ' Gravel Bee Thickness 5 ' Standpipes Present (Y/N) Y Date of Last Adequacy Test September Trench 1985 38' To Property Line To Existing or Abandoned System on On Adjoining LOtS 87 ' TO Cutbank (if present) 45 ' None in area 5' is located in good draining natural gravel material. No seepage evident from ~utbank. D. LIFT STATI ON - NONE Date Installed Size in Gallons "Pump On" Level at High Water Alarm Leve at Tested for Electrical Codes IY/N) Dimensions Manhole/Access (Y/N} "Pump Off" Level at Vent IY/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Perm~ttee Bedroom Rating Against HAA Req Jest I certify thatJ haye checked, Y. crified, or conformed to all MO, A apo HAA guidelines in effect on the date of this inseecuon. Signed '~/~ ~,,,(~'~f'4.~ a t e ///7/~ ~-- Company ~J///~lt.,¢ ~-~'6/~. MOA No. Receipt No. ~ ~ C~<~ ~5 Date of Payment Amount: $ Page 2 of 2 72-026 (11/841 EngJneer's Seal 401 ERST FIREWEED LRNE RNCHORRGE, RLRSKR 99503-2197 (907) 276-3770 DRTRFRX NO. (907) 279-5092 RNCHORRGE · JUNERU · BETHEL · FRIRBRNK$ November 7, 1985 Municipality of Anchorage Department of Health and Environmental Protection 825 L Street Anchorage, Alaska 99501 Subject: Gentlemen: Lot 9, Section 18, T15N R1W Health Authority Approval The north end of the drain field on the subject property is located approximately 45 feet from a cutbank. This cutbank extends downward on a 2.1 slope for nearly 25 feet. The soil in this septic system is clean gravel with a percolation rate of 85 square feet per bedroom. No evidence of seepage is apparent on the cutbank slope. Ail effluent in the system is apparently percolating downward. I can see no problem with the location of the septic system and the proximity of the cutbank. Sincerely yours, Michael E. Anderson, P.E. MEA/jb 'To 4o-/" ,'o J / / / / '1 ./ ../ IZO' TO DEPT. OF ENVIRONMENTAL CONSERVATION / / ANCHORAGE/WESTERN DISTRICT OFFICE 437 'E' STREET, SUITE 303 ANCHOR~GE~ ALASKA 9~501 BILL SHEFFIELD, GOVERNOR Telephone: 274-2533 November 7, 1985 Quadra Engineering,Inc. 401E. Fireweed Lane Anchorage, Alaska 99503-2197 SUBJECT: Lot 9, Section 18, T15N, R1W, Chugiak, Alaska (8621-FA-106) Dear Sir: The Department has revieued the Engineer As-built plans For the subject project. Final approval is hereby conditionally given ?or the uater system and the "Certi?icate to Operate" is attached. Conditional approval is given upon that a minimum o? (1) uater sample be taken each month during operation and a copy o¢ the test results be ?oruarded to this oFFice. Any ?uture expansion oF the subject project uill require additional approve From this o??ice. Sincerely, Michael P. Leuis Environmental Engineer MPL/msm cc: Lynette ATTACHMENT: Dean, ADEC - Anchorage ~~~~\~~~ STATE OF ALASKA ~~~ DEPARTMENT OF ENVIRONMENTAL CONSERVATION · , CONSTRUCTION AND OPERATION CERTIFICATE for PUBLIC WATER SYSTEMS APPROVAL TO CONSTRUCT Plans for the construct on or mod f cation of F' approved. by ~ Al public water system located Alaska, submitted in accordance with 18 AAC 80.100 //~1' ~ have been reviewed and are -['~' conditionally approved (see attached conditions). S¥ ~ITLE D^T~ 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 rcontract or(let ~o. or desar,ptlve reference: Approved by Date ,,.? ' ..l.. ,...,.I (,AI.f )/, APPROVAL TO OPERATE The "APPROVAL TO OPERATE" section must be completed and signed by the Department before any water le made available to the public. The construction of the water system was completed on granted interim approval to operate for 90 days following the completion date. public (date). The system is hereby BY ~ TITLE DATE As-built I~'n~s~j~]~ted during the interim approval period, or an inspection by the Department, has confirmec the syste~l~,_o~,~t~. ,~dAaccording to the approved plans. The system is hereby granted final approval to operate. ,, ~~ ~ 3. PINK - ENGINEERIMUNI-BOROUGH (Complete Section C) ~8~407 (Rev. 11183) 4. GOLDENROD. MUNI-BOROUGH (Complete Section A) MUNICIPALITY OF ANCHORAGE DMSION OF ENVIRONMENTAL HEAL~I'H DEPARTMENT OF HEALTH AND FiNVIRONMEWrAL PROTECTION APPLICATICN FOR HEALTH AUIq~ORITY APPROVAL CERTIFICATE Cene~al Infotm~tion Application Date ~ on,J( include lot, block, subdivision, section, /_ 3co / 6 Z-/j-,t/ Location (add~ess c~ directions) (b) (c) Applicants Applicant is (check or~) Lending Institution Buyer ..E---: ; Other ~_~ (explain) (d) Lending Institution Te le_phone ie lephon_ Address }~al Estate Co. & Agent Address Telephone Type. of ~esideno~ S i ngle-Eami Nureber of Bedroom~ Other (describe) 3. Wat___e_y Supply_ Individual ~b.ll.,,~' Con~r~nity ~----[ Public ~--~ Note: If coTr~tnity well system, must have '~iti-en confirmation frctm the State De. pa3zt~Nent of t~%viroD/rental Conservation attesting to tlbe legality and?%~'~atus' Is the well adequate for the number of bedror~ms s]?scified in this .Sewage Disposal Is the wastewate~ disposal system adequate for the timber of t~drocr~? [Page 1 of 2] 2-15-84 5. En.qirmering Firm ~roviding Inspections_, Tests,. Data and Information I certify tJ]a'~a~ checked, verified, or conformed to all ~DA HAA Guidelines in effect o~/~ Signed.// Z~/wJ× x/'.,-'/,/~'%...~ Date Address Signed by Date ( ENGINEER SEAL) 6. DHEP Approval Approved for Approv~d~ Disapproved Conditional Terms of Conditional Approval %he Municipality of Anchorage Dapa~tn~nt of }{.~alth and Enviror~rental P~otection does not guarantee t~ continued satisfactory performance of the wate~ supply and/or the wastew~ter disposal system. This approval indicates that, as of the validation cl~te showr~ above, based on the data and information furnished by an engineer regist~_~red in the State of Alaska, the water supply and wastewater dispcsal system is safe and fu~.c tional for the Dzm~be.r of bedroca~ and type of structure indicated. (D~EP SEAL) 7. Mail the HAA to the follcwing address: KB2/d5/s [Page 2 of 2] 2-15-84 MUNICIPALITY OF ANCHoP, A~i~ Legal Description: ~ ~$ Static ~ter ~133( ~ ~t At ~ ~ Casing ~ight ~ G=~nd ~o '~ T ' Sanit~y ~al on ~sing Elec~ical Wiring in ~nduit~ ~essi~ ~nd ~l~ead ~p~ation Distance ~ ~11: To ~a~st ~ of ~s~ption Field on Lot/~ ~ ; ~ Adjoining ~ts SEPTIC/HOLDING TANK DATA Date Installg~L/~~ Size ~3~)~)~, No. Of Ccmpa=tments ~ ~ession o~ Ta~ (~ ~te ~s~d ~~ ~p~ation Distance ~ ~ptic~olding. Ta~= / To Wate=-Supply ~11 /m ~ ~ To ~ilding F~ndati~. ~ / To ~o~rty Li~ /~ ~ To Dis~sal Field /O ~ To ~ter~e~vi~ Li~ /~~ To S~, ~nd, ~e; ~ ~jo~ ~aina~ Sour. , ~ I ~, , " [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD ~1%TA Soils Rating in Absorption Strata Date Installed ~-~L/~ ~/ Width of Field 35 ~ Square .Feet of Absc~ption/~ea Depression over Field ~Y~/ Results of Last Adequacy Test Lang of Field Depth of Field Gravel Bed Thickness .... Stan. Separation Distance frcm Absc~ption Field: To Water-Supply Well / 6~ y To Property Line /62) /~ To Buildin~ Foundation ~D ~ . . To Existing or Abandoned System cn To Stream/Pond/Lake/or Major Drainage Course /%/ / ~/- To D~iveway, Parking Area, or Vehicle Storage A~ea ~¢///~ C~.,ents D. LIFT STATION Date Installed Si~e in Gallons "Pump O~" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Ccmments Dimensions ~ Manhole/Access (Y/N) Pumpin~ Cycles du~lng Adequacy Test. Meets MOA * Check P~mi/~ Bedroom Rating ~a~nst HAA ~quest Signed Date Cu.~a~/ MOA No./ / [Page 2 of 2] 2-15-84 LEGAl. DESCRIPTION ' TREET LOCAT[O~ ' T~P~ R~8 DENCE SINGLE FAMILY ~ One ~ Four ~ Other ~ Two ~ Five MULTIPLE FAMILY~ , ' ~. Three ~ Six WA~ER SUPPLY ~ INDIVIDUAL' ~ ATTACH WELL LOG, A well I ~r[lled ~ COMMUNITY since June TY ~ INDIVIDUAL/ON-SITE** ~ PUBLIC UTILITY I NOTE: THE INSPECT ON FEE MUST ACCOMP BE INITIATED. · THIS SIDE FOR OFFICIAL USE ONL ~ DATE RECEIVED ~ INSPECTION APPOINTMENTS . · , T ME TIME TIME DATE DATE DATE INBPECTOR INSPECTdR ' I~SPECTOR ' 'DIR EC~IONS: 1. TYPE OF RESIDENCE NUMBER OF~EO~o~MB' ~ SINGLE FAMILY F'~ ONE [] THREE, r-I FIVE [~] OTHER [] MULTIPLE FAMILY , .r-3_ TWO [] FOUR [] SIX 2. WATER SUPPLY PERMIT NUMBER r~ INDIVIDUAL DEPTH OFWELL '" ~ COMMUNITY DATE DRI[~LED ' ' ' ' ~ PUBLIC UTILITY Connection Verified LOG RECEIVED ~..~..~ · ' S; SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [~ INDIVIDUAL/ON -SITE DATE INSTALLED ' F'IPUB!~IC U~.I LITY , Connect on Verified NS-i=ALLEFr~ .... [] Septic Tank or C-~ HoJding Tank size: if Tank i~ homemade SOILS RATING * ' give dimensions; . TYPEOF TANK" ' MANUFACTURER .... TOTAL ABSOR[~T (~N AREA MATER AL I 4,' D STANCES sept c/Ho d ng-Tank Absorpt on Area Sewer Line Nearest Lot Line WELL TO: Absorption Area to nearest Lot bins 6; COMMENTS r [~ APPROVED FOR % ' 'BEDROOMS [] coNDITIONAL APPROVAL (latter must accompany certificate) [] DISAPPROVED bATE ' ' BY {Ttla) / ' LEGAL DESCRIP'I~IDN 3/78) STEVEN A. JOHNSON and Associates PO. Box 76 · Chugiak, Alaska 99567 · (907) 688-3085 Nay 18, 1979 ~r. William Knapper P.O. Box 157 Chugtak, AK 99567 Re, Results of an Adequac~ Test performed on Lot 3OB, BL~ Small Tract, ~W 1/4, Sec. 18, T15N, RiW, S.~. Dear Mr. Knapper~ Transmitted herein are the results of an adequacy test oerformed by me on a septic system serving a three bedroom residence ~t the above-referenced location. yxistzng ~Mstem DeMi~ %q~ Condit~_o~n A septic system installation inspection report was not available at the time of this test. The original owner reported the ~ystem was installed five years ago. However, the report wa~ snbsequently lost. Probing of the septic tank indicated it is of steel constr~c- tion. The seepage pit is located approximately forty feet from the septic tank. ~de~.c-~_T~-~e~t_~rpcednre ~nd Result_~s Adequacy testing was begun on !~ay 16 and completed on ~ay 17, 1979. During the co~rse of the test, one thousand gallons of water were added to the seepage pit. The fluid levels in the seepage pit and septic tank were monitored cootinuously as the test volume was added. &pproximately one thousand gallons of effluent were pumped from the septic tank after the test volume was added to the seep- age oit. Based on measurements of the fluid levels in the seepage pit over the co.~rse of this test, I conclude that ~the septic system in its present condition: 1) has an absorption capacity of 152 gallons per day ~er bedroom. is capable of absorbing 1~1 gallons in a four-hour oer~od, which ~s ,-qu.~valent to a shor't term surge rate of 0.6 gallons per minute. Consulting services for: On-site water and sewer systems, geotechnical and mineral exploration programs, site suitability studi~s rTe DATE SIGNED DATE Redi~prme 4S 471 Poly Pak 150 sets) 4P471 SEND PARTS 1 AND 3 WITH CARBON INTACT - PART 3 WILL BE RETURNED WITH REPLY DETACH AND FILE FOR FOLLOW-UP 06-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Form No. 18-310 (3-78) Date Collected Source , Date Received Time Received p,m. Eat qo. Presumptive 10mi ;[0mi ;[0mi 0 0mi 1.0mi 24 Hours confirmatory EMB Broth 24 hours= Multiple Tube Report: Membrane Filter: Direct Count Verification: LTB __Broth 48 hours: t0ml Tubes Positive/Total ;[0mi Portions Collform/;[00m f BGB