Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
GREENBROOK BLK 4 LT 14
Municipality of Anchorage Page _. ,// of ~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .b'"~ ~/o~/Y PID Number: ~ /? Name: (~ ~-~/* ~//,w.~.. Wastewater System: [] New J~ Upgrade Address: ~ ~' 'Fo F'~-~,-/-~? /:~,,,,e ~,,~ ABSORPTION FIELD Phone: I No. of Bed "~/"~ ~*~:~-,--~ r~/orns: 1~ Deep Trench [] Shallow Trench [] Bed [] Mound [] Other LEGAL DESCRIPTION soil Rating: !Total Depth from original grade: ~). ~ GPD/Sq. Ft. Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe /¥ ¥ ~"~'~'°~' /. Pt. ~- ~t, Township: I Range: I Section: Fill added above original grade: Gravel length: ~' Ft. (~ '-'~ Ft. WELL: [] New [] Upgrade.~.../ Gravel depth: Number of lines: J Distance between lines: Ft. Classification (Private, A,B.C): Total ~ ~Caeed To: Total absorption area: Pipe material: Driller: ~ Date Drilled: Static Water Levsh Installer: Z~"Pt* ~/,.?.~ Date installed: ~ ~, ~,.TANK ' SEPARATION DISTANCES a Septic a Holding ~.E.P. To Septic Absorption Lift Holding Public/Pdvatel Manufacturer: ~ Capaci~ Jn gaJlons: Prom Tank Field Statlo~ Tank Sewer Li~es We,, ~/,~~// ~ ~ ~ ~.~ ~a.r,~h / -- SuEace w~ 2/~~ ~/~ ~/~ ~ ~ LIFT STATION Lot Foundation ~/~ ~ / ~ ~ / ~/~ //~ ~7~ ,, ~ ~ Cu~ain Pump Make & Modal Electrical Inspect ohs pe~ormed by: Remarks: BENCH MARK Assumed Elevation: ENGINEER'S SEAL x~.......~. . ~ ~.. Inspections peflormed by: .~ ~ Dates: 1st ~"/~/ /5:?~ ,, , 2nd ~/~ / ~ 9epartment of Hea.h Serv Reviewed and approved by: te:/~ ~ "'" ... 72~13 (1/91) MOA 25 Permit No. ~/'J /~/~/ Page 2_ 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 PID No.: LOT $4i BLOCK 4 SCALE: dUFFMAN ROAD HTr, AECS COs THO GREENBROOK i,,=50, A~IO~4 I I I I I C. REID, JR. CE -2251 72-013 A (2/91) MOA 25 Permit No. ~'~u /a ~ //-/ Page 'J of ~ Municipality of Anchorage " DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report PID No.: O /7 ~Y..?/~ J. El* IEAL REID, Jl~ 72-O13 A (2/91) MOA 25 INSPECTIONS [907) 563-3464 REP{ IORAGE,~BU!LDING ) EAST TUDOR FORMATION. (907) 786~8211 · :.ELEC.,TEMp. ~ ...... . ..... E} ~?LBG..UNDGR.;:~¢:~ '~:?:FI :;~:¢~::':~i--I · ELEC. SERVI(~Z~").,./~i' ~,' ~'PLBG. R~'0~",~"-: B~'6 ~EAM ''''~: -~"'~ ':~:'O 'ELEC. ROU~'"bAS T~:~:~:' ..... ~'~'MiNG '~:~?~-~'s'~":v~'U "ELE~ 'F NAL ~.- :GAs "'~.~ ¢ '"SU~TION ..... ~'~:~"'eO '.OTHER ' :~"~'~:~,MECRANi~X~:;:e- SHEETROCK --','-'-..'?<;~ Z;¢ .... ' '-' "~' ' U STRUCT. FINAl;'¢*''<*'~ FIRE FINAL '~ . _ .: ~ .: INE AT NEXT INSPECTll ~n CORRECTIONS-I ~-ONCEAL'UNTIL REINSPECTED ONS ARE MADE, PLEASE CALL FOR INSPECTIOb rillS NOTICE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT NUMBER:SW910214 DESIGN ENGINEER:AK ENVIRONMENTAL CONTROL SERVICES OWNER NAME:KELLMAN CAROL OWNER ADDRESS:6940 FREITAG DRIVE ANCHORAGE, AK 99516 PAGE 1 OF 1 PERMIT DATE ISSUED: 7/26/91 EXPIRATION DATE: 7/26/92 PARCEL ID:01743103 LEGAL DESCRIPTION: GREENBROOK BLK 4 LT 14 LOT SIZE: 50569 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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 (iSAACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ISSUED BY.'~--~-'~-''~ ~ /~'-~'~"~ ' / RECEIVED ,JUL 2 4 1991 Municipality of Anchorage SPECIFICATIONS FOR A TRENCH-TYPE WASTEWATER DISt~e$~A'~al~'~f~anServices LEGAL DESCRIPTION: LOT 14, BLOCK 4, GREENBROOK SUBDIVISION 1.0 GENERAL 1.1 '"The Drawings, sheets 1 thru 12, shall be a part of this specification. 1.2 All materials and workmanship shall meet the requirements of the Municipality of Anchorage, Department of Health & Human Services (DHHS), the conditions of the permit, and all applicable rules and regulations currently in effect. 1.3 Ail elevations and depths are advisory, and are to be verified or modified in the field by the engineer or inspecting agency. 1.4 It is the responsibility of the property owner or installer to adhere to approved designs for installation, maintain the specified separation distances, and have the appropriate inspections. 1.5 It is the responsibility of the property owner or installer to report to the engineer any observed conditions which would put the system in violation of state or Municipal regulations. 1.6 If the installation is not inspected by an AECS engineer, AECS will not be responsible for the installed system. An engineer at AECS should be consulted prior to construction to determine the number of inspections that will be' required and to explain what these inspections will involve. 2.0 SEPTIC TANK 2.1 If there is an eXisting septic tank,'it may be used it if meets the capacity requirement for the residence and the approval of the MOA. 2.2 The septic tank shall be' a UPC-approved two-compartment tank, constructed of 12 gauge steel with bitumastic coating and set level on undisturbed soil. If the tank is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inch burial type polystyrene rigid board insulation. 2.3 The septic tank and trench shall be a minimum of 2.4 2.5 2.6 2.7 100 feet from any private well or body of water, 150 feet from Class "C" wells, and 200 feet from Class 'A" or "B" wells, unless otherwise specified. Less than the required separation distance must have prior approval or waiver by ADEC or MOA. The septic tank shall be a minimum of 5 feet from the house foundation, and a minimum of 5 feet from the absorption area. Piping shall be fitted with a mechanical watertight calder coupling on the outlet and inlet of the septic tank. Piping shall be 4 inch solid PVC ASTM D-$034 or cast iron, sloped a minimum of 1/4 inch per lineal foot. If the piping is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inch burial type polystyrene rigid board insulation. Cleanouts shall be installed as designated and capped with air-tight rain caps (Jim Caps or equivalent), and extended a minimum of I foot above ground level. If a lift Station is required it shall be a combination lift station septic tank per Anchorage Tank and Welding, Inc. using an ORENCO lift station design. Specifications and design drawings are on file with the Municipality and the engineer. $.0 ABSORPTION AREA 8.1 3.2 The gravel for the trench shall be 0.§ to 2.5 'inch, screened rock with less than 3 percent pass.ing the No. 200 sieve. All substitutes must have prior DHHS 'approval.- ~" T'he bo~om and 'side's b'f the excavation shall be - raked with the backhoe blade to ensure that it has not been compacted during excavation. The bottom elevation shall be level. 3.3 Monitor standpipe(s) shall be placed as shown in the drawings, and shall be 4 inch rigid PVC ASTM D-3084, or cast iron. The section shown with holes may be 0.§ inch holes drilled on 6 inch centers on opposing sides of the pipe, or a regular section of perforated sewer pipe clamped to a solid section with either a no hub coupling or a solvent joint. A rubber rain cap (Jim Cap or 8.4 8.5 3.6 8.7 equivalent) shall be installed over the top of the pipe. The distribution pipe shall be perforated 4 inch ..,PVC with a minimum crush strength of 1500 pounds and shall meet the approval of DHHS for use as drainfield pipe. If the system is a pressure distribution system see Section 5.0. All distribution pipes shall be laid level. Trenches may be paralleled, but must have a minimum separation distance between the trenches of 10 feet or 2 times the gravel depth (which ever is greater). 75 feet is the maximum allowed linear length of any trench. If the final grade over the trench is less than 4 feet above gravel, insulation is required, using burial type polystyrene rigid board insulation. There shall be 1 inch of insulation for every foot of soil less than the required 4 feet of cover, but there must be at least 24 inches of soil cover even though insulation is used. The solid pipe extending from the septic tank to the drainfield shall also have a minimum of 4 feet of cover or an equivalent layer of insulation to prevent freezing of the line. The gravel shall be covered with a layer of nonwoven engineering cloth. 4.0 INSPECTIONS 4.1 A minimum of two inspections are required for the installation of the trench. The first inspection will be of the open excavation to assure that the system is installed in the proper soil strata, correct depth and meet minimum spec'ified design parameters. 4.2 The second inspection will be after placement of the gravel, monitor standpipe and distribution pipe to verify proper installation and position prior to backfill. 4.3 The inspection of the septic tank installation can be incorporated with any one of the above listed inspections. 4.4 The lift station will require either an MOA electrical inspection or certification by a licensed electrician, 5.0 depending on whether the building code applies to this part of the city. PRESSURE DISTRIBUTION SYSTEM 5.1 The lateral and header pipes are to be Schedule 40 PVC or ABS in the sizes indicated on ihe drawings. 5.2 The laterals are to be level within plus or minus one inch. 5.3- Ail joints are to be solvent welded. 5.4 There shall be 2.5 inches of rock over the top of the headers and laterals. 5.5 The holes in the pipe are to be properly sized and spaced. ~ The holes shall be clean with no cuttings still attached to the pipe or left free inside the pipe. 5.7 Holes may be reverse beveled if it does not increase the outside hole size. 5.6 ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 CHECKED BY DATE SCALE C. REID, JR, - 2251 'EASr-~,F_~rrS O~ R~C~b~'OTHEF~" 'THOSE-' 'SHOWN '~'ON L .THE RECORDED· PLAT ARE NOT 'sHowN .Anchorage !~-cord]ng, ~prov~en~ ~at~ thereon are wL ~e prop~ ~ aha do not ova-bp or enc~ach on the p~op~ l~ng adjacent th~eto, ~ ~ng adja~nt que~on and that ~e Bn~ ~ o~ v~ible easem~ on ~id p~)- ~ Jn~catedh~eon:. . ~ ~OC~' · .,:::- . . ..~ .~ : . ........... · ................. ~.,. ....... ~. · ..Mb~,..? PERFORMED FOR: LEGAL DESCRIPTION: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ~- /d ~ '-// ~"¢'~/' ~¢¢ ~,¢o~' Township, Range, Section: COMMENTS SLOPE SITE PLAN WAS GROUND WATER ENCOUNTER ED? ¢~O S ~ L IF YES, AT WHAT O DEPTH? p E Deplh to Water A[le~ ? ~2 f Monitorino? Dale: Reading Date Gross Net Depth to Net Time Time Water r~ P. Drop PERCOLATION RATE c~' (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~'-~ FT AND ~ '(¢) ET PERFORMED BY: ~' ' ~ /~' I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 2/~0~/¢/ 72-008 (Rev. 4/85) ALASKA EnUIROIlmE[1TAL CO[/TROL $eRUICE$. ~nq,n~mnq ~' ~nuironmental Studies InC. LOT /~ TH ~ Supplemental Soils informaLion. Subdivision ~fe~ ~rea~ Block LOT /~ LOT TH ~ TH LOT TH 1 2 3 4 5 6 y- 8 9 10 11 12 13 14 15 16 17 18 19 20 1 2 3 4 5 6 7 8 9 10 11 12 13 14 ~6 11 17 18 18 19 19 20 - 20 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18- 19 20 1200 U.Jest 33rd Auenu¢. Suite B ,,, Ancgoroq¢. A)os~a 99503 · [907} 276-!361 PERCOLATION TEST DATA SHEET ADDRESS .... DATE ZIP CODE TOTAL DEPTH OF HOLE //~ ft. .ZONE TESTED -~,J'- ft TO ~z. 0 ft t. ~, 1'7' .OOu/ /,~,/F---- ,X~/.~/,4x READING ~ CLOCK TIME NET TIME DEPTH l~ NET DROP RATE (min/in) 'FINAL PERCOLATION RATE PERFORMED BY L, ~?¢~'d 7. .---/- h , le ' ., , (min/in) · ' Testlab ': Alaska ~" . 4040 "B" Street April 17, 1981 W.O. #A19708 Second and Fourth ~unchorage Limited Partnership 4611 Business Park Blvd.. Anchorage, Alaska 99503 Attention: Mr. Les Pace Re: Subsurface Investigation for Suitability of On-Site Sewage Disposal,~Lot 4, Block 1;~Lot 2, Block 2; Lot 3, Block 2; Lot 8, Block 2; Lot 9, Block 2; Lot 10, Block 2; Lot 17, Block 2; Lot 19, Block 2; Lot 26, Block 2; Lot 3, Block 4; ~ot 4, Block 4; Lot ~, 'Block 4; ~ot 12, Block 4; Lot 13, Block 4; Lot 14, Block 4, G~eenbrook Subdivision· Dea~ Mr. Pace: During March and April of 1981, we drilled a 15 foot boring on each of the above lots and placed a perforated, 3/4 inch PVC pipe in each hole so that the water table could be monitored over a period of time and a percolation test run in the hole. The holes were drilled using a Nodwel~·mounted, MobileB50 drill rig owned and operated by Denali Drilling, Inc. The drilling was supervised and the test holes logged by Mr. Ted Krupka, senior technician, and Mr. O~M. ~atch, geologist with Alaska Testlab. After ~he holes were drilled, our technician returned on several occasions and checked the water level in each of the test holes. After a period of time the holes were saturated, left to stand overnight, saturated a~ain and a percolation test run. The percolation test was run by monitoring the·drop in the water table elevation at 10 minute intervals for a minimum of one hour. The percolation rate listed in this report was computed using the Slowest 20 minutes of that percolation test. Included with this report is a'test hole location sketch for each lot an~ a log of the b~r~ng placed on each lot. The results of this exploration are described as' follows: Lot 4, Block 1 The water table eievation measured in the test hole at this site remained fairly constant at about 12 feet. The percolation rate measured on April 15 was 6.0 minute~/inch. Because of the need to keep. the systcm shallow and ~he high silt content, we recommend a more conservative design percolation rate of 10.0 minutes/inch. '. , ~./. ~ Second and Fourth Anchorage ~/ Limited Partnership ./ April 17, 1981 ' Page Two We recommend 'the sewage system be placed as high as possible, in the upper 4 to 8 feet, to avoid high water problems during the spring breakup. Lot 2, Block 2 The test hole was placed in-the front of the lot, and this is where we would recommend the on-site sewage disposal system be placed. The lot slopes considerably to the back, where it appears there may be a high water table. The water table in the test hole was observed at 8.0 feet on March 18, during the peak of breakup then lowered to 10.5 feet by April 9. The percolation rate measured on April 15 was 4.0 minutes/inch. However, we recommend using a more conservative percolation rate of 10.0 minutes/inch, due to the silt content of the soils. We also recommend that the disposal system be kept as shallow as. possible. It may require mounding to provide adequate insulation and yet maintain the necessary separation between the system and the ground water level during spring.runoff~ Lot 3, Block 2 The disposal system on this lot should also be located at the front of the lot, near the test hole, as this lot slopes downWard' to the back. The water level in the test hole was measured at 11.6 feet on April 18, but had measured at 8 1 feet on March 9. The water level was encountered at 11.4 feet on March 15, and the percolation rate on this date was 12.5 minutes/inch. We recommend a mounded ~sewage disposal system be used to maintain the necessary separation from the seasonal high water level, and adequate insulation of the system. -~t 8, Block 2_~ When drilling the test hole, no water was observed within the 16 foot depth hole at this site. The following day, April 9, water was observed at 7.6 feet. The water level in the test hole was 8.2 'feet on April 15. This water is probably surface seepage from thawing conditions. The percolation rate was 'measured at 5.5 minutes/inch, however, we recommend a design rate of 10.0 minutes/inch because of the silt content. A mounded sewage disposal system due to the high spring water level, should be used. No water was observed in the test hole while drilling, but was found at 7.8 feet the next day, April 9. The water is probably surface seepage from thawing ~onditions. The measured percolation ' :~ · ~econd and Fourth Anchorage · ~/ Limited Partnership ~ J . April 17, 1981 Page Three ' rate was 5.2 minutes/inch, however, we recommend a design rate of 10.0 minutes/inch. Since the seasonal.water level is quite high, we recommend a mounded disposal system so sufficient 'separation is achieved. Lot 10, Block 2 The test hole was located in the southwest corner of the lot, and we recommend that'the sewage disposal system be placed in this area. The water level is quite near the surface towards the front of the lot. The water level while drilling on April 8 was 9.0 feet, then was found at about 12 feet over the next few days. On April 14, the percolation rate was measured at 2.5 minutes/inch. We recommend that a more conservative rate of 10.0 minutes/inch be used, due to the silty nature of the upper soils. The system should, be placed as high as possible, in the upper 8 to ~0 feet, to avoid conflicts with the seasonal high water, mounding may be necessary for insulation. ' Lot 17, Block 2 No ground water was encountered while drilling on this lot on April 8, or when checked again April 9 and Aprii 16. The measured percolation rate was 5.4 minutes/inch, however, we recommend a more conservative design rate of 10.0 minutes/inch because of the siltier nature of the soils. Lot 19, Block 2 No water table was observed in the 16 foot test hole while drilling on April 8, or on April 9. The percolation rate was measured at 8.9 minutes/inch, however, we recommend a more conservative design rate of 10.0 minutes/inch because of the silty nature.of the soils. The system should be placed as high as possible, as high seasonal water levels were found in the immediate area. Lot 26, Block 2 The test hole was drilled nea.r the center of the lo't April 8, and no water was observed. The test hole was alsd found dry April 9. The measured percolation rate was 6.2 minutes/inch. oNn° ~_art~ ~was_o.bserved-in the test hole at this site while drilling' ~ o, out was at 12.5 feet the following day. The measured percolation rate was 14.6 minutes/inch. .The disposal system should be kept as high as possible t...o avoid conflicts with the · 'l I . Al,\~k...\ 'Second and Fourth AnChorage Limited Partnership . April 17, 1981 . .Page Four . seasonal high water. Lot 4, ~lock 4 The measured water level in the test hole at this site remained fairly constant and high. Saturated conditions were encountered at 12 feet while drilling on March 14. The water table elevation was found at 6.8 feet on March 23, at 6.8 feet on April 9, and at 8.3 feet on March 16. The measured percolation rate was 40 minutes/inch. Because of the high ground water, a shallow mounded disposal system should be used. Lot 6, Block 4 The high water level at this.site necessitates a highly mounded system; or using insulation to provide frost protection while maintaining the necessary separation between the disposal system and the seasonal high water. While' drilling, saturated conditions were encountered at 13 feet. On'April 18, the water level was measured at 5.4 feet, then'at 5.i feet on April 23, the water level had lowered to seven feet by April 9, and then to 7.5 feet on April 15. However, much of this water is probably from surface water and melting seasonal frost. The measured percolation rate was 3.8 minutes/inch, however, We recommend a more conservative design value of 10.~0 minutes/inch. ,. ~' Lot 12, Block 4 Again, the disposal system should be placed as high as possible at this site. The water level in the test hole remained fairly constant at eight feet. The water level was measured at 2.8 feet on March 8, but it appeared that this high level was caused by infiltration of surface water, and was not the true water level at the time. The measured percolation rate on March 17 was 3.4 minutes/inch, but it is recommended the more conservative value of 10.0 minutes/inch be used, because of the high silt content of the.upper soils. Lot 13, Block 4 The test hole was drilled near the center of the lot on April 7, and no water was observed. Again on April 9, no water was detected. On April 15, the measured percolation was 9.0 minutes/inch. We recommend the disposal system be placed between 5 and 11 feet, to avoid the surface silts. _~ Lot 14, BloCk 4 No water wa's encountered while dril'ling, on April 7, or when ,A'f I.', ALASKA TESYLAB ~Second and Fourth Anchorage Limited Partnership Page Five. .~ - checked April 9. The measured percolation rate was 4.0 minutes/inch. We recommend a more conservative rate of 10.0 minutes/inch be used, since the upper soil is silt. If you have any questions regarding these tests, please feel free to call. Very truly yours, ALASKA TESTLAB Ca~l A. Bassler Geotechnical Engineer Approved.by: CAB/mg Attachments Manager cc: Ralph' Westover, Tryck, Nyman & Hayes Lot 14, Block 4 Table O WO #A19708· Date: 4/8/81 Logged by: O. Hatc~ Depth in Feet From To 0.0 '" 1 .0 1.0 11 .0 11.0 16.0 Soil Description Brown Peat F-4, Brown Gravelly Sandy Silt, ML, moist, stiff, occasional cobbles, NP NFS/F-2, Brown Gravelly Sand, SP, trace silt, moist, medium dense, 2" maximum Set 3/4" perforated PVC pipe to run perc test and to monitor water table elevation. Measured Perc Rate = 4.0 minutes/inch. Recommended Design Perc Rate = 10.0 minutes/inch. Bottom of Test Hole: Frost Line: Free Water Level: 16.0 Feet 1.5 Feet 4/7/81 4/9/81 - None Observed - None Observed Road o 7E. DT .~ /4 N -..._ =40o~5'C0'' o ¢ NORTH ALASKA ENVIRONMENTAL CONTROL SERVICES, INC, 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEETNO. /~- ~ OF CALCULATEDS¥ '~ ' '~ DATE CHECKED BY DATE SCALE NAME MAILIN~ ADDRE~ MUNICIPALITY OF ANCHORAGE \, ~, DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE 'T-~ ~ tLE I~- ;2 7 G-i oE3~ U [~"N EW [] UPGRADE LOCATION LEGAL DESCRIPTION Fes ] Well . . I Absorption area Manufacturer ~ f~ ~- r~ Well Dwelhng DISTANCE TO: I Manufacturer DISTANCE TO: No. of Jines I Length of eac~ line I Top of tile to finish grade.., Length Width Type of crib diameter Well DISTANCE TO: ISS DISTANCE foundation Foundation Total length of hnes Material beneath tile Depth Crib depth Building foundation Driller Sewer line Dwelling~ ~ / Mater al ~ IWidth ~ Material Nearest lot line /~¢ [Trench wid~_~) inches inches NO. OF BEDROOMS PERMIT NO. No. of compartments Liquid depth PERMIT NO, Liquid capacity in gallons PERMIT~ E-)O~) Distance between lines Total effective absorption area PERMIT NO. Total effective absorption area Nearest lot line Distance to lot line PERM T NO. Septic tank Absorption area(s) OTHER PIPE MATERIALS SOl L TEST RATING [NSTAELER REMARKS APPROVED DATE LEGAL 72-01~ IRev, ~/7~ F'ERMI T NO. AF'F'LIE:ANT WESLEY TEGELER 3:71"1 E. 84TH. LOE:F~T I ON LEGAL LOT 14 BLK 4. Greenbrook Subdivision TYPE OF SL-IiL RBSORF'TIOI'.~ SYSTEM IS: TRENCH LOT SIZE 9'9999 SC. tLARE FEEl" I"IF~::.::IMt, JM NLIMBER OF BEDROOMS = 4 SOIL RATING ,::SQ FT,-'E,R..='" 200 THE REQUIRED SIZE OF THE SOIL AESOF,'PTION SYSTEM IS: [:,EF'TH= ':" -=. LE~,~,_STH= 72: LS F-: F~ %-' E L [:,EF'TH= 5. THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINF'IELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND, AND THE BOTTOM OF THE EXCAVATION <IN FEET). THERE iS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). PERMIT RPF'LICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE iNSTRLLRTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THRT THE WELL WILL SERVE. BRCKFILLING OF AN'T' SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJEF:T Ti} PR]SEr:LITtON. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWBGE DISPOSAL SYSTEM IS ±00 FEET FOR A PRIVATE WELL OR 150 TO 2E~0 FEET FROM A PUBLIC WELL. DEF'EN[:,ING UPON THE TVPE OF PUBLIC WELL. MINIMUM [:,ISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMLINITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AN[:, CONSTRUCTION DIAGRAMS FIRE AV~3iLABLE TO INSURE PROPER INSTALLATION. PEF:i~"I :[ T E::<F' ][ F-:E$ [:,E£:E~"-'tE:EF." ---~:-1.~ 1 ....... I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BM THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. ~-/MuNICIPALITY OF ANCHORAGE k~./ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~25 L. Slreet. AnCh~rage, Alltkl 99501 2644720 ' SOILS LOG - PERCOLATION TEST ~'"/PEflCO LATION TEST PERFORMED FOR: 5~COVI~ ~. ~)~?fh ?~¢"~ll'l~v'~hip DATE PERFORMED:~¢~ SLoPe SITE PLAN D .OUND wATe . ENCOUNTERED? N C) ~L 0 P E IF YES. AT WHAT DEPTH? -3- 10- 11 '12 13' 14" 15 17 18 COMMENTS PERFORMED BY: Reading Date Time Time Water OraO FER~LATION RATE ~ ~ (minuleili~hJ Alaska 4040 "B" Slreel Testlab · Anchorage, Alaska 99503 Phone (907) 27~1551 April 17, 1981 WoO. #A19708 ( Telecopier (907) 272-574~ Second and Fourth Anchorage Limited Partnership 4611 Business Park Blvd.. Anchorage, Alaska 99503 Attention: Mr. Les Pace Re: Subsurface Investigation for Suitability of On-Site Sewage Disposalt~Lot 4, Block 1;~Lot 2, Block 2; Lot 3, Block 2; Lot 8, Block 2; Lot 9, Block 2; Lot 10, Block 2; Lot 17, Block 2; Lot 19, Block 2; Lot 26, Block 2; Lot 3, Block 4; ~ot 4, Block 4; Lot 6, 'Block 4; ~ot 12, Block 4; LOt 13, Block 4; Lot 14, Block 4, G~eenbrook Subdivision' Dear Mr. Pace: During March and April of 1981, we drilled a 15 foot boring on each of the above lots and placed a perforated, 3/4 inch PVC pipe in each hole so that the water table could be monitored over a period of time and a percolation test run in the hole. The holes were drilled using a Nodwell.mounted, Mobile.B50 drill rig owned and operated by Denali Drilling, Inc. The drilling was supervised and the test holes logged by Mr. Ted Krupka, senior technician, and Mr. O.M. ~atch, geologist with Alaska Testlab. After the holes were drilled, our technician returned on several occasions and checked the water level in' each of the test holes. After a period of time the holes were saturated, left to stand overnight, saturated again and a percolation test run. The percolation test was run by monitoring the'drop in the wa'ret table elevation at 10 minute intervals for a minimum of one hour. The percolation rate listed in this report was computed using the slowest 20 minutes of that percolation test. Included with this report is a'test hole location sketch for each lot an~ a log of the b~ri'ng placed on each lot. The results of this exploration are described as follows: Lot 4, Block 1 The water table eievation measured in the test hole at this site remained fairly constant at about 12 feet. The percolation rate measured on April 15 was 6.0 minute~/inch. Because of the need to keep. the system shallow and the high silt content, we recommend a more conservative design percolation rate of 10.0 minutes/inch. Second and Fourth Anchorage Limited Partnership April 17, 1981 Page Two We recommend 'the sewage system be placed as high as possible~ in the upper 4 to 8 feet, to avoid high water problems during the spring breakup. Lot 2, Block 2 The test hole was placed in'the front of the lot, and this is where we would recommend the on-site sewage disposal system be placed. The lot slopes considerably to the back,' where it appears there may be a high water table. The water table in the test hole was observed at 8.0 feet on March 18, during the peak of breakup then lowered to 10.5 feet by April 9o The percolation rate measured on April 15 was 4.0 minutes/inch. However, we recommend using a more conservative percolation ~ate of 10.0 minutes/inch, due-to the silt content of the soils. We also recommsnd that the disposal system be kept as shallow as. possible. It may require mounding to provide adequate insulation and yet maintain the necessary separation between the system and the ground water level during spring-runoff'. Lot 3, Block 2 The disposal system on this lot should also be located at the front of the lot, near the test hole, as this lot slopes downward to the back. The water level in the test hole was measured at 11.6 feet on April 18, but had measured at 8~1 feet on March 9o The water level was encountered at 11o4 feet on March 15, and the percolation rate on this date was 12.5 minutes/inch. We recommend a mounded sewage disposal system be used to maintain the necessary separation from the seasonal high water level, and adequate insulation of the system. 8, Block 2 ~. When drilling the test hole, no water was observed within the 16 foot depth hole at this site° The following day, April 9, water was observed at 7.6 feet. The water level in the test hole was 8.2 feet on April 15. This water is probably surface seepage from thawing conditions. The percolation rate was measured at 5.5 minutes/inch, however, we recommend a design rate of 10.0 minutes/inch because of the silt content. A mounded sewage disposal system due to the high spring Water level should be used. ' No water was observed in the test hole while drilling, but was found at 7.8 feet the next day, April 9. The water is probably surface seepage from thawing conditions. The measured percolation Second and Fourth Anchorage Limited Partnership April 17, 1981 Page Three rate was 5.2 minutes/inch, however, we recommend a design rate of 10.0 minutes/inch. Since the seasonal.water level is quite high, we recommend a mounded disposal system so sufficient separation is achieved. Lot 10, Block 2 The test hole was located in the southwest corner of the lot, and we recommend that'the sewage disposal system be~placed in this area. The water level is quite near the surface towards the front of the lot. The water level while drilling on April 8 was 9.0 feet, then was found at about 12 feet over the next few days. On. April 14, the percolation rate was measured at 2.5 minutes/inch. We recommend that a more conservative rate of 10;0 minutes/inch be used, due to the silty nature of the upper soils. The system should, be placed as high as possible, in the upper 8 to l0 feet, to avoid conflicts with the seasonal high water, mounding may be necessary for insulation. ~ ~Lot 17, Block 2 No ground water was encountered while drilling on this lot on April 8, or when checked again April 9 and April 16. The measured percolation rate was 5.4 minutes/inch, however, we recommend a more conservative design rate of 10.0 minutes/inch because of the siltier nature of the soils. Lot 19, Block 2 No water table was observed in the 16 foot test hole while drilling on April 8, or on April 9. The percolation rate was measured at 8.9 minutes/inch, however, we recommend a more conservative design rate of 10.0 minutes/inch because of the silty nature-of the soils. The system should be placed as high as possible, as high seasonal water levels were found in the immediate area. Lot 26, Block 2 The test hole was drilled nea~ the center of the 10t April 8, and no water was observed. The test hole was als6 found dry April 9. The measured percolation rate was 6.2 minutes/inch. P , but was at 12.5 feet the following day. The measured percolation rate was 14.6 minutes/inch. .The disposal system should be kept as high as possible to avoid conflicts with the ';, i ! ~ A[/\SKA IIJSiLA}~ Second and Fourth Anchorage Limited Partnership 'April 17, 1981 Page Four seasonal high water. Lot 4, Block 4 The measured water level in the test hole at this site r~mained fairly constant and high. Saturated conditions were encountered at 12 feet while drilling on March t4. The water table elevation was found at 6.8 feet on March 23, at 6°8 feet on April 9, and at 8.3 feet on March 16. The measured.percolation rate was 40 minutes/inch. Because of the high ground water, a shallow mounded disposal system should be used~ Lot 6, Block 4 The high water level at this site necessitates a highly mounded system; or using insulation to provide frost protection while maintaining the necessary separation between the disposal system and the seasonal high water° While drilling, saturated conditions were encountered at 13 feet. On'April 18, the water level was measured at 5.4 feet, then'at 5.1 feet on April 23, the water level had lowered to seven feet by April 9, and then to 7.5 feet on April 15. However, much of this water is probably from surface water and melting seasonal frost. The measured percolation rate was 3.8 minutes/inch, however, we recommend a more conservative design value of 10.'0 minutes/inch. Lot 12, Block 4 Again, the disposal system should be placed as high as possible at this site. The water level in the test hole remained fairly constant at eight feet. The water level was measured at 2.8 feet on March 8, but it appeared that this high level was caused by infiltration of surface water, and was not the true water level at the time. The measured percolation rate on March 17 was 3.4 minutes/inch, but it is recommended the more conservative value of 10.0 minutes/inch be used, because of the high silt content of the.upper soils. Lot 13, Block 4 The test hole was drilled near the center of the lot on April 7, and no water was observed. Again on April 9, no water was detected. On April 15, the measured percolation was 9.0 minutes/inch. We recommend the disposal system be placed between 5 and 11 feet, to avoid the surface silts. Lot 14, Block 4 No water wa's encountered while drifling, on April 7, or when fA'[ ! ~ AIA~;~A TF~I-IA[{ Second and Fourth Anchorage Limited Partnership April 17, 1981 Page Five checked April 9. The measured percolation rate was 4.0 minutes/inch. We recommend a more conservative rate of 10.0 minutes/inch be used, since the upper soil is silt. If you have any questions regarding these tests, please f'eel free to call. Very truly yours, ALASKA TESTLAB carl A. Bassler Geotechnical Engineer Approved.by: Melvin R. Nichols, P.E. Manager CAB/mg Attachments cc: Ralph' Westover, Tryck, Nyman & Hayes Lot 14, Block 4 Table O WO #A19708. Date: 4/8/81 Logged by: O. Hatch Depth in Feet From To 0.0 1 o0 1.0 ', 11.0 11.0 16.0 Soil Description I¢ Brown Peat F.-4, Brown Gravell~ Sa_~q~ Silt, ML, .moist, stiff, occasional cobbles, NP NFS/F-2, Brown Gravelly Sand, SP, trace silt, moist, medium dense, 2" max{mum Set 3/4" perforated PVC pipe to run perc test and to monitor water table elevation. Measured Perc Rate = 4.0 minutes/inch. Recommended Design Perc Rate = 10.0 minutes/inch. Bottom of Test Hole: Frost Line: Free Water Level: 16.0 Feet 1.5 Feet 4/7/81' 4/9/81 - None Observed - None Observed. MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Location (address or directions) (b) Property owner ~../¢x"- ')"~'~ ¢(~'f" Telepho.ne: (home) ~--e~Business.. (c) Lending Institution ~ ~o~ Telephone (d) Real Estate Company and Agent ~ ~x P¢~~ - Telephone .. ~7~~ (e) Mail the HAA to the following address: (or check here I~, if hold for pick up.) L st contact person and day phone number below: 2. TYPE OF RESIDENCE Single-Family I~ Number of bedrooms . 3. WATER SUPPLY Individual Well [] Community ~ Public [] Note: If community wei'l system, must have written confirmation from the State Department of Environmental Conservation attesting tO th legality and status. 4. SEWAGE DISPOSAL On-site ~ Public [] Community [] Holding Tank [] ... Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72°025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as cf the validation date shown below, Iverifythat my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional end 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 r'/¢~ ~/¢/¢ 7~¢_,~,'/;cs/' ~¢¢¢~(~ Telephone Address / ~ ~c~ ~ ~40~ ~ ~/~ Date ~ ~y I~ /)~ 6. DHHS APPROVAL Approved for ~ bedrooms by Approved ~_ Disapproved. Terms of Conditional Approval Conditional Date The Municipality of Anchorage Department of Health and Human Services(DHHS) issues Health Authority Approval cerificated 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 condu'ct inspections or analyze data before a certificate is issued. The MunicipalityofAnchorageisnot responsibleforerrorsoromissions in the professional engineer's work. 72-025 (Rev. 7188) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 A. WELL DATA Well Classification Ct¢''('~ ~ Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments Legal Description: ~,~,~ /~ ~'/A- q Co,..,,,.,;, 6' Date Completed Depth of Grouting If A, B, C, D.E.C. Approved (Y/N) Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Oleanout/Manhole ; Date P ¢0 /...d-'.z.cr ,¢f/,,.-cAe B. SEPTIC/HOLDING TANK DATA Date Installed ,~/~'"/~:~-~ Size I?-~ Standpipes (Y/N) ~ Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) N SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well ? ?,,~' To Property Line ';2 ¢~ ' To Water Main/Service Line ~ ?.5~' To Stream, Pond, Lake or Major Drainage Course Comments No. of Compartments )" Foundation Cieanout (Y/N) Date Last Pumped ,.,h-/(~/'~ ; for Temporary Holding Tank Permit (Y/N) /~, To Building Foundation 5-' To Disposal Field' 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed .~/5--/'83 Width of Field ~ ,¢' ~ Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test /'~r~ Type of System Design ~'r~"~ Length of Field ¢¢" Depth of Field I ~ Gravel Bed Thickness 3' o~r-~,/~ .... Statndpipes Present (Y/N) Date of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: ~ f5-~ To Water-Supply Well To Building Foundation Lot N, A~. To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line t¢' ?~r ~?~'¢ r~¢~ ~,;/~ To Existing or Abandoned System on ; On Adjoining Lots > "~0 ' To Cutback (if present) /4,,¢, D. LIFT STATION h~,~,~ Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA inspection. Signed ._¢~~ ~ ~ Company I:=[~lU~ ~ ~_j~n~c~ ,ff'¢n~/c ¢',¢¢ ,~:, Date ~~y 1~ ~ I)~ MOA No. ~ -O~ ~ Receipt No. Date of Payment Amount: 72-026 (Rev, 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 in effect on the date of this Engineer's Seal DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 3601C STREET, SUITE 316 ANCHORAGE, ALASKA 99503 STEVE COWPER, GOVERNOR 563-6775 DATE: January 6, 1989 PWSID: .210346 To Whom It May Concern: According to the records on file in this office, the GREENBROOK SUBDIVISION Water System is in compliance with the State o? Alaska Orinking Water Regulations. Sincerely, VEC:pkk MUNICIPALITY OF ANCHOPAGE DMSION OF EN%rfRONMENTAL HEAL1/~ DEPARI'MENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR PjLa~LTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Lega/~ Descripticn (include lot, block, subdivision, section, tc~nship, range) Location (add~ess o_~ directi, ons) , (b) Applicants Name~ . . Applicants AddreSs ~l/~_~c~. ~ ~~\~[q~£C_~.~ (c)Applicant_is (check one) Lending Institution ~-~; Cwner/builder ~; Buyer ~ ; Other ~ (explain); (d) [ending Institution ~~ / ~!]-%k. Telephone~p~ (e)I~al Estate Co. & Agent__ Addres~ Telephone 2..Type of ~sid6. nc~ Single-Family Number of Bedrcoms 3. Water S~pplj~ O~er (~s~i~) Individual Well ~ Co~unity ~ Public ~ Note: If cc~munity ~11 system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Is t~he ~11 adeq~]ate for the nua~ber of bedrcca~ specified'in this HAA .~/N) 4. Sewag~ Disposal O~site SKI Pub~io ~ ~o,~nity ~ ~oldi~g ~a~ ~ Is the wastewate~ disposal system adequate fc~ the n~e~ of b~drocrms ~N) [Page 1 of 2] 2-15-84 5. Engirmering Firm Providing Inspections, Tests, Data and Infornmticn I certify that I have checked~ verified~ or conformsd to all MPA HAA C~didelines in effect on the date of this inspection. s ig~d ~ Date ~5/3 ~' ( ENGINEER SEAL) 6. DHEP Approval Approved for___~/' kedr ccn~ Appr ore d. ~-~. ..... Disap~'oved ~--~ Conditicnal~-~ Terms of Conditional Approval The Municipality of Anchorage Department of ~alth and Environmsntal Protection dces not guarantee the continued satisfactory performance of the water supply ~-~/or the wastewater disposal system° This approval indicates that, as of the~ validation date sh~n above, based on the data and information furnished by an engineer registered in the State of Alaska, the water supply ~d wastewater disposal system is safe and func- tional for the number of bedrcoms and type of structurge indicated. (D HEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s [Page 2 of 2] 2-15-84 ae MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (BAA) CHECKLIST - FEBRUARY 1984 Well Classification Well Log Resent (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances f~om Well: To Septic/Holding Tal~k on Lot To ~Nearest Edge of Absorption Field on Lot To Nearest Public Sewe~ Line C leancut/Map~hole Water Sample Collected By Water Sample Test Results MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL. PROTECTIO~ APR 2 '," '? RECEIVED i~,B, or C, D.E.C. Approved(Y/N) Dat~ Completed Yield Depth of G~outing. Pump Set At Sanitary Seal on Casing (Y~/N) Depression A~ound Wellhead (Y/~q) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date Cu~ents B. SEPTIC/HOLDING TANK DATA Date Installed ~-~. ~ Size ~ $~O ~al. No. of C~,~a~tm~nts ~ ' Standpipes (Y/N) \~/~ Air-tight Caps (Y~)~t~.~ Foundation Cleanout (Y~). W~5_ ~p~ession o~ Ta~ (Y~) Nm ~te ~st P~d ~ A P~ing~intenan~ ~n~a~ ~ File (Y~) k~/6 ; for Holding Ta~ High-Wate~ ~am (Y~) ~/~ ~ra~y Holdi~ Tank Pe~t (Y~) Separation Distances f~om Septic/Holding Tank: To Water-Supply We 11 +. i ~C)' ~: To P~operty Line __ ~JO' To Water MaipJSe~vice Line + /0' course ~/O© To Building Foundation To Disposal Field To Stream, Pond, Lake, c~ Major D~ainage Co~t~ nts [Page 1 of 2] C. ABSORPTION FIELD [1ATA Soils Rating in Absorption Strata Date Installed ~.~-~ Width of Field ~' Squar~ Feet of Absorption A~ea Depression over Field (Y/N) Results of Last Adequacy Test J~JJ~J~J' % Type of System Design Length of Field Depth of Field /~' Gravel Bed Thickness ~-~? ~ Standpipes Present (Y/N) Date of Last Adsquacy Test Separation Distance from Absorption Field: To Water-Supply Well * /~ .L~.: To Property Line /0' To Building Foundation '/ 7' To Existing or Abandoned System on Lot ~/~ ; On Adjoining Lots /~/~ To Water Main/Service Line ~/0' To Cutbank(if present) To Stream/Pond/Lake/ar Major Drainage Course .I~ J O© TO Driveway, Parking Area, or Vehicle Storage Area -~©' D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Wate~ Alarm Level at Tested for Electrical Codes(Y/N) Dir~ ns ions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA Counts ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HA_A Guidelines in effect on the date of this inspection. KB1/dL/s i [Pa~ 2 o~ 2] MOA No. DEPT. OF ENVIRONMENTAL CONSERVATION BILL SHEFFIELD, GOVERNOR ~lephone: ~07) 274--2533 Address: 437 E Street Suite 200 Anchorage, AK 99501 April 26, 1984 PWS I.D. #210346 To Whom It May Concern: According to records on file in this office the Greenbrook Subdivision Water System is in compliance with the State Drinking Water Regulations. JFH/msm cc: Laura Ogra AK Environmental Control Services (561-5040) Sincerely, Enav~ironmentai~i~ld officer