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Home My WebLink AboutASPEN RIDGE BLK 1 LT 1A pen Ridge Block Lo1- I #017-093-01 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 MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS We~l I Absorption area ~1 Dwelling PERMIT DISTANCE TO: 1~+ ~ ~ Z Manufacturer[~ r~ Material ~ [ No. of compartments ~ h Liq. capa~,~lons,~ IF HOMEMADE: Inside length Width ~ Liquid depth ~ Well Dwelling PERMIT NO. DISTANCE TO: ~ ~ ~ Manufacturer Material Liquid capacity in gallons Q Well ~ DISTANCE TO: l~n~ Foundation ~'e~ ~earestlotline~i Pfi~MIT~ }0~ ~ ~ ~ No. of lines Length of each Total length of Trench widt~ Distance between lin~ ~ ~ inches ~ O ~ ~ lop of t~le to fish ~'inches I /grade Material beneath ti~ Total effective absorptio~ar~ Length Width Depth PERMIT NO. ~ ~ , Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS SOIL TEST RATING INSTALL~~ ~~$~ ~ ~E~A~K8 .. APPROVED DATE LEGAL 72-013 (Rev. 3/78) PERMIT NO. [-1LIf~IJ~I--'RLITY OF Rf-JCF' .... ~RRJSE DEPARTMENT ~. HEALTH AND ENVIRONMENTAL . 20TECTION 825 'L' STREET, ANCHORAGE, AK. 99501 284-4?20 LWELL 8~JO OD-d--SITE SE~JER PERMIT ( 82i05~ ) APPLICANT LOCATION LEGAL SUN CONST INC L1Bl ASPEN RIDGE SPA 474E ANCHORAGE 9950? ~45-1089 LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: DRAINFIELD MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING <SQ FT/BR>= t75 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [.~EPTH= 7 LENGTH= 82 GRA~'EL [:,EPTH= --_~ 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>. THE TREf-JC:H L~lOTH IS 5. 888 FEET. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE E×CRVRTION (IN FEET). RE~_~!IJ I RED SEPT I C: TA~JK S I ZE= i250 GALLO~JS 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 ~' I NSPEC:T IONS ARE RE(~I_I I RED BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS i00 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM R PRIVATE WELL TO R PRIVATE SEWER LINE IS ~5 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED 8ND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERr~ I T E×P I RES OECEI'-IBEI-~: _?~-1 .. 1982 I CERTIFY THAT i: 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 THE CODES. ~ I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE THAN 4 BEDROOMS. ....... Municipality of Anchorage Development Services Department Budding Safety Division On-Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.a k.us (907) 343-79O4 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Expiration Date: ,/(3 - / ~ - o 2... Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unles$ 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 Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding tank [] [] Community On-site [] [] 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 5 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. DSD atso 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 sample results less than 30 days old. (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. 4. 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 wastawater 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 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, ~nd regulations in effect at the time of installation. .Nam~ of Firm lc'(¢c (-/c, r) 7'~c,~ ~,'¢,~/ ~r~.;¢</ Phone ~' ¥C'- I~'.~-%- Address I~(S'~ E~-..¢,(~ gl;, Engineer's Printed Name -?'"b~o~..~o¢'~ 5. DSD SIGNATURE ~/ ^ .... veal for ~ bedrooms. D sapproved. Conditional approval for bedrooms, with the following stlpulaboh~:" Additional Comments By: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: (Rev. Municipality of Anchorage Development Services Department Building Safety Division O~Slte Water & Westewater Program 4700 South Brogaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (9O7) 343-79O4 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Parcel ID: O 17 - O9 3' - o / Well type P V/' If A, ~, or C provide PWSID # Data completed U/~/,6Z Sanitmyseal (Y/N) Y' Total depth ~ ~ ~ fl. Cased to '7 ~ ft. FROM WELL LOG Dateoftest l! / t~/,~ 2. Static water level ~- It. Well production O. '~5' g.p.m. · Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION ~. ~'P g,p.m. WATER SAMPLE RESULTS: .Coliform (2 colonies/100 mi. Nitrate ~.~' mgJI. Date of sample: 7/~/OZ Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material .' ~'e? ~'~ c / $~ · I Tanksize 1~.*-'~' gal. Number of C°mparlments Foundation cteanout (Y/N) Y Depression over tank (Y/N) Date of pumping ~O~'~e,-I~¢,ol Pumper C. ABSORPTION FIELD DATA ¥ t ~" in. Other bacteria ~ colonies/100 mi. 7'e¢4 5' ,,~. Date installed I~// Cleanouts (Y/N) High water alarm (Y/N) /~/, I ~! z t !~Z Soil rating (g.p.d~ or ~/bdrm) t 75'..~/f ~.,System type 5' ~- ¢~, ~"~ ~,v',~,,,, .~,,,/,,(. Date installed lt. Width ~ It. Eft. absorption area "/¥/ ft2 Monitoring tube __ 7/?- /~oo'L Results (Pass/Fail) Fluid depth in absofl3tk:m field before test ~ in. Water added~'~ gal. Elapsed Time:'~O'O min. Final fluid depth I~ · in. Absorption rate >= Any rejuvenation troatment (pest 12 mo.) (yiN & type) ~Je,~ ~.. Length Total depth e". ~' ff. Date of adequacy test Gravel below pipe 3 ft. Depression over field IV For ~/ bedrooms New depth ~',~in. ~'¢3~ g.p.d. If yes, give date JV, ,4 O. UFT STATION Date installed 'Pump on" level at in. Datum E. SEPARATION DISTANCES Size in gallons 'Pump oft' level at in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septtctank/llffstaflononlot '~, I IO° Absorption field on lot '~' [ O :~ ' Public sewer main ia. ,4. Sewer/septic se~ice line ~. RS' Manhole/Access (Y/N) High water alarm level at Meets almm & circuit requirements? On adjacent lots' ~,' too, On adjacent lots ~/~o ' Public sewer manhota/cleanout Holding tank ~. ,~.. in. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK' ON LOT TO: Building foundation ~ 3o Property line Watermain /~.,4. Water sen~ce line ~, l,=" ' Sudacewater Wells on adjacent lots ~ IO~ ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Propertyline 5" ~ t;,~ Buildlngfoundaflon WatarSer¥iceline ~, ~' Sudacewatar '~, Curtain drain A/o,,~, .~a~-, Wells on adJacent lots F. COMMENTS ~ Fcr' ~1¢co~ ~-,. D,~,~ RaF~. . O. ENGINEER'S CERTIFICATION ' ' I certify that I have determined through ~ld inspections and ~,~. review of Municipal records that the above systems are in conformance w/th MOA HAA guidelines Engineer's Printed Name ~-'-. t r,.: , .2,¢', HAAFee $ ;3 "7~' ~ WaiverFee$ Date of Payment -7/J ~/O 'Z.. Date of Payment Receipt Number __~__ Receipt Number (Rev. 12/00) . , Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Health Authority Approval # 020323 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block 1, Lot 1 of Aspen Ridge subdivision, the well's productivity was determined to be 0.89 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4-bedroom residence is 0.41 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concemed are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. OUL.~Og'O2iT~£) 08:~$ POA ~£L:907 2?? $~56 P. O02 p P,A 7. O..P,. j~I,~E S SIZEMORE AND ASSOCIATES LOT 1, BLK. 1, ASPEN RIDGE SUB0. ~EC£RT., AS BUILT PLOT PLAN JUL;OS-OZ O4:OlPU FI~t~CT&E ENVIRON~NTAL SRV · '~tk CT&E Environmental Services Inc. 90T5615301 T-$56 P.OZ/O~ F-636 CI & £ Ref.# Client Kame Project [~ame/# Client Sample ID Matrix Ordtre~ By PWSID S=mple Rerrmks: 1023974001 Flattop Technical Sty. LI, Blk 1, AsT~en Ridge S/D LI, Blk I, Aspen Ridge S/D Drinking Water All Date%/Tlmes am Alask~ Standard Time I~Hnled Date.q'lme 07/08/2002 10:09 Colle¢Icd Dale~lme 07/0~002 12:30 Retched D~le~lme 07/0~002 15:10 Tt'~hnleal Dlrettor o Slephe~'"~de Nitram-N 0.896 Limits Date Dale 0.200 mg/L EPA 300.0 (<l O) 07/02/02 ~DT l~icrobiolog~ Labora~.oz~ Tmal Coliform 0 col/lOOmL SMI8 9222B 07/02/02 SBH MuNICIpALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O, Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal descriPtion Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address Day phone , Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER'SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 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 (Rev, 1/91) Front MOA #21 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 inveS.ti_,gation 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. 6. DHHS SIGNATURE //"" Appro, vedfor /c~)U'/''~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: ' Icl, !~.~-~-~i'T~ Date P' / 3- ? ~ 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. 72425 (Rev. 1/91) Back MOA ~¢21 , t:CEIVED Municipality of Anchorage AU6 11 DEPARTMENT OF HEALTH & HUMAN SERVICE.~uNiQPAuT¥ OF ANCH(~~ Environmental Services Division ~NVIRONMENTALSERVICE$1 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Description: A. WELL DATA Health Authority Approval Checklist I.D.: Well type ¢//'"} ¢ ~ ~ ~ A, B, or C, attach ADEO letter. ADEC water system number Log present (Y/N) y Date completed /f//~/~--- Total depth ~ ~ Cased to Casing height (above ground) /Z__v Sanitary seal (Y/N) ¥ FROM WELL LOG Date of test //,/./~'~ f? ~ Static water level Well production WATER SAMPLE RESULTS: Coliform ~) Nitrate Date of sample: ; Wires properlYprotected (Y/N) AT INSPECTION g.p.m. 1, g.p.m. Collected by: Other bacteria B. I~EPTIC/HOLDING TANK DATA Date Installed tl~/'~-'!,h~'. ~ankslze / ~-~(~) Number of Compartments ?Cleanouts (Y/N) Y Foundation cleanout (Y/N) F Depression (Y/N) /~' High water alarm (Y/N). Date of Pumping '/~d ! '~ ~-'~Pumper ''~'~ ~ ~' ~ ~ Date inet, led t~/~ f~. Soil rating (g.p.d.~ or ~) Wi~ Effective ~sorpfion area 7 +l D [ Gravel thickness below pipe .~ r , , . Total depth ,~ / Monito~ng Tu~ pm~nt ~) ~ Depm~ion over field ~) ~ Date of adequacy test ~/~lc~_ Results(Pass/Fail) FZS~,~ For 4]' b~r_ogm, Fluid depth in absorption field before test (in.); ~ , Immediately af~er~_...C~lal, water added (in.) Fluid depth t "-~'- (ins) Minutes later: '~"t~) '~-~:~0. , Abso~flon rate = > ~O O q.p.d. Peroxide Eeatment (past 12 months) ~) .~ - ' IfYes, gNe date 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested ~~ ~"Pump off" level at* *Datum ~ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT ~..O: Septic/holding tank on lot Absorption field on lot Public sewer main ~ Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANC~ES FROM SEPTIC/HOLDING TANK ON LOTT,Q: Foundation ~ '~,. d.~ ~C'/'~Pr°perty line ~"~'~-~ Absorption field Water main/service line ~ Surface water/drainage /~v/~d)d~-~Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line SuVaco water Curtain drain Building foundation '~w~-~ Water main/service line ~. ! Driveway, parking/vehicle storage area /'~/~(~(~//~ Wells on adjacent lots F. ENGINEER'S CERTIFICATION I certify that I have determined thru f~ld inspections and review of Municipal records Engineer's Name~ ~,~. ,,'~ % ~ D r~;~:~;:~;?,'''~ ~ / HAA Fee $ ~.~ ~'D, ~ Date of Payment ~"//'// /'~ 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number C:T.':~E ES I ~NCHOR~GE 9075615~0~ P. 0~.,'02 CT&E Environmental Services Inc. Laboratory Division 200 W. Potter Drive Anchorage, AK 995'18 Tel: (907) 562-2343 Fax: (907) 561-5301 ChemLab Ref, #: Client Name: Project Name: Client Sample ID: Matrix: 98.4008-1 James 8izemore & Associates n/a L1 BI.1 Aspen Ridge $/D Drinking Water PW$1D n/a -Sa'~nple Remarks; Client PO#: Printed Date/Time; Collected Date/Time: Received Date/Time: Technical Director: n/a 8/7/98 09:30 7/3o198 12:15 7/3o198 14:30 Stephen Ede Parameter Results PQL Units Total Coliform (MF) 0 co1/100 mi Nitrate 0,529 0.1 mg/L Allowable Prep Method Limits Dale SM9222B EPA 3O0 10.0 Analysis Date Init 7/30/98 TMW 8/6/98 RMV MUNICIPALITY OF ANCHORAGE 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 GENERAL INFORMATION Complete legal description Location (site address or directions) m Property owner ~[.~,.,., (~) ~ e.~ ~ ~' Mailing address ~ q 0'c) '~-c.o,..~-o~"' Lending agency ~o ~- ~'.~,~ ~ ~ cew--~,, 0- Mailing address Day phone Day phone Agent ~.¢¢ Address ~.~..~. L.c~.. ~l, Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well I,''/ Community well Public water NOTE: Day phone ~?~-- I~.~ If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 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 (Rev. 1/91) Front MOA #21 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 -~'~ I~,Je ~,1 Address hO Engineer's signature bedrooms. DHHS SIGNATURE ;~/,,,,"" Ap p roved fo r' ~'/.~ ~ L//~..,) Disapproved. Phone /:;,q'7 ~ - -~ ~ I Jo Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAl. CHECKI.IST Legal Description: A, WELL DATA Well type 'T~ Log present (Y/N) Total depth ~.O Sanitary seal (Y/N) ~ Date of test Static water level Well flow Pump level If A, B, or C, attach ADEC letter. Date completed Cased to ADEC water system number '%%\~ 9.~ ~Z. Driller Casing height Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION '-'-"' ~/V g.p.m, g.p. ~ ~ ~ o SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~ I lC:, Absorption field on lot I Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: / 0 Nitrate Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed "~/3,~ ~ ~ ? Tank size Cleanouts (Y/N) ~/' Foundation cleanout (Y/N) High water alarm (Y/N) Date of pumping Compartments Depression (Y/N) Alarm tested (Y/N) · Pumper ~ ,,~o_~_ ,~ I''~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ;, ! Il2 To property line ~ L/l:::) Surface water/drainage On adjacent lots Absorption field Foundation Water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION ~'~/.~ Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pump off" level at High water alarm level Meets MOA electrical codes (Y/N) CYcles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed I Ol?--f ~ ~'~-- Length ~' G Width Total absorption area Depression over field (Y/N) Results (pass/fail) ~ Peroxide treatment (past 12 months) (Y/N) '/N'I Soil rating Gravel thickness 1"7 ~ System type [~ ~' o~ ~_ ~",~.44 c~ .-% Total depth "r Cleanouts present (Y/N) ~/ Date of adequacy test '1'~ [ ~ [~ 'z_ for /"// bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot I (~ '"/. To building foundation ~ ~ On adjacent lots /% I ~ Surface water I"[ lC) Curtain drain I'..I/C;~ On adjacent lots ~ i ~ Property line To existing or abandoned system on lot Cutbank ~ o ~,1 ~ Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature _?,,~::: Engineer's N ~JP ~i Date '~\ D v/ I '7.--. HAA Fee $ /7 ~''' Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. __. _ ~ ~_'--'-----~ --_ -----------------~.-----~.~ 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS RESULTS for INVOICE; 60497 Chemlab Ref # 92.6241 SampiB ~ 1 Matrix: WATER FAX: (907) 561-5301 Client Sample ID : 14400 PRATAR PWSID : UA Collected : 11/09/92 @ Received : 11/10/92 ~ 10:50 Preserved with : AS REQUIRED Client Nam. :TOBBEN SPURKLAND, Client Acct :TOBBENS BPO# . PO~ :NONE RECEIVED Req# Ordezed By : Send Reports to: EDE 1)TOBBEN SPURKLAND, P.E. Parametex Results Units Method Allowable Limits NITRATE-N 0.42 mg/1 EPA 353.2/300.0 10 Sample ROUTINE SAMPLE COLLECTED BY: STUART. Remarks: ] Test~ Periormed See Special In~truct]on~ Above ]JA=UnavaliablB ND~ None Detected "Se~ Sample Remarks Above NA- Not Analyzed LT=Les~ Than, GT-Greatex ~han Member of the SGS Group (Soci~t~ G~n~rale de Surveillance) APPLIO'NT FILLS OUT UPPER HAl .' ONLY , . Buyer Address Zip Code Address /~ ~ ~e~so ~ Zip code Realty Co. & A~nt Phone Address Zip Code ~treet Locati~ Type of Resi~nce ~Slngl~ Family ~ Multiple Family No. of Bedroo~ ~ ~ Olher Water Supply ~divtd~al A~ACH WELL LOG. A w~l log is required for all wells drilled ~inc~ June 197S. ~ Community For w~lls drilled prior to tk~t date, give w~ll depth (attach log if available). ~ Public Utility Se~lsposal ~ Public Utility When $onnect~d to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACgOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. o'F' Time Time Time Time Date Date Date Date Inspoctor Inspo~tor Inspoctor Inspoctor Field Notes: t~.~PPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE ~ 72.023 (3182) March 10, 1993 Sun Construction, Inc. SRA Box 474E Anchorage, AK 99507 Subject: Lot 1 Block 1 Aspen Ridge Approval for the individual sewer and %~ater facilities cannot be granted until the following items have been completed: o ?fhe top of the well casing should be sealed so that it is water tight. ~ ?he water analysis report needs to be submitte(~ to this l~/office from the Chem Lab, 5633 B Street, for our review. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, JR145/p/E1 Jim Roberts ~ Associate Environmental Specialis~