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HomeMy WebLinkAboutSPRING HILLS ESTATES BLK 1 LT 5pring H il'l Block 1 Lot 5 015-051-43 ~' I MUNIClPALITY OF ANCHORAGE ! ' J'~OA DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE'DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME IPHONE ~ ~EW MAILING ADDRESS ' r LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS DISTANCE TO: o ~ ;~ ~O ~ ~ Z Manufacturer ~E~ ' Material 3 ~ ~ ~ N°' of compartments  Liq. capacity in gallons Inside length Width Liquid depth ~ ~ DISTANCE TO: Well ~ Dwelling PERMIT NO. O Z ~ Manufacturer Material Liquid capacity in gallons Q Well ' Foundation Nearest lot line PERUlT NO., --X~ ~ ~ ~ No. of lines ~ Length of each line Total length o~line~ Trench width Distance between lines  Total effective absorpt~n area a ~ Top of tile to finish grade Material beneath tile ~ Z ~ ?~ inches Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area m Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. m Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS SOIL TEST RATING ~ '~0.,~ INSTALLER ~ REMARK$~ / 72-013 (Rev. 3/78) Department,, f Health and Environmenta~ 3rotection 825 L Street, Anchorage, AK. 99501 264-4720 * * * HANDWRITTEN PERMIT * * * WELL AND/~DR ON-SITE SEWER PERMIT P'~rmit ~ Location: ... Phone Number: Type~-of Soil Absorption System Is: Trench: y Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: L,,~ Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: DEPTH ~ LENGTH ~c~ GRAVEL DEPTH. ,~ WIDTH' Th~ length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The-gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTICCHS~.-DTNG) TANK SIZE = ;L~-~ GALLONS * * Permit' applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. ' * * * TWO(2)'INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection.and approval by this departme will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fe for a-private.well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25' feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper.installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * I..certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. ... (2) I will'install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the~cesidence i,~ remodeled to Signed: //_~~. ~ c//.~ Applicant~ · include more. that 3.bedrooms. Issued by: Date: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 g Street, Anchorage, Alaska 99501 2644720 SOILS LOG -- PERCOLATION TEST [] SOILS LOG r-i PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 '5 6 7' '8 9 10 11 12 14 15 16 DATE PERFORMED: SLOPE · I I'1 1 .'1 .'. '1 SITE PLAN WAS GROUND WATER S ENCOUNTERED? ~Jo L O P IF YES, AT WHAT DEPTH? .' Gross . 'Net Depth to Net ~.'"~ek; . , . Time ' Time Water Drop · ':';'""-"'~.i,". "~" - '~'" - __.~., :..,.__ ,, ~_ ,~ ,..~.,~ .,o - . :q/~ ~ .- 3.c,u ....,., 'r,,tf~/ ¢/33 - ,.~. oo /PERCOLATION RATE .::~ 92. TEST .RUN 'BETWEEN 'FT. AND s,:,l ~ .:8' % :~' ,~'g ,-,'~,'~t1 .~ i ~ ~' ) L, 'PERFORMED BY: '"'[~'-~I CERTIFIED BY: :72-008 (6f79) '~ ,(minutes/inch) -~8~',I~ DATE: ff'~ ~v~-W DRILLING, Inc. P.O. Box 10-378 * 10300 Old Seward Highway (907) 349-8535 ANCHORAGE, ALASKA 99511 · ' DRILLING LOG Well Owner~ ~-~-' ,Use of Well Location (address of: Township, Range, Section, if known; or distance main road LOt $ Block I Spring ]{ills Donestic Size of casing 6" Depth of Hole Static water level 130 ft. Screen ( ); Perforated ( 255 feet Cased to 25/,.60 feet (below) land surface. Finish of well (check one) Describe screen or perforation None Well pumping test at ~ gallons per (bca~r) of drawdoWn from static level. Date of completion December 13, )98~ open end ( 1L~: ); (minute) for I hours with WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 TO 2 ¢~6in~_,. stickup 2 TO 40 40 TO 80 $0 TO 120 120 TO 124 124 .TO 150 150 .TO 195 195 .TO 21.~ 212 .TO 238 238 .TO. 240 240' TO. 252 252 TO 255 TO. TO .TO Broom silty sand&& ~ravel Brown silty sand Brown silty sand & gravel Brown silty gravel (damp) cray ~ilty ~ravel ~ro~ Silty ~rdvel Gray silt Brown silty ~ravel ~lww~ C~.,~cd Contractor Cer~ic~te l~o's. 81~ & 913 Browm silty gravel (damp) Brown silty grav~! - wet. Waterbearing Gravel 3 -- CONTRACTOR Parcel I.D. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage,'AK 99519-6650 www.ci.anchorage.ak.us ~ (907) 343-7904 CERTIFICATE OF-HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Expiration Date: ~ - ~ ,,,A" - O L.~ Complete legal description SPRING Location (site address or directions) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent HILI-~ESTATES SUBDIVISION; LOT 5, BLOCK 1 · 9441 SPRING HILL DRIVE * ANCHORAGEr AK * 99507 ELIZABETH WILSON 9441 SPRING HILL DRIVE * . Day phone ,546-3706 ANCHORAGE, AK * 99507 Day phone Day phone Mailing address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage Community (~lass Well r'"] Public Water System r"] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank ~] Community On-site E~] Public Sewer E~ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based onlY'upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Cedificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sampleS. (Cedificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 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, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedreoms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. NameofFirm GARNESS ENgINEERINg gROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. (~ARNESS, P.E. Phone 357-6179 Date" . Engineer's Comments: . In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineefing analysis of the system in accordance with ADEC and MOA DSD 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 t~ readily identifiable features. The operational life of ali wells and septic systems depend on the local soils condition, groundwater leve/s that may fluctuate during the year, and the water usage of the family being sen/ed by the system. These conditions are outside the control of the eva/uator of the system. Satisfactory test results do not guarantee future performance of the system, no~ do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. 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 wi//it confer any legal fight whatsoever. 5. DSD SIGNATURE Approved for ~ bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory · Manitenance Agreements. SuPPlemental Engineer"s Reort Other Original Certificate Date: Be Legal Des, cription: WELL DATA Well type ~ PRIVATE ' ; . If A, B, or C provide PWSID# N/A Date completed 12/13//1983 ..Samtary seal (Y/N) YES Totaldepth 255 ft. .- -Casedtol.254.6 ft...; ".ii'..~.ii ~ . FROM WELLLOG~r. .. : ' ': MuniciPalitY of Anchorage i' DeVelopment Services Department : Building Safety Division On-Site Water & Wastewater Program , 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 ': www.ci.anchorage.ak.us (907) 343-7904 "~ HEALTH AUTHORITY ,b, PPROVA CHECKLIST SPRING iHILL EsTATEs I~SUBDIVISION; LOT 5, BLOCK Sl~tic w~ter level 130 W~ll pro'duction 5' .~, ',l:, g.p.~. WAFER ~AMPLE ' ' ' RESULTS. ~! ,-' , COlifOrm :. 0 c°lOnies/i00 mi. ' '.. Nit~are:, 1.o9 mg.lL. '::' :N/A Ars~enic: : ' mg.lL. ' ; ;-: Dai'~ of sample: .5/12/2oo4 Collec~,edby:.. r SE C/"OL0 N TA"K ATA: .... ~, l', '; ' ' : ' 'SEPtIC/STEEL' i Date installed - Tank ~ype/Material Tahk"sizd" 1250 gal. .: Numberof Compadments 2 lea N) : Well L, og (Y/N) ..YES wires properly'~ i~rotected (Y/N) YES Casing height '(above ground) .22 AT INSPECTION 5/.12/2004 i:'21'1~ ! .ff. .4.86 g.p.m. - !: · Other bacteria in. ,.i.'~. colOnies/100 mi. GEG~ Ltd. 10/12/1983 YES 't:~:' ";' i N/A Foundabon cl~anout (Y/N) ,YES .Depresi~ O~ (~ve~ ta~k (Y/N) NO High Water alarm (Y/N) Date'of p~mping 5/10/2004 :' Pumper .:I A+ HOME tSERVICES ABSORPTION FIELD DATA ; , i ~{i: i ~BELOW EXISTING (;RAD£1 .... ' - ' Dat~"installed~ 10/12/1983, Soil rating(g.p.d.lft~or<~,,..~ 368 .. ,Sys~!em. type :. DEEP.TEEN.CH_ Lehoth' !' -121- ,..fl ,; '- ......... Width ~.I,, I' , .3 , ff. -.. · :::Gravel below pipe , 4-7.5 ff. __.,.?__ --7--'~'-"'7~, ' "' ; ~ " , '~' t "' Tol;' depth*g.'(MAX)ff' E,. abSorpti0n'~;~ ~29'6 fi' Monitoring tube yF~S'!i Depression overfield NO Dal~"of" : .... ' ~;ii~ ' "' For ,3 bedrooms a~leqUacy test *'5/13/2004 ...... Results (Pass/Fail) PASS ,u;-!i! I , F ;depth in absorption fi~id before'teSt __ Water added 507 gal. : 'New depth 26.5in. ' I i - . . I ; ....... ;; :~ ' ' ' Elapsed Time: 995 m~n. ~ ~ ~ in. Absoi'ption rate >=, 450.+. g.p.d. ,i:,. ," '. ~ ' ', .... 'i,, .... : NoNE KNOWNs[-': I~yes,givedate - Any rejuvenabon treatment (past 12 mo.) (Y/N & type) ~MT ONLY EXTENDS ~40.5" BELOW I~E~Ti. "~*TE~'~ 80 'FOOTi LONG.SEcTION OF TRENCH ! ': ' : '' :' :' '·'~' r~:/ :'!. - : :::! D; LIFT STATION . .. - ' Date installed ~ Size'in gallons :.'i~ ."Pump on" level at ~n. .High water alarm level at ~ in, Da~t~m ~~ C'Y~Ios test~l~ ~ : 2 Meets ~alarm & circuit re;quirement~i SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'-F Absorption field 'on lot 1 oo,+ Public sewer main N//A Sewer/septic service line 25'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line ~ · 5'+ ~ Water main N/A Water service line 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: : Property line 10'+ Water service line 10'+ Curtain drain· NONE. KNOWN COMMENTS Building foundation 10'+ Surface water 100'+ Wells on adjacent lots 100'+- On adjacent lots 100'+ On adjacent lots 100'+ , Public sewer manhole/cleanout N/A !Holding tank · N/A , Absorption field 5'+ Surface water 100'+ Water main N/A Driveway, parking/vehicle storage 10'+ ..G. ENGINEER'S CERTIFICATION ! certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with 'MOA HAA guidelines in effect on this date, Engineer's Printed Nan;la JEFFREY A.-GARNESS Date · ,.~'/'~---~/0 z3r' ' ' Date of Pa~,ment Receipt Number Waiver Fee $ Date of Payment Receipt Number '.. LS-6914 .-" '% ESM'T. ~ 89758'50"V/ 22,34' BE'IgN'EEN ITI~.IrlRAGE RECORT~ING DISTRICT, ALASKA AND T~ THE VISIBLE ]MPRI]VEHENTS SITUATE~ THEREB~ ~TH~N THE PRBPERTY L~NES AN9 THAT ND ENCEDACHHENTS EX]ST D~HE~ THAN NDe/9. :R~A~T ANCHORAGE, ALASKA THIS 9AY DF _:HAY ........... ~004 .... . / HBLT LAN~ ~URVEYING 9343, F~i11-7~ TEL. 345-5513 / THE INFORMATION HEREON ~S FOR THE USE OF L~NDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS EXISTING STRUCTURES AND PLATTED LOT UNES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING .'AD STRUCTURES OR FENCEUNES. ' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. NOTE.' ANY rENCEMNES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROF OR LOCATE STRUCTURES. ANY PAVING SHOWN MAY BE APPROXIMATE DUE TO SNOW CONDITIONS. / - % , · I HERE2Y CERTIFY THAT I HAVE PERFDRMEI~ HDRTGAGEE'S INSPECTION OF THE FOLLI]~/ING 9ESCRI~EI) PROPERTY. LOT 5, ~LDCK 1, SPRING HILLS ESTATES IllI lull HOME SERVICES, INC. CUSTOMER · 7501E.]40th Avenue Anchorage, Alaska 99516 345-1890 INVOICE # p.i 245OO Block Lot DATE DESCRIPTION AMOUNT " ' TOTAL -~"'; · REMARKS . ~. ~_. .~.~..~5~.T~,.~2.1~/:' '. o .,j:'~ . .,. .~.,,... .~,. ,'-,.-. . __ ~./(~'-~,., . , ~." /:.-_ ~.--'-,'..;.; .' t -' ! ...__/.'..../ - ~¢ /". j $ .~. .... :'..";" , ". ¢~.,,; ~ .. ; ,. , .' .~.. ..-.?'. · !/(; "', Gallons ' ~,/' Septic ~ Leach Area ~ Holding Tank ,....~---. Standpipes / 4,2.'-' Time [] PROBLEM AREA ~ CALL FOR MORE INFORMATION [] NEEDS TO BE DONE AGAIN IN 6 MONTHS [] Good Shape ~] sludge buildup on bottom ,[] Floater on top [] Jim cap missing or [] Cut standpipe to 1' above ground [--]! Needs Septictrine needs replacing 05-1B-04 04:14PU FROU'-CT&E ESI, SGS EHV SERVICES 9075615301 T-3gB P.03/04 F-060 SGS Ref.# Client Name Project Name/# Client Sample ID Matrix 1042476001 Gamess Engineering Group, Lid. Spring Hill Estates, BI, L5 Spring Hill Estates, 131, 1.5 Drinking Water All Dates/Times are Alaska Standard Time Printed Date/Time 05/18/2004 11:3 l Collected Date/Time 05/12/2004 14:45 Received Date/Time 05/12/2004 16:00 Technical Director Stephen C. Ede Allowable Prep A~alysis Parameter Results PQL Units Method Container ID Limits Date Date Init Private Individual Analysis CO3 AlkalinRy 20.0 U 20.0 mg/L SM2D 2320B OH Alkalinity 20.0 U 20.0 mg/L SM20 2320]3 Conductivity 235 1.00 umhos/cm SM 2510B pH 7.60 0.100 pHuniTM EPA 150.1 Alkalinity 114 20.0 mg/L SM20 2320B Total Coliform 1 ! OB, No Coli col/lOOmL SMI8 9222B C 05/i 3~04 AM C 05/13/04 AM C 05112/04 KC C (6.5-8.5) 05112/04 KC C 05113/04 AM . ^ ¢<=1) os/l~o4. 05-18-04 04:13PU FROU-CT&E ESI, SGS EHV SERVICES SGS SGS Rcf.# Client Name Project Name/# Client Sample ID Matrix ] 042476001 Oarness Engineering Group, Ltd. SprinR Hill Estates. BI, L5 Spring Hill Estates, BI, L5 Drinking Water 9075615301 T-39B P.02/04 F-060 All Dates/Times are Alaska Standard Time Printed Date/Time 05/18/2004 11:31 Collected Date/Time 05112/2004 14:45 Received Date/Time 05/12/2004 16:00 Technical Director Stepl~C. Ede Sample Remarks: Allowable P~ep Analysis Panu~e?._- Results PQL Units Method Container ID Limits Date Date Init lqickel 2.00 U 2.00 ug/L EP200.8 D Antimony ! .00 U 1.0O ug/L EP200.8 D Thallium 1.00 U 1.00 ug/L EP200.8 D Selenium 5.00 U 5.00 ug/L EP200.8 D 05114104 05116104 WAW 05114104 05116/04 WAW 05114104 05116104 WAW 05114/04 05/16104 WAW Metals Depa=tment Hardness ~ CnCO3 5.32 5.00 mg~ SMI7 2340C D 05/14/04 05/16/04 WAW Individual Analysis Aluminum 20.0 U 20.0 ug/L EP20O.8 Arsenic 5.00 U 5.00 ug/L EP200.B Barium 3.00 U 3.00 ug/L EP200.8 Cadmium 0.500 U 0.500 ug/L EP200.8 Calcium 612 500 ug/L EP200.g Chromium 1.00 U 1.00 ug/L EP200.8 Copper 12.5 1.00 ug/L EP200.B Iron 250 U 250 ug/L EP200.S Lead 0.378 0.200 ug/L EP200.8 Magnesium 920 50.0 ug/L £P200.8 ' Manganese 1.51 1.00 ug/L EP200.$ Phosphorus 200 U 200 ug/L EP200.$ Potassium I 100 500 ug/L EP200.8 Silicon 5960 200 ug/L EP200.8 Silver 1.00 U 1.00 ug/L EP200.8 Zinc 14.3 5.00 ug/L EP200.$ Chloride 5.91 0.100 mg/L EPA 300.0 Fluoride 0. i 02 0. ] 00 mg/L EPA 300.0 Nitrate-lq 1.09 0.100 mg/L EPA 300.0 Nitrite-N 0.100 U 0.100 mg/L EPA 300.0 Sulfate 9.27 0.100 mg/L EPA 300.0 Total Dissolved Solids 148 10.O mg/L SM20 2540C HCO3 Alkalinity 114 20.0 mg/L SM20 2320B D D D D D D D D D D D D D D D D B B B B B C C (<=50) (<=2000) (<=5) (<=100) (<=1300) (<=300) (<=151 (<=50) (<=100) (<-5000) (<----250) (<--21 (<=10) (<=1) (<=250) (<=500) 05114104 05/16104 WAW 05/14/04 05/16/04 WAW 05114104 05/16/04 WAW 05114104 05/16104 WAW 05114104 05116104 WAW 05114104 05116104 WAW 05114104 05116104 WAW 05114104 05116/04 WAW 05114104 05116104 WAW 05114104 05116104 WAW 05/14104 05/16104 WA~ 05114104 05116104 WASh 05114104 05116104 WA~ 05114104 05116104 WA~ 05114104 05116104 05/14/04 05/16/04 WA~ 05112104 05112/04 05112~04 05112/04 05112/04 05/17/04 05113104 ~lS~ SGSIC'I'&E ENVIRONMENTAL SERVICES Drinking Water Analysis R~port for Total Coliform Bacteria READ IN~TRUC;T1ONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE MUST BE COMPLETED BY WATER SUPPUER 2OO W. PO'iTER DRIVE ANCHORAGE, ALASKA 99518 Tel: 907-562-2343 Fax: 907-561-53131 L~b Ref No. I 1042476-/ [] send nesu~ ri I '1 SAMPLE COLLECTION: l)=d.: ~ ~"~ T,,~.~'"~' [] Routine lime: AM ~.~} 'El Repeat Sample to ~b a~: ame as colle~or Othe~ ~ [] Sarape ever 30 hours eld: Resuttl may be unreliable r'~da Hour Weber SAMPLE TYPE: Phone #: Fax #: m TO BE COMPLETED BY LABORATORY .Sample 'Receiving: ..... Date: ~" [~'~--- C~ DelNt~ Math~; Re~ed By:.. ~ ~ N~ Comments: ~ Tmat~ Wa~r D Untrea~d Wa~r [] RUSH SAMPLE BacterioloaicalWater ~nap~s[s ~eco . · ' - ' MMO.MUG (P/A) R£SULTS: I ANC FBK JUN I Analyst: ~ · Analytical Method: Membrane Filter MMO-MUG (P/A) Reported lay:. .~, :,(~) Y'~/ ~gnaturm D 090-:1 t'O/t'O'd 86£-1 05-24-04 O§:48AU FROM-CT&E ESI, SGS ENV SERVICES 9075615301 S~S/CT&E F..NVIRONME~TAL SERVICi~S' Drinking Water Analysis Report for Total Coliform Bacteria *READ IN~'rRucTIONS ON REV~P,~- SIDE I~EFORE COLLEC13NG SAMPLE MUST BE COMPLETED BY WATER SUPPLIER [] PUBLIC WATER .qYBTEM ID~ ~ .'T--'- '  iVATE WATER SY~T*EM SAMPLE COLLECTION: T-452 P.OI/OI F-150 2O0 W. Po'n'ER DRIVE 'ANCHORAGE, ALASKA D9518 Tel: 907-562-2343 Fax: i)07-561-5301 1042750' [] Se~d Ram~lta FISend Invoice ~MPLE TYPE: ' l~t=: F1 Routine [] Traated.Wa. to~' · [] Repeat Sample ri Untreated Water'. - '"' Tranmpm*t~d ~ · ~o ~.u e~n e as collector ~then TO BE COMPLETED BY LABORATORY ,Sample Receivln{3: [] RUSH S'AMp. I'E Temp: . l!)ellvery Method: c..., ~ L~"~""'~~x~" ' ' ' MMO-MUG ~PIA) REEUL'rB: ' FBK JUN Anal~t: _ · Anmlgtlc.l Method: Membrane Filter MMO-MUG (P/A) Reported tc~ ' i~.i.c,~ .I ' MEMBRANE FILTER RESULTS: IDatafrlm~; · Dimcl Cram: ~ ~lOOmL vertr,:atiorc " ISp3k. wire: .... t..;~a:_: [~ Satisfact6ry r,-~,,=. { EC'. . [::]. Unsatisfactory 1NTC. Tee N~mw~ "" Cmml - I · .. Form # FW- 0o53 12/17/03 er~vlcesl GENERAl2 or ~ w~,~ Clubb ~., ~- .....,... · ........ Day phone. 345 62~ : .... '" t:' .... ...~ ~:~, ,,,.~;...: ;..~ '~'-? '~ ............ Day ~,one:~...~, ..., ~,. '..'~ ":,.'" ~ ,' ,~ .: ;.~. '.~ ~' '- '~" ,'~'F~ , ..... ~, ,~' '. ':'." '~ ,.~' ..... ' ~ · ,: ~ '- ~.~ 2;,'.'NUMBER OF BEDROOMS: :~ .b::.' ::'}.. :~ :~hr~ ~} ','~ ;~..:~',: ,.L;>..?~ ~; ~;;~ .~::,~'::.),~, :{,.;{)..,}' ;: {:~'.:~;' '=': :. (~': ,?.,~ . ~T=~ ~UppEy-,~ ~....:. ~ .~ ~.,~.~ ;.,-,~.,~.,~. ,..: ' ,,~PE OF~WASTEWATER.DISPOSAL, :,. · .... · ~ ", .,: ~l,a,,,a,,ol ~AI~II ~ · ~. . : ~..;. ., .. ,..., · . ~ ~.:. Individual ,, ~,.~.,.,~..-~: ~ .... ~ .. . .. . · .' .~ .:~ Individaal Water~$~o~ge~?-:~~ .... . :0 ~-.~: .' ':.' :. :~--!~,~;~?l??g ~ank....~ , .. - : '~:,'; - ,, ,., :~,[; . -.? :- .;',.;~,, ~ . ', ., ..';. .' .;;..: ~ ..... ... ,,.. -. ,,~.,. : ., ~.: ' ~nm~-ni~'~J~JW~ll -~' ' -~ ,: ,. :~-',~ Co~mun~On-~lte:.';'" ,~,'.:. :.'. ~ -_ -- .- Y~ ":.~ ~ Public'Sewer ' O Public Water S tern., .'~ :... ......~ ,,, : .-. :: :. . -:..~ , . · ~ .... ~ '.. , ., The Municipality of Anchorage Depadment of Health and Human Semites (DHHS) Issues Ced~mtes 0f Health Authori~ ~pproval {H~) based only upon the representations ~iven !ri'Paragraph 5 by an independent pro[essional civil en~inee[~ reflistered in theState ol ~laska. Ced~mteS 0[ Health ~uth~fi~ Approval 'ar~ required ~0r the transfer of tiile (except beMeefi ~Pou~es) on pro~edies Seined by a sinflle' family On-s~te ~ste~hter disPOsal :and20r water. supply ~ystem. DHH8 ~also issu~ H~s upon request to home omers. Ced~mtes o[ Health ~uthori~ ~pproval are valid for O0 days from thd dar0 o[ issue foF propedies seined by ~ pr~ate or Clas~ C Well'and may be reissued ' with new water sampl~'msults less than g0 days old. Cedifimtes are valid for one. year for propedies se~ed Cla~s ~ or B wells or a publi~ water' system. The Municipali~ o[ ~nchomfle is not responsible for errors or omissions in the professional en~in~Fs work. ':' :*- "":~ INSPECTION :B¥~ ENGINEER ~sea on~ -' ' "? :'?'.'-::..;~'. ~";"h Con&t~onal approval for z".:-'-.-', .bedrooms, w~th the Attachments: HAA Checklist X · Septic 'System ~,dvisory Well Flow Advisory Expiration Date: ~ '-' / ~-" O I (Rev. 10/99) Maintenance Agreements .. Supplemental Engineer's Report '-. Other .... Odginal Certificate Date: z.~ Reissue Date: ke Be Ce Municipality of Anchorage Development Services Department Building Safety Division on-site Water & Wastewater Program- i -- 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 ,~ ! www.ci.anchorage.ak.us !l:!. (907) 343-7904 !:'' ' : HEALTH AUTHORITY APPROVAL CHECKLIST: Legal Description: Lot 5, Block l, Spring Hills · ' Parcel ID: 0t5-051.43 WELL DATA Well type ~' If A, B, or C provide PWSID Datecompleted t2/13/.t983 Sanitary seal (YIN)Y_ Totai'del~ih' .:255 .ft. ' Cased to 2-54.6 ft. ':i ~ ii il ' FRoM WELL LOG ' Date of test 12/13/1983 Sta~ic tJr level Well pro~u~¢tion WATER SAMPLE RESULTS: Colifo~-rfi I0 colonies/100 mi. ~:' ,!1 ',; ;I. Date of sample: 4/5/2001 SEPTIC/HOLDING TANK DATA t30 ft. 5' g.p.m. Nitrate..6 mg./l. ' Collected by: MEA Fluid'd~ih Jn absorption field before test 0 in'. ,' ' ~-~ap~d.Time: 'I,440 min. Final fluid depth 4 in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) .Wires properly p~0tected (Y/N) Y . .Casing height (above ground) >24 AT: INSPECTION : 4/7/2001 3.03 other ba(~teria O-colonies/i00 Tank Type/Material Septic/Steel .: Date installed t0112/1983 Tank s~ze; '.1,250 gal. Number of Compartments 2 ..... J' . Cleanouts FoundatiOnlcleanout (Y/N) y. Depression over tank (Y/N) N_. ' ~High' Water alarm (Y/N) Y ' Date'~t~ ,P~'pin~ 6/;I/2000 ' Pumper A Plus Home Services ABSORPTION FIELD DATA Date installed '101flt983 Soil rating (g.P~d./ft~ 0r~ibdrm) 368 SF/Bdrm:. Lend.th!.i'1~li ft. 'Width 3 ft. : Gravel below pipe 4/8 Total deP{hSI12 ff. Eft. absorption area 1,296 ~ Monitoring tubeY Depres~Si0n over field N Date of adequacy test 4/7/200t ' Results (Pass/Fail) Pass . System ,tyPe Deep Trench Water added767 gal. Absorption rat~ If For 3_ bedrooms New depth.14 in. g.p.d. give date N/A D. LIFT STATION Date installed 'Pump on" level at . in. Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL oN LOT TO: Ge Size in gallons 'Pump off' level at Cycles tested - Manhole/Access (Y/N) in. High water alarm level at in. Meets alarm & circuit requirements? Septic tank/lift station on lot Absorption field on lot >100' Public sewer main N/A >100' .... On adjacent lots >100') On adjacent lots >t00' Public sewer manh01e/cleanout N/A Sewer/septic service line >25' ~ Holding tank' N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Water main NIA Property line >5' Water service line >10' Absorption field >5' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main N/A Water Service line >10' Surface water >100' Curtain drain None Noted COMMENTS . A se~:l, ment of the absorption trench is under the concrete patio slab. .~Wells on adjacent lots '>100' ENGINEER'S CERTIFICATION I cerlify that ! have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date; Engineer's Printed Name Michael E. Anderson, P.E. Date 4/11101 Driveway, parking/vehicle storage. >25' HAA Fee $ ~-- Date of Payment Receipt Number (Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number Apd111,2001 Wes Clubb P.O. Box 112313 Anchorage, AK 99511 Subject: Lot 5, Block 1, Spring Hills Subdivision Well and Septic System Inspection, Testing and Certification Certificate of Health Authority Approval Dear Wes: The septic system on Lot 5, Block 1, Spring Hills Subdivision was originally constructed in October of 1983. It consisted of a 1,250-gallon septic tank and an absorption trench with a total length of 121'. The pdmary trench is 80' long with an effective depth of 4' and a total depth of 8'. At the midpoint of the trench a second trench was constructed perpendicular to this trench. It has an effective depth of 8' and a total depth of 12'. This second trench has been covered with a concrete slab and there is currently no access. The slab was apparently placed during construction of the house. A Cedificate of Health Authority Approval was issued on the well and septic system on June 6, 1984, after the concrete slab was in place. Our inspection showed the trench to be completely dry. We then began to inject water into the second compartment of the septic tank to measure the absorptive characteristics of the trench. Flow was originally set at 3 gallons per minute. A minor obstruction is apparently blocking flow from the septic tank to the absorption trench as the water level in the tank began to rise. Once flow was slowed the water level dropped. The restriction will reduce the flow rate from the septic tank to the absorption. trench, but may not be a problem with normal effluent flows from the house. Access to the trench is limited to the cleanout/monitor tube at the east end of the line so cleaning the obstruction from the line may be difficult. A total of 767 gallons of water was added to the absorption trench and the water level rose to 14". Approximately 24 hours later the level had dropped to 4" indicating at least 450 gallons of water had been absorbed. The trench is apparently operating as it was originally designed at the current time. It must be noted, however, the system is more than 17 years old and has reached the average age of a normal septic system. The static water level in the well was measured at 215' below the surface prior to the beginning of our flow test. After 4 hours and 13 minutes the level was measured at 220' and more than 767 gallons of water had been produced. The average production from the well was measured at slightly more than 3 gallons per minute with only minor draw Lot 5, Block 1, Spring Hills Subdivision April 11, 2001 Page 2 down. The well is in compliance with all requirements of the Municipality and is producing more than the required amount of water for a 4-bedroom home. The absorption trench was constructed closer than 50' to a slope greater than 25%. It has functioned in this manner since 1983 and there are no apparent signs of effluent leakage on the slope. It would seem unnecessary to require any protective measures against effluent surfacing on the slope at this time. In general, the well and septic system are operating in conformance with the original design parameters and is eligible for certification. Sincerely, Michael E. Anderson, P.E. Attachments 04-09-01 17:32 FR0~CTE ENVIRON~NTAL 5615301 T-220 P.03/03 F-lg5 CT&E Environmental Services Inc. Laboratory Division 200 W. Pouer Drive Drinking Water Analysis Report for T~tal Coliform Bacteria A,cho.,oo. AK 996~8-~eos · Tel: (907) 562-2343 READ INSTRUCTIONS ON REYER~E SIDE BEFORE COLLECTING SAMPLEFax: 19071 561-5301 MUST BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: PUBLIC WATER SYSTEM i.D. # PRIVATE WATER SYSTEM 13 Sesd SAMPLE DATE: 'Month Day Year SAMPLE TYPE: /1~ Routine n Repeat Sample (for routine sample with lab ret. no. -) Q Special Purpose SAMPLE LOCATION Treated Wot, Untreated Water Time Collected Colleeted By Satisfactory C] L[nsatisfacmty eample over 30 bouts old, results re. ay ~ ~ ufireliable Sample too long in transit: sampl.e sh. ould not be ovcr~l]muts old_ at c..x. nmmatto.n to indicate reliable resultS, rlcase senn via speciaJdelivery mail. new sample . J4-//-~-" .. Dale Received Time Received ]'~.0 ^..lys,, Analytical Method-' .~embrane Filter r n ~MO-MUG *..N_u..mb. er .of.co]on!~lO0 mi. Result. Analyst Fazed Client notified of unsatisfactory results: Phoned Spoke ~iTh Fazed Da~e: Time: ..__.__.._-- BACTERIOLOGICAL WATER ANALYSIS RECORD ~) Colonies/100 mi BGB COLIFIRM Coliform/100 mi Time I -~7(~ .rs Comments: MMO-MUG Result: Total Coliform Membrane Filter:. Direct Count Verification: LTB Fetal Coliform Confirmation Final Membrane Filter Results R e c e i v e d T i m e _.A~p r~3 3 P M~r °* tho ~os ;~WRnNMENTAL FACILITIES IN ALASKA. CALIFORNIA. FLORIDA. ILLINOIS. MARYLAND. MICHIGAN. MISSOURI. NEW JERSEY. OHIO. V~.ST VIRGIN~ T-220 P.02/03 F-195 CT&E Ref.# Client Name Project NamrT# Client Sample ID Matrix Ordered By PWSID ' 1011686001 Anderson Engineering Lot 5. Block 1, ~ilLs Lot 5, Block 1, ~Hiils Drinking Water :5'f',~ Client PO# Printed Date/Time 04/09/2001 16:09 Collected Date/Time 04/05/2001 14:00 Received Date)Time 04/05/2001 16:15 Technical Director Stephen C. Ede Released By ~~ Sample Remarks: Allowable Prep Analys~s Parnmcttr Results PQL Units Method Limit~ Date Date Init Waters Department Nitmte-N 0.600 0.500 mg/L EPA 300.0 10 max O4105101 SCL Microbiology Laboratory' Tota! Coliform 0 0 colll00mL SMi89222B 04105101 KAP Received Time Apr. g. 4:33PM ' - MUNICIPALITY OF ANCHORAGE DMSION OF ENVIRONMENTAL HEALTH DEPARII4ENT OF HEALTH AND ENVIRONMENTAL PROIECrION APPLICATION FOR HEALTH AUIHO~TY APPROVAL C~-RTIFICATE 1 .. General .Info~mtion Application Date (a) Leg.a, 1 Descripti.on .(include lot, block, su,bdivision, ~ection, township, range) Address (e) ~al Estate Co. & Agent Address Telephone .~ of Basidence Single-Family Number of Bedrocks ~ Other (describe) 3. Water Supply Individual Well ~/ C~,,,unity ~--] Public ~-~ 4 Note: If oa[,~unity well ~stem, ~st ~ ~it~n ~nf~ti~ ~ ~ State ~~nt of ~viro~ntal ~n~r~tion attesting to ~ ~gality ~d 'status. Is ~e ~11 .ade~a~ f~ the ~r of ~~ s~cified in ~is ~ ~) 4. ~ Dis~al O~ite ~~ ~blic ~ ~i,,unity ~ ~lding Ta~ ~ Is ~ ~s~water dis~al sys~m ~quate f~ ~ ~r of ~~ ~) [Page 1 of 2] 2-15-84 Engineerin.c Firm Providing Inspections, Tests, Data and Information certify that I have checked, verified, c~ confcrmed to all MOA FAA Guidelines in effect on the date of this inspection. Date ~/~/~, / , Telephone .%-~ ! - ~-O~+ (% Signed by Date .6. DHEP Approval Approved fo~ ( ENGINEER SEAL) The Municipality of Anchorage Dapart~ent of Fealth and Enviror~ental Protection does not guarantee the continued satisfactory performance of the water supply and/or the wa§tewate= disposal system. This approval indicates that, as cf the validation date shown abo~, based on the data and infc~Taation furnished by an engir~er registered in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional for the. numi~r of bedrocms and type of structure indicated. (D~EP SEAL) 7. M~,t~H~to the following address': KB2/d5/s [Page 2 of 2] ae MUNICIPALITY OF ANCHORAGE (MOA) ' HEALTH ALrfHoRITy APPROVAL (HAA) CHECKLIST-.FEBRUARY 1904 ' Legal Description: L0r&" ~/-Oc~ WELL DATA Well Classification !'~R I'%J/4~-~ If A, B, c~ C, D.E.C. Approved(Y/N) /~;//g Well Log P~esent ~N):I Date Cc~pleted, ]~/,~/~ ~ Yield_~... Total Depth ~_~2~' i. cased to ~_~z~,~ Depth of Grouting Static Water Level.-' ii '/.~(~' Pump Set At Casing Height Above GrOUnd ~. O sanita~ Seal on casing ~N) Electzical'Wiring 'in COnduit' ~N) -" Depression Around Wellhead (Y~ · Separation Distanoes f~cm Well: To Septic/Holding Tank'yon Lot ~ ! ! W- / ; On Adjoining Lots. > l To Nearest Edge of AbSorPtion Field on Lot/-~- ~'~-0t ~ On Adjoining Lots ~ TO Hearest l:klblic Se~'r Line /~.~q To Roarest [~lblic CleanOUt/Manhble /%///4 - To Nearest Se~ Service Line on Lot Water Sample Collected By ~- P~'r ~$ ~; Bate ! ~/~/~ L~ Be Bate Installed /~5- ~ ~ - ~ ~ Size ~ ~ Stan~i~s ~) Ai=-tight ~ps ~) ~pression o~= Ta~ (Y~ ~te ~st P~d P~ing~inte~nm ~a~ ~ File (Y~)~A; f~ Holding Ta~ High-Wate= ~am (Y~) ~/~ ~a~ ~ation Distan~s ~ ~ptic~ol~nG Ta~: To ~ter-Supply ~11 . ~ ~ ~ To ~rty Li~ ~ ~ ~ ~ No,~ of Ccmpar truants iFoundation Cleanout .~N) / ~oldirg Tank Permit (Y~) ~/~ To ~ildi~ F~n~tion i O, ~ ' To Dis~sal Field ~ t TO S~em, ~, ~e, ~ ~jor ~aina~ 2-15-84 ': Date Installed i i .,:: Width of Field ABSORPTION FIELD DATA Soils Rati4 i.~ Abso ,rptior Type :of system Design Strata Length of Field · i: Depth of Field: Square F~t' of! Depression over Results of Lest ~scrp'.tion iArea Field Gravel Bed..ThiCknesS!~ ~:~.~.~" ~r.~ Standpipes P=esent ) ~,~ i Date -of Last Adequacy Test ~ ~; Adequacy Test ;~ i :~ i Separation .Distance fr~ Absc~ption Field: '. · To Water-Supply Wall ~ = O ' .i. · " ' To Building Foundation i 1/~,~ To Existingr!dr System not AP/ i , , on joining > TO Wate~ Ma~n/Se~v~ce Line /~; ~ To Cutbank(lf p~esent) To St~e~un/Pond/Lake/C~ Majo~ Drainage Course /%///% . . To D~iveway; i Parking Area, c~ Vehicle Storage Area /'~ Size in Gallons !. {!:/[~,//~ Manhole/Access (Y/N)~ Pump On Leal at {:I /t//f~- Pump Off Level at High Water Alarm. Level:at, ' Fl~//% Vent (Y/N) ~1 Pumpzng Cycles during Ade. quacy :Test, Meets !Check Permitted Bedrc~' Rating A~ainst HAA Bequest ** 'i that 'ha%~i che~led,l ~erified, c~ confc~ed to ~'1 :MoA . {t~ c~te of ~his.~nspe~,~." ' .... !; I KB1/d5/s [Page 2 of 2] ~HAA GUidelines ih effect 2-15-84 TELEPHONE'(907) 562-2343" 'ANCH,ORAGE INDUSTRIA'~.CEN~rER ' ~ .... · t~, ,. ;' ' 5633 BStreet ' !~ ' * ....... .'.. ~ ,..':','l~"..TM ; · "~;;",;'- '" .~ .~. Drinking water Analysis Report for Total Coliforr~ Bacteria ~.~ : * . . . ~ SAMPLE DATE: I ~1~1 Mo. Day SAMPLE'TYPE: , El Check Sample (for routine sample with lab ref, no, El Special Purpose SAMPLE 4.1 5 [3 Treated Water 1~9-O'ntreated Water .. . ':-,'~'f '~ TI me ' '-~,.~ ':' Collected I ,"-'" : · Collected ':' ~ By '." ..d,;9.' ;-..'... ~-'" READ INSTRUCTIONS BEFORE , '- ': COLLECTING SAMPLE TO BE. COMPLETED BY LABORATORY .. Analys~s shows th~s Water SAMPLE to be: ~ Satisfactory ~ "' ~'J--I Unsatisfactory ' ~?:,: .:!= ,:: '.; . . . !Fl'sar~pie too long in transit; sampleshould . ~.. n6t;be over 30 hours old at examination to .... Indi~:ate reliable results. Please send new sa .mp,' le~ via spe. c. lal delivehJ mall. .' Date Received :, :-..TimeReceived __.~l~,.~_~ :t Analytical MethOd: '~ ~'--' ~ '"":. i'.': °: ' -:.. El Fermentation Tube , ~Membrane Filter ., · ,, :~ ,'.., ~ Lab' Ref. No:r, Result*,. Analyst - a: ~1~-',-<<;':~, I I' I I-I-I I " "'1.I-r-I ,. ,. I' I rT'l ,' ' ' eNO. O~ c(goniel/lOO mi. ~' No. of POlitiv~ portion. m-~220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD . /, ,. : ,. : .:.L.z '.. ~ .., !'. '. ':' , g "-' ~.. Rev. lS83 I~lembrane Filter:. Dlre~:t Count ' '- : · t Collform/100ml ' _ ...__..Verlfi~_;~tion:- LT8 '" '" ' - '" "'~ '*' ' BOB '' ' ' '" ' ' ' ;~ .... Time: / __-~"~C5' a.m. ' TNT~ = Too Numerous To'Count ":