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Home My WebLink AboutT15N R1W SEC 9 LT 51TISN RIW C. 9 Lot 5:1. #051-104-21 Municipality of Anchorage Page 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: St,,fq'?O.l..4'( PIDNumber: ~ ~'1'16~-.,2-1 Name: R. :T.. VA,~s/~ Wastewater System: I:] New [] Upgrade ¢J07 /_-~J~ ~,~2-1 ./~"~to2/;~O ~ DDee i-I Shallow Trench r'iBed r'lMound r'lother LEGAL DESCRIPTION So, P~.ng: ~D~q Ft TotatDepmfromorlglnalgracle: SEPARATION DISTANCES ~ Septi~ r~,o~din~ D S.T.[.. Water /~ ~ Ir~ / / LI~ STATION Lot ~ ~ ~ Size in gallons: Line Remarks: ~v~h~,J ~..~ ~.1.I ~ ~, BENCH MARK Depadmenl et Heallh and Human Se~ices approval Reviewed and approv~ by: ~~ ~,~Date: ~- I~- O J Permit No. 5 ~' ~ 0~-7 Page '~ of Municipality of Anchorage 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 Insl~ection Report Legal Description: /-.,,'r $'1 -J'/5',V' ,~/ l,v' $'~'~-~'-'" ~J PID No.: Well & Sewer 100+ I $00 gallon Tank .'Well 0 25 50 100 i APPROX. SCAI.E IN FEET Lot 51, Section 9, T15N, RIW Chugiak, ALASKA SITE PLAN August, 1999 21957 Aurora Borealis I Fig. I L . ,. / Existing Crib each Line ..,,x ~'/~xean out for pit ~21ean out to tank Garden Clean out to ! Barn Garage 0 12.5 25 50 APPROX. SCAI.M IN FEET New 1500 gallon Tank · Well Lot 51, Section 9, T15N, RIW Chugiak, ALASKA SITE PLAN August, 1999 21957 Aurora Borealis [Fig. I 2 To Whom It May Concern: I, R.J. Vassar, can operate a backhoe for personal use, did rent the backhoe used for removal and replacement of my existing 1000 gallon tank with a 1500 gallon tank. R.J. Vassar MUNICIPALITY OF ANCHORAGE Department of Heaf~h and Human Services On-Site Se~ces Program 825 L Street. Room 502 P.O. Box 196650. Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 04, 1999 Expiration Date: Aug 03, 2000 Permit Number: SW990247 Legal Description: T15N RIW SEC 9 LT 51 Design Engineer. 0000 None Required Owner Name: Richard J Vassar Owner Address: PO Box 670788 Chugaik, AK 99567-0788 Parcel ID: 051-104-21 Site Address: 021957 AURORA BOREALIS RD Lot Size: 108900 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit Is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail construction must be In accordance with: 1. The attached approved design. 2. Ail requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to Apd115, a subsurface soil absorption system under construction during freezing weather must be either. A. Open and closed on the same day. I~. Covered, sealed, and heated to prevent freezing. Received Issued By: SHANNON &WILSON, INC. GEOTECHNICAL AND ENVIRONMENTAL CONSULTANTS SEATTLE RICHLAND FAIRBANKS ANCHORAGE SAINTLO~I$ BOSTON August 4, 1999 Municipality of Anchorage Dept. ofHealth & Human Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Sewer Permit - Replacing failing tank ~vith large tank and test pit for future upgrade. At the location of the existing tank, which was placed in 1973, there is a depression at the outlet end ofthe tank. The tank was not coated, so it is likely that the tank is failing rather than the outlet connection failure. The system has caused no problems to date although the depression has gotten larger since the spring thaw. The existing tank is a 1000 gallons which outflows into a wood crib cistern and then to the leach field. The replacement tank will be 1500 gallon. The existing tank will be removed and non-compactable soils will be wasted and replaced with clean pit run sands and gravel. These materials will be placed and compacted at my direction, to near finish grade. A 6-inch layer of topsoil and grass will beased to bring the site back to it's original configuration.. There are future plans to build on to the existing home which will add one or two bedrooms. A test hole will be excavated and logged at the end of the existing leach line to obtain specific soils data for upgrading the septic system to a 4 - 5 bedroom capacity. Itappears that the c~stern' leach capacity is greater than the septic flow. The existing leach lines are dry and do not show signs of ever having carried any treated leachate. Keith F. Mobley P.E.~ Senior Associate Attachments: On-Site Well and Sexver Application Current Site Plan 5430 FAIRBANKS STREET · SUITE 3 ANCHORAGE, ALASKA 99518 907-561-2120 FAX 907-5614483 0 ~5 §0 100 APPROX. SCALE IN FEET Lot 51, Section 9, T15N, RIW Chugiak, ALASKA SITE PLAN June, 1999 21957 Aurora Borealis I Fig. I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LOCATION NO. OF BEDROOMS PERMIT NO. V~ · ~" ~0~! IAbs°rpti°narea DISTANCE TO: I I[.~.X~ i ~ ~ I~J~ ___ Manufacturer ~/ Liq. capacity in gallons/ IF HOMEMADE: DISTANCE TO:j Well Insidelength Dwelling Material Width No. of compartments Liquid depth PERMIT NO. Manufacturer Liquid capacity in gallons DISTANCE TO: ( ~-' IMaterial Nearest Iot ~(~ Trench 'dth Top of tile to finish grade~_. ( ! lines tile Depth Width Total effectt'v~ absorption area PERM,T /'¢ Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO, DISTANCE TO: Building foundation Sewer line Septic tank Abs~on area(s) OTHER SOIL TEST RAT, REMARKS APPROVED DATE LEGAL Fff::'PL.. J: C:F~NT RUS"F I C HOMES FiL. !...OCf:TT' I ON L[CCg:::It L~5:iL S 5' T::LSI",IF~r:I.N THE I:;~'.E '2 T PEE:' S ]: ZE OF:' THE '::;" ]'1.. F:IE::iSOF:'.PT ! ON ., 'r _ I I....I I :1: :!."]: THE: I....E[",JG"FH D ]: MENS I OIq I :!5 THE LENGTH c: l f',1 ]:::'EE'T' ), O1:::' 'THE 'T'f:;:'.'ENC:H OI:R [:d:;i!t:::l :[ NF :[ El_I::'. -[]"-ItlE I::'.,llii:[::'"['t-"l OF I;::1 ]"fRE'_:]'-,!CH OI:R PIT I'E; THE [:)IS'T'FII",IC:Ei: EIE'T'FIEEN THE: i~.i;I.JF~'.F'FII]:EE OI= THE GF;;:OL.IND FII",ID THE BOTTOM OFr THE E;:.;:C:FIVFI-FICq'q (:I:N F:'EIET::'. THE[RE '['.:5 NO SEi:T I,.IIE:,TH FOP. TI'"IIii~: (3F:f::IVE:L. E:,![~.:F'TH IZ THE MINIMUM E:,E:PTH OF Gf:~:F:IVEL.. E~ETI,.IE:EEN TFtE OUTF'f:IL.I.... t::'II;:'liE FIf',!D '1'1-'111~: [3OT'T'OM OF' '[FI[ii: E]~'~',CF!VF:ITION ErI::tCI:::FIL.L..II",IG OF FIN"/ :,~_IIL. II HI'THOU'T' F:IF,ff:IL I!'-~E;PEC'I"IOF,I I::tNC, I-tl FR ~1., F,FF'FII:;'TME!]"~F" I.,.!]:L.I_ [.[...:L.IE..)L..I 'l"O F:'F;'.OSE:C:I...rT'IOI'-,L MII'..!IML.IM I:;:,I:i.~;"FFINC[~:: li311.~:TI,E~f]E]q t:::I [,.![~:i.._l.~. FII',I[> I::IF,I'~.' ON.....SIT'E SEI.,IFIGE DISPOSFIL S"r':E;'T'Ehl ::[.(~:J~':~l FEET !::'O!:R F:I F'I:;'.I'v'f:I'T'E; HEL. LOP. :1J:.5!2) TO ;;~:I;B~I F:EET' FP. OM F~ F'UE',[...];C NELL. LIF'O!",I THE TYF'E OF' I::'UE:L. IC HIE:L..L.. M t N ]: MUM [:) I S'T'F:INC:E F:f~'.OM Ft F'f;'. I ',/'laTE HELL 'T'O FI F'F: :[ ',,,'f::ITE :E',EHEI:;~: L. I NE I S 2G FEET TO FI C:f.]MML.INI"["~" SE],.IEF~: [...INEt: IS 'Z?5 FEE]". OTHEF~'. F;'.EQI.J I F~'.EME~]',!TS MFI"r' FIF'F'L."/. SF'EC I F' l C:FIT I OF,IS F~N[:' CON?FI;~'.fJCT I OBI [) I !:::I(3F~'.F:IM:5 f:II:RE FIVFIIL.I:::IEfl_I~ TO IN'.~;I...IF[:E~: I::'F~'.OF'E[;~: IN:~;TFIL. LFITIC~N. :1: ..:I::: ...... J. I"' 'r 'Fl'"lf:lT ::I.: :[ FIM FFIM I L. I 1::1!:;~'. I,.! :[ TH 't'l'"lli~: I:;i!l~:l:~!l...I ]'. I~:EI'"IENTS F:'OF['. ... t I - ]. r I.... SE..],.IEF[:?., 1::':'~,'1"1...l [, THE IIL.III.I....ll HLI, ~ (:)F' . hl....H..E~P ;:7 ]: I.,rI]][...L ]]1.,,.::, I P L..I_ 'T'HE .:, .: I Ell IN ::::::::::::::::::::::::::::::::::::::::: HITH THE ..... :::J:: I L.IN[:,EF~:STF:IN[::, 'f'HFIT "I"HE :'ff..t-?; I TE ZENEF: .,: .:, I E 11 I',IFt'~.' rq:EQU I EXCAVATION ROBERTA. SHAFER WORK June 10, 1982 CIVIL ENGINEER 694-2979 Mr. Hal Kostlin Area Realty Box 594 Eagle River, Alaska 99577 Dear Mr. Kostlin, Reference: Lot 51: Section 9: T15N: R1W A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The absorption trench was full of water and approximately 800 gallons of water had to be removed. The seepage pit was then recharged with 1000 gallons of fresh water and after a period of 24 hours, 197 gallons had per- colated out of the crib. It can be concluded from th~ above test that the septic tank is adequate for the new three bedroom residence to be located on this property. However, the seepage pit was only adequate for approximately one bedroom and will require upgrading before the new three bedroom home is connected to this system. The existing trailer house currently connected to the system will have to be removed from the system at the time the new home is connected. If we may be of further assistance, please do not hesitate to call. s/ss cc: First National Bank Eagle River Branch Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA QGRE 'ER ANCHORAGE AREA BOp Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 JGH INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION LEGAL DESCRIPTION SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH NUMBER OF MANUFACTURER ~' f;9.[.~ '~CL(~ _~ MATERIAL ~i]4t~J [ ~'~] ~ COMPARTMENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY .,Z/(~;~E2g2 GALLONS. SEEPAGE PIT: OF PITS / DIAMETER -- OR WIDTH /,~'~( LENGTH /~2,/ DEPTH '- NUMBER ~ / LINING MATERIAL l- C)~ CRIB SIZE: DIAMETEF~X/r~EPTH (¢>/ DISTANCE FROM: WELL ,- / TOTAL EFFECTIVE BUILDING FOUNDATION /~) ,~L NEAREST LOT LINE ABSORPTION AREA (WALL AREA) ADDITIONAL ABSORPTION SQ. FT. we,,: TYPE L~ z ~ 0D¢2~,, CONSTRUCTION ~' DEPTH -- DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC ~ SEEPAGE It' FOUNDATION ~' LOT LINE -- SEWER LINE -- TANK I(~O , SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS_ DISTANCES: INSTALLED BY: PIPE MATERIAL: LOT SLOPE: REMARKS: Form NO. EQ-031 DIAGRAM OF SYSTEM ~.A.A.B. GrEATEr ANCHOrAGe Area Borough DEPARTMENT OF ENVIRONMENTAL QUALITY SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. INSTALLATION O~: SEPTIC TANK ~ ~ SEEPAGE PIT DRAIN FIELD . OTHER FINANCED THROUGH TO BE INSTALLED nY ~ ~q~ COMPLETION DATE ANTICIPATE~ 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. WATER main TO SEPTIC TANK ~ ~ ~ SEEPAGE P]T ~ SEPTIC TANK, ~ G / PIT ~~F~ / 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. CONFORM TO BOROUGH ~EGU ATIONS REGARDING INSTALLATION, L, ICENSED DESIGNER [ CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QDALITY 3330 "C" Street ANCHORAGE, ALASKA 99509 Case # Performed For A. Legal Description: Lot 5! Block This Form Reports Soils Log Soil Test Must Be Logged To 4' Depth Feet Soil Characterist~c~ 12-- 13~ 14-- Dated Performed__ ~ SubdivisionS. ~ '/-I~ Percolation Test Below Proposed Seepage System Was Ground Water Encountered? If Yes, At What Depth? Reading Percolation Proposed Depth COM~[NTS: Net Drn -1 Date Gross Time ,l Net 'rime Depth to H20 ......................... £ ......... [ ........... Rate Minui:e ...................... Installation: S¢.erag~ Pit ~ Drain Field of Inlet,__~__~.~: ....................... Depth to Bottoi~l of'Pit Or Trenc~ Test [.la I e: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 ! ,~: ~ 343-4744 Parcel I.D. # ~"'~\ - ~O"'~L~. ~ \ 1. GENERAL INFORMATION , Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA# ~ ~x~.~t ~ Lot 51; Section 9; T15N; R1W Location (site address or directions) 21957 Aurora Borealis Property owner Ken Shaft Day phone 688-2499 Mailing address P.O. Box 671128, Chugiak, Alaska 99567 Lending agency Day phone Mailing address Agent Day phone~, Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 'w TYPE OF WATER SUPPLY: Individual wel x Community well Public water NOTE: ff community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site x 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. 72JJ25 (Rev. 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER ,~ AS certified by my seal affixed i~ereto and as'of the validation date shown below, I verify that my., investigation of this Health Authority Approval applic~ation 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 isin comPliance with al! Municipal and State codes, ordinances, and regulati0ns in effect on 'the date of this inspection. s & s £N61NE[ERINC, Phone L~'~ Name of Firm _ ~o~4 ;'-~s[~ R;,~,- L~ 3~.~ No. Engineer's signature Date . St DHHS SIGNATURE ~~.~b _.~ Approved for edrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: 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. 72~25 (Rev, 1/91) Back MOA ~21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L--crc' ¢J¢~ ,. ~4-,<;,-~; 'q'~'¢ ~,, ~-4'~[ Parcel I.D. Log present (Y/~ Total depth Sanitary seal ~/N) A. WELL DATA Well type Date completed - ~,,~ K- / Driller Cased to V/Z- ~ d-~C~asing height Wires properly protected (~/N) If A, B, or C, attach ADEC letter. ADEC water system number FROM WELL LOG AT INSPECTION Date of test ~-~ 2. '~-? / Static water level ~/ / ,~1 ' Well flow //~ g.p.m. ~ U Pump level LJ I~ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 1 O0 /co Absorption field on lot Public sewer main Public sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed ~"'- /I ~ '7 ~ Cleanouts (~/N) y High water alarm (Y/~ Date of pumping ~-~ ~ -~ / Collected by: Other bacteria S & $ ENGINEERING 17034 Eagle River Loop Road No. Eagle River, Alaska 99577 Tank size / Oc~o Compartments Foundation cleanout (~7N) ~/ Depression (Y~ Alarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot / ~ / +~ On adjacent lots To property line /D Absorption field Surface water/drainage / Foundation Water main/service line 72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) __ Vent (Y/N) "Pump on" level at ~level at High water alarm level ~ Cycles tested Meets MOA elect~ _ ISTANCE FROM LIFT STATION TO: On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ~'-/1-7~ /~ -~. aZ. Soil rating /07 ~,/~,'Z System type ..~---~'/~ Length - 5-? Width Surface water Curtain drain Total absorption area Depression over field (Y,~ Results (~o--~a il) Peroxide treatment (past 12 months) (Y,~ _ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon lot_ IpC~ To building foundation On adjacent lots Gravel thickness L,, ¢ - ,2L' -Total depth Oleanouts present t~/N) _. Date of adequacy test :~'- for ~"?""¢~ ('~") bedrooms L~W/~/° ~'~/~ If yes, give date. '"/~ On adjacent lots ~ oo ' ¢**' ~Property Fine_ /0 l ¢ 7~- To existing or abandoned system on lot /.1/,,~ --Cutbank '"/~ Water main/service line., lz~ Driveway, parking/vehicle storage area. E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. E ~:Jla River Loop I{oad No, 204 Engineer's Na~e.,~;p~ HAA Fee $ Date of Payment Receipt Number. 72-026 (Rev. 3/91) Back MOA Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING 5633 B STREET ANCHORAGE, ALASKA99518 TELEPHONE (907)562-2343 ANALYSIS REPORT ET SAMPLE for WORKordert 34406 Date Report Printed: MAY 22 91 ~ 18:44 FAX: (907) 561-5301 Client Sample ID:L51 SEC. 9; TISN; RIW PWSID :UA Collected MAY 20 91 ~ 14:30 hrs. Received MAT 21 91 ~ 14:35 hrs. Preserved with :AD REQOIRED Client Name :S & S ENUIREERINC Client Aect :SRSENOP EPO t PO # NONE RECEIVED Req ~ Ordered By :R. SHAFER Analysis Completed :MAY 22 91 Send Neports to: Laboratory Supervl~qr :STEPHEN C. EDE lis & S ENGINEERING Chemlab ReP ~: 912146 Lab Smpl ID: 3 Matrix: WATER Allowable Parameter Tested Result U~ts Method Limits NITRATE-N 1.1 mg/l EPA 353.2 lO 3ample ROUTINE SAMPLE COLLECTED BT: RAY 1 Tests Performed * See Special Instructions Above UA-Unavailable RD- None Detected ** See Sample Remarks Above NA- Not Analyzed LT-Less Than, GT-Greator Than ROBERT SHAFER, P.E. ROGER SHAFER June 23, 1991 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGIN EER~NG STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Mr. Dan Boll~s Mu~i~pality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVED JUN 2 4 1991 Municipa~liiy of Anchorage Dept. Heal(h & Human Services REFERENCE: Lot 51; Sec. 9, T15N, RIW, S.M. H~alth Authority Approval Request D~ar Mr. Bolles, This letter is in response to your request for v~rifica~on of casing depth prior to issuing a H~alth Authority Approval on the referenced property. On June 21, 1991 a camera was run down the well casing by White's - R&J Services. Attached is a log developed with the use of the camera. As can be seen the total w~ll depth is 41.33 ft. below the top of the casing with perforations ~ 33.33 ft. With the casing h~ight of I. 11 ft. above the ground, this places the perforations ~ 32.16 ft. below the ground surface. This w~ll was drilled in 1971 or 1912 by the late previous owner, Ardee Holman. At tha~ time the required casing depth was 30 ft. With this information we request a Health Certificate be issued. If you require additional information for your review, please contact us. Sincerely, ROBERT A. SHAFER, P. E. RJS/gm 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 White's - R & J Services P. O. BOX lt2191 ANCHORAGE, ALASKA ggstl (907) 345-2702 Sune 21, 199[ LOG Well ~ P~ivate Well City : Chugiak, Alaska Job #: 9114 Date: June_21, 199[ Time: 10:OB am Inspectorz Joseph White Casing z 6" Steel Screen Type : 1/4" x 3" slots Screen Depth: 33.3' Well Depth ~ - 47.3' Depth= VTR Time: Observattons~ 0 000 9.83~ 20,58' 39.75' 47.33' 160 Top of casing. P~tles~ adapter, Static water level, Beglnntng of perforations (slots), Apparent end of casing. Bottom of well. Notes: Castng ex~ended + 1.17' above surrounding ground. Measurements for the above a~e taken from the top of the casing. cc: S a $ Engineering (copy by fax (# 694-1211}, and by US mall) APPLF '~IT FILLS OUT UPPER HAL ONLY ..,,./ ,~,op~,rtyOwnsr ~',0 ~ &/ ~ ~/IPP.~ Phono '" Buyer Address Zip Code Lending Institution / ~ ~ 7/~ ~. ~ Phone LegalDesoript~n ~1~ ~Z~ ~c ~ Z.~r ~=/ ~.~, Type of Resl~noe ~l~gle Family ~ Olhe~ Water Supply ~lndivldual A~AOH WELL LOG. A wall Icg Is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give well deplh (altach Icg If avellable), lndlvldual Year Individual Installed: t ~] ~ ~ Public Utility When Connected to Public Utlill~ ~ ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OOESSING CAN BE INITIATED. Time ~/ ~ Time Time Time ~ ~ __~ ~ Date Date Date ' Field Notes: \ ( ~ ) APPROVED BEDROOMS *~C;;~',T',~'!-° OF APPROVAL {.~ ) DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size 72023(3182)