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HomeMy WebLinkAboutT15N R1W SEC 18 LT 173"rl5o pelt° Stce • MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION - ` I I ENVIRONMENTAL ENGINEERING DIVISION \\ 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME �f / d/in J l M Eye/I/s/� PHONEQf 6fttaS • ■ NEW UPGRADE MAILING AGDp/q,,ESS Al LEGAL DESCRIPTION / / 3 iv ' : /N sE' . at LOCATIONNO. A7I%G ./M/o00 ,Lot y% OF BEDROOMS ,..3 SEPTIC TANK DISTANCE TO: Well / Absorption area Dwelling f f-, - .� PERMIT NO. ManufacturerS Liq. capacity in gallons I Ai IF HOMEMADE: Inside length Material No. of compartments Width Liquid depth U, Z S � F DISTANCE T0: Well Dwelling PERMIT NO. Manufacturer r Material Liquid capacity in gallons TILE DRAINFIELD TRENCH DISTANCE TO: Well /8� # / Foundation/O Q f-/ Nearest lot line PER M lb/ pia..-0 No.r Length ofy2chJyneii -GG.r�L}} Total Ipggjli tripes ({'� Trenc widthty -- II inches Distance b,e,s e. li es ./w Top of tile to finish gQCade r f 4_ Materiiay eneath tile Z ' f m.Ml I/ Total effective abs rptiop area SEEPAGE PIT Length • DISTANCE TO: Width diameter Well Dept- T/ .lc- ( /V ( a PERMIT NO. Crib depth Total effective absorption area Total Building Nearest lot line -1 W lass Dep h Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption weals/ OTHER PIPE MATERIALS •■ ,° I tire 1 11 I ✓ ex S i / 1 Mom iiih!HhIIlUII is or r tin � t•UUI••flU .„A. 0,.......•,,,,,, •aVIrsa■■■■■aill ■■■. o c ✓■■■■I.■■■■■■■■ u■ 4 T Robert A. Sh r. r t �,, uI ■■■PI ■■■■■ ■■■. QtoiF'err... ti>'r�. yv 4 . 40:1'4^:‘^> APP•OV/ DATE LEGAL /i Ave l 26 (c 79 -01,8 (F7"ev. 3/78) 4-10'UPA I 4 -.HT K 1 F":" ����CURnFilicil '''' " DEPARTMENT OF HEALTH AND ENVIRONMENTAL. PROTECTION 825 'L/ STREET, ANCHORAGE') HK. 99501 264-4720 C1 r4 1"1Ft:7 :"7,4_4,41EA--.. IT F" FS: �rl!Z� PERMIT NO. ( 790570 ) APPLICANT JIM EYCHHNER LOCATION OFF OF BIRCHWOOD LOOP LEGAL L 173 T15N R1W SEC 18 AREA REALTY EAGLE RIVER LOT SIZE 100000 SQUARE FEET TYPE OF SOIL RBSORBTION SYSTEM IS: TRENCH MHXIMUM NUMBER OF SOIL RHTlNG (SQ ET/BR)- 95 THE REQUIRED SlZE OF THE SOIL ABSORPTION SYSTEM IS� 417),FJP"'T.1.,A '' 4 lAril 411— THE LENGTH DIMENSION IS THE LENGTH (IH FEET) OF THE TRENCH OR [)RHINFIELD. THE DEPTH OF H TRENCH DR PIT IS THE nI:)THNFE BETWEEN THE OF THE GROUND AND TME BOTTOM OF THE EXCAVATION (IN FEET) THERE IS NO SET WIDTH FOR TRENCHES. THE GRHYEL DEPTH IS THE MINIMUM DEPTH OF GRHVEL BETWEEN THE OUTFHLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTRLLHTION INSPECTIONS OF ANY WELLS ADJACENT TO THIS FROPERTY AND THE NUMBER AF RESIDENCES TWO' THE WELL WILL SERVE. —^ ' ), r4S OT" En Cs 4 ' FIFE ���— BACKFILLING OF ANY SYSTEM WITHOUT FINAL INcoPECTION AND HPPROVHL BY THIS DEPARTMENT WILL BE SUBJEC| TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSHL SYSTEA IS 100 FEET FOR H PRIVATE WELL/ OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL OTHER REQUIREMENTS MAY HPPLYT SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE HYHlLHBiE TO INSURE PROPER INSTALLATION. �-1-...:1-.1 I. 1 F. "Jr. Ft.!! E���' I LERTIFY THHT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN HCCORDHNCE WITH THE COPES ]] I UNDERSTAND TWIT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED T0 INCLnDE MORE THAN ] BEDRDOMS / SIGNE V]� ..:.n..w:r+✓wsx!v(q.SMT1GYT.O�_._35--w'^'!^.."'!. • •:::.. Tint' it g .g by ooc co. aa= IJLU VAN WATL WELL P. O. BOX 272, CHUGIAK, ALASKA 99667 • TELEPHONE 683.2759 wVNER. OF LAND %,1 i ^'t 4 i 4. N lobJ ,C DEPTH OF WELL DDRFSSo 140.a: / G' ItfUtSid� EGAL•DESCRIPTION_ r 1 w P LW .V iB L 113 DRAW DOWN FT ATF •Started 4/16 /71 Ended q /I 7/7 9 GALS. PER HR 02 i 0 ERMIT NUMBER 7 4 0 4 G 6 KINtj OF CASING G' 4 00 1" STATIC LEVEL OF WATER FT 3o' 4 7 IND OF FORMATION: rom_... Ft. to Ft rom__a_Ft.to %c} Ft. S../4 440 'it ele44/ . •rom4 __Ft. to a Ft. .r+y'*'n 1 ELN % `roni_CA a Ft. to d ar .Ft. .$-4"'R7 4-71r mmg--Ft.to gs� Ft. S#v" S71^'E rrom._Pr Ft. to '�!p Ft. rrom__ Ft. to Ft. From_l_4 Ft. to_ From Ft to From Ft to From rt to Ft. Ft Ft From Ft to F• From Ft to Ft From Ft. to Ft Soar.'d S. r-o.,,,t. From Ft. to Ft. ,j'fj T `.r4K r Ee /9 -3 6P m Ft to Ft LFt To` -31 'From Ft to Ft =rom_. __Ft. to Ft Front Front_—..._Ft. to From_ __.—Ft. to _..Ft. Ftom__._Ft. to_ Ft. Ft to Ft Ft From Ft to Ft From Ft to Ft. From Ft to Ft From Ft to Ft From Ft. to Ft. From Ft. to Ft. From Ft to Ft Frorn..__—Ft.tn Ft. From__ ._Ft to Ft. From_ Ft. to_ _Ft. Frmn_ __Ft. to Ft. MISCL. INFORMATION: 3s / � r6 n14 Cori C�4S' •t./w: DRILLER'S NAME ' r� PAE. J r-.1 u" F �r A_ 'IE -I- a Y -e r A Fr Fl r.4 p, - FA ti!!:_' ►=''tl ai ft DEPARTMENT LIF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, 1=W 995E91 264-4720 11..1EEE-.._E.._ F'R.I.1 :I: T' PERMIT NO. 790466 :, APPLICANT JAMES E.'YCHANER LOCATION E:I RCHWOOD LOOP LEGAL T1EN R1W 518 L173 PO B0:: 13 688 2683 LOT SIZE 108900 SQUARE: FEET. P1INIPIUPI DISTANCE BETWEEN A WELL AND ANY Ord --SITE SEWAGE DISPOSAL. SYSTEM IS 100 FEET FOR A PRIVATE WELL; OR :1.:540 TO 2410 FEET FROM FI PUBLIC WELL DEFENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 31:+ DAYS OF THE WELL COMPLETION. TIC'N. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTFILLATIOP1. ECP' I F E. - S ce E- c Fz r' -E s Er-_ L ac _t .2'S' d-" I CERTIFY THAT 1: I AM FF'IPIILIF!P WITH THE REQUIREMENT. FOR ON --'SITE SEWERS AND WELL'S AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTFILL THE 5'YSTEPL,IN ACCORDANCE: WITH THE CODES. SIGNED: ISSUED PPL I cnrw 2HRNER GflTER ANCHORAGE AREA BORO' �H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME JAN/1;C J E1/2Y4-M»Eet 79C GHuGu c LEGAL DESCRIPTION (73 f€ . t) ric LOCATION 80261'4w! P L©FSp SEPTIC TANK: DISTANCE FROM WELL .246' SeloleC)1 MATERIAL CoYkoccTC 66V -lire) PHONE Sw( NUMBER OF COMPARTMENTS LIQUID CAPACITY GALLONS. INSIDE LENGTH 0/i INSIDE WIDTH CI (6 1 I LIQUID 3T 3 1 SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH 12— LENGTH 17^ DEPTH SCS , LINING MATERIAL LOC, DISTANCE FROM WELL 200' iliteel BUILDING FOUNDATION 32' NEAREST LOT LINE _-, TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) a-99 SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL -. DATION NEAREST LOT LINE OF LINES NUMBER OF LINES _r DISTANCE BE WEEN LINES ABSORPTION AREA 5Q FT RENCH WIDTH IN TOTAL EFFECTIVE EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN ABOVE TILE WELL: TYPE DE T NEAREST (f SEPTICGE LOT LINE SEWER LINE TANK SYSTEM CESSPOOL DI TANCE FROM WATER B IjV)}tlC'/OU¢I DATION SAMPLE NEAREST OTHER SOURCES DIAGRAM OF SYSTEM DATE C (c0,9 APPROVED Y L, I HEALTH AUTHORITY GAAB-HD.2 GREATEI, NCHORAGE AREA A. HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 ROUGH Case No 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT .777 -dial I civi_A tete 6W-‘,9 I Fro NAME OF APPLICANT k T Q Al ES d•-1101A40MAILING ADDRESS r P I . Toy-7X.SHONENO RESIDENCE ADDRESS LOCATION OF INSTALLATION Tek 0,‘ et gid/Ag%o LEGAL DESCRIPTION ADT /73 &<2 776747 /GLl ✓1-i APPLICATION TO INSTALL: SEPTIC TANK SEEP..E#GE-PIT , DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH `be 2-F TO BE INSTALLED BY -PER60S$N- LIceWSQD E'4-caucC4Ue- TEST RESULTS ANTICIPATEDDATE OF COMPLETION 394-134 344 --agog BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT a 9 {i r wo nc.e. THIS IS TO SERVE AS me, e, [ icJ. AA/Pe PERMIT TO INSTALL A AS DESCRIBED. BELOW. SIZE OF UNIT TO BE ERVED SEPTIC TANK SIZE / I'- O "ET PE _5�� EEPAGE AREA DIAGRAM OF SYSTEM DISTANCES: aa5- TYPE 441 o , F "*o 0 We a 1< v t) N C U� Health Authority I certify that I am familiar with the requirements of Greater Anchorage Area Borough' Ordinance No. 28-68 and that the above described system is in accordance with said code. A/0 7- f et LI 110/0 o± S o r L 4E'5+ APPLICANTS SIGNATURE 6! ?leceer.., ` .xv DATE EATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT 327 EAGLE STREET ANCHORAGE, ALASKA 99501 CASE 11 Performed For // - -' Date Performed 2) 61/447469 Legal Description: Lot Block Subdivision kik / 3 f'4, / This Form Reports a: Soi—ilssrLog �/ -Percolation Test Depth Feet Soil Characteristics 7 F 6,0 4 t41e enhre Sou/4ecsi and Gies/ LUG//J Are composed o/ Gay; //n Ecu con/ainJ a /1!9/y rode con/enn/ wi,)/i Any perceni-eqn e--11 Jhn4//°f 1.arlic„ayM, r{rt*/he Nor/h wG/ -t,ad rbeim 6sa3 Gs 1s oun d on AI e ealionr the a.) is oorit lease/ compa6 eel- kW 7%e• di `is re/a/a' 4. nt;01 f, Was Ground Water Encountered? If Yes, At What Depth Ab, 96 e Location Sketch 1 1 ---� a-- IIIII ..... �MI�� SMI. MIMI SIM 11111111111111111111 MIN Reading Date Gross Time Net Time Depth To H2O Net Drop Frop,sed Installat� ion; Seepage Depth Of Inlet S' COMMENTS:____ e if rd 41,),>)41,),>) Pit ter— Drain Depth To Bottom Of Pit Or Q 4/ifr.a•r ro.i/»,jf- [v Field Trench they,' YO' r aiii2Len A- . Test Performed By: Aviv n Data Certified By: Dat 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA # // 3 D'/ Parcel I.D. 051.231.19 Expiration Date: 8 — / cj © 3 1. GENERAL INFORMATION Complete legal description T15N, RIW, SEC18, SE1/4, LOT 173 Location (site address or directions) 19425 RICHNER RD., CHUGIAK, AK 99567 Current Property owner(s) JAMES & NANCY FOSTER Day phone 688-9229 Mailing address Same as above Lending agency Mailing address Real Estate Agent ELENA NOVITSKY Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 3 Day phone 317.3063 TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑ Individual Holding tank ❑ 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 title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further 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 KND ENGINEERING, INC. Phone (907) 696-6111 Address 20441 Ptarmigan Blvd., Eagle River, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS 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 in land use, local soil characteristics, groundwater levels • that may fluctuate during 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, KND can not give any estimate of how long a system will function satisfactory for current or future occupants or can KND guarantee that no unseen encroachments, deficiencies or discrepancies exist. Date 5115/03 p vet �P�7•'�"�f'r L•°�s�e� 14 f� Konne; U I� • 4,e: �•. CE 7116 I :•�� •� 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory OF Ail, • I. ON-SITE •'• �' WATER AND : rn • TER PROGRAM - Maintenance Agreements �J� , . •'• p��.� Supplemental Engineer's Report IJJJ�,°��EM )EVA s���� Other (Rev. 01/02) Original Certificate Date: ..5 / 9 - 0 3 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 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: T1ON. RIW. SEC18. 6E114. LOT 173 A. WELL DATA Well type private If A, B. or C provide PWSID # Well Log (Y/N) Y Date completed 911711979 Sanitary seal (Y/N)L. Wires properly protected (WN) Y Total depth 100 ft, Cased to 35.75 ft. Casing height (above ground) 1.5' FROM WELL LOG AT INSPECTION Date of test 911711979 4/24/2003 Static water level 47 ft. 34 ft. ' Well production 3.5 g.p.m 1.42 g.p.m. WATER SAMPLE RESULTS: Coliform A_cotonles/100 mi. Nitrate _0.100 mg./I. Other bacteria A. colonies/100 mi. Arsenic: 16 mg./I. Date of sample: 4124/03 & 5112103 Collected by: IND Enaineerinq B. SEPTICIHOLDING TANK DATA Tank Type/Material septic / concrete Date installed 10/7169 Tank size 1000 gal. Number of Compartments 1 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Onside aaraael Depression over tank (YIN) y_.,High water alarm (YIN) N Date of pumping 4123103 Pumper Sanftagl C. ABSORPTION FIELD DATA Date installed 1017169 & 9I26179 Soil rating (g.p.d./ft2 or ft2/bdrm) I);t. System type Crib wl Trench Length cab 1r trench 25' ft. Width crib 12 trench 5' RGravel below pipe crib 6' trench"' ft. Total depth ft. Eff. absorption area 4.3$.ftMonitoring tube L. Depression over field j1 Date of adequacy test 4124/03 Results (Pass/Fait) pass For L bedrooms Fluid depth in absorption field before test I_ in. Water added 41g gal. New depth 1¢ in. Elapsed Time:1121min. Final fluid depth . in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date Parcel ID: 051.231.19 D. LIFT STATION Date installed SIA "Pump on" level at _ in. Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main 75'+ Size in gallons Manhole/Access (Y/N) "Pump off" level at in.HIgh water alarm level at in. Cycles tested Meets alarm & circuit requirements? Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent Tots 100'+ Public sewer manhole/cleanout 100'+ Holding tank 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water service line 10'+ Water main 104 Wells on adjacent Tots 00'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'. Building foundation 10'+ Water Service line 10'+ Surface water 100'+ Curtain drain 50'+ Wells on adjacent lots 100'+ F. COMMENTS Two cost tank cleanouts and fine between tank and crib installed / repaired. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems am in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Kenneth M. Duffus Date 5115103 Absorption field 5'+ Surface water 100'+ Water main 10'+ Driveway, parking/vehicle storage < 5' Day prior to test -1500 g. riarge. ••CO, 4.V I, 149IH .= 1r ... s.u....•... .i 1 VjW% CE 7116 :'•J . .+ Oks RaFEsst©NA,. r HAA Fee $375.00 Date of Payment 5/15/03 Receipt Number 03 5 Yid S (Rev. 12/01) YY�.L Waiver Fee $ Date of Payment Receipt Number 05-14-03 04:35PM FROM-CTjE ENVIRONMENTAL SRV 9075615301 T-569 P.01/01 F-468 CT&E Environmental Services Inc. 200 W. Potter Drive Anchorage, AK 995184605 Telephone: (907) 562-2343 Facsimile: (907) 561-5301 • 200 W. Pottor Drive lrinking Water Analysis Report far Total Coliform Bacteria Anchorage, AK 99548-1605 RTsAwzirsZ UIrTIQNS QNREMERS1bS.(m 2WFORE COLLECTINGSAMI'Ll: rel' (990 07) 562-234661-53011 • fau: TO BE COMPLETED EY LABORATORY Analysis shows this Water SAMPLli to be: Satisfactory Unsatisfactory . Simple over 30 hours old, results may be unreliable • Satiiple too IOUs in transit; sample should nothe,OveraliPhoifrs old at ettatnination to indicate reliable results. Please scud . .nett/ sample via special delivery.ntan Date Rece[Ved 'r1•ria Time Received ISCa Analysts Began ' ) 720 Analytical Method . Membrane pitta •a WO -MUG 10 m1. Result" MUST BE COMPLETED BY WATER SUPPLIER a PUBLIC WATER SYSTEM I.D.1/ ,PRIVATE WATER SYSTEM X' Send Reptile t] . Sendlnvoice Kati E1RriA- Z tJr /n11. w acr Sisu:w Nam:Mammy Plaa; Sb4-s7°►/ t'iuno Nambcr Zods!/ Pi1M'/0,►r1 11a1Ln9 Addicw Cut ' EMWe FM/ ViEsiT ult./CU-ON 00-3q3 3 Yn9 N1amac 9/1577 Swp . •zipo�i CI Send Results 3 Send Involce Company Koos 11419 Mdln» Swot 2413 Cada SAMPLE DATE: SAMPLE TYPE: Month • i . 1142-1 . Day X0131 Year Routine •o Treated Water o Repeat Sample (for reufine sa(nple ')(7 Untreated • Water rvithJab reL•ho. . ) o Special Purpose • a ltrac SA111i'LE.LQCATIOJ Collected ?sS& R:& 3Ette .SE /y .'-oT f73 3PM Conecteu .13y Pkpe Print 1032579 Jetta t �+• t �•t.-. AnCh Fbks Jun Analyst • Date: Time: Client notified of tinsatisfactory results: 0 Phoned Dare: • Spoke with Time F0 tl 0 Fazed BMA 'LRIOLOGICAL WATER ANALYSIS RECORD MAO -MUG Result: Total Collfortn . E Coli • Membrane Fitter: Direct Count :Verification: LT13 0 . Fecal Coliform Confirmation Final Membran Film Results Reported Iiy4 Comments: ' ColonlestUiO nil Ii CII • COLIFIRM Date 513--3 Collform/100 mi Time / 7:3D hrs TNTC -Too Montero to T1 Crum OB - Other Boc 4a 05-01-03 10:44AM FROM-CT&E ENV k.URENTAL SRV lotr SGS Ref.# Client Name Project Name/# Client Sample ID Matrix 1032268001 KND Engineering TISN R1 W SEC 18 SE/4, L173 TISN RIW SEC 18 SE1/4, Lot 173 Drinking Water 9075615301 ("'1, T-386 P.02/03 F-176 All Dates/Tlmes are Alaska Standard Time Printed Date/Time Collected Date/time Received Date/Time 05/01/2003 9:18 04/24/2003 17:00 04/25/2003 10:17 e SnReDirector Released 04-4-1/ Sample Remarks: Parameter Results PQL Units Method Allowable Prep Analysis Limits Date Date Init Waters Department Nitrate -N .Microbiology Laboratory Total Coliform 0.100 U 60 O0, No Coli. 0.100 mg/L EPA 300.0 (<1'10) 04/25/03 3S col/100mL SM18 922213 (<=11 04/25/03 KAP Sent By: NINE J CORPORATION; 907 894 9210; c�• i a•♦ br %• -w.t 11 Apr -25-43 9:33AM; • • 4( • •' •:::••1: .•y • y • 1:.:..; .• •� ?k ,.• y. .. �. •',fir 1 • •Iteytr• \; • c az' zt 1 R • •I -. TI •• ;1 ws iP t ,. • • , h �• f r F, . Page 1/1 •t • • • • •• . ; `• �• \••-� %'j; •.•-tc : '`` i :•�,' ++ `W,; •»:J;,• e.'' , .. • • ��••'�':. ..'• 4•'• • 4+tt-f �ise • .� `•�a' . -. .,- • u • • • • • •'..r' ' �' ...•'reg.•. ~ r• •i gleams k MUNICIPALITY OF ANCHORAGE MUNICIPALI�1' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIUNr. 825 L Street • Anchorage, Alaska 08601 ENVIRONMEN STREET. LOCATION �7%,,// / /%%i • Jr) t!axe.wood 4e72) r7Ad Af 36 /J yr/s, d r SEP 1 7 44CHO_RAGE \ ^,,.i�{ &i\ hC M 1079 _.—•• Oit(l/�. s Pm ir' ll ENVIRONMENTAL ENGINEERING DIVISION Telephone 284-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND REEGiliVIfijj DIRECTIONS: Complete ell parts. on page 1. Incomplete requests will not be processed. Please allawton (10) days fo proceasIng. 1. PROPERTYQWNERPHONE' C.)(2 Mei to- Pc Aieli cc -A III COMMUNITY since June 1975, For wells drilled prior to that date, give well 611-a6 a''3 MAILING ADDRESS:. 4?XOQlJ/ [[ 4%5ka 795 G6 7 X INDIVIDUAL/ON•SITE** If system is over two (2) years old an adequacy test is required in PUBLIC UTILITY by this, Department, PROPERTY RESIDENT Bs dl above) PHONE 2. BUYE - Jcrm.e s Nar2Cy A;G74e� PHONE 69/ 373 MAILING ADDRESS qq//// /,y// [ /� �y �J ✓� tA...y " ' /Q54 q 7 9s / / 3. LENDING It a9/6UTION Lomas le- Ne,fi1/4foh PHONE MAILING ADDRESS 4. REALTOR/AGENT- A2fit/ ,'- 2ea/id/ess /tiny c e Rr¢' PHONE 76-6- i /r,4 MAI LING ADDRESS0.,66‹ £ 9 LGtYQ/t 4/it" . 191c �} r y67/: 7 5,.`LEGAL .DESCRIPTION T A" -Al g/14/ Sec /2 / /7S STREET. LOCATION �7%,,// / /%%i • Jr) t!axe.wood 4e72) r7Ad Af 36 /J yr/s, 6. TYPE OF RESIDENCE NU BER OF BEDROOMS NI One a Four IDOther SINGLE FAMILY ' IN Two w Five MN MULTIPLE FAMILY $ Three ® Six 7. WATER SUPPIA' X INDIVIDUAL* *ATTACH WELL LOG. A well log Is required for all wells drilled III COMMUNITY since June 1975, For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL. SYSTEM **If individual/on•site, give installation date X INDIVIDUAL/ON•SITE** If system is over two (2) years old an adequacy test is required in PUBLIC UTILITY by this, Department, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-01013/78) 1-x erd '4 5:.15,3,c.amoo d /eat , %ren a -t AO& o 4.0>,x..s, ,La 4 ygitdvP/ /200-Ct et4/ 300 74/s c//Rax. DAVID A. SLENKAMP ROBERT A. SHAFER MECHANICAL ENGINEER CIVIL ENGINEER Mr. J:im Eych,nner c/o Aron Renity ATT!: Joyce Porte Parkgate Professional 13ailding, P.O. fax 249 Fnr1e River, Alnska 99577 694-9055 September 25, 1979 694-2979 MUNICIPALITY i",- I,NCI-IORAGE DEPT. l'-r,C 1 11J19 RECEIVED Dear 1^r. Fychnner, Reference: Lot 173, T15N, RIW, Section 18 Joyce Porte, Area Realty, requested thnt we perform en adequacy test on the ,sewer system located on the referenced property. This test was performed on September 22nd end 23rd, 1979. The septic tnnk was pumped and found to have n capacity of 1000 gnllons. The neouano pat wns then charged with 1000 gnllons of water. At the end of n 24 hour period, the percolation from the seepage pit resulted lin rerr.ov1 of approximately 319.8 gnllons or 106.6 gallons per bedroom. Thr minimum necontnble rate is 150 gallons per bedroom. As a result of the above tent it cnn be concluded thnt the septic tank :i.sndequ^te, however the seepage pit is only adequate for aopro d.meteJy 2 bedrooms. It will he necessary for you to have n soil log performed and to obtnin n permit from the Municinnlity of Anchorage, Department of Henith and Enviornmentnl Protection, 825 L Street, Anchorage, to upgrade the system to accommodate a. bedroom. If we cnn he of further service to you, please do not hesitate to call on us. cc: Lomas and Nettleton Go. Area Realty Department of Health and Envi.ornmentnl Protection SRB 196X EAGLE RIVER, ALASKA THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR-. INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS IN SINGLE FAMILY 0 MULTIPLE FAMILY Se ONE IN THREE 0 FIVE ® OTHER BB TWO ® FOUR 0 SIX 2. WATER SUPPLY PERMIT NUMBER ❑ INDIVIDUAL DEPTH -OF WELL 0 COMMUNITY ® PUBLIC UTILITY DATE DRILLED Connection Verified " LQG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER, III INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY DATE INSTALLED Connection Verified ® Septic Tank or 0 Holding Tank INSTALLER Size: If Tank is homemade SOILS RATING give dimdhslons: TYPE OP TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES - WELL TO: Septic/HoldingTank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 6. COMMENTS II/APPROVEDFOR 3 BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ■ DISAPPROVED DATE BY (Title) LEGAL DESCRIPTION 72.010 (Rev.: 3/78)