HomeMy WebLinkAboutMANOR LT 7AAonor
Lot 7
#050-671-49
Municipality of Anchorage Poge 1 of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchors9e, Alaska 99519-6650 Telephone: 545-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: 8W0004,~6 PID Number: 050--671--49
Name:CHARLES & SANDY MADSEN WastewaterSystem: [] New · Upgrode
Address:
1633 INSPIRATION DRIVE EAGLE RIVER. AK 99577 UPPE./LOWm ABSORPTION FIELD
No. of Bedrooms:
~h°ne:(907) 694--7031 4 []Deep Trench ·Shallow Trench r~Bed E]Mound ri.Other
LEGAL DESCRIPTION 0.6 ~P./S,. F, 4.5 - 7.0 F~
7 MANOR 1.5 - 4.0 ~ 3.0
- - - 0.5 - 2.75 R (56'/60') 116' TOTAL F'~
Orovs~ wi~: Humber of lines: JOla~on~ .~w.en
WELL: [] New [] Upgrode ../ 5 R 2
. ,,C_"~\~'~-~'/Ft. R 1000 SO. rt. ASTM D-5034/F-810
SEPARATION DISTANCES · Septic [] Holding [] S.T.E.P.
To Septic ~sorpUon Lift Holding ~ublic/Pfivote .o.~o~tu~,~.UNKNOWN c,~°~ty in geilons: 1250 '
From Tank Field Station Tank Sewer Une~
Well 100'+ lO0'+ - - 25'+ FIBERGLASS 2
lOO'+ ~oo'+ - - - LIFT STATION
Surface
Wcter
Lot 5'+ 10'+ - -I
Line
Foundotion 5'+ 10'+ -- -
Drain ', NONE KNOWN
I I
~emerks: *EXISTING TANK WAS EXCAVATED BENCH MARK
AND THE INTEGRITY WAS FOUND TO BE DOOD. BO'FrOM OF DOOR THRESHOLD NEAR
JR'S PUMPING PUMPED 1200+ GALLONS ON POINT "A"
9/14-/00. 106.91
Inspections performed by: AWWC, INC. Dates: 1st lo/16/2ooo ,'
i"':'"',
2nd lo/16/2ooo ~ J/~'~'~'."'-'~" '":'"'I
3rd 10/17/2000 ~ ',. elfrf~lA. Gorness:
Department of Health and Human Services approval ~i"'Jl c~s3 ....'}~¢
ll~e~ ¥'...v ... ~:~
Reviewed and approved b ~. /~/y~/-Date: /¢ -,,~,..~-oc,
,.E,,,.,...,,..: AS-BUILT DRAWING
SW000436
~o/~,/2ooo
.~w~ ~, .'TIf ;'f
~S~ ~TER & WASTE;VATER ~o,~, ~ 1¢ .~0~
GONSUkTANTS, lNG. ....
CHARLES & SANDY MADSEN (907) 694-70~1 2 OF ~ '"~
WPE OF WORK:
AS-BUILT DRAWING Of SEPTIC SYSTEM UPGRADE
PARCEL ID NUMBER:
PERM.- "UMBER, AS--BUILT DRAWING 050--67'--49
SW000436
NOTE: THE UPPER TRENCH
WAS INSULATED AND THE
LOWER TRENCH WASCqSULATED
ONLY ON THE DOWNHILL SIDE
UPPER
~S~ WATER & WASTE~TER ~o~: c.~.~.
PREPPED FOR: PHONE NUMBER: PAGE NUMBER:
CHARLES & SANDY MADSEN (907) 694-7031 5 OF 5 ,
PROFILE AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE
MUNICIPALITY OF ANCHORA GE
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: Oct 12, 2000
Expiration Date: Oct 12, 2001
Permit Number: SW000436
Legal Description: MANOR LT 7
Design Engineer: 0041 AK Water & Wastewater Consultant
Owner Name: Charles Madsen
Owner Address: 11633 Inspiration Dr. Total Bedrooms: 3
Eagle River, AK 99577-
Parcel ID: 050-671-49
Site Address:
Lot Size: 80435 SQ. FT.
Permit Bedrooms: 3
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Date: /dZ~) ~//~.~ -4:~:)(~
Date: -Oo
ALASI WATER & WASTEWATER
October 2, 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 for Lot 7, Manor Subdivision
To whom it may concern:
The existing 3 bedroom house is served by a private well and septic system. The existing septic
system is in state of failure and needs to be upgraded. A test hole was excavated south of the
existing septic system. The proposed septic system will be designed around the 30 foot radius of
this test hole. We are proposing that a ne~v 1000 gallon septic tank be installed if existing tank is
of poor integrity and two five foot wide drainfield be installed. Comments regarding the
proposed design are summarized as follows:
1. SOILS: A soil log which shows the soil classifications, groundwater monitoring, and the
percolation test results are attached. It is our opinion that due to the overall appearance of the
soils, an application rate of 0.6 gallons/day/ft2 should be used, and that the insitu soils will serve
as a sand filter.
2. TRENCH DESIGN:
a. Percolation Rate:
b.
e.
d.
e.
f.
g.
h.
i.
J
5.0 minutes/inch
Allowable Application Rate: 0.6 gallons/day/ft2
Number of Bedrooms: 3
Design Flow: 450 gallons per day_
Minimum Absorption Area: 450ft2
Total Depth: 7 feet (max.)
Effective Depth: 3 feet
Width: 5 feet
M~mmum Length: 90 feet long (2 ~ 45 1o g)
Effective absorption area = 500 ft2
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed
upgrade.
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
4. TOPOGRAPHY: The area for the proposed septic system has a 15 to 25 % slope running
north/northeast to south/southwest; in short, there are no slope concerns.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact us at 337-617. Thank you for your
assistance.
Presi,
NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, a soils logs,
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 ' Website: akwwc.com
· REP~ED FOR PHONE NUMBER: PAGE NUMBER:
CHARLES ~ SANDY MADSEN (907) 694-7051 I OF 2
MANOR SUBDIVISION; LOT 7,
SITE P~N Of PROPOSED SEPTIC SYSTEM UPGRADE
4o ~ ~"~ -INSTALL DOUBLE
',__ '-/,y,,,. ~ \ ~ CLEANOUTS (DBL) /
\ /
~3 BEDROOM
TO BE USED ~ ~ ~. D]~R~R (~) ~ .~ ~
IN.ALL FLOW
N~ 1000 G~ON SEPTIC T~K ~
IF OF POOR I~EGR~ v 0
~ PROPOSED D~NR/~S. EXCAVA~
Z/ ~ ~ A ~ENCH ~T IS 7 ~ DEEP
M~IMUM BY 5 FE~ WIDE BY 90
~/~ ~ ~. ~D 3 ~ OF C~, WASHED
NT
~ DATE:
10/5/2000
Al ASI~ WATER & WASTEWATER ~:
:¢:: -: CONSULTANTS, 1" = 40 .............. .... : .....
C,A.LES ~ SAND~ ~ADSEN (907) ~94-70~ ~ Or ~
MANOR SUBDIVISION; LOT 7,
~E OF WORK:
DESIGN OF PROPOSED SEPTIC SYSTEM UPGRADE
ALASKA WATER & WASTEWATER CONSULTANTS, IN,,. ~ OF,~z~
6901 DEBARR ROAD, SUITE 28 * ANCHORAGE, AK. 99504 ."' -.
ISOlL LO0 - PERCOLATION TEST]
PERFORMED FOR: CHARLES ~ SANDY MADSEN ~"~'"~t"~ ........
DATE PERFORMED: 9/26/00
reTEST HOLE
so,~ C~SSIFICATmONS
GM/SM/ML
7-- DEPTH TO
DENSER ~ DATE
11 ~l~tl DATE READING CLOCK NET TIHE WATER LEVEL NET DROP
- ~)~11 TIME (MINUTES) READmNG (INCHES)
~- ~!~11 9/~/oo ~ 2:s~ _
'- ~i]~ll ~__ 5:08 _. 10 .... 3 ~(4"_ 2 1/4"
16 ~ 8 3:38 10 4" 2"
- "~'~ I --Z ~-'~ __ -
17~ ~ '- 10 5:48 10 4" 2
/ --'~- 4:48 ...... ~-~
18~ ~ ~ 12 ~ 4:48 10 --~ ,, -~"
19 ~ [ PERCOLATION RATE 5 (HIN./INCI/D PERC. HOLE DIA. 6 (INCHES)
~ TEST RUN BETWEEN 7.5 , FT.~ 8.0 FT.
20
CO~NENTS: PERC-HOLE WAS PRE-SOA~[~ FOR 4+ CgS~/~E///
PERFORMED BY A~SKA WATER · WASTEWATER I, ~ j ~ ~ ~ , CERTI~ THAT
THIS WAS PERFORME~ I~ ACCORDANCE WITH ALL S~ ,~ MU~CI~ L GUIDELINES IN EFFECT ON THIS
DATE. DATE: ~ ]2/~ ~ . v
DEPTH TO DATE
;ROUNDWATER
DRY 9/26/00
15' 9" 9/28/00
15' ~o/3/oo
AWWC, Inc., Year 2000
ALASIC WATER & WASTEWATER
CONSULTANTS, INC. ~ :
Onsite Wastewater Disposal System Standard Construction Specifications
I. REFERENCE PROPERTY:
Manor Subdivision; Lot 7, This design is for a five (3) bedroom residence.
II. DEFINITIONS:
1. Property o~vner or homeowner: The legal property owner or his/her representative.
2. Engineer: Alaska Water & Wastewater Consultants, Inc. (AWWC, Inc.)
3. Contractor: The company hired by the property owner to knstall the septic system. If the propei~ty
owner installs the system then he/she would also be the contractor for purposes of this installation.
4. DHHS: Municipality of Anchorage, Department of Health & Human Services
5. M.O.A.: Municipality of Anchorage, Department of Health & Human Services
III. RESPONSIBILITIES:
· Property Owner Responsibilities:
1. CONTRACTUAL RELATIONSHIP: The property o~wter shall contract with the contractor to
perform the work outlined in these specifications and plans, in accordance with the attached DHHS permit.
There is no contractual relationship bet~veen the contractor and the engineer. The engineer shall inspect
the work, as required by DHHS, so as to document the installation. Final acceptance of the contractor's
work rests with the owner and the DHHS.
2. SINGLE FAMILY RESIDENCE ONLY: This well and/or septic system design is for a single
family residence only. The homeowner is responsible for notifying the engineer if the residence is used as
a business or multi-family dwelling. In such cases, the installation permit must be obtained from the State
of Alaska, Department of Environmental Conservation.
3. DISCLAIMER REGARDING AS-BUILT SURVEY: The validity of the design site plan is
limited by the accuracy of tl~e as-built survey provided to the engineer by the property owner or his/her
representative. The property owner shall notify the engineer regarding any known inaccnracies associated
with the as-built survey. The engineer assumes no responsibility for the accuracy of the survey.
4. UNPLATTED EASEMENTS: The property owner is responsible for notifying the engineer
and the contractor of any unplatted easements, not shown on the as-built survey, which the new well or
septic system may encroach into. Such easements are typically identified in the property title report.
5. DISCLOSURE OF SITE CONDITIONS: The property owner shall notify the engineer and the
contractor of any seasonal groundwater or surface water runoff conditions known to him/her which could
potentially effect the operation of the septic system. The proposed septic system must be at least 100 feet
from any streams, ponds, creeks, swamps, bogs, or any other surface water as defined by the DHHS. This
disclosure is of particular significance when the site evaluation and design work is being done during the
winter months when surface waters are frozen and there is snow cover.
Page 1 of 7
AWWC, Inc., Year 2000
The property owner shall notify the engineer and the contractor of any known subsurface conditions that
would prohibit or restrict the installation of the septic system. Items of concern would include, but are not
limited to buried piles of construction debris, undocumented septic systems, areas which consist primarily
of fill (imported) soil, subsurface th'ainage systems, & abandoned wells.
6. DRINKING WATER WELLS: The property owner is responsible for notifying the engineer
if, to his/her knowledge, any of the adjacenI properiies are used as a duplex, business, or multifamily
dwelling. The new septic tank and leachfield must be at least 100 feet from any private well, 150 feet from
any class "C" well, and 200 feet from any community well, unless appropriate waivers are obtained.
Furthermore, the property owner shall notify the engineer of any undocumented wells, unknown to the
engineer, but known the property owner, that are on his/her lot or adjacent lots.
7. CURTAIN DRAINS: The new drainfield must be at least 20 feet down gradient and 50 feet
upgradient from any subsurface drains. This includes foundation th'aim. The property owner should notify
the engineer of any such drains that are not shown on the design drawings for this installation.
8. POST CONSTRUCTION SITE RESTORATION: Unless specifically agreed upon otherwise,
the property owner is responsible for final grading of the areas which settle after construction. Prior to
awarding the contract, the homeowner should communicate to the contractor any expectations regarding,
but not limited to post construction site clean-up, re-landscaping, and restoration of any asphalt, fences,
trees, decks, ect. that are effected by the construction. All mound type drainfields are required by the
MOA to be re-vegetated. The property owner is responsible for this work unless other arrangements are
made with the contractor.
If the property is being sold, the property owner shall ensure that the aforementioned items are addressedl~
with the buyer, and, if the work is to be completed after the sale of the property, that necessary funds arel~
lescrowed to fund the completion of the work. ~ 1~
9. PROPERTY OWNER INSTALLATION OF SEPTIC SYSTEM: If the property owner intends
to install the septic system he/she must first have obtained approval from the Municipality of Anchorage,
DHHS (343-4744). Homeowner installations typically require more time for engineer inspections. The
homeowner should discuss the additional costs associated with such inspections with the engineer prior to
starting the project.
10. ENGINEER CHARGES TO INSPECT THE INSTALLATION: The property owner is
responsible for payment of all the engineer inspection charges. These charges are in addition to the soils
testing and design work that was required to obtain the MOA sewer/well permit. The number of
inspections will vary depending on the actual field conditions encountered and the construction methods
used. If there are any questions by the property owner, or his/her representative, regarding charges for
installation inspections they should be discussed prior to beginning construction. AWWC, Inc. will
provide you with a written copy of the fee schedule.
11. CHANGES IN THE SCOPE OF WORK: See Section V, "Disclaimers" regarding design
changes. See "Contractor Responsibilities", paragraph one (1) regarding changes in site conditions.
· Contractor Responsibilities:
1. PRE-CONSTRUCTION LAYOUT: The contractor is responsible for locating all buried
utilities, easements, property lines, surface water setbacks, well radii, and water service lines which may be
encroached upon by the proposed septic system. The contractor shall ensure that all setbacks are flagged
by a registered land surveyor, or other appropriate means, prior to construction. AWWC, Inc. field
engineers/inspectors will not be responsible for the establishment for of any of the aforementioned
setbacks.
lille contractor should recognize that the location of all wells, surface waters, structures, and other items[~
hown on the design drawings are typically derived from as-built surveys, and municipal records. The[.~
s-built sm~veys and municipal records (prepared by professional engineers & land surveyors) have been[~
ssumed to be accurate for purposes of this design; however, the accuracy has not necessarily been field
erified. Prior to beginn ng any construction the contractor shall field locate ali items which have
Page 2 of 7
A WWC, ]'nc., Year 2000
protective setbacks and verify that there are no encroachment concerns. Any encroachments, for which
waiver have not been granted, should immediately be brought to the attention of the property owner
Itheir representative) and the engineer. ~ ~
The test hole pipes shall not be removed/abandoned until after the engineer has established their location
relative the new drainfield during the first inspection of the drainfield installation or during the
pre-construction layout. The new drainfield/s must be within a 30 foot radius of the test hole/s used for
establishing the design criteria.
The contractor should establish the elevation of all existing and proposed system components priortol
starting construction so as to insure that the necessary grades can be maintained. This is particularlYl~
significant when the elevation of the ,existing system components is unknown because clean-outs are notl~
present, buried, or non-functional (can t measure down them because of obstructions). It is recognized thatl[
Iconditions can be discovered that will materially ch~ge the desi..g,n a~d t?, co~s~ction costs.. ........ J~
2. DISCREPANCIES BETWEEN DESIGN DRAWINGS AND SPECIFICATIONS:
Constrnction shall be in accordance with the approved site plan and design drawings, and any special
provisions noted on the municipal sewer permit. The contractor is responsible for notifying the engineer of
any discrepancies noted on the design plans or drawings, prior to starting work.
3. CHECK GROUNDWATER LEVELS IN TEST HOLE MONITORING TUBES: Prior to
beginning construction, the contractor shall check the liquid level in the test hole monitoring tubes to
ensure that there has been no change in the groundwater levels that would impact the proposed design.
Any rise in the liquid level should be brought to the attention of the engineer so that design changes can be
made if necessary.
4. MAXIMUM DEPTH OF DRAINFIELDS: The maximum depth of the drainfield is shown on
the design drawings or is noted in the narrative portion of the design package. The contractor shall notify
the engineer of any inconsistencies noted in the design package.
For pmlooses of this installation, the maximum depth of the drainfield will be based upon taking a
measurement at the deepest pm1 of the excavation between the highest ground elevation encountered
(usually on the uphill side of the excavation) and the bottom of the trench or bed excavation. The
contractor shall exercise caution n,o,t to remove evidence of the original grade prior to establishment of the
total system depth. In short, don t remove the organic layer until after the original grade elevations are
lestablished by the inspecting engineer.
5. SUITABILITY OF MATERIALS USED FOR CONSTRUCTION. The contractor shall ensure
that al~l materials being used are in compliance with the most current guidelines established by the
Municipality of Anchorage. This includes, but is not limited to, the following:
a. Draim'ock
b. Sand filter material for conventional beds, trenches, or mound systems.
c. Sand filter material and pea gravel for Intenmittent Sand Filters (ISF).
d. Anchorage Sand and Gravel (AS&G) "block pea" material for Upflow Filters.
It is recornmended that the contractur provide the engineer with current sieve analysis' from the
sand/gravel supplier to document the suitability of the material. The engineer assumes no responsibility for
ensuring that the materials delivered meet the MOA requirements.
6. BURIAL RATING OF TANKS: The contractor shall ensure that the septic tank, lift station, or
holding tank pumhased has a burial depth rating suitable for the actual installation.
7. SEPTIC TANK AND STEP TANK SIZES: Prior to purchasing a septic tamk or lift station the
contractor shall verify that it is adequately sized for the number of bedrooms shown on the permit issued
by MOA. The minimum septic tank size is 1000 gallons and the minimum STEP tank size is 1250 gallons.
These size tanks will handle residences with up to 3 bedrooms. For each additional bedroom over tlu'ee (3)
Page 3 of 7
AWWC, [nc., Year 2000
the septic tank or the STEP tank volume shall be increased by a minimum of 250 gallons. For example, a
four (4) bedroom residence must have a 1250 gallon septic tank or a 1500 gallon STEP tank.
8. INSPECTIONS - ENGINEER NOTIFICATION: The contractor shall notify the engineer at
least 24 hours prior to starting construction. If deemed necessary, a preconstruction site visit shall take
place. The contractor shall coordinate with the engineer any inspections which will be required during
weekends, holidays, or before/after normal working hours (8:00 am to 5:00 PM). The property owner
may incur additional charges for inspections ~vhich do not occur during normal business hours. It is
the contractor's responsibility to notify the engineer a least 2 hours prior to any inspection.
9. REGULATORY NON-COMPLIANCE. The contractor shall report to the engineer and the
con~'actor any observed condition which would put the septic system in violation of State or Municipal
regulations.
10. BACKFILL OLD TEST HOLES: Any remaining test hole excavations shall be filled and
mounded as part of this project. Unless instructed otherwise by the engineer, the old test hole groundwater
monitoring pipes shall be removed.
11. FINAL GRADING FOR DRAINAGE: The contractor is responsible for final grading so as
to ensure that surface runoff does not adversely effect the septic system constructed, adjacent septic
systems, or adjacent sV:octures.
12. SOIL COVER REQUIREMENTS: The contractor shall ensure that the final cover over the
tank and drainfield is either compacted adequately when backfilling, or mounded sufficiently to ensure that
there is adequate soil cover over the tank and drainfield after settlement occurs. If seasonal conditions
prevent this, the property owner (or his representative) shall be notified that additional fill may be required
after settlement occurs. This notification is of extra significance when the property is changing ownership.
13. CHANGES IN CONSTRUCTION COSTS: The contractor is responsible for obtaining
approval from the property owner for any additional construction costs associated with design
modifications or changing field conditions prior to doing the work.
14. WORKING IN RIGHT-OF-WAYS AND TRESPASSING PRIVATE PROPERTY: The
contractor is responsible for coordinating (including payment of encroachment permit fees) all access
through public and private properties with the appropriate authorities and/or property owners.
Furthermore, the contractor shall inform all parties of any potential impacts to adjacent properties prior to
beginning any construction.
15. MAINTENANCE & OPERATIONS MANUALS: The contractor shall provide the
homeowner with the manufacturer's installation/maintenance manuals for all system components installed
under this contract. If not given directly to the property owner the manuals should be placed enclosed in a
protective cover (plastic bag) and placed in a readily visible location.
16. INNOVATIVE SEPTIC SYSTEMS. START-UP INSPECTIONS: The con~'actor shall
notify Anchorage Tank & Welding Company (272-3543) after the installation of an Intermittent Sand
Filter kit or AdvantexTM system (supplied by Anchorage Tank) is installed so that the appropriate start-up
inspection can be scheduled. This notification also activates the quarterly maintenance schedule. Such
notification is typically not required for BioCycle installations since BioCycle of Alaska is typically
involved with the installation. The contractor shall contact BioCycle of Alaska (283~4794) regarding any
start-up notification requirements.
· Engineer Responsibilities:
1. SYSTEM DOCUMENTATION: The engineer is responsible for inspecting the installation of
the septic system and preparing as-built documentation, to the satisfaction of the M.O.A.. Inspections are
performed as necessary to document the const~ction &the system to the satisfaction of the M.O.A. In all
cases, inspections shall be performed as necessary to establish the following:
* The original grades at the drainfield/s site
* The bottom of all trenctffbed excavation
* Top of sand on all sand filters
* Top of drainpipe
* Septic tank, or lift station, or holding tank prior to backfill
* Placement of filter fabric and insulation
* After final grading is completed
Page 4 of 7
AWWC, [nc., Year 2000
2. LIMITED AUTHORITY: The inspecting engineer has no direct authority over the contractors
activities or consU~ction/safety practices. Should the engineer identify conditions which dictate a design
change, he or stle may recommend that work be stopped, and/or the design be modified. If design
modifications are necessary, the engineer shall notify the property o~vner or his/her representative. The
inspecting engineer does not have the authority to direct the contractor to modify the system design in such
a way that it would be in violation of State or MOA regulations.
3. SEPTIC TANK INTEGRITY: The engineer shall inspect the condition of the existing septic
tank and determinh~g its suitability for re-use. If the engineer detmmines the septic tank to be structurally
unsound, it must be replaced.
4. COORDINATION OF DESIGN CHANGES WITH THE MOA: If design changes are
necessary, the engineer will coordinate the approval of the changes with the MOA. The contractor does
not have the authority to proceed with any design modifications until verbal or written approval is obtained
fi'om the MOA.
5. COORDINATION OF WAIVERS: If, during construction, it is determined that a waiver will
be required in order to install the system as designed, the engineer will apply for the necessary waiver/s to
the appropriate State or MOA regulatory bodies. The engineering services and State/MOA fees for such
waivers will be charged dh'ectly to the propel~y owner as part of the inspection costs.
SECTION IV. CONSTRUCTION GUIDELINES:
Cons[ruction shall be in accordance with the approved site plan and design ch'awiugs and any special
provisions noted on the municipal well and/or sewer permit. All materials, components, workmanship, and
construction practices shall comply with the Municipality of Anchorage's latest ordinances regarding wells
and septic systems, as well as DHHS policies. The failure of the inspecting engineer to notice a material or
construction non-compliance does not relieve the contractor of his/her responsibility to correct such a
deficiency.
· Septic Tank, Holding Tank, or Lift Station Installation:
1. The burial rating of the tank shall be adequate for the actual burial depth encountered.
2. The tank shall be level and sufficiently bedded to prevent settling or shifting of the tank.
3. All standpipes on the tank shall extend a minimum of 12 inches above final grade.
4. Tanks installed with less than 4 feet of cover shall be insulated. See "Contractor Responsibilities",
paragraph 12 regarding final soil cover.
5. The sewer service line from the house to the tank shall he sloped a minimum of 1/4"
per foot, unless prior approval is obtained from the engineer.
6. The inlet and outlet lines from the tank shall be bedded in draimock or the soil shall be adequately
compacted to prevent future settlement of the soil.
7. A foundation clean-out will be installed ( 1-4 feet from the house) if one does not currently exist.
8. Post tank clean-outs shall be installed per MOA requirexnents. Does not apply to holding tanks or lift
stations with pressurized lines.
9. In high gmundwater areas, all tanks shall be anchored to resist buoyancy forces when there is not
adequate soil cover to resist the uplift force. The engineer shall make this determination.
10. The final soil cover shall be graded so that there is positive drainage away from tank.
11. All holding tanks and lift stations shall have an audible and visible alarm inside the residence.
12. All lift stations shall be wired in compliance with ali MOA guidelines and the Uniform Electrical
Code. A mnnicipal electrical permit and inspections must be obtained in areas where required by
the Municipality of Anchorage.
13. The contractor shall remove the old tank, or abandon it in compliance with the Uniform Plumbing
Code (UPC). The contractor is solely responsible for the abandoament procedure.
14. ISF AND REACTEX INSTALLATIONS: Thc control panel for the Inte~xnittent Sand Filter and
Reactex systems shall be located outside the residence, for easy access during inspections. A
remote alarm must be installed inside the residence as per DHHS requirements. Mounting the
Page 5 of 7
A ~'WC, Inc., Year 2000
panel directly to an exterior wood wall should be avoided because the closing of the relays creates
a "clanking" noise that may be offensive to the property owners.
15. ISF INSTALLATIONS: The air compressor shall be equipped with 0 to 10 psi gauge for the purpose
of monitoring air flow to the sand filter. The pressure gauge will be located so that it is easily
monitored by the property owner.
· Installation of Conventional Absorption Bed & Trenches:
1. Excavate the proposed bed/trench to the dimensions shown on the design. The bottom of the excavation
shall be within 2 inches of level (2 inch maximum variation between high and low spots). If the sidewalls
or bottom of the excavation become smeared, they must be raked or scarified before placement of the filter
sand or drainrock.
2. The trench or bed should be at least 5 feet from the test hole excavation.
3. All soil tests and excavation depths are advisory to the design and are to be verified in the field by the
engineer. If design changes are necessary, and the changes effect the contractor charges to the property
owner, the contractor shall obtain approval from the property owner prior to proceeding with the work.
4. Once the drainrock is installed, the distribution pipe is to be placed level (0.02 feet difference between
high and low shots) with the perforations faced downward. Draimock is then to be placed over the
distribution pipe, to provide a minimum of 2 inches of cover over the pipe. The drainrock shall not be
pyrmnided over the drainpipe but shall be the same elevation over the entire trench/bed width.
5. A silt barrier must be installed between the final drai~rock layer and the native soil backfill. The silt
barrier shall cover the entire drainrock surface.
6. Monitor tubes shall be installed at the locations shown on the design drawings, and extend a minimum
of 12 inches above final grade. The portion of the monitoring tube extending through the drainrock shall
be perforated from the bottom of the trenct~bed to the invert of the distribution pipe.
7. Backfill over the final drainrock layer must not be less than 2 feet. Insulation must be installed when
the backfill depth is less than 3 feet. The insulation shall cover the entire width of the trench/bed, the
contractor shall "shoot" the final grades to ensure cover depth is adequate, prior to notifying the engineer
that the work is complete. The final cover over the drainfield must graded so that there is no potential for
water to pond over the trench/drainfield. See "Contractor Responsibilities'; paragraph 12 regarding
final soil cover.
installed with this design the contractor shall provide a functional valve key to]~
8.
If an
alternator
valve
SECTION V: DISCLAIMERS
· UNFORESEEABLE SITE CONDITIONS: The design of this septic system, prepared by AWWC,
Inc., ~vas based upon a limited evaluation of the soil, groundwater, and site conditions. The extent of
the evaluation is consistent with standard engineering practice in the field. Furthermore, this design
was evaluated and approved by the engineers or technicians on staff at the Municipality of Anchorage,
DHHS, based upon the information provided to them. Occasionally, during construction,
unforeseeable subsurface conditions (high groundwater, poor soils, buried debris,....) are encountered
that make the proposed installation not feasible. In such cases it is typically necessary to do more soils
testing, groundwater monitoring, and design work. These additional engineering services will be
performed on a fee basis at an hourly rate. AWWC, Inc. will obtain verbal authorization from the
property owner (or his&er representative) prior to proceeding with the work, and will provide a
written estimate if requested. The property owner should discuss with the contractor any changes in
the installation cost associated with the design changes.
· IF THE PROPERTY BEING SOLD AND FUNDS ESCROWED FOR THE UPGRADE, it is
important to bear in mind that the ability to upgrade the septic system on this property is not 100%
certain (for the reasons stated in the previous paragraph). There is always the possibility that
conditions could be encountered that would prevent the installation of anything other than a holding
Page 6 of 7
AWWC, Inc., Year 2000
tank. Although such a situation would be rare, it is important that all parties recognize that such a
scenario is possible.
SEPTIC SYSTEM PERFORMANCE: The design of this septic system is based upon limited soils
testing, groundwater monitoring, and a visual assessment. It is possible that the actual soil conditions
are less favorable then the testing data indicated and that adverse, unforeseeable, changes in the
surface/subsurface water conditions could impact the performance of the system. Numerous other
factors, out of the control AWWC, Inc., may adversely affect the long term performance of the system.
Such factors include, _but are not limited to, excessive number of residents in the house, plumbing
leaks, the use of septic system additives, failure to pump septic tank regularly, failure to alternate
drainfields (when this is an option), or/and excessive use of water. Given these variables, it is not
possible to ~van'antee the performance of a septic system.
As the preparer of this document, AWWC, Inc. is aware of the content and assumes the responsibilities
outlined in it. By contracting with the property owner to perform this septic system installation, thelt
contractor is acknowledging his/her responsibilities as addressed and accepts these responsibilities. I~
I have read reviewed the design drawings and this seven (7) page specification package and am aware of
the responsibilities of each party, and the limitations of the system performance.
PROPERTY OWNER/s (Printed):
SIGNATURE:
DATE:
SIGNATURE:
DATE:
Page 7 of 7
Parcel LD. #
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environrnental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519~650
(907) 343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILLY DWELLING
050-671-49
1. GENERAL INFORMATION
Complete legal description MANOR SUBDIVISION: LOT 7.
Location (site address or directions) 11633 INSPIRATION DRIVE EAGLE RIVER, AK 99577
Property owner CHARLES &: SANDY MADSEN
Mailing address c./~ pAMELA SLOAN @ P.O. BOX 196615
Lending agency
Mailing address
Agent LAURA HAMILTON w/ PRUDENTIAL_ VISTA Day phone
Address 16655 CENTERFIELD DRIVE EAGLE RIVER. AK 99577
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3, TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
4
XXX
Day phone (907) 694-7031
ANCHORAGE. AK 99519
Day phone
(907/ 689-6506
If community weft system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding Tank
Community on-site
Public sewer
NOTE:
XXX
If community wastewater system, provide written confirmation from State ADEC
ing to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21 Computer Version
Note: Alaska Water and Wastewater Consultants, Inc. shaft be paid $1,600.00 at,
or prior to, closing for the engineering 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 insp¢cfion, the on-site water supply and/or wastewater
disposal system is in compliance with all lunicipa~nd State codes, ordinances, and regulations in effect
NameofFirm ALASKAWAI~:I~/&~,~,T/EV~//,T~ROONSULTANTS, INC. Phone f907)337-6179
Address 6901 DEBARR RO~AD, ~U~TE .~J3 ./~.CHIpRAGE, ALASKA 99504
Engineer's Signature / ~ /t<::;:¢(...._.~- Date /O/~ z/00
In conducting this evaluation, AWWC, /nc, d to provide a thorough, conscientious engineering analysis of the
system in accordance with ADEC and MOA DHH,. 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 eeptic eystems depend
on the local soils condition, ground water levels that may fluctuate during the year, and the water
usage of the family being served by the system. These conditions are outside the control of ~ .
OF
A
the evaluator of the system. Satisfactory test results do not guarantea future performance
AWWC, Inc. can therefore not provide any warranty for future estimate of how long the
system wil/ continue to meet the operational requirements of the ADEC or MOA DHHS.
The content of this report is for the sole benafit of the owner listed above. Any
reliance upon or use of this report by any other person or nary is not authorized, /.r .~ey .~...~e~./... ~-'~
nor will it confer any legal right whatsoever.
6. DHHS SIGNATURE
1,."' Approved for 'Lc/'"
Disapproved
Conditional approval for
bedrooms
bedrooms, with the following stipulations:
Additional Comments
By: ~ ~,~/~,/~-,-~ ~/. ~--~' Date / 0 ~ ,~ EL O 0
The Municipality of Anchorage Department of Health and Human Services (DFIHS) 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 engineer's work.
72-025 (Rev. 1/91) Back MOA ¢Y21 Computer Version
Legal Description:
A. WELL DATA
Well Type PRIVATE
Log present (Y/N)
Total depth *66'
Sanitary seal (Y/N)
OCT ~ 4 2000
Municipality of Anchorage ,c~
DEPARTMENT OF HEALTH & HUMAN ~,J~ 0F^NcHoRA~
825 "L" Street, RmEn~'i0r~n/~-nec~oalraS;e?~lceass~)aiv~i~l (907)034N3M~'~L SERVICES DtV~
Health Authority Approval Checklist
MANOR SUBDIVISION; LOT 7, Parcel I,D,:
Date of test
Static water level
N/A
050-671-49
FROM WELL LOG
If A, B, or C, attach ADEC letter. ADEC water system number
YES Date completed .3/1/78
Cased to *66' Casing height (above ground). 18"+
YES Wires propedy protected (Y/N) YES
AT INSPECTION
*,:3/1/78 10/16/2000
*ARTESIAN ARTESIAN
Well production *0,5+ g.p.m.
*PER PREVIOUS HAA. WELL LOG ILLEGIBLE
WATER SAMPLE RESULTS:
Coliform 0 Nitrate 0.78 mg/L
Date of sample: 10/16/00 Collected by:
7.02 g.p.m.
Other bacteria 0
A.W.W.C., iNC.
B. SEPTIC/HOLDING TANK DATA * FIBERGLASS- INTEGRITY VERIFIED ON 10/16/2000
Date installed 5/17/78 Tank size .1250 Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N)
Date of Pumping 9/14/00
C. ABSORPTION FIELD DATA
Date installed 10/16-17/00
Length 56'/60' Width
YES Depression (Y/N) NO High water alarm (Y/N) N/A
Pumper JR'S PUMPING
[UPPER/LOWER]
~or ft2/bdrm) 0.6
rating
5.0' Gravel thickness below pipe
Effective absorption area.1000 SQ. FT. Monitoring Tube present (y/N) YES Depression over field (y/N)
Date of adequacy test NEW Results (Pass/Fail) - For_ 4
Fluid depth in absorption field before test (in.); - _ Immediately after -
Fluid depth - (ins) Minutes later: - Absorption rate =
Peroxide treatment (past 12 months) (Y/N) - If yes, give date.
72-026 (Rev, 3196)* Computer Version
* BELOW FINAL GRADE.,~
System type TRENCH
3.0' Total depth *6.0-7.4'
NO
Bedrooms
gal. water added (in.): -
D. LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Size in gallons .-.~'-/~
"Pump o~u~p off' level at*
~~*Datum
E, SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot 100%
Absorption field on lot 100%
Public sawer main N/A
Sewer/septic service line 25'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sawer manhole/cleanout. N/A
Lift station N/A
5'+
100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation 5'+ Property line 5'+ Absorption field
Water main/service line 10'+ Surface water/drainage 100'+ Wells on adjacent lots __
SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO:
Property line 10% Building foundation 10'+ Water main/service line
Surface water 100'+ Driveway, parking/vehicle storage area.
Curtain draiI .~(~ONE KNOWN
I cerfify that I h~ d~i~ t~ field inspections and review
of Municipal re~o~ s ~b~ve systems am in confo~ance
Enginee(s Nam~ ~ ~ /~ A. GARNESS
Date ~o ~/oO
10'+
10'+
Wells on adjacent lots
HAA Fee $ ~_~:;~:7,~,
Date of PaYment /'z~//~
72~26 (Rev, 3/98)* Computer Veto[on
Waiver Fee $
Date of Payment
Receipt Number
10-18-00 17:33 FRO~rCTE ENVIRON~NTAL 5615301 T-670 P.01/82 F-G70
CT&E Environmental Services Inc.
Laboratory Division
200 W. Potter Drive
^ncherage, AK 99518
Tel: (907) 662-2343
Fax: (907) 561-5301
CT&E Ref, #:
Client Name:
Project Name:
Client Sample ID:
Matrix:
1006472001
AK Water & Wastswater Cons.
n/a
Manor S/D Lot 7
Drinking Water
PWSID n/a
Client PO#: n/a
Printed Date/Time: 10/18/00 17:30
Collected Date/Time: 10716/00 15:50
Received Date/Time: 10/17/00 10:45
Technical Director: Stephen Ede
Released By: ~
Sample Remarks:
Allowable Prep Analysis
Parameter Res[llts PQL Units Method Limits Date Date Init
TotaIColiform(MF) 0 col/100ml SM9222B 10/17/00 KAP
Nitrate 0.78 0.5 mg/L EPA 300 10.0 1o/17100 SCL
10-18-00 17:34 FRO~-CTE ENVI RON~ITAL 5~15301 T-$?O P.02/02 F-678
Labor~to~y Division ~~~~
200 W. Potter Drive
)rinking Water Analysis Report for Total Coliform Bacteria Anchorage, AK 99~18-160~5
Tel: (907) ~62-2343
READ INSTRUCTIONS ON REFERSE SIDE BEFORE, COI.,L, ECTING SAMPLE Fax: (907) 561-5301
MUST BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY
[] PUBLIC WATER SYSTEM I.D. #
~ PRIVATE WATER SYSTEM
El Send Resuln Q , Send Invoice
w~ s~,~ n~,~c..~Ij~S, KA WATlgR &
Cby
SAMPLE DATE:
Month
MPLE TYPE:
Routine
a Repeat Sample (for routine sample
with lab re£ no. . , )
Cl Special Purpose
Analysis shows this Water SAMPLE to be:
~1~ Satisfactory
O Unsatisfactory
[] Sample over 30 hours old, results may
be unreliable
Sample too long in transit; sample should
not be over~hours old at examination
to indicate reliable results. Please send
Analysis Began J. ~' ~ ~
[] 1001547E
DayYe
D
Untreated Water
Time Collected
SAMPLE LOCATION Collected By
Analytical Method: j~x Membrane Filter ~3 MMO-MUG
* Number of colonies/100 mi.
~No. Result* Analyst
.E.C. Anch Fbks Jun []
Foxed
Time:
Client notified of unsatisfactory results:
[]
Phoned Spoke with
Date: Time:
Foxed
Membrane Filter: Direct Count
Verification: LTB_ fiGB
Fecal Coliform Confirmation ~
Final Membrane Filter Results , , --
Colonies/lO0 mi
COLIFIRM
CollfornYl00 mi
~~ Member of the $ 3g Group (SoCial& Ganerale de SurveiUenco)
ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA. FLORIDA, ILLINOIS, MARYLAND, MICHIGAN. MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA
JR's Pumping
PO Box 773511
Eagle River, AK
(907) 694-6454,
99577
Invoice
BILL TO
AWWC
6901 Debarr Rd
Ste. B
Anchorage, AK 99504
JOB SITE
Jody
11633 Inspiration
Lot 7 Manor Sbd
Eagle River, AK 99577
Invoice Number: 1166
P.O. Number:
!-Quantity ] [ ServiceType
1 Septic Pumping
Invoice Date 28-Sep-200 Order Num: 1166 Serviced 14-Sep-2000
Job Description: 1200 gallons
Ex~e~;i~n~ F -i:a~- ~.~(2 Workers I
$85.00 No No
@ %
Subtotal NonTaxed: $85.00
Subtotal Taxed: $0.00
Tax: $0.00
Subtotal: $85.00
Less Payment: $0.00
Please Pay: $85,00
Payment Terms: Net 30
CASI~ FORblATION
CASIN FORbiAT1ON
2.87
288
289
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHOBI'f'Y APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
{a) Legal Description (include lot, block, subdivision, se..~tion, township, range)
Location (address or directions)
(b) Applicanl Name ~_~~ Telephone: Home ............... Business
Applicant Address --~":C~ '~~--:'"'--~~:
(C) Applicant is (check one): Lending Institution ~; Owner/builder Lq; Buyer ~; Other ~ (explain);
(d) Lending Institution ~'~'~_~ ........ Telephone __~'~ ¢ 7¢ ~
Address ~' O, ~ ml~ rZG ?~~.-~. ~.~ ........ ~ 2
(e) Real Estate Company and Agent .._~1 ~.-- J~'~' -' ./~X'~-~
Telephone [0~ C~ ~f_
(f) ~ the HAA to the following address:
GFI~ lgSX
TYPE OF RESIDENCE
Single-Family J~ Multi-Family
Number of Bedrooms
Other
WATER SUPPLY
Individual Well'~:¢- Community D Public []
Note; If community well system, mest have written confirmation frorn the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite~L Public L~ Community [] Holding Tank [-J
Note: If community well system, rnust have written confirmation from the State Depar[rr ent of Environmental Conservation
attestin9 to the legality and status.
72-025 {I It84)
Page 1 of 2
EHGiNEERtNG FIRM PROVIDINL~ .,,ISPECTIONS, TESTS, FILE SEARCH, DA'~.. AN[) INFORMATIOf~
As ce~lified by my seal affixed hereto and as of the valid ation date shown below, I verify that rny i nvestig
A,~li-tc~r~, Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and ad
foe the nur~ber of bedrooms and type of structure indicated herein. I further verify that based on the information obtai
f¢om f~e Municipality of Anchorage files and from my investigation and inspection, the on-site water supply arid/(
w,'~!e'¥/aler disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
date of Ibis inspection.
I~¢ame of Firm Telephone
DHEP A PPROV_~A ~L~ ~
/4pprc'¥'ed fo;' _~.-¢~.~,~.~bedrooms by~
Approved __~ __ Disapproved(-`,/
T(~.[m3 of Conditional Approval
Conditional.
CAUTION
The ,Mur~cipa~ity of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Appro';ai cettificales based solely upon the representations given in paragraph 5 above by an independent professional
engm:aer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
ir~stitutions 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 Mumcipality of Anchorage is not responsible for errors or omissions in the
professions! engineer's work.
Pa.ge 2 of 2
~UNICIPALITY OF ANCHORAGE:
DEPT. OF HEALTH &
~ENVIRONMENTAL PROTECTION
AUG 2, 3 1985
R[¢EIVED
WELL DATA
MUNICIPALITY OF ANCHORAGE (MOAI
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
x._fDal Description:
Well Classification
Well Log Present
Total Depth
Static Water Level
~-~ ~ ¢'~ If A, B, C, D.E.C. Approved (Y/N)
Date Completed ~. \ _ r-( ~ Yield
Cased to (~:,L¢, c Depth of Grouting
/~--q'-~----~_ t..~.,~.-~ Pump Set At k.--hl(--~
Casing Height Above Ground ~ ~ ~ Sanitary Seal on Casing((~N)
Electrical Wiring in Conduit (Y/~ ~*--~ 'vJ~.~.~ ~_.,%~ Depression Around Wellhead (Y/~j)
Separation Distances from Well:
To Septic/Heff~im:j'Tank on Lot I, ~,,~ '
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole ~"~/,4 To Nearest Sewer Service Line on Lot ~ ¢4-'
Water Sample Collected by ~-~:..~-~' ~:i,~-~,~,,,...~ _¢..~O~r,.,-.-~-~ ;Date ~;-'7---~"
Water Sample Test Results
Comments ~.,J ~-¢.¢.¢.¢.¢.¢.¢.¢.~ L_ ~ ,,~,~ c
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer
B. SEPTIC/44OLD;~',~G TANK DATA
Date Installed '~'-~q ' "~' Size
StandpipeS) Air-tight Caps
Depression over Tank
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/14e~ Tank:
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course
No. of Compartments
Foundation Cleanout
Date Last Pumped
J4 · for "'-'-
Temporary Holding Tank Permit (Y/N)
To Building Foundation ~, ~
To DispoSal Field Lp ~
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72~026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata '~-'~5- ~/CC.--"'
Date Installed
Width of Field ~"
Square Feet of Absorption Area ~-~
Depression over Field (Y/~i)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation '~ '
Lot
To Water Main/Service Line LO ~ .-l--
T0 Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present(~:~/N)
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present)
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
panhole/Access (Y/N)
"Pump Off" Level at
/ ~ Vent (Y/N)
Pumping Cycles during Adequacy Test, Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed Date ~:~'~ - ~--'~ J ~"' ..
Receipt No. ~O ~ I ID
~ate of Payms~t
Page 2 of 2
72-026 (11/84)
CHEMICAL & GEOLOGICAL LABORATORIES Oz, ALASKA, INC.
TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL CENTER
5633 B Street.
Drinking Water Analysis Report for Total ColifOrm Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM: (*) See h on back
I.D. NO.
Water System Name Phone No.
Mailing ~Jdres~ .
City State Zip Code
SAMPLE DATE:
Mo. Day Year
SAMPLE TYPE:
J~-Routlne
D Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
[] Treated Water
Er'Untreated Water
SAMPLE
NO. LOCATION
I
3 I
4 I
Time
Collected
Collected
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
Satisfactory
[] Unsatisfactory
[] Sample too long in transit; sample should
not be over 30 hours old at examination to
indicate reliable results. Please send new
sample via special delivery mail.
Time Received
Analytical Method:
[] Fermentation Tube
~ Membrane Filter
Lab Ref. No. Result* A[~alyst
0~1220 (b)
Rev, 1983
BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Membrane Filter:. Direct Count
Verification: LTB. BGB
Final Membrane Filter Reeut~e ("-~") ,~
Time:
TNTC-- Too Numerous To Count
Collformll00ml
Collformll00ml
,.m.
DTio0102~
N
ENGINEERS, [NC.
MORTGAGE HOLDER
PLAT APPROVAL_
APPROVALG
LOTS [THRU 7, &TR, A
MANOR SUBDIVISION
LOTS 6 THRU I0 BLK. 3' MTN. MANOR SUBDIVISION
S&S ENGINEERS, Inc, s~vEvo~
1983-2015
DTI001025
MANOR SUBDIVISION
- ~, 198:5-2OI5