Loading...
HomeMy WebLinkAboutLATTA LT 4Latta Lot 4 #015-142-53 Municipality of Anchorage Page 1 of 3 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: SW000158 PID Number: 015-142-53 Name: Wastewater System: ❑ New INUpgrade ANN MARIE HOLEN Address: s/D ABSORPTION FIELD 9241 IATTA CIRCLE LoYa 'I Phone: No. of Bedrooms: (907) 562-6006 3 ■Deep Trench ❑Shallow Trench 11 Bed O Mound 11 Other LEGAL DESCRIPTION Soil Rating: G 8 Depth from original gn9.0 Ft. 9.0 rate GPD/Sq. Ft. Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 4 — LATTA 4.0 FL 5.0 Township: Range: — 58Ction: — rill added above original grade: Gravel length: 60 — 0+ Ft. Ft. Gravel width: Number of lines:Dlatanes between lines: WELL: ❑New p Upgrade 2.5 R Cioeeilicatlon (Private, A.B,C): Total De Cased To: Total absorptl.. area: Pipe material: SCH 40 PVC, ANG FL 600 SG. FL ASTM D -3040/F-810 Ddller. Dale Drilled: Static Water Level: Installer. A+ HOME SERVICES Date installed: 9/18/00 Fl lista:Pump Set At Casing Height Above Ground: TANK GPM F. IL SEPARATION DISTANCES 11 Septic 11 Holding ■S.T.E.P. TO Septic Absorption Lift Holding Public/Private ManufooWrer. ANCHORAGE TANK Capacity in gallon.: 1250 From Tank Field Station Tank sewer Lines 100'+ 100'+ — — 25'+ Material: STEEL Number of comportment.: 2 Well Surface 100'+ 100'+ - - - LIFT STATION Water Lot 5'+ 2'+ — — — Size In gallons: 1250 Manufacturer. ANCHORAGE TANK Line 'Pump on' level at: •Pump off Iws1 at High water alarm at: Foundation 5'+ 10'+ — — — 41" 41 45" Curtain Pump Maks & Model: EIectdwl Inspoctlons performed by: Drain NONE KNOWN #20 OSI 05 HHF M.O.A. BENCH MARK Remarks: THE EXISTING SEPTIC TANK WAS COMPLETELY location and Oexription: TOP OF PORCH BEAM — NORTH EAST SIDE ABANDONED. OF HOUSE Assumed Elevation: 100.00 pt ENGINEER'S SEAL o0p0�0 o �4 � ... • ••B:S��pO 000 Inspections performed by: AWWC, INC. Dates: 1st 9/15/00 :....: .. :....:...� ...PA 2nd 9/15/00 3rd 9/18/00 '., e fr A.. •••. esS: Department of Health and Human Services approval f ' —7953 4 G„a '••......... Reviewed and approved by: �! Date: /�'/S' QO �ooa professloo\\ 040p���0 72-013 (Rev. 9/91) MOA 25 PERMIT NUMBER: SW000158 AS -BUILT DRAWING PARCEL INUMBER: 015-11 42-53' \ ( \ LOT 3 I LATTA S/D I E I — \ NEW DRAT IFN ELD I 1 \ o ( LOT 5 I LATTA S/D \ I I � I 2 FOOT LOT UNEI IMS\\\ WAIVER I TH#1 �n EXISTING THREE BEDROOM HOUSE AST FCO CONNECT TO EXISTING 4" LINEI / NEW 1250 GALLON S.T.E.P. TANK WITH DUAL OUTLETS \ -----/— — — — — — --J — --------j 10' UTILBY EASEMENT I / \ / EXISTING DRAINFIELD TO BE — _ USED AS A RESERVE SITE LOT 2 DAVID RING ALASKA WATER & WASTE J.W.M. SCALE: 4 __�� CONSULTANTS, INC. — '• 6901 DEBARR ROAD SUITE 213 • ANCHORAGE, AK 99504 " PHONE (907)337-6179 • FAX (907)338-3246 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ANN MARIE HOLEN (907) 562-6006 2 OF 3 QQ e re A. a ess: LEGAL DESCRIPTION: Q "9� 7953 ao, LATTA SUBDIVISION; LOT 4 •.•„ TMP AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE. ����4000s%0O' PERMIT NUMBER: AS -BUILT DRAWING P015L 1142- 53R SW000158 r FINPL GKADL: - 94.36'+ 5f / 5f2 w TOP OF fANK- AT Wf - 90.36' NSW 1250 GALLON AT WT -896 IM/FK5.f. f', TANK T -69B0' r TOP OF TANK Af OUl f - 90.32' `WKf OF KIPt Af OU11.Ef - 8966' -89.41, ALASKA WATER & WASTEWATER CONSULTANTS, INC. —, . =- ­ 6901 DEBARR ROAD. SUITE 2B' ANCHORAGE. AK 99504 - PHONE (907)337-6179 • FAX (9D7)338-524 PREPARED FOR: PHONE NUMBER: ANN MARIE HOLEN (907) 562-6006 LEGAL DESCRIPTION: LATTA SUBDIVISION; LOT 4 TYPE OF WORK: PROFILE AS -BUILT OF SEPTIC SYSTEM UPGRADE J.W.M. N.T.S. NUMBER: 3 OF 3 N R .... . . .. . .. . .. ... .......... e fr A. arness; 04.. '•, .7953 .•' �o G 44�QaT'ro 004poo�� ,26'37 Page 22 of 29 INSPECTION REPORT MUNICIFAMW OF AINC711ORAGE -- -BUILDMG SAFE'IrY DIVISION 4?00 SOUTI-1 BIZAGAW STREET" ANCRORAGE, ALASKA IMPECTIOAIS: Voiee: (902) 3434300 Ftir. &07) 343-8239 INFOIM4 7YON.- (9" 343-8211 Ar4ME.- EDS ELECTRIC PER WITNUMBER: 00-9011 ADDRESS: 11241 LATTA CIRCLE DATE: 9/21/00 PWONE W.- 227-0476 P110AW #2: LOT- 4 BLOCS: SVBDIVISION., LXITA C0A1'41FN'1-,V SEPTIC STATION PM CALL TOAIURANTCJE TB,1E,1,,MM 7TPE OF #2: 1,1yWPFcJ7()JV. Electrical Final FD Nonon-compliance observed. I_ i Corrections essential fbs explained below. ) CO. approved. Will re-cxiunuic at next inspection. —j I' DO ROL conceal turd! re-U!Spa(Aed. ❑ C.C.O. approved worriments below). COMMENM Reinspecfior;0 e - RECEIVED OCT 12 -2*0 Mu iicipality of Anchor.,-3.gp, Dept. Health & Human! �L; ', INSPECTO-R.- Ai TE., TIWE N CORAECTIOPYS,ME MV)El, PLE-qV,C41 L FOR 1AW1>E(-770Ar 0034 D0,N`0T1Y,�i1j0VL, IWISAWYCE. Permit Number: SW000158 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 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 09, 2000 Expiration Date: Jun 09, 2001 Parcel ID: 015-142-53 Legal Description: LATTA LT 4 Design Engineer: 0041 AK Water & Wastewater Consultant Site Address: 011241 LATTA CIR Owner Name: Ann Marie Holen Lot Size: 19895 SQ. FT. Owner Address: 11241 Latta Cir. Total Bedrooms: 2 Permit Bedrooms: 3 Anchorage , AK 99516-1651 This permit is for the construction of: Disposal Field [�] Septic Tank Holding Tank F-] 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: Issued By: Date: 6— Date: -00 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On -Site Services Waiver Review Worksheet WR#: WR000032 PID#: 015-142-53 HA#: Date Received: May 30, 2000 Legal Description: Latta, Lot 4 Engineer: Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2-13, Anchorage, AK 99504 Applicant: Ann Marie Holen Waiver Requested: 2 foot lot -line waiver Criteria: 1. Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation 2. Special Conditions: 3. Other: Total: Permit#: Waiver is Granted: X Waiver is not Granted: List Conditions or Reasons for above: SEE BA16-lNEER Is #17iit(NE17 L EflER me TUST1P/C4T1PA1 Darer? HtOK 9. 00 Date: 6 — 9= X Rec#: 05875 Amount: $115.00 By: 12/91/ Name of Reviewer Date Paid: 5-30.00 Municipality of Anchorage Department of Health and Human Services 825 "U Street Rick Mysvom. P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor litip://www.ci.atictiorage.ak.us June 12, 2000 Jeffrey Gayness Alaska Water & Wastewater Consultants, Inc. Subject: Waiver Request for Latta, Lot 4 Waiver Request #WR000032 Parcel ID #015-142-53 SW000158 Dear Mr. Gamess: Your request for a waiver of the required 10 feet horizontal separation from the on-site wastewater disposal system to property line has been approved. The approved separation distance is 2.0 feet. This waiver approval applies to the existing on-site wastewater disposal system to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. Sincerely, Daniel J. Roth Civil Engineer On -Site Water Quality Program ALASKA WATER F& WASTEWATER CONSULTANTS, INC_ May 9, 2000 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Upgrade Design for Latta Subdivision; Lot 4 To whom it may concern: The existing 3 bedroom house is currently served by a private well and septic system. The existing drainfield is in a state of failure and is in need of an upgrade. A test hole was excavated on the property. The proposed septic system will be designed within the 30 foot radius of this test hole. We are proposing that a 1250 gallon S.T.E.P. tank and a deep trench type drainfield be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached is a log which shows the soil classifications, groundwater monitoring, and the percolation test results. The soils below the organic layers are a GM material from 1.5 feet to a depth of 15 feet (bottom of test hole). No groundwater was encountered during the excavation of the test hole. On 4/27/2000, groundwater was at 14.75 feet. A percolation test was performed between the depths of 6.5 feet to 7.0 feet which had a percolation rate of 11 minute/inch. It is our opinion that due to the overall appearance of the soils, a application rate of 0.8 gallons/day/ft2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: I 1 minutes/inch b. Allowable Application Rate: 0.8 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 563 ft2 f Total Depth: 9 feet (maximum, at any point) g. Effective Depth: 5 feet h. Width: 2.5 feet i. Reduction Factor: N/A j. Minimum Length: 60 feet long k. Effective absorption area = 600 ft2 6901 Debarr Road, Suite 2B — Anchorage, AK 99504 — Ph: (907)337-6179 — Fax: (907)338-3246 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As can be seen on the attached topography site plan, the average topography of this property is generally flat; in short, there are no slope concerns. 5. LOT LINE WAIVER: We would like to request that your department issue a property line waiver on the subject property for separation between the drainfield and the northeast property line at two (2) feet. There are no wells, septics, or water lines that have been encroached upon. We do not anticipate any adverse effects by this waiver. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179. Thank you for your 10 NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, a soil log, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B —Anchorage, AK 99504— Ph: (907)337-6179— Fax: (907)338-3246 —__—��—_--y-----_---- I I W LOT 7 LATTA S/D ( ER�7 I � ULOT 6 ) LATTA S/D 0, ( P4 1V LOT 1 DAVID RING 1 E. 112th VENUE— LOT 2 / LATTA S/D , / LOT 28 RON'S K1SnHc THREE DROOM HOUSE LOT 3 LATTA S/D P I LOT 1 t i LATTA S/D �10 PROPOSED SEPTIC 1 SYSTEM. SEE DESIGN PAGE 2 OF 2 c _---- — —J L—_.— _._ _— ' -- ---------------I APPROXIMATE I LOCATION OF I EXISTING SEPTIC SYSTEM I I I FIELD VERIFY WELL LOCATION I LOT 2 DAVID RING ALASKA WAfi , R & WASTKWATLR K o W J.W.M. - CONSULTANTS, INC.= -- SCALE: 6901 DEBPRR ROAD, SUITE 2B' ANCHORAGE. M( 99504 •PHONE (907)337-6179 • FAX (907)338-3246 1 ,� — 1 �D' PREPARED FOR PHONE NUMBER: PAGE NUMBER: ANN MARIE HOLEN (907) 562-6006 1 OF 2 LEGAL DESCRIPTION: LATTA SUBDIVISION; LOT 4 TYPE OF WORK: SITE PLAN FOR SEPTIC SYSTEM UPGRADE i f J iJ f y ar Ss. it s C 7953 ' �0 JIi�1, ems.•'' .... '� cc0,�> f I " LOT LATTA S/D \\ 11 i i LAI S/D \\ \\ WI I II t r, ( P4 1V LOT 1 DAVID RING 1 E. 112th VENUE— LOT 2 / LATTA S/D , / LOT 28 RON'S K1SnHc THREE DROOM HOUSE LOT 3 LATTA S/D P I LOT 1 t i LATTA S/D �10 PROPOSED SEPTIC 1 SYSTEM. SEE DESIGN PAGE 2 OF 2 c _---- — —J L—_.— _._ _— ' -- ---------------I APPROXIMATE I LOCATION OF I EXISTING SEPTIC SYSTEM I I I FIELD VERIFY WELL LOCATION I LOT 2 DAVID RING ALASKA WAfi , R & WASTKWATLR K o W J.W.M. - CONSULTANTS, INC.= -- SCALE: 6901 DEBPRR ROAD, SUITE 2B' ANCHORAGE. M( 99504 •PHONE (907)337-6179 • FAX (907)338-3246 1 ,� — 1 �D' PREPARED FOR PHONE NUMBER: PAGE NUMBER: ANN MARIE HOLEN (907) 562-6006 1 OF 2 LEGAL DESCRIPTION: LATTA SUBDIVISION; LOT 4 TYPE OF WORK: SITE PLAN FOR SEPTIC SYSTEM UPGRADE i f J iJ f y ar Ss. it s C 7953 ' �0 JIi�1, ems.•'' .... '� cc0,�> / I LOT 3 \ _ LATTA S/D Ld PROPOSED PRESSURIZED DRAINFIELD UPGRADE. EXCAVATE A TRENCH THAT IS 9 FEET DEEP U �+ MAXIMUM BY 2.5 FEET WIDE BY 60 FEET LONG. I I / Q g ADD 5 FEET OF CLEAN, WASHED SEWER I w ¢' \ DRAINROCK. THE DISTRIBUTION LINE IS TO BE g 1-1/4 INCH SCH 40 PJC WITH 1/4 INCH y�T DIAMETER HOLES SPACED 2 FEET ON CENTER. _ 1 LOT 5 I \\ I o LATTA S/D I \ I I JIM S\ 2 FOOT LOT LINE TH#� \ \ WAIVER REQUESTEDI y - EXISTING THREE BEDROOM HOUSE j / FCO I CONNECT TO / EXISTING 4" UNE I I a / PROPOSED 1250 ` I I GALLON S.T.E. P. TANK / WITH DUAL OUTLETS / 10' UTILITY EASEMENT / \ � EXISTING SEPTIC BE TANK TO BEABANDONED EXISTING DARE ETO — — COMPLETELY USED AS A RESERVE SITE A NOTE: THE CONTRACTOR SHALL HAVE THE NORTHEAST PROPERTY LINE AND THE 100' LOT 2 WELL RADIUS FOR THE REFERENCED DAVID RING - PROPERTY FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. DATE: 5/9/2000 006��0 o QF pp �. •• ... ��00 DRAWN BY: ALASKA WATER & WASTEWATER K.D.W. �p� p * �it000 SCALE: �„ — 40, CONSULTANTS, INC. _- ....... D 6901 OEBARR ROAD, SUITE 2B • ANCHORAGE. AK 99504' PHONE (907)337-6179 • FAX (907)338-3246 D PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ANN MARIE HOLEN (907) 562-6006 1 2 OF 2 f re A. Garness; Q Q49s••, C —7953 LEGAL DESCRIPTION: ; LATTA SUBDIVISION; LOT 4.• c0oQQ ..•• ' 44�peaP" eeS100, p�O�OppOo TYPE OF WORK: DESIGN FOR SEPTIC SYSTEM UPGRADE ALASKA WATER & WASTEWATER CONSULTANTS, INC. 690PHONEDEBA(907) 33756 9 * FAX (907 38 32469504 SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: LATrA SUBDIVISION; LOT 4 PERFORMED FOR: ANN MARIE HOLEN DATE PERFORMED: (907) 562-6006 DEPTH TEST HOLE #1 (feet ORGANICS 1 2 DATE DRY 4/14/00 DRY SOIL CLASSIFICATIONS 4/27/00 13.0 ` s 1O oo GW ORG 6" — 2 2:29 30 3 3/16" 2 13/16" 3- GM CL 4 4 30 3 1/4" 2 3/4" GC OL — 6" — 6 SW 30 MH 5 eo �0. a SP CH SM / OH 6 SC 7 GM 8 9 10 11 21314 12- 13- 14 15 B.O.H. 61718 16- 17- 181 19 20 COMMENTS: DEPTH TO GROUNDWATER DATE DRY 4/14/00 DRY 4/21/00 14.75' 4/27/00 13.0 ` s 1O oo DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 4/17/00 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING 7.0 FT. 6" — 2 2:29 30 3 3/16" 2 13/16" 3- 4 3:00 30 3 1/4" 2 3/4" 5 3:01 — 6" — 6 3:31 30 3 1/4" 2 3/4" PERCOLATION RATE 10.9 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 6.5 FT. AND 7.0 FT. PERFORMED BY ALASKA WATER & WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFO M D IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON DATE: LT28 N'S E. 112t g� LOT 2 J LATTA S/D a U LOT 8 (7 LOT 7 LATTA S/D TTA 5/D C Ep�1Q 3 AIR EAS LATTA S/D LOT i S/D W. SE C ~ LOTS LATTA S/D I LT5 LA S/D / 0`2F] VERIFY Ll LOCA N ,QO LOT 1 DAVIDG OT 2 DA ID RING DATE: 5/ /2000 BY: K.D.W./ W.M. ALE: - 1 9 0 6901 DEBARR OAD. SUITE 2B ` A HORAGE, M( 99504 •PHO (907)337-6179 •AX (907)338-3 PREPARED ORPHONE NU ER: PAG D ANN MARIE HO N (907 562-60 6 1 OF LEGAL D SCRIPTION: LA TA SUBDI SIGN; LO'/4 TYPE OF WORK: POGRAP ICAL DR ING 'UNICIPALITY OF ANCHORAGE Heal-.., and Environmental Protect. )n Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 ---------- INSPECTION REPORT ON-SITE SEWAGE DISPOSAL, SYST'kJA - NAME._ S%\m�+S— �Q= L' __ MAILING ADDRESS �"�'"�,� ����� �Ct�' — PHONE 3-5 -5 LOCATION hA-1-_���T— LEGAL DESCRIPTION__ SEPTIC TANK: DISTANCE 4rOP,wC`� BOO �'^ NUMBER OF FROM WELL__— MANUFACTURERsJkOS�� --_MATERIALS $CR-��-RS _COMPARTMENTS_ INSIDE LENGTH__ INSIDE WIDTH. LIQUID DEPTH - LIQUID CAPACITY\.00IO GALLONS. TILE DRAIN FIELD: 9mg urc-.EL- 100{ 3 1 TOTAL LENGTH p 1 DISTANCE f -ROM VIA -LL _---__—FOUNDATIONA �I -NEAREST LGL LINE- _V5 -_ _..__OF LINE '4"&-- # Of Lines ©NE___ DISLANCE. BETWEEN LINES "�\�X—TRENCH WIDTH5_s IN. TOTAL EFFECTIVE ABSORPTION AREA _ S' �. -__— _— SQ. FT. LENGTH OF EACH LINE L 1 0 DEPTH OF FILTER DEPTH: TOP OF TILE l -O FINISH GRADE.: -_7 (o _MATERIAL BENEATH TILE` IN. ABOVE TILE _IN, SEEPAGE= PIT: DIAMETER—_.__OR WIDTH--., LENGTH— DEP-1.1-I _�_--�—�— Log Crib _Rings, Crib Size: DIAMELER__.._DEPTH.__DISTANCE FROM: WELL - TOTAL EFFECTIVE 13UILDlNC FOUNDATION _ , NEAREST LOT LINE __— . ABSORPTION AREA (WALL_ AREA) SQ. FT. Well Class: Depth: Well Distance To: Lot Line _ Bldg: _ Sewer Line: Pipe Materials: �'�j _ j # of Bedrooms: 3 6,R. i ]Installer: Remarks: 1 t) I i 1 1 ! I I DATELLZ APPROVED 1 -I_..r 1 I- -- M -W DRILLING, INC. DRILLING LOG Well Owner Location (address of: Township, Range, Section, if known; or distance main of Well I JJ Size of casing—_'Depth of Hole l' `' feet Cased to feet Static water level ft. (68Dv@) (below) land surface. Finish of well (check one) open end Screen ( ) ; Perforated Describe screen or perforation Well pumping test at —gallons per (}lour) (minute) for hours with ' ft. of drawdown from static level. Date of completion WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness i TO TO TO r,J��,i; ;�', •;�txc'.I. jq�1 «ir'� C�:rtifi�d .�oab_ oi ,crti 2 —STATE TO TO TO TO TO U TO . -) 7 1 :,. TO TO TO r,J��,i; ;�', •;�txc'.I. jq�1 «ir'� C�:rtifi�d .�oab_ oi ,crti 2 —STATE � ���������� DEPHRTMEIs. T ( HEHLTH HND ENVIRONMENTHL OTECTION er 2516 E /dDOR RD / HNCHORHQE/ HK ~77 �� /'�~^\/o PERMIT NO ( 76907 ) ,.PPLICHNT JF�|ESFm k I EY 4425 IRENE DRIVE ]]]-7848//~_}7 LOCHTION LHTTH COURT LEGHL L4 LHTTH SUBD LOT SIZE 20000 SQUHRE FEE/v TYPE OF SOIL HBSORBTION SYSTEM j_:,;.; TRENCH 'I. MUM NUMBER OF BEDROOMS � ] SOIL RHTING (SQ FT/BR)� 190 THE REQUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS� I li-A ::,JL. C;J, �If: ���... .... 11� THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTHNCE BETWEEN THE SURFHCE OF THE GROUND HND THE BOTTOM OF THE EXCHVHTION (�N FEET) THERE IS NO SET WIDTH FOR TRENCHES THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRHVEL BETWEEN THE OUTFHLL PIPE HND THE BOTTOM OF THE EXCHVHTION (IN FEET) ���� .... .... �K����� EITHER H CLHSS I OR II NSF HPPROVED PLHNT MRY BE INSTALLED H CONTINUOUS MHINTENHNCE HGREEMENT IIF H MHINTENHNCE HGREEMENT IS NUT KEPT CURRENT YOU MHY BE REQUIRED TO ENLHRGE THE SOIL HBSORPTION SYSTEM HND/OR YOU MHY BE SUBJECT TO PROSECUTION IF H CLH5S I SYSTEM IS USED THE LENGTH IS IF H CLHSS II SYSTEM IS USED THE LENGTH IS ..... BHCKFILLING OF HNY SYSTEM WITHOUT FINHL INSPECTION HND HPPROVHL BY THIS DEPHRTMENT WILL BE SUBJECT TO PROSECUTION I CERTIFY THHT i� I HM FHMILIHR WITH THE REQUIREMENTS FOR ON—SITE SEWERS HND WELLS HS SET FORTH 8Y THE MUNICIPHLITY OF HNCHORHGE 2� I WILL T. L. THE S;STEM IN HCCORDHNCE WITH THE CODES ]� I UNDERSTHND THHT THE ONITE SE�1:1.R SYSTEM MAY REQUIRE ENLRRGEMENT IF THE RESIDENCEIS REMODELED TO INCLUDE MORE THHN ] BEDROOMS GREAUR ANUUlt/1U ARLA boHcwGll Department of Environmental Quality 3330 "C" Street FIS 9B u Anchorage, Alaska 99b03 SOILS LOU - PEROLATION TEST Performed for_ _Date Perforniad 8-1(-'7,5- Legal Description:���- ¢ /�����--�� _- _ This form reports: Soils log >C_ i Perco ation test Depth Feet 6�1f- 2 _ 2edclr5 h brzuwn cv/ rr� s c� a� O 2CrCe./7 iG.S 3- `l - -5a.*-* G¢aud i6e) Grzaveuy Gross Time Net Time Depth to Water Gvn�a r ��5 %2Clt >G�Um ��r.reYv 6 - 0 rz (e,1ses or/ 57/11- anter 7 - erne da'Y2e&1 eMYL. 8 - dame Labbla e."z70 ma7r 1 gab rzuundcd �o �u6an'c .'141z, 9 Loci ,na,%s fr rva 1�\ 4-\ N5 0 10 -.` SJ 0 12 - 13 - 14----�--- t3cit;m ��== ecu- ,_� ��c �_—�2y� 14' Was ground water encountered? /fid, If yes, at what depth? (teadiny Date Gross Time Net Time Depth to Water Net Drop Percolation rate minuLe. Proposed installation: Seepage Pit Drain Field Depth of Inlet _ _ _ Depth to hottom of pit or trench _ COMMENTS: ti Performed [3y:1rJr1/� ;F. Cerfied QY:�s�iL Uate; -..��- �5y78 g 70 i'. Municipality of An o��7arge On -Site Water and Wastewat r ro r6 n j-, (907)343-7904 :,F ti z Certificate of On -Site Systems 15 Parcel I.D. 015-142-53 Expiration Date: C — •.� 1. GENERAL INFORMATION Complete legal description LATTA; LOT 4 Location (site address) 11241 LATTA CIRCLE 'ANCHORAGE, AK 99516 Current Property owner(s) CHARLES & ELISE STRAUSS Day phone 346-2789 Mailing address 11241 LATTA CIRCLE 'ANCHORAGE, AK 99516 Real. Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 4. TYPE OF WATER SUPPLY: Individual Well lid Individual Water Storage ❑ Community Class _ Well ❑ Public Water System ❑ Waiver/Variance request Received by: osa ,o berelease, to,. COSA Fee $ 1521�6 Date of Payment 1 131 (1 Receipt Number t511lka COSA# mcA611io2 TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank ❑ Community ❑ Public Sewer ❑ Date: 4k A requested by the engineer. Waiver Fee $ _ Date of Payment Receipt Number Waiver # 5. STATEMENT OF 111109l 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 Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Garness Engineering Group, Ltd. Phone (907) 337-6179 Address 3701 E. Tudor Rd., Suite 101, Anchorage AK 99507-3246 Engineer's Printed Name Jeffrey A. Garness Date In conducting this evaluation, GEG provided an engineering evaluation ofthe well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industrypractices. The reported results describe the condition ofthe systems on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the systems. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systems; therefore, GEG makes no warranty (express or implied) regar^frtg the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail. The content of this report is for the sole benefit of the person/party who retained GEG. Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the person/party who paid for this report 6. DSD NATURE r� 7SI System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for 0 Y OF 1 �Nc'yo rr'- `� ON-SITE WATER AND WASTEWATER a �o3 PROGRAM bedrooms, with the following stipulations: 9))) SERV)G������ Original Certificate Date: J%J The AWIci m gf Chordga Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representatie given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 9-1-12.doc If more than 1 septic system is on the lot: COSA Checklist # _of Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: LATTA; L4 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N A Date completed 10/17/77 Sanitary seal (Y/N) YES Total depth 111 ft. Cased to 110 ft. FROM WELL LOG Date of test 10/17/77 Static water level UNK ft. ParcellD: 015-142-53 Well Log (YIN) YES Wires properly protected (YIN) YES Casing height (above ground) 12+ in. AT INSPECTION 6/1715 60.5 ft. Well production 6 9•p -m- 4.9 g.p.m• WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Nitrate ND mg./L. Collected by: GFG ltd Arsenic: NO ug./L. Date ofsample2Lt5 AA B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 9/18/00 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date of pumping 5/7/15 Pumper A+ HOUSING C. ABSORPTION FIELD DATA Flow EXISTING GRAD 10/11/1977 190 DEEP TRENCH Date installed , 9/18/00 Soil rating (g.p.d./feo/bdr 0_8 System type DEEP TRENCH 48 e 6 Length 60,E i ft. Width 2.5 ft. Gravel below pipe 5.0 ft. *44 � 574 Total depth *8.61 ft. Eff. absorption area 600 ft2 Monitoring tube YES Depression over field NO Date ofadequacy�t 'i.**6/26/15 Results (Pass/Fail) PASS For 2 bedrooms t','. Fluid depth in absorption Meld before test 0 in. Water added 359 gal. New depth N 11 in. Elapsed Time: 135 min. Final fluid depth 8_5 in. Absorption rate >_ 300+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date — **PER GEG INSPECTION ON 6/4/2015 THE 2000 TRENCH WAS 100% FULL AND IN A STATE OF TECHNICAL FAILURE. ON 6/15/215 DIVERTER VALVE WAS SWITCH TO 1977 TRENCH. TESTED 1977 TRENCH ONLY. **PER 2000 M.O.A. ELECTRICAL D. LIFT STATION (STEP) INSPECTION. Date installed 9/18/2000 Size in gallons 1250 Manhole/Access (Y/N) YES "Pump on" level at 41 in. "Pump oir level at 41 in. High water alarm level at 45 in. Datum BOTTOM OF TANK Cycles tested 3+ Meets alarm & circuit requirements? **YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAtft station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots *79' Public sewer main 75'+ Sewer/septic service line 25'+ Public sewer manhola/deanout 100'+ Holding tank Animal containment areas—_ ---.50 '+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line *2'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *SEE MOA WAIVER #OSP151012 FOR LATTA; LOT 3 G. ENGINEER'S CERTIFICATION i certify that l have determined through 8eldinspections and Y* review ofMuniclpal records that the above systems are in "' """" conformance with MOA COSH guidefines in effect on this date. .....:... Q .J rey G Hess: Engineer's Printed�me JEFFREY A. GARNESSJEFFREY A. GARNESS �Q g� ` C 7 53 Date �I3! / S oadpr et� . (Rev. 11/05) o � dU zn i Og m g fl 45 fl m� i& -H <w€�� wo gog Q$ �cm4 = I WU �Z�o Wg��azs FQ LL2 U WiY ¢2CCG QC O e z HWH Zc� g FSWzez�rc m M€ @ oz¢ez 3�ogr€ € � ifl' umineks=_Menr �; so hex- !i �Fi E s• W <S 3z=m Qin 0 30.3 N m EX1sTING cg N �. ; n HOy9E m n .90:3 23.4' ri LU i _ N W � Y U m z r m QC7 tp W U W QQI m m £o. BOL =pN T qU zOgLtO i36 V127 � U 14 0 �v w o ZZ. m y CD F:a �raQO Wm vpppo'� 0 0' MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES a Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 (907)343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING Parcel I.D. # 015-142-53 HAA # 1. GENERAL INFORMATION Complete legal description I ATTA 5URDIVI510N• LOT 4 Location (site address or directions) 0941 1ATTA CIRCLE ANCHORAGE AK 99516 Property owner ANN MARIE HQLEN Day phone (907) 562-6006 Mailing address 9241 UATTA CIRCLE ANCHORAGE AK 99516 Lending agency Mailing t Agent — Day Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 XXX Day phone 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 ADEC ing to the legality and status of system. 72-025 (Rev. 1191) Front MOA #21 Computer version �)C., iJ/po Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $7, at, or prior to, closing for the enoineerina services provided. 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 inspe on, the on-site water supply and/or wastewater disposal system is in compliance with all Municipa1� d State codes, ordinances, and regulations in effect on the date of this inspection. j Name of Firm Address 690' Phone (907) 337-6179 Engineer's Signature �---- - — Date�b� /oO In conducting this evaluation, AWWC, Inca =mp ed to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and M A HH,' Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend J on the local soils condition, ground water levels that may fluctuate during the year, and the water o�oo usage of the family being served by the system. These conditions are outside the control of o0 the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. p� • ' AWWC, Inc. can therefore not provide any warranty for future estimate of how long the * 7. system will continue to meet the operational requirements of the ADEC or MOA DHHS. , , , „ The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, ...... .. .................. nor will it confer any legal right whatsoever. f gy A. Garness;' 6. DHHS SIGNATURE _L/' Approved for 3 bedrooms Disapproved Conditional approval for Additional M jCE-7953 ,'ro f e s slo`10 bedrooms, with the following stipulations: Date /O'/rS-Od 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. "rhe Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA 921 Computer Version Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L" Street, Rm 502 Anchorage, Alaska 99501 (907) 343.4744 Health Authority Approval Checklist Legal Description: LAT -FA SUBDIVISION; LOT 4 Parcel I.D.: 015-142-53 A. WELL DATA Well Type PRIVATE If A, B, or C, attach ADEC letter. ADEC water system number N/A Log present (Y/N) YES Date completed 10/17/77 Total depth 111' Cased to 110' Casing height (above ground) 18"+ Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES FROM WELL LOG Date of test 10/17/77 Static water level UNKNOWN Well production 6 g.p.m. WATER SAMPLE RESULTS: AT INSPECTION 9/28/2000 Coliform 0 Nitrate 0.17 mg/L Other bacteria 0 g.p.m. Date of sample: 9/28/2000 / 10/09/00 Collected by: ARROW PUMP & WELL SERVICE B. SEPTIC/HOLDING TANK DATA (S.T.E.P.) Date installed 9/18/2000 Tank size 1250 Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression (Y/N) NO High water alarm (Y/N) YES Date of Pumping NEW Pumper C. ABSORPTION FIELD DATA *BELOW ORIGINAL GRADE Date installed 9/18/2000 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 System type DEEP TRENCH Length 60' Width 2.5' Gravel thickness below pipe 5.0' Total depth *9.0' Effective absorption area 600 SO FT Monitoring Tube present (Y/N) YES Depression over field (Y/N) NO NEW Results Pass/Fail — For 3 Bedrooms Date of adequacy test ( ) Fluid depth in absorption field before test (in.); — Immediately after — gal. water added (in.): — Fluid depth — (ins) Minutes later: — Absorption rate = — Peroxide treatment (past 12 months) (Y/N) NONE KNOWN If yes, give date ----- 72-026 (Rev. W96p Computer Version D. LIFT STATION Date installed 9/18/2000 Size in gallons Manhole/Access (Y/N) YES High water alarm level at* 45" Cycles tested NEW 1250 "Pump on" level at* 41" —"Pump off' level at* *Datum BOTTOM OF TANK E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 100'+ On adjacent lots Absorption field on lot 100'+ On adjacent lots Public sewer main Public sewer manhole/cleanout N/A 41" Sewer/septic service line 25'+ Lift station 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ _Absorption field 5'+ _ Water main/service line 25'+ Surface water/drainage 100'+ Wells on adjacent lots 100'+ _ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line 2'+ Building foundation 10'+ Water main/service line 25'+ Surface water 10o'+ Driveway, parking/vehicle storage area 10'+ _ Curtain drain F. ENGINEER'S 1 certify that t� of Municipal e with MOA HJqj Id inspections and review stems are in conformance this date. Engineers Name * ' JEFFREY A. GARNESS Date /d g HAA Fee Date of Payment Receipt Number 72-026 (Rev. 3/96)* Computer Verslon Wells on adjacent Waiver Fee $ Date of Payment Receipt Number A:.Gdfrt�ss;'... —7953 Oct -10-00 15:49 CT&E Anchorage/Micro 907 561-5301 P-02 CT&E Environmental Services Inc. Laboratory Division 200 W. Porter Drive Drinking Water Analysis Report for Total Coliform Bacteria Anchorage, AK 99518.1605 Tel: (907)562.2343 READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE Fax: (907) 561-5301 MUST BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY alysis shows this Water SAMPLE to be: ❑ PUBLIC WATER SYSTEM [.D.# Satisfactory —PRIVATE WATER SYSTEM p Unsatisfactory eedResults .i . Sendvok +In jas�� /iia/ rr Q [ i05/ P4�atpr Co�sulfok% LLr�Rcw�_-ww P-51 7 9 em % nM ane um L IPS Ad&W—_ IIr ❑ Send Results ❑ Sendlnvotes mI Ilinr MIW/ry LIR �'4}I. l LIInxA m FO-Fql [a SAMPLE DATE: E Montb Day Y4 SAMPLE TYPE: ❑ Routine ❑ Repeat Sample (for routine sample with lab ref. no. ) ❑ Special Pbrpose SAMPLE LOCATION 426 LiLde yQ � Comments: ❑ Sample over 30 hours old, results may be unreliable ❑ Sample too long in transit; sample should not be over3 Vhours old at examination to indicate reliable results. Please send new sample via special delivery ail. Date Received D IF Time Received Analysis Began Analytical Method:Membrane Filter ❑ MMO-MUG if colonies/100 ml. 1006261 .No. Result* D Treated Water ji Untreated :Nater Time Collec Collected By 00 .M {�fiow , IP Plsaa Prim / BACTERIOLOGICAL WATER MMO-MUG Result: Total Coliform Membrane Filter. Direct Count Verification: LTB BGS COL Fecal Coliform Confirmation Final Membrane Filter Results �m Reported By Vv ate —VDILD Time Analyst Date: Time: RECORD E. Coil Colonies/100 ml TNTC- Too Nw,Isrom To Ceuer OB - OrAsr Bansria —Q Member of the SGS Group iSociet6 G6n6rale de Su ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA Sent to A.D.E.C. Anch Fbks Jun ❑ Faxed Dale: Time: Client notified of a cter-y-results: �71� Phoned Spoke with raxcd Date: Time: RECORD E. Coil Colonies/100 ml TNTC- Too Nw,Isrom To Ceuer OB - OrAsr Bansria —Q Member of the SGS Group iSociet6 G6n6rale de Su ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA 10-06-00 12:18 FROM -CTE ENVIRONMENTAL 5615301 T-117 3.02/02 F-902 ME Environmental Services Inc. Y.L Laboratory Division ririiioiAwAim 200 W. Potter Drive Irinking Water Analysis Report for Total Coliform Bacteria Ancharrage, z 9 15.1605 READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE Fax: 907 661-6301 ,AT TeT AF rOMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY ❑ PUBLIC WATER SYSTEM I.D. # pl PRIVATE WATER SYSTEM ❑ Send Rauh ❑ Send Invoke aska Water & ana NOMW a er Dnsu/tanfs, Inch _ MMIInXA4ANNTr 2'::IV8UIte 26 zipcoog ❑ SendRelmin ❑ AfAV11511afer C=W, N> asp rwifater Consultants, IrIC. MA,A eaarr Road, Suite 213 e v Ow SAMPLE DATE: MSL h Day SAMPLE TYPE: ❑ Routine O Repeat Sample (for routine sample with lab ref. no. ) ❑ Special Purpose SAMPLE LOCATION 1 C %E 1 e4, Comments: Analysis shows this Water SAMPLE to be: ❑ Satisfactory Unsatisfactory ❑ Sample over 30 hours old, results may be unreliable ❑ Sample too long in transit; sample should not be oveT3i1011ours old at examination to indicate reliable results. Please send new sample via special del`iv III . Date Received GU Time Received Analysts Began Analytical Method: Membrane Filter ❑ MMO-MUG • Number of coloniestl00 ml. o. Result* Analyst 1005996 ❑ - Treatea.._._. CiUntreated Water Time Collected Collected By 5:30 Lau Plenty Prior VrGO(I _.C. Anch Fbks Jun ❑ Faxed Date: Time: Client notified of unsatisfactory results: Phoned Spokewlth Faxed Date:. --4y= Time: BACTERIOLOGICAL WATER ANALYSIS RECORD MMO-MUG Result: Total C((99lIiform E Coli Membrane Filter. Direct Coast L W rg ` 0 Coloniesiloo mi Verification; LTB — -t— BGB �' ,-_COLIFFRMI Fecal Collform COnfirmsdoa Final Reported Member o1 f-pr�it/ Collform/100 ml Gd Time It, ,r /5-6bn Gdndralede TNTC -Ton Numrrowf To Cuunr Oa • Olen aanma ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY. OHIO, WEST VIRGINIA � ,� Delp 10-02-00 17:01 FROM -CTE ENVIRONMENTAL 5615301 CT&E Environmental Services Inc. Laboratory Division CT&E Ref. #: 1005877001 Client Name: AK Water & Wastewater Cons. Project Name: n/a Client Sample ID: Latta S/D Lot 4 Matrix: Drinking Water PWSID n/a Sample Remarks: 200 W. Potter Drive Anchorage, AK 99518 Tel: (907) 562-2343 Fax: (907) 561-5301 T-879 PAI/02 F-567 Client PO#: n/a Printed Date/Time: 10/02/00 16:45 Collected Date/rime: 09/28/00 12:20 Received Date/time: 09/28/00 13:40 Technical Director: Stephen Ede Released By: Allowable Prep Analysis Parameter Results P01- Units Method Limits Date - Date Init Total Coliform (MF) 8 OS w( coli, no fecal col/100 ml SM9222B 09/28/00 JDT Nitrate 0.17 0.5 mg/L EPA 300 10.0 09/28/00 SCL MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date /� -7/8c' 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) lamr a L ftn 5 ti � Location (address or directions) M31 (c) �A I -vcz' 5 Applicant Name L_1" tY'X'N IN tC Y?Y"TrUpf'fone: Home' — Business Applicant AddressC/A0 (000 cpwlz� 1Zz ! � r Val< YRS�f Applicant is (check one): Lending Institution,12iOwner/builder ❑ ; Buyer ❑ ; Other ❑ (explain); - (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone — (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single-FamilyX Multi -Family ❑ Other Number of Bedrooms 3 3. WATER SUPPLY Individual Wel Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/94) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 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 W"79_4r +ATUY- 4E -t444- � ` Telephone -7 � Addre Date C1 T � W�..•e/ �. .. •.. •.•�.. Al 1 „ q THOM A. MCHER Engineer's Seal 6. DHEP APPROVAL Approved for 4/'' 125r '��)bedrooms by �r �" '� %''" Date Approved Disap�ed Con 4al Terms of Conditional Approval AQ CAUTION /_tir—dG-, The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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 engineer's work. Page 2 of 2 72-025 (11184) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: lcsT- 4 L� �^�) A. WELL DATA Well Classification * �\ V- If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) YiG"'mDate Completed /_T7_ Yield Total Depth I I 1 , Cased to Depth of Grouting N �� Static Water Level Pump Set At —! t� Casing Height Above Ground �� Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) y4c% Depression Around Wellhead (Y/N) N koz Separation Distances from Well: To Septic/Holding Tank on Lot 1 ; On Adjoining Lots 117 To Nearest Edge of Absorption Field on-L6t 06 ; On Adjoining Lots To Nearest Public Sewer Line —tea I A- To Nearest Public Sewer 4 [ Cleanout/Manhole To Nearest Sewer Service Line on Loth Water Sample Collected by 1-� ;Date Water Sample Test Results + M SPyle'-x� Comments t_1%Z P5 �1 J 14 :_ V" L%Zl' t cal B. SEPTIC/HOLDING TANK DATA Date Installed 110 size Q - No. of Compartments Standpipes (Y/N) _ — Air -tight Caps (Y/N) `� Foundation Cleanout (Y/N) M Depression over Tank (Y/N) "0 Date Last Pumped 111111`t-4 i 8!(b Pumping/Maintenance Contract on File (Y/N) ti ! _ ; for rJ t Holding Tank High -Water Alarm (Y/N) N t (k Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well To Building Foundation I W �,,.r�, To Disposal Field 101, To Property Line 1!5, — To Water Main/Service Line = To Stream, Pond, Lake, or Major Drainage Course n Comments Page 1 of 2 72-026(1 1/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ©rI"` esign Type of System Design— Date Date Installed/ � D f j/ L77 Length of Field Width of Field Depth of Field /� 6 Gravel Bed Thickness 7 Z. Square Feet of Absorption Area 7 Standpipes Present (Y/N) Yes Depression over Field (Y/N) Njlc0 Date of Last Adequacy Test ( / I (a (� Results of Last Adequacy Test 't-->IATi S FnJiyl Qui 1::� {Z. 2 89 -vin, Separation Distance from Absorption Field: To Water -Supply Well ©. To Property Line )� To Building Foundation 1014, To Existing or Abandoned System on Lot W I Ar On Adjoining Lots ?Do "�_ To Water Mai Service Lin z- a-" To Cutbank (if present) 1'� To Stream/Pond/La e/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) _ Comments ;s (Y/N) Level at Vent (Y/N) Pumping Cycle 4uring Adequacy Test. Meets MOA ** Check Permitted Be Against HAA Request ** I certify that I h the ed, veri ' conformed to all M A and/HAA guidelines in effect on the date of this inspection. Signed Date 1 ` Company Receipt No. '2�`70 1% ,D - Date of Payment I ` I q Amount: $ (0 � Page 2 of 2 72-026 (11/84) �.�oaea i M A. t�+.,• ••.S �'� '•' Engineer's Seal Pr �� . 9Tµ.... .....: �' 0A 1�.L 0 0 THOM�A. FISCHER ,Q '.• CE - 6793� X00 ra�Ptofmioo\ -�:*t Municipality of Anchorage January 22, 1986 P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907)264-4111 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Thom Fischer, P.E. Whitewater Engineering Construction 11600 Cange Road Anchorage, Alaska 99516 Subject: Lot 4 Latta Subdivision Waiver Request, WR86-010 Dear Mr. Fischer: This Department has granted your request for a waiver of the minimum horizontal separation distance required by 18 AAC 72.021 for the distance between the well and septic tank on the subject property. The required distance has been waived from 100 to 96 feet. This waiver is valid for the existing three bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw