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HomeMy WebLinkAboutMOUNTAIN AIR ESTATES #1 BLK 7 LT 5 Municipality of Anchorage Page I of ,3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage. Alaska 99519-6650 Telephone: 34.3-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number:. SW000264 PID Number:. 017-171-08 Name:DOLORES CATHERINO Wastewater System: [] New · Upgr<3de 15231 SNOWFLAKE DRIVE 99516 ABSORPTION FIELD No. of Be~rooml: Phone:(907) 345--8996 · Deep Trench ri Shallow Trench Fl Bed ri Mound f'lOther LEGAL DESCRIPTION o.e ~o/~ ~ 8.5 - lO.O 5 7 MOUNTAIN AIR EST 5.7 - 5.2 rL 4.8 WELL: [] New [] Upgrcde 2.5'+ rL 1 r~ ~ 778 se. ~ ASTM/D 3034/ F-810 rL DENALI 9/20/00 - 9/29/00 ~., ,~ ~ TANK SEPARATION DISTANCES I S.ptic n Hold;rig From Tank F~eld Stotion Tank ~ u~, PREMIER PLASTICS 1300 Wetl 100'+ 100'+ - - 25'+ PLASTIC 2 s~,oc, lOO', lOO'+ - - - LIFT STATION Water L~t S'+ el' - - - ~'~ I ._ ._.~.__ Foundotlon 5'+ 10'+ -- -- -- NONE KNOW~ Drain ~er~tork$: *VERBAL LOT UNE WAIVER GRANTED DURING BENCH MARK CONSTRUCllON. SEE LOT UNE WNVER I.t.~lLR. TOP OF FOUNDATION CLEANOUT. -(~LD SEPTlC TANK WAS ABANDONED PER UPC. .;__._: -TEST HOLE WAS EXT/NDED TO 16.5' DEEP. NO WATER 100.00 rL OR IMPERMEABLE SOILS ENCOUNTERED. ~:="=~'~ Inspections performed by: AWWC, INC. Dates: 1st 9/20/2000 ~C~ "'~ I /I-J ~' 2nd 9/25/2000 .5.:.. ~ :2~'....; ..... 4th 9/29/2000 ~A ,.,o :' ',~{ ~' ¥ ~ ~:~; ~ess." '~. lO/19/2ooo .Department of Health and Human Serv~es iapproval R~v,ewed and approved b~Dote:~ BUILT DRAWING prRHIT NUUBDt: AS ~ 017-171-08 SW000264 ~ ~-'~'------7-~./ A B / ~ ~ ~NC 10' ~ ~~ ~2 49.0 22.1 / .... DBL1 50.4 25.6 I ~ ~ MT2 103.8 65.5  ~ ~ ~ ~ ~ ~N~ 1~0 ~D~ELOP~ m~ ~, ~ ~ co~o hXk. /  ~R~ W~ R~ '~, ~O 2' OF M.O~ '~ ~PR~D ~O RL~ ~ .... ~ .... k w~ ~ ON mE ~----7 .... k BO~OU ~O ~ 4.8 ~ OF C~. W~HEO N~ D~NR~~ ~ER D~N~K. A~SI~ WATER & 5~STE~TER DOLORES CATHERINO 345-8996 2 OF 3 ~0~J'.:. t~[-**** ...."~,~ MOUNTAIN AIR ESTATES SUBDIVISION; LOT 5, BLOCK 7, AS-BUILT OF SEPTIC SYSTEM UPGRADE SW000264 AI~SI~ ~TER & ~STE~TER K.O.w. DOLORES CATHERINO (907) 345-8996 MOUNTAIN AIR ESTATES SUBDIVISION; LOT 5, BLOCK 7. "~[.. "'. .......... "¢~ AS-BUILT PROFILE OF SEPTIC SYSTEM UPGRAD~ STEWATER CONSULTANTS, INC. November 3, 2000 Municipality of Anchorage Department of Health and Human Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Lot Line Waiver for Mountain Air Estates Subdivision; Lot 5, Block 7 ' To whom it may concern: We request that your department issue a 1 foot lot line waiver from the east property line to the new drainfield. On 9/20/2000, we contacted your department and received verbal approval for the waiver prior to the installation of the new drainfield. I am unaware of any/qdverse impacts this waiver would have on adjacent wells or septic systems. i f you ha~e any~tions, please contact us at 337-6179. Thank you for your assistance. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akw~vc.com MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On-Site Services Waiver Review Worksheet WR'~: .010007 PID~: 017-171-08 HA~: Date Received: 1t-3-00 Legal Description: MOUNTAIN NR ESTATES BLOCK 7 LOT5 Permit~: SW000264 Engineer. ALASKA WATER AND WASTEWATER INC. 6901 DE BARR ROAD~ SUITE B ANCHORAGE~ AK. 99504 Applicant: DOLORES CATHERINO Waiver Requested: ABSORPTION FIELD TO LOT MNE OF 1 FOOT Criteria: 1. Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation 2. Special Conditions: 3. Other:. P~n~: Total: Waiver is Granted: ~ List Conditions or Reasons for above: Waiver is not Granted: Date: ~ ' /" O l ILO. lh)x 1!)66.50 · Zl.700 S. Bragaw Strcct Anchorage, Alaska ~)519-(;1~50 * (907) 3a8-~101 02/01/01 ALASKA WATER AND WASTEWATER INC. 6901 DEBARR ROAD, SUITE 2B ANCHORAGE, AK. 99504 Subject: Waiver Request for MOUNTAIN AIR ESTATES BLOCK 7, LOT 5 Waiver Request #WRO 10007 Parcel ID #017-171-08 Dear JEFFREY A. GARNESS: Your request for a waiver of the required 10 feet horizontal separation from the on-site wastewater disposal system to property line has been approved. The approved separation distance is 1.0 feet. This waiver approval applies to the existing on-site wastewaterdisposal system 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 Department of Health and Human Services On-Sire Sen/ices Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (gO7) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jul 28, 2000 Expiration Date: Jul 28, 2001 Permit Number: SW000264 Legal Description: MOUNTAIN AIR ESTATES #1 BLK 7 LT 5 Design Engineer:. 0041 AK Water & Wastewater Consulta Owner Name: Colores CatheHno Owner Address: 15231 Snowflake Dr. Anchorage, AK 99516-4435 Pamel ID: 017-171-08 Site Address: 015231 SNOWFLAKE DR Lot Size: 42159 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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 ( 18MC72 ) and Drinking Water Regulations ( 18MC80 ). 3. The engineer must notify DHHS at least 2 hours prior lo 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. 5. The following special provisions. A TEST HOLE SHALL BE EXCAVATED TO 16 FEET PRIOR TO SYSTEM INSTALLATION TO CONFIRM IMPERMEABLE SOILS. Received By: Issued By: Date: Date: ?- ALASKA WATER & WASTEWATER CONSULTANTS, INC. July 7, 2000 Municipality of Anchorage Department ofHealth & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Septic Upgrade Design for Mountain Air Estates gl; Lot 5, Block 7 To whom it may concern: The existing 3 bedroom house is curremly served by a private well and septic system. A }tAP, was issued for the property on 10/I 1/95, which was accompanied by an advisory letter (draintield was filled to 100% capacity in order to achieve the required absoprtion rote. At this time the field is surcharged, but still quite functional. The property owners retained AWWC, Inc. to design a septic system upgrade. 1. GENERAL: There are numerous site restrictions which limit the type and size of septic system which can be installed. The lot is relatively narrow, with steep topography on the southern half of the property. On the attached site plan, it can be seen that there is a cutbank (100% +) that starts rougly 50 feet downhill from the center of the existing trench and about 30 feet downhill from the new test hole. Given the width ofthe existing trench (3 feet) and its effective depth (8 feet), the new trench would have to be approximately 17. 5 feet away from the center of the existing trench. This would place the downhill edge of the new trench only about 30 feet away from the eutbank. In order to avoid this it will be necessary to do one of the following: Install a lift station and place a new draintield '(trench) uphill from the existing trench, between the well radius and the east lot line. The property owner would like to avoid the cost associated with installing a litt station. Install an innovative system, with a small drainfield immediately to the north of the test hole (see the site plan). This is the preferred option by the engineer, but is cost prohibitive to the property owner. Re-build the existing dminfield. This is the property owners option of choice 6901 Debarr Road, Suite 2B ~ Anchorage, AK 99504 ~ Ph: (907)337-6179 ~ Fax: (907)338-3246 A test hole was excavated to the southeast of the existing trench. Below the organic layer was a GW/SW/SM layer to a depth of 3-4 feet. Below that was primarily a GM soil of varying density/consolidation to a depth of 14.5 feet. No groundwater was encountered during the excavation, or 10 days later (5/22/00). Percolation tests was performed between 3.0-3.5 feet and 5.5-6.0 feet. The percolation rates were 12.6 rninfmch and 120 min/'mch accordingly; however, it should be noted that it believed that the 120 minfmch perk is not representative because it was performed in a tight silt lense/pocket. In order to avoid utilizing an innovative septic system, or a lift station, we are proposing to excavate out the existing septic system (including the contaminated soil) and lengthen it as much as poss~le, so as to maximize the available absorption area. The existing trench (512 square feet) was based upon a 150 square feet per bedroom soil rating and has performed adequately for 19.5 years. The proposed extension will ensure even better performance. The existing trench is supposedly 12 feet deep with an 8 foot effective depth. The 1980 test hole was excavated only to a depth of 16 feet. The new test hole (5/12/00) was only 14.5 feet deep. It is anticpated that the existing trench will be excavated out to a depth of roughly 13 feet deep. The intent is to install 3 feet of sand on the bottom of the excavation so as to limit the total depth to around 10 feet. The newer portion of the trench will only be excavated to a depth of 10 feet. It is our intent to dig a 16 foot test hole prior to the installation to confirm there is no bedrock or impermeable soils. The new trench will be approximately 65 feet long and have an effective depth of roughly 6 feet, for a total absorption area of roughly 780 square feet. This will be an increase of 152% over the current drainfield size. Comments regarding the proposed design are summarized as follows: 2. TRENCH DESIGN: a. Pcreolation Rat.e: 1.2.6 rain/inch, 120 mirffinch, and 150_ sq. ft. per bedroom. b. Allowable Apphcat~on Rate: Assume 0.6 gallons/day/ftz c. Number of Bedrooms: 3 d. Des!gn Flow: 450. gallons per day _ e. Minimum Absorption Area: 750 ft2 f. Total Depth: 10 feet (max.) g. Effective Depth: 6 feet h. Width: 3 feet i. Reduction Factor: N/A j. Minimum Length: 65 feet long k. Effective absorption area = 780 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: See the attached topography drawing. 6901 De~rr Road, Suite 2B ~ Anchorage, AK 99504 - Ph: (907)3374179 - Fax: (907)338-3246 I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you hay. any questions, please contact us at 337-6179. Jeff ~amess, P.E.,~.S. President NOTE: ~fttached is a site plan drawing, a design drawing, a topography site plan, a two page soil log, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B ~ Anchorage, AK 99504 ~ Ph: (907)337-6179 ~ Fax: (907)338-3246 '""\ /11 UOUNT,~N AiR ESTATES laOU~A~N ,eR ~A~ ~ ~OU~ ~R ~A~ ~ / / ~ /%. /~,, ,, - -~.~_ . I/ I x ~ i/'~ ......... ~ '~ // // %-' /,~' c~KJ ~- ~1~12ooo K.D.W. ,,o,.~..,.....,.,,..,,,....,o,.,,..,.-,,,...,,,, ~R~ Foe PUOUE auue~: ~E auae~: ~ ~ ~ ...... DOLORES CATHERINO (907) ~45-89~6 1 ESTATES SUBDIVISION; LOT 5, BLOCK 7 ~.. '. MOUNTAIN AIR SIT[ P~N FOR SEPTIC SYSTEM UPGRADE , ~ON~ OF 1980 ~ ~VA~/C~ O~ (13 M.O~ ~PR~ ~D ~ ~10u O~~ (c~ oF ~ ~). ~CH ~ ~ ~E ~A~RE OF S~P[ ~U~ ~S[~ WATER & ~STEWATER ~ '[~/4'~:~ ~ ~ '~ , ~ONSULTANT$, lNG .............. ~. ............. PR~ fOR: PHONE NUMBS: g0UNIAI~ AIR ESIAIE$ SU8DIVI$108; LOI 5, BLOCK 7, DE$IG~ 0g SEPIIC SYSIEM UPGRADE 'g~ ALASICA WATER & WASTEWATEP, CONSULTANTS, INC. ~,~ o..F../~;~ 6901 D£BARR ROAD, SUITE 2B "ANCHORAGE, AK. 99504 ~=:~,.~..,,,~.....~'" ISOIL LOG - PERCO~TION TEST I LE~ DESCRIPTION: ~OU~N ~R SUBD~SION; LOT 5, BLOCK 7 ~ .......... ~ .. ,,,~ ............ : .... DA~ PERFORMED: 5/12/2000 I TEST HOLE ~1 I OD?Si"" ........... OR~ICS (PAGE 1 OF 2) '~*~ GP ML -- ~ GH CL ~c OL ~ / SW . HH ~ SP CH SC BONDED GM DEPTH TO ' DATE I ' ;ROUNDWATER ~1+ O~ 5/12/2000 D~ 5/22/2000 SITE P~ '= O0 11 DATE READING CLOCK NET TIHE WATER LEVEL NET DROP TIHE I (HINGES) RE~ NG (INCHES) 12 5/16/00 PERC. HO~ W~ PRESO~ED 4+ HOURS PRIOR TO 13 1 4:30 ~ 6' 2 5:00 30 5 5/8' 2 5/8' 14 ~ 5:00 6' 4 5:50 ~0 ~ 5/8' 2 ~/8' 15 5 5:50 ~ 6' 16 6 6:00 30 5 5/8' 2 5/8' 17 18 19 PERCO~TION ~TE 12.6 (HiN./INCH) PERC. HOLE DIA. ~(INCHES) 2 TEST R~ BETWEEN ~.0 FT. ~D 5.5 FT. COHHENTS: PERCO~ON DATA ON ~IS PAGE FOR UPPER BENCH PERC. HO~ ONLY. PERFORMED BY A~ WATER A W~ATER. I, JE~FH~ ~ G~NESS, CE~I~ ~T THIS W~ PERF~D IN ACCORD~CE W~ ALL ~A~ ~D MUNICIPAL GUlDEUNES IN E~ECT ON DATE: ~13 I ~ DEPTH TO DATE ;ROUNDWATER DRY 5/12/2000 DRY 5/22/2000 ALASKA WATER & WASTEWATER CONSULTANTS, INC. IsolL LOG - PERCOLATION TESTI ~,.=.= ..... t. ,..~,. .... ~ ....... LEGAL DESCRIPTION: MouhrrNN AIR SUBDNISION; LOT 5, BLOCK 7 ~/,........~t j. j t/v~..~j_ PERFORMED FOR: DOLORES CATHERINO ...... ~ ~1 ~1 ~,...~..o....~J~.. .... GM CL SW MH \ / s-- ~ SP CH / SM OH . ~ 6-- SC ~ GROUNDWATER TH~ 0 10-- ~1-- ~ DATE RE. lNG CLOCK NET TINE WATER LEVEL NET DROP ~ TINE (HINGES) RE. lNG (INCHES) ~ 12/14/99 PERC. HO~ W~ PRESO~ED 4+ HOURS PRIOR TO 0 6' 19-- PERCO~TION ~TE 120 .(HIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20--- TEST R~ BETWEEN 5.5 FT. ~D 6.0 COHHENTS: PERCO~ON DATA ON ~lS PAGE FOR LOWER BENCH PERC. HO~ ONLY. PERFORMED BY A~ WATER & W~ATER. I, JEFFR~ A. GARNESS, CERTI~ ~AT THIS W~ PERFO~M~ IN ACCORD~CE W~H ~ ~ATE ~D MUNICIP~ GUIDEUNES IN EF~CT ON DATE: 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 ~ Well Absorption a~ea / DISTANCE TO: I I ~ I / Manufacturer JJ .... ~ MateriaYl ~ ~ No, of comoartments ~ D TAN ET ~We ~Dwe ng PERMITNO, atena] - Liquid capacity in gaHo~s ~ ~Well Foundation I No. of lln~s. I Length ol ea~ ll~ I Total length of lineL~ * I T[~I]cN ~Id~ DIsta{]c~ b~tw~njines I Length Widtb Depth PERMIT NO. [Type of O~ {CTib diam~ Crib depth ~tal ~ffectiw absorption area ~ Well ~ ~oundation ~rest loll ~e I DISTANCE TO: ~ ' [ ~ L .......... Building fou~at~ Se~er line -~ ~--~-~i~ank _ OTHER PIPE MATERIALS SOIL TEST RATING I NSTA L LERf~~.~~ REMARKS LEGAL 'Box 1869, STAR ~0I~ A ANCHORAGE, ALASKA 99502 SlX/INcH:WA~R :'WELL DRILLED AND CASED OUT TO THE bEPTH OF RATE OF' . . P~oPEm*Y OWNER ~. ' LOCATION OF' WELL $1T~ · ~l.q. o0 .PER FOOT. gee. ~)u.k.e..344-6633 ,C~. 5'B~. ~/ Su~. DRILLER Be~l,,~. C./_~J_~ Of ~ ~~ ~0~. WELL LOG: 0 ..... 17' ,~,,~z~e..L ~.Ct.h. 35~ c, Lag,. .... 54 .... 65' ,q ~e.t ~.Z.Z,~ ~e.,l.,. ,q ~r,~cz~ aemun,t o.~ ~a,t~ p,,~du.c,t~n.. , 65---122' tt.a,td, pa~. ,q cer/~n,t.~ ~,t,=,~ ," .' Co.o,~ aC ~,,uL,Cl,,f~: $2736.00 Co,~,t. of. 15e~ Se. ad.: [122.50 MUNICiPALiTY OF ANCEIORAGL' DEPT. OF [!::,t.;, & ENVIROIqMENIAt RECEIVED COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF , THANK YOU VERY MUCH. $2758,50 DATF, .,,,.,,,,. .,,.,,,,,...,. ,,,,,,.,..,.. WILL I~E 8 ON PAET DUEACCOUNTE. ~""ILUI'-.~ I C:. I [:,EF'FIRT['IENT FIERLTH RND EN',,,'IF.:f"INMENTAL 625 "'L'" STR. EET., RNCHORRGE., RK. 99501 ,¢._ LOCRTION SNOW FLRKE RD I_EUHL :~5 B~ N~I~N>~RE : LUT ::,I~E~ 4~.~59 SQURRE ~EE~ THE R.E~UIR. E[:, SIZE OF THE THE LENGTH DIMENSION IS THE LENGTH "..'IN FEET:.', OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCR',/RTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTF'RLL PIPE RN[:, THE BOTTOM OF THE EXCRVRTION ,:.'IN FEET.'.,. PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTRLLRTION INSPECTIONS OF' RN'¢ WELLS RDJRCENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THRT THE NELL WILL SERVE. ................. -rl.,..IC~ ,:: 2 ::, I I"-.ISPEC:T z OI'-,IS RF.."E I~."E,_--~.. El Z BRCKFILLING OF I=IN'¢ '=';'~'STEM WITHOUT FINRL INSPECTION RND RPPROVFIL B'¢ THIS DEPF-IRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM [:,ISTRNCE BETWEEN R WELL RND RN'T' ON-SITE SENRGE DISPOSRL SYSTEM IS ±F~F~ FEET FOR R PRI',,,'RTE NELL OR :L50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMLIM DISTRNCE FROF1 R PRIVRTE NELL TO FI PRI'v'RTE SEWER LINE IS 25 FEET RND TO R COMMUNIT'T' SENER LINE IS 75 FEET. NELL LOGS RRE REQUIRED 8ND MUST BE RETURNED TO THE DEPRRTMENT WITHIN _-..':.8 DR"r'S OF THE NELL COMPLETION. OTHER REQUIREMENTS MR"F RPPL"t. SPECIFICRTIONS 8N[:, CONSTRUCTION [:'IRGRRMS RRE RVF:IILRBLE TO INSURE PROPER INSTRLLRTION. I CERTIF"r' 'THRT l: I RM FRMILIRR WITH THE RE6!UIREMENTS FOR ON-SITE SENERS RND NELLS RS SET FOF~:TH B'¢ THE MUNICIPRLIT¥ OF RNCHORRGE. ;2: I WILL IN'=;TRLL THE SYSTEM IN RCCORDRNCE WITH THE CODE'--';. ]:: I UNDERSTRND THRT THE ON-SITE SEWER S"r'STEM MR"r' REC,!UIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS. SIGNED: .... RPPLICRN'T VENTURE NORTH CONST INC -_:__ : ISSUER, E,,~~_ ............ BF-ITE~ _ 'q4. 0 LOI SOILS LOG MUNICIPALITY OF ANCHORAGE ~/~,~.-.~ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION C3 TEsTPERCOLATION Pouah ~, .amd~eg., ~lml(e Og(SO2 27~-2991 SOILS LOG - PERCOLATION TEST PERFORMED FOR: [//.,,'e=::,A~'7-//~'~,/~C~/V/~/R'fi-J-/ ~,~ ~~ATE PERFORMED:,~ -- ~ - ' - - S~OPE ' SITE PLAN WAS GROUND WATER 1 ~"~ ENCOUNTERED? 12 ' DE.H? 13- 14 Gross Net Depth to Net Reading Date Time ..... Time Water ' Drop PERCOLATION RATE (minutes/inch) · TEST RUN BETWEEN ' ,. FT AND, FT CO~ENTS . . · ~ ' - ...... BARNARD ENGINEE 203 West 15th Avenue 72-~ (7/76) AJ~hOrage, Alaska 99501 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 (~ I '7 - [ '7 / - d; ~, NAA # ~.~ ~ "~-~ ?~ L'i ~'~ GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Day phone ~'~:-- ~/~: '7~- Lending agency Mailing address Day phone Agent Address 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 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. [ Address ~0 ~ ~ /~- ~t ~' ~% Engineer's signature ~ . ~.L.~L~.~.,.~-~ Date DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the fol! /rog stipulations: Additional Comments ~,.~ /~/'-7'/gcJW/b-~..3 ~J.~L ,J%/U..(7'~"/~ //'~//~,~/ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only u~on 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) Bac~ MOA ~21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street. Room 502 · Anchorage, Alaska 99501· (907) 343-4744 Legal Description: A. WELL DATA Well type ~ Log present (Y/N) Total depth Sanitary seal (Y/N) Health Authority Approval Checklist Parcel I.D.: If A. B. or C. attach ADEC letter. ADEC water system number __ Date completed Cased to I ti/q Date of test Static water level Well prodnction WATER SAMPLE RESULTS: Coliform Date or sample: B. SEPTIC/HOLDING TANK DATA FROM WELL LOG Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION % g.p.m t g.p.m. Nitrate ~ ~-~ Other bacteria Collected by: ~t ,-- 5 Date installed /¢~'O Tanksize ttg-~ Number of Compartments ~- Cleanouts(Y/N) Foundation cleanout (Y/N) ~ Depression (Y/N) ~ High water alarm at o um.,n Pumper . A ~ C. ABSORPTION FIELD DATA Date installed ICl,fro Soil raung (g.p.d./ft2 or fl2/bdrm) /~"O System type /~_d,,t,,~4 C ~ Length ~ ~. Width ~ Gravel thickness below pipe ~ t Total depth /~,~ t Effective absorption area ~/~- Date of adequacy test qAzT/q~- Fluid depth in absorption field before test (m.); Fluid depth ~l::~ (ins.) Minutes later: Peroxide treatment (past 12 months) (Y/N) Monitoring Tube present(Y/N)__/"/~_ Depression over field (Y/N) Results (Pass/Fail) '~ For ~ bedrooms t;/,~u 8e./'~o-- i~,..',z ~1 ) Immediately ~er~O gal. water added (in.): Absorption rate = .~ 1"/~.~(~) g.p,d. lfyes, give date D. LIFF STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main ! Sewer/septic service line 7 ~" Size m gallons "Pump on" level at* *Datum "Pump off' level at* On adjacent lots ; On adjacent lots Public sewer manhole/cleaimut Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ] ~ I Property line ~/to I Absorptioa field Water main/service line ~__~__Surface water/drainage ~/~'-O Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation Surface water Curtain drain b~ Water mare/service line > oO-,~ Driveway, parking/vehicle storage area ~ Wells on adjacent lots ~ [0-~ Property line F. ENGINEER'S CERTIFICATION I certify that I have determined thrufield inspections and review of Municipal recror'cl~, 'that ~hg ~oue'$yste~ts are ~ ,,~,,-u~-~-t~nes in ~w~'rr~c' on this date. :i , ,:" .,, .~:. , ',,', , % , in with MOA H~ Engineer s Name t O bb~ ' , [ q,~,5 X -'"~' 5 ;-" ; .............................................................................................." --- Date of Payment dO/~/¢f Date of Payment Receipt Number 332 [ ( ~3 g 3 ) Receipt Number Rev. 8/95 OSS: haa.wk.doc SEPTIC SYSTEM ADVISORY I~,AT,TH AUTHORITY APPROVAL NO. /~//~ Prior to a recent adequacy test on the septic system for this lot,~ inches of standiung water was observed in the absorption field. This indicates that approximately~P'?? % of the absorption area is inundated. However, this system did meet the minimum absorption requirements for a ~ bedroom residence. This advisory must be attached to all copies of the subject Health Authority · CT&E Environmental Services Inc. Laboratory Division r~a~.~`~:a'~a~:ar~'~r~r~:a~:~J~JJ~jJ~JJJJ~~ Drinking Water .Analysis Report for Total Coliform Bacteria 2o0 w. ~o=,er O~*e Anchorage, AK 99518-1605 PoEqD hVSTRUCTIO~VS ON 2LEVERSE SIDE BEFORE COLLECTEVG SAA4PLE Tel: (907) 562-2343 M'UST BE CONiTLETED BY WATER SUTPLiER [] PUBLIC WATER SYSTE.M I.D. # L I I I Ill ~. PRIVATE WATER SYSTEM [2 Send ResuR~ [2 Send Invoice [] Send Results El Send Invoice SAMPLE DATE: Da y Yea r Ro LE TYPE: utine [] Repeat Sample (for routine sample ~ith lab ref. no. ) [] Special Purpose SASLPLE LOCATION {~,,, Treated Water Untreated Water Time Collected Collected By Please Print : -: Fax: (907) 561-5301 TO BE COMPLETED BY LABORATORY .Analysis shows -dais Water S.-M~ITLE to be: ~ Satisfactoo' D Unsatishctory Sample over 30 hours old, resuhs may be unreliable 12 Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new samole via special deJiver-y amaih Date Received' ~'/~...~.J ~,~-'~' ~, .'r~, Time Received .Analysis Began l Analytical blethod: er' Membran* Filter ~ MMO-*IUO * Number of colonies/100 mi. Lab Ref. No. · Result* Sent to A.D.E.C. ("~c0 Fbks Client notified of unsatisfactoO' results: st ~--~ Jun [] Faxed [] [] Phoned Spoke with Faxed Date: Time: BACTERIOLOGICAJL WATER ANALYSIS RECORD MMO-.XFUG Result: Total Coliform Membrane Filter: Direct Count Verification: LTB Fecal Coliform Confirmation Final Membrane Filter ResuJts Reported By /~'7~ - E. Coli LO ~ Colonies/100 mi BGB ~ COLIFIRM r, wc- too y. .... · To 0 ~/I00 mi Date. e~ "2-} ' e~5' Time /~ hfs PART ONE-' ur n r MemberoftheSGSGroup(Soei~t~G~ 6aledeSu~,e~l[a~c-~e}.~,; ...... ~'~'~ *"¢~,!, ! ....... tt~ll CT&E Ref.~ Matrix Client Sample ID Client Name Ordered By Project Name Project# PWSID CT&E Environmental Services Inc. Laboratory Division ~.e-.a~'j.~'J,~'~'~'~.~'~'~',e'J~'~'.~'~ 95.4170-1 Laboratory Analysis Report WATER POTABLE L5 B7 MOUNTAIN AIR EST. TOBBEN SPURKI~, P.E. TOBBEN SPURKI~ UA WORK Order 18205 Printed Date 09/26/95 ~ 16:23 hrs. Collected Date 09/22/95 @ 13:45 hrs. Received Date 09/22/95 @ 16:00 hrs. Technical Director STEPHEN C. EDE Sample Remarks: SAMPLE COLLECTED BY: T.S. QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date Init Nitrate-N 0.10 U m~/L EPA 353.2 10. 09/25/95 DJS See Special Instructions Above UA - Unavailable ** See Sample Remarks Above NA = Not Analyzed U = Undetected, Reported value is the practical q~antification limit. LT = Mss Than D = Secondary dilution. GT = Greater Than 200 W, Potter Drive, A.chorage. AK 99518-1505 -- Tel: (907) 552-2343 Fax: (907) 561-5301 ztt= CT&E Environmental Services Inc. L a b o r a t o ry D ivi s i o n READ L~TTRUCTIO3T 0.~' REVERSE 5IDE BEFORE COLLECTLVG SA3/PLE Drinking Water Analysis Report for Total Coliform Bacteria :oo w ~o~.~: o,~. Anchorage. AK 99518-1605 N~:ST BE COYdPLETED B\' WATER Sb-PPL[ER C, /~'BLICWATERSYSTE.MID # t' t I t I I j ~'/PRIVATE WATER SYSTE.X[' ' Send Results ~ Send Invoice Send Resuhx Cl Send [,~ voice Day Year ,L~ Treated 'Water Untreated Water Month Ro LE T'kTE: utine Repeat Sample (for routine sample with lab vet'. no. _ ) Special Purpose Time Collected SAM2PLE LOCATION Collected By h./ 7 H L 5-7.3 Tel: (907) 562-2343 Fax: (907, 561-5301 TO az CO. [, Lr_ ~ cD BY Analysis shows this Water SAMPLE Sample over 30 hours old. resuhs ma~ be unreiiabie Sampte :oo long ia transit: sample should no~ be over Z8 hours old at examination :oindiza~ere ableresu[ts P[easesend new sample via spezi~{ de[ive~ mail. Date Received .. ~ O J~ Time Recei~ ed / ] Ana[)'sls Began ~ Ana(ydcalMethod: ~ Membr~neFilter MMO-MUG ' Number of colonies.'100 Lab ReL No. Result* ~aI?'st SentmA.D.E.C. ~ gbks Jun Tim~: Client notified oF unsadsfactoO. results: Phoned Spoke ~ ith gaxed Dale: Time: BACTERIOLOGICAL WATER A3';ALYSIS RECORD MMO-M-L'G Resuli: Total Coliform E. Coli Membrane Filter: Direct Count Verification: LTB BGB Fecal Coliform Confirmation Final Membr2 Filter R'~ults /~ Colonies/lO0 mi COLIFIRM l2_ liform/100 mi Timehfs A HOM SERVICES, 12216 Wilderness Road Anchorage, Alaska 99.5 ] 6 34.5 .. ! 890 CUSTO~R Tobben Spu]kla. d. P l. INVOICE # 0435 BI(x;K .................. Lot AMOUNT $9~.0<) ............................ TOTAL REMARKS ................ :~_~_ .......... ii -'' t'~'~¢'bGall°ns /Septic .......... Leach Area ....... Hotd,ng Tank ~/ __ Standpipes ~2.,:~ Time PROBLEM AREA-- CALL. FOR MORE INFORMATION NEEDS TO BE DONE AGAIN IN 6 MONTHS Good Shape ~ sludge buildup on bottom Jim cap missing or ~_~., Cut standpipe to '~' above groLJnd needs replacing J_J Floater or~ top [_-I Needs Septictrine MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) (b) (c) Legal Description (include lot, block, subdivision, section, township, range) L 5 B 7 Mountain Air Estates, Add. No. 1 ; Sec. 35, T12N, R3W Location (address or directions) 15231 Snowflake Drive, Anchorage, Ak Applicant Name Robert Martin Telephone: Home 345-_4248 Applicant Address 15231 Snowflake Drive~ Anchorage~ AK 99503 Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [] (explain); Business 344-2501 (d) Lending Institution Rainer Mortgage Telephone 561-1744 Address 4797 Business Park Blvd., Anchorage, AK 99503 (e) Real Estate Company and Agent Century_ 21 Sleeper, Inc., ATTN: Andy Helm Address g~5~ 01~ R~w~r~; Annhnr~g~: Al( Ctqc~fl? Telephone 344-2501 (f) Mail the HAA to the following address: Hold for pickup. TYPE OF RESIDENCE Single-Family ~ Multi-Family [] Other Number of Bedrooms Three (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 the legality and status. Page 1 of 2 SEWAGE DISPOSAL Onsite ~ Public [] Community i'-I Holding Tank [] Note: if community well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. 72-025 (11/84) 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 this 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 compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Alaska Soil Testing and Engineerir~lephone 561-7453 Address 6100 A Streets Anchorage, Ak 99502 Date April 22, 1985. Engineer's Seal This office has received written conf~rmation of the conditional of April 26, 1985 and it has been met. Therefore, this property now meets MOA requirements. DHEP APPROVAL Approved for T~r¢¢ Approved ~ Disappr~y/ed ~ Con ditio~'-~l Terms of Conditional Approval Date 6/11/85 CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 Ju~e 3 ]-985 ALASKA SOIL TESTING AND ENGINEERING 6100 A Street, Anchorage, Alaska 99502 (907) 561-7453 MUNICIPALitY 01: DEPT. OF I IEALTH 8, ENVIRONMEN'rAL PRC,~ E:CliON , ,, 5 1985 RECEIVED Municipality of Anchorage Environmental ties]th Division 825 L Street Anchorage, AK 995©1 Subject: I.ot 5, Bk. 7, Nouz:ta~n Air EsN~te.~, Add. No. l Gentlemen: On Uay ~1~ '198.5, ~ark Holum of Alaska Soil Testing and ~ng~neering rc~d. ewed the well sea] on thc :~ubj'-'ct property pursuant to the cond:~t:iona]. Health Authority Appro~aI certJfScate ~.'h~ch wa~' submitted on April 22 The condition~,l approval certificate required rep].ace~eFt of the well seal. The ~lay ~1 review found the well seal to be in place and to satisfy the ret'4Srements of the conditional approval. id. ease call if we ~ay provide addJtioanl J nfon:ation. Very t~u]y yours, ALASKA SOIL TES'I']i',,G AND Maz'k. Plolum, f>.E. Hanager MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date April 22, 1985 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot.~ ~', J~k. 7, Mountain Air Estates, Add. No. 1; Sec. 35, T12N, R3W, S.M. Location(addressordirections) 15231 Snowflake Drive, Anchorage, ~_~ 345-4248 (b) Applicant NameR°bert Martin Telephone: Hu,,,~ Business 344-2501 Applicant Address 152~31 Snowflake Drive, Anchorage,__,~ 9951.6 (c) Applicant is (check one): Lending Institution []; Owner/builder ['~; Buyer []; Other [] (explain); (d) Lending Institution Rainer Mortgage Telephone 561-1744 Address Lly~ai ~Sd3~orage: AK 99503 (e) Real Estate Company and Agent Century 21 Sleeper', lnc., Attn; Andy Itelm Address __8050 Old Sewardt Anchorage~ AE 99~O~.2- Telephone ~44-2~0]. (f) Mail the HAA to the following address: Hold for pickup, 2. TYPE OF RESIDENCE Single-Family[] Multi-Family[] Other Number of Bedrooms ~hree 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 the legality and status. Page 1 of 2 SEWAGE DISPOSAL Onsite ~ 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 (11~84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown betow, I verify that my investigat~or~ o! tt~,itM Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, funchena~ arid ~ for the number of bedrooms and type of structure indicated herein. I further verify that based on the informahon obtl from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effec~ the date of this inspection. Name of FirmAlaska SoilTesting and Engineering Telephone 561-7453 Address 61OO A Street: Anchorage, AK 99~O2 Date April 22, 1985 (Note repair to be made on well seal.) CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspectioos or analyze data before a certificate is issued. Tl~e Municipality of Anchorage is not responsibte for errors or omissions in the professional engineer's work. Page 2 of 2 MUN C ,^UW Or ANCHO,Ae MUNICIPALITY OF ANCHORAGE (MOA) DEPT, OF HEALTH & HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTECTIOI~ CHECKLIST- FEBRUARY 1984 264-4720 APR ~' Legal Description: Lot 5, Bk. WELL DATA Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: Welt Classification Well Log Present (Y/N) Total Depth 144 fto Cased to 14/+ ft. Static Water Level 68 ft. 32 inches Y Private If A, B, C, D.E.C. Approved (Y/N) Y Date Completed Sept. 20, 1980 Yield 10 gpm (J/ef. Comm. 1) ~" Depth of Grouting N/A~ Pump Set At l~O ft. Sanitary Seal on Casing (Y/N) N (Ref. Comment 2) Depression Around Wellhead (Y/N) N To Septic/Holding Tank on Lot 100 £t. To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line 3.00+ ft. Cleanout/Manhole 1OO+ ft. ; On Adjoining Lots 106 ft. ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot 130+ ft. 130+ ft. 47 ft. Water Sample Collected by Mark Holum, P.E. ; Date 4-2-85 .- Water Sample Test Results Satisfactory ~ .... Comments 1)Well yield confirmed at 450 gal/day per 24 hr drawdown test 4/1-2/85. 2) The well seal is improperly seated in the well casing due to misalignment of ~' the electrical conduit. The well seal is to be reseated in the well casing after SEPTIC/HOLDING TANK DATA the ground thaws. Funds are to be escrowed for repair of Date Installed12-3-80 Standpipes (Y/N) Y Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) N/A Separation Distances from Septic/Holding Tank: To Water-Supply Well 1OO fto To Property Line 49 ft. To Water Main/Service Line l0 ft. Course 230 ft. the seal. Size 1000 gal. Air-tight Caps (Y/N) N No. of Compartments 2 Y Foundation Cleanout (Y/N) Y Date Last Pumped 4-2-85 (Recei~ot attch,) ~ ; for Temporary Holding Tank Permit (Y/N) N/A~ To Building Foundation lO ft. To Disposal Field 9 ft. To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 12-3-80 Width of Field ~6 inches Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well 106 £t. To Building Foundation 18 ft. Lot N/A To Water Main/Ser~,ice Line 18 ft. To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments 150 ft2/ bdrm(Soil lo~l-)ype of System Design Deep trench Length of Field 32 ft. (Insp. Rpt.) Depth ot Field 12.3 ft. Gravel Bed Thickness 8 ft. 512 ft2 Standpipes Present (Y/N) Y N Date of Last Adequacy Test 4/1-2/85 Satisfactory (Greater than 450 gal/day) To Property Line 40 ft. To Existing or Abandoned System on ; On Adjoining Lots 100+ ft. To Cutbank (if present) N/A 200 ft. ft. D. LIFT STATION Date Installed N/A Size in Gallons "Pump On" Level at High Water Ala~:m Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** 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 inspection. Signed Date 4-22-85 CompanyAk Soil Testing & En~rMOA No. ST85-260 Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) ALASKA SOIL TESTING AND ENGINEERING 6100 A Street, Anchorage, Alaska 99502 (907) 561-7453 Location: Type: Ad~ress: Client: Adequacy Test Lot 5, Bk. 7, Mountain Aire Estates Septic Tank and Drain£ield ~$~1 Snowflake ~ Robert Martin Date Time ~uantity of Depth Below Water Added to Grade of Water Drainfie]d Level in Drainfield (Gallons) (inches) 4-1-85 12:30 pm O Dry to 124" 76 12: ~)0 1~6 " 1: O0 2)4 " " 1: 32 500 " 2:00 " " " 4-2-85 2:00 pm O " 3:15 O " 3: 27 500 105 " 3:35 600 Dry to 124" 3:50 " " Depth Below Grade of Water Level in Septic Tank (inches) Comments: The septic system was in use prior to and during the test. Conclusion:The absorption rate of the drainfield exceeds the m~nimum rate of' 450 gal./day :for the three bedroom single family dwelling. The absorption rate is satisfactory. Performed by: ~ark Holum~ P.E. · ~,. ~ L,' ', · DATE RECEIVED INSPECTION APPOINTMENTS ~ _ j']'IM E DATE DATE LL~ ~ ? DATE DEPT. OF MUNICIPALITY OF ANCHORAGELN' NMENTAL DEPAHT~ENT OF HEALTH ~ ENVIHON~ENTAL PHOTEOTION ENVIHON~ENTAL SANITATION DIVISION Telephone 264-4720 R E C E I V E REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER J PHONE M~ILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION ~AI LING ADDHESS J PHONE 4. REALTOR/AGENT 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE J~ SINGLE FAM LY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [--I Four [] Two [] Five ]~ Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY --1 PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give wel depth (attach log if available.) YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT N'UMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTI LITY Connection Verified INSTALLER []Septic Tank or []Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Sept~c/H°ld'ng Tank IAbs°rpti°n Area ISewer Line INearest L°t Line Absorption Area to nearest Lot Line 5. COMMENTS 3 [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY ~,~ 72-010 {Rev. 6/79) Received T Dote .. 0 "r' I- 0