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Home My WebLink AboutRIVERVIEW ESTATES BLK 10 LT 9Riv rvicw Lot 9 Block 10 #050-801-08 Municipality of Anchorage page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DiViSION P.O. Box 496650 · Anchorage, Alaska gg5'J9-6650 · Telephone: 343-4744 On-Site Waslewaler Disposal System and/or Well Inspection Report Permit Number:.--~' ~ ~00 J L'/L 5' Pig Number: Pho,,e:~__~7~ No. of Bedrooms:~ O Deep Trench ~ShalJowTrench O.ed UMound UOIher LEGAL DESCRiPTiON so,,..,,..: ~,~ GPD/Sq.F,, WELL: ~ New ~ Upgrade Gravel widlh: ~ Fl. J T - Ft. SEPARATION DISTANCES ~s~p.~ ~ ao~.g u S.T...~. · o Sep,,c Absorplion Uff Ho,ding Pub,ic/PHval Manu[aclurer: Lot S'ze in gallons: Line ~5' J'~' "Pump on" level al:~~~waler alarm al: Remarks: BENCH MARK Reviewed and approved ~y: Dale: }}- }~-~ '~ PERMIT NO. SW000145 PAGE 2 OF 5 Municip. o[i~_y_..of AnchoroQe DEPARTMENT OF HEALTHAND HUFFAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,I], Box 196650 tAnchor~ge, A{~sk~ 99519-6650 · Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEOAE LOT 9,BLOCK 10, RIVERVlEW ESTATES P.I,D. NO. 050--801--08 LOT 8 -10' UTILITY EASEMENT I0' MIN, NEW 1250 GALLON TANK MT2 DBL1 & DRIVEWAY 100' WELL RADIUS SCALE: 1" = 40' LOT 5 ROBERT C. COWAN CE - 8801 PERMIT NO. 5W000145 PAOE ,~ OF 5 Municip. o, Lit oF' A~nc h or'o.ge DEPARTMENT OF HEAl. TH AND HUHAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.D. Box 196650 ·anchor'age, atasko, 99519 6650 · TeLephone: 343 4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 9, BLOCK 10, RIVERVIEW ESTATES P.I.D. NO. 050--801--08 ST1 FINAL GRADE/ C01 MT2 C02 NEW 1250 GALLON SEPTIC TANK C01 96.8' C02 94.0' :INAL ORADE ST2~ 98.6' ~ INSULATION FCO 25.0' 18.0' ST1 15.5' 52.5' ST2 8.5' 40.5' ~DBL1 7.5' 44.0' BBL2 8.5' 45.5' C01 25.0' 54.0' MT1 24.5' .54.0' C02 4.5.5' 81.5' MT2 41.0' 79.5' MT2 -- 85.6' INSULATION C01 -- 90.1' C02 = 89.9' MT1 -- 85.8' · WATER FOUND @ 81.6' 76.6' B.O.H. 11-02-2000 03:19PM FROM CreatiuehKttchenhDesi~n TO 6941211 P.02 Munici ality of Anchorage 'P . Department of .e~a~it~h. sa~n~tHuman Serv,¢es P,O. Box 196650 Anchorage, Alaska 99519-6650 . ~"¢k My~trom htr p://vc, vw.ci.a nch orage,aKus Mayor Pel air Number:. #SW 000145 Date of Issue: 6-2-00 Parcel Identification Number: 050-801.08 Da :e Started: .9-~-00 ' Date'Completed: 914-00_ ls well located at approved permit location? [] Yes [] No Riven/law Estates BIk ~0 Lt g Michelsohn & Daughter Construction 1_~ :al Description: Pr6perty Owner Name & Address: Boi'ehole Data: 750 West Dimond Blvd. Anchorage, Ak 99515 Depth (ti) Soil Type, Thickness & Water Slrata From To Sil~ gmvel & Boutdem ': ':.' ~" ~ 2 ' ~ 27 F~ctu~d bedrock ' 27 B~ck 38 ' 347 RECEIVED ~0V 1 4 2000 iVlunio;paJity ot Anchorage Health & Human ServJcea Method of Drilling [] air rotary [] cable tool Casing tTpe:.steel Diameter: 8 inch6s.' Dept~ 40 feet [ Liner Type: - : Diameter: inches Depth: __ feet Casing stickup above ground: _2 fee~ Static water level (from ~ound level): 39 fee~ Pumping level: 347 feet at~er 24 hours pumping ,65 gpm Recovery Rate: .6..5. gpm Method of Testing: Pump test after hydrofracin.q Well Intake Opening Type: [] Open End [] Open Hole [] Screened Start ~ feet Stopped feet [] Perforations 8tart .-- feet Stopped . feet Grout Type: Bentonite #.8. Volum& 1 bg Depth: Start 0 feet Stopped + fee~ Pump: Iutake Depth' feet ~. ] ~. · pump size' '1/15 Brand:Name :: '..... - , Well Disinfected Upon Completi6n? [] Yes~ [] No Method of Disinfection: CIorine Tablets Comments: Well Driller: Alpine Drilling & Enterprises · P 0 Box ~10496 AnChorage AK 9951~ · ARenlion: Thewelldnllershallprov~deawel og to the property owner thm 30 days of complefion and' the propeny : WATERWELL - TEST PUMP REPORT Well Toml~p~: =~7 . Depth of C~ing: ~0 -~n~m ~ 'To ~" Remark: , Pump ~bmafion 8~fic Water ~el: Pump On " Time '. Water Flow Remarks Level GPM I' NOV O(O 6,~u,, c~p~iity of Ant horsge O~pt. b esltn & Huma~ Services Ir ./ ROBERTC. COWAN, RE. ROBERTA. SHAFER, RE. ENGINEERING$1UDIES AND REPORTS WELL [NSPECTION & FLOW TEST ROAD DESIGN CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: The septic inspections for ghe, referenced property, w?re performed on 6/;7/00 and ~/Iq/oo . Prior to submitting the On-site Wastewater Disposal System and/or Well Inspection Report we are waiting for the ~$~,~ J~R~y to be completed. If we may be of further service please contact us. Sincerely, RoberL C. Cowan, P.E. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER. ALASKA 99577 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Jun 02, 2000 Expiration Date: Jun 02, 2001 Permit Number: SW000146 Legal Description: RIVERVIEW ESTATES BLK 10 LT 9 Design Engineer: 0003 S & S Engineering Owner Name: Michelsohn & Daughter Const. Owner Address: 750 W. Dimond Blvd. Anchorage, AK 99515- Parcel ID: 050-801-08 Site Address: Lot Size: 62333 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] SepticTank [] 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. Received By: ~¢¢-J~/ ~~ Date: IssuedBy: ~/~~ ~)~ Date:¢~2-*O~/'~ Rick Mystrom Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage Alaska 99519-6650 http://www.ci.anchorage.ak.us January ll, 1999 Robert C Tomlinson PO Box 201571 Anchorage, Alaska 99507 1571 Subject: Lot 9 Block i 0 Riverview Estates Subdivision Permit # SW980003 PID # 050-801-08 The subject permit, issued January 8, 1998 by this office for a single family well and/or on-site wastewater system, has expired as of January 8, 1999. A new permit must be obtained from this office for a well and/or on-site wastew~.ter system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Program Manager On-site Services enc: Copy of Permit t PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW980003 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:TOMLINSON ROBERT C OWNER ADDRESS:P.O. BOX 201571 ANCHORAGE, ALASKA 99501-1571 DATE ISSUED: 1/08/98 EXPIRATION DATE: 1/08/99 PARCEL ID:05080108 LEGAL DESCRIPTION: RIVERVIEW ESTATES BLK 10 LT 9 LOT SIZE: 62333 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: ~'' ROBERT C. COWAN, P.E. December 24, 1997 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 SEWER&WATER INSPECT[ON WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAl_SYSTEM OESIGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 9, Block 10, Riverview Estates S/D Request you issue a permit to drill a well and install a septic system to serve the proposed four bedroom house on the referenced property. A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation no groundwater was encountered and after seven day groundwater monitoring, the monitoring tube was found to be dry. This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. There are no points of contamination within the proposed well radius which can be seen on the attached site plan. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/jm DEC 6 1997 Enclosure ¢IRONMENTAL SERVICES DIVISIO, RECEIVED 17034 NORTH EAGLE RIVER LOOP· SUITE 204 · EAGLE RIVER, ALASKA 99577 i" = 60' SCALE SITE PLAN DESIGN r II -' II ~ 0 0 o~°~ PERFORMED FOR: 6- 7- 8- 9- 10- 11 13- 14- 15- 16- 17- 18- 19- 20- Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1 2 3 4 .0 ~'~ ~_..~AI I~.~°wnship, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? SITE PLAN IF YES, AT WHAT L DEPTH? pO E Depth to I Gross Net Depth to Net Reading Date Time Time Water Drop COMMENTS _~r¢~ S & S ENGINEERIN G PERFORMED BY: [ / u~ cag~ ~v~r ~uy ~ga. ~. ~ ' ' ACCORDANCE WIT~Le~,~~ GUIDELINES IN EFFECT ON THIS DATE. PERCOLATION RATE ~ (minutes/inch) PERC ROLE DIAMETER '~-~" TEST RUN BETWEEN ~ FT AND /~ FT I CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: ? / ~ // ¢/ ~ 72-008 (Rev. 4/85) ROBERT C. COWAN, P.E. SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORIS WELL INSPECTION &FLOWTEST SITE PLANS SOIL TEST PERCOL~,TION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 9, Block 10, Riverview Estates S/D December 24, 1997 GENERAL: The scope of this project includes the installation of a 1250 gallon septic tank and a five foot wide drainfield to serve the proposed four bedroom residence or the referenced property. Construction shall be in accordance with the approved site plan and 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 any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Deparlrnent for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP" SUITE 204 · EAGLE RIVER, ALASKA 99577 Page Two Lot 9, Block 10, Riverview Estates S/D December 24, 1997 4. Septic tanks installed with less than 412. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 12. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away fi:om the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. Page Three Lot 9, Block 10, Riverview Estates S/D December 24, 1997 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the//200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Page Four Lot 9, Block 10, Riverview Estates S/D December 24, 1997 Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/OWNER Parcel I.D.' 050-801-08 GENERAL INFORMATION Compleie i~gaJ de§Cription Municipality of Anchorage Department of Health and Human Serviceg-~j~ Division of Environmental Services On-Site Services Section 825 "L" Street Room P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-4744 CERTIFICATE OF HEALTH AUTHORIT~':APF{ROVAL FOR A SINGLE FAMILY 'DWEbblNG ~-, Expiration Date: Lot 9, Block 10, Riverview Estates . Location (site address o~directions) NHN Riverpark Circle CUrrent Properiyowner(s) Michelsohn & Daughter ConstrDayphone 522-3375 Mailing address 750 W. Dimond Blvd., Lending agency Mailing address Real Estate Agent Anchorage, AK 99516 Day phone Day phone Mailing Address 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 4 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 Cedificates 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 Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 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. I fudher 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. S & $ ENGINEERING Name of Firm 17e~l-EaCc, Address Eagle River~ Alaska 99577 Engineer's Printed Name Robe~'t: C. Cowart DHHS SIGNATURE Y, Approved for ¢ Disapproved· Conditional approval for Phone Date bedrooms. bedrooms, with the following stipulations. Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Expiration Date: Original Certificate Date: Reissue Date: 72~025 (Rev. 01/00)* Municipality of Anchorage ~ Department of Health and Human Ser~j~c~..~ Division of Environmental Services I~ ~ C E I V E D On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us NOV ! 4 Z000 (907) 343-4744 MUNICIPALiTy OF ANCHOI~,GE HEALTH AUTHORITY APPROVAL C ~q_t~NTAL SERVtCES DIVISION Legal Description: A. WELL DATA Well type ¢,0_1 Date completed Total depth .~-:~ ft If A~ B, or C provide PWSID # __ Sanitary seal /7''~< Cased to ~ ff Parcel I.D.: O~'~7-)- Well Log ~/'~ Wires properly protected ~-~ Casing height (above ground) L~J in. FROM WELL LOG AT INSPECTION Date of test Static water level ft Well production O, ~'~'-- g.p.m ~ ~ ~ g.p.m WATER SAMPLE RESULTS: Coliform colonies/100 mi Nitrate __ Date of sample: ////0/~ Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Date installed ~ Tank size / ~_--~--~ gal Number of Compartments Cleanouts y¢$ Foundation cleanout y~-5 Depression over tank /~.(0 High water alarm Dateofpumping ~Y/~- -~ A/~--~/ Pumper ..A///~/ c. A SO.PTION.ELD DATA Date installed ~'///-'~/{/~) Soil rating (g.p.d./ft2 or ft2/bdrm) /~, ~ System type mg/I Other bacteria__colonies/100 mi S & S ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Length ¢*-~"~) ft TOtal depth ~ Date of adequacy test ,A'/~'~7/~j 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)/~y/_~,&/¢ ,~l/FT/tJ'k./ Width !~ ft Gravel below pipe ~- ft ft Effective absorption area~r-~) fF Monitoring tube_~ Depression over field ,~,/O For 4 bedrooms gal. New depth_ -- in. Absorption rate >= ~- g.p.d. If yes, give date -- . 72-026 (Rev. 01/00)* D. LIFT STATION Date installed~t ~lto~s "Pump on" level at .&~'~Pump off" level at Datum /~ I Cycles tested SEPARATION DISTANCES in Manhole/Access High water alarm level at in Meets alarm & circuit requirements SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot ~/(~ / ¢' On adjacent lots Absorption field on lot /O7) ,¢ On adjacent lots Public sewer main /k/~ Public sewer manhole/cleanout / Sewer/septic service line ~-¢- Holding tank /-,./ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main ,W Drainage __ Property line Water service line Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line / O /+ Building foundation /O ~ Water Service line / ~/-/- Surface water /d~O '-~ Curtain drain A/O/',/E ~,,,///'~J,qWells on adjacent lots /E)~ /¢ Absorption field ¥ /¢' Surface water /Er~ ~¢- Water main r-,,/ /,.~ Driveway, parking/vehicle storage F. COMMENTS G. ENGINEER S CERTIF CAT ON ¢,."~ ,' ' . ",~ I certify that I have determined through field inspections and ;,~ "~;'~:~-'~3F ':~.: .... ',,.,,, ,,;' ......... ;,~ ....... : ,, ','~ rewew of Mumc~pal records that the above systems are ~n , ~,~/zt,'~,, conformance with MOA HAA guidelines in effect on this date, .., ,-. /' ¢, ¢,\ ,o~,T C. cow^N Engineer's Printed Name /t' &,¢ ¢..¢ 7- "-- . t--Ok/4A '¢0[~', c~-8801 ........ h Date HAA Fee $ Date of Payment ///,,/~'//~'-~ Receipt Number 72-026 (Rev. 0~/00)* Waiver Fee $ ///~' Date of Payment /////¢/~ Receipt Number ~ NOU-20-2000 10:09 S&S ENGINEERING LabonRory Division ,LL---~---- · 90? 694 1211 P.02703 200 W, Pa. lr Dram D.~..~.~.,, W~ter Analysis Rc~ort for Total Coliform Bacteria ~~ TO BE COMPf,.E'~D BY L.~BORATORY r MU~ 1 ue, ~,ul~rl.~ ~ ~-' ...... ~l ~ daie.W~ SAMPL~ o PUBLICWA~RSY~MI,D-e J J J [ I J ~ ~ p~VA~ W&~R SyS~M O MMO. MU~PJmdO To~Collhlm f~ Cd/ Co~I~ ~ VedaS: L~ ~B COL~ . .. Frei Cot~ Con~ ~ NOV-20-2000 i0:10 S&S ENGINEERING 90? $9~ i21i P.03/05 ,~__. CT&£ Environmental Services Inc. Nittate-N 0.500 U Cllenl~ PORt PrinTed Date/Time 11/15/2000 10:14 Collected Date/Time 11/10/2000 8:50 R~eived Dat~me 11/10/2000 17:30 Teeh~lt~ Dl~c~or Stephen C. Ede L/mi~ 13~ D;t= Init 0..~00 mglL EPA 30b,0 10 ra~x 11/10/00 SCL Total Coliform T~TC OB coltl00mL SMI8 9~ lt/li/00 KAP TOTAL P. 03 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On-Site Services Waiver Review Worksheet WR#: WR000098 PID#: 050-801-08 HA#: HA000583 Date Received: November '14, 2000 Legal Description: Riverview Estates, Lot 9, Block 10 Engineer: S & S Engineering, Inc. '17034 Eagle River Loop Road, #204, Eagle River, AK 99577 Applicant: Michelsohn & Dau~Thter Construc?,o**n, ..... Waiver Requested: Lot.linewaiver Permit: SW000'145 Criteria: 1. 2. Special Conditions: 3. Other: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Points: Total: Waiver is Granted: .2( List Conditions or Reasons for above: Waiver is not Granted: ~T~4 Date= I)-- M -oo Rec_~: 06452 Amount: $'115.00 Name of Reviewer Date Paid: '11-'14-00 § >2 _~ :