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HomeMy WebLinkAboutPARADISE VALLEY BLK 7 LT 2Paradise Volley Lot 2 Block 7 #020-41' 3,-19 Municipality of Anchorage Page_ ! of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION · P.O_ Box 196650 · Anchorage, Alaska 99519-6650 o Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number:- SW0001'80 PlO Number:C20-413-1'9 ' Wastewater System: ~] New. [] Upgrade ' The Thomas Company . . ^~: ' - ' ABSORPTION FIELD . P'.O. B0~ .7~0110. Ea~le Riv6r, AK e~o.e: 6:94-2202 ' .. ' [N~e~°Om(s~)' SDeepTr~ncl} ~ha!lo~'iren~h t2]Bed OMound [3Other ' ":-EGA-Lb DE$(DHIF'/IUN---:---~'---'----"" . so,m.~.g: .' . . -. - · .... - - . · 1 .2 GPO/S4. Ft "-' 4 " 2". ' .' ".'.'. 7' . Paradise Valley'. · 0 ."-. Ft. ~ow.~hip:.._. -'.' ' ' . "'J" '. ' ',.' .' "J - ' " "-- ' 3. 2 Ft' 40 . · WELL;:'. :'.' ~New-- ..'"'~ -- [] uFgrad~"i'.."-- -.. .'.:...; -- .~ . '. ' .~ '...1..:- . '1 ": "' ':"( Ct~ssit~cat,ol](Pd'~aeAB.C)::' .... .' 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':¢:' '' "- :/ ' : " '] :.:'."Lct'..:'~.,.' ~:¢? -. , .¢~ 10 '- "~.5 ! -,' 'N/A: ¢50"'- -- Ano iOTRc~¢ '~P2n~/(~rCr~¢o " ~o..~tio.' >5!'.:.-'.'~-io.h .:~'5" ' .~/~:~ .~./'~. ..' 42 :,-.'... '"'-'1" - 42, '7-' I :44" -.- ':' ' ....... Pump ~ke&t¢~ - EIe~trlc~ I~o~ p~ffom~d by: . ::::Drain-'Cu~ta'n :-,~ None' ~' ": :', ~o~A(~]'] 5~ .LdE :.-'" ]:'. ' -':-7 '~i CePh ~'~""" l:-Munic'ipa.li.ty 'of. Andhora~fb :. '"Remarks:' '3 ' :':?": "::":.' ':. ':':..', '::" !': '''- . :.' ~ .-' - :':":.. -,-'::L...'...: .' L.';. ':>...'':j_./- .¢ .BENCH.. . MARK:'."'' ':"' ' - .' . ' :.'., '- -" ~ .'.": ' ¢ ·..- ' · .'-.- "".- Bottom Step F~om F~O~t ~nl-rano¢ ..... "," : :' ' '"' ' ' . .' ': I :-". .... · .... .' . .. ......................... -.- -.. -.. .-.-..- 0-0.0- · F . - .. . · -. ...... - .... ,-'.-: .:' ,- · ..:. -' - . . -- ' '-. - --.~'~G~S~.;~..~,..: -.- . .--... -...:_ . :- ... --..... .,..:. . ..... · .., ,. .... . .... .... ,... :', . -.- · :.... · ,- · : ..: . . . 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Box 196650 - Anchorage, AK 99519-6660 - 343-4744 On-Site Wastewater Disposal System or Well Inspection Report L Lot .1 Permit Number SW000180 Three PID No. 020-413-19 / v 7 / /' / / / // Alte] / / Site / House / PLAN A: Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O, Box 196650 - Anchorage, AK 99519-6650 - 343-4744 On-Site Wastewater Disposal System or Well Inspection Report Page 3 of 3 Permit Number SW000180 PID No. 020-413-19 102.3 97.7 Gallon [ ~97.5 STEP Tank[ Transport Line 1.25" Distribution Line - 1.25" Opening Size 3/8" No. of Openings - 20 Opening Space~-- 2' 107.5 20' 8' I ] 100.0/ LEGEND C M MH S Geotextile Fabric ~ Drainfield Rock~ Cleanout Monitor Tube Man Hole Septic Tank Vent 40' ~99.9 92.5 PROFILE AS-BUILT ' 1"=10, ' Dopartment of Hoalth and Human Services 825 "L'1 Street P.O, Box 196650 Anchorage, Alaska 99519-6650 Mayor Permit Number: #SW 000180 Date of Issue: 7-20-00 Parcel Identification Number: 020-413-19 Date Started: 8-23-00 Date Completed'. 8-24-00 Is well located at approved permit location? [] Y~ [] No Legal Description; Paradtse Vally BIk 7 Lt 2 Properl~ Owner Name & Address: The Thomas Co. P 0 Box 770110 Eagle River, Alaska 99577 Bo~ehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To Stick-up 0 2 Gravelly silt 2 9 bedrock 9 367 H20 290 305 RECEIVED OCT 24 2000 Municipality ol/~m~/a¢~'t~l.~¢ Dept. Health & tuJtJmen ~/'~ Method of Drilling [] air rotary [] cable tool Casing type: steel Wall Thickness: _025 inches Diameter: _6 inches Depth: 2~0 li2et Liner Type: Dimneter: __ inches Depth: __ Casing stickup above ground: _2 t~et li2ct Static water level (ti'om ground level ): 13 feet Pumping level: 367 t~et alter 12_ hours pumping 1.5 gpm Recovery Rate: 1.5 gpm Method of Testing: air lift Well Intake Opening Type: [] ()pen End [] ()pen Hole [] Screened Start t'eet [] Pcrlbrations Start ['eel Stopped t~et Stopped f'~t (;rout Type: Bentonite 11 S Volume: ] bg Depth: Start 0 feet Sl.epp'cd _+ feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected U pon Completion? [] Yes [] No .Method of Disinfection: Clorine Tablets Well Driller: Alpine Drilling & Enterprises P 0 Box 1~0498 Anchorage AK 9951 Attention: The well driller shall provide a well log to the property owner within 30 days ol'c0mpletion and the properly ;?O'd ZOZCJ-l:,69 ':)NI 'O3 SVNOH/ ]H.L ¥8Z :LO OO-/-'[ RECEIVED OCT 24 2000 MUnicipaliiy of Anchora, Dept. Health & Human 8~,, .,i , ,' I ,,} !.) ..' I ~',/ ~ i DO NOT REMOI.~ Tills Nf)TIC'E, ..... . .~;~0 0 [).4 7'? MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Sfreet, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER'DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Jun 20, 2000 Expiration Date: Jun 20, 2001 Permit Number: SW000180 Legal Description: PARADISE VALLEY BLK 7 LT 2 Design Engineer: 0014 Anderson Engineering Owner Name: The Thomas Company Owner Address: PO Box 770110 Eagle River, AK 99577- ParcellD: 020-413-19 Site Address: Lot Size: 29803 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Date: June 6, 2000 Municipality of Anchorage Department of Health and Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 2, Block 7, Paradise Valley septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 2, Block 7, Paradise Valley Subdivision intends to construct a new [hree bedroom home on the property. We are therefore requesting a construction permit be issued for a new well and se otic system to serve the house The Site Plan shows the location of the new system along with the alternate site. The backup documentation provides the parameters used in the design of the system and provides the configuration of the system. The 100' protective radius from the proposed well location as well as the radii from the surrounding wells is also shown. Placement of the well in the location proposed will still allow room for placement of a septic system on the adjacent Lot 3, Block 7, Paradise Valley Subdivision Several test holes have been placed on the lot in the recent past. All show varying levels of groundwater and bedrock. Our test holes placed in the northeast corner of the lot revealed well graded sands and gravels with some silt with percolation rates between 1 and 5 minutes per inch. Groundwater was encountered at 9' below the surface and stabilized there over the ensuing monitoring period. These results are s~milar to test results in the same area completed by S & S Engineering in 1995 and LeRoy Reid in 1984. We are therefore proposing placement of a 1,250 gallon STEP tank and a shallow 5' wide absorption trench with 4' of gravel beneath the distribution line. The distribution tine will be placed immediately below the organic layer which is 1' below existing ground. The total depth of the system will be 5' below the surface which will aIIow 4' separation from the groundwater level and 6' above the bedrock. The existing drainage on the lot is shown on the site plan and is pnmarily from northeast to southwest at varying grades. The absorption trench will be pla ced parallel to the contours in an area With a grade of less than 10%. Grading will be accomplished once the system is complete so drainage is away from the trench and septic tank but in the direction of the current drainage pattern. If the system is constructed in accordance with our. design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells Lot 2, Block 7, Paradise Valley June 6, 2000 Page Two in the'area or those to be constructed in the future. 2. The system, if constructed as designed, will have no.adverse ~mpact on existing septic systems in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Micoael E. Anderson P.E. Attachments AREA MAP SCALE 1" = 100' THIS PROJECT / / / / 4D, I I IWid~ A~sorption lll~r~cy ' /' / JJLlte~ate/ / ./ /- / L~t 4 ;ed / SITE SCALE 1" = 30' LOT 2, BLOCK 7, PARADISE VALLEY DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home Perc. Rate: 5 Min./Inch Application Rate: 1.2 GPD/SF 5' Wide Trench System 1,250 Gallon STEP Tank 4' Drainfield Rock Pressure Distribution System 3 Bedrooms X 150 GPD / 1.2 GPD/SF = 375 SF of Absorption Area 375 SF/5 LF (Width) X .5 (Red. Factor) = 37.5 LF Trench Length Therefore: Construct a 5' Wide By 40' Long Absorption Trench As Shown on the Site Plan with 4' of Drainfield Rock Beneath the Lateral. Distribution Pipe in Trench Placed at 1.0' Below Original Ground Surface. Total Depth of Trench to Be 5.0'. Mound Over Trench to Provide a Minimum of 3' of Cover. Natural Backfill~~ ( 3 ' Minimum~._J~T~__ .......... ~' -Geotextile Fabric ~ 1" PVC ~w_ ' Drainfield Rock NOTE: TYPICAL WIDE TRENCH SECTION (NO SCALE) Grade Area Over'Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 10' Separation From Lot Line. Minimum 4' Separation From Groundwater. Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: The Thomas Company Legal Description: Let 2, Block 7, Paradise Valle OG/OL GW/SW TESTHOLE NO, I f Subdivision ;LOPE SITE PLAN See Site Plan 11 12 13 14 15 16 17 18 21 Bottom of Hole Bedrock Was Groundwater Encountered? Yes S If Yes, What Depth? 9' L Depth to Water O After Monitoring 9' P Date: 6/5/00 E Reading Date Gross INet Depth To Net Time':Time Water Drop 1 28-May 4:50 6.5" 2 5:00 10 11.5" 5" 3 5:01 7" 4 5:11 10 12" 5" 5 5:12 7" 6 5:22 10 12" 5" Perc. Rate: 2 Min./Inch Perc. Hole Diameter: 6" Test Run Between 3 Ft. and 4 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: MEA. I, Michael E. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 5/28/00 Municipality of Anchorage Depadment of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: The Thomas Company Legal Description: Lot 2. Block 7. Paradise Valley Subdivision SLOPE SITE PLAN OG/OL GW/SW TESTHOLE NO.2 See Site Plan 1 11 12 13 14 15 16 17 18 Bottom of Hole Bedrock Was Groundwater Encountered? Yes If Yes, What Depth? 9' Depth to Water After Monitoring 9' Date: 6/5/00 Reading Date Gross Net Depth To Net Time Time Water Drop 1 28-May 4:55 3.25" 2 5:95 10 8.25" 5" 3 5:06 4" 4 5:16 10 9" 5" 5 5:17 4" 6 5:27 10 9" 5" 21 Perc. Rate: 2 Min./Inch Perc. Hole Diameter: 6" Test Run Between 3 Ft. and 4 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Same Material as Test Hole 1. Performed By: MEA. I, Michael E. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 5/28/00 ANDERSON ENGINEERING P.O. Box 240773 ANCHORAGE AK 99524 (907) 522-7773 Cell (907) 441-4000 JOB ~"'~ ~"' SHE~' NO. OF DATE Z 150.00 O ..i~-:_i ..... i..~..~..-$-.i--...~...-~..i...~-.-b...4..,..~-+. '7.:"1*LL'~-i' P~~i HPS'~i i 1/2 Hp to 1 /2 p i~il ii ii SINGLE PHASE, 60HZ ..,.~. _..~ ..... ~.+.? ..+-+....,.. -.?~..+..~ .................. .?. .z_~.. ~..~ ...... = ........... ~..z ................... ~.. ~ ~ ~ ~ !]?~ ?~ '~'~;2~ 115/2~ VOLT .20 OSI 15 HHF - 9 stage'...-...4..*..~..-; .... i-.i-.-.-b$ ~2 , ~ ~.- - -4--bb--+--~--' '+---~ ............... ~"~"~'"! ..... .".' ~"r"r"r ~; ~ , ~ ...... : : , i' ::: ~ i ~ ~: : ~ ~i~ ~5/92 *-,- ~- ~.-*--*--~ ...................... ~-----~ ....... *'-~---~-----}-'-'+-r -~-'~ .... ~,~ ':xz, 5~5 ~ :::ic~:::.tis...~..i..~..~.."*"*"'+ 4--z--L -i..-i..1 ....... 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Fl' ' '"i-'17~/.'.E 7.iT/'.. 7.f...L.L. ~..i.. :.~...E: ..L. LL .....i...~..i..L ...L~...~. q-+..}-. :--.} ...... 1--.1--.- 2o osI o5 HHT- 5 stage,' '" '{-i {'"" WT{-T'F' ).~ 5.~ 10.~ 15.~ 20l~ 25.~ ~.~ 35.~ ~.~ 45.~ NET DISCHARGE, GPM [ORENCO SYSTEMS, INC {2826 COLONIAL ROAD ROSEBURG, OR 97470 (503) 673-0165~ ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 2, BLOCK 7, PARADISE VALLEY SUBDIVISION GENERAL: The scope of this project includes the procurement and placement of a new 1,250 gallon combination septic tank and lift station and pressure distribution system. Work also includes the construction of a new 40' long x 5' wide x 4' effective depth absorption trench at the location shown on the attached Site Plan. The new trench distribution piping shall be constructed 1' below existing ground level to provide a minimum of 4' separation from groundwater and 6' separation from bedrock. Direct bury insulation may be required to provide the minimum coverage required over the new trench. In lieu of insulation 3' of cover may be placed atop geotextile fabric over the new trench. ConstructiOn shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK/LIFT STATION INSTALLATION The 1,250 gallon septic tank/lift station must be constructed by certified tank manufacturer. Construction shall include an 18" manhole to provide access to the lift station. 2. The septic tank shall be sufficiently bedded to 3revent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. Lot 2, Block 7, Paradise Valley June 5, 2000 Page 2 of 3 6. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. Ail pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: The lift station must be constructed by a Municipally approved septic tank manufacturer. An Orenco 20 OSI 05 HHF-5 pump is recommended. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Cauider, Fernco, or equal). Lot 2, Block 7, Paradise Valley June 5, 2000 Page 3 of 3 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil !ayer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: A minimum of two inspections are required by Municipal Ordinance. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as-built of the completed system. Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L' Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-4744 Parcel I.D. 020-41 3-1 9 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Expiration Date: Lot 2, Block 7, Paradise Valley Location (site address or directions) 5821 Romania Drive Current Properly owner(s) The Thomas Company Mailing address /*2~ ,~'~T:k~ ~-7~,,'[ I (~ Lending agency Dayphone 694-2202 Day phone Mailing address Real Estate Agent Mailing Address Day phone Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well Three ( 3 ) TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] Individual Holding Tank [] Community On-site [] Public Sewer The Municipality of Anchorage Department of Health and Human Services (DHHS) 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 Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. 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 less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municieality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72 025 {Re,;. 01,00)' 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 based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval application show 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. [ 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone Address P.O. Box 240773 Anchorage, AK 99524 522-7773 Engineer's Printed Name DHHS SIGNATURE /..-"" Approved for Disapproved. Michael E. Anderson/ P.E. Date 10/23/00 ~ bedrooms. ~a~..~. ?"~,' ...... - . .'-..- Conditional approval for bedrooms, with the following sti~i~'i~8~'' Additional Comments Attachments: HAA ChecMist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Expiration Date: Oriainal Certificate Date: Reissue Date: 75 025 fRev 01,00)' "- Municipality of Anchorage Department of Health and Human Services R E C E i V Division of Environmental Services On-Site SerVices Section 825"L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 OCT 2 '~ ~000 www. ci.anchorage.ak.us (907) 343-4744 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 2, Block 7, Paradise Valley ParcelI.D.: 020-413-19 A. WELL DATA Well type Private If A, B, or C provide PWSID # __ Date completed _8 / 24 / 00sanitary seal y Total depth 367 ft Cased to 20 ft FROM WE~L LOG Date of test 8/24/0b Static water level '13 ft Well Log y Wires properly protected ¥ Casing height (above ground) > ~4 AT INSPECTION in. ft Well production 1.5 g.p.m WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi Nitrate .5 Date of sample: 1 0/1 8/00 Collected by: B, SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 8/9/00 Tanksize 1,250 STEP Cleanouts Y Foundation cleanout Y Date of pumping New Construction C. ABSORPTION FIELD DATA g.p.m _ mg/I Other bacteria 10 colonies/100 mi NEA gal Number of Compartments 3 Depression over tank N High water alarm __ Pumper N/A Date installed 8/1 0/00 Soil rating (g.p.d./ft2 or fi2/bdrm) 1.2 Length 40 fi Width 5 ff Gravel below pipe 4 Total depth 7.2 fi Effective absorption area 375 ft2 Monitoring tube ¥ Date of adequacy test New Const. Results (Pass/Fail) Fluid depth in absorption field before test in Water added__ Elapsed Time: min Final fluid depth in · Any rejuvenation treatment (past 12 mo.) (Y/N & type) N Y System type 5' Wide Shallow Trench fi __ Depression over field N For bedrooms gal. New depth in. Absorption rate >= __ g.p.d. .If yes, give date N?A 72-026 (Rev. 01/00}* LIFT STATION Date installed 8/10/00 Size in gallons 250 "Pump on" level at 42 in "Pump off" level at 42 in Datum Bottom of Tank Cycles tested New Const.. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot > 100 ' Absorption field on lot > 100 ' Public sewer main N/A Sewer/septic service line > 10 ' Manhole/Access ¥ High water alarm level at 44 in Meets alarm & circuit requirements__Y On adjacent lots > 100 ' On adjacent lots > 100 ' Public sewer manhole/cleanout Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Property line > 5 ' Water service line > 10 ' Wells on adjacent lots >100' Building foundation > 5 ' Water main N/A Drainage > 100 ' Water Service line > 10 ' Curtain drain None Noted F. COMMENTS SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line > 10 ' Building foundation > 10 ' Surface water > 100 ' Wells on adjacent lots > 100 ' N/A Absorption field > 5 ' Surface water > 100 ' Water main N/A Driveway, parking/vehicle storage > 20 ' G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Mi~h2¢l E. Date 10/23/00 Waiver Fee $ Date of Payment HAA Fee $ ,~ ~ · ~ Date of Payment _//') /~- /2L/ Receipt Number ~2 ~"-.~ ~ ~/~/ ~ Receipt Number 72-026 (Rev. 01/00)' 10-22-00 09:38 cROM-CTE ENVIRONMENTAL 5615301 T-844 P.02/84 F-922 CT&E Environmental Services Inc. Laboratory Division 200 W. Potter Drive Anchorage, AK 99518 Tel: (907) 562-2343 Fax: (907) 561-5301 RECEIVED OCT 24 2000 Municloality of Anchorago DepfL Health & I-tumat*~ 8ervice~ CT&E Ref. #: Client Name: Project Name: Client Sample ID: Matrix 1006529002 Client PO#: Anderson Engineering Printed Date/Time: rl/8 Collected Date/Time: L2 B7 Paradise Valley Received Datefl-ime: Drinking Water Technical Director: r]/a PWSID n/a l 9/24/00 09:25 10/18/00 13:30 10/18/00 15:00 Stephen Ede Sample Remarks: AIInwable Prep Analysis Parameter Results PQL Units Method Limits Date Date Init Total Coliform iMF) 10 OB w/out Coil co1/100 mi SM9222B 10/18/00 KAP Nitrate 0.5 U 0.5 mglL EPA 300 10.0 10/18/00 SCL Recelvee - me 0ct,24 8:38AM