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HomeMy WebLinkAboutT15N R1W SEC 4 LT 16N ction 4 Lo-I- :1. 6 ! - 07: -13 Municipality of Anchorage Page I of Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 'L' Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW010417 PID Number: 051-072-13 Nmne: Craig and Laura Haws Wastewater System: New [] Upgrade P.O. Box 771895 Eagle River, AK 99577 ABSORPTION FIELD ~o~: ,~ ~ ~o~-o~,: Shallow 5' Wide Trench 688-6821 Three (3) Soll Rating: To(al Depth fr~m o~gmal ora(M: LEGAL DESCRIPTION 1.2 Block: LOI: SuOdlvt~m: Depth to ~ bO~mn fi'om original grade: Gr~vel depth I{)e~'math pipe: 16 8.5 Town~: Range: ~_~cJJ_~o~: Fill added above ~ grade: Gravel Length: 15N lW 4 0 Ft. 39.5 Well: Existing 5 n. 1 Ft. n. 395 F~ ASTM D3034 PVC F,. Charles Barr Cont. 10/15-16/01 -: I TANK SEPARATION DISTANCES Ig septic [-] Holding I"] S.T.E.P. [-I Other: Tc~O Septic AbsorptionUti Holding ~lc/Pnvmte Tank Field Station Tank S~U,, Anchorage Tank 1,000 r,~,,,, ~ w,, >100' >100' N/A N/A >25' Steel Two s~.~w,t., >100' >100' N/A N/A ~ / LIFT STATION - NONE ON LOT ~ ~. >5' >10' N/A N/A c.,,. F~ >5' >10' N/A N/A .~,, ~. ~.~,,: in. in. c,,,.o,.~ None Noted P~m. ldake&Mo~l ~kl~ctior~p~rfo~medby: Ra~: BENCH MARK Existing Septic Tank Pumped, Crushed and Backfilled. Existing Absorption Trench Abandoned Garal~e Slab ~ Midpoint in Place. 100.0 Enoi~r',~mp ;..: 4~TM ,, .~-:~.-:, Inspections performed by: Stuart Gilbert Dates: 1 2 $~'.. ca Dep~,rtment of He~,lth a.cl Hum~,n Service~. approval Reviewed and al)proved by' ate: (~.~,. t0/~) Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT 4700 South Bragaw Stree~ Anchorage, AK 99519-6650 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number SW010417 PID No. 051-072-13 Page 2 of 3 Ex~st A B S1 90.5 86.2 S2 95.2 85.1 M1 111.3 92.8 C6 103.5 97.0 C7 114.0 95.5 C7 H1 C5 C3 Municipality of Aflchonlge DEVELOPMENT SERVK:ES DEPARTMENT 4700 South Bragaw Sired Anchorage, AK 99519-6650 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Repod Permit Number SW010417 PID No. 0514)72-13 Palle 3 of 3 c.) ~ c4 ur.) Sep. 90.~2 89, 9 Geotextile Fabric .79.0 39.5.' ~ ,/",?. · ' ' ' ' ;'?7 e, %. PROFILE AS-BUIL 1" = 10' ~ ~ '.',~c ~',:~ ~. / ~so~ :~ ~ MUNICIPALITY OF ANCHORAGE Development Services Department On-S/re Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 9951~.6650 (90?) 343-7g04 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 03, 2001 Expiration Date: Oct 03, 2002 Permit Number: SW010417 Legal Description: T15N RIW SEC 4 LT 16 Design Engineer: 0014 Anderson Engineering Owner Name: Craig & Laura Haws Owner Address: PO BOX 771895 EAGLE RIVER , AK 99577-1895 Parcel ID: 051-072-13 Site Address: 021735 KNIK VISTA ST Lot Size: 108900 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: tv': Disposal Field iv'! Septic Tank Holding Tank [ I Privy i Private Well I 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: Issued By: Date: /0 --01 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWEPJVVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-072-13 Permit Number SW 0 10~ 1 7 Property owner(s) Craig and Laura Haws Mailing address (1) P.O. Box 771895 Eagle River, AK 99577 Mailing address (2) Legal description (Lot, Block & Sub'd.) BLM Lot 16~ Section 4, T15N, RIW Legal description (Section, Township & Range) Day phone 688-6821 Zip Code Lot Size 2.5 Acres THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Acres/Sq.Ft. Number of Bedrooms Three [--] Well Only [] [--I Water Storage [] [--I Jacuzzi [] [] Water Softening Unit [] 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. (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev, 12/00) Waiver Fees: Date of Payment: Receipt Number: September 24, 2001 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: BLM Lot 16, Section 4, T15N, RIW Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of the subject lot is currently selling his house and must upgrade his septic system to obtain a Certificate of Health Authority Approval. We are therefore requesting a permit be issued for the construction of a new septic system to serve the three-bedroom home. The attached Site Plan and backup documentation identify the location and configuration of the new septic system and the parameters used in the design. Also identified on the plans are the location of the existing septic system and well on the lot and the test hole location. Existing drainage patterns are shown and will not be altered by the development of the lot. A bluff exists near the south side of the lot and the current system is less than 50' from the edge. The new absorption trench will be more than 50' from any break in grade greater than 25%. The existing septic tank will be pumped and removed from the site. The existing absorption trench will be abandoned in place. A test hole was placed near the location of the new absorption trench. This hole indicated well graded to poody graded gravel with some sand and silt. The majority of the material in the test hole was found to pass a No. 4 Sieve. A sand liner is not required. Percolation tests in the material resulted in rates of less than I minute per inch. No groundwater was found dudng placement of the test holes, and none was noted dudng the monitoring pedod. We are therefore proposing to place a 5' wide absorption trench system with 4' of gravel beneath the distribution pipe. The total depth of the trench will be 12.5'. The distribution pipe will be placed at 8.5' below the ground surface to provide sufficient drop from the house to the septic tank and then to the absorption trench. The total length of the new absorption trench will be 38'. The ground surface on the lot slopes as shown on the attached Site Plan with only minor slopes near the proposed septic system site. The new absorption trench will be constructed on a faidy fiat surface in conformance with Municipal requirements and parallel to ground contours where possible. All components of the new septic system will be constructed 100' from the existing well on the lot. If the system is constructed in accordance with our design the following statements BLM Lot 16, Section 4, T15N, RIW September 24, 2001 Page Two apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be 'maintained. Sincerely, Michael E. Anderson, P.E. Attachments SCOPE OF WORK: 1. Pump and Remove Existing 1,000 Gallon Septic Tank. 2. Abandon Existing Absorption Trench in Place. 3. Place New 1,000 Gallon Septic Tank. 4. Place 2 Post Tank Cleenouts. 5. Construct New 38' Long X 5' Wide X 4' Effective Depth Absorption Trench. 6. Regrade All Disturbed Areas. 7. Revegetate Area As Required. BLM ~ot 16, Section 4 T1 5N, RIW i [ Existing Well ~ [ ~sorption Tren~~--~~ \ Hous~ [ N~E: No Conflicts With Existing ~11~ or Septic Syst~s in the ~ea. SITE PLAN SCALE 1" = 50' BLM Lot 16, SECTION 4, T15N, R1W DESIGN FACTORS: Three Bedroom Home Peru. Rate: LT 1 Min./Inch Application Rate: 1.2 GPDISF SYSTEM REQUIREMENTS: 5' Wide Trench System 1,000 Gallon Septic Tank 4' Drainfield Rock 3 Bedrooms X 150 GPD 1 1.2 GPDISF = 375 SF of Absorption Area 375 SFI5 LF (Width)*.5 (Red. Factor) = 37.5 LF Trench Length Therefore: Construct a 38' Long X 5' Wide X 4' Effective Depth Absorption Trench. Flowline Elevation in Trenches to be 8.5' Below Original Ground Surface. Total Depth to be 12.5' Below Existing Ground. All Components of the Septic System to be Outside the 100' Well Radii. Mound Over Trench to Provide a Minimum of 3' of Cover or Provide 2" of Direct Bury Insulation and 2' of Cover. NOTE: 8I ag ' ~:.~_~ ' .~lat~ral~ - . . ~ : "; , _F.-." :':' 5' ~PICAL ~DE TRENCH SECTION (NO SCALE) Grade A~ ~er Trench to Drain Away. Minimum 6' Secretion From B~r~k. Minimum 4' ~mtion From Groundwater. Minimum 1~' Secretion From Wells in the Area. Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: Craig Haws Legal Description: BLM Lot 16. Section 4. T15N. RIW SLOPE North OG/OL GWIGP Some Silt 5 6 7 8 9 10 11 South No Was Groundwater Encountered? If Yes, What Depth? Depth to Water After Monitoring Date: None ~2~01 Date Performed: SITE PLAN See Site Plan S L O P E 12 13 14 15 16 17 18 21 Bottom of Hole Reading Date Gross Net Depth To Net Time Time Water Drop 13-Sop 5:05 1' 8:15 5 Dry 9" 8:16 1.25" 8:21 5 Dry 8.75" 8:22 1" 8:27 5 Dry 9" Perc. Rate: <1 Min./Inch Perc. Hole Diameter: 6" Test Run Between 8 Ft. and 9 Ft. Comments: Test Cavity was Presoaked Prior to Test. More than 50% of Matedal Passes No. 4 Sieve. Performed By: Mike Anderson. I, Michael E. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 9124/01 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: BLM LOT 16, SECTION 4, T15N, R1W GENERAL: The scope of this project includes the removal and disposal of the existing septic tank on the lot and the abandonment in place of the existing absorption trench. It also includes the procurement and placement of a new 1,000-gallon septic tank at the location shown on the site plan. Work also includes the construction of a new 38' long X 5' wide X 4' effective depth absorption trench at the location shown on the Site Plan. The distribution line in the trench will be placed at 8.5' below the existing ground surface. Total depth of the trench will be 12.5' below the existing ground surface. The new septic tank and trench must be constructed at least 100' from the well on the lot. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,000-gallon septic tank must be procured from an approved source and installed at the location shown. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. o The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. BLM Lot 16, Section 4, T15N, RIW September 24, 2001 Page 2 of 3 A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfleld. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. Distribution piping must be placed level with perforations down ato.p a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. A silt barrier or geotextile fabdc must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. o o Contractor shall vedfy the septic tank and drainfield are a minimum 100' away from any pdvate water wells in the area, 150' from a Class "C" Well or 200' from any community well. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. Grade area surrounding the absorption trench to drain away. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). BLM Lot 16, Section 4, T15N, RIW September 24, 2001 Page 3 of 3 5. A permeable geotextile fabdc (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as-built of the completed system. MEMORANDUM DATE: November 5, 2001 TO: FROM: Jeff Poet Mike Anderson, P.E. SUBJECT: BLM Lot 16, Section 4, T15N, R1W Septic System As-Built/Certificate of Health Authority Approval Well Location The well location shown on the as-built drawing for the lot is correct. The well location shown on the Site Plan submitted with the permit application was is not correct. The odginal site plan was based on a surveyed as-built which did not show the location of the well. All components of the new septic system are outside the 100' protective radius of the well on the lot. Please let me know if further information is required before the Certificate of Health Authority Approval can be issued for this lot. GRE. ANCHORAGE AREA BO, Dep~rtment of Environmental Quality 3330 C Street Anchorage, Alaska 99503 ,,/ INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ,,'-I) / c:h~,~b ~_ / NAME ~q¢!ll?~ ~,~2~C~_~l~-/.~ MAILING ADDRESS ¢'~DOX 6~ ~fl~e )~'0e~ PHONE SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURER ~.~C~ MATERIAL NUMBER OF COMPARTMENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /~-~ GALLONS. SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL BUILDING FOUNDATION 30~'., ADDITIONAL ABSORPTION OR WIDTH /~I, LENGTH I~-~1, DEPTH ~.¢/ CRIB SIZE: DIAMETER <~1 DEPTH (¢! DISTANCE FROM: WELL /'~O" TOTAL EFFECTIVE NEAREST LOT LINE -- ABSORPTION AREA (WALL AREA) ~2~ SQ. FT. WELL: CONSTRUCTION BUILDING ,,.-, r- NEAREST FOUNDATION /') ¢ LOT LINE CESSPOOL APPROVED?/L~/ DISAPPROVED OTHER SOURCES DEPTH ,~"-O ' DISTANCE FROM: NEAREST SEPTIC //Fi SEEPAGE /20 *~ SEWER LINE TANK SYSTEM REMARKS DISTANCES: INSTALLED By:~? PIPE MATERIAL: LOT SLOPE: REMARKS: Form NO. EQ-031 DIAGRAM OF SYS?/~yr/ // // DATE ~/~¢/¢.~ APPROVED ~ ¢(' A / 0 ~ E EI~.._ EERING ~ VT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 333-52~0 Russell Oyster Earl Ellis 694-2774 333-5240 Civil Engineering Surveying Soils ~ Foundations Land Development SOIL LOG Performed for: ~/~/~/~ ~.~. ~.>~ ~ ~ ~/¢<~b~ ~/u~/2~,/~. ?76~7'7 Legal Description: zLmT' /6~ ~, Depth (feet) Soil Characteristics 0 1 2 3 4 5 6 7 8 9 lO 11 \ 12 Ground Water Encountered: Yes No ~/ If yes, what depth Proposed Installation: Seepage Pit ~/ Drain Field Cpmments: 2~m~.~ ~F ~/~' y~.~ ~y/ 2~"~>~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and 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 Parcel I.D. 051-072-13 Expiration Date: GENERAL INFORMATION Complete legal description BLM Lot No. 16~ TtSN~ RtW, Section 4 Location (site address or directions) Knik Vista Current Property owner(s) Craig and Laura Haws Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class ~ Public Water System P.O. Box 771895 Eagle River, AK 99577 Three (3) Day phone 688-6821 Day phone Well Day phone TYPE OF WASTEWATER DISPOSAL: [~ Individual On-site [] [-] Individual Holding tank [] r'~ Community On-site [] r-'l 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 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 pdvate 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 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 files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Pdnted Name Michael E. Anderson, P.E. 5. DSD SIGNATURE Approved for .'~ bedrooms. Disapproved. Phone 522-7773 Date 1111101 .,_., /~ ~ ENGINEER S Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Odginal Certificate Date: (Rev. 12/00) Municipality of Anchorage Development Services Department Building Safety Division On-Site Watm' & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 wvnv.ci.anchorage.ak.us (907) 343-7~04 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Desc~pUon: BLM Lot t6, Section 4, T15N, RIw Parcel ID: 051.072-t3 ~WELLDATA Well type Private Date completed __ Total depth If A, B, or C provide PWSID # Sanitary saaJ (YIn)Y_ Cased te >40 fl. FROM WELL LOG Well Log (Y/N) N W~res properly protected (Y/N) Y Casing height (above ground) >24 AT INSPECTION Date of test 10/28/2001 34.t Well production WATER SAMPLE RESULTS: C~lform 0 celonies/lO0 mi. Date of sample: 10/28/2001 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,000 gal. Foundation cleanout (Y/N) Y_ Date of pumping C. ABSORPTION FIELD DATA g.p.m. Nitrate t.24 mgJ~. Collected by: Mike Anderson Numbe~ of Compartmonts :2 Depression over tank (Y/N) N_ Pumpor New Conatmctlon Date installed t0/16/2001 Soil rating (g.p.dJft~ ar ~/bdrm) 1.2 6PD/SF Length 39.5 Total depth 12.5 fl. Date of adequacy test 5.0 g.p.m. Other bacteria 0 colonies/100 mi. Date installed 10/15/200t High water elarm (Y/N) N System type 5'WideTmnch ff. W'ztth $ lt. Gravel below pipe 4 Eft. absorption area 395 · Moniluring lube Y Depression over field N_ Results (Pass/Fail) Fluid depth in absorption field before test in. Water added gal. Elapsed Time: __ min. Final fluid depth in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date For bedrooms New depth in. g.p.d. D. LIFT STATION Date installed "Pump on" level at. in. Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/~iff station on lot >100. Absorption field on lot >t00. Public sewer main N/A Sewer/septic service line >25' Size in gallons 'Pump off' level at, Cycles tested in. Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots >100. On adjacent lots >100' Public sewer manhota/cleenout N/A Hcflding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Water main N/A Wells on adjacent lots _>100. Prope~y line. >5' Water service line >10' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line >t0' Water Sewice line >10' Cudain drain None Noted F. COMMENTS Building foundation >10' Surface water >100. Wells on adjacent lots >100' Absorption field >5' Surface water >100' Water main >10' I:~veway, pastJng/vehicie storage >~0' in. G. ENGINEER'S CERTIRCATION I ce. filly that I have determined through field inspections ~d rawew of Municipal records that the above systems are in conformance wfth MOA HAA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 11/1/2001 HAA Fee $ Date of Payment Receipt Number (~v. ,,/,/o / Waiver Fee $ Date of Payment Receipt Numbe~ 1'40~-~1-:~:::~1 G~:53 CT&E ESI CT&E Envlroflmoflml Servloos Inc. 90"~620119 P.01/94 C'F&E Rd'd~ I 01756100 ! Client PO# CbutNamo Andorson Enginom~f l)rJntod Dalw'Tfme 1 !/01/2001 8:19 ProJeetWame/~ N/A ColiocUd DaWTim. 10/2a/2001 14:00 OJeut hmpb ID BLM lot 16 Rocdvod Date/Time 10/29/2001 15:30 M~rriz DFink~g WoMr TeebnJml Director Stop#eh C. IF, de Ordorod By Rdea#d By Staple Remarb: AJIow~ble ~ Andytis Init Nitrs~.N 1.24 0.$00 mr/L EPA 3OO.0 (<10) ! 0/29/0 ! SCL Tmal CoiEorm ~ol/iOOmL, SMI8 9~1~ (<1) 10/29~1 Received Time Nov. 1, 8:49AM Page 1 of 1 From Stuart Gilbert <stuarte@alaska.net> Date Wednesday, October 31, 2001 8:18 pm To "Mike Anderson,P.E." <andengr~gci.net> SubJect BLM Lot 16 Well test data: Lot 16 BLM Well Test October 29, 2001 (no well log) A 4 hour well test was performed using an Acoustic Well Probe to read water levels in the well and a water meter connected to a garden hose from which to read flow rate and water volume being pumped from the well. Flow was unrestricted for 4 continuous hours ~t a constant flow rate of 5 gallons per minute. 1,200 gallons were pumped from the well. Pump stayed running while the level dropped from the static of 34.1' below the top of pipe to 41.1' below top of pipe. Test was conducted while pump ran continuously and sucking sound was audible from pump sucking air so water level remained at the pump intake throughout the test. Recovery was 100% in 30 minutes. I believe that the total depth of the well is approximately 80'. Well is cased to about 41'. I believe that I was picking up the echo of the drive shoe since I could not get a reliable water level reading below 41.1'. Pump intake is at approximately 50' since I was getting sporadic readings in that vicinity that always returned to 41.1'. It is common to get unreliable readings while in bedrock. RESULTS Well produced 5 gallons per minute for 4 hours therefore passes the test for a 3 bedroom home. Well cased to more than 40'. Sanitary seal in place, wires in a protective conduit and well stick up 24" http://augustine.gci.net/frame.html 11 / 1/01 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) Lot 16; Section 4; T15N; RIW Location(address ordirections) Glacier Road (b) Property owner Ma.qRie Borrecco Mailing Address Telephone : (home) 688-3027 Business_ (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent' JACK WHITE COMPANY/L~nda Banner Address 10928 Eagle River Road, Eagle River, Alaska 99577 Telephone 694-5500 (e) Mail the HAA to the following address: (or check here E~, if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING/694-2979 17034 Eagle RivQ_~ Loop Road. Suite_ 204 EaglQ_ River, A~aska 99577 2. TYPE OF RESIDENCE Single-Family,~ Number of bedrooms 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[}( Public [] Community [] Holding Tank [] Note: If oommunity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-825 (Rev. 7/88) Page 1 of 2 A. WELL DATA Well ClassifiCation Well Log Present (Y~) Total Depth L),/~, ! Cased to ~ ~ Static Water Level '~" J MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) MUNICIR~E ~K~.~qO~l~.~ R U A Ry 1984 ENVIRONMENTAL S E R Vt C E~ 4~$'¢l~¢j~J~J SEP 1 5 1988 RECEIVED ~ Date Completed d,~, Depth of Grouting ~ Legal Description: Casing Height Above Ground Electrical Wiring Jn Conduitd~N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot If A, B, C, D.E.C. Approved (Y/N) Yield o/c2~t. ~j:2,,~,~ ~ Pump Set At (--~---, Sanitary Seal on Casing~N) /v' Depression Around Wellhead (Y~ ; On Adjoining Lots / C)Z2 /'~ j ,~:~ I ; On Adjoining Lots .To Nearest Edge.of Absorption Fiel~.~,~//~ot To Nearest Public Sewer Line To Nearest Public Sewer To Nearest Sewer Service Line on Lot /~./~ Water Sample Collected by ~ ~l~'~:z-~,~J~ ; Date Water Sample Test Results ~F~~ ~ ~/~ Comments ~ ~ ~ ~-~--~e. B. SEPTIC/~ TANK DATA Date Installed ~'~'~'~7:~ S ze ,/~C)E2 No. of Compartments Standpipes~/N) f Air-tight Capsd~YN) F Foundation Cleanout Depression over Tank (Y/d~j) /"J , Date Last Pumped Pumping/Maintenance Contact on File (Y/N) . /J/.'~ ; for '"--'--- Holding Tank High-Water Alarm (Y/N) /,'~- Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well //f~ ! To Building Foundation TO Property Line . .. / r2 /'¢' To Disposal Field /'~ '(,' To Water Maj'~/.Service Line / ,~ To stream, POnd. Lake or Major Drainage Course / 42~ /~ J Y 72-026 {Rev. 7/88) Front Page 1 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. ~~k 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907)562-2343 FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SAMPLE for Work Order ~ 9054 Date Report Printed: SEP 12 08 @ 12:59 Client Sample ID:Li6, SEC 14 T1SN R1W SM PWSID :UA Collected SEP 6 88 @ h~s. Received SEP ? 88 @ 17:00 h~s, Preserved with :4 DEG, C Client Name : S & S ENGINEERING Client Acct: SNSENOP P.O.$ NONE REC'D Req ~ Ordered By Analysis Completed ;SEP 9 EE Send Reports to; Laboratory Supe~¥b~or :STEPNEN C. EDE 1)S & S ENGINEERING Released By Special Instruct: Chemlab kef ~: 2518 Lab Smpl ID: 1 Matrix: WATER Allowable Parameter Tested Result/Units Method Li~tts NITRATE-N 2.4 rag/1 EPA 353.2 10 Sample RON~INE SAMPLE Remarks: Tests Per£o~med See Special Instructions Above UA=Unavailable None Detected *' Nee Sample Remarks Above Not Analyzed LT=Less Than, GT=Greate~ Then