HomeMy WebLinkAboutCEARK TR D LT 1
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 Page 1 of
On-Site Wastewater Disposal System and/or Well Inspection Report
Perm;t Number:. SW000389 PID Number: 020--441--08
Nome:
MICKEY BIESZCZAK WastewaterSystem: I-I New · Upgrade
Address:
15851 CLARKS RD. ANCH. AK, 99516 ABSORPTION FIELD
No, of Bedrooms:
Ph°ne:{.907)' ' 770--8541 .3 I'l Deep Trench ri Shallow Trench I-1 Bed I-IMound
LEGAL DESCRIPTION ,~, ,o,~0~ ,o,o, o.,,h ,.m .~
cpo/sq, r~
D 1 CEARK ~.~
Township: -- Range: -- Section: -- F;li added abo~ ~lnol grade: ~ length:
WELL:O New I-I Upgrade r~ Ft.
Ft.
~~u Ipump s.' At: FL ~.ing Height ~ve G~:~ TAN K
SEPARATION DISTANCES m Septic m Hold;ng O S.T.E.P. O Other
T~O Septic ~sorption Uft Holding ~blic/P~at~ Uan~ Co~ci~ ~ gallon~:
Tank Reid Station Tank ~.,~ u,,, ANCHORAGE TANK 4000
wetl N/A N/A N/A 100'+ 25'+ STEEL 1
su.~. w~t.~,/A N/~ ,/A '50'+ - LIFT STATION
Foundation N/A N/A N/A 10'+ - >amp ~' NI at: ~at: High ,~*t alg~
Cu~a;n Dra~n NONE KNOWN ,
Remarks: *50' S~BACK WAIVER IN EFFECT BENCH MARK
~I~ING SEP~C T~K ABANDONED PER UPC BOSOM OF.SIDING ON
EXISTING D~INFIELD WAS ABANDONED IN P~CE CONCR~E S~B ~ POINT "A"
100.00 n.
INSTALLED BY DEN~I S~ER ~ D~IN AND EXCAVA~NG
Inspections performed by: AKWWC. INC. Dates: 1st 11,7,00
2nd 12/4/02
Development ~s Depa~ment Approval /. ~00~% ~)..[c :-~ ....~
R~viewed and approved by: Date: ~ ~f~'i~ ........
PERMIT NUMBER:
swooo~9 AS-BUILT DRAWING ,,~c[L .o020_4,.Nu. BE.:_0~
A B C
CO! 86.43 74.91
$T1 201.gg 193.04
~S~ ~%TER & 5~STEWATER
PR~[D FOR:" PHONE NUMe~R: '
UlCKEY BIESZCZAK (907) 770-8341
AS-BUILT DRAWING OF HOLDING TANK
PERMITNUMBER:AS--iBLTII'T I)R~l~INC- PARCEL ID NUMBER:
SW000589 020-441-08
TOP Or 'r.a~K AT INLET - 77.8B ~ ~'~FIHAL GRADE - 8'~;.4B - 86.32
/
ST1= / ~n~u ST2=
NEW 4000 GALLON
HOLDING TANK
CONSULTANTS, INC.~~ 1 = 40' ~ .................... ; ....
PR~ED FOR: PHONE NUMBER: PACE NUMBER:
MICKEY aI[SZCZAK (907) 770-8541
~E OF WORK:
PROFILE AS-BUILT DRAWING OF HOLDING TANK
MUNICIPALITY OF ANCHORAGE
Building Safety Division
MEMORANDUM
DATE: June 3, 2003
TO: File
FROM: Joe Goodall
Engineer II, On-Site Water Wastewater Program
SUB J: Ceark Tact D Lot 1
The original design plan was altered in the course of construction.
The location of the holding tank was moved to a more westerly location. A
50' waiver to surface water was granted at the time the permit was issued.
The location of the holding tank on the as-built still meets the 50' separation
distance that was waived by Dan Roth.
qOTE: ALL LOW LYING AREA AND PONDING / "" ~ . / '~_ _'"-~ -- '"- ""--
AREAS WITHIN 100 FEET OF THE PROPOSEE / ~ ~/
HOLDING TANK ARE TO BE FILLED WITH / /- ~
i '~"-~ ','~. i _, / '//
LOCATION OF DRNEW
APPROXtMATE ~ r--.... ....- ""
DRNNAGE DITCH WITH
RUNNINg WATER.
A~ASY, J~ WAT~ER AND WAS~WAT~ER CO~TSLT~T~S,
CEARK SUBmV~S~ON= LOT 1, TRACT D ~.f:.:...~.~V;.~,./'.~ .... ~...: ....
DESIGN OF' HOLDING TANK
PHON~ .u~.= ~_
PREPARED FOR:
244-8286
BIESZCZAK (907) ~"$. "... ~ .'"~?,~,~
MICKEY ~t~[~,- .......... "~.~'~-:=~
DATE: JDRAWN BY: J,CALE: PAGE:
11/15/99 J.L.M. 1 = 50' 2 Of 2 '~,~,~! ofe,,s :;..~
I
~1
Zz~T I ~
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Sep 21, 2000
Expiration Date: Sep 21,2001
Permit Number: SW000389
Legal Description: CF_ARK TR D LT 1
Design Engineer: 0041 AK Water & Wastewater Consultant
Owner Name: Mickey Bieszczak
Owner Address: 15851 Clarks Road Total Bedrooms: 3
Anchorage, AK 99516-
Parcel ID: 020-441-08
Site Address:
Lot Size: 120574 SQ. FT.
Permit Bedrooms: 3
This permit is for the construction of:
~ Disposal Field [~ Septic Tank r~ Holding Tank [~ Privy
r--] Private Well r-'] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date:. ?~_~
Rick Mystrom.
Mayor
Municipality of Anchorage
Department of Health and Human Services
825 'L' Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
htr g*://www.ci.anchorage.ak.us
October 4, 2000
Jeffrey Gamess
Alaska Water & Wastexvater Consultants, Inc.
6901 Debarr Road, Suite 2-B
Anchorage, AK 99504
Subject:
Waiver Request for Ceark, Tract D, Lot 1
Waiver Request #WR000073
Parcel ID #020-441-08
SW000389
Dear Mr. Gamess:
Your request for a waiver of the required 100 feet horizontal separation from the holding
tank to surface water has been approved. The approved separation distance is 50.0 feet.
This waiver approval applies to the existing holding tank to surface water. 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 343-4744.
Sincerely,
Daniel J. Roth
Civil Engineer
On-Site Water Quality Program
MUNICIPAUTY OF ANCHORAGE
Department of Health & Human Services
On-Site Services
WR#: WR000073
Date Received: September 11f 2000
Legal Description: Cearkf Tract Dp Lot I
Waiver Review Worksheet
PID#: 020-441-08 HA~:
Engineer: Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road~ Suite 2-B~ Anchorage~ AK 99504
Applicant: Mlcka¥ Bieszczak
Waiver Requested: 50 foot waiver from holding tank to surface water.
Permit~: SW000
Criteria: 1. Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
2. Special Conditions:
3. Other:
Total:
Waiver is Granted: )4 Waiver is not Granted:
List Conditions or Reasons for above: ~l~ J$ T~ ~f ~.~ t ~ ~ ~'f $£ ~ ~IW~ ~7~t~
Date:
Rec~: 06326 Amount: $625.00
By: pj~ ,/t/
Name of Reviewer
Date Paid: 9/t1100
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2B ~ Anchorage ~ Alaska 99504
Phone (907) 337-6179 ~ Fax (907) 338-3246
Consulting Engineers
November 15, 1999
Municipality of Anchorage
Department of Health and Human Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Server Upgrade for Lot 1, Tract D, Ceark Subdivision. IIOLDING TANK
To whom it may concern:
The existing 3 bedroom house is served by a private well and a septic system that consists of a
1000 gallon septic tank and a bed type drainfield. The system is in a state failure and does not
meet Municipal standards, so it must be upgraded.
During our site visit to assess the property for a septic upgrade site, it was discovered that there is
sporadic areas of ponded water over the entire lot. There is also a creek that runs along the
northeast property line. Per phone conversation with your department (Donna Mears), it ~vas
concluded that given the history of the area and the presence of surface water, the only viable
option for this property would be the use of a holding tank. There is no place on the property to
put the tank and meet the 100 foot setback to surface waters. We are proposing to install a 2000
gallon holding tank outside the 100 feet creek setback and 75+ feet from the well. All ponded
areas do~vnslope, and within 100 feet of the tank, will be filled with soil.
A copy of the proposed~ design is attached.
337-6179. ~t~/~
Presi~en~ U ~
If you have any questions, please contact us at
I I ~1;~
' i ~1 ~ ~ --
m , . ~ROPOSED "O~'NG
I d m [ ) ) ) (SEE D~ICN
,/ / ,lllI
V ~ /,mmm
/ //~mm
,~ /Il
/ / ~m'
: ,// ,,,~ ............ . --
/' / ~ ......... ,/, ....... ~-
:~ m~ ......... ~/~ ........ ~___
' I~ ......... ~ ........ ~--~-
S~TE P~N FOR NOrDeN6 TANK ~ ~ .~ ....... ~.:...,~
MICKEY BIESZCZAK (907) 244-828~
'1~/~5/~ K.6lw./J L.M ~ = ~00' 1 OF
HOLDING TANK ARE TO BE ~LL.ED WffH j / ~".~. ~
APPROXIMATE LOCATION._,, r ~ / / / /
COMPLETELY ABANDONED.~ \ '"' ~ " / HO, LD'NG ~ANK
APPROX~TE LOCATION OF ~R~'WAY //'"-.. ~-. '
~ "-..-APPROXIMATE LOCATION OF
DRNNAGE DITCH WITH
RUNNING WATER.
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6g01 DE~RR ROAD, SUrgE 2B. ANCHORAGe,, AK. 99504
CEARK SUBDIVISION; LOT 1, TEACT D -
DESIGN OF HOLDING TANK
MICKEY BIESZCZAK (:907) 244-8286
MUNICIFALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502. Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name DISTANCES
Phone(s) Perm,{ No. OZ/x / ~N~oI Bedrooms WELL
Township, Range, Section
~I~N) ~W~ ;~ ~ dr, veway.AS-BUILT DIAGRAM (Show ,~,,on o, well. sephc s~tem, pro~,, hnes. ,oundahOn.water hod,es, etc.,
TAN KS ',~ Aw
~SEPTIC ~ HOLDING
ManuIacture, Capaoty ,n gallons FO ~'
TYPE Of SYSTEM
~ TRENCH ~ED ~ W. DRAIN ~ OTHER
or,ginal grade ~. ~ FT ~. O FT
F,II adeee a~ve or,gma~ grade g~a~el depih ~neam p~pe
~ FT O-ff FT
Gravel length ~ ET J~ ET
Tota, absorption area Distance ~,w~n lines
Number of hnes I Sod rahng P~ materiaI
installer Date Installed -- . ~, ~1 Z$ J
~IVATE m OTHER (Identifv)
Cla~dmabon (A.B.C) Total Depth ~ Ca~d [o
REMARKS: -
No aM: fkf.J bJou Ins~ctions~ale: N ~.Pedormed by: ENGINE[~'SS~L
~ F ~~~ C~ilylhal~is
r
72-013 (3~85)
P.O. BOX 6650
ANCHORAGE, ALASKA 99502-0650
(907) 264-4111
TONY KNOWLES,
MA YOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
August 21, 1986
Laura Ogar
Corwin and Associates, Inc.
4790 Business Park Boulevard
Building D, Suite One
Anchorage, Alaska 99503
Subject: Lot 1 Tract D Ceark Subdivision
Waiver Request, WR86-117
Dear Ms. Ogar:
Your request for a waiver of the 100 foot separation required between
the septic tank and well on the subject lot has been granted. This
distance has been waived to 88 feet.
This waiver is valid for the existing three bedroom single family
dwelling only.
Sincerely,
Stephen S. Horris
Civil Engineer
On-site Services
SSM/lJw
4790 Business Park Blvd. · Bldg. D · Suite One · Anchorage, Alaska 99503 · (907) 561-6151
August 8, 1986
Municipality of Anchorage
Department of Health
and Environmental Protection
825 "L" Street
Anchorage, Alaska 99501
SUBJECT: CEARK SUBDIVISION, TRACT D, LOT 1
To Whom It May Concern:
At the request of our client,· Mr. Chris Hamre, Corwin &
Associates, Inc. performed an inspection of the septic system
that he is installing on his property.
To ensure a i00-foot separation from the well and stream and to
maintain grade in the accepted receiving soil strata, the bed
was placed as close to the driveway (10 feet) as possible. The
septic tank was then placed in the only area available to
ensure a gravity system and maintain 100-foot separation from
the stream. Unfortunately, the distance from the tank to the
individual well on-site is 88 feet.
The lot has moderate slopes with drainage away from the well.
From the well log it is apparent that a 30-foot layer of
hardpan lies directly above 157 feet of bedrock into which the
well casing is drilled. (See attached.)
The septic tank is an approved steel tank fitted with cauider
couplings to ensure a water tight seal and is being fitted with
manhole gaskets.
To relocate the tank would cause considerable financial
hardship to our client, would require a lift station installed,
the field relocated in an area of greater slope, and result in
a generally inferior disposal system.
After reviewing conditions we believe we are faced with two (2)
options:
1. Waive the separation distance and ensure proper treatment
and disposal of tank effluent.
Municipality of Anchorage
August 8, 1986
Page Two
2. Enforce separation distance and modify, relocate, and
install inferior system.
Corwin & Associates, Inc. believes that the first option,
although nonconforming to regulations, will ensure greater
protection of the environment and water quality and, therefore,
request that a waiver be granted.
Sincerely,
CORWIN & ASSOCIATES, INC.
Laura Ogar
Environmental Engineer
LO/d
1201 Z~OI~ $7. 99515 A.%'CHORAi~E, ALASKA
SIX INCH WATEr WELL Drilled .......... OUT TO THE DEPTH OF 930
DRILLED AT the RATE OF ~2~.00 PER FOOT. ~ 1~°~ 22~ 1~ oreo
ProPERTY OWNER //~, ~ /{~vt~ 345-1840 268-5658
LOCATION OF WELL SITE ~f;* I ~. "D" Su~o Ceo~K S.b~
DRILLER
WELL LOG:
0 .... 18'
18---46'
MUNICIPALITY OF ANCHOIbN3E
r')FPT C~F HI:Al TH
ENVIRONMENTAL P/OTECi'IC~
s~ ~ ~~ 4o~ ~ b~. APR 8 1986
Coa.~e 9,,u~e,L ~ 15~ ~. S ~ ~
46---73' ~~. ~ ~~ ~ ~
73--~0' B~. 3~ ~~ ~ ~ ~ o¢ ~ ~ho~,~ ~ 165 ~
210 ~ 218 ~. ~o ~ ~ ~ ~ ~o~ ~ ~ ~o ~ ~ o~ ~
C EJ V E D
~5175.00
C~INC~~~~DR AND MATERIAL FOR COMPLETION OF SAID DRILLING.
WRITE CHECK PAYABLE TO RAMPART DRILLiNg WORKS FOR THE SUM OF J~Jl?5. O0
THANK YOU VERY MUCH.
DaTE
BERNIE CLAUS OF RAMPART DRILLINGA/VORKS '
SERVICE CHARGEOF 1~% PER MONTH WILL ~E ASSE~E_~ ON Pa~t ~U= acC~,,~?~'
~" MUNICIPALITY OF ANCHORAGF~'~
Department of Health and Environmenta_ Protection
Pouch 6-650, Anchorage, AK 99502
264-4720
On-sit~rmit
Permit No: ~-~ ~'J ~ ~ -- . ~' z
Date Issued: ~//~/~ , ~ ~~~ ~~ ~
Applicant: _ ~~ /G~ /~" ~~",~ ~ ~
-- __ ~~ _~ .~1~.
Address: /~~/ g~ ~~ ~t~
Lot: /
// J,J Range:
Legal Description: S/D: _~ .
Section: ~ Township:
Lot Size: _~. 7~. ,~Sq..__. Ft. or Acres)
Lot Location:
Max Bedrooms:
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.)
Gravel depth (ft.)
Total depth (ft.)
Gravel width (ft.)
Gravel length (ft.)
Tank size (gal.)
Soil rating (sq. ft./br)
TRENCH BED - W. DRAIN
/o~
SWP/024 rev.1/85
** Gravel length 75 feet requires multiple runs (not exceeding 75 feet each)
** Tank must have at least two compartments
I certify that: ~f ~ ~_~-~ ~i,"~
· e sewers and wells as set
1 I am familiar with the requirements for on-sit /~- ~-
forth by the Municipality of Anchorage(MOA) and the State of Alaska.
2. I will install 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
back 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 the maximum number of bedroom~
stated above, and any enlargement or modification 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-BUILTS WILL
NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRICAL WORK MUS~BE DONE/B~ A LICENSED ELECTRICIAN.
SIGNED: ~~~~__~~~ DATE: ~~i[~-~".~
Applicant
ISSUED ~Y, DATE, __ ~/~~5~--
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
3
5
6
7
8
9
10
(ENGINe.AL)
Township, Ran ge, S ection:'7--//j~//~c~ ~/'t~
SLOPE SITE PLAN
11
12
13
14
15
16
17
18
19
2O
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT i * O
DEPTH? ~.~ p~
E
Depth Io Waler After ~ ~"l i
MonilorinD? Dale:
COMMENTS
Reading Date Gross Net Depth to Net
Time Time Water Drop
+'~ '~ IIIi- lid ( I~ ,~%~ ,/~
PERCOLATION RATE /~- /~''' (minutes/inch) PERC HOLE DIAMETER
PERFORMED BY: --.-- ~7,94""'"--____ I -~ .
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE.
72-008 (Rev. 4/85)
CERTIFY THAT THIS TEST WAS PERFORMED IN
-- F
R ~
O
·
REPLY
~t~o-"~-~J® 4S 472
SIGNED
SEND PARTS 1 AND 3 INTACT -
PART 3 WILL BE RETURNED WITH REPLY.
DETACH AND FILE FOR FOLLOW-UP
DATE
POLY PAK (50 SETS) 4P472
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lOt, block, subdivision, section, township, range)
Ceark S/D, Lot t, Tract D
Location(addressordirections)
15851Clarks Road
(b) Property owner
Mailing Address
Hamre/Bieszczak
15851 Clarks Road,
Telephone · (home) 345-7578Business
Anchorage~ AK 99516
(c) Lending Institution
Mailing Address
Telephone
(d) Real Estate Company and Agent
Address
None
Telephone
(e) Mail the HAA to the following address: (or check here ~, if hold for pick up.)
List contact person and day phone number below:
Please call Mountain Engineering at 696-1700
2. TYPE OF RESIDENCE
Single-Family I~ Number of bedrooms __
3
3. WATER SUPPLY
Individual Well ~ Community [] Public []
Note: If community well system,~ must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site E~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-025 (Rev. 7/88) Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION'.
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of thi~
Health Authority Approval 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 co. mpliance with all Municipal and
State codes, ordinances, and regulations in effect on the date of this inspection.
Name of Firm Mountain Engineering Telephone 696-1700
10251 Crestview East Eagle River, AK 99577
Address
Date
3/20/90
Engineer's Seal
6. DHHS APPROVAL
Approved for
Approved /'~//~'
bedrooms
Disapproved Conditional
Terms of Conditional Approval /_/~)~'*
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated 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, 7/88) Back Page 2 of 2
A. WELL DATA
Well Classification
~ MUNICIPALITY OF ANCHORAGE (MOA)
~"~l?f O1: AN~-~uth°rity Approval (HAA)
· ~"~,~-~/ -RVic~T - FEBRUARY 1984
E~AL SE 343-4744
MAR 2 1990 Legal Description:
RECEIVED
Residential
Well Log Present (Y/~ Y Date Completed 9/20/85
Total Depth 230' Cased to unkwn Depth of Grouting unknown
Ceark S/D,Lot 1,Tract D
If A, B, C, D.E.C. Approved (Y/N)
/
Yield 3.5 - 4.0
Pump Set At 180' '/'
Sanitary Seal on Casing (Y/N) Y
Depression Around Wellhead (Y/N) N
Mountain Enqineerinq ;Date
Passed - Coliform & Nitrates
; On Adjoining Lots >200 '
98 ' ; On Adjoining Lots >200 '
To Nearest Public Sewer CleanouVManhole None
79.3'
3/17/90
Static Water Level 24 '
Casing Height Above Ground 21"
Electrical Wiring in Conduit (Y/N) Y
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot 88 '
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line None
To Nearest Sewer Service Line on Lot
Water Sample Collected by
Water Sample Test Results
Comments Well flow test performed on 3/17/90 by Mountain Engineering.Well
produces in excess of 7 GPM for 4 hours.
See 8/21/86 waiver of well to septic separation distance.
No. of Compartments 2 ( steel )
Y Foundation Cleanout (Y/N) Y
Date Last Pumped 3/20/90
; for NA
Temporary Holding Tank Permit (Y/N) NA
B. SEPTIC/HOLDING TANK DATA
Date Installed 9/3/86 Si~e 1250
Standpipes (Y/N) Y Air-tight Caps (Y/N)
Depression over Tank (Y/N) N
Pumping/Maintenance Contact on File (Y/N) NA
Holding Tank High-Water Alarm (Y/N) NA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well 88'
To Property Line >10 '
To Water Main/Service Line >10'
To Stream, Pond, Lake or Major Drainage Course
Comments
To Building Foundation
To Disposal Field 5'
46.6' '
108'
See 8/21/86 waiver of septic to well separation distance.
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed 9/3/86
Width of Field 17 '
125 SQ FT/BR
Type of System Design
Length of Field 34 '
Depth of Field 3 '
Bed
Square Feet of Absortion Area
Depression over Field (Y/N)
Results of Last Adequacy Test
578 SQ
N
PASSED
Gravel Bed Thickness 12"
FT Statndpipes Present (Y/N)
Date of Last Adequacy Test
- 3 Bedroom
Y
3/17/90
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well
To Building Foundation
Lot None
98'
56.6'
To Water Main/Service Line >10 '
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
To Property Line >10 '
To Existing or Abandoned System on
; On Adjoining Lots None
To Cutback (if present) None
118'
>10'
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test.
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this
Signed Mark Pearson
Company Mountain Engineering ~' ~;'~ ~ ~'%~ '~,:
; ? .E gi eer' Sea,
Date ~/~/~O
MOA No. CE89-007
F/ -
~ / ~ ~ ?~ Receipt No.
Receipt No.
Date of Payment ~ '--~-/~ ~-~ -- ~--~
Amount: $ / "~'4:~)' ~
Waiver Fee: $
Date of Payment
72-026 (Rev. 7/88) Rack Page 2 of 2
c~/e~.c~ · aeo/.oa~c~. ~o~romes or ~s~, ~vc. ~(.~
TELEPHONE (907) 562-2343 5633 B Street
Anchorage, Alaska 99518
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
PUBLIC WATER SYSTEM I.D,#
:-- PRIVATE WATER SYSIEM
..._) ' PhoneJNo.
Name
C~ty ~.~ State Zip Code
Mo. Day Year
SAMPLE TYPE:
~ Routine
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
.) E~ Treated Water
Untreated Water
SAMPLE
NO. LOCATION
21 I
S I I
Time Collected
Collected By
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
Satisfactory
LJ Unsatisfactory
[-] Sample too long in transit; sample should
not be over 30 hours old at examination
· . to indicate reliable results. Please send
~-. na,~u eamnla via soecial delivery mail.
Date Received
Time Received
Analytical Method: Membrane Filter
· No. of coloniesll00 mi.
Lab Ref. No. Result*
I FTq
I [-1-3
I rtl
//~st
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
BACTERIOLOGICAL WATER ANALYSIS RECORD
Membrane Filter:. Direct Count Collform/100ml
Verification: LTB BGB
Final Membrane~esu~ Collfo,~100m,
Time: / ~ ~ a.m.
p.m.
TNTC = Too Numberous To Count
OB '-' Other Bacteria
PART ONE OF TWO
REMAINDER TO FOLLOW
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
ABALISIS REPORT BI SABLE for %'ork Order t 204A8 Date Report Printed: MAR 21 90 ~ 09:19
Client Sample ID:LI. TRACT D CRANK
PW$ID
Collected ~&g 17 90 ~ 14:40 hrs.
Received MAR 17 90 @ 15:00 hrs.
Preserved ~lth :AS REOUIRED
Client Bane : MOUh~AIN ENGINEERING
Client Acct: MT~h~NGN
P.C.~ BONE RECEIVED'
Req ~
Ordered Ey :
Analysis Completed :MAR 19 90 Send Report~ to:
Leboratory Supe?i?r.L:~EPNEN C. EDE lJEOUNTAIB ENGIBEERIBG
Released ~y : ~ d~ ~ 2)
Special
Instru:t:
Chemlab gel ~: 900506 Lab Smpl ID: 1 Ymt~lx: ~ATER
Allowable
Parameter Teste~ Result U~ts Rethcd Limits
NITRATE-B 0.86 ~g/1 EPA 353.2 10
Sanple ROUTINE SAMPLE
Rer~rks: SABLE COLLECTED BI LOCKIER.
Tests Per£orned ' See Special Instructions A2ove UA-Unavailable
None Detected "See Sample gemrks ABove
% /
/
m