HomeMy WebLinkAboutMOUNTAIN PARK ESTATES #2 BLK 7 LT 6Mountain Pork Estates #2 Lot 6 Block 7 #017-432-10 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 ,Telephone 264-4720 SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME ON E I ~ NEW DISTANCE TO: , ~' Liq. cap DISTANCE TO: IF HOMEMADE: Wel I Manufacturer 7/ DISTANCE TO: Well No. of ,ine~ Top of tile to finish grade Length Type of crib Width Crib diameter Well Inside length Width Dwelling Material Foundation/~../ I.earest,ot Total length of linZ{ f Trenchw~2~ inches Material beneath tile ~ inches Depth Crib depth NO. OF~DROOMS No. of c.~_rtments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. Distance b et ~/7~f~* Total eff~orption area PERMIT NO. DISTANCE TO: Class Depth Driller Building foundation Sewer line DISTANCE TO: OTHER Total effective absorption area Nearest lot line Distance to lot line PERMIT NO, Sept c tank Absorpt on area(s) Building foundation PIPE MATER h~LS SOIL TEST RATING REMARKS APPR~ DATE LEGAL SIX INCH WATEr WELL Drilled AND CASED OUT TO THE DEPTH OF Drilled AT THE rate OF ~21o 00 PEr fOOt. 760 7e~t. 345-2948 LOCATION Of WELL site £t. 6 SZk. 7 ~t. 2~¢k ~4~t~..c~b~, WELL LOG: 0 .... 27' S4J~g 110 .~¢~.t o,~ boZZo~ o,~ ~o, te,z ~.f_.~. 7/2 Ho.'~Je. Su~b~e~Lbg~ ~AouY~d be Zn~taJ~tez~ MUNICI?ALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MAR 6 la qq Co.8.L o;L ,D.vL.tLL,za: ~'27.00 X 160 .:~ee.t: RECEIVED COST INCLUDES ALL LABOr AND MATERIAL FOr COMPLETION OF SAID DrlLLING.-~. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF' THANK YOU VERY MUCH, -'~"ii~5!~~] ~ BERNIE CLAUS OF RAMPART DRILLING WORKS DATE .7uP~'?-u-,~,e"4 177 ~~}~cc.'D6~ /Z' ~ ' ~ 0 DEPRR].'MENT ~'' HEF:ILTH RND EN',,,I'F:F~blMENTFII._ ~-~"O'f'ECTIFdq · ' :325 "' STREET., F,b, 3HC, RF, 3E., F.K. E.~'. '~,. ~_.,.'} ~ · FIPF'LICRN'F HEIblZ F'REY PL] E:F~::.,: '10-8L~.5 _.4 ....... 4.~, LF, CRTION L_PINE & SOU'FHF'flF.:K ¢.-; "-' LOT S I ZE LEGRL L_,E,,. MT PRRK EST ~2 2200E~ SE..RF.:E FI~E'I" T~FE UF _,OIL RE,_,UF..FTIUN _,~_,TEH I,~,.~TF..ENbH r,lFr?~iirlyrl NUMr-',EF.: UF BE[:F:C,3MS : :,OIL RRTING (SO FT,.."BR)= t5~ I~L~L3 ].'HE F.!EQUIRED SIZE /OF THE SOIL RE:SCIRPTION,,S"/S"FEM IS: ' THE LENG DIMENSION IS THE LENGTH (IN FEET':, OF THE TF. EN..H-' OR E:,F.:RINFIELD. ].'HE DEPTH OF R TRENCH OF.: PTT IS THE E:,!STFtNCE BETWEEN THE SURFRCE OF' THE GROUND RND THE BOTTOM OF THE EXCR',,,'RTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GF.:FIVEL DEPTH IS THE MINIMUH DEPTH OF GRFt',/EL BETWEEN THE OUTFRLL PIPE RND THE E;OTTOM OF THE ENCR',,,'FITION (IN FEET). PERMIT RPPLICRNT HRS THE RESPONSIBILIT'¢ TO INFORM THIS DEF'RR]"MENT DURING 'THE INSTRLLRTION INSPECTIONS OF RN'T' HELLS RDJRCENT TO THIS PROPERT'¢ RN[:, THE NUMBER OF RESIDENCES THFtT THE HELL ~4ILL SERVE. Ti...~.C~ ..'.." 2 > I II'-~]$F'EC:-]" Z C~ 1"-,I ~.: F~F-:E F-:EL%.,LI I BRC:KFILLING OF RN'T' S'¢STEM WITHOUT FINRL INSPECTION RND FIPPRO',,,'RL B'T' THIS [:,EPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RND RN'T' ON-SITE SEWRGE DISPOSRL S'¢STEM I"'4 :tE1Ct FEET FOR R PRI',,,'RTE WELL OR 158 TO 2RC~ FEET FROM R PUBLIC 1.4ELL DEPENDING UPON THE T'¢PE OF PUBLIC HELL MINIMUM DISTRNCE FROM R PR I ',,,'RTE WELL TO R PRI',,,'RTE SEWER LINE IS 25 FEET FIND TO R COMMUNITN' SEWER LINE IS 75 FEET. WELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ]:F't DR"r":; OF THE HELl.. COMPLETION. OTHER REQLIIREMENTS MR'¢ RPPL'T'. SPECIFICRTIONS FIN[." CONSTRLICTION DIFtGRRMS RRE R',,,'R!L_RBLE TO INSURE PROPER INSTRLLRTION. F'F--F:~"I ]: T E::-::F" 'r RES [)EC:E~-IE:EF-: I CER'TIFb' THRT t: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RI'.,!D WELLS RS SE:]'' FORTH B'¢ THE MUNICIPRLIT'-r' OF RNCHORRGE. ':2: I ~-4ILL INSTRLL THE S'.'r'STEM IN RCCORDRNCE WITH THE CODES. 3:: I UNDERSTRND THRT THE ON-SITE SEWER S'¢STEM MR',? REQUIRE ENLRRGEMENT IF' THE F.:ESI[.EN_E I':; REMODELED TO INC:LU[:,E MORE THRN 4 BE[,R]OMS. ~_...~..,, ,-:., ......................... . ISSUED E"T' ','4, 1~ ~ [~]~- ~T T~ ~LL' N~LL ~. :"(~)()IV ~(~ L]~ }E, ~, FEET. . December 28, 1975 ~780162 J-D Enterprises 600 West 45th Avenue ~13 Anchorage, Alaska 99503 Subject: Lot 6 Block 7 Mountain Park Estates Subdivision A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date° If there are any further questions, please contact this office at 264-4720. Sincerely, Les No Buchholz, R.S. Senior Environmental Specialist kWB/ljw enc: copy of permit 8:25 "I..,. 6E~E~ I.,I 45TH EST t .E "t" :!5; ! ZE TYF'E OF SCi]:[,.. FII3SEIRBTtOI'.,I SYS'T'EM IS: TI:;:ENCH ]: CERTIF:'Y ]"HRT 1: I Fli'"l FF~,!"1]:L. IF:IR !,.!:i:TH THE REt;:!UIF;.".EMEI'4T.S F:'OF?. OI'.,t.-..:E;]:TE: S'i;IEHEF;;:S:, I::INI} t.,.IEL. L..S F:!S SET FOI:;;'."f'H IE:Y 'T'HE I'"ILIN I C': !' PI::iL. ! TY OF F!NCF!OF~:RGE. 2: t !4 :!: M_ ]:tq:i?l"F~M._ THE SYS]"EM I t",1 I::ICCOF,:[:,i:::It',IE:E !4 !' ]"H THE CO[.':,E:5. 3:: :1: I...Ii",I[:,ERSTF:INI} ]"HFtT THE ON'"".:FJ!TE SE!.qEF.': :.:'i;YS]"EM P'i!:::!Y F;?.E(;:!UIF;;:IE ENI_FIF~:GEMEI',IT ]:F:' ]"FIE F:;:ES :[ DENCE !'."~; REMO[:,ELEt:) "t'O I NCLU[:,E t'ICd:;'.E TtYl;:It",! 4 t~!:E"'Z[:,t:;;:OOMS. MF:h',-:;]: MU.h'I I'.4UPIE:ER OF E:E[:,I~:OC$1S.; = 4 SO ! L. RFtT I NG ,( SQ FT,.."SR :: ..... "l"l...li:::' l..X.:Ef_::!l_.l ]: RED '_..'5:, :!: ?.F:".': (iF 'T'HE ::.:;f' 'ii L I::tI?.:j;ClI:;~:PT ! O!",I i1::::,, EE: ".¢::' "".r"' t!,-~ ...... ::IL. :a... L.. IiEE ?-.,~ C}~ -f- F.q ......:]~:L:ii ':a._ E I1 .....IE>, Ii!!E: F" '"'1!'"' Ifll ...... ]"HIE LENGTH [:, Z MENS I O1'.,! )' ':.J THE I~..!ENGTH ~ ::, OF "[]t-..tE "FF-::Ei'.,!CI-.! O17. I}RFI:[ I'.~F::' I EL.D. THE DEPTH OF:' F:I TREI"4CH lip:: F::';[T I':.:.; I..-~E :ti'-I~:. E:ET~/IEEN THE S:;LIt:;;:F:'FtCE OF:' THE ). G!:;:]I. I'-![, 1'":lI'.4E:, 'T'HE E~OT"r'oI',! OF TI...I[~: E,--, .H, bll :]:1"'4 'T!'.tERE 1".:!!; 1"40 SET I,.II[)]"H F:'OR '1"1; / .x THE .TRF, [.L. [:,EF:']"H I:E; TI-.E t'"! I:;;:F:t',~L E:ETHEEN (}1.,I T F I::II...L, F:' i F:'E " L THE' E',OTTEIM OF-' "Fl.-IF:' EXCFI',, 'I']N \(Il",! ~ . u:-:;~: [1~!~:~ C;;:~ ILJl % F~'.' E~.£ E:::, :S:; EE F:" '"T" ][ C~ ""H"" .r.,::-:~ ~'*.Ji U-=:: S'.-."; % 2-}.'. lEE ==.~_. ;;;.-?:_" ~!!~;; ~(;:..'~, u:::~ I~:::::~ L. !L_. C]:n iP..~ ':'~; Fz'IERi"t, 2!; '1" Fhr':'F'L. I CFIF,IT,[I-t1::I":!!; ]"HIE R :.::'.~ F:'O 113 I/L/. t T 'r TO I.,I~~~IZ'..:.; I.".:,EF'FIIi:'T'MENT [:,lJl:;: ]: t",!G THE :[ h!STF:ILM::IT I ON I 1"4Sfi'ECT IONS'; or-:' FIN ~_L...S Fi[:,J'F~]'.,tT TO '1"I...I I':i; F:'ROF:'I?_-':I;;:TY F!I'.,ID THE NIJME¢IER OF:' F::ES:;I[:,EI'..~CIES THFIT 'T'I~.E !.,.!EL.L. HILL ~¢EF..:',,,'E. // ...... "'¥' iI..,,..~ C::~ ":'~ 'J~!: ::" % ['"i ::':':¥ F::" E: C: '~)F/ % ,L"::[ lt".ql :SE:',' ~'r::::~ F,;t E:iF I~"q;: E: C;;;:." ~._~ ][ IF;;?.' E: ES:: ........................ E:F:ICI<F:'IL.L.]:I'.~,Ei OF:' I::!I",!'¢~SY'.::;TEM i.,.!]THE~UT F}'f",tt::IL. !I",!:E;F:'EC]"tO!"4 FIt',![)I:::tF:'PRC¢,,,'FII. Eft' 'T'H 'I: ::"-i; DE ::' :: Fi "'i-" E' NT I.,.t ]: L.I... !~E \':?.;UE:.TECT q" ] F'R ] '.:;.t~{i:: ... 'T' I O1'!. ~ ,,. LI.I.~IEi FI.::']~/[' F'OR !::! PRI'v'F:!]'E I.'.IE. LL..~ OR ::lJ:.SI;:.'~ TO ;.:.!'.¢30 FEET I::'F~:OM FI F'IJBL]:C HELL. E:,EF::'[.:.'NDZt",IG LIF'OI'-,t THE TYPE OF:: F'LI[3L. IC I.,.IEL. L. I,.tEI_!.... LOGS FIRE REg!Ut!.7.-'.ED RN[:, ML.IL:;T 8E F;;:ETUF;.:NE[:, ]"O 'T'HI'X DE'F::'F:tRTMENT t,.!ITHIt"4 ]:El DI:::IY:E; EtF:' THE !.,.!E:LL E:Oi"IF'LET!EIN. OTHER !~:EI~!U Z REMEI",FFS MI:::iY i::tF:'F'LY. ':'!!;F:'EC ]~ F ]: (-":1::1]" Z Oi'.,!'.;~; FtI',ID C:ONSTRUE:T I ON [::, I t:::lL"iil:;?.!::liV!'.:~; F:IRE F:I'Y'I::I :I: LF:II:'~;ME TO ]; I',tSLII'~:E I::'RC~F::'ER :[ !",ISTFtLL.FIT I ES!. 2204 Cleveland Anchorage, Alaska 99503 Performed For j_p Enterprises' Oate Performed._4-]l-7~ Le~al ~escrtntton: Lot_fz__Block./__Subdtvtston MOuntain Park Estates~_~__. This form Renorts Sotls Lo~~~ Percolation Test Oeeth Feet Sot1 Characteristics 4---~ 12-- Peat Brown Gravelly Silty Sand 14-- Brown Silt Bottom os Test Hole 18-- 20-- Was Ground Water Encountered/ No If Yes, At what Depth? Readinq 4-13 ~_______i 4-13 Date 4-12 __ Gross Time Net Time 4 Hr. Sat. Depth to H20 57 1/2" N~_O .water Net Dron 10 min. 65" 10 min. i 71" . , R ~6" -~6" _ I mi . '2" I 10 m.~i n ,._____] '0 " Percolation Rate 1"/8 Uinute Prn.osed Insta~1~ation: Seeoaae Pit Drain Field , Oeo~h of~Tn-te~ . Oep~-B--~Tom Of Ptt O~ C~M~TS.~t. draina_j~e ar'------'~a re--er bedroom. __ :. CTL Test Performed By Data Certtf~edDateB~:~)~ Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES 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 017-452-10 1. GENERAL INFORMATION Complete legal description MOUNTAIN PARK ESTATES SUBDIVISION ~2: LOT 6. BLOCK 7 Location (site address or directions) 7051 SOUTH PARK DRIVE, ANCHORAGE, AK 99516 Property owner Mailing address Lending agency Mailing address Agent BETH SIMPSON HENRY AND ROSEY FREY Day phone 7051 SOUTH PARK DRIVE, ANCHORAGE, AK 99516 Day phone Address ¢/0 DYNAMIC PROPERTIES, ,3111 (907) 787-4500 Day phone (907) 261-7600 "C" STREET. ANCHORAGE. AK 9950,3 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well x× Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding Tank Community on-site Public sewer NOTE: xx If community wastewater system, provide wdtfen confirmation from State ADEC ing to the legafity and status of system. 72~025 (Rev. 1/91) Front MOA #21 Computer Version Note: Alaska, Water. and Wastewater Consultants, Inc,. shaft be paid $1168.64 or prior to, closing for the engineering services provioec~. 5, STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipa,I/~q"d State codes, ordinances, and regulations in effect on the date of this inspection. ~../'.// NameofFirm ALASKAWA'T'~R&~ST, E~V,~,TERCONSULTANTS, INC. Phone (907)337-6179 I ~ t/ ////I Address 6901 DEBARR ROAD/Stilt ~ .2B//,~,b4CH©RAGE, ALASKA 99504 Engineeds Signature ( ¢-'~, ,~/¢'~/~' ~/~ Cw ~ Date ¢~, c~ __ - / In conducting this evaluation, AWWC, In~ a~ter~i ,ted to,de a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA ¢DHI; $ 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 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 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. AWWC, Inc. can therefore not provide any warranly for future estimate of how long the 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. 6. DHHS SIGNATURE ~ Approved for "~ bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: Note: The well for this property meets existing State and Munic~p;~l Cnd.es. There are nitrates present. It is suggested that periodic testin~ be performed to insure the wells continued suitability. Current nitrate concentration is 8.53 mg/1. EPA maximum concentration is 10.0 mg/1. More information on nitrates is available from the On-site Services Program, DHHS, 343-4744. The Municipality of Anchorage Depadment 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 cedificate 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 #21 Com~uter Version /lUG ~ 8 2000 Municipality of Anchorage ~ DEPARTMENT OF HEALTH & HUMAN SERVICES ~ ......... MUNICIPALITY OF ANCHORAGE Envimnmema uenncos un~s~oo..,,-;,':_... ~ 825 "L" Street, Rm 502 Anchorage, Alaska 9950~l~t~/")N~T4~Ji~RV CES DIVI$I(~ Health Authority Approval Checklist Legal Description: Mountoin Pork Estotes #2; Lot 6, Block 7 Parcel I.D.: A. WELL DATA Well Type PRIVATE If A, B, or C, attech ADEC letter. ADEC water system number 017-432-10 Log present (Y/N) Y Date completed Total depth 160' Cased to 67' Sanitary seal (Y/N) YES FROM WELL LOG Date of test 6-3-81 Niflate 6/5/B1 Casing height (above ground) Wires properly protected (y/N) AT INSPECTION 5-26-2000 65' g,p.m. 4.8 9 - ~' 3 n,~ o~er bectsda 5-- Collected by: A.W.W.C., INC. 1250 Number of Compartments Depression (Y/N) NO High water alarm (Y/N) Pumper. A+ HOME SERVICES Static water level 75' Wall production 6 WATER SAMPLE Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed 5/29/B 1 Tank size Foundation dsanout (Y/N) YES Date of Pumping 2/26/2000 C. ABSORPTION FIELD DATA Date installed ~ 5/29/81 Length 61' Width Effective absorption area 450 N/A 1 2"+ YES g.p.m. 2 Clsanouts (Y/N) YES N/A Soil rating (g.p.d./fl2 or fl2/lxlrm) 150 System type .Grovel thickness below pipe 4' Total depth Monitoring Tube present (Y/N) YES Depression over field (Y/N). TRENCH 6' NO 3 Bedrooms gal. watsr edded On.): 21.25 450+ GPD Date of adequacy test Fluid depth in absorption field before test (in:); Fluid depth 16" (ins) Minutes later:. Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* Gomputm- Vemlon 5/26/2000 Results (Pass/Fall). '~' PASS For 8 Immediately after 760 100 Absorption rate = NONE KNOWN If yes, give date Date installed ..... Manhole/Acceso (Y/N)_ ~ ~~" level at* "Pump offf level at* _ Septic/holding tank on lot Absorption field on lot. Public ~ewer main Sewer/septic service line E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 100% 100'+ N/^ 25'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Water main~ervtce line 10'+ Surface watar/dmlnage 100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property fine 10'+ Building foundation 10'+ On adjacent Iota 100'+ .On adjacent lots 100'+ __ Public sewer manholelcleanout N/A Lift station N/A Absorption field Wells on adjacent lots __ 5'+ 100'+ Water maln/cervice line 10% Surface water. 100% Driveway, parking/veh cie otomge ama__. 10 + _ HAA Fee $ Data of Payment ,~//c~,/0'-~, , 72-026 (Rev. 3/g6)* Computer Vemlon Waiver Fee $ Date of Payment Receipt Number 06-66-00 06:42 FROM-CTE ENVIRONMENTAL .CT&E Environmental Services Inc. 5615301 T-191 P.02/03 F-304 CT&£ Project N'la, ltlelt~ Client Sample Ordered By pWS~ 1004835001 AK. Wale~ ~r WasTewaler Consaltams Inc. Mm Park 2 L6. B7 Mm Park 2, LO6, B7 Ddnking Water 0 Client pOP Printed Dale/Time 08/24/2000 12:21 CollecTed DaTe/Time 08/21/2000 14:00 Received Date/time 08/21/2000 14:00 Technical Director Stephen C. Ede Released B~ ~ Sample Remarks' Results PQL Umr~ Meti~d Lirmls Date Dare Init Ni~ate-N 8.53 0.500 mg/L EPA 300.0 10 max 08/*-2/00 SCL M4 crob~olog~r LabOratorY Tor, d Cohform 5 OB, No C0h ~ol/lOOmL SMlg 9222B 08/21/00 KAP 08-25-00 05:42 FROM-CTE ENVIRONMENTAL 5815301 T-151 P.03/03 F-304 CT&E Environmental Services Inc, Laboratory Division ~.d'll,~a',d~,~,e 200 W. Po°er Dave sis Report for Total Coliform Bacteria ^"="°'""" ^K ees~.-~soe Drinking Water Analy To~: mo?} sa:.2a4a , VER, EE SZDE BEFO~ COL~CTING SAMPLE Fa~ 1~7 fi81-5301 "' ............ Analysis ~hows ~is Wa~ SAMPLE PUBLIC WATER sYSTEM l.lB. pRiVATE WATER sYSTEM ~3 ~ $endR~ulr~ SAMPLE DATF~ ~ Mood! SAMPLE TY~E: o Routine with tab reC no._j ~) 0 Special ~urpos~ sAMPLE LOCATION Day Year r~ Trear~M Water ~ UnTreateU Water Time Collecte~ Coll~ed By Sample over 30 houri o1~ resu}~ ~y be ~h~lc nog ~ ov~}~ou~ ol~ at ex.ma°on m indicam gillie ~ul~. PI~c s~d new s~pl~ ~a spgial ~x~ ~?./ Client notified of unsatisfactory results: Phoned Spok~ wlrb Faxea BACTERIOLOGICAL WATER ANALYSIS RECORD ENVIRONMENTAb FACII.ITIE& IN ALASKA, CALIFORNIA, FLORIDA, IU.,121S. MARYLAND. MICHIGAN, MISSOURI. WE'd/JERSEY. oHiO. wEST VIRGINI.~ ALASKA WATER & WASTEWATER CONSULTANTS, INC. June 5, 2000 Heinz and Rose Frey '~"~'"~=~' ~ ¢?'~// ~chor~c, ~ ~5~6 ' -~ -~ ~ ' ~ ~0~ Subject: Lot 6, Block 7, Mo~t~ P~k E~ates Su~i~ion ~2 D~ ~. ~d ~s. Per your request we performed a well flow test and a septic adequacy test at the referenced property on May 26, 2000. Our findings are summarized as follows: WELL: A flow test was performed for the well on 5/26/2000. Prior to starting the test the static water level was 63 feet below the top of the casing (BTC). The well produced 1164 gallons in 240 minutes with a maximum draw down of 7 feet. This corresponds to a flow rate of greater than 4.8 gallons per minute. Upon this data the well production meets the MOA requirements for a three bedroom house. SEPTIC SYSTEM: A septic adequacy test was performed on 5/26/2000. Only the south portion of the trench was tested. On the day of our inspection the liquid level in the monitoring tube (MT) was found to be 19.5" below the invert of the drainpipe (the sump only ex~ends 27.5" below the invert) prior to the septic test. 760 gallons of water was introduce into the MT which caused a liquid level rise of 13.25 inches. 100 minutes after the flow of water was stopped the liquid level had dropped 5.25 inches, indicating that approximately 300 gallons had been absorbed. From this test it was determined the septic system meets the MOA absorption rate for a three bedroom residence (450 gallons per day). The tank was pumped prior to the test by A+ Home Services. The adequacy of a septic system is influenced by numerous factors, including, but not limited to, seasonal surface water infiltration, groundwater variations, septic system maintenance (frequency of septic tank pumping, usage of biological additives) conditions of drainpipe and pipe joints (which can be damaged by seismic activity and deteriorate 6901 Debarr Road, Suite 2-B * Anchorage, Alaska 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * email: akwwc.com misc. objects), and the amount of water being introduced on a continual basis. Consequently, the results of this adequacy test are only valid for the specific day of the test. Furthermore, because of the limited nature of this investigation, it is possible that there are hidden defects which may not have been detected. No warrantee is made regarding the future performance of this septic system Once you have a buyer water samples will need to be taken and the paperwork will submitted to the Municipality of Anchorage (MOA) for Health Authority Approval. The costs are as follows: $100.00 Water Samples $300.00 HA), fee If you have any ques )ns or concerns, please contact us. We appreciate your business. s 4_ Seffr~p ~. ~ arness, P.E., M.S. Pres~efit ~ JAG/jwm 6901 Debarr Road, Suite 2-B * Anchorage, Alaska 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * email: akwwc.eom MUNICIPALITY bF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF H~ALTH AArD ENVIKONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or direction) (b) (c) (d) (e) Applicants Name H~n z F~e/ Telephone - Home Business Applicants A~dress ?.O. go~ I/c;~9o~ .~ ~n~[~f ~R ~9~lJ Buyer ~; Other ~ (~plain); Lending ~nstitutiom /~ ~ ~ S ~ Telephone Real Estate Co. & Agent Address Telephone (f) ~the HAA to the following address: ~ype of Residence Single-Family~ Number of Bedrooms Individual Well~ .0 Multi-Famtly.~. Other (describe) ¢o, nni [i Public I i iii Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 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] 5. Ensineerin~ Firm Providing Inspections~ Tests~ File Search~ Data and Information As certified by my seal affixed hereto and as of the validation date show~ below, I verify that my investigation of- this Health Authority Approval shows that the om-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 M~nicipality 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 regula- tions in effect on the date of this inspection° Name of Firm Address I ¥~30 Approved for~~%edrooms Approved ~ Disapproved Terms of Conditional Approval CADTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ~ALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT~ ATIONS GIVEN IN PARAGRAPR 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTE~k~D IN T~ STATE OF ALASKA. THE DMEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTSo EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED° TH~ MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK° (DHEP SEAL) RRd/ej/D18 [Page 2 of 2] 7-19-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: 81o¢ t* WELL DATA Well Classification ~v~v~'~ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) ~ Date Completed ~Z3/~{ Yield Total Depth ~ ~O¢ Cased to ~7¢ Depth of Grouting N,~- Static Water Level ~ Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot Pump Set At (.Z4/,~-~c~u.'~ Sanitary Seal on Casing (Y/N) ~ Depression Around Wellhead (Y/N) N To Nearest ECge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results ; On Adjoining Lots 'p~ I ~O' ; On Adjoining Lots ~. To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date. ~ ~ / ~ Comments B. SEPTIC/HOLDING TANK DATA Date installed .¢',,/8.~'/,~/ Size Standpipes (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well _{1~° To Property Line ~ To Water Main/Service Line Course ~ ¢OO¢ Air-tight Caps (Y/N) No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped ,/, ~' '¢' ;for ~'~ Temporary Holding Tank Permit (Y/N) To Building Foundation ~ ~." To Disposal Field 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 1,5'(:2 Date Installed ~/~-'~ /~! Width of Field ,,~ ' Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: Type of System Design Length of Field Depth of Field ~,,..,¢~G.~a~l Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test 3 6 To Water-Supply Well To Building Foundation 20' Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line IO ~ To Existing or Abandoned System on ; On Adjoining Lots ~ :~O To Cutbank (if present) lO0 ' D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/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 ** certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. t/a/aK Signed ~]-'~ ~, ~ Date Company ¢(¢/"/-o/~ ~"¢c~,q.-a/ ..C¢,'u~'¢~MOA No. Rsoeipt ~o. ~ ~ ~ ~ ~ Dateof Payment ~- ~ ~ Amount: $ ~ ,OC~ Page 2 of 2 72-026 (11/84) Engineer's Seal .,,? ~. DA'i=~ RECEIVED ~,/ ~- INSPECTION APPOINTMENTS TIM~E TIME TIME C'f'~4 - ~ '. ,'x~ ~ r.,o, DATE DATE DATE ~U~IClPALITY OF A~CHORA~ DEPT. OF HEALTH & ~.~m~ o~ .~. · ~w~o~ ~o~c~o~mT~U ~ROT~CnO~  82S LStreet-Anchorage, Alaska 99501 NOV 2 ~ 1981 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 R E C E 1 V E D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIHECTIONS: Complete all parts on page 1. Incomplete requests will not be proce~ed. Please allow ten (10) days for processing. 1. PROPERTY OWNER I PHONE MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION I PHONE MAILING ADDRESS 4. REALTOR/AGENT ~ PHONE I MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION c.o~ s o~./wj4 ?,~'<~¥ .ff Z.--(.4 f~ l 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four [] Other__ ~ SINGLE FAMILY ~ Two [] Five [] MULTIPLE FAMILY [] Three [] Six 7. WATER SUPPLY J~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) ' 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SiX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [~]INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: /~-.~0 If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL . /)~ 4, DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS E~]//'APP ROV ED FOR ,-) BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY 72-010 (Rev. 6/79)