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HomeMy WebLinkAboutCONTOUR ACRES BLK 2 LT 2Contour Acres Lot 2 Block 2 #017-451-16 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: 545-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW990210 P]D Number: 017-451-16 Name:BRIAN HOEFLER Wastewater System: · New [] Upgrade Address: 5520 COUNTRY CLUB LANE ANCH., AK 99516 ABSORPTION FIELD Ph°ne:(907) 561--2139/345--8496 Ne. of Bedrooms: 5 · Deep Trench ~ Shallow Trench B Bed O Mound O Other LEGAL DESCRIPTION 0.6 ~,,/sq. ~ 9.03 - 9.52 2 2 CONTOUR ACRES 1.82 - 2.51 ~ 7.21 - - - 1.19 - 3.24 ~ 90 WELL: a New ~ Upgrade 2.5 ~ 1~ - PRIVATE 265 ,. 250 ~ 1298 so.~ ASTMD-3034/F810 ALPINE DRILLING 10/20/99 214 ~. KINCAID + SONS 2/17-3/2/00 TANK SEPA~TION DISTANCES = s.~t~ ~,o,,~., ~ s.~.E.,. To Septic ~so~Uon ~ft Holding ~ubl~c/Pdv~te From T=nk Reid St=tion T=nk s.~.r u..~ ANCHORAGE TANK 1500 Well 100'+ 100'+ - 25'+ STEEL 2 su,.=. ~oo'+ lOO'+ - LIFT STATION ~ Water Drein NONE KNOWN I I Remarks: ~,~ I~ ~ coo~ BENCHMARK ~, ~ ~ ~ ~ THRESHOLD OF MAN DOOR ON NORTH {~O~ END OF HOUSE 100,00 ~ .............. i '.~'~ Inspections pe,ormed by:_ AWWC, INC. Dates: 1st 2/,7/00 ,~':. E ~ ~ ........ ~.~. 2nd 3/2/00 ~ t~ ~ ~ ~ ~ ....... t.....".-: 3rd 3/6/00 & %id ~f r~/~ 'nes~.' of Health and Human Semites approval DepaAment ~h?~ ',.. ,..' Reviewed and approved b ~ ~ Date:~-9o-e° $W990210 017-451 -16 ~ T TH~5 DBLI~ I ~1 (~OCYCLE OR / / FCO ST~ ~.o3 ~3.5~ ~N / co2 ~.9~ ~o~.o4 ~ 55 6/26/2000 BRIAN HOEFLER (907) 561-2139/~45-8496 2 OF 3 , ~eTre, A. ~s~: "~ _E~AL DESCRIPqON: qk ~_., . ~ ,.' '~ CONTOUR ACRES SUBDIVISION; LOT 2, BLOCK 2 AS-BUILT OF SEPTIC SYSTEM UPGRADE :. A B ST1 34.03 6.3.58 ST2 42,30 70.68 DBL1 45.51 73.39 DBL2. 46.36 74.17 C01 59.88 89.17 MT 72.49 91.05 C02 98.91 08.04 PERMIT NUMBER: sw99o~o AS BUILT DRAWING PARCEL'"C4 FIt¢~ PREPPED fOR: PHONE NUMBER: PAGE NUMBER: BRIAN HOEFLER (907) 4/18/00 3 Of CONTOUR ACRES SUBDIVISION; LOT 2, BLOCK Z, AS-BUILT OF SEPTIC SYSTE~ UPGRADE ........ _C_ ~O~JNTRY Ct. UB 00'01'00" w 275.00' LANE ,00'~0~' ~ .Og',60. O0 N Fpom : ALPINE DRILL 90? 345 0202 Jun. iS. 2000 09:29 PM Munici alit of Anchorage · p Y Department of Heal!h and Human Services 625 'L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 .. Rick Mystrorn hllp:l/www.ci.anchoraga.aR.us ' · Mayor Per,nit Number: #SW~9~0219 Date o£.Is.~e: .7~2t-99 Parcel Identification Number:~ Dale SLaHe~,: ~ Date Completed: 'I0-20-99 Is well located at approved permit location? [] Yes [] Legal I)eaer~pttoU~: Contour Acras BIk 2 It 2 PrOl~rly Owner Name & Address: Borehole Data: Soil 'type, ]'hietates$ & Water Strata sticl~-up silt gravelly silt silty cobbly gravel w/bldrs gravelly silt s#ty cobbly gravel w/bldrs silty gravel water sand S gravel silt bedrock Bdan Hoofler 320f Merganser Ave Anchorage, Ak 99616 Oepth (ft) From To 0 2 2 4 4 4~ 41 65 65 18t 181 210 210 221 221 226 226 247 247 265 RI-'_C £ IV£D JUN 28 2000 Municipality of Anchorage Oept. Health & Human Service~ Method of Drilling [] air rotary Casing type: ~teel Wall Thickness: .250 inches Diameter: _6 inches Depth: 2~50 feet Liner Type: Diameter: .__ inches Depth: Casing stiekup above ground: _2 feel [] cable tool Static water level (t}om ground level): 214 feet Pumping level: 265 feet after _2 hours pumpiDg _4 gpm Recovery Rate: _4 gpm Method of Testing: Air lift Well Intake Opening Type: [] Open End [] Open Hole [] Screened Start feet Stopped , [] Perforations feet Start 22._.~ feet Stopped 226 feet Grout Type: bentonite t! 8 Volume: 1 bg Depth: Start_0 feet Stopped feet Pump: Intake Depth .__ feet Pump sim hp Brand Name Well Disinfected Upon Completion? [] Yes [] No Method of Disinfection: CIorin~ rObla(s Comments: Well Driller: Alpine Drilling & Enterprises P.O. Box 110496 Anchorage AK 99511 A~tention: Tim well driller shall provide a wall Jog to lhc property ownor withi*~ ~0 day, of completion aad the properly MUNICIPALITY OF ANCHORAGE Depalfment 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/WATER sUPPLY PERMIT ~/'O~/(P'~.?'~ pY'v~ Initial Date Issued: Jul 21, 1999 Expiration Date: Jul 20, 2000 Permit Number: SW990210 Legal Description: CONTOUR ACRES BLK 2 LT 2 Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: Brian Hoefler Owner Address: 3201 MERGANSER AVE ANCHORAGE, AK 99516-2708 Parcel ID: 017-451-16 Site Address: 005320 COUNTRY CLUB LN Lot Size: 124700 SQ. FT. Total Bedrooms: 5 Permit Bedrooms; 5 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. Received By: Issued By: Date: ALASI WATER & WASTEWATER February 28, 2000 Municipality of Anchorage Department of Health & Human Services Division of Enviromnental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Second Revision of Septic System Design for Lot 2, Block 2, Contour Acres Subdivision. Permit # SW990210 To whom it may concern: The design for the septic system on this lot was modified on 10/5/99 and verbally approved by Donna Mcars. The test hole locations were aproximate on that design and have been corrected by a land survey. Much of the proposed area around test hole #2 is buried with up to 4 feet of fill. Also, the new septic tank has been placed in the proposed area. Consequently, we have performed additional soils tests and relocated the drainfield accordingly. If you have any questions, please call us at 337-6179. jei ~x~ Gaha~s, P.E., U.S. Pr, fit NOTE: Attached is a site plan drawing, soils logs for the new test holes, and a design drawing which are all part of the revosed design package for this system. 6901 Debarr PPad,, Suite 2B ~ Anchorage, AK- 99504 ~ (907) 337-6179 ~ Fax (907) 338-3246 Ii' DESIGN / REVISED ,, I CONTOU~ ACRES S2;"D \ -.~ <~ LOT 1 BLOCK \ ~sx~ W~T~ CONTOUR ACRES SUB"IVISION. LOT 2, BLOCK 2, BRIAN HOEFLER 565-2159/345-8496 )A~: JD~WN BY: JSC~: PAGE: 2/28/00 J J.L.M./J.W.M. J ~0'~7~ Z ~ iz~o~°- /111 · PROPOSED DEAIN.~.,~E~. EXCAVATE A--~ RESERVE srTE (BIOCYCLE OR-~ TRENCH THAT IS (~ET DEEP (MAX), ~ REACTEX SYSTEM, UFT I~Y 90 FEET LONG-BY 2.5 FEET WIDE, ~ STATION WILL BE NEEDED) I ~//~ i TO SLOPE CONTOURS. X, ~ ~ ...... -.... 10' UTILrTY EASMENT ........ ,~/ , ..'Y"X ?.; .~°/ _ x ...-/.'-' _~ <;" ~ J TH#2 / ~--EXlSTING 1500 gALLON ~ j . / SEPTIC TANK ALASKA WATER AND WASTEWATER CONSULTANTS, INC. ~'~'~'~'~ 0901 DEDARR ROAD, SUITE 2B, ANCHORAGE, AK, 99504 PHONE: (907) 337-6179/FAX: (907) 358-3246 ' "' LEGAL DESCRIPTION: .,, 'IYPE OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE DATE:2/28/O0 J.W.M. 1 -- 40' ;[ OF 2 ~rOfess[O~ I ALASKA WATER & WASTEWATER CONSULTANTS, INC. PHONE (907) 357-6179 * FAX (907) 338-3246 ' ISOIL LOG - PERCOLATION TESTJ ~.:'..~.~ !~.,..~.. LEGAL DESCRIPTION: CONTOUR ACRES SUBDIVISION; LOT 2, BLOCK 2 ~ ///,~i,y~x.~__..~.- PERFORMED FOR: BRIAN HOEFLER DATE PERFORMED: 8/12/98 (/O~..'"J.. C~-7953 ....",~ JtEST HOLE #2J __ : ORGANICS 1..... ._. (PAGE 1 OF 2) ~ ORGANIC/LOAM SOIL CLASSIFICATIONS 2~-j~~: -- ~ SITE PLAN1' +THi~ GM Cl i GC OL o ,SW HH *THIS THJ2 ~ sP CH ~--~ SM OH DEPTH TO DATE - -- ML 3ROUNDWATER DENSE SILT WITH SM LAYERS DRY 8/12/98 J THROUGHOUT DRY 8/19/98 PROPOSED ,~ ,~'~'~ ~ V j ' I , 11[llllt ' DATE READING CLOCK NET TIME WATER LEVEL NET DROP l J]:"[,: TIME (MINUTES) READING (INCHES) 12 8/13/98 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING 13 1 2:30 6" 2 .3:00 30 2" 14 3 3:01 6" 4 3:31 30 2" 4" 15 ~'~B.O.H: 5 3:35 6" 16J -'- 6 4:05 30 2" 4" 18 19 PERCOLATION RATE 7.5 (NIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20 TEST RUN BETWEEN 3.5 FT. AND ~.0 FT. COMMENTS: PERCOLATION DATA ON THIS PAGE FOR UPPER BENCH PERC. HOLE ONLY. PERFORMED BY ALASKA WATER & WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON DATE: ~/~/~ DEPTH TO DATE 3ROUNDWATER DRY 8/12/98 DRY 8/19/98 ALASKA WATER & WASTBWATER CONSULTANTS, INC. [SOIL LOG - PERCOLATION TESTJ LEGAL DESCRIPTION: CONTOUR ACRES SUBDIVISION; LOT 2, BLOCK 2 ............ PERFORMED FOR: BRIAN HOEFLER DATE PERFORMED: 8/12/9B ~2,~,:.b'.... ~:-7953 ....'~,~ DEPTH--(feet)ITEST HOLE #2[ 1-- (PAGE 2 OF 2) '~'~.~.~-~.'~.."~:~ S~iL CLASSIFICATIONS :~t:.,..~ ~ SITE PLAN1 ;:.,,;..-.¢::, GW ~=~: ORG I": I00' J 4-- GC OL 'm#,~ SW MH *'m#5 B-- Sp CH 6- LU'--' SC . --. a. SROUNDWATER DATE - -- 10-- 3: . , u CLOCK NET TIME WATER LEVEL NET DROP 11 -- ~- DATE READING TIME (MINUTES) READING (INCHES) U-0 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING 12-- 13 -- ~ 1 2:29 L~ 2 2:59 30 3 1/4," 2 3/4," 14,-- ~ 3 3:00 6" o 4, 3:30 30 3 1/8" 2 7/8" 15-- ~ 5 3:35 6" 16-- ~u 6 4:05 30 3 1/8" 2 7/8" 17-- 18-- 19-- PERCOLATION RATE 10,4 (HIN./INCH) PERC, HOLE DIA, 6 ,(INCHES) 20----- TEST RUN BETWEEN 6.0 FT, AND 6,5 FT. COMMENTS: PERCOLATION DATA ON THIS PAGE FOR LOWER BENCH PERC, HOLE ONLY. PERFORMED BY ALASKA WATER & WASTEWATER, l, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERF~R~J/~D IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES iN EFFECT ON DATE: DEPTH TO DATE ;ROUNDWATER ?u~. WATER & WASTEWATER CONSULTA1N'TS, INC.~=~.~ OF',~;.,~ PHONE (907) ~137-6179 FAX (901) 558-3246 PERFORMED FOR: BRIAN HOE~ER ~'~ *' [ ..... ~"'] ..... :'"3 I TEST HOLE . · · 2-- -- F~ S I C~ SIFICATI NS SITE PCANk ..................... $-~7S .... ~ GW ~ ORG I r' = IOO' /N 4-- 3-- WI~ ML (DENSER DEPTH ', ~,* ~ ~, GM GP GC SW ~~ OL CL ~mt~ TH~7+ ML MH . -. +m~2X ~ I +mis mt2, 5 ' Sp CH SM OH // 7-- DEPTH TO DATE GROUNDWATER -~ 11- DATE READING CLOCK NET TIHE WATER LEVEL NET DROP TIHE (HINUTES) READING (INCHES) 121 2/25/00 1 1:38 6" 2 2:08 30 MIN 1 1/4" 4 3/4" 13~ 3 2:08 6" 4 2:38 30 MIN 1 5/8" 4 5/8" 14~ S 5 2:38 6" 6 3:08 30 MIN 1 5/8" 4 5/8" 19 PERCO~TION RATE 6.5 (M)N./INCH) PERC. HOLE DIA. 6" (INCHES) 20 TEST RUN BETWEEN 3.5 FT. Al ~.. 4.0 FT. PERFORMED BY A~S~ WATER ~ WAST~ATER I, , CERTI~ THAT DEPTH TO DATE GROUNDWATER / DRY 2/23/0,0 ALASIrdt WATER & ~TASTEWATER CONSULTANTS, INC. PHONE (907) 337-6179 * F~ (907) 558-3246 LEGAL DESCRIPTION: CONTOUR ACRES SUBDIVISION; LOT 2, BLOCK 2 PERFORMED FOR: BRIAN HOEFLER ,~.Jef ey . ~.' I, s,I DEPTH ~ 2 SOIL C~SSIFICATIONS ~'~-~-~- 111111111 , 0, SW NH TH~2 ~ Sp ] CH / SH ] OH // SC // TH~I DEPTH TO DATE DRY 2~23/00 lO~l~l]~l~l I ~ 11~sM DATE READING CLOCK NET /I~E WATE~ LEVEL NET DROP TINE (NINUTES) READING (INCHES) 12 2/25/0C 1 1:38 2 2:08 30 MIN 1 1/4" 4 3/4" 13 3 2:08 6" 4 2:38 30 MIN 1 5/8" 4 5/8" 14 5 2:38 6" 6 3:08 35- MIN 1 5/~" 4 5/8" 16 ~ 17~~ 18 19 ~ PERCOLATION RATE 6.5 (~IN./INCH) PERC. HOLE DIA. 6" (IMCHES) 20 N~)~ , CERTI~ THAT MU GUIDELINES IN EFFECT ON THIS DEPTH TO DATE 3ROUNDWATER DRY 2~/23/00 COMMENTS: PERFORMED BY ALASKA WATER & WASTEWATER I, { THISDATE. WASDATE:PERFORMED. z~/~ ~120ACCORDANCE WITH ALL STATl /~N ~.~ ALASKA WATER & WASTEWATER CONSULTANTS, INC. ~ OF' ~ 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK. 99504 ....... ISOIL LOG - PERCOLATION TEST] .r-.;.7. T ?-: DATE PERFORMED: 2/2,3/00 toilS..:. '.! ~-7953 .'" [Ih % '.. .." (fe*O TEST HOLE #7 '~I~,2"~,~ .......... '~', SOIL CLASSIFICATIONS 3-- ~ GP FT1T~ ML I ~,TH#4\\ TH#6 GM CL .,~s~ TH#7+ 4- GC o, ,~. ,?~. ~ ~- ~ sP CH / SN OH 7I--'~ DEPTH TO DATE 3ROUNDWATER (/) SEE PAGE 1 FOR 9-- <~ -- GROUND WATER. CD 10-- _~ 0 CLOCK NET TINE WATER LEVEL NET DROP 11 -- U') DATE READING TINE (NINUTES) READING (INCHES) n-' 2/25/0(3 1 1:57 6" 12-- 0 LL 2 2:07 ~0 MIN 5 5/8" 5/8" 1~-- --- 3 2:07 Ld 4 2:57 30 MIN 5 1/2" 1/2" 14--- (_9 5 2:37 ~ 6 3:07- ~0 ~N-- 5 1/2" 1/2" 15-- LLI 16-- (/3 ___ 17-- 19-- PERCOLATION RATE 60 (MIN./INCH) PERC. HOLE DIA. 6" (INCHES) 20-- - TEST RUN BETWEEN 8.0 FT. AN~/~ L5 FT. PERFORMED BY ALASKA WATER & WASTEWATER I, , CERTIFY THAT THIS WAS PERFORM)ED I~ ACCORDANCE WITH ALL S--"J-A~E//~)~'~JNIC'~P, AJz/GUIDELINES IN EFFECT ON THIS DATE. DATE: ~ Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B ~ Anchorage ~ Alaska 99504 (907) 337-6179 N Fax (907) 338-3246 Consulting Engineers July 8, 1999 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: Proposed Well and Septic System for Lot 2, Block 2, Countour Acres Subdivision To whom it may concern: The proposed 5 bedroom house will be served by an onsite septic system and a private well. Comments regarding the proposed upgrade are summarized as follows: SOILS: On August 12, 1998, two test holes were excavated and a percolation tests were performed. On April 30, 1999, three additional test holes were excavated and percolation tests performed. Attached are the soils logs and pe~colation test data. No ground water was encountered at the time of excavation of the test holes. Due to the favorable percolation rates and the overall appearance of TH#2 & TH#5, the primary site will be installed within the 30 foot radius of TH#5 and the alternate site would be installed the 30 foot radius of TH#2. Also, due to the overall appearance of the soils a 0.60 application rate should be used. TRENCH DESIGN: a. Percolation Rate: 8.6 & 9.6 minutes/inch (for TH#5 b. Allowable Application Rate: 0.60 gallons/day/ft2 c. Number of Bedrooms: 5 d. Design Flow: 750 gallons per day e. Minimum Absorption Area: 1250 Ct2 f. Maximum Total Depth: 11 feet g. Width: 2.5 feet h. Length: 2 ~ 45 feet long each (90 feet total length) i. Effective Depth: 9 feet j. Effective absorption area = 1620 ft2 SURFACE WATERS: There is no surface water within 100' of the proposed septic system. TOPOGRAPHY: As can be seen on the attached topography site plan, the average slope is a 15-20 percent slope farming from approximately east/southeast to west/northwest; in short, there are no slope concerns, The trenches are to be installed parallel to all slope contours. CLOSING: I am open to any suggestions from your department, which would be an improvement to the proposed design. 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 Y~I for your assistance. //! Sincerely ~ ! · M.S. Presi/ NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, nine soils logs and a 4 page construction specification letter which are ali part of the design package for this septic system. I ~ I LOT 1 BLOCK ~ mi CO.lOU~ AORES ........... _~ ..... ~ ~TERNATE ............. 5~ PROPOSED SEPTIC ~M ~ I :~-~--~" ~ ~ ' caS~ ALASKA WATER AND WASTEWATER CONSULTANTS, INC. PHONE= (~O7) CONTOUR ACRES SUBDIVISION, LOT 2, BLOCK 2, SITE P~N FOR PROPOSED WELL LOCATION 'REP~EO FOR: PHONE NUMBER: ~-~/~s-~4~ BRIAN HOEFLER m I DATE:7/8/g9// D~WN BY: J.L.M./K.D.W. 1 = 100' 1 OF 2 / NOTE: THE CONTRACTOR SHALL HAVE THE NORTH PROPERTY UNE FLAGGED DY A REGISTEREO LAND SURVEYOR PRIOR TO CONSTRICTION 10' UTIUTY EASEMENT /~LONw~G~pRoPOSEO DRNNFIELD '~. · CAVATE ~WO TRENCHS :il-lAm TH#3 J E 11 FT. DEEP (MAXIMUM) 2.5 FT WIDE BY 4,5 FT. TH#~4 LONG EACH. ADD 9 FT. OF CLEAN, HED DRAINROCK. INSTALL ~ T/////CO~//cO TRENCHS PARALLEL TO SLOPE LLI CONTOURS. Z 0 III III n Ii )- Il/ ~ I/i RESERVE SITE. ]WO'~....~ I ! . ' Ill ' III ..~_2.~. LONG TRENCHES ~/ // I-- Il/ fli WITH 9 FT. TOTAL DEPTH. ~. / Z ~ UTi/; /1! 6 FF. Of EFFECTIVE. / / ~L~/ / ~ PROPOSED ~ 'X ,~! UT,'I! I/ ~- I1 / 1500 GALLON '~ ~CO '"'~1 ;: ~ II / SEP]lC TANK 0 ~ ~_ ~. ~ INSTALL FCO~ /' WE.. \ 'X / ALASKA WATER AND WASTEWATER CONSULTANTS, INC. PHONE: (907)337-6179/FAX: (907)538-32'4-6 /'~'1 ."J-'~,', CONTOUR ACRES SUBDIVISION; LOT 2, BLOCK 2 ......... ~YPE OF WORK: DESIGN fOR PROPOSED WELL LOCATION AND SEPTIC SYSTE~ ,k~.~..~/ t/~ ~'k~=':'"'l BRIAN HOEFLER (907) ..... K,D.W. 1 = 4.0' 2 OF 2 ALASKA WATER & WASTEWATER CONSULTANTS, INC. ..~'~,-.r ,...,, PHONE (907) 337-6179 * FAX (907) 338-5246 I SOIL LOG- PERCOLATION T£STI ~.4it.}.~.~.. LEGAL DESCRIPTION: CONTOUR ACRES SUBDIVISION; LOT 2, BLOCK 2IL ~}[...2.~[ 8/12/98 DATE PERFORMED: ~. '.. __ u11;,% "-.[ ..." ORGAN,CS I TEST HOLE # 1 I 'a~'%~' ........ ~r o fess[o~ DEPTH (PAGE 1 OF 2) 1~ ORGANIC, LOAM ........ SOlE CLASSIFICATIONS ;~..,,:?.:.~¥: GW z~: ORG I" = I00' [ GP ML GM I CL .... SW MH ~J5 TH~2 - ~ ' SP I CH SM ~ OH SC ML SROUNDWATER DENSE SILT WITH SM ~YERS DRY 8/12/98 THROUOHOUT DRY -- Y ~o 11 DATE READING CLOCK N~T TIME WAIER LEVEL NEI DROP TIM~ (MINUTES) R~ADING (INCH~S) 12 8/13/98 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING 13 1 2:35 ~ 6" 2 3:05 30 4" 2" 14 3 3:05 ~ 6" 4 3:35 30 4" 2" 15 5 3:37 ~ 6" 16 6 4:07 30 4" 2" 17 _ 18 ~9 PERCOLATtON RATE lS (M~./~CH) PERC. HOLE mA. ~ O~CHES) 20 TEST RUN BETWEEN 4.O FT. AND 4.5 FT. COMMENTS: PERCOmT~ON DATA ON TH~S PAGE FOR UPPER BENCH PERC. HOLE ONLY. PERFORUED 8Y A~SKA WATER & WASTEWATER. I, JEFFR~ A. OAR~ESS, CERT~ THAT TH~S WAS PERFGRgED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON PATE: 71~ DEPTH TO DATE SROUNDWATER DRY 8/12/98 DRY 8/19/98 ALASIr~A- WATER & WASTEWATER CONSULTANTS' INC' 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, At<. 99504 PHONE (907) 5;57-6179 * FAX (907) 358-3246 ' LEGAL DESCRIPTION: CONTOUR ACRES SUBDIVISION; LOT 2, BLOCK 2 ~';':'"/"~/' '/'7~' ....... ;... (feet), , ~xP~r o f e s sioO~°~:~ 1_ (PACE 2 o~ 2) SOIL C~SSIFICATIONS 2-- SITE PLANk .......... 6H CL 4~ 6C OL o ~ SW HH s¢ tm PROPOSEO m CLOCK NET TIHE WATER LEVEL NET DROP 11 ~ ~ DATE READING TIHE (HINUTES) READING (iNCHES) i ~ 8/13/98 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING 13 ~ ~ 1 2:35 6 3/4" 14~ m - 3 5:35 30 6" 1/4" 0 19-- PERCOLATION RATE 120 (~IN./INCH) P~RC. HOLE DI~. S (INCHES) 20:- TEST RUN BETWEEN 7.0 FT. AND 7.5 FT. COHHENIS: PEECO~IION DATA ON IHIS PAGE FOR LOWER BENCH PERC. HOLE ONLY. PERFORMED BY A~SKA WATER & WASIEWATER. I, JEFFR~ A. GAYNESS, CERII~ THAT THIS WAS PErFUmED I~ ACCOSDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON PHONE (907) 337-6179 (907) ~:~..~,,. - DATE PERFORMED: 8/12/98 ~EPTH ~ .... ~ (PAGE 1 OF 2) ~ ~ ORGANIC/LOAM SOiL C~SS]FICATIONS ~L 3ROUNDWATER DENSE SILT WITH :-,: su ~YE~S D~ ~/12/~ w~ ~0 ' ~] DATE R~ADING CLOCK ~ET TIHE WATER LEVEL NET DROP ~l~: [, ~ TIME (MINUTES) READING (INCHES) 12 8/13/98 PERC. HOLE WAS PRESOAKED ¢+ HOURS PRIOR TO TESTING 15 ~ 1 2:30 6" __ 2 3:00 30 ___ 2" ¢,, 14 -- 3 3:01 6" 15 ~-~ '_ ~ 4 3:31 30 2" ¢,, ~ 5 3:35 6'T 16 IB~'H' 6 4:05 30 2" ¢,, 19 PERCOLATION RATE 7.5 (NIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20 TEST RUN BETWEEN 3.5 FT. AND 4.0 FT. COHHENTS: PERCO~TION DATA ON THIS PAGE FOR UPPER BENCH PERC. HOLE ONLY. PERFORMED BY A~SKA WATER & WASTEWATER. I, JEFFR~ A. GARNESS, CERTI~ THAT THIS WAS PERFQR~D IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON DATE: DEPTH TO DATE ;ROUNDWATER DRY 8/12/98 DRY 8/19/98 PHONE (907) 3,57-6179 * FAX (907) 338-3246 ,..' .. [SOIL LOG - PERCOLATION TESTI LEGAL DESCRIPTION: CONTOUR ACRES SUBDIVISION; LOT 2, BLOCK 2 "~~ PERFORMED FOR: BRIAN HOEFLER 1__ (PAGE 2 OF 2) SOIL C~SSIFICATIONS GM CL 4-- GC OL 5 ~ ~ SP CH SH OH 7-- ~ DEPTH TO DATE GROUNDWATE~ 10~ ~ CLOCK NET TI~E WATER LEVEL NET DROP 11 ~ ~ D~TE READING TIHE (HINUTES) READING (INCHES) o m PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING z ~ 2 2:59 30 3 1/4" 2 3/4" 14~ ~ 3 3:00 6" 2 o 4 3:30 30 3 1/8" 2 7/8" 15 ~ J ~ ~ 6" ~ 6 4:05 50 5 1/8" 2 7/8" 16~ 19~ PERCOLATION RATE 10.~ (HIN,/INCH) PERC, HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 6,0 FT. AND 6,5 FT, 20~ CO~HENTS: PERCO~TION DATA ON THIS PAGE FOR LOWER BENCH PERC. HOLE ONLY, PERFORMED BY A~SKA WATER · WASTEWATER. I, JEFFR~ A. OARNESS, CERTI~ THAT THIS WAS PERFCR~D IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON DEPTH TO DATE GROUNDWATE~ ALASKA WATER & WASTEWATER CONSULTANTS, INC. PHONE (907) 337-6179 * F~ (907) 338-3246 LEGAL DESCRIPTION: CONTOUR ACRES SUBDIVISION; LOT 2, BLOCK 2~-"~' ~'/-~ ~-'~ '~.~ ~"~ PERFORMED FOR: BRIAN HOEFLER ~ ~e~, A. Garness~ ....... DEPTH ~ (fee~ SOIL C~SSlFICATIONS ~ ~ SITE PLAN '~":'""¢ GW ~:~: ORG I": O0 ,>:.~-~ ¢ GP ~a~ HL I GH CL GC~' OL TH~4 SW MH ~5 m~2 ~ SP CH + SM OH SC DEPTH TO DATE GROUNDWATER DRY 4/~0/99 DENSE SILT WITH DRY 5/7/99 PR SM POCK~S/ 16.5 6/50/99 ~EO ~YERS 10 THROUGHOUT 11 DATE READING CLOCK NET TINE WATER LEVEL NET DROP TINE (MINUTES) READING (INCHES) 12 5/5/99 PERC.~HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING__ ~ 1 3:10 ~ 11" 13 ~~ ~ 2 3:40 30 11" ~ 0" 1~ 5/5/99 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING 1 5:13 ~ 6" 15 2 ~:~5 50 5 1/4" 3/~" 16 ~ ~ 3 3:4~.- ~ 6" m z 4 4:15 30 5 3/8" 5/8" 17 ~ ~ 5 4:15 6 4:43 30 5 3/8" 5/8" 18 19 PERCOLATION RATE 48 (MIN./INCH) PERC, HOLE DIA. 6 (INCHES) 20 TEST RUN BETWEEN 5.5-6.0 FT. AND 3.0-3.5 FT. COMMENTS: PERFORMED BY A~SKA WATER ~ WASTEWATER, I, JEFFR~ A. GARNESS, CERTI~ THAT THIS WAS PERFUMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON DEPTH TO DATE GROUNDWATER DRY 4/50/99 DRY 5/7/99 16.5 6/50/99 ]SOIL LOG - PERCOLATION TEST]"'"'"-'/ ""'"" ~/{~:°."' 4'.~,~/J,~A LEGAL DESCRIPTION: CONTOUR ACRES SUBDIVISION; LOT 2. BLOCK 2 PERFORMED FOR: BRIA, .OEFLER ~,~¢¢.~;;;?...), DATE PERFORMED:4/30/99 '-- ' .'" X¢ [TEST HOLE ~4 (PAOE 1 OF 2) DEPTH ~ (feet) SOIL C~SSIFICATIONS ~ PLAN[ +~ · .;~g,:;~:~-:~ GW =:::: ORG I" = I00' J ML GH CL WITH SOME SAND GC OL TH~4 AND O~VEL ~ ,~ SW HH SM I OH ML/SM SC ~ % TM~I + DEPTH TO DATE - ~ GROUNDWATER PROPOSED ,~ Z V 10 ~1 DATE READIN~ CLOCK NET TIHE WATER LEVEL NET DROP TIHE (HINUTES) READING (INgHES) ~ 5/7/99 PERC. HOL~ WAS PRESOAKED ~+ HOURS PRIOR TO TESTIN~ 1~ 1 2:55 _~ 6" 2 3:25 30 1/2" 5 1/2" 14 ~ ~3 ---~:25 ---- ~6" 4 3:55 -~ 1/2'~ 5 1/2" 15 5 3:55 16 6 4:25 ~ 30 1/2" 5 1/2"__ 17 18 19 PERCOLATION RATE 5.5 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20 TEST RUN BETWEEN 3.5 FT. AND 4.0 FT. COHHENTS: PERCO~TION DATA ON THIS PAGE FOR UPPER BENCH PERC. HOLE ONLY. PERFORMED ~Y A~SKA WATER ~ WASTEWATER. I, JEFFR~ A. GARNESS, CERTI~ THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON DATEr ~/~/~ DEPTH TO DATE GROUNDWATER ALASKA WATER & WASTEWATER CONSULTANTS, INC. ~ OF' .A.~ PHONE (907) 337-6179 * FAX (907) 338-3246 h l SOil LOG - PERCOLATION TESTJ PERFORMED FOR: BRIAN HOEFLER DATE PERFORMED:. 4/30/99 ~/0~../. ~E-7953 .." I I .-' DEPTH -- (feet) TEST HOLE #4 u~[** ~ .......... SOIL CLASSIFICATIONS 2-- SITE PLAN[' +m#~ GH CL 4-- GC OL TH#4 ' -o o °~ SW HH *TH#5 TH#2 SH OH 6 -- ,-' I SC ~ ----, ~ 'rH#~. 7 -- .~ DATE - -- 3ROUNDWATERI _S~ ? WELL o ~ ~u) CLOCK NET T]HE WATER LEVEL NET DROP 11 -- c~ DATE READING TIFIE (HINUTES) READING (INCHES) ,,0 5/7/99 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING Z o 13-- ~ 1 2:56 6" ~- 2 3:26 50 5 1/4" 2 5/4" 14-- ~ 5 3:26 6" ~ 5 ,3:56 tn 6 4:26 30 3 1/4" 2 3/4" 16-- td _ bJ 17-- 18-- 19-- PERCOLATION R.aTE 10.9 (PIlN./INCH) PERC. HOLE DIA. 6 (INCHFS) 20--- TEST RUN BEIWEEN 7.0 FI. .aND 7.5 FI. CO[V]N]ENTS: PERCOLATION DATA ON THIS PAGE FOR LOWER BENCH PERC. HOLE ONLY. PERFORMED BY, ALASKA WATER & WASIEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERF(JRI~D IN ACCORDANCE WITH ALL STALE AND MUNICIPAL GUIDELINES IN EFFECT ON ALASKA WATER & WASTEWATER CONSULTANTS, INC. PHONE (907) 557-6179 * FAX (907) 338-5246 ISOIL LOG - PERCOLATION TEST]BLOCK 2 ,,~/~..'"'~_Cl//~J~./..~ F...'~./--.'-.. I I "' TEST HOLE ~5 DEPTH ~ (feeO ORGANICS (PAGE 1 OF 2) SOIL C~SSIFICATIONS l ~.,..,,,~ ~- SITE PLANJ +~3 ~.~;.,~ ~:- ~ GP ML GH CL ~ SP CH SM OH SC GROUNBWATE~ ML DRY ~/~0/99 DENSE SILT WITH PRO,OSEO ,~ SM ~YERS DRY 6/50/99 WE~ ~ THROUGHOUT ~o ~ ~ DATE READING CLOCK NET TIHE WATER LEVEL NET DROP TIHE (HINUTES) READING (INCHES) 12 5/7/g~ PERC.~HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING 15 ~ 2:58 6" 2 5:28 50 2 5/8" 3 5/8" ~4 '- 5 5:28 4 5:58 50 2 ~/2" 5 1/2" 15 5 5:58 6" ~ ~- 4:28 3o 2 ~/2" 3 ~/2" 18 2g PERCOLATION RATE 8.6 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES) 0 TEST RUN BETWEEN 5.5 FT. AND 4.0 FT. COHHENTS: PERCO~TION DATA ON THIS PAGE FOR UPPER BENCH PERO. HOLE ONLY. PERFORMED BY A~SKA WATER & WASTEWATER. J. JEFFR~ A. GARNESS, CERTI~ THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON DATE: ~ J ~ / ~ DEPTH TO DATE GROUNDWATE~ DrY 4/50/99 DRY 5/7/99 DRY 6/50/99 ALASKA WATER & WASTEWATER CONSULTANTS, INC. 69D1 DEBARR ROAD, SUITE 2B * ~CHO~GE, AKm 9950~ ~SOIL LOG - PERCOLATION TESTJ , LEGAL DESCRIPTION: CONTOUR ACRES SUBDIVISION; LOT 2, BLOCK 2 .... (fe.O TEST HOLE ~5 ~ ...... SOIL C~SS)FICATIONS 2-- , .. - tSITE PLAN[ I GM CL 4-- ~ GC OL ~ o o, SW HH ~5 TH 1+TH~ 5-- ~ SP CH ~ GROUNDWATER 0 ~ CLOCK NET TIHE WATER LEVEL NET DROP 11 -- ~ DATE READING TIHE (HINUTES) READING (INCHES) ~ 5/7/9g PERC, HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING ~ - ~-- ~:29 -~0 2 7~s" ~ ~/~" 14 ~ m 3 3:29 o 4 ~:59 30 2 7/8" 3 1/8" 15-- J ~ 6" ~ 5 3:59 19-- PERCOLATION RATE 9.6 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20 TEST RUN BETWEEN 6.25 FT. AND 6.75 FT. COHHENTS: PERCO~TION DATA ON THIS PAGE FOR LOWER BENCH PERC. HOLE ONLY. PERFORMED BY A~SKA WATER & WASTEWATER. I, JEFFR~ A. GARNESS, CERTI~ THAT THIS WAS PERFO~M~ IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON 10' LITILfTY EASEMENT ~ ~ ~TH#3 ~/ (MAX.), BY 52 FEET LONG BY 2.5 FEET <~ ~/ WIDE. ADD SiX FEET OF CLEAN, WASHED \ ~ ~ SEWER DRAINROCK, INSTALL TRENCHES ~ PARALLEL TO ALL SLOPE CONTOURS. RESERVE SITE CD ~ TH#5 / / II r~ z- ', /// // ,.-,~ PROPOSEO J III !rr~- I, / 15oo GALLON o~ '-'w~u_ ill' //,J~ j/ / SEPTIC TANK o -------.. I ~li ,~l~- l/ / ~ I /#MT /Il' II / INSTALL DOUBLE ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 20. ANCHORAGE. AK. 99504 LEGAL D£SCRIPTION= CONTOUR ACRES SUBDIVISION; LOT 2, BLOCK 2 ~....: DESIGN FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM BRIAN HOEFLER (907) 563-2139/345-8496 DATE:I 0/4/99 ORAWN BY: SCALE: PAGE: K.D.W. 1 = 40' 2 Of 2 REVISED DESIGN / , I,. 100' WELL RADIUS <l~ LOT 1 BLOOK S278 \ J / CONTOUI~ ACRES \ ~ / j z J J= SITE P~N FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM ~,,~4 .............. :....~ PREPPED FOR: PHONE NUMBER: ~A~ BRIAN HOEFLER 565-2159/545-8496 v~'..l/;~-~ ...' ]A~ JD~WN BY: SC~: PAGE: 10/4/99 I J.L.M./K.D.W. I ~: ,oo, I 1 OF 2 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 017-451-16 1. GENERALINFORMATION Completelegaldescription CONTOUR ACRES SUBDIVISION: LOT 2. BLOCK 2. Location (site address or directions) 5520 COUNTRY CLUB LANE ANCHORAGE. AK 99516 Property owner Mailing address Lending agency Mailing address BRIAN HOEFLER Day phone (907) 561-2159 5520 COUNTRY CLUB LANE ANCHORAGE, AK 99516 Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: Individual well xxx Community well Public water NOTE: If community well system, provide wdtten 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. 72~25 (Rev. 1/91 ) Front MOA #21 Computer Version INote: Alaska Water and Wastewater Consultants, Inc. shall be paid $400. O0 at, ] or pr/or to, closing for the engineering services provided. J 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 andk)r wastewater disposal system is safe. functional and adequate for the number of bedrooms and type ef structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage fifes and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municip~l/~nd State codes, ordinances, and regulations in effect on the date of this inspection. ,.~Y/ Name of Firm ALASKA WA~ &,~S,'I~I~(C~A'dER CONSULTANTS, INC. Phone (907) 337..6._179 Address 6901 BEBARR~OAd, S~¢E/~C'/AN~HORAGE, ALASKA 99504 , Engineer's Signature %H~,//F~/~/#//' Date In conducting this evaluation, AWWC, ¢c. ~tte~Cpted to -pdovide a thorough, conscientious engineering analysis of the system in accordance with ADEC and/MO,~ DRHS 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 afl 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. At44/VC, Inc. can therefore not provide any warranty 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/s 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 -~ Disapproved Conditional approval for bedrooms bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Computer Version Legal Description: A. WELL DATA Well Type PRIVATE Log present (Y/N) Total depth 265' Sanitary seal (Y/N) 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 COUNTOUR ACRES S/D; LOT 2, BLOCK 2, Parcel I.D.: 017-451-16 if A, B, or C, attach ADEC letter. ADEC water system number N/A YES Date completed 10/20`/99 Cased to 250' Casing height (above ground) .2. ~ Date of test Static water level 214 Well production 4 WATER SAMPLE RESULTS: Coliform 0 Date of sample: 6,/15/00 B. SEPTIC/HOLDING TANK DATA Date installed 2/17/00 Foundation cleanout (Y/N) Date of Pumping NEW C, ABSORPTION FIELD DATA Date installed ' 3/2/00 Length 90' Width YES Wires propedy protected (Y/N) YES FROM WELL LOG 10/20/99 g.p.m. ATINSPECTION Nitrate- 0.799 mg/L Other bacteria 0 Collected by: A.W.W.C., INC. Tank size 1500 Number of compartments 2 Cleanouts (y/N). YES YES Depression (Y/N) NO High water alarm (Y/N) N/A Pumper Soil rating~r fl2/bdrm) 0.6 2.5' Gravel thickness below pipe System type DEEP TRENCH 7' Total depth 10.71'-12.27' Effective absorption area 1298 SQ. FT. Monitoring Tube present (Y/N) YES Depression over field (Y/N) NO Date of adequacy test NEW Results (Pass/Fail) For 5 Bedrooms Fluid depth in absorption field before test (in.); Fluid depth (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3198)* Computer Veto[on Immediately after gal. water added (in.): __ Absorption rate = If yes, give date D. LIFT STATION ~~'""~ Date installed Size Manhole/Access (Y/N) ~at* "Pump off' level at* *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 100'+ Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots 100% 100% On adjacent lots 100% N/A Public sewer manhole/cleanout N/A 25'+ Lift station N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Absorption field ,) -F__ Water main/service line 10'+ Surface water/drainage. 100% Wells on adjacent lots '100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line Surface water_ Curtain drain 10'+ Building foundation 10'+ 100'+ Driveway, parking/vehicle storage area F. S.G . ER'S 9 I certify that I ~bve d~t~Fl of Municipal l'ecordsIti'(~ with MOA HQ guid~¢~f, Signature ~--~/~ Engineer's Name/./ ~ tj Date ~,/4i)° NONE KNOWN Wells on field inspections and review systems are in conformance ~n this date. JEFFREY A. GARNESS Water main/service line__.1._0'+ .... 10'+ adjacent lots ~F_ HAA Fee $ ~'~"3~'~'0 Date of Payment ~'/,,'2-~>~/~2~ Receipt Number 72-026 (ROY. 3/96)* Computer Version Waiver Fee $ Date of Payment Receipt Number 06-20-00 17:45 FROM-CTE ENVIRONMENTAL ,~t~ CTIE EnvlrormmenIal Services Inc. 6615301 T-E98 P.02/03 F-454 CT&E Client Name Project Name/# Client Sample ID Matrix Ordered By pWSID 1003122001 AK WaTer & Wasrewa~--x Consul~an~ lac. ConTour Acres S/D L2 B2 ConTour Acres S/D L2 B2 Drinking Water 0 Sample Remarks: Clien! PON Printed Dater'-rime 06/20/2000 16;38 Collected Date/Time 06/15/2000 14:49 Received Date/Time 06/16/2000 13:00 Technical Directq~ Stephen C. Ede Pre~ AnaLysJ~ Oa~e Da~e Init Nftrate-N Hfcro~fotogy kaborasory cot/lOOmL SM18 92228