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Home My WebLink AboutSOUTH LAKEWOOD HILLS #1 BLK 6 LT 1South Lakewood Hills Block 6 Lot 1 #015-151-29 GRF "ER ANCHORAGE AREA BO"UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME 4bee-j- i�O . W MAILING ADDRESS 2109 ��1*q E GI Dal _ PHONNEZ'9"'S/I LOCATION LEGAL DESCRIPTION–/--, SEPTIC TANK: DISTANCE NUMBER OF FROM WELL MANUFACTURER MATERIAL MATERIAL CD��C✓e �C COMPARTMENTS ' INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH—LIQUID CAPACITY /2-'S� GALLONS. SEEPAGE PIT: NUMBER OF PITS—/—. DIAMETER OR WIDTH z�T_ LENGTH 2? DEPTH— y /to(WON O AV / LINING MATERIAL Z�PCt1fitR16 SIZE: DIAMETER —DEPTH -6-1 DISTANCE FROM: WELL rr�� / ,, TOTAL EFFECTIVE BUILDING FOUNDATION_`?` NE -0-AREST LOT LINE . ABSORPTION AREA (WALL_ AREA) _SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE PIrj .Ut? 6, /I'''Cl CONSTRUCTION BUILDING NEAREST FOUNDATION - LOT LINE CESSPOOL OTHER SOURCES APPROVED_ DISAPPROVED DISTANCES:A�_ 3a_.1"' C 7'-3'3"5y1 INSTALLED BY: GIC! 60 `U'Vd PIPE MATERIAL: all Cce,�✓I i LOT SLOPE: REMARKS: 'SOI' oq�' Form No. EQ -031 DEPTH A90 t DISTANCE FROM: NEAREST SEPTIC SEWER LINE—_TANK_ REMA DIAGRAM OF SYSTEM SEEPAGE SYSTEM _ .Se ��epa GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL. QUALITY PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99503 f TELEPHONE 274-4561 ffY SEWAGE DISPOSAL SYSTEM --y APPLICATION AND PERMIT ?�7L= , :fes!-GDG=i'//L %ll�7D//GddG1i PHONE NAME OF APPLICANT _ MAILING ADDRESS —J' — INSTALLATION LOCATION _,e0—//. LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH lG% ; �� _ SEEPAGE PIT DRAIN FIELD —.—. OTHER —, SOIL TEST RFSULTS 1 L- 11� —_ NOTE. THIS I'ERMI'P 15 NOT VALID COMPLETION DATF ANTICIPATED OUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DFPARTMF.NT OF FNVIRONMENTAL QUALITY AUTHORITY WILL BF SUBJECT TO PROSECUTION. .l2i SEPTIC TANK SIZE �'— TYPE —L_� -- SEEPAGE AREA SIZE.__.— MINIMUM DISTANOES, REQUIREMENTS DIAGRAM OF SYSTEM ,/ / FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT _2 z� —. DRAIN FIELD—_, SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK -_,'SEEPAGE PIT 7— DRAIN FIELD — _ J TO NEAREST LOT LINE. S� O/ /,7� r��p ^�IJ WFLL TO SEPTIC: TANK —L�_— SEEPAGE PIT —Lf////J DRAIN FIELD �fL� / _ ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK _—L�—, SEEPAGE PIT .-,L[== -. DRAIN FIELD /�� j l L j SEPTIC TANK.��y._� SEEPAGE PIT1� DRAIN FIEL / U_ --. TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION S FEET INTO UNDISTURBED SOIL, 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNCR I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 20.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE ' APPLICANT'S SIGNATURE FORM NO. EQ -016 ■■_�■ .5 ■■■ ■ I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 20.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE ' APPLICANT'S SIGNATURE FORM NO. EQ -016 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENUIRONMENTAI., QUALITY Case 3330 "C" Street ANCHORAGE, ALASKA 99503 Performed For , \=3��c•,C2 _Dated Performed( T - Legal Description: Lot_ Block -.Subdivision 50yC This Form Reports Soils Log >C __ 0 __—_Percolation Test; _ Soil Test Must Be Logged To 4' Below Proposed Seepage System Depth Feet Soil Characteristics 3-- 4- 5-- __4-5-- G L" 6 -- 7 -- g_- 9 -- 1 0 -- 1 1 -- 13 -- 14 -- Was 3 -- 14 -- Was Ground Water Encountered? Item, If Yes, At What Depth? Reading Date Gross Time Net Time Depth to H?0 Net Drop rerco l d C ion t(a Le ml nute Proposed Installation: Seepage Pit Drain Field _ Depth of Inlet __Dep1;h to BBonton of Pit or Trench COMMENTS: /,� b - � �/� 7"" � Test Performed BY /[_�z._S tz,�/ Date Certified BY: Date: MUNICIPALITY ANCHORAGE • '� DEPARTMENT OF HEALTH &HUMAN SERVICES R E (_ 1w/"�-" /dpy Division of Environmental Services ? o�C Z J4/4- On -Site Services Section �� /t G / P.O. Box 196650 Anchorage, Alaska 99519-6650 c ( 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 03-5-151-29' HAA # .L Q S 1. GENERAL INFORMATION Complete legal descriptionLot � ,, Block 6, South Lakewood Hills SSD Location (site address or directions) - 11001 Wildwood Drive Bob Ballow 563-4557 Property owner ______ Day phone — _ Mailing address 9601 Sidorof Lane, Anchorge, AK 99516 Lending agency Day phone — Mailing address Agent Janet Gellert/Prudential __ Day phone 345-1290 Address — ---- -- -- Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: a " _ 3. TYPE OF WATER SUPPLY: Individual well XXX Community well _ Public water _ NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xxx Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADE:C attesting to the legality and status of system. 72-025(Re%1/81) Front MOAe21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING Phone `I -7 17034 Eagle River Loop Road No. 264 Address Eagle River, Alaska 99577 Engineer's signature 6. DHHSSIGNATURE V Approved for EQ VA bedrooms. Disapproved. Conditional approval for Additional Comments 0 M ITI r,, Date s / ;L y / -1 I2 �O R ROBERT C. COVNAN i�� O ••� CE -8801 r14;' 'fit `;p-'"•. ''C` :: bedrooms, with the following stipulations: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 72-M (Fv. 1/91) Beck MOA V1 RECEIVED Municipality of Anchorage MAY 24-1996 C*D— DEPARTMENT OF HEALTH & HUMAN SERVICESA,uNICIPAurY OFAND Environmental Services Division ENVIRONMENTAL SERVICE; 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: Le! I_l3 LO cK 6 Parcel I.D.: 491S_ —/ S/ cJ SOUTH �cc✓owtlon Fli��=� A. WELL DATA Well type / i v R__7- IL, If A, B, or C, attach ADEC letter. ADEC water system number —_ Log present (Y/0, ik 0— _ Date completed "" . / 6) 7 3 Total depth —� r'•0.9 F``44ased to _ Yo Sanitary seal O/N)_\/ o` S FROM WELL LOG Date of test u b'c Static water level U —_ Well production v WATER SAMPLE RESULTS: Coliform Casing height (above ground) Wires Wires properly protected &I) _ Y S —_ AT INSPECTION 4 9 b -- ! g.p.m. S 3---g.P.M. Nitrate __ 0 • � rf 7 —_Other bacteria 0 Date of sample: _—s�a ° 9 `I _— Collected by: _ S 81 S ENGINEERING 17034 EagleZuveEcop ijoad No 2.04 B. SEPTIC/HOLDING TANK DATA Lagle River, Alaska 99577 Date installed K I t 3 / 7 3 Tank size ) d _ Number of Compartments __L_ Cleanouts 61N)_ Y+ J Foundation cleanout &/N) _ �/'�`S Depression (Y f N 0 _ High water alarm (Ya r' o Date of Pumping _l oS=� �1 $$ Pumper h . f 1V o w Ss:„ 4 %1"4 S C. ABSORPTION FIELD DATA Date installed V/)3/7-3 _ Soil rating (g.p.d,/ft2 orkTXiRW _!�rn v —System type. Length��a_ s__Width '-L 5 Gravel thickness below pipe —_Total depth _ Effective absorption area 0 10 I_' �, Monitoring Tube present ON) YESDepression over field (/ _ N Date of adequacy test_ a `1 6 Result (Pas�Fail)_ �'� y S — For _— —_bedrooms A I/ " r 11Fluid depth in absorption field before test (in.); 'f /1, Immediately after 60`7 gal. water added (in.): S 3 Fluid depth S` I_ (ins) Minutes later:. 3 � � _ Absorption rate=_6 `1 `1' _—_g.p.d. Peroxide treatment (past 12 months) (Y/N) 21f 72-026 (Rev. 3/96)* If yes, give date D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* E. SEPARATION DISTANCES "Pump on" *Datum Size in gallons SEPARATION DISTANCES FROM WELL ON LOT TO: f INS>A 1L� A / Septic/holding tank on lot l r'hro& ro IW -)3) On adjacent lots Absorption field on lot /oo On adjacent lots Public sewer main Sewer /septic service line N �A S' / Y_ "Pump off" level at* Public sewer manhole/cleanout Lift station 7 0o -- oo � W /4 Al 1.4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: � r / Foundation 4- Property line S t Absorption field S Water main/service line /o Surface water/drainage / co Wells on adjacent lots o SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: i Property line Building foundation O Water main/service line Surface water Driveway, parking/vehicle storage area Curtain drain N O N E u Pic w Wells on adjacent lots / 0 u 4 F. ENGINEER'S CERTIFICATION /0 1- /o /4 - l certify that I have determined thru field inspections and review of Municipal reci�bGthe ababEl�flj�r in conformance with O H idefin s in effect on this date.* Signature—=' ignature /� /�IZJz 1E, En ineer'sName d8E�zT nWJA) Date S- t `I 1+ r HAA Fee $ OD Waiver Fee $ n C Date of Payment/Z l 1 Date of Payment Receipt Number ZJ Receipt Number 72-026 (Rev. 3/96)* Frza - INSPECTION APPOINTMENTS DATE RECEIVED 444�'*4_� TIME TIME - TIME - DATE DATE DATE ❑ Two ❑ Five ❑ MULTIPLE FAMILY INSPECTOR : INSPECTOR INSPECTO, ❑ INDIVIDUAL' *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY o MUNICIPALITY OF ANCHORAGE - MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROT ECTI ONDEPT. OF HEALTH & ENVIRONMENTAL PLOTECTION _ 825 L Street - Anchorage, Alaska 99501 V 1 ENVIRONMENTAL. SANITATION DIVISION JUIV 1 1981 Telephone 264-4720 C ``'' jj�� OF INDIVIDUAL WATER AND SEViIEUIN.W REQUEST FOR APPROVAL DIRECTIONS: Complete all parts on page 1. Incomplete requests will not he processed. Please allow ten (10) days for processing. 1. PROPERTtOWNF:R PHONE [�- MAILINGADD��RESS //,� PROPERTY_ RESIDENT (If different from above) c/ PHONE r Vc 2. BUYER. c ,� PHONE `-� MAILING ADDRESS - 3.. LENDING INSTITUTION—r —r gg PHONE MAI LING ADDRESS C7 xJc r a� ISG_ FPHONE — 4. REALTOR/AGENTIT . MAILINGADDRESS. S. LEGAL DESCRIPTION "d (ac -- 1_.cc s em% STREET LOCATION I%4\rVA 1- � nol ------ 6. TYPE OF RESIDENCE u NUMBER OF,BEDROOMS [$"ANGLE FAMILY EI' Four ❑ Other One Wl—_ ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY - - ❑ INDIVIDUAL' *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) -------- 8.SEWAGE DISPOSAL SYSTEM ---- --- INDIVIDUAL/ON-SITE" YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST 13EFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) 1 � uI 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY - 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ TWO ❑ FOUR ❑ SIX ❑ OTHER 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Sizer If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER j A TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS A4 0 ., 1-1 ❑ APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) [�J_-DISAPPROVED DATE BY 72-010 (Rev. 6/79) MAY -24-99 14:18 FROM -CTE ENVIRONMENTAL 5615301 T-073 P.04/05 F-122 ME Environmental Services Inc. Laboratory Division wowwwwwwwwwamAi, ,fir, 200 W. Potter Drive Orinking Water Rep s Anal siort for Total Coliform Bacteria Anchorage, AK 95510.1605 Y C Tel (907) 562-2343 RE,ID IrVSTRUCTIONS ON REV4FRSF $1p. 664rogL' COLLECTING SANI'4,E fax (907) 561-5301 a PUBLIC W.ATFR SYSTEM l.D. a =FT= = i! PRIVATE WATER SYSTFM 11L'i St'nd Rnu(n Jbt Send lnvorca V 5 & S ENGINEERING me arm ^^r 7834 Eagio River Loop Road No. 204 --- 1 ] Send Re5nIr3�®^ Q Send Invoice'® I i NJ:z..�ve.i.. •..---� �—Z01j4lI M1�R{ 101nMPY SAMPLE DATE OE t=i - . RE Month Day Year SAMPLE TYPE. "�f Routine Q Treated Water cl Repeat Sample (for routine: Nam If! )Q Untreated Water with lab ret. no. ) :j Special Purpose Tirnc Collected SAMPLE LOCATION Collected fly o P,Lo� Ufa. --'gK'—Vjo te4+so( 11:0U4'? .dos C Pianx pool C'ornrnenes: V Analysis shows this Water SAMPLE to be- Sausfactory CI Unsatisfactory q Sample over 30 hours old, results may be unreliable t1 Sample too long in transn; sample should not be over 48 hours old at examination to indicate reliable results Please send naw sample via special delivery mad Pate Recelved� 7 sACTMOLOGICAL WATER ANALYSIS nCOIU) ro1M0•MUG Result: Total Coliform _. " — _ E. Coli membrane Filter Direct Count _,_„_, Q _-- -_ Colonies/100 nil Verifieatiou: LTH ,- BGn . _COLIFIRM — Vecal Coliform Confirmation Final Membrane Filter Res�u�lts `_,�,,,_. �� Coliform/I ml Reported HY _fFaa-2 Date =�1 Time �U____—• bis Avrc-F.C...' 00 -000, anarma Mumbai of too $69 Group ISaaote 0e1'era(a qo Survadlancol ENVIRONMENTAL FACILITIES IN ALASKA. CA.IFURNIA. FLORIDA. ILLINOIS. MARYLAND. MICHIGAN. MISSOURI. NEW JERSEY- OHIO. WEST VIRGINIA ( L Z J Time Received - — Analysis Regan — Analytical Metlmd: -pf—lviembraae Fdtar o MMO-MUG Number of coloracs/ 100 m1. ro� No. Result" Analyst s —1 sz2 Sent to A.D•E.C. Ancb Fbks Jun Fa.en Daw: Time Client notified of unsatisfactory results: Panned Spoke stein Faint sACTMOLOGICAL WATER ANALYSIS nCOIU) ro1M0•MUG Result: Total Coliform _. " — _ E. Coli membrane Filter Direct Count _,_„_, Q _-- -_ Colonies/100 nil Verifieatiou: LTH ,- BGn . _COLIFIRM — Vecal Coliform Confirmation Final Membrane Filter Res�u�lts `_,�,,,_. �� Coliform/I ml Reported HY _fFaa-2 Date =�1 Time �U____—• bis Avrc-F.C...' 00 -000, anarma Mumbai of too $69 Group ISaaote 0e1'era(a qo Survadlancol ENVIRONMENTAL FACILITIES IN ALASKA. CA.IFURNIA. FLORIDA. ILLINOIS. MARYLAND. MICHIGAN. MISSOURI. NEW JERSEY- OHIO. WEST VIRGINIA MAY -2499 14:10 FROIKTE ENVIRONMENTAL 5615301 AILCT&E Environmental Services Inc. �PW./e/'iWr4A C g & F ReU# Client N=ie 4roject Name/A Flamm Sample W Matrix Ordered By a W,W) 992207001 S & S &nginecring A'/A L 1 B 6 SQ Lakewood Hills Ni Drinking Water Pcrz�rae r e r ResgLrs Lf T-073 P 02/05 F-122 Client PO# Printed Date/Time 05/24/99 11:36 Collected Date/Time 05/20/99 11:00 Received Date/Time 05/20/99 12:20 Technical Director: Stephen C. Ede Released BY /711 A / / i Pql. unirc Mesnoa AllmrODle Prep Anel YSis l.lmar5 Dere Dow 1n1T NtAL Coliform 0 c0/100mL SM18 92220 05/20/99 KAP ::i 'Crate -N 0.847 0.500 m0/l. EPA 300.0 10 man 05/20/99 05/20/99 SCL _l NIL icip"ty of Anchorage Department of Health and human Services 825 "L" Street P.O. Box 196650 Anchorage. Alaska 99519-6650 dJa vnr hup: mvnv.a.anchorage.akus S & S Engineering ATTN: Robert Cowan, PE 17034 Eagle River Loop Rd, #204 Eagle River, AK 99577-0000 June 16, 1999 Subject: Waiver Request for SOUTH LAKEWOOD HILLS #1 BLK 6 LT Waiver # WR990035 Lot Line Request for Parcel ID 015-151-29 Dear Engineer: Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater disposal system to the lot line has been approved. The approved separation distance is 0 feet. This waiver approval applies to the current on-site wastewater disposal system and lot line separation only. Any future upgrade to the on-site wastewater disposal system and lot line will require all separation distances to be met or another waiver approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. Sincerely, Jeff Poet Engineering Technician III On -Site Water Quality Program MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR990035 PID# L. I�1-,�"]HA# Ha990232_ Permit # Date Received: June 14, 1999 --\e Legal Description: Lot 1 Block 6 South Lakewood Hills #1 _---_—_ Engineer: Robert C Cowan, PE, S & S RnRineerin&_--__ 17034 Eagle River Loop Road, Suite 204, Eagle River�Alacja 99577L_ Applicant: Bob Ballow ---__-----_ Waiver Requested: Lot line waiver of -0 feet from the west ,prone.rty IinQ to__ the leachfield Criteria: —1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient ---_ E. Horizontal Separation TOTAL: 2. Special Conditions: __-----_ 3. Other: -- ------- Waiver .is Granted: Waiver is NOT Granted: List Conditions, or Reasons for above: ----_ Date: _60 9 99 —_ By: Rec #: 04929/5423 Amount: $_ 115.00 Rev Date Paid: June 14, 1999 _ HEALTHAUTHORITV APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELLINSPECTION & FLOW TEST SITEPLANS ROADDESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSVSTEM DESIGN nG June 11, 1999 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 1, Block 6, South Lakewood Hills 41 ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907)694.2979 FAX(907)694-1211 RECEIVED JUN 14 1999 Municipably of Anchorago DOM Health & Human Services Request you issue a Health Authority Approval on the referenced property and grant a waiver for the separation distance between the west property line and the leach6eld at 0 feet. We do not anticipate any adverse effect on the adjacent properties because it is a right of way. If you require additional information, please contact us. Sincerely, -Ze,/z_ 1- Robert C. Cowan, P.E. RCC/skh 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 fhav onto I,; ., awn 4�w n June 8, 1901. HO -1- S1 REWl ANC I10RAV E, ALASKA 99501 (9011 264,1111 Of -O GE Al, SULLl�1AX 644 /OR D! P 1 i=v I Of 1][ ACf n AS D N I .AL PHO FF(s ON Robert Ballow Star Route A Box 36`X. Anchorage, Alaska 99507 Subjcct: Lot 1. Block 6 South Lakewood Hills Subdivision Approval for the. .ind:i.vidual sewer and water facilities cannot be granted until the following items have been completed: (1.) 'Phe water analysis report needs to be submitted to this offioc from the Chem Lab, 5633 B Street, for our review. (2) The septic tank pumped with a receipt submitted to this office. (3) Expose the well for our. inspection to determine proper construction, also to insure minimum distance requirements are met between the well and sewer system. (4) A cleanout: needs to be installed to the septic tank: and the seepage area. This will need to be reinspected when it has bean completed. (5) An adequacy test- needs to he performed on the existing :Leaching area. This teat w:i.11 determine if the system is adequate according to National Standards. A .Li_st.i.ng of private firms performing the test is enclosed. This report needs to be submitted to this, office for our review. if there are any further questions, plca.se call this office at 264•-472.0. Sincerely, Robert: C. Pratt, R.F. Associate Specialist RCP/1jw tti GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 2798686 Date Received -4�h Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Aopr.oval Requested By: 2 3 Address: A 'la i Phone: Property Owner:-----, wner:--- —. Phone: I - I Legal Description: 4. Location: 5. Type of Facility to be Inspected: Number of Bedrooms:—- 6. Well Data: A. Tyner/ B. C. Construction ( D. 7. Sewage Disposal Svstem:nti A. Installedi'�— B. C. Septic Tank: 1. Size1So� D. Seepage Pit: 1. Size (3)( A J 2. Depth Bacterial Analysis CCr.�1l�tC�i 7 Instal le;r �XLy_1J�� Manufacturer , <,� E. Disposal Field: Total Length of Lines-- 8. Distances: � I A. Well To: Septic Tank r Absorption Area Sewer Lines Nearest Lot line n 4 , Other Contamination — B. Foundation to Septic Tank�Absorption Areaw.Z&—_ C. Absorption Area to Nearest Lot Line @eq.ieEt for Approval of Individual Sewer S Water Facilities Page Two 9. Comments; Approval Valid for One Year From Date Signed reater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certiry Gnat the information contained in this request for approval to be a true and accurate representation of the subject Sewer and water facilities located at; Signed—. -----Date- -- 06-1220 (a) STATE OF ALASKA DER MENT OF HEALTH AND SOCIAL SI "CES Lab. No, DIVISION OF PUBLIC HEALTH DATE BACTERIOLOGICAL WATER ANALYSIS OFFICE - - - ' (i,- _ - - - —1 Records in this office indicate this WATER SUPPLY to be of: PUBLICSEMI-PUBLIC❑ INDIVIDUALO OTHER__ REPORT RESULTS TO__._ O Satisfactory O Questionable O Unsatisfactory Sanitary Status. i ./ s-- NAME - " Analysis shows this Water SAMPLE to be: LT Satisfactory O Questionable O Unsatisfactory. ADDRESS _ ZIP - If an "Unsatisfactory" or "Questionable" status is indicated above CITY - CODE you should take immediate action as recommended below. -- 1. Notify consumerswater.is polluted. Boil orchomically ADDRESSit rr .`I - �r - ( , ' treat this water as outlined in the enclosed leaflet OF SOURCE , r - ' „--- "Drink It Pure." SAMPLE COLLECTED BY_ ' 2. Increase chlorination sufficiently to meet recommended residual standards. Determine source of contamination and take action necessary to maintain DATE COLLECTED` �� I TIME COLLECTED `)-� ohm a safe water supply at all times. Sample Collected From O Kitchen Tap ftl Bathroom Tap ❑ Basement Tap 3. Check chlorination and other mechanical equipment Make certain it is ❑ Other (List) C - functioning properly. • • • r 4. If after checking equipment a disinfecting residual is not obtained, please wire this office for emergency assistance or advisory services. Well O Dug D Driven O Drilled O Bored SOURCE: 5. This is a surface water source and should[ to pollution by man and animals. ❑ Spring ❑Cistern ❑ Other An approved Water supply source should he developed. Dug Well or Cistern Construction: Walls— El Wood ❑concrete 11 Metal OTile OBrick or 6. Improveyour Dspring Odugwell Odrivenwell Odrilledwell Debtern Concrete Top — ❑Woad ❑Concrete ❑Notal ❑ Open Ton 7, Holocene your well to a safe location in relationship to your sewage disposal LOCATION: O In Basement O Basement Offset O Under House system. D see enclosure O In Yard DOther__ Building Sewer Septic8. Sample too long in transit; sample should not be over 48 hours old at DISTANCE TO: or Other Drainage Pipe Feet Tank --Fee - t examination to indicate reliable results, please send new sample. Tile Seepage Cess- - Field - —Feat. Pit —Foot. Pool --Feet Privy. Feet. - - D Bottle Broken in transit, please send new sample. Other Possible - Sources of Contamination— 9. Contact your nearest O Local Health Department or O Alaska Cast Asbestos MATERIAL Building sewer— ❑Iron O Wood ❑Tile ❑Fibre ❑Cement Division of Public Health, sanitation office for bulletins, consultation and assistance. - O Plastic Joint Material —Type _ -- SANITARIAN'S REMARKS - GENERAL: Does Water Become Muddy or Discolored? DYes O No When? Dlameter.f Well ----Depth-- Feet. Well Casing _ Material Diameter—___ Depth Length of Water Dopth. - - - Drop Pipe From Bottom— Feat. PUMP LOCATION: D In Wall 0 Offset In. O In Basement O In Utility - Basement Room - OOnTop ❑Other - Of Well PURPOSE OF EXAMINATION: Illness Suspected? El Yes ON. New Source of Supply? D Yes D No Repairs to System? O Yes D No - - READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE 1 06-1220 (b) 13ACTERIOLOGICAL WATER ANALYSIS RECORD Date Received Time Received P'a Lab. No. Lactose Broth 10cc lode lode load tote (.Oce 0.1cc 24 hours 48 hours --- - - - - Brilliant Green � 24 hours - --- -,: - — 48 hours EMB —Lactose Broth, 24 hrs.--- -Coliform rs. _—Coliform Density -- -MF results- -Detergent Test _ i—Reported by This analysis indicates Coliform Organisms to be: 48 Date _ AGAR Gram's stain —(Most probable No, per 100ce.) 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