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HomeMy WebLinkAboutSTONY BROOK LT 2Stony Brook Lot 2 #015-511-20 Municipality of Anchorage /— Development Services Department Building Safety Division (! On -Site Water & Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 Onsite Wastewater Disposal System and/or Well Inspection Report Permit Number. SW070303 PID Number: 015-511-20 Name: KENT HARRINGTON Wastewater System: ■ New ❑ Upgrade Address: 10900 STONY BROOK DRIVE a ANCHORAGE, AK ABSORPTION FIELD Phone: No. of Bedrooms: (907) 229-6659 2 ■Deep Trench OShollow Trench OBed OLlound Oother LEGAL DESCRIPTION Rating: 0 8 Told opth ren arpads M /sR. rt 12' MAXMrt Block: Lot: subdivision: Depth to PW boll. Rare "Inal qad« Goat dpth beneath To%. — 2 STONY BROOK SEE DWG. rt 8.0 rt Township: Range: Section: n added ala.. orgnd Rade Gravel length: — — — SEE DWG. rt 26 rt. WELL: []New ❑ Upgrade Gael wktn 2.5 N Iovr of UMe 1 D4lanae OH•ew, Dns — FL rt. aoeelRoAlan Prhale, A.B.O. Total Dep ' Corel Taalaotgcll) Tota absorption ors Pipe .alarid: D 3034/ F-810 �A1E� rt. C' rt 416 so. rt D.Dw: S Date GRek stalk watw Leal: Unetdlo: Dolor netal.e: AMD CONSTRUCTION 11/14/2007 .r � rt TANK rYdIX)6 `\N Pu.p Set At cooYq ""t Aaota Gard: CP rt FL SEPARATION DISTANCES ■septic OHoiding OS.T.E.P. 00ther io Septic Tank Absorption Field Lift Station Holding Tank ublia/PrIvate Smear Lie, mowtactve•. ANCHORAGE TANK Cpadlr n pail.. 1000 7 r, Well 150'+ 150'+ — — 25'+ umlarlal: STEEL el CorpwMenls 2 Surface Water 100'+ 100'+ — — — LIFT STATION Lot Line 5'+ 10*+ — — — Sue In gallon YmW«We: Foundation 5'+ 10�t — — — Pump an l at Pump OW et: qh •at. da. el Curtain Drain NONE KNOWN Punp ud�e d: aptrkd npeatk,s iwfenned by Remarks: BENCH MARK Lecatkn and D.Otkn: TOP.OF WOOD BOX SONOTUBE BY TANK Aseurnel u.ptlwn. 100.00 rt ' Inspections performed by: GEG, Ltd. Dates: 1st 11/14/2007 ENGINEER? SEA 000 2nd 11/14/2007 ACV, OF.,A� 5�0� Development Services Department Approval -.. 4I SOD 0 .*CO* .. ..............D Conditional approval: Date: ; fr y A. rn s. 0 Q °o •, CE-795/jj \��p �4ed Professio^o\ Reviewed and approved by: Date: 0$ (Rev. 4/05) o 11-1U, p06o PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: — SW070303 015-511-20 STONY BROOK 5/0, BLOCK 2, LOT 360ePpv'� A B ST1 102.24 113.93 ST2 97.42 107.96 DBL1 95.83 105.82 DBL2 95.11 104.85 C01 193.02 101.91 MT1 91.69 99.28 CO2 79.62 79.72 STONY BROOK 5/0, BLOCK 2, LOT 360ePpv'� — _\� ----------- / --�- - - MACBETH DF, 5® 1.50' i A GARNLSS ENGINEERING GROUP, Ltd.� YK . CONSULTANTS& GENERAL CONTRACTORS w—•�.—.��•--••� ••••• • ......••• ......•• 3101 L Tg011 X01A WT 101 • MgIM.OL M N 7 • I\Ilr[ (941)1])-41" • IN (M)} =" • r M' w•.,so...,y rYyrew I PREPARED FOR: PHONE NUMBER: PACE NUMBER: .. A. .... ss. - KENT HARRINGTON 229-6659 2 OF 2. LEGAL DESCRIPTION: DRAWN BY: oOo j CE— FFG rYPe TOWNYYKBROOK SUBDIVISION, LOT 2 K.D.M. uo j�e .4/.,e o0 DATE: �� dp a AS -BUILT DRAWING 12/7/2007 ���ODo�o (Rev ows) NEW 1000 GALLON SEPTIC TANK VOOD 7y EXISTING 2 I AD / WILL ,kEDROOM D CC C y SYSTEM 7 MTO11 BL1 I CO NEW DRAINFIELD•:' �; •. r.'• PERK HOLE :,� . • r: L,n..:J •;,� / 8 [PROPOSED WATER LINE EXISTING I 4 BEDROOM I HOUSE — _\� ----------- / --�- - - MACBETH DF, 5® 1.50' i A GARNLSS ENGINEERING GROUP, Ltd.� YK . CONSULTANTS& GENERAL CONTRACTORS w—•�.—.��•--••� ••••• • ......••• ......•• 3101 L Tg011 X01A WT 101 • MgIM.OL M N 7 • I\Ilr[ (941)1])-41" • IN (M)} =" • r M' w•.,so...,y rYyrew I PREPARED FOR: PHONE NUMBER: PACE NUMBER: .. A. .... ss. - KENT HARRINGTON 229-6659 2 OF 2. LEGAL DESCRIPTION: DRAWN BY: oOo j CE— FFG rYPe TOWNYYKBROOK SUBDIVISION, LOT 2 K.D.M. uo j�e .4/.,e o0 DATE: �� dp a AS -BUILT DRAWING 12/7/2007 ���ODo�o (Rev ows) TOP OF TANK AT INLET - 96.01 INVERT OF BUNG AT INLET = 95.41 FINAL GR) 98.50-9 TION FINAL GRADE - 99.55-99.68 ST1 / / ST2 - TOP OF TANK AT OUTLET = 96.01 NEW 1000 GALLON SEPTIC TANK INVERT OF BUNG AT OUTLET = 95.20 RADE - 97.12-99.12 ABRIC PIPE - 95.12 TRENCH - 87.12 RELATIVE ELEVATION OF BOTTOM OF TEST HOLE - 81.12 (NO GARNESS ENGINEERING GROUP, Ltd. .T". _- •.. •CONSULTANTS& GENERAL CONTRACTOR L 1110011 IMM. MM 101 • w1p1o11M[, N( rowi . N101S (f01)111 -N» . IM (Wn) =O • �M �••. .ymn EPARED FOR: PHONE NUMBER: PACE NUMBER: •• •• ••••••••••• ••••••• KENT HARRINGTON 229-6659 3 OF 3 f A. Garn ss: ;AL DESCRIPTION: DRAWN BY: oO� a E- '• FFG STONY BROOK SUBDIVISION, LOT 2 K.D.M. ••j.jl� 'E OF WORK: DATE: OQOd pro le sslo� AS -BUILT PROFILE DRAWING 12/7/2007 �DO000��6 (Ra 01105) MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Nov 05, 2007 Expiration Date: Nov 04, 2008 Permit Number: SW070303 Parcel ID: 015-511-20 Legal Description: STONY BROOK LT 2 Design Engineer: 0855 GARNESS ENGINEERING GROW Site Address: Owner Name: KENT HARRINGTON Lot Size: 55480 SO. FT. Owner Address: 10900 STONY BROOK DRIVE Total Bedrooms: 2 Permit Bedrooms: 2 ANCHORAGE. AK 99516 - 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 DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 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. Date: Issued By.(Date: �% Municipality of Anchorage Development Services Department \ Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. h 16 - J I ) -COD MCA. I' 9 Property owner(s) KENT HARRINGTON Day phone 229-6659 Mailing address 10900 STONY BROOK DRIVE * ANCHORAGE AK 0 Site address I hCl or) S� -jP)YD1)L lY• Zip Code 99516 Legal description (Sub'd, Block & Lot ) STONY BROOK SUBDIVISION, LOT Legal description (Township, Section & Range) Lot Size 65!51 LI Sq.FL THIS APPLICATION IS FOR (® all that apply): Absorption Field Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 2 THIS APPLICATION IS AN: Initial Upgrade ❑ Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. _GARNESS ENGINEERING GROUP, Ltd. Permit/Rush Fees: V('0 -0a Date of Payment: I p 12 G� 0 -7 Receipt Number: (a? ( I (Rw. 11/05) Waiver Fees: Date of Payment: Receipt Number: GARNESS ENGINEERING GROUP, Ltd. --+ CONSULTANTS & GENERAL CONTRACTORS October 26, 2007 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic for Stony Brook Subdivision, Lot 2, To whom it may concern: The proposed 2 bedroom ADU will be served by a private well and septic system. We are proposing to install a 1000 gallon septic tank and a deep trench type drainfield. One test hole was excavated on the property. The drainfield will be designed around the 30 foot radius of this test hole. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which show the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: As can be seen on the attached design drawing the average topography below the drainficld is a 15-20 percent slope running approximately northeast to southwest. 5. The septic system which serves the primary residence will be less than 150 feet from the existing well (now class "C"). Attached is an ADEC waiver for this encroachment. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any qunions, please contact us at 337-6179. Thank you for your assistance. P.E., NOTE. -Attached is a site plan drawing, a design drawing, one soil log, which are all part of die design package for this septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 *Anchorage, AK 99507-1259 Ph: (907) 337-6179 0 Fax: (907) 338-3246' Website: www.gamcssengineering.com Oct 24 2007 12:08 P.02 1 W� O, I I 1 ► „ll /�\ W SARAH PALN, GOVERNOR J LLLJII LL�� U �� CJ ll v (J V ((ff��JJ 555 CORDOVA EPOF ENVIRONMENTAL CONSERVATION ANCHORAGE,AK99501 . Phone: (907)269-7519 D SIOAt OF WATER Fax: (907)269-3487bffp://www.state.ak-us/dec/ hnpJ/www.state.ak-us/dec/ W4STEWATER DISCHARGE PROGRAM October 24, 2007 Jeffrey A. Garness, P.E. Gess Engineering Group 370 E. Tudor Road Suite 101 Anc oraee. Alaska 99507-1259 Re. Stoney Brook SV, Lot 2 -South Anchorage -Waiver of Separation Distances between The New Class C Public Water System and the Existing Septic Tank and Drainiield-ADEC Plan Tracking Dumber 6300 W. Gamess: On Teptember 14, 2007 the Department received an engineering plan submittal requesting a wai er between the new Class C Public Water System and the existing 1,250 gallon septic Tank andhe existing drain field for the above listed location. The use on the lot is about to change by adding two bedrooms over the garage. The isting well is planned to be connected to the garage and a new septic tank and drainfield ,will I e installed which meets the 150 foot separation distance_ The existing 4 bedroom home was built with a separation distance of 104 feet to the existing 1,250 gallon septic tank and 120 feet to the onsite wastewater disposal system from the source well. The!following justify granting these waivers: the well log, soil report, resent satisfactory water s results for coliform bacteria (none found) and nitrate (.331 mg/1). The engineer has also reconmended this waiver be granted. Based upon the information presented, the engineer's recommendation, and the past actions granting waivers in this subdivision by the Department, in accgrdance with the Wastewater Regulations (18 AAC 72.020), the following waivers are • The separation distance between the Class C source well and the 1250 gallon septic tank is reduced from 150 feet to 104 feet (the reported existing distance) • The separation distance between the Class C source well and the onlot disposal system is reduced from 150 feet to 120 feet. (the reported existing distance) iistances noted in the waivers are from your submittal. It appears that these distances are the nearest edge of the wastewater disposal system component to the nearest edge of the ing public water system source well. If the wastewater disposal system fails or amination can be traced back to the system, these waivers will be invalid. ew construction will maintain the 150 foot separation distances required to the planned gallon septic tank and the deep trench type soil absorption system. are advised that if this development will require placing fill in wetlands or working in a +?:in:ed on Recy-led rsxr Oct 24 2007 12:09 P.03 river, or lake, permits from the U.S. Army Corps of Engineers and the Alaslm Department ral Resources may be required. A Coastal Projects Questionnaire will help you identify :rmits and approvals that may be required for your project. approval does not imply the granting of additional authorizations nor obligate any state, al or local regulatory body to grant required authorizations. An} person who disagrees with this decision may request an adjudicatory hearing in accordance wi 18 AAC 15.195-18 AAC 15.340 or an informal review by the Division Director in acc rdance with 18 AAC 15.185. Informal review requests must be delivered to the Division Dir ztor, 555 Cordova Street, Anchorage, Alasla 99501, within 15 days of receiving the decision. AdJ adicatory hearings requests must be delivered to the Commissioner of the Department of En ` onmental Conservation, 555 Cordova Street, Anchorage, Alaska 99501, within 30 days of theecision. If a hearing is not requested within 30 days, the right to appeal is waived. you for your cooperation. If you have any questions please do not hesitate to contact me at 19. Respectfully, C.t/�%ate..✓ i'� I William R. Rieth, P.E. Environmental Engineer Enclosure; As stated cc: Filliam Smyth, WW' w/o enc. W SOUTH LANK Ew000 HILLS, BLOC 2, LOT 7 r4 I I O'MALLEY DR ARG SOUTH LAKEWOOD HILLS, BLOCK 2, LOT 1 PT�Ic SQUTH aEWOOD HI LS, BLOCK 2, / 1 LOT 10 � I PROPOSED 2 IEDROOM ADU -------- -PROPOSED �- ----1 SEPTIC SYSTE \\ GROUP, Ltd. p A 4 I ....-_.,_:.._,.�.,., ...-...e,,.... CONSULTANTS 3 GENERAL CONTRACTORS IMI L TUOdI IIMO, TII[ 101 IN AVCxORYr Ax KW7 IN AOL (907P37- 1" • M2 (Y M» 32" IN RMOC �. Mi PREPARED FOR: PHONE NUMBER: PACE NUMBER: ••• • • •• ......•••• KENT HARRINGTON 229-6659 //TH/1 Q p .•• r y A. Gorness.: / DRAWN BY. STONY BROOK S/D, / �•,+1:Ri BLOCK 2, LOT 3 �0 �!//�A�'oAd ' TYPE OF WORK: / I PROPOSED SEPTIC SYSTEM DESIGN 11/1/2007 CANA TR A REM NO ENCROACHMENT CONCERNS I STONY BROOK S/D, EXISTING 4 I BLOCK 2, LOT 2 BED ROOM HOUSE 1 I I 1 I \ I 1 \ STONY BROOK S/D, I I BLOCK 1, LOT 4 —4010%,VIA" Vie GARNLSS ENGINLLRING GROUP, Ltd. p A 4 I ....-_.,_:.._,.�.,., ...-...e,,.... CONSULTANTS 3 GENERAL CONTRACTORS IMI L TUOdI IIMO, TII[ 101 IN AVCxORYr Ax KW7 IN AOL (907P37- 1" • M2 (Y M» 32" IN RMOC �. Mi PREPARED FOR: PHONE NUMBER: PACE NUMBER: ••• • • •• ......•••• KENT HARRINGTON 229-6659 1 OF 1 Q p .•• r y A. Gorness.: LEGAL DESCRIPTION: DRAWN BY. oo v .• CE 7 53 Fa STONY BROOK, LOT 2 K.D.M. �0 �!//�A�'oAd TYPE OF WORK: DATE: e�professlo"o40 PROPOSED SEPTIC SYSTEM DESIGN 11/1/2007 OF BEDROOMS:2 PER DAY (CPO): 300 BON RATE/S: (1 MIN./INCH 0 APPLICATION RATE: 0.8 DRAINFIELD SO.FT.: 375 MAXIMUM DEPTH:12 FEET WIDTH: 2.5 FEET LENCTH:25 FEET M.O.A. APPROVED SAND FILTER: N/A FEET EFFECTIVE:8 FEET REDUCTION FACTOR: N/A ACTUAL SO.FT.: 400 TO OBTAIN A COPY OF THE LETTER CONTACT CEC. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND NOTE: THE CONTRACTOR SHALL HAVE THE ALL WELL RADII FLACCED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. BOLOCK NY 2 OLOT 3DB \� PGP n J PROPOSED U GALLON SEPTIC INSTALL DOUBT CLEANOUTS . u 4 INSTALL FOUNDATION I K� CLFANOIIf PROPOSED 2 HOUSE PROPOSED WATER UNE MACBETH DR\ / 1' - 50• ilit GARNISS ENGINEERING GROUP, Ltd. ,.,, CONSULTANTS d GENERAL CONTRACTORS . ..�..� 0 ....... .. .. ......... ..... MI L TIIX.11 AWA t 101 • AND401MGL M ft O • I110M[ (YO)j]1)y1T • rN (w7)J " • OOLIL �w,.,v�µ.wlppe. a PREPARED FOR: PHONE NUMBER: PACE NUMBER: .•. •• ••..••••..... ..... KENT HARRINGTON 229-6659 1 OF 2 Q p '-..J r A. Carnes .EGAL DESCRIPTION: DRAWN BY: O� E `G STONY BROOK SUBDIVISION, LOT 2 K.D.M. Opp I AFa YPE OF WORK: DATE. Oppp�osslo o PROPOSED SEPTIC SYSTEM DESIGN 11/1/2007 DEPTH TO GROUNDWATER DATE oo� pp�4 7/16/2007 DRY OF DRY 7/25/2007 �' o ��• — GARNESS _ NGINEERING GROUP,P' 2 10:50 CONSULTANTS g *� ]]01 L 101 • ANGIN•IGE, AIL YY90] • AM1M1L i0] I-.I7p •ENL GO -3]IM • MSe511L ,•m.wwp'vrYywnl .t • • • • • • • ' MON• WfE 10:50 — 6• SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: 10:54 STONY BROOK SUBDIVISION: LOT 2 f � rness PERFORMED 6" FOR: .J QD KENT HARRINGTON DATE: 7 17 2007 ° •, CE-7953 °� 11•.1.0.volp DEPTH (reef)TEST — 6" oqo ����4000���00 6 11:00 HOLE 1 10-0 6" 7 11:01 — 6" _ 8 11:06 SOIL CLASSIFICATIONS 2 .,. GW ORG 3— — 6" GP ML ••• 11:11 GM CL 0^ 6• 11 4 — • 6- GC OL 12 11:17 Y SW MH 5—.... 6- SP CH SEE ATTACHED SM . ; off 6 SC SITE PLAN 7 00; SP/SM .. 8 .,• 9 S® 10 11 ••• ••'' •,° 12 .•.• 13—••' .•., ,• 14 ' :� .,• .•"' 15 •� ;. . 16 ,� �.�.• •••• SP 17 •' ••" ...•.•• I •.•. M. o••,• 18 D.O.H. 19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 7.5 FT. AND 8 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: JORDAN TROISI COMMENTS: RECOMMEND USING A 0.8 TRENCH APPLICATION RATE GEG, Ltd. 1, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE PERFORMED BY WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: it DEPTH TO GROUNDWATER DATE DRY 7/16/2007 DRY 7/17/2007 DRY 7/25/2007 10:47 — DATE 18-6, READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 7/17/2007 1 10:47 — 6" _ 2 10:50 3 0" 6" 3 10:50 — 6• _ 4 10:54 4 0" 6" 5 10:55 — 6" _ 6 11:00 5 0" 6" 7 11:01 — 6" _ 8 11:06 5 0" 6" 9 11:06 — 6" _ 10 11:11 5 0^ 6• 11 11:12 — • 6- _ 12 11:17 5 0• 6- ' L I / — EPTIC SOUTH — LAI( D � HI BLOC `'. 2, LOT 7 \ .j1 SOUTH LAI( 000 — BLOC 00� HILLS, BL CK 2, 5 1 E K 2, •�' LOT & LOT 1 LOT 10 \ ;re A R it n Cu 3`f. _I i TM ONY R S/D. :f BLOC 2. OT 3 "- � I B K OO 20EXIBED DOM ` H E I � I I \ I I I I i I i C I I I LE: P' STONY B 0 D, I I I BLOC OT I ' GARNESS ENGINEERING GROUP, Ltd. 'r 0 •- >•—»•--•M»------ CONSULTANTS 6 GENERAL CONTRACTORS O ro+ c nnoit solo. sl.rt IOI w 11JJ I" . F" u.s . stave ..... 0 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: .• ........ ••••......0 KENT HARRINGTON 229-6659 1 OF 1 Q A o f ey Go nese;' LEGAL DESCRIPTION: DRAWN BY: Op°Dr CE— eQ STONY BROOK SUBDIVISION, LOT 2 K.D.M. pp ee''•(3�,z3 .D�e O TYPE OF WORK: DATE: �QOd Profassio(%O PROPOSED SEPTIC SYSTEM DESIGN 7/18/2007 r� • i MUNICIPALITY OF ANCHORAGE ' 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 PHONE ❑r�NEW e� oc. 333-7,563 19UPGRADE MAILING ADDRESS LEGAL DESCRIPTION 1-o+ © Tin) to w Eve -_23 LOCATION NO. OF BEDROOMS -1 K Well Absorption area Dwelling PERMIT NO. DISTANCE TO: Uy F Z Manufacturer Material No. of compartments 'wF IS rn Liq. capacity in gallons - IF HO EMADE: Inside length Width Liquid depth 1' DISTANCE TO: Well Dwelling PERMIT NO. JUZ U z G Manufacturer Material Liquid capacity in gallons x � Well Foundation Nearest lot line PERMIT NO.. w x DISTANCE TO: _ u z No. of Tines Length of each line Total length of lines Trench width Distance between lines Z w inches Top finish Material beneath tile Total effective absorption area /-- of tile to grade p inches Length Width Depth PERMIT NO. w wp Type of crib . AJ Crib diameter Crib depth Total effective absorption area IA UJ DISTANCE TO: Well/ SD'fcog Building foundation ( � Nearest lot line / IS J C±DISTANCE Depth Driller Distance to lot line PERMIT NO. wBuilding TO: foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS aA - .r n 3a SOIL TEST RATI N 15Di INSTALLER A1CW4px J l REMA/RRKS v /n� C�+N1C_ ,S� .fir 1=0 Mo trlo 5 t Ji IN4 30 .� i� S Ii s,4-na was 4d4eA e r i ® _ k' /fC -qnm X IX K e'C` S i3 LILL°( APPROVED DATE LEGAL �ItS�SsLcild, `Ti9aAiq-1 S L0 a ���I C-� I L-- 1 7- 'e C3 FO fr4 " C� F1 dt% 113 E-� IQ DEPARTMENT O. HEALTH AND ENVIRONMENTAL | JTECTION 825 L STREET, ANCHORAGE, AK 99501 ' 264-4720 ' ^ C3 PA_E3 3" -F E= E3 En hJ E= F=Z F" E= FT P1 1 1-r PERMIT NO: 850308 ' DATE ISSUED: 06/17/85 _ (/~ , APPLICANT: NEWTON EXCAVATING � ADDRESGr 5237 EAST 22 AVE ANCHORAGE, AK 99504 . CONTACT PHONE: 333-7563 ^ LEGAL DESCRIP: SUBDIVISION: STONEYBROOK LOT: 1 SECTION: 23 TOWNSHIP: 12N RANGE: 3W LOT SIZE: 1"25A (SQ.FT^ OR ACRES) MAX BEDROOMS: 4 BLOCK: T. A1 Listed below are the options available to you in designing your septic system. Choose the option that best fits your site. DEPTH TO PIPE BOTTOM (FT,) 3"5 **' GRAVEL DEPTH (FT.) 0A TOTAL DEPTH (FT.) 4"0 ^ GRAVEL WIDTH (FT.) 22"0 GRAVEL LENGTH (FT,)41.0 GRAVEL VOLUME (DU"YDS") 33"5 TANK SIZE (GALS) 1,250^0i** SOIL RATING (SQ"FT./BR) 150 **DEPTH TO PIPE BOTTOM < 4"0 FT" MAY REQUIRE A LIFT STATION ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS _ ^ ^ -` _ _ ^-_ _ _ _ -^ ^ ~ ~ - _ _ _ _ _ ^ ~ - -. _ _ _ . _ - _ _ ~ ~ __ _ ^ - I certify that: / 1" I am familiar with the requjrements for on-$ite sewers and wells as set forth by the Municipality of Hnchmrage (MOA) and the State of Alaska" 2" I will instal] the system in accordance � with all MOA codes and regulations, , and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set hack distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4^ I understand that this permit is valid for a maximum of 4 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, `/ THEN' (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-RUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN" ' SIGNED .DATE: Z-------------- ------------------- APPLICANT: NE GAVATING ' ISSUED BY DATE: � b+.Ls(-j r�MUNICIPALITY OF ANCHORAGF� Departmen{ if Health and Environments .Protection 825 L Street, Anchorage, AK. 99501 264-4720 # # # HANDWRITTEN PERMIT Permit # 7'�079� WEL-( -AiVD/OR ON-SITE SEWER PERMIT Applicant: a"t yi Address: Location: Phone Number: .25(Y(-(-00(0 Legal Description: (-';� 7r 4L'C� Lot Size: Type of Soil Absorption System Is: Trench: ✓/ Drainfield: Seepage Bed: Holding Tan) =_ Maximum Number of Bedrooms: Soil Rating(sq.ft/br) /�S The Required Size of the Soil Absorption System Is: DEPTH, LENGTH ____ GRAVEL DEPTH s57 WIDTH The 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). - /1-5-6 * * REQUIRED SEPTIC(HOLDING) 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(Z) 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 u 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 cordance with codes. (3) I un stand that t on -sit ewer system may require enlargement if th r sidenc is e odeled t include more that�i3 bedrooms. Signed: t Issued by: _d plicant / Date: SWP/024 (1/81)ug Q L L� Ja ✓ 1/ �i �"v �_ f �� 7�� 27Y'as5 -3� 1 SOILS LOG' , MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 _ 264-4720 f �CA SOILS LOG — PERCOLATION TEST C���j PERFORMED FOR: 6?a E)?W Cn DATE PERFORMED: I?—JLAn6 OM LEGAL DESCRIPTION: Irk 1r rt F1-I-�iiC�" l L ERn ` � SL PE F1rF.-T-TIVB' \I 1 2 (Y11L) 3 - 4 5 (n1L) 6a s�1� rrly+s� 7 8 (C)i n) 9 10 1,5 11 i WAS GROUND WATER ,1n ENCOUNTERED? _ Vim_ 12 IF YES, AT WHAT DEPTH? l 13 14 15 16- 17 COD 18 -TI-11 vtze_ 15 `Xld,t� ' 19- tAse OS`t-tG IY�St,>1 Lc vl Cy 6?,( SITE PLAN 20 tll �,C)Y" q`CtuCY-. PERCOLATION RATE a (minutes/inch) TEST RUN BETWEEN �'']] %% FT AND �_FT PERFORMED BY: - _ CERTIFIED BY: / DATE: (% D 72-008 (6/79)���� 7 , `- Reading Date Gross Time Net Time Depth to Water Net Drop -11L'ol aiaq 460 jL -11 lep tGo 9`r ica 16% p t12O '.tl 1 1 COO `t ICJ cC . oo .3 CR CQ0 5 q 1O 6D a0b 20 tll �,C)Y" q`CtuCY-. PERCOLATION RATE a (minutes/inch) TEST RUN BETWEEN �'']] %% FT AND �_FT PERFORMED BY: - _ CERTIFIED BY: / DATE: (% D 72-008 (6/79)���� 7 , `- NAME GRE` S�UGH ER ANCHORAGE AREA B0►' Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM r/ P✓o/ 1'r_" gqUip MAILING ADDRESS�^/�/�� PHONE a6S—ry-33J'� LOCATIONLEGAL DESCRIPTION' 3l -a o/L. —/ SEPTIC TANK: DISTANCE/ /� ,/ NUMBER OF FROM WELL �o MANUFACTURER C72E2- MATERIAL uL � ��6��'/"COMPARTMENTS —/ INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /2-5--0 GALLONS. SEEPAGE PIT: NUMBER OF PITS�� DIAM, ETER OR WIDTH —1-4-/ LENGTH—/6, DEPTH LINING MATERIAL/</a%+S 1211_6 —1 -4 - SIZE: DIAMETER DEPTH- /DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION ZD NEAREST LOT LINE w ABSORPTION AREA (WALL AREA) 5 %6 SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE ZiVOIb�. CONSTRUCTION f/O O/2/LCG7� DEPTH a'20 / DISTANCE FROM: BUILDING /f NEAREST NEAREST '/o //-/-SEPTIC / SEEPAGE FOUNDATION ��, LOT LINE D SEWER LINE Y�TANK 10S SYSTEM / 2D CESSPOOL—,OTHER SOURCES APPROVED L-�' DISAPPROVED REMA DISTANCES: INSTALLED BY: �Oyn% PIPE MATERIAL (_RSY 2720n/ LOT SLOPE: REMARKS: 700 p ,iIFR2odc0 Got 41 P�e2i✓!. Form No. EQ -031 DIAGRAM OF SYSTEM DATE 9`-2-7V APPROVED J-w� O 1?7Pr1' rte, GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 PERMIT NO. AI,Eu1 (?,o•d-C7-- SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT /,{Al f i• 7FG�MMEL fax id -9B / ,t&H 7F /,v/A & NAME OF APPLICANT �MAILING ADDRESS M ^ PHONE INSTALLATION LOCATION • `RG8C-rAl Cry ' IS*V /V) le- (J%F 0//•' �TLCElf LEGAL DESCRIPTION 0 T INSTALLATION OF: SEPTIC TANK SEEPAGE PIT "�< DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED 2.EE R'Oe� dlNLtr ��c�rn v FINANCED THROUGH TO BE INSTALLED BY SOIL /J^ TEST RESULTS / W'o I�M`;-u NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED v � �� FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE / f.YPE SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM T � FOUNDATION TO SEPTIC TANK ww FOUNDATION TO SEEPAGE PIT 2u / DRAIN FIELD V / SEPTIC TANK TO SEEPAGE PIT WALL If / SEPTIC TANK IV . SEEPAGE PIT Z� DRAIN FIELD / TO NEAREST LOT LINE.-XW/ ELL TO SEPTIC TANK / B U SEEPAGE PIT / — DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK - SEEPAGE PIT — ASEPTIC TANK, ` / SEEPAGE PIT ( o-� DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 41NCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 26-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. /7 / / //// DATE - /O APPLICANT'S SIGNATURE Performed for Legal Descript'on: This form reports: Depth Feet PJZFATER ANCHORAGE AREA BOROUGH Dep Aent of Environmental Quality 3330 "C" Street Anchorage, Alaska 99503 Date performed (v e is log X t. v Percolation test 2- ti 3 4- 5- o - 8- 10 - I1 - 12 _ 13 - 14 - Was ground water encountered? 46. If yes, at what depth? 1 Reading Date Gross Time I Net Time Depth to H2OI Net Drop Nercoiation rate minute, Proposed installation: Seepage Pit Drain Field Depth of Inlet Depth to bottom of pit or trench C(IMMFNTS c Performed By: Certified .g - 0 GREATER ANCHORAGE AREA KORO"-) Department of Environmental Qu,.iity 3330 "C" Street Anchorage, Alaska 99503 ® SOILS LOG - PEROLATION TEST Performed for u ►tit Legal Descripti n: -- This form reports: Soils log I_ Depth �� `Z Feet 2 - 9M 4 5 - 1� S S W - 6- 7- ,= 9 - 10 - S� ope 11 - 12 - 13 - on 14 - Was ground water encountered? Ne.*> -^ If yes, at what depth? Date Performed Reading Date Gross Time Net Time Depth to Water Net Drop Percolation rate minute. Proposed installation: Seepage Pit Drain Field ---------------- ULpth of Inlet — Depth to bottom of pit or trench COMMENTS: EQ -040 (6/74) Ij 0 - N'atter Sand ' $:_rrav el ? ' `= - - .21 %:: i✓:iJi I CJP NCHORA _. .. .:.. - LTH &- ROIv vlc\FAL ROTECTI( f I"certify the above true and correct. { z, / G weld w/i h S 1! S SE%{IVE%l�JVW /✓61iif z 1, Sec-.23JT121✓,R3v; SM _,. _.::...._ ,•-Driller ...... .......................... 7 2 - 0610'71 9. 2 W ZI - I `f Wf59.b �.. FQ�il DniLLIIyG ce; DGGS 1336ID:GRA PH. 279.2849 ANCHORAGE, ALAS:, 9P5o1 CC: Mani of ' e advise you to attach this certificate to your deed !1916 Certified Well 3ot1n - - For - Location.. �t-_2� Stone Brook Subdivision ...... Date Complet d----.12 1--7 .......... ,.... _ ........ ....... ".Depth of well_—_.2.20 Feet - - - . `- Size of-casing_3.jX •Tndjtj_ "-- .-.--------- .--.:..::_...: " Distance to water. .:= 1 R2 :; eRt " - - ." umping ---212 Few* - Distance to waterwhile pumping-- _ -- •- ------ ....at rate " ., of -- --...3.0- �,--- _.::gallons per "hour. _ Description of�Formation `;'. :,. ".from to ... cid azr_ .3�ai .: Trim.'=?qPd, 0 70 ,arl ,a: Gravel CrP-i- -Hard';-70 10-0 -1 aV 100 125 a ,3. n; Gravel, 125 . - 145 I v' aro 'ra e1- rn =^ 5of,t 14 5 1 0 5 e _ B ri Hf l_, 150 1R 5_ C r - Rr .t-7We3: -.19 190. -sanda r'ra`.a Rr31 -`- he3:. 190 200 Clau`Sandw-GraVPl-'. Grey '; -Ned. 200 - 21'7: - N'atter Sand ' $:_rrav el ? ' `= - - .21 %:: i✓:iJi I CJP NCHORA _. .. .:.. - LTH &- ROIv vlc\FAL ROTECTI( f I"certify the above true and correct. { z, / G weld w/i h S 1! S SE%{IVE%l�JVW /✓61iif z 1, Sec-.23JT121✓,R3v; SM _,. _.::...._ ,•-Driller ...... .......................... 7 2 - 0610'71 9. 2 W ZI - I `f Wf59.b �.. FQ�il DniLLIIyG ce; DGGS 1336ID:GRA PH. 279.2849 ANCHORAGE, ALAS:, 9P5o1 CC: Mani of ' e advise you to attach this certificate to your deed !1916 Municipality of Anchorage Development Services Department =14 r . e: Building Safety Division Onsite Water 8 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, I Parcel I.D. 015-511-20 HAA#_ f tQ 0 1. GENERAL INFORMATION Expiration Date: /0 — //— Q. Complete legal description STONY BROOK SUBDIVISION• LOT 2 Location (site address or directions) 10900 STONEY DRIVE • ANCHORAGE. AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address CHRISTINE REDICK Day phone 565-6332 10900 STONEY BROOK DRIVE • ANCHORAGE AK Day phone MANNY ESCOBEDO w/ PRUDENTIAL JACK WHITE Day phone 762-5854 3201 "C" STREET SUITE 200 • ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well N Individual On-site ■ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ 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. Certificates 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. DSO 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. (Certificates 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. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid S 1,470.00 at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verity 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 bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, SUITE 28 • ANCHORAGE, AK 99504 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 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, groundwater 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. AKW WC, Inc. 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 will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Phone 337-6179 Date /,/, 2 Conditional approval for bedrooms, with the fllowing stipulations: Attachments: HAA Checklist ✓ Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other tttt(tff((f/fff"� �11OFAN c UN -SITE WATER AND '.s Yh(UVCWm - •••..�. /0A."�NT I / 6y: L /r�--Lit Original Certificate Date: — : (Rev 1tN1) Municipality of Anchorage ' Development Services Department Building Safety Division Onsite Water 6 Wastewater Program 4700 South Bragaw St. P.O. Box 19SS50 Anchorage, AK 995198650 www.ei.enchomge.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: STONY BROOK S/D; LOT 2 Parcel ID: 015-511-20 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N A Date completed 12/13/1973 Sanitary seal (Y/N) YES Total depth 220 ft. Cased to 220 ft. FROM WELL LOG Date of test 12/13/1973 Static water level 182 ft. Well production 8 — g -p.m - WATER SAMPLE RESULTS: Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 6/20/2002 190 ft, 2.19 g.p.m. Coliform 0 colonies/100 ml. Nitrate 0.306 mg./L. Other bacteria 0 colonies/100 ml. Arsenic: N/A mg./L. Date of sample: 6/20/2002 Collected by: AKWWC, INC. B. SEPTICIHOLDING TANK DATA Tank Type/Material STEEL Date installed 8/2/1974 Tank size 1250 gal. Number of Compartments 1 Cleanouts (YIN) YES Foundation cieanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 7/1/02 Pumper DENALI SEWER & DRAIN C. ABSORPTION FIELD DATA 8/2/1974 Date installed 6/18/1995 Soil rating OE?Vor ft'/bdrm)125 150 System type SEEPAGE PIT/BED Length 16/60 ft. Width 16/15 ft. Gravel below pipe 9/0.5 ft. Total depth 11/3 ft. Efl. absorption area 576/900 ft' Monitoring tube YES Depression over field NO Date of adequacy test 6/20/2002 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test E in. Water added 640 gal. New depth E in. Elapsed Time: E min. Final fluid depth E in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date – •ONLY TESTED BED D. UFT STATION Date installed "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons High water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout N Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 00' Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and Wey review of Municipal records that the above systems are in .. • ....• conformance with MOA HAA guidelines in effect on this date. Engineer's Printed ame JEFFREY A. CARNESS Date _ i3 02. a^coca Naf,o f eswo^Ooo HAA Fee $ 315 Date of Payment Receipt Number Waiver Fee $ 150 / Date of Payment :7 15 O a Receipt Number a a off - (Rev. 12101) WS00 s�t3 ALASKA WATER & WASTEWATER CONSULTANTS, INC. June 25, 2002 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water R Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Lot Line Waiver for Lot 2 Stony Brook S/D. To whom it may concern: We request that your department issue an zero (0) foot lot line waiver from the west property line to the existing drainfield. I am unaware of any adverse impacts this waiver would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. assistance. P.E., M.S. 6901 Debarr Road, Suite 213 * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akw%vc.com imunicipality of Anchorage George P. Il'uerch. Mayor +c 7 BtAldinf, Safety DiA7sion P.O. D).c MM • 4700 S. Bragaw Street Anchorage, Alaska 99519.6650 • (9(r) 34341 301 h u p: //e���c.tl.aneL nm�a:d<.us 7/10/2002 Jeffrey A Gamess, PE Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Rd. Suite 2B Anchorage, AK 99504 Subject: Waiver Request for Stony Brook Lot 2 Waiver Request #WR020043 Parcel ID #015-511-20 Dear Mr. Gayness: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 0.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeffrey W. Poet Engineering Technician On -Site Water & Wastewater Program Municipality of Anchorage Development Services sent � building Safety Division On-Sitc Water and Wastewater Program 4700 Bragaw Street P.O. Dox 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: WR020043 PID#: 016-611-20 HAM HA020305 Permit#: Date Received: 713102 Legal Description: Stony Brook Lot 2 Engineer. Jeffrey A. Garness, PE Alaska Water & Wastewater Consultants. Inc. Applicant: Christine Redick Waiver Requested: 0 feet from the west property line to the ezistlna drainfleld Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Waiver is Granted: _s/ Waiver is not Granted: List Conditions or Reasons for above: Date: —7l O — o By: Reviewer Rec#: 22263 Amount: $160.00 Date Paid: 7/10/2002 L, J N A9.5�,•�n��w 1gn.nn� 10' UTILITY EASEMENT r �l SHCO Lp 296 I S ASPHALT r SS DRIVEWAY a z S SS S r: S S DECK R S (r I .nW OQ ' wo 676 OVELL 10' UTILITY EASEMENT S 89e56'3U"L 19O.UU' J n v _ _ L OF A .` 491H* '•9, ............................... ........................... SHANE A. HOLT LS -6914 ,41 D�O:,_Ie•aenof ��o AS -BUILT SURVEY SCALD 1- . 40' I HEREBY CERTIFY TWAT I HAVE PERFORMED A MORTGAGEE'S INSPECTION OF THE FOLLOWING DESCRIBED PROPERTY. LOT 2. STONY BROOK SUB. HE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SNOW ANY CONFLICTS ETM XISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADI TU9R TRUCTURES OR FENCEUNES. TH VI ASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PUT, ARE NOT SHOWN HEREON. EN OTE: ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROP RTDA R LOCATE STRUCTURES. DA NY PAVING SHOWN MAY BE APPROXIMATE DUE 70 SNOW CONDITIONS. NO q ALASKA THIS __14TH__ 2002____. 6670. FB70-61 Al 6-24-02; 3:46PM; 1p, CUE Environmental Services Inc. CUE ReEN 1023651001 Client Name AK Water & Wastewater Consultants Inc. Project Namd# 10900 Stony Brook Client Sample ID Stony Brook L2 Matrix Drinking Water Ordered By Stepbe^Ede PWSID 0 Sample Retnarks: ;907 581 5301 0 2/ 3 All Datesfnmet are Alaska Standard Time Printed Date/I3me 06/24/2002 13:02 Collected DateMene 06/20/2002 7:59 Received Date/rime 06/20/2002 10:00 Technical Director Stepbe^Ede Released BY Parameter Results P L Units Mahal fir"Us D Allowable Prep aalysit Q Limits Date Date snit Waters Department Nitrate•N 0.306 0.200 mg/L EPA 300.0 (<10) 06/20/02 IDT Microbiology Laboratory Total Coliform 0 coV100mL SM1892223 (<I) 06/20/02 KAP w Y1 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services M On -Site Services Section ENVIRONMENTAL SE VICES 40E P.O. Box 196650 Anchorage, Alaska 99519-6650 SERVICESDIVISION 343-4744 JUN 2 7 1997 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.# HAA# 1. GENERAL INFORMATION Complete legal description Lot 2; Stony Brook Subdivision Location (site address or directions) 10900 Stonybrook Drive AK Property owner r -Bobbi & Dan weigman Day phone 346-4052 ?Mailing address 10900 Stony Brook Anchorage, AK 99516 Lending agency.. _. Day phone Mailing address Agent Address Unless otherwise requested, HAA=will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well xxx Community well Public water Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xxx Holding tank — community on-site Public sewer — NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOAM 1 5. Q 0 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 Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. S & S ENGINEERING p Name of Firm Phone 6 < I y - 9' / age Itiver LOOP Road No. 204 Address Eagle River, Alaska 99577 Engineer's signature DHHS S Approved for Disapproved. Ibedrooms. Date 6 /a 6 OF ROBERT C. COWAN CE -6604 Conditional approval for bedrooms, with the following stipulations: Note: The well for this property meets existing State and Municipal Codes. Tl,^3^e•-are-nitrates =Psesen� Tt is sugga r d that pprindip r cr' g be performed to insure the wells continued suitability. Current nitrate LVIICelILLat±Vll 1.5 9.92 llbi1• PP.22S IIISh2m13m e93teentE'a1:ieIlzs X8.8 ms/i. More information on nitrates is available from the On-site Services Program, Additional Comments 4UTIC 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-M(RW.1/81) Back MOAN21 Legal Description A. WELL DATA 41 Municipality of Anchorage f'RoFq��ryoF DEPARTMENT OF HEALTH & HUMAN SERVICES yql qN Environmental Services Division t/V sFpyc'sG° 825 L Street, Room 502 • Anchorage, Alaska 99501 • (90� 343-4,A) F �) ti Health Authority Approval Checklist �o% a STONY 13ROOk S10 Parcel l.D.: Well type PAr v#TC- Log present (fir N) Y6 S Total depth P-2.0 Sanitary seal (9/N) Date of test Static water level Well production Y4,5 if A, B, or C, attach ADEC letter. ADEC water system number Date completed / a / 13 / 73 Cased to i` 0 f FROM WELL LOG 1 a1,3 �-7 1`8ar WATER SAMPLE RESULTS: Coliform O Nitrate Casing height (above ground) Wires properly protected (AVN) Y� J AT INSPECTION g.p.m. y, $ g.p.m. 01- q ;�_ Other bacteria Le Date of sample: (7 /0 A 7 Collected by: s & 5 ENGINEERING 17634 Eagle River Loop Road No. 204 B. SEPTIC/HOLDING TANK DATA Eagle River, Alaska 99377 Date installed $ a / 7 y Tank size J aS (9 Number of Compartments 1 Cleanouts (�N) Y65 Foundatiorrclejanout,&N) YDepression (Y/0) h" 0 High water alarm (YA& P 0 Date of;Pumpmg„ °t 7 Pumper i36NAC, I S 4&W4A, DRgw C. A6.SOF1IPTION.FIELD DATA' Dateiristalled�fla)�Y �G�' lYS Soil rating (g.p.d./ftlor /bdr i)-s-�- ISO systemtypeeRiO `t 166'b Length JO Go' Width �e°�• f Gravel thickness below pipe d S Total depth tI %! Effective absorption area 9'7 b k 90oMonitoring Tube present �/N) Y'0 Depression over field (Y( Date of adequacy test / 8 /q 7 Results (Pass/Fail) A A S i For bedrooms Fluid depth in absorption field before test (in.);6 Y /" $ D Immediately after! 77 gal. water added (in.): I If Fluid depths i o (ins) Minutes later: 3 Absorption rate = G D D Peroxide treatment (past 12 months) (Y/N) A?v ^4 - 72-026 (Rev. 3/96)' AeNONA*' Ifyes,givedate D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Size in gallons "Pump on" level at* , mp off' level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Lqj 16holding tank on lot e o On adjacent lots / 0 o t Absorption field on lot r ov On adjacent lots /00 Public sewer main N 14 Public sewer manhole/cleanout Sewer /septic service line S 0 f Lift station r✓ 1N SEPARATION DISTANCES FROM SEPTI HOLDING TANK ON LOTTO: Foundation s f Property line S Absorption field Water main/service line S f Surface water/drainage y00 t Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: 'Pa /A S 4 1 0 0 (--,, Property line / o f Building foundation � S -F Water main/service line a S- -t- Surface Surface water /0J 4 Driveway, parking/vehicle storage area Xs t Curtain drain tj642- K.JowrJ F. ENGINEER'S CERTIFICATION _ Wells on adjacent lots r / certify that / have determined thru field inspections and review of Municipal in conformance with MOA HAA guidelines in effect on this date. Signature>�� w Engineer's Name �OiJhit; C. �aW#Pj Date 6 HAA Fee $ Waiver Fee $ _ Date of Payment dpr Date of Payment Receipt Number. --WW Receipt Number 72-026 (Rev. 3/96)* 00 t are A_ CT&E Environmental Services Inc. CT&E Ref.# 973107003 Client PO# Client Name S & S Engineering Printed Date/Time 06/20/97 16:16 Project Name/# N/A Collected Date/Time 06/17/97 13:30 Client Sample ID Lot 2 Stony Brook Received Date/Time 06/17/97 14:15 Matrix Drinking Water Technical Director: Stephen C. Ede Ordered By PWSID 0 Released By/%CYt(R/I Parameter Resutts Nitrate -N' - - 9.92 Total Coliform - 0 Allowable Prep Analysis PRL Units Method Limits Date Date Init 0.500 mg/L SM18 4500-NO3F 10 max 06/18/97 JBL col/100mL SM18 92228 06/17/97 RAM r Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lor.2- S�,�J7 f:�90o/< SO Parcel I.D. Pl (� _5�1 /— A. Well Data Well type P/C(I/61-1-E If A, B, or C, attach ADEC letter. ADEC water system number /Jm Log presen (Y ) Y6 S Date completed «I /3 93 Driller %a ,s Drc/cc /7v G Total depth Z Z Z c0 Cased to 2d Casing height Sanitary seal(6)N) /(� Wires properly protected®N) Absorption field on lot X00 � ; On adjacent lots / OU 't Public sewer main 75(/— Public sewer manhole/cleanout /OU tf Sewer service line ZS rY-- Petroleum tank ,too /JL &�6QIJ WATER SAMPLE RESULTS: Coliform 0%OU /t't't� Nitrate 0' 10 Other bacteria`�- Date of sample: 914- Collected by: B. SEPTIC/rTANK DATA Date installed 8� �pi� Tank size Z� FAC— Compartments Cleanouts (Y/ ) (CJ Foundation cleanoutgN) `/ ;S Depression (Y,& -LfO High water alarm (y& d0 Alarm tested (Y/N) 1A Date of pumping ¢ Pumper At H�e- 597,51//t= -SLI SEPARATION DISTANCES FROM SEPTIC/HetDtfMTANK TO: Well(s) on lot /60 rf On adjacent lots /00 11(— Foundation To property line C O /'L Absorption field Surface water/drainage &0'4- 72-026 (3/93)* 4- 72-026(3/93)' Front 5 r -J- 5 fi- i Water main/service line /U CONTINUED ON BACK PAGE FROM WELL LOG AT INSPECTION Date of test Static water level Well flow g.p.m. 1516/ g'p'm. � r" � N N Pump levell UK 2ZZ coo SEPARATION DISTANCES FROM WELL TO: Septic/kelding-tank on lot /OoYY ; On adjacent lots Absorption field on lot X00 � ; On adjacent lots / OU 't Public sewer main 75(/— Public sewer manhole/cleanout /OU tf Sewer service line ZS rY-- Petroleum tank ,too /JL &�6QIJ WATER SAMPLE RESULTS: Coliform 0%OU /t't't� Nitrate 0' 10 Other bacteria`�- Date of sample: 914- Collected by: B. SEPTIC/rTANK DATA Date installed 8� �pi� Tank size Z� FAC— Compartments Cleanouts (Y/ ) (CJ Foundation cleanoutgN) `/ ;S Depression (Y,& -LfO High water alarm (y& d0 Alarm tested (Y/N) 1A Date of pumping ¢ Pumper At H�e- 597,51//t= -SLI SEPARATION DISTANCES FROM SEPTIC/HetDtfMTANK TO: Well(s) on lot /60 rf On adjacent lots /00 11(— Foundation To property line C O /'L Absorption field Surface water/drainage &0'4- 72-026 (3/93)* 4- 72-026(3/93)' Front 5 r -J- 5 fi- i Water main/service line /U CONTINUED ON BACK PAGE C. LIFT STATION t-R)0_JC /AW SCrGQ T Date installed Size in gallons Vent(Y/N) High water alarm level Meets MOA electrical i lot "Pump on" level at ANCE FROM LIFT STATION TO: D. ABSORPTION FIELD DATA adjacent lots Manufacturer (Y/N) "Pump off" Level at tested Surface water Date installed �/8 �� Soil rating (GPD/Ft2) SO System type /S V Length O ! Width S ( Gravel thickness U• s ' Total depth Total absorption area qC0 9� Cleanout presen (Y/) `r✓�S Depression over field (Yo@-1 c) Date of adequacy test %�/3/�� Results ass ail) Ahcf for O ItA Bedrooms Water level in absorption field before test After test Peroxide treatment (past 12 months) (Y/N) If yes, give date _ JJ//,+ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot X00 1� On adjacent lots /,e- Property line To building foundation / Q r-54-- To existing or abandoned system on lot On adjacent lots 2 O �1- Cutbank JVD re—, Water main/service line_ Surface water l00 (�/__ Driveway, parking/vehicle storage area S "1C_ Curtain drain AhJE K"o" /J . E. ENGINEER'S CERTIFICATION i1_ I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signatureyz 4 _ Engineer's Name �C30E,Z7- C. CO W4,) Date 9 /;t/ / y H HAA Fee $ 3fg , co Date of Payment 6j-4'2 /—V -ter l Receipt Number 72-026 (3/93)' Back t, V ROBERT C. COWAN age ^c CE 8801 Waiver Fee $ Date of Payment Receipt Number I te CT&E Ref # Client Sample ID Matrix Commercial Testing & Engineering Co. Environmental Laboratory Services �o®orirsooio®®®®eoioriioiiooiiioirr®� LABORATORY ANALYSIS REPORT 94.4498-1 LOT 2BLK 2 STONY BROOKS/D WATER ClientName S & S ENGINEERING Ordered By RJS Project Name Project# PWSID UA Sample Remarks: ROUTINE SAMPLE C Parameter Nitrate -N .ECTED BY: SS. QC Results Qual Units 0.10 U mg/L WORK Order 81908 Printed Date 09/06/94 @12:56 Ins. Collected Date 09/02/94 @10:55 hrs. Received Date 09/02/94 @12:00 Ins. Technical Director STEPHEN C. EDE Released B 5A—A. Method EPA 353.2/300.0 Allowable Ext. Limits Date 10 * See Special Instructions Above UA=Unavailable ** See Sample Remarks Above NA=Not Analyzed U=Undetected, Reported value is the practical quantification limit. LT=Less Than a D=Secondary dilution. Or=Greaterlhan 0 5633 B Street, Anchorage, AK 99518-1600 — Tel: (907) 562-2343 Fax: (907) 561-5301 Anal Date Init 09/02/94 CMR ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA MUNICIPALITY OF ANCHORAGE 1492-47 • DEPARTMENT OF HEALTH & HUMAN SERVICES} Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel 1. D. # — �'\ � — �1 (-) 1. GENERAL INFORMATION .Complete legal description SAN ooK Zo % 2 Location (site address or directions) 0 znn Sr-0NV5A0or< Property owner- A 4Aj 77 Z�?g / Al ikgt Z- Day phone Mailingaddress. /0 70o Si en�� BRgr� k �l 9J �/NC{ o RASE A/� i9s/6 Lending agency_, /Yo22(.Jesr- A/o o1-CACS A( I'- Day phone 274 Mailingaddres's' Agent gr-e,vDay phone 276 -q;Z5­0 Address AnPt est- [qoKr-66+-6r_- 2sso a����i 57f, € (jc/noARK 7 %So3 Nb rL: ITO )e. Al. CSlATE A-GrNT /N VO (vC'o/,. 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: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rm l/91) Front MOA N21 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 Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm 01614 P4UKAA( ConlSUL7IA16t Eni6111,1EEk5 Phone 277--'7111 Address Zo3 w� )6LIo4 �ubKAr, AK- 99So I Engineer's signature Date Q - ; 7L 337 6. DHHS SIGNATURE( Approved for ZL bedrooms. a Disapproved. Conditional approval for Additional Comments bedrooms, with the following stipulations: WTIC 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 MOAM Municipality of Anchorage 4497-4-71 Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L-oT 2 STDr t % 6AD09 Sug Parcel I.D. A. WELL DATA Well type MIVi4TF, If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) y ® Date completed JZ._I*J�-7230 Driller ED;; MILLINtb� Total depth 2 Z 8 Cased to A SSOmt O FUU[ OEPi asing height l 2 tt ® Y© Sanitary seal (Y/N) Wires properly protected (Y/N) - A C FROM WELL LOG AT INSPECTION 7 3 �'' Z. Pel 3 Date of test rJ n , NorlE oN WILL (a. LL LO Static water level j 4 Y I � do < n Well flow g.p.m. g•p." `�� o Pump level NONE ON WELL wu ASStrvt� lo' oFF (SoTTo 0 ti Z-) M Z SEPARATION DISTANCES FROM WELL TO: Septic/heldfreg tank on lot Ito ; On adjacent lots I+© 16D lots 77 Iy�f I Absorption field on lot ; On adjacent 1,1;N /A Puhlic sewer manhole/cleanout N/A Pu is sewer main Public sewer service line Petroleum tank 0"l[4= 1NOICA " Notl)p WATER SAMPLE RESULTS: O Coliform d Nitrate NIP( I) Other bacteria Date of sample: 9'-2Z - "Y Z_ Collected by: B. SEPTIC/1140LO NCa TANK DATA Date installed � Tank size 1250 Cleanouts WN) � Foundation cleanout (Y/N) no- r Compartments 0 (D 1® Depression (Y/N) N High water alarm (Y/N) N /A Alarm tested (Y/N) Date of pumping 4-2,3-9 SEPARATION DISTANCES FROM SEPTIC/Heb5+Nf4*N1K TO: / t I.4- 2 Z _`' Well(s) on lot On adjacent lotsFoundation_ 2 To SE�t�l=. P IT To property line n Absorptionfieldcg5(or'roFIF-L-d Water main/service line �1A Surface water/drainage SONE 06SCAVEa Ur WEASv(LW/061- g2.VEO BY Ga PGE �-t2 �L ]2-026 (Rev. 3/91) Front Mon zt �--Ovn OtdE-IS KILEs CONTINUED ON BACK PAGE Ct SEE ATTAcHEO C. LIFT STATION Date installed ! Manufacturer Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot NZA On adjacent lots D. ABSORPTION FIELD DATA "Pump off" level at Cycles tested Surface water 0 Q Date installed ie iSoil rating I C5 C) System type MUD w cil L z Length (00( Width I� ( Gravel thickness 0Total depth t Total absorption area 9©D Cleanouts present (Y/N) Yd Depression over field (Y/N) 14 (D Date of adequacy test -4-7-2-el 2 Results (pass/fail) PAS s 0 for Q' Q Peroxide treatment (past 12 months) (Y/N) OWN ti c (NOtcAWO NO If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ,�©(t ® On adjacent lots °y7 IOv Q Property line 101 (D bedrooms (.4 To building foundation - 0 To existing or abandoned system on lot NQIJF 0 On adjacent lots 71"7 tO0 ( ® Cutbank NON re- m Water main/service line NIA Surface water NONFn CAS V" Drivewa Z� ( + ow.,4 WIXOI-r> O Q Y. parking/vehicle storage area Curtain drain Mot.l� E. ENGINEER'S CERTIFICATION I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in ef6ggJ.9 t (h date of this inspection. CI _ �T,pl9 �o atl4 �Ntl�S$h'6�(6 V1. tlatl®�(M Signature s ag(, r> � o�YP Engineer's Name ,p),y a'+l�A°PN43C.(MN q"±fi4 Date �,2g Q "ICA SQAV-O/c,6S2aU" Affo4S fc �t�5 HAA HAA Fee $ —/ /U Date of Payment Al—,,3 V--i.2� Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number QN SGS Member of the SG$ Group (Socigi9 GA06rale de Survolllance) i 1492471 CHEMICAL & GE01,0GICAL LABORATORY A DIVISION OF COMMERCIAL TESTING St ENGINEERING CO, i — -- ' 5833 0 STREET ANCHORAGE, ALASKA 00510 TELEPHONE (907) BB2-2343 FAX' (907) 581.5301 - n.aeaeaY ANALYSIS RESULTS for INVOICE 153072 Chamlab RefA 92.1677 $apple I 1 Matrix: WATER Client Sample ID L2 STONEYBROOK Client Nam :NIGR PffuuN CONS ENGR PWSID UA Miant Acct :HIGNPHU BPOI POI :NONE RECEIVED Collected APR 22 92 112 20 his. Regl Received :-APR 22 92 1 12:35 his, ordered By 'CARL -, Pxeeexyed with : AS REQUIRED _ Analysis Completed : APR 23 92 Send Reports toi Laboratory Sup r sor STEPHEN C. EDE - - 1)HIGR PHUKAN CONS ENGR 2) Reloased By :w.. - - '••rParamatat^Y---•• ••••••••• _•••••••• ••Roeulta •••••Unite •••••••• Method Alluvablo•Liaits-•--••••_-- .......... .................. ••------- II _ _ ....----- ...----------------------------------------------------` NITRATE N- - M1(D 10) ogll EPA 353.2 -- 10 "(0.10) Sample ROUTINE SAMPLE COLLECTED BT: C.H.A. JOB 11192471. Rematke, .... .................. ............. ...... _ ......................................... ... ..'- 1 Teets Pexforteed - '. See Special Instructions Ahoye DA-Unavailable ND- None Detected " Soo Sample Remarks.Aboys NA- Hot Analyzed - - LT-Loss Than, OT•Gxeatot Than ' QN SGS Member of the SG$ Group (Socigi9 GA06rale de Survolllance) ai yYpa�YZ o aOoRY?��OZ4 i=is O�noxx eFn� a ;apy� `ax 2 n�A��emn mn warm a nA0>Y P8 y rr nn on$p$n�e Rn I. I I r �.lr 1 •_ i�ij �%L �. 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