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HomeMy WebLinkAboutSKYWAY PARK ESTATES BLK 5 LT 45 kyway Park Estates Block 5 Lot 4 #019-151-16 Municipality of Anchorage Page 1 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW0001 33 PID Number: 019-151-16 ' : Name7o Wastewater System: ❑ New MI Upgrade ger Wirch Address:ABSORPTION FIELD P..O. Box 110348 Anchora e AK 9951 Phone: 344-7574 No. T of Bhree edrooms:3) T ;U Deep Trench D Shallow Trench 'D Bed D Mound D Other LEGAL DESCRIPTION Soil Rating Total DePitofrom original gratle: .6 GPD/Sq. Ft. Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe 4 5 Skyway Park Est. 3 Ft. 7' Ft. Township: Range: Section: Fill added above original grade: Gravel length: .5 Ft. 72.5 Ft. WELL: Existing _ Gravel width: 3 Number ) of lines: Distance nlinez / Ft. Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft 1 , 01 5 3C. Ft. ASTM D3034 PVC Driller: Date Drilled: Static Water Level: Installer: Date installed Ft. S&A Enterprises 6/7/00 Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES )1 Septic D Holding D S.T.E.P. To Septic Absorption I Litt Manufacturer: Capacity in gallons: From Tank Field Station Anchora e Tank 1,250 -WeW >100' >100' N/A Material: - Num TwoCompartments: Number >100' >1 00' N/A ;/A FNA LIFT STATION - N/A WateSurfacr Lot > 5' >10' N /A Size in gallons: Manufacturer. Line Foundation > 5 ' > 1 ' N /A 'Pump on" level at "Pump off' level at: High water alarm at Curtain None oted n LO Pump Make &Model Electrical inspections performed by: Drain Remarks: Existing Septic System BENCH MARK Remains in Place for Future Use. Location and Description: Top of Garage Foundation Wall Assumed Elevation: 100.0 Ft - - NV '4au9 '8 MEA 6/7/00` Inspections performed by: Dates: 1st Q${ 2nd 6/7/00: ^ 1. .144 E. >G . a. Department of Health and Human Service approval ����}a EPwG t -a•' r Reviewed and approved by: Date: 72-013 (Rev. 9/91) MOA 25 `� I o F _i 00'017z 11 Z H 0 N 0 Municipality of Anchorage Page 2 of 3 C DEPARTMENT OF HEALTH AND HUMAN SERVICES o = ENVIRONMENTAL SERVICES DIVISION p 0)� P.O. Box 196650 - Anchorage, AK 99519-6650 - 343-4744 m rnr- On -Site Wastewater Disposal System or Well Inspection Report z z v " Permit Number SW000133 PID No. 019-151-16 m Gravel Driveway C6 1 .......�` 8l LLnww New Garage. (Location Not Exact) 3 : S2 M1 C5 Service 81 Line To Garage 2 A C1 .Existing Three Septic Bedrooi Tank Home x ;0 X ®Welting z IZ ltl: PLAN AS -BUILT SCALE 1" = 30' .oti z z ' c� a A B S1 41.0 73.7 S2 48.3 82.7 C5 54.5 84.5 C6 98.6 95.0 M1 69.0 .84.0 AlIllifl .ci O � L C Municipality of Anchorage Page 3 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 - Anchorage, AK 99519.6650 - 343-4744 Onsite Wastewater Disposal System or Well Inspection Report Permit Number SW000133 PID No. 019-151-16 N rn v to to U U I Iuv 1,250 Gal ,fl s S; N sO Sep. Tank o° \ 90 ao 94.08 \ 11 93.85 0 13' 2',,2' 5' 20' 5' 3' 8' 5' 3.5',1 .5' 13' N U 93.4 Drainfield 86.3 / ash {niuJ Ytt�� 30' A...,... w.w/r..t...I 97.0 Geotextile Fabric Rock 93.4 .79.0 20' 22.5' :,� PROFILE AS R Permit Number: SW000133 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 3434744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Lam, (ol-/OD e fDat,r\ 6/ 7/60 Q 5p, Date Issued: May 30, 2000 Expiration Date: May 30, 2001 Parcel ID: 019-151-16 Legal Description: SKYWAY PARK ESTATES BLK 5 LT 4 Design Engineer: 0014 Anderson Engineering Site Address: Owner Name: Roger Wirch Lot Size: 69600 SO. FT. Owner Address: PO Box 110348 Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage . AK 99511 - This permit Is for the construction of. Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy El Private Well ❑ Water Storage All construction must be In accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. Received By: Issued By: Date: o/. •-' 2 --0e',1 MUNICIPALITY OFANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343.4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW000133 Legal Description: SKYWAY PARK ESTATES BLK 5 LT 4 Design Engineer: 0014 Anderson Engineering Owner Name: Roger Wirch Owner Address: PO Box 110348 Anchorage , AK 99511 - Date Issued: May 30, 2000 Expiration Date: May 30, 2001 Parcel ID: 019-151-16 Site Address: Lot Size: 69600 SO. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit Is for the construction of., Q✓ Disposal Field f✓ Septic Tank ❑ Holding Tank 0 Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each Inspection. Provide notification by catling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 15. The following special provisions. V, THE PROPOSED ZABEL FLOW DIVERTEW SHALL NOT BE INSTALLED UNTIL A FORMAL WAIVER REQUEST FOR THE ON -LOT WATER WELL TO ABSORPTION CRIB IS OBTAINED FIRST. THE EXISTING WASTEWATER 7 SYSTEM SHALL REMAIN DISCONNECTED FROM THE HOME UNTIL SUCH TIME. Received Issued By: Date: Date: L ^30 —06- May 22,•2000 Municipality of Anchorage Department of Health and Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 4, Block 5, Skyway Park Estates Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of, Lot 4, Block 5, Skyway Park Estates Subdivision intends to construct a new garage on the property with a bathroom and septic dump for a recreational vehicle. The garage will be detached from the house. The existing septic system will be ; upgraded to serve both the three bedroom house and the new garage. We are therefore requesting a construction permit be issued for a new septic system to serve both the house and garage. The system has been designed for a four bedroom home even the house has only three bedrooms. The location and configuration of the new . system is shown on the attached Site Plan and back up documentation. The existing system will remain in, place and maybe reused in the future if circumstances require. A test hole was placed on the lot in mid May at the location shown which revealed silty gravel with a percolation rate of 30 minutes per Inch. Frost was noted in the test hole to a depth of 6'. No groundwater was encountered in the test hole and none was found during the. ensuing monitoring : period. We are therefore proposing a deep trench system with a maximum depth of 11' from original ground. The length of the trench will be 70' with an effective depth of 8'. A flow diverter valve will be near the foundation cleanout and the old septic tank and absorption crib will remain in place for future use if the crib should dry out and rejuvenate itself. All sewage flow will be directed to the new septic tank after construction. The existing drainage on the lot is primarily from north to south'at flat to shallow grades with some slope from east to west. � The absorption trench will be placed in an area with little to no grade in either direction. Grading will be accomplished once the system is completec so drainage is away from the trench and septic tank but in the direction of the current drainage pattern. . If the system is constructed in accordance with our design the following statements apply: 1. 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. Lot 4, Block 5, Skyway Park Estates Subdivision May 22, 2000 Page Two 2. 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. 3. The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. 4. 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 f i 09 O o FOUND OPEN PIPE o Xltoin9 Se � !n "'ell er �lne at F V 12SO (;,,, epfic ank fer valve� oundation Cleanout. CI - Serv, ewAbsorPtionPtic ra„ kA Use, ner to Prop dce ie Positive p�9e to New Sto PI'l T" O age Away Fr tic Tank otic Septic Syste m• . . PFA •%%.f� r O �•+�jr i she E pLqN SCALE; J" 30 LOT 4, BLOCK 5, SKYWAY PARK ESTATES SUBDIVISION DESIGN FACTORS: Four Bedroom Home Pere. Rate: 30 Min./Inch Application Rate: .6 GPD/SF SYSTEM REQUIREMENTS: Deep Trench System 1,250 Gallon Septic Tank 8' Drainfield Rock 4 Bedrooms X 150 GPD /..6 GPD/SF = 1,000 SF of Absorption Area 1,000 SF/16 SF/ LF of Trench = 62.5 LF Trench Length Therefore: Construct a Deep Absorption Trench System With One Lateral 70' in Length with 8' of Drainfield Rock Beneath the Distribution Pipe. Distribution Pipe In Trench Placed at 3' Below the Original Ground Surface. Total Depth to be 11' From Original Ground Surface. Insulate or Mound Over Trench to Provide a Minimum of 3' of Cover. Place Zabel Flow Diverter Valve at Foundation Cleanout and Tie Existing Septic Tank and Absorption Crib In To System For Future , Use.._ . I«� Natural i Backfill 2.5' .5' 8.0' Geotextile Fabric 4" PVC HoleS Down Drainfield Rock TYPICAL DEEP TRENCH SECTION i (NO SCALE) i 2EL'� NOTE: Grade Area Over Trench to Drain Away. Provide 3' Cover Over Trench and 4' Over Tank or Insulate. Maintain 10' Separation From Lot Line. Maintain 100' Separation From All Wells r K OFA •Municipality of Anchorage :.. Department of Health & Human 825 L Sheet Anchorage, AK 99502-0650 �� • ` f SOILS LOG- PERCOLATION TEST I'it '• •-�;{ �`,= Performed For: Roger Werch Date Perfor ' Legal Description: Lot 4, Block 5, Skyway Park Estates I \ "� si ()PF SITE PLAN 1 7 OL TEST HOLE NO. 1 ," .. adv Silty �® ao Gravel GM Was Groundwater Encountered? No If Yet What Depth? Depth to Water After Monitoring _ None 11 Date: 521100 12 , 13 Becoming Very Dense Bottom of Hole See Site Plan g L 0%-I% D ®�M• ," .. �® ME �oo�as Perc. Rate: 30 Min./Inch Perc. Hole Diameter: 8" 21 Test Run Between 8 Ft. and 9 Ft. Comments: Test Hole Pre Soaked Prior to Test. Frost Still in Ground to 6' Depth. Performed By: MEA I, Minha I 17. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: . 5122100 Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: Roger Werch Date Legal Description: Lot 4, Block 5, Skyway Park Estates TEST HOLE NO. it I I Silty Gravel 6 8I I GM Bottom of Hole 15 16 1 N 0 a 0 en a Was Groundwater Encountered? No If Yet, What Depth? Depth to Water After Monitoring Date: 11 SITE PLAN See Site Plan 0%-1% r Perc. Rate: 30 Min./Inch Perc. Hole Diameter. 8" Y1 Test Run Between 8 Fl. and 9 Ft. Comments: Same Material as Test Hole No. 1 Performed By: MEA I, Michael F Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 5122/00 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 4, BLOCK 5, SKYWAY PARK ESTATES SUBDIVISION. GENERAL: The scope of this project includes the procurement and placement of a new 1,250 gallon septic tank. It also includes the construction of a new 70' long x 3' wide x 8' effective depth absorption trench at the location shown on the site plan. Distribution pipe will be placed at 3' below the original ground surface. The total depth from original ground of the new trench will be 11' below ground surface. The existing sewer service line from the house must be intercepted at the foundation cleanout and rerouted to the new septic tank. In addition a second service from the new garage must also be constructed to the new septic tank. Both lines will intersect prior to the entrance into the septic tank. A minimum of 4' of cover is required over the septic tank. In lieu of 4' of cover, 2" of insulation and 2' of cover is acceptable. A minimum of 3' of cover is required over the absorption trench. This may be accomplished by mounding over the trench or by providing 2" of insulation and 2' of cover. 2. 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. 3. 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. 4. 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. 5. 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 The new 1,250 gallon septic tank must be procured from an approved source and installed at the location shown on the plans. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Lot 4, Block 5 Skyway Park Estates May 20, 2000 Page 2 of 3 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric 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. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. 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. 7. Grade area surrounding the absorption trenches to drain away. 8. 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). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). Lot 4, Block 5 Skyway Park Estates May 20, 2000 Page 3 of 3 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable geotextile fabric (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. M [FOUND OPEN PIPE -------- ---- --- { K: sting Sewer Line at Foundation Cleanout. Flow Diverter Valve. ig Septic Tank for Future Use. ,250 Gallon Septic Tank According to Plan. gw Absorption Trench According to Plan. ervice Line From Garage to New Septic Tank. o Provide Positive Drainage Away From Septic System. SITE PLAN SCALE 1" = 30' MUNICIPALITY OF ANCHORAGE Deparbns d of Health i Hunwn Setvioee On4Me s«vlow Waterer Review Worltaheet WP*. WR000033 PIE* 01!_ ,13144 HI*: Dow Received: June 2,20M Leo Description: Rlnr w Park Estaas. Lot 4, Stook 5 Permlw: En01neK: A -11 1 A I KnOlIMMIN PO Solt 210773. Anohoraos. AK 999 Applicsrtt: Rocisr Wirch ........« Waterer Requested: 80 boot waiver lhom the absorodon field to the well Crlleds: 1. Geology Points: A. Water Table S. Soll Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation 2. Special Conditions: 3. Other: Waiver Is Granted: Ust Conditions or Reasons for shove: Total: Waiver is not Granted. Dale: L — / — DD By: aw Name Of Reviewer Recto 06797 Amount: $020.00 Deb Paid: 6-2-00 wA/veR *EQ 4ss r fo/t Lor f /s[o w/4.tveR R&qussr vjgoEm wR emog3 iv Y poirly ASmris wAivoie RtQvifr colt o4mar I ArmR w6 tt ro soeP°46E Pir of 9Qf6Er SEPTIC OAr,4 — TNS SEEP,46.r. 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SUBJECT: Lot 4, Block 5, Skyway Park Estates Subdivision Separation Distance Waiver — Absorption Crib to Well RECEIVED JUN 02 = ,•LI I r OF ANCHORAp WLnuM SERVICES ()#Ml l(P Attached is the waiver request package to allow encroachment of an existing absorption crib into the 100' protective radius of a private well. Water sample results have yet to be completed, but I have assumed they will be acceptable as evidenced in the waiver request. Heather, at CT&E is supposed to fax the results to you when they become available which should be some time early Friday. The reference number for the sample is 1002582. 1 will be out of town on Friday so am not able to personally deliver the results. The property owner, Roger Wurch is anxious to obtain the waiver and will probably be contacting you. Thanks for your help with this matter. 7 9 7 May 31, 2000 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 4, Block 5, Skyway Park Estates Subdivision Separation Distance Waiver Absorption Crib to Well Dear On Site Services Engineer: The septic system on the subject lot was placed in October of 1969 prior to the placement of the well. At that time the separation distance requirements were 50' between a well and septic tank and 100' from an absorption field. The cleanout for the crib on this property is almost exactly 100' from the well. The assumed location of the absorption crib, however, is 90' from the well at its closest location. We are therefore applying for a waiver to allow the absorption crib to remain 90' from the well. The well is located approximately 10' upslope from the absorption crib. The total depth of the well is approximately 60' with casing thought to extend the entire depth of the well. No well log could be found for this lot, but the adjacent well located directly to the west is 60' deep with the subsurface soils consisting of silt and silty gravel. These materials are identical to those encountered on this lot during exploration for the new absorption trench. The silty gravel was found to percolate at a rate of 30 minutes per inch. The static water level in the well is at the 40' level which is similar to that found in wells in the surrounding area. A water sample was taken from the system and analyzed for coliform and nitrate content. Results indicate low levels of nitrate content and no coliform or other bacteria. The well is obviously not being influenced by the effluent from the septic system. Separation Distance Waiver Guidelines Water Table 30' Below Crib 4.0 Soil Type Silt, Silty Gravel 3.5 Permeability Silty Gravel 2.0 Water Table Gradient Slopes Away +5% 4.5 Lot 4, Block 5, Skyway Park Estates May 31, 2000 Page Two Horizontal Separation 90' 2.6 Total 16.6 The conclusion based on the aforementioned point totals is that almost surely no form of contamination can be expected from household sewage. It is therefore recommended the waiver be approved to allow placement of the existing absorption crib at 90' from the existing well. Enclosed is a copy of the well logs from the neighboring wells and the only documentation available concerning the well on this property. Based on the close proximity of the wells it is logical to assume the soil formations are similar. Sincerely, Michael E. Anderson, P.E. Attachments JOWL i L W4 _• 06-01-00 16:51 FROM -CTE ENVIRONMENTAL A&« CT:E Environmental Sarvic" Inc. 5615301 T-646 P-02/03 F-414 CT&E Rei#r 1002582001 Client PON Client Name Aodcrson Engiueertng Printed Date/Time 06/01/3000 16:13 Project Namel# Skyway Part: Estates Collected Date/Time 05/30/2000 15:40 Client Sample ID Lot 4, Block 5 Received VaTe/Pime 05/30/2000 16:15 Matrix Drinking Water Technical Direaw Stepben C. Ede Ordered By PWSID 0 Released h la fh .-de&A A/ Samplo Remarks: AItowadla Prep Analysts Paramorer Reswlrs PQL unirs hethod t.iialts Dau pate lnic WATERS DEPT wirrare-N 0.500 u 0.500 109/L EPA 300.0 10 max 05/30/00 SCL MICRO LA60RATORT Torat Coliform 0 col/100m1 WE 92226 05/30/00 KAP 06-01-00 16:52 XIL FROU-CTE ENVIRONMENTAL 5615301 CT&E Environmental Services Inc. Laboratory Division T-646 P.03/03 F-414 200 W Potter Drive Drinking Water Analysis Report for Total Coliform Bacteria nch orages2 23 3`1$ 3405 READ INSTjt(jCTIOIVS OR REVERSE SIDE SEFOJW COLLECTING SAMPIE FaA t90711151-2;91 MUST BE COMPLETED BY WATER SUPPLIER I TO BE COMPLETED BY LABORATORY o PUBLIC WATER SYSTEM I.D. N Cl PRIVATE WATER SYSTEM O Seel itfsMw O kA/ /atotcf a*+. rho" K61111w Fag ry J a Inv"" .rnl L HN -u to .,. AFJ C41 -XOGNIN SAMPLE DATE. OKI MGM& SAMPLE TYPE, XRQU"no Q Repeat Sample (for routine ssmpM wirb lab ref. no. ) 0 Speciallurposs SAMPLE LOCATION 4�� 8 Comments: ww 9E Day Year a Treat" W afar a Untreated Water Time Colleeted Colloctsd By Anal sit shows this Wittcr SAMPLE to be• Satisfactory Q Unsatisfactory o Sample over 30 hours old. rasults may be unreliable 0 Sample too long in trattstt; Sample should not be over 43 hours old at examination to indicate reliable results. Plcase send new sample via sp al delivery mail Dap Received 1 TION Recelvod / �h Analy:b i SSG Analy0col Method: JC Membrane Filter 0 MiMO-Muo 1008582 10. n .analyst a a.n..� �►qCnfi =bui J..w Q - " Due Time Client modfled of utlsstisfactory results: Phoned Spoke with F�r4 Due! Tann BACTERIOLOGICAL WATER ANALYSES RECORD MMO-MUG >f wRt teal Co1llYlrts E. C•4 —. Membrime blum Mrax Coast ( j _ Colon1ev100 M1 Verification: LTB _ SG$ COLIFIAM rnrr T« N.wpt.7 r. C.„no Of Owe sawm Fecai Conform Conflrmadon Final Membrane Fater Ronlat Conferatl100 ml Reported ft q I Time ILAC hrs Is � Meffew of tM 504 t3rw+O (See" GeMrolo On SurvoiII&Mo) ENVIRONMENTAL FACILM13 IN ALASM CALIFORNIA. FLORIDA. ILLINOIS. M"VLAND, MICHIGAN. MISSOURI. NRH► j/RSEY. OHIO. wEST VIRGINIA ■ From : ALP 1 NE DRILL 907 345 0202 c� y A�ujg`. 29. 1999 10:22 PM P01 STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING & WATER MGMT LOO; T10N OF WELT. 9 �� 0 141— 'S� WATER WELL RECORD "ROUONa sav ON LOT KOCK SECTION OTRe SI<cTION TOWNSHIP RANGE WPAI 114 ON 0 . [is ❑W LOCATIONISKETCH: WELL OWNER: or DEPTHS MEASURED FROMVcasing top ❑ground surface WELL DEPTH: DATE OF COMPLETION Depth of hole: fl� ft BOREHOLE DATA: Depth Depth of casing: ft Material TVDe and Color From To ` h DEPTH TO STATIC WATER LEVEL: ft below 'M top of casing ❑ ground surfaoe• Date: _2 i� 64, �9 METHOD OF DRILLING: lWair rotary ❑ ceblo tool ❑ other USE OF WELL: 'C domestic ❑ irrigation ❑ .monitor.. S� -7 Z. ❑ public supply ❑ other ; H 145-40 CASING ST1C -U ft. Diam: In. f•{:S . Casing type In. ft WELL INTAKE OPENING T11PE. ❑ open end i®, acre ❑ perforated ❑ open hole -5nq ; L e Depths of openings: S1 to °'ti ',ft SCREEN TYPE:_ Diam: In. , Slot/Mesh Size: i Ate" Length: ft GRAVEL PACK TYPE: Volume used: Depth to top: GROUT TYPE: :a Depth: from ft to ft DEVELOPMENT METHOD: Duration: PUMPING LEVEL AND YIELD: SG ft after hra pumping ppm PUMP INTAKE DEPTH: ft Horsepower: WELL DISINFECTED UPON COMPLETION? 4s V66 ❑ N0 CONTRACTOR INFORMATION: Business Name Ignature of Authorizedespy entative.at6 e Received Time Au9•30• 9 0 3 A M REMARKS: PLEASE MAIL WHITE COPY OF LOO TO: DNRIDIVISION OF MINING & WATER MGMT 3601 C St, Sults 800 ANCHORAGE AK 99903-6836 Phone 49071269-8639, Fox (907)662-1384 ticiiin- so ON 1p► Paso -_., .��. •.ty}E.�:.�,..' wii�. ;`E' .- ►letsoct+sti«.selthanrati Ib. or .r * Y 'A;.OD 110;'' ^.,�..,,p;.. r... _ I -�.tt. a• i • • Iolr os t+Klt aRKi+z9!Vee „•., 1446 1. rats oseas� s�Mf rt.tews la Moab FVectlar itstiwllt. r'• n. to .YtiSlf� / _1Wt1 TresA{r �Regtsr.r -. ` � • tR: to B FINIS* OF YELL'.• ni� IC, Ueee801&r Nt E a(Tlra:tla► from No" Interseetloot• Slot/Mtsh Stze: f-tM.1" ;ie. oMIEIF of WELL Ftttinge: 9L STATIC YATMLEVEL--, Addr TAtsovs ~ �41lr susfacm ~ , p r• f" r _ 99 r q .Stwel`Addrest andrArer of Wet" Lpcetlon kiµ a:: itlfS tvlW►ING :F1tEt be.lor l-MAW- ld[L�3 L0� :. Fee! tlelota. ce►* 4%. WILL.0E1►TM: (coepletdl f r ut Shta Eltwtlon I ��� c�� r. waz NEA01C011/CEL1 MOiot Pi rxi^+•.--' lam. r.. .. �... . .... • . urr Bottom . /�.x C t Y ;t ti lleterlal Tyne'` ow QNaa«t Caweetl�?'LiOther: M • Material : z i,t..l'liei Ari7 w.+ ai ~ aotirett<�., s 6b USE: , QF�►ird svoµy D larr. ,. aRKi+z9!Vee alrrigation , '-i: 1446 EfTest Well" QOt,•id. r % T« CASING: QTAreedoo • r'• n. to .YtiSlf� / _1Wt1 ft. Oto tR: to B FINIS* OF YELL'.• Slot/Mtsh Stze: f-tM.1" Ftttinge: 9L STATIC YATMLEVEL--, _ TAtsovs ~ �41lr susfacm y }" kiµ a:: itlfS tvlW►ING :F1tEt be.lor l-MAW- .` ft. arty -pupping. •�'' .i `'r`r-,..,�, _` :.t-�kk'I�•.:��, ir+ .. '�{,s .. •art: eRtsi?''1''�+ �t!� ^}.i3 •,a - waz NEA01C011/CEL1 MOiot Pi rxi^+•.--' lam. r.. .. �... . .... • . -., , r ,1w;i ' (UPI t1 well. Adopt a- _ ncbta above 9 tL GROUTING: IlelliWwtdata.. Elmo QNaa«t Caweetl�?'LiOther: M • Material : t x FU1V: (1 t av&l 1 able)N "y71- Length oP Orap; Piper !i'4 taptcltjn �� S Type: QSubateesdble►.': fproCetinG V• y - RE! aJets lit. REMARKS: ,!= 1S. YATEI6 WELL CONTRACTOR'S CERTIFICATIONt I S! This well ..as dril ld under fry. jurlsdlctlon *"this reoort Is. true to the best of mywra+ledge and bat lOf: r Eir�.CIS surd a Jrets� ^•_ tract L.ea^fie er , ;.n „ i'r:�•�'�"fir t. Address: i fir% 1.t' �/� Date: .,AAB LL, I Gpr-ATER ANCHORAGE AREA BORO"3H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING NAME —ADDRESS %/ " S C� I /. ��� - PHONE LOCATION —"L�"�10 �/�`�'r LEGAL DESCRIPTION SEPTIC TANK: ` NUMBER OF DISTANCE FROM WELL MATERIAL �1�`/•�l _COMPARTMENTS LIQUID CAPACITY / C 'Zc _ GALLONS. INSIDE LENGTH INSIDE WIDTH— SEEPAGE IDTH SEEPAGE SYSTEM: SEEPAGE PIT LIQUID DEPTH NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH �. LENGTH, DEPTH — NUMBER /C ✓� . DISTANCE FROM WELL XG S / BUILDING FOUNDATION. LINING MATERIAL � NEAREST LOT LINE ` TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) J(/'� SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA , FOUNDATION_ DISTANCE BETW INES DEPTH: TOP OF TILE TO FINISH GRADE_ FT. LENGTH OF EACH LINE NEAREST LOT LINE TRENCH WIDTH TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: DISTANCE FROM WATER Tvoc• DEPTH BUILDING FOUNDATION.—SAMPLE_ LOT LINE DISTANCES: NEAREST SEPTIC SEEPAGE SEWER LINE , TANK SYSTEM , CESSPOOL DIAGRAM OF SYSTEM NEAREST OTHER SOURCES APPROVED � DATE HEALLH AULHORITV -�'- GARB -HD -2 GR EATE'L ANCHORAGE AREA _,OROUGH ase No. 24 Z HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska "501 1�1� sk279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT �' �MAILING ADDRESS / �" /,LLIz%u.^/PHONE N0. — RESIDENCE ADDRESSLOCATION OF INSTALLATION LEGAL DESCRIPTION "-ti i=`/1J`- ' - �`' —•� �J�` ` `rk il` 1.:' Com' �`4 Zc�1� APPLICATION TO INSTALL: SEPTIC TANK L-' , SEEPAGE PIT L-' , DRAIN FIELD ` , OTHER TO SERVE THE FOLLOWING FACILITY •= '' -'`` A FINANCED THROUGH r ZZ TO BE INSTALLED BY PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS ��!�C y/ , PERMIT TO DISTANCES: AS DESCRIBED BELOW. SIZE OF UNIT TO SEPTIC TANK SIZE TYPE Vii- '7f wLL 74AI� ,riN � hal S7/� INSTALL A���� BE SERVED'-.....-.. _ SEEPAG AREA 1 4 X TYPE DIAGRA: SYSTEM r 1 `v V Health Authi I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that th above described system is in accordance with said code. DATE '7 J /� APPLICANTS SIGNATURE �� �c oloF 3NdQp0MN33�iD 0010C O. o oo'oVz x'i Id o H of i o c c Iz, 0) z 1�� I 0 mm zz z i � i mr •o m T• - m 'i O i i i i OW C W in tL i I. ;l O coLn 0 N) Ill m O O W F+(D �.. Ort O tl D Nd •Q . dN R nro (D x m rt i O F+ <.0 _ m I..., W O'8tt 1N3W3SH3 A-,IIIIn 01 j 0 '0$7 H ,I, R 0 S r�0, 0 c Ox z y _o n o m W CL N Do, m 0 0 0 a 0 7 0 O TI T% Dm 2 m Dme nNcD m.. O .mm. Cn-z ? = ,x -- v�.Do� O cnwv" 0-0 D—� oCD w v0.a 0 -IfD f 14A Agg 4 m < (=D rn �ye9 �a mnon)0 � -4-n w d 'A II r��•L O O �g o w s'g to p m m C = D 7 � y O ,. m m Or O N d 7 .W to A - 3