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HomeMy WebLinkAboutTHE LANDINGS BLK 1 LT 3The Landings Block 1 Lot 3 #020-061-10 M -W Drilling, Inc. *P.O. Box 110389+Anchorage, AK 99511♦ ♦907-345-4000 ♦ 907-345-3287 Fax* Job No. 12-107 GROUNDWATER WELL AS -BUILT & LOG Well Owner: Matt & Kim Lambert Use of Well: Domestic Legal Description: 16031 Hyannis Circle. Anchoraaa AK QQR1 A Block CONSTRUCTION Drill Method: Air rotary Hole Size: 6" Casing Size: 6" Cased to: 74.62 Material: A53 Well Completion: Open end x Screen Screen/Perforation description: Perforated Method: Hole Depth: 335' Wall: .250 Grout Notes: ( 3) Sack(s) of Bentonite Well Development: Air and pumping Well Disinfected: N Method: p� Yield test at 1+ GPM for 4 hour(s) with 100% of drawdown (DD) from static level(SWL). Method: Pumping Static Water ( L): 196' Start Date: 3/6/12 Completion Date: Test Pump Date: Final Pump Install Date: 6/12 WELL LOG Ak Gen Conk Lic No 1000 Mark Begich Mayor Well Drilling Permit Number: Parcel Identification Number: Legal Description Development Services Department Building Safety Division On -Site Water $ Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 _www.mun_ i G_g/onsite s n e r r (907)343-7904 Pump Installation Log Block Lot Pump Installation Date: Date of Issue: o_�, Property Owner Name & Address- %�r'Vl e:-t✓1n � l�'la'r%,e-W Lr�r�C,-1 i Lo3i d14 , z Cf. Pump Intake Depth Below Top of Well Casing: feet Pump Manufacturer's Name—Q), ame )�1 Pump Model: _ _ /D /o -f- �7� Pump Size hp Pitless Adapter Burial Depth: (4,.5 feet Pitless Adapter Manufacturer's Name: fy) S 3itless Adapter Installer: rf- � pr` 11, Nell Disinfected Upon Completion? ?9 yes ❑ No dethod of Disinfection: -om ments: .ump Installer Name: aL , to Q` ` .ompany: Tailing Address: ity: State: ttention: The pump installer shall provide a pump installation log to DSD within 30 days of pump installation. 10 SGS Ref.# 1121418001 Client Name Residential Testhug-Cash Account Project Nanrel# 16031 Hyannis Citnle Anch AK Client Sample lD 16.031 Hyannis Circle Anch AK Matrix Drinking Water Printed Date/Time 05/1112012 1 3 1 R CollectedDabe/Thne 05/01/2012 8:33 Received Dateffimx 05101P2012 9:30 Tectirdad Dtrector Stephen C. Ede Sample Remarks: Allowable Prep Arwllais .:.uta Raalts LCQ '� "..tLod Container IC Lnnirs Date Date Lu[ Metals by ICP/MS Arsenic ND i n0 ..g i. GP200.8 C (Q0) 05 03 12 05 04 12 ACF Waters Department Total Nitrate Nitrite -N ND 0.100 mg L SM21 4500NO3-F A (Q 0) D510 12 AYC Microbiology Laboratory E. Coli Negative I 100ml- SM21 922111 A 05 01 12 DLC Total Colifonn Negative I t00mI. SM21 9223B A 05 01 12 DLC On -Site Water System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP121023 Tax Code Number: 02006110000 Work Type: Well Initial Permit Effective Dates: February 29, 2012 to February 28, 2013 Design Engineer: Subdivision: THE LANDINGS Site Legal Address: THE LANDINGS BLK 1 LT 3 G:3235 Owner/Address: LAMBERT KIMBERLY & MATHEW 16031 HYANNIS CIRCLE ANCHORAGE AK 995164812 Site Mailing Address: 16031 HYANNIS CIR, Anchorage Lot Size in Sq Ft: 27079 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field N Septic Tank N Holding Tank N Privy Y Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Receivi Issued cbdet'�'i MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. #02G - 4(0/-/0 Property owner(s) Mailing address _ Site address % phone 9c? - 0 Legal description (Sub'd., Bloc & Lot) L \ ` L Legal description (Township, Range & Section) -T / I h) �� LJ 1 S E C-7. Lot Size -Sq. Ft. Number of Bedrooms 'J THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (® all that apply) Initial ElAbsorption Field ❑ Septic Tank ❑ Upgrade ❑ Holding Tank ❑ Renewal ❑ Privy ❑ Private Well Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 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. owner or Permit/Rush Fees: 4 .1oa to Waiver Fees: _ Date of Payment: C91OLCI 1Ia Date of Payment: Receipt Number: 63524D Receipt Number: Permit No. CL�l'Ot0�23 Waiver No. G.Muilding%On SiteTormsVient FormsTermit App_010411Aoc (Rev. 1111) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 284-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT DISTANCES 0 a o TO SEPTIC ABSORPTION WELL r e FRSM TANK FIELD WELL Permit No. No. o�tlrooms LEGALCESCRIPTION 3 LOT LINE ��— �. It -- Subdrv,,is��'vvn� /!? GBJJt//7CJ 5 FOUNDATION a rd. -- SEPTIC ❑ HOLDING rte/ v, 1 2 TYPE OF SYSTEM ❑ TRENCH V113ED ❑ W. DRAIN ❑ OTHER spin to pipe bottom from Total depth from original grade ,glnal grade „+—a Z:5FT .6P 11 added above original grade Gravel depth beneath pipe 072 FT Ot S ravel length Gravel width FT eo )lot absorption area Distance between lines I3 0 SOFT j umber of lines Soil falling Pipe material q' I e64-81) FT AP �3UU?4- staller a Y�'1L.a `cls Date Installs R1 v � WELLS PRIVATE ❑ OTHER (Idenliiv) REMARKS: N. ►1GGG'Lim auaiv: FV., e �.'7 ENGINEERS SEAL V .I spections Pmform0 Date: 'y ..+' V r�7� p J.� a' .• a ale®�� r vs0 vasM oeo 17034 Gaglo River Loop Road No, 204 Iflaur Musket 995P? cErllly Mxe) Int oapactl was.ptAsrated according [a all iii .....,, pqmunicipal and State guidelines in ellect sal this &te:yJR'� 'C�� 9 . A A. Ah Ga,C.il- /1�v®Lan7I% OI.�Lrte./..r./! at Health Department Approval: Date: 72.013 (3/86) V"�" MUNICIPALITY 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 O a 6, / - p O OM SEPTIC ABSORPTION WELL Address [FR7- —TANFIELD ELL �•�o 0LEGALGESCBIPTIGN Phonate) Permit No. No. of Detlrooms T LINE `-�-• Lot � Block J Subtlivis, n / L nc s� ! Township, Flange, Section FOUNDATION e� ` -t--. _•_ —v— AS -BUILT DIAGRAM tShow, location of well, septic system. property lines, foundation, driveway, water bodies, etc.) TANKS w -.d - --- SEPTIC ❑ HOLDING Manufacturer r Capacity in gallons /50 Material No. of Compartments TYPE OF SYSTEM 0410 ❑ TRENCH (BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from original grade C5FT Total depth from original g,.do FT It 7 _ N V Fill added above original grade FT Gravel depth beneath pipe �t S FT Gravel length / � 61 FT Gravel width 2� FT Total absorption area /2O Ci SOFTNumber Distance between lines _ ofof lines Soil rating ��SQ FT Pipe material ��'• Insfalle�-F"-''-+A-Y� Date Inslalle WELLS Ib? PRIVATE ❑ OTHER (Identity) e m O (,9 , 1 eel 027 Class,( cation (A,B,C) Total Depth FT Cased to FT Installer Date Installed: 19, \ G REMARKS: 7 ISE264 67 SGele: (. y ENGINEER'S SEAL lupections Performed tj Date: +y !�.'1• � : � t ���,�'� •aa �,, �� a �� .esa ae ae.n x r,. eke ;• —_ 9 -l- +alai A. Shwh;ra. No -P , ao 9 P°°O ea vv Ool• —Date. U 4nf'e. Rp oma. V I /"Vi-' `•-/� �V 1 R, 5 ENGINEERING 17034 [sRylo River Loop Road No, I �Q� ceruly IIT thlns�waspedormedaccordingloall Municipal and Stale guidelines In effect on this date: _ lfj� i Health Department Approval: �a-ur-rt � It 72-013 (3/85) ||UN1.1 .11 (-�L1|y UF oNLHUKHh� Department o| Hea1kh & Human Wervzces 82� L Street, Anchorage, Alaska 995^1 043-4/2o GN - SITE SEuJEP Permit Numher: 90()16Y Upgrade Date [ssued: 06/25/90 Engineer Designed ,Q \ Uwner Namo: RUN MDSHER Day Phone: Owner ��dress: 16031 HY0NN{G ClRCLE /H6 161/ ANCHDRAGE, AK 99516 farcei Id: O20-061-10 iot Lega1: Subdivision: THE LANDINGS TEND" Lot: 3 Block: 1 Section: 3 Township: 11N Range: 3W Lot Size 27079 (sq.ft. or acres) Max 8edrooms: This Permit: T Total Capacity: 3 TANI::�: Minimum total septic tank capaciiy: 1,000 gallons^ Each septic !ant mUsi have at least 2 compartments. Depth to top o; sepLic Lant(s) < 4.0 �eet requires insulation over tank(s). [NFURM U.|{.H,S. PRIOR TO INSPECTIONS BY ENGINEER, IF AFTER UF1 HOVRS, CALL 343-4601 AND LEAVE 8 MESSAGE^ WNSTRUCT PGR ENGlNEERS ATTACHED DIPSlGN, [ syn rL| A 7WO /2) FUOT s0NU FILTER 8ETWEE� 0-2 FEET 8ENEATH THE SURFACE OFTME GRUUND^ VERIFY INTEGRITY OF E:ISTING SEPTIC TANK. FHS PERMIT EXPIRES 12/31/90 MND VALID FOR A SINGLE FAMI|Y HOME, l CERT]FY THAT: 1. I am familiar with the requi,ements [or on-site sewers and wells as seL forth by the Municipality of Anchorage (MOA) and the State of Alaska, 2 T will install the system in accordance with all MOA codes and regu1ations, and in compliance with Lhe design criteria of 1his permit. 3. I will adhere to all MOA and State of Alaska requi,ements fop the set back distances from any existing well, wasiewater disposal system or public sewerage sys[em on this or any adjacent or nearby lot" 4. l understand that this permit is valid for a maximum of 3 bedrooms" l aiso unUerstand that the capacity of the total system is 3 bedrooms and any en1argement wi|l require an addiLionel pe,mit, INSPE CTION REPORT J f MUNICIPALITY OF ANCHORAGE INSPECTIONS 3500 LAST TUDORU �ING S (907)563-34AFETY DIVISION 5` 64 STREET ADDRESS LOT/ _LoK -OUNDATION -❑� FO-TiNG Q_ OND BEA{, El ❑ INSULATION _ ❑ SHEE7"ROCK _- STRUCT. FINAL❑ OT_HEe___ 777 O ��- —INFORMATION (907) 786-8271 PERMIT ,nom/PHONE`-J_ _ SUBDIV. /11t; ELEC, TEMP. -� /DATE ELEC. SERVICE LJElPLB. UNOGR, ELEC.ROUG . PLBG. ROUGH ELEC. FINAL'\ GAS TEMP. OTHER GAS MECHANICAL— FIRE FINAL ' - MECH. FINAL ZONIN❑ PLBG. FINAL_�� X _ NONCOMPLIANCE OBSE _� ❑ OTHER NON �-� RVED �� ❑ CORREC IT ONS p WILL REEXAMINE EXPLAINED OWE L AS _._N�NEXT INSPECTION BELOW COMMENTS _ �D0 NOT�CEAL UNTIL aFini�„�-__. ----��,otuALL FOR INSPECTION NS!TION 84-002(Bev, 11187) 00 NOT REMOVE THIS NOTICE Ux A LEGAL L0/ Z:5;, DRAWN VV. —y F /, -rHE CKD. i DATE 6//6 /90 E SHT. / O`/ L3 S�n Ai>>. 2.1 fid} WELL 9AD1U5—_a\ JtvELL y L— O� \ v I Q�oSSe� J 0 I (OD I PROTECT! VF_ WCL lRAOIU5 a ®� �aF 44,1 k o....e.....r..e..eyY+Y Municipality of Anchorage i DEPARTMENT OF HEALTH & HUMAN SERVICES ; •° ° °ie "°'"` 825 "L" Street, Anchorage, Alaska 99502-0650°°' SOILS LOG — PERCOLATION TEST 9 tte. layi•nr �� PERFORMED FOR: N 05V1C I�_ DATE PERFORM�i O LEGAL DESCRWTION:(p_�1lYK1. LAn.)C/r.Ic.S e h Township, Range, Section: 1 I ETI—� 7""� SLOPE SITE PLAN 2 3 \q C, � . 2e / 4 O \ '� ,r(�' O W M16* 5 O 6 .\ O \.8 O o 9 O O 10 0 11 12 � 13 14- 15 16- 17 -- 18-- 19- 20- COMMENTS 81920COMMENTS — WAS GROUND WATER ENCOUNTERED? is S IF YES, AT WHAT / L DEPTH?0 'nit -A 6F Z E lk� Depth to Water Aller t 1_—`' Monitoring? _ 57 Date: ![/J -::tip Reading Date Gross Time Net T me Depth to Net Drop -2-1 to 2Water l t{ 3 t t t� t �� 3 °1' — PERCOLATION RATE (minutes/inehh)) PERC HOLE DIAMETER TEST RUN 13ETWEEN _ FT AND / _ FT PERFORMED RY:17034 Eagle Rivet' LOOP KOad No. Eagle Riveas a g9S77-- ACCORDANCE WITH ALL STATE AND MUNICIPAL GUII 72-008 (Rev. 4/85) /( CER "IIFY THAT THIS TE T WAS PERFORMED IN ON THIS DATE. DATE: 7—' O cma� � Qn�fl ��E�auv IRCDUW0G SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 330 Teen. DRILLED AT THE RATE OF PROPERTY OWNER LOCATION OF WELL 9698.00 PER FOOT. n. Ron Olo4he& 978 Lt. j B tk. .I Su&. DRILLER _ BViate CtauA ol- RampVIt 171ti1.{.LAg Oonk'J. WELL LOG: 0----23r VJJaj rAn—'�' �'re 6- (2�� ---- --- �3� 7p-1LO1Gdpolt._�Sn.�o in,f_ yr.n(alrind 4�!-V r__ s4Aty._gAaae.L. 4036 .fin -160 len ono. �L_(e.IL_jarLea/zd. i.Q-', R �orlrmen_ Jul�2ck tr2tJt thin Cc�tie�rn r o.on�trnP _ 295_306' Sed imeat-;VL nock. _ 306--33Q-'—R wate�t becur a alWnttW6 Mack. Ponom 4Acifa 92 .to125 Xeet._ To.tat watvi, w_codw--ton. 4hau,W uteW 800 to a 2044tlr.Le 900 � fa l� rye�c 24 hotvz time �icarne. To tat waters 4 tand 2n, ca4,UW jhou td 4how ,to at .teat 5 feet of- 4w:�-ace. 2t t:he nate of, 9.6 gaL4 Rvc Ao-t. J'W)Lfi 4hotr td be .in,4 taU.ed to 90 feet. lata, coot of- D&ZU.uzry: ChaAqe on tty .ion 220 Tec t of 74-U'Uagg: 93960.00 u �p y� �, �A b COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING, WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF ---wa n0 THANK YOU VERY MUCH. [3E IE CLAUS OF RAMPART DRILLING WORKS DATE �> %8 \_ SERVICE CHARGE OF 1%% PER MONTH WILL BE ASSESSED ON PAST DUE ACCOUNTS. - SIX INCH WATER WELL DRILLED DRILLED AT THE RATE OF 345-1626 . PROPERTY OWNER A7 ,ciaoRAG:C, Ax.AsuA 344-7'714 OUT TO THE DEPTH OF U �-O .__ rJ 6� l _ / 0 5554. ?,3.00 _ PER FOOT. GLa�We' .dot 774 A OM4. & rrkj. Ron & XaTHZEen IWSgER 16031 l ann-Z4 cuLC. 99516 LOCATION OF WELL SITE a. 3 Btk. I Sub. Zc n d i n�s DRILLER BPh/7lD. CJni» a��/�(Ur� D2wJlwn9 GJok4n VVELL I..C)G: 0---330' OnZU-a.G OateA IJeU d& -ied 4cueta% 14 aga. Deepened PLom. 330 .to 555 A. P2adacti.on of .lit LtLa.L bJP-U CBed&ock_&&caen hole fAan 45 4) had dtopped aj .to mtn,unat., 330--555' Bedtaek. R .oedi&mtaAut Zack. new watyt vLeLd 4howinq Aon 468 .to 472 A. Thio anea..Lo a g4nw;tat & p.ctaLl4 bedAack. 4 good _ape IliallAJ. man.tl. a-tI1.PJL •tfLfJL aJLP_ad a gran Ua,t .type tock wh,tch 4houtd 4how tn.ctea4ed poteraW4 .dot wa,ten y,teLd. Thio 6JeU, 4hautd .fiu-&ea4e prod xUan, w40L u je. R hatdeA ntetanr.otj9 c bedrock .Lam. 515 to 555 PaA atea may, break .Lao.oe wi th wa-te& V,tebd w JL u4c a.E ldeU,. The ma,te4. aL uu4 a. good pa-ten.tia 1, Ovate t beaAtag. gtantUa& tock. lJate2 V Le l d a, taJL deepen aq .to 555 A 4hou,L pump 600 .to 800 gattanj alt wat.eA peri day.. (24 h4A.) TIUA wei)- 4hau,Ld ado double o� thcLt ptodtw Uon, w.Lth, uje o� hle-U ove t 4eue4a4, aton th4. MUNICIPALITY OF ANCHORAGE DEPT. OF FIEALTH & ENVIRONMENTAL PROTECTION Guvuye -%at 174 A oaiq.: 823.00 peh A X 774 .fit: 84000,00 `A41G 7 1990 RU. m0btLt5att0n & 4e.iu'&1A Zir L ed .ta -tlaA . oatage. w.6t. RECEIVED ECEI`/ED COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING, WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 84000.00 THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS DATE 7u4 17th, 9985 �./ "ten✓.-�V�-... SERVICE CHARGEOP IVa% PER MONTH WILL BE ASSESSED ON PAST DUEACCOUNTS. NAME �GRf E'ER ANCHORAGE AREA 130 HUGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS -3 /y - LOCATION G,*lG' .5��:,Ce,' /.//�/�G.��/� _ LEGAL DESCRIPTION- - x, SEPTIC TANK: DISTANCE OF FROM WELLi ANUFACTURE,D F2 �^� > >- NUMBER M —M`�/��_MATERIAL l'1L�FT'i COMPARTMENTS INSIDE LENGTH INSIDE WIDTH------ LIQUID DEPTH-,--'--'- LIQUID CAPACITY GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER OR WIDTH LENGTH_'��, DEPTH _ LINING MATERIAL �4 CRIB SIZE: DIAMETER Jl DEPTH _� DISTANCE FROM: WELL ao' ���it�� (f TOTAL EFFECTIVE BUILDING FOUNDATION JJ /, NEAREST LOT LINE -? ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: i TYPE _CONSTRUCTION BU I LI) ING­` FOUNDATION CESSPOOL NEAREST LOT LINE SOURCES APPROVED DISAPPROVED DISTANCES:=J'1«I/'J NEAREST SEPTIC SEWER),IIVE_ TANK_ REMAR DIAGRAM OF SYSTEM INSTALLED BY:llc1 <ocq rca/ PIPE MATERIAL: rr._ Pu 'cn .G Sar�lE �6nr(e/ LOT SLOPE: ,�/, 1.� ?T/ Ano REMARKS: iii 19./C2"LfifJ DATEiL ..fli121 Form No. EQ -031 r �7 /J [cF Cd/G� APPROVED^ G.A.A.B. DISTANCE FROM: fE,riklt is/>- , tel= Y\C v GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 IVITIUIIIVIiIUI�II�I%/)/) TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT NAME OF APPLICANT / %�A� A�J// c� MAILING ADDRESS INSTALLATION LOCAT LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED Z_L�C�-�' ✓ _ GIG',-+�C��� (J� i.� FINANCED THROUGH TO DE INSTALLED BY 7 solL resr RESULTS NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST /n COMPLETION DATE ANTICIPATED PERMIT NO SEEPAGE PIT >-<DRAIN FIELD OTHER— , FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. {(Q J („ _ (J TYPES ./�C<<J' Cr%iLC�LCC EEPAGE AREA SIZE SEPTIC TANK SIZE ZZ MINIMUM DISTANCES, REQUIREMENTS CI` J / FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT (LL/ DRAIN FIELD _JL} SEPTIC TANK TO SEEPAGE PITWALL_ SEPTIC TANK SEEPAGE PIT .4 J , DRAIN FIELD 1 TO NEAREST LOT LINE. ^''I WELL TO SEPTIC TANKp ��/U J' SEEPAGE PIT DRAIN FIELD C/-`) ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK —142 . SEEPAGE PIT O s DRAIN FIELD SEPTIC TANK, �CSEEPAGE PIT _L�, DRAIN FIELD / TO RIVER, LAKE, STREAM, CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL EACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. (,Gi>Ii,�2Fil.� G.A.A.B. OR LICENSED DESIGNER TYPE DIAGRAM OF SYST9M�1'C I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 2868 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE / '/ / APILICANT'S SIGNATURE Ae' (`e. e��"�L FORM NO. EO -816 7 C'i2F:k'Y�;It iu@CNO?r"`}: PJfi'A � �xip"6^4{ ftihL'Gtt �7EPhlT1;:N. �5�7 E;AGL4: ;,7, p+Rrforinvel tk or Mosher 6 Lonal, Descrip¢a'oni of 3 w i�c Wig+ �9 _ -, [late Nark',)rmno 1 may 74 ihir; Form Ralorsr. a: SoS1^ Suh i c: Landing Depth XX _..�.,, �.,_ _,4 rcoata`c: te., d.F sct soil Chnr,:cterivtica s The Gm was fairly com- pact with a moderate t( high cobble and boulder content. The Gm -Ml contact was fairly con- sistant with respect tc depth, 1�2 )J M1 Wag Ground 11at9r 911COunt ered7 Yes TY Yost At what Aopth et Readina propobod I Dept), Of I COMMENTS: If rw^<�«, ti� I,oC.a21c>) sketch Datet Gross Time I Not Time �JIJ Depth To NZn + Not Drop Fit Ur"n :'fe3<S XX Ueot7i ! o�5ot tom ""it Cr above the ,seven foot de.ptlr^ -a-*�.-�.�.. Test porfo y t'mtd A r Percco ,.. JkDC45 Certified & per: Mtcipty ®f circ,, '` °_� �''^+,� Department of Health and Humar. Services 825 "L" Street "; laYorOf11' P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 April 12, 1995 Keith & Sally J. Boggs 16031 Hyannis Circle Anchorage, Alaska 99516 Subject: Lot 3 Block 1 The Landings Subdivision Permit #SW940069, PID #020-061-10 The subject permit, issued April 11, 1994 by this office for a single family well and/or on-site wastewater system, has expired as of April 11, 1995. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as -built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and ' $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Sin erely, I J es Cross, .E. ' Program Manager On-site Services enc: Copy of Permit MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940069 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:BOGGS KEITH & SALLY J OWNER ADDRESS:16031 HYANNIS CIR ANCHORAGE AK 99516 PARCEL ID:02006110 LEGAL DESCRIPTION: THE LANDINGS BLK LOT SIZE: 27079 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 1 LT 3 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 2 DATE ISSUED: 4/11/94 EXPIRATION DATE: 4/11/95 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 1.5.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DIIHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THE "OLD" WELL AS SHOWN ON THE SITE PLAN MUST BE PROPERLY ABANDONED. THE "NEWER" WELL AS SHOWN ON THE SITE PLAN MUST EITHER BE PROPERLY ABANDONED OR CONECTED AND MAINTAINED IN SERVICE WITH THE NEW WELL. THE PROPERTY OWNER MUST PROVIDE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 A WELL LOG AND A SITE PLAN SHOWING THE LOCATION OF THE NEW WELL. RECEIVED BY: PAGE 2 OF 2 ISSUED BY: DATE: P Municipality of Anchorage -. Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St./ P.O. Box 196650 Anchorage, AK 995196650 �, www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-061.10 HAA# '114�Li�ig3 Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 3 Block 1 The Landings Subdivision . Location (site address or directions) 16031 Hyannis Circle Current Property owners) Robert C. Nauheim Day phone 345.6824 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 749 Ocean Yew Drive Anchorage, AK 99515 Day phone Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Three 3 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 fitle (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 private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work TYPE OF WASTEWATER DISPOSAL: ® individual On-site 0. ❑ Individual Holding lank ❑ ❑ Community On-site 13. ❑ 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 fitle (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 private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or 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 Finn Anderson Engineering Phone 522.7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 317/2002 rENGINEEq S 5. DSD SIGNATURE ©Q~ri� .• CE -4337 -' tll_*� Approved for 3bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: ' Lf 1 Original Certificate Date: 3 — / 4/'�- (Rw. tuo) 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 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: I at I Black *5 The I sridlngs 5-6divislem Parcel ID: A. WELL DATA Well type &drum If A, B, or C provide PW SID N Date completed 7/1711395 Sanitary seal (YM) Y Total depth eft. Cased to - A2.ft. FROM WELL LOG Date of test 7/17/10165 Static water level Irnknorm ft. Well production 56 9 -P.M. WATER SAMPLE RESULTS: Well Log (YM) Y Wires property protected (YM) Y Casing height (above ground) t -2a` in. AT INSPECTION _27 ft. M 9 - p.m - Coliform _a-colonies/100 mi. Nitrate 9 mg11. Other bacteria () colonies/100 ml. Date of sample: 3r =122 Collected by, ar., 1x-16 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SaptWbtmd Tank size -1,25gal. Number of Compartments 3 Foundation cleanout (YM) Y Depression over tank (YM) N Date installed 7/17/149n Cieanouts (YM) Y High water alarm (YM) Y Date of pumping 2nB�nm Pumper AG Aim's Eun4 C. ABSORPTION FIELD DATA Date installed 7/17/90 Soil rating (g.p.d./fe or fe/bdrm) 2B4 SF/BArm System type -nAdd D&I Length 64 ft. Width 2n ft. Gravel below pipe 5 ft. Total depth 4 ft. Eft. absorption area 1,280 ft2 Monitoring tube Y Depression over field N Date of adequacy test 2/ 912DO2 Results (Pass/Fail) Pam For 3 bedrooms Fluid depth in absorption field before test 5615 in. Water added475 gal. New depth& -5L55& in. Elapsed Time: L440 min. Final fluid depth 5/35 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) N If yes, give date l D. LIFT STATION Date Installed 7H811990 Size In gallons 250 Manhole/Access (Y/N) Y 'Pump on' level at 43 in. 'Pump off level at 39 in. High water alarm level at 48 In. Datum Bottom of Tank Cycles tested 5 Meets alarm 8 circuit requirements? Y E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot >100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main NIA Public sewer manhole/cleanout NIA Sewer /septic service line >2S Holding tank NIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field >5' Water main NIA Water service line >iW Surface water MOT Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >IV Water main >10' Water Service line >10' Surface water MW Driveway, parking/vehicle storage >25' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION �P;•' ''.jsfad� I caddy that I have determined through field Inspections and �' � 49 *0 review of Municipal records that the above systems are in a conformance with MOA HAA guidelines in effect on this date.Ir Engineer's Printed Name Michael E. Anderson, P.E. 10d si =SSR a I Date 3169M y�E�t�o �4•.•''v; HAA Fee $ zi S • o o Waiver Fee $ Date of Payment /bob Date of Payment Receipt Number l % D r Receipt Number (Rev. 12/00) March 7, 2002 Municipality of Anchorage Building Safety Division On -Site Water and Wastewater Program 4700 S. Bragaw Street Anchorage, AK 99507 Attention: Jeff Poet Subject: Lot 3, Block 1, The Landings Subdivision Certificate of Health Authority Approval Well Flow Dear Jeff: The well on Lot 1, Block 3, The Landings Subdivision was originally placed to a depth of 330' in July of 1978. Water production at that time was estimated at .7 gallons per minute. The well was deepened to a depth of 555' in July of 1985 in an attempt to increase the water production. Unfortunately, later flow tests concluded the production did not increase. A test completed in July of 1992 indicated a production rate of .3125 gallons per minute with the pump in the well set at 490'. Sometime after that date the pump in the well was replaced. When the new pump was returned to the well it could only be placed at approximately 160' below the surface due to a blockage in the well. Our testing indicates the pump is set near that depth today. A well flow test was performed in August of 1998 produced a reading of .39 gallons of water per minute. Our test completed on March 4, 2002, indicated a production rate very close to .39 gallons per minute, but the static water level was found at 62.7'. The pump automatically shuts off when the water in the well reaches a depth of 158'. We cycled the well several times to arrive at a consistent water production rate. It is obvious from our results and those achieved in the past that this is a very marginal producing water well and should be noted as such. .Although the well production rate is marginal, it does meet the Municipal requirement of .312 gallons per minute. Sincerely, Municipality of Anchorage •• ••, Development Services Department Building Safety Division ..... On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchomge.ak.us (907) 343-7904 Water Well Advisory Health Authority Approval # 020083 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block 1, Lot 3 of The Landings subdivision, the well's productivity was determined to be 0.35 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA#�L�L 1 Lot 3, Block 1, The Landings Parcel.I.D. # 020-061-10 `r 1. GENERAL INFORMATION Complete legal description Location (site address or directions) 16031 Hyannis Circle, Anchoraqe, AK 99516 Property owner ei.th t3oggs Day phone — 257.3 7 8 3 Mailing address, '1.16031 Hyannis Circle, Anchorage, AK 99516 `"lending agency;_ _16s, n_uSAL.Tnn ___ Day phone 1s&2Bnn "'Mailing address PO'Box 196613, Anchorage, AK 99519 :t Agent, Qnnaie_1idxriaZE •une Properties Day phone 227=0921 Address2525'C Street, Anchorage, AK Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: _ -3 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attestr ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site —� Public sewer --_ NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72.025(Rev.1/81) Front MOA#21 - - S. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S& S ENGINEERING Phone G y- ;L -Cl 17034 Eagle River LOOP 7 q Road No. 204 Address Eagle River, Alaska 99577 Engineer's signature Date 1/1, �9Y 6> DHH6 SIGNATURE Approved for Disapproved. �i ROBERT C. COWAN J�Q Cifr\ CE -8801 �J�Z.: i, ICV �C,--- iH.B E E bedrooms. Conditional approval for Additional Comments bedrooms, with the following stipulations: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M (BW. V87) Back,-MOAM IV l -i • Municipality of Anchorage SEP 16 1998 DEPARTMENT OF HEALTH &HUMAN SERVIGEr.61aNnury of ANCHOR/ Environmental Services Division "'°' NkAPN1"r srevicF nn, 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: L0 )` 3 9ocK, I =/ � L�J,vpr�wl parcel LD.: O a 0_0 6 A. WELL DATA Well type P 01 \14 r 4- If A, B, or C, attach ADEC letter. ADEC water system number Log present (tl}'N) —'Y k -:S _o Date completed ft6r6N * ° 7/17 / 9 S` Total depth S S / Cased to _ 2/t7 f _ Casing height (above ground) Sanitary seal &N) _%� S _ Wires properly protected &N) _ yf J' Date of test Static water level Well production FROM WELL LOG 7/ryld'S- v / is 6 0 0 - V-0 o WATER SAMPLE RESULTS: .g,p-rrr AT INSPECTION i G ` OOSSIOL4 0'3s74vor..d) �- 6. 3 C) g.p.m. Coliform 0 _ Nitrate _ (9 ' 1 _ Other bacteria Date of sample: I `I _ Collected by: _ S & S ENGINEERING 17034 Eagle River Loop Road No. 204 B. SEPTIC/HOLDING TANK DATA Eagle River, Alaska 99577 Date installed_7 I y I 10 Tank size > S Number of Compartments _I Oleanoutsq?/N)_ Y -:1' Foundation cleanout (Y/6' -I- o r ia­� 0 Depression (Y/fi)) v 0High water alarm (WN) r 4-' 5 Date of Pumpirfg Pumper 1+-4- yo wf ,S4, x✓ ci`5 C. ABSORPTION FIELD DATA Date installed —1 7 I"1r? Soil rating (q.p.d./W orL _ dD D' `� -System type. Tf Length_ G 41 / —Width_� o Gravel thickness below pipe. o - S Total depth Effective absorption area IV 0 �, Monitoring Tube present O/N)Y4 S Depression over field (YO) w o Date of adequacy test _ S._ 9 4 _ Results assf all) _ �4 s S o For -_ 3 bedrooms f Fluid depth in absorption field before test (in.); _bA y Immediately afterj3 o I gal. water added (in.): _w_ Fluid depth PAI (ins) Minutes later: a o Absorption rate = Peroxide treatment (past 12 months) (Y/N) _ Ivo�� k ­w,.il If yes, give date _ 72-026 (Rev. 3/96)* D. LIFT STATION Date installed 7 O Size in gallons O Manhole/Access (6N) Yui 1 "Pump on" level at* (7 a "Pump off" level at* G High water alarm level at* S r 7 *Datum Cycles tested 3 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot /00 ' + Absorption field on lot Public sewer main Sewer /septic service line 0 J 4 - TLP 0r 1a lf. 14a�4- On adjacent lots On adjacent lots N / A Public sewer manhole/cleanout i /vv � i aJ 4 i Lift station I D o SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: I r Foundation S fi Property line S' � Absorption Water main/service line --L0 '} Surface water/drainage /00 r- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: r Property line / d P Building foundation / O Surface water ?00 Curtain drain N d^ K No w N F. ENGINEER'S CERTIFICATION ,%� /u 5' / U 0 -/ Water main/service line Driveway, parking/vehicle storage area 20 _ Wells on adjacent lots / d o I certify that I have determined thru field inspections and review of Municipal in conformance with MOA HAA 9 Veline fn effect on this date. Signature Ivo 4 Lal✓"— Engineer's Name )C d a 6R C. Co 4,4"' Date `1 h t, /C) B HAA Fee $ :Z 6 p Date of Payment //�Z/� / l Receipt Number /-1 -, l c� h I 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number T ROBERT,C. COWAN GFS 8801 ° •.i e�4, are MUNICIPALITY OF ANCHORAGE M E M O R A N D U M WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO. 14A 5 S 02 V During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Lot Block of 'F1 4j9NDiniGs Subdivision, the well's productivity was determined to be 4.359 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. HEALTH AUTHORITY APPROVALS SEWCR & WATER MMNEXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELL INSPECTION & FLOW TEST SITE PLANS 80ADOESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN s&s� �(neeninG WELL FLOW TEST DATA CLIENT: K.Icr/4 99&6,3 LEGAL DESCRIPTION: Lo T_ WELL DEPTH: s-4— DATEDRILLING CgMPLETED: .1 6 LL 0 (. < I i- t/ CASING DEPTH: Y D 74- i l � l % Sls >LMnlvtq DRILLER: ROBERT C. COWAN, PE. ROBERTA. SHAFER, P.E. CIVIL E140INEERS (907)094-2979 FAX (907) 694-1211 DATE: $/ S- /q 5 M P.y •tiT' I MISC. DATA: CASING HEIGHT: -I' SANITARY SEAL: S WIRES IN CONDUIT: 'Y C , T"ti4ot�'d,,.+Iy1GRADINOO.K.: NJ ._ L'�L, aLn.4hr+roN BACTERIA AND NITRATE SAMPLES COLLECTED (date): TEST DATA: CLOCK TIME METER READING (GAL) PUMPING RATE (GPM) DEPTH TO WATER (FT) "EMARKS Io 0 1s-Igcl1) sWl -- J j S y Ql c. 77-6 Vic— T a. S'G.4l�/Ii31 n..v i V i`I 4 d N 0. ja'.3� 17.38 n M19 (41Z I y 3 G ("1L /,s -M, (7. K 0 IOGSSI /d b/c 0✓SSiRvc->Io,� RESULTS: WELL CURRENTLY PRODUCES C9. 3'1 GPM WITH A DRAWDOWN TESTED BY: go A C FLOW RATE NOT GUARANTEED --SUBSEQUENT VARIATIONS CAN OCCUR, 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, AL.ASI(A 99,577 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99:119-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # CY-AD-_\0 1. GENERAL INFORMATION HAA# iJt7a�ll 1�`� Complete legal description L -0-T- 3.1 I sosDIvtSIUA1 Location (site address or directions) 16 0 3 ) I I`/ 4 N N 1 12C L -F_ ACJ C A-iAs tt- �I c1 Sl Property owner Mailing address Lending agency Mailing address Agent ti V WA -i, 6Z � SA-LLl4 Jlra wEJ+-DeAj Day phone 34'S" 3n37 ILO 3 I 4'-r AN tj 15 C 12 -CLQ ) A -j 614 • Ak. Address N A/ /A• NIA Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OI: WATER SUPPLY: Individual well Community well Public water 3 \IJ Day phone ^f /q, Day phone 1,114 NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1191) Front MOA 921 -P 95/ 4, 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. 5 &ZV I c-aS Name of Firm AU\ -SYS w��f-2� w�S1�w>9 phone 3-7 7-6 Address 8 4 1 1 Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments M =z/bedrooms. 1I ITW cH Date OF AlJe rey A, Garnets We CE -7953 4�®o ROf E S S10N� bedrooms, with the following stipulations: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7M25 (Rea 1/91 Back MOA 1121 Municipality of Anchorage Department of Health & Human Services IC ryh V C D HEALTH AUTHORITY APPROVAL CHECKLIST V L l� I_OT' R IFRIG aL Legal Description: CaAA Cam L,40w(- S S/p Parcel I.D. JUL% I�9� Municipality of Anchorage A. WELL DATA Dept. Health & Human/7gervices Well type P21UA � If A, B, or C, attach ADEC letter. ADEC water system number �r Log present (Y/N) \4fa Date completed A /7 OF Driller �AMpA2�, Totdl depth ! SG75 Cased to ?'3a / Casing height +� \� Sanitary seal (Y/N) ���' Wires properly protected (Y/N) _yam ..i ( FROM WELL. LOG AT INSPECTION O Date of test _! /� 95— 7 �v Static water level UNV-A0VJIli _ d91 Pr. BF-Low -MP CA;106r cl + OWell flow g.p.hi. .3125 g.p.m. / y}R6wAd WELL Pump level��14JoyJrJ _UNy'.rJOWIV Rua- BE1-+0-vc:.0 4a B- CZ 4--f O FF�— 4 SEPARATION DISTANCES FROM WELL TO: O a 2 Q Septic/holding tank on lot 153 FiEl" 1 On adjacent lots > IOU �( (C)3' To Cucs�asr C/� o 04 � On adjacent lots' > 1 oe S� GovYR Absorption field on lot 3 2i nv Fozcc r�nw J Public sewer main oN 2A°61rav1SK R°public sewer manhole/cleanout N/� Z Sewer service line > 25 $+fl&5 Petroleum tank OVPF_ 035�Vay • ow ti 31A - IND+C11-"r T14,F" APE NO 7AJK.s n WATER SAMPLE RE ULTS: 0. o, Coliform — Nitrate — ) M h Other bacteria go Date of sample: % /� 9 Z Collected by: 6' vasS 1 o B. SEPTIC/HOLDING TANK DATA I • P Sy/ f ��.NGtHD2AC 7 J Date installed 1$ 9n Tank size 12ay 6j0r� Compartments 7�1�10 7 � SFS' cr>vE2. S (4 Cleanouts (Y/N) Y _ Foundation cleanout (Y/N) �� Depression (Y/N) A1C Ia High water alarm (Y/N) ---Alarm Alarm tested (Y/N)� Q Date of pumping Pumper _ A + X SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: 515,r- eoy Well(s)onlot 1S.2> Onadjacentlots >-;�/00 LLL n-�FI�O Z� Foundation- To prop ndation Toprop/g Fli� Sol'fr� t ouF5DVUp+E Surface water/drainage NONE- OBS&JZV_ 'PCR, ( 63 Sff� E)N P.XPoIL'> 7/10/9 o 72-026 (Rev. 7/91) Front /+ ! CONTINUED ON BACK PAGE Z. pE1z. SI'�"E- VISIT ON 711-1/c,-Z. `1 q2., C. LIFT STATION CS't Date installed 7Z 10/90 Manufacturer /�r�GHaf�AC 1�K Size inZ gallons ManhoWAccess (Y/N) V E S Vent (Y/N) "Pump on" level at 35 "Pump off' level at 3 High water alarm level YF_ S Cycles tested Meets MOA electrical codes (Y/N) y a S SEPARATION DISTANCE FROtFT STATION TO: O 2. y SFf co Well on lot 16 SET On adjacent lots _>> 100 t� Surface water D. ABSORPTION FIELD DATA NON'S 0$SEQvJ510 0 Date installed/y8/9D Soil rating 2/'B� System type MOyND Q Length 64 FT Width 20 FT. Gravel thickness /r © Total depth 31 6 7r z 12P�t� Total absorption area Fi•z Cleanouts present (Y/N) Depression over field (Y/N) N O Date of adequacy test _ I 7 9 2 Results (pass/fail) Pp. -&S- forte bedrooms Peroxide treatment (past 12 months) (Y/N) N / A If yes, give date NI(Q SEPARATION DISTANCE C1A5as B$QRPTION FIELD TO: / 5� co�Q r C� Well on lot 103 c/u o� "F -LD On adjacent lots too ��P� party line si=r- r 20\3 To building foundation �^ I2 To existing or abandoned system on lot YNkNOWIQ N/A5��� oPPosi1 5)n&5 On adjacent lots Cutbank �P` Water main/service line Surface water t,)DWE Driveway, parking/vehicle storage area �U FF%iO Curtain drain N/� (� Pi^..1Z. Int S P&,c7ll7� RS-Po(L9'- P&1'7//6/9i) P E. ENGINEER'S CERTIFICATION � S t� V I S Cr 7/t -7/`%Z 1 certify that I have checked, ver' ' , or conformed to all MOA and HAA guidelines in effect on the date of this inspection. OF .° Signature Engineer's Nam A. Date 7f 2 -2, ey A. Garnets W �9 CE -7953 HAA Fee $ Date of Payment " Receipt Number a 3 %""q / 72-026 Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number Alaska Water 8c Wastewater Services "Preserving the Last Frontier" July 237 1992 R E CEIVEED JUL 2 71992 Municipality of Anchorage Municipality of Anchorage Department of Health and Human Services Dept. Health &Human Services Division of Environmental Services On -Site Services Section P.Q. Dox .196650 Anchorage, Alaska 99519-6650 Ref: Health Authority Approval. (HAA) Application for Lot 3 Block 1, The Landings Subdivision To whom it may concern: 1. SEPTIC SYSTEM ADEQUACY TEST: Water was introduced into the clean --out, located at the southeast; end of the bed, at an average rate of .77 GPM for a total of 600 minutes (462 gallons). The water level in the system was monitored with a float located in the monitoring tube at the northwest end of the bed. During the test the water level in the monitoring tube did not rise, or fall, indicating that the system was absorbing the water at a similar rate. Based upon this, the system was deemed to be adequate for a three bedroom house (450 GPD). 2. SEPTIC SYSTEM IS NOT LEVEL: During the site visit i,t was rioted that there was no liquid in the monitoring tube Located at the southeast end of the bed, and there was 6" of liquid in the monitoring tube located at the northwest; end of the bed. This difference was noted throughout the adequacy test. After the adequacy test, I ''shot" the elevation of the clean -outs and monitoring tubes at each end of the bed;, and found the clean-out at the north end of the bed to be 6" Lower than the clean --out at the south and of the bed. There was a 9" difference in elevation between the two monitoring tubes, the south, again, being higher. I contacted the engineering firm which did the inspection of the system installation in July of 1990, "S & S Engineering", and asked them to make a site visit and give me their professional opinion. A copy of their brief response is attached with this letter. According to Roger Shafer of "S & S Engineering", the sand bed has settled 6"- 12", but: the integrity of the system does not appear to have been effected. I disagree with this conclusion, and it is my opinion that the sloped piping will reduce the life of Telephone - Fax 3380246 • 8471 BrookAdge Drive 0 Anchorage, Alaska 99504 the mound system because the continual. saturation will. not allow it to "breath". Consequently, the biomat will -for -in more quickly and the system will fail progressively from the north end to the south end. "rhe buyer of the home should be aware that the life of this system will be reduced due to this condition. 3. WELL ADEQUACY TEST: An adequacy test was run on the well by pumping „77 GPM (average Flow rate) Por a total of 600 minutes. The total volume pumped was 462 gallons. The static water level, at the beginning of the test, was 291 feet From the top of the well casing. The drawdown on the well at the end of the adequacy test was somewhere below 400 Feet from the top of the well casing. The actual extent of the drawdown could not be determined because the cable on the well sounder was only 400 feet long. I waited until 24 hours had passed since the well test had began and measured the well recovery. It had only recovered to 383 Peet however, the homeowners had used an estimated 50 gallons in that time period. At this point it was clear that the well recovery, in this range, was inadequate. Consequently, T decided to draw the wel..1 down to the pump level (490 'feet), monitor the recovery, and try to Find if there is a range in which the recovery rate exceeded .3125 gpm (as required for a 3 bedroom house). This required that the cable on the well sounder be lengthened to 500 feet. The data Por the drawdown and recovery is as follows. DRAWDOWN_ Time (minutes) 0 1 2 :3 4 .10 15 20 2) 30 40 50 Volume pumped (gallons) 0 6 12 17 22 27 44 59 74 88 101 1'26 146 Drawdown (ft.) 379 pump off 379 pump off 379 pump off 385 not measured 392 405 417 428 438 451 470 480-1, hit obstruction Pump? WELL RECOVERY Time (minutes) 0 5 10 15 20 25 30 40 50 60 70 E30 90 1,20 150 ;1.80 390 42_0 Well drawdown 480+ 480 478 476.5 475 473.5 472 469 466 463 460 not measured 454.5 446„25 439.25 432.75 398 395 Attached is a plot of the well drawdown and the well recovery. It can be seen that when the well is drawn below 450 fleet, the well is recovering at a rate slightly greater than .3125 gpm. in short, the well meets the requirements for a three bedroom house (.3125 gpm), but only marginally. This is consistent with the results obtained by "S & S Engineering” in 1990, of 19.2 gph (.32 gpm). Since the well. is 555 feet deep it would be possible to lower the pump from its existing elevation (490 feet) and Perhaps obtain "a slightly higher yield. Regardless, the existing well i:: - probably inadequate to meet water• demands 'for washing cars and watering lawns unless a storage tank is installed. In addition, it is imperative that any potential home buyer be aware that the flow rate of this well can change over time, and may in fact fail to adequately produce at some future date. 4. SEPARATION DISTANCE TO WELLS AND SEPTIC SYSTEMS ON ADJACENT LOTS:. Due to the large lot sixes, I'only verified that the separation distance from the well to the closest septic system (holding tank on Lot 6, Block 1, The Landings S/D) was greater than 100 feet. In addition, the closest well to the septic system is the well on Lot 1, Block 1, The Landings S/D. This distance is over 200 feet, consequently, it was only field verified to be greater than 100 feet. The closest septic system is located on Lot 1, Block 1, and is perhaps over 100 feet from the septic system on my clients lot. Therefore, the separation distance was noted as not; applicable (N/A). 5. FOUNDATION CLEAN-OUT: `rhe "Foundation clean-out" is located right next to the .septic tank rather than being located within S feet of the foundation. This was approved an the initial inspection report dated 7/18/90. 6. SEPARATION DISTANCE FROM ABSORPTION FIELD TO PROPERTY L.INE: Since the absorption field is buried, and the property lints were not Flagged at the time of my inspection, it was not possible to verify whether the 10 'Foot separation distance to the west property line has been met. This distance should be verified on the as --built survey it one is performed for this pending sale. If a survey. is not done, it must be assumed that "S & S Engineering" accurately documented the separation distance in their inspection report. If this is not acceptable to the home buyer, the lot line must be flagged by a surveyor and the separation distance to the buried drainfield estimated. If you have any questions regarding contacted at 337--6179„ If all goes NAA to the homeowner. Thank you. Sincerely, 7e G'ey A\ C�(�rn©ss, P.E., M.S. Oi er/Consultant ;JAG/.Jag Walkerl.wps this report, well, please I can be mail the U TO: 10 HEALTH AVTMCRITY ROADOEWUN ENa NIVIINO STUDIES STRUOTURAL& APPROVALO AJDREPORTS MEOMANIOAL MSREOTI" W SfwERd WATER VJIL YEBT WFLLIOMIVU iON ON SITE WASTE WATER MAIN EXTENSIONS 6FLOW TEST D141P08AL SYST8m G891Oe BEWERLWATER PERCOLATION SITE PLANS BURVEVB INBPEOTIDN TEST FACSIMILE MESSAGE FROM;"1,;�?'c� S & S ENGINEERING 17034 N. EAGLE RIVER LOOP ROAD SUITE 204 EAGLE RIVER, ALASKA 00677 TELOPMONE (007) 094.2070 FAX NUMBBI (90 7) 694 121 1 NumgE�raf 1 ,. 1 (Including this hla on ono) * MESSAGE * I as &y:;r 1--� 1 1" I , -njr, it. ROBERT SHAFER. P E. ROGER SHAFER. P.E. CIVIL ENGINEERS September 4, 1992 (97) 694 2 7g FAX 694 E9CF rrivc n. n_NswP RECEIVED Dan Bottea HEALTH AUTHORITY APPROVALS ,, 0 " tcta SEP r Municcpay o6 Anchorage 8 EP DEPARTMENT OF HEALTH AND HUMAN SERVICES 1992 825 L Street Municipality of Anchorage P.O., Bax 196650 Dept. Health & Human Services SEWER &WATER Anchorage, Alaska 99519-6650 MAIN EXTENSIONS REFERENCE: Lot 3; Block 1; The Landings Subdivision; Dean. Dan, SEWER & WATER INSPECTION This letter i6 to advise you o6, and detail, .the repai)ts reeentey made to the septic system 6erving .the re6ereneed property., Starting 6rom .the north end o6 .the leaeh6ietd bed, .the coven oven .the ENGINEERING STUDIES sy6ten was removed to .the depth o6 .the di6tLibution pipes., Excavation AND REPORTS o6 the cover over .the leaeh6ield dist4ibution pipes was continued untie approximately three-6owctk6 os the bed was exposed.; Elevation mea,smement6 were taken and we bound .the distribution pipes in the north one-third o6 the bed had settGeed out o6 level. With ,the WELL INSPECTION r instaUation o6 additional sewnock the dstn,ebutcon pipes were & FLOW TEST leveled again. We suspect .the cause o6 6ettZing i6 due to .the current dosing point o6 .the leaeh6ield at the bar end o6 the bed. There6ore, at .this time we SITE PLANS disconnected the piping 64om the U6t station at the mani6old and continued it across the top o6 .the bed. We .then reconnected .the intet pipe approximately 20 6t. 6rom the south end o6 the bed. At this point a section o_p-e,r4D-4aced___di6t,Libu.tiQn-.p,.pe was r�2aeed_with solid pie ROAD DESIGN to act as a mas oldor the ineetpi�ng. T e xi.6.t station pump was then operated to .test the new p�pcng and dist)Libuti.on., Sewer )Loch was then placed back aver the bed a6 weU as in6ulation and bitter 6ab&ic., The system was then covered with Boit and regraded. SOILTEST With the dosing location nearer the center o6 the leaeh6ield bed we suspect the previously experienced problems o6 distnibution piping settlement is minimized and po6sibly alleviated. PERCOLATION TEST 16 you have any questions, please heel Gree to contact me. Sincerely, STRUCTURAL& MECHANICAL INSPECTIONS ROGER J. SHAFER, P.,E. RJS/gm ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 L 3,dl L,a,/W, P5 MUNICIPALITY OF ANCHORAGE ,} O Department of Health & Human Services y r DIVISION OF ENVIRONMENTAL SERVICES dr)343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D.# nrn C1nI- It) HAA# �Ac1 r- -'�:)q1� 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 3• Block 1: The La"dinas Subd vfGton Location (address or directions) (b) Property owner Ron Mosher Telephone : (home) Business Mailing Address 16031 Hyannis Circle, Anchorage, Alaska 99516 (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent 2001 REALTY/Pete Kalamarides Address 2600 Denali, Anchorage, Alaska 99503 Telephone (e) Mail the HAA to the following address: (or check here KI, if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING/694-2979 17034 Eagle River Low Road Sutra 204 _ Eagle River Alaska 99577 2. TYPE OF RESIDENCE Single -Family K) Number of bedrooms 3 3. WATER SUPPLY Individual Well A 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 K) Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 1,e9) Page 1 of 2 Z to Z abed §0e9 caea „ee, szo-u Niom s,aaau!buo euoissaloid aql ui suoiss!wo ao sioije aol alq!suodsaa lou si a6eaogouV to /1!led!o!unw og1,ponssi si aleo!l!laao a ejolaq elep azAleue ao suo!loadsuilonpuoojou opSHHOlosaaAojdw3 sluawaa!nbeialelspue leaapalu!eliaolls!lesoljapiou!suo!lnl!;su! bu!pual i!a4l pue sawo4 to saasegoand of Asolinoo a se s!ql saop SHHO 94l 'e>IselV 10 alelS aql ul paaals!bei aaau!6ua euo!ssaloid luapuadapu! uv (q anoge 9 gdei6eied u1 u9A16 suoileluasaadai aql uodn Aluo paseq poleoippoo lenoaddV Al!jo41nV 411eaH sonss! (SHHQ) saoiAaaS uewnH pue glIeaH to luawliedaO a6eaogouy to Al!!ed!piunw ag1 NOIIf1Vb IenoaddV leuo!l!puo0 to swial leuoil!puo0 panoiddes!Q------ —panoaddV ale(] ,(q swooape - <H aol panoiddV 11 IVAOHddV SHHO '9 auogdaal algia LLS66 ejsalV'aeA!21®iGeg oa t ssaippV ON12133NION3 S'8 S waid to aweN uo!loadsui s!ql 10 alep a41 uo loalla ui suollelnbaa pue 'saoueulplo 'sapoo ale1S pue Iedio!unw Ile ql!m aouugdwoo ui si walsAs lesods!p aaleMalsum to/pue AIddns aalem al!s-uo oql 'uo!loodsui pue u011e611sanu! (w wojl pue sa q a6ejo4ouV to (1!ledio!unW aql woal pau!elgo uo!lewaolul a4l uo paseq leyl ,(luaA aaglanl I •u!aaa4 poleo!put ainlonjls to adAl pue swooapoq to aagwnu a41 Aol alenbape pue leuo!lounl 'ales si welsAs lesods!p aalemalsem ao/pue Alddns jalem alis-uo a41 1E41 SMOLIS lenoaddV Ajpo41nV 4lIEaH si4l to u0ile61lsanu! Aw 1e41,(l1a9A I 'molaq uMo4s olep uollep!IeA aql to se pue olaaa4 pox!lle eas Aw Aq paipliao sV NOIIVW803Nl (INV VIVO 'HOUV3S 3'lld'SIS31 'SNOI103dSNl `JNIOIAOad W813 JNI833NION3 '9 O�PG4/q� MUNICIPALITY OF ANCHORAGE (MOA) �Health AtNhority Approval (HAA) CHECKLIST - FEBRUARY 1984it l\ o��E 343-4744 J�\L�Q��C,�p� Legal Description: 3 C�L'�- j O' i 11 A�WELL DATA ��` ��Ol Well Clas�fstion (t-� If A, B, C, D.E.C. Approved (Y/N) N a, Well Log Present (9N) _ Date Completed 7 - 1-7 - 8a Yield Total Depth SSr Cased to Depth of Grouting Static Water Level 2 - Pump Set At I / Casing Height Above Ground _ 10 -k Sanitary Seal on Casing�DN) �4— Electrical Wiring in Conduitd'N) SEPARATION DISTANCES FROM WELL Depression Around Wellhead (Y4W r To Septic/Holding Tank on Lot / Pn 4 ; On Adjoining Lots / C -)[::)I./ - To Nearest Edge of Absorption Field op L.ot / OD / •P ; On Adjoining Lots / To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole —14 A I To Nearest Sewer Service Line on Lot Water Sample Collected by `�' 5 �//�E ��� ; Date 13 X70 Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA s y cTr_J� Date InstalledSize No. of Compartments 2— Standpipes69N) --Y--Air-tight Caps ON) _ � Foundation CleanoutgVN) Depression over Tank (YLND —)Date Last Pumped %✓��✓ Pumping/Maintenance Contact on File (Y/N) /A ; for / Holding Tank High -Water Alarm (Y/N) /'4 IJA Temporary Holding Tank Permit (Y/N) �'A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply LoI //' / r pp y Well To Building Foundation � L I r To Property Line /� / l o Disposal Field To Water Main/Service Line � b r� To Stream, Pond, Lake or Major Drainage Course Comments 72-026 (Rev. 7/88)Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 2 � Type of System Design Date Installed -7-10—Jo Length of Field Width of Field Depth of Field Gravel Bed Thickness U)-1 Square Feet of Absortion Area Zgp Statndpipes Presento/N) Depression over Field (Y/6P I�1 Date of Last Adequacy Test N 1A Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD To Water -Supply Well % CC) � To Property Line 10i To Building Foundation lr_w> To Existing or Abandoned System on r Lot /o ; On Adjoining Lots V - To Water Main/Service Line o (� To Cutback (if present) W ,A To Stream, Pond, Lake, or Major Drainage Course I/ r:>o /.A To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed ./ g - 94) Dimensions / Z 5_0 (5;Al-• Size in Gallons ST Manhole/Accessil!Rd) . "Pump On" Level at 3 'Pump Off' Level at 0 High Water Alarm Level at `No Vent�N) `/ Tested for �/7� -- l/ r—w sy-5 �� Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (YEN) Comments "`Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in inspection. Signed S &y_ENGINFERING Company '17034 Eagle River Loop Road No. 204 Eagle River, Alaska Date MOA No. a o 8Ei Ca 00 Receipt No. /\ Receipt No. v Date of Payment �7 Waiver Fee: $ — Amount: $ / % 0— 0 Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 this �eea+Fenga p), 5heot: .fin^y��Ll