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HomeMy WebLinkAboutT15N R1W SEC 8 LT 52B ij~)~.~ MUNICIPALITY OP ANCItORAGE DEPARTMENT OF HEAL'tH & t:NVIRONMEN'fAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 [ Street - Anchorage, Alaska 99501 Te[0phone 264-4720 ON-SITE SEWAGE DISPOSAL SYoTEM AND/OR WELl. INSPECTION REPORT LEGAL DESCRIPTION F-~ Manufacturer [ ~ Mate,]~ , "I Liq~'~l~l~sa:lL IF HOMEMADE; IInsIde length W'd Liquid depth Well Lengti~ of ea~,~/.L~line/ Foundation I Near~ lot line Z o T~-a~ Im~gth o[ line} I T, en(~ DISTANCE TO: Length Width RADE NO, OF BEDROOMS Liquid capacity in gallons betw en ' ,s Total effective absorption area PERMIT NO. Type of crib rib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: 31ass'~"~'~r)c~r~ ~~--I Depth Drifter Distance to Io, lin,; PERMIT NO. Building foundation Sewer tine Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATER]ALS SOIL TEST RATING INSTALLER DATE LEGAL PERMIT BPPLICBNT STFIR GROUP OGNST. INC LOCRTION LEGBL T'lDNRiW S8 L52B TYPE OF SOIL FIBSORPTION SYSTEM MRXIMUM NUMBER OF BEDROOMS = THE RE~UIRED SIZE OF THE SOIL RBSORPTION S'¢STEM I C:: I F'FjI_ :ir T"T' OF Rr*ICH':'~RIF:IGE .... DEFFIRTMEN'r' HERLTH RND ENVIRONMENTRL ;OTECTION 825 'L' STREET., RNCHO~RGE., BK. ~501 264-4728 ~/~ ~ FIr-ID C~f-~--S I TE SESL-JE~: PE:R['I I ] " 4t0± RI;~CTI_. BLVD SUITE 20~'~95"' ~7'~ "~r --Z~:,t' ~¢"' LOT ~IZE 999999 ~QIJRRE FEETS TRENCH SOIL [)EP]'H:= :1_~ I_ E] I'-,i I,]i T' H := 25 13 I~.". F-1%-' E L g~ EP'TF-t = THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE E,s(CRVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWFEN THE OUTFRLL PIPE RND THE BOTTOM OF THF E>(CRVRTION (IN FEET). F.:E~.]'.~IL.! I Iq:Eli., ._.EFT I C ]FRNF{ -?. I ZE:= it088 (~RLL. C~I'4S PERMIT RPPLIC:RNT HR$ THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTIRLLRTION INSPECTIONS OF RH~r' WELLS RDJRCENT TO THIS PROPERTY RND THE NUflBI_R OF RESIDENCES THRT ]'HE WELL WILL SERVE, TI.4Ca .... ~:.. ,.~.~: ) I I'-~$PEEC:T I Cll'-IS F~RE RIEQU ][ BRCKI='ILI~INC OF RNY SYSTEN WITHOUT FINRL INSPECTION RND RPPROVRL BY THIS DEPRRTM[."NT WILL BE _,UBJEE. T TO PROSEOUTION. MINIIdUM DISTANCE BETWEEN 8 WELL RND RNY ON-SITE SEWAGE DISF'OSRL SYSTEM d. ElO FEET FOR R PRIVRTE WELL OR 150 TO 280 F'EET FROM R PUBLIC WELL DEPENDING UPON TH['] TYPE OF PUBLIC WELL MINIMUM DISTRNCE FROId R PRIVRTE WELL TO R PRIV8TE SEWER LIHE IS 25 FEET RND TO R COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS RRE REQUIRED RND MUST BE RFTURNED TO THE DEPRRTMENT WITHIN -?-8 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MRY RPPLY. SPECIFIBRTIONS RND CONSTRUCTION DIRGRRMS RRE RVRILRBLE TO INSURE F'ROPER INSTRLLRTION. PIE~:I~I :[ T E.._-.s,(p I RES [)EC:EMESER _~.:~_. I ::[: FORTH BY THE MUNICIPRLIT9 OF RNCHORRGE. 2: I WILL INSTRLL TH['] SYSTEM IN RCCORDRNCE WITH THE CODE~. _~:: I LINDERSTRND TNRT THE ON-SITE SEWER SYSTEM MRY RE()U~RE ~NLRRGEMENT IF' THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS. RPPLICRNT STRR GROUP CONST. INC I..,=,U[:D B~ ...... DRTE .... V4. 0 CERTIFY TI-IRT I BM FRMILIRR 1.4ITH THE REQUIREMENTS FOR ON-SITI--f4_EWEF.,=- '~' RND WELl_Lq RS C;ET 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 G£ORGE M, SULLIVAN, MA YOI~ DEPAR'rMENT OF IIF.'ALTH AND ENVIRONMENTAL PROTECTION December 3~L', 1980 Frederick C. Jew Star Route Box 868 North Birchwood LOop Chugiak, Alaska 99567 Permit ~ 800089 Subject: T15N R1W Section 8 LOt 52-B A pe~llit issued by this department for well and/or sewer system has expired as of this date. Permits are issued on a calendar:year basis, as stated on the permit, by authority of Mun~c~pc[10rdinanco. If you have drilled the well,.a well log should be sent to this department to.document the installation date. If an engineer inspected the insLallatlon of the on-'site sewer system, please have them send us the as-builts for our files. If there are an~ further questions, please call this office at 264-4720. Sincerely, // f~ Les N. Buchholz, R.S.~/ Senior Environmental ~p~cialist LNB/ljw enc: Copy of Permit SWP/057 PERMIT NO. RPPL I CRNT LOCRT I QN LEGRL FREDERICK C JEW SR BOX 868 N. CRRNBERRY LN. ,EoT:,~2~B:SEC 8:TI~N,R£N:S.W ? TYPE OF: SOIL RBSORPTION SYSTEM ZS: TRENCH BIRCHWOOD LOOP LOT SIZE 45077 SQUF]RE FEET MR~4IMUM NUMBER OF BEDROOMS = 1.~ ~CIIL RRTINO (SQ FT/E,'R)= 85 TFIE REQUIRED SIZE OF THE c;OIL RBSORPTION SYSTEM IS: E:, E: P"T t-I1= ::.t. E4 L. IS 1,'qlG-F H----- .22 "3 f;:; R '...' E~ L [?.., E F' T H =- THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIEL. D. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNC. E BETWEEN TFIE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVR'FION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE ORRYEL DEPTH I:B THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL. PIF'E RND THE BOTTOM OF TWE EXCRVRTION (IN FEET). F'ERMI]' RPPLICRNT HR':'.; TFIE RESPONSIBZLIT'-r' TO INFORf~ THIS DEPRRTMEN"F DURING THE INSTRLLRTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROPERTY F-~ND THE NUMBER OF RESIDENCE':; TFIRT THE WELL WILL SERVE. TI-.-I() ,C .s-_., ::, ][ ~'-t~---;PEL~:- T 3; ,')-t'42; FIRE BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL 13Y TH~S DEPRRTMENT WILL BE .SUBJECT TO PROSECUTION. MIN]:MUFI DISTRNCE BETWEEN R WELL RND RNY ON-SITE SENRQE DISPOSRL SYSTEM IS .'LOL~ FEET FOR R PRIVRTE WELL OR 15E~ ]"0 200 FEET FROM R PUBLIC WELL DEPENDING I.JPON THE TYPE OF PUBLIC WELL. MINI. MUM DISTRNCE FROM R PRIVRi"E WELL TO R PRIVRTE SEWER LINE IS ~-:'5 FEET RND TO Fi COMMUNITY SEWER LINE IS '?5 F'EET. OTHER REQUIREMENTS MRY RPPL. Y. SF~ECIFIC:RTIONS RND CONSTRUCTION DIFIGRRMS RRE RVRILRBLE TO INSURE PROPER INSTRL. LRTION. P'EF;~t"I I ']- E.~F" :[ F~ E ~.-; I:)E:C:E f'IBE;R g:t.. I CERTIFY THRT 1: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FORTH BY THE MUNICIPRLITY OF RNCHORRC~E. 2: I WILL INS'f'RLL TFIE SYSTEM IN RC:CORDRNCE WITH TFIE CODES. ]~: I UNDERSTRND TFIRT THE ON-SITE ~EWER 9Y5TEM MRY REQUIRE ENLRROEMENT RESIDENCE IS REMO[:,ELED TO INCLUB~ MORE THRN ~ BEDROOMS. .............. RND WELLS RS SET I F THE 08-E GEO] CHNICAL 8 DEVEL . PIVIENT Box 90, Davis St., Eagle River, Alaska 9!]577 6~4-2774 or 6~8-2280 Russell Oyster Earl Ellis 694-2774 $0~L L0('~ 688-2280 Soils 8- Foundations Land Development Performed for: Name:__DR.~J.. C.,, ,Fal("°.~n~r, . . ,,.- M,~il'Ing Address: 1____~¥~5_w. 9th Ave. Anohora~e~.ska 2,?-~Q.~. Legal Descriptlon:~.~Lot 52-B _Secti°n. 8 ~~._T1 N R1W S.M.._, ~_~--~ ..... . Depth (fee_~]_ So 1 Ch~racteris~ M1 - Silt topsoil ~th roots a~ organics. 275 sq. fto/BR. GW - Sandy Gravel with cobbles to 12 inches° Very clean and loose. Overall very porous, 85 sq. ft./BRo GW ~ Sandy Gravel with some cementing with silts. Occasional 6 inch to 12 inch lenses of clean sandy gravels as above, 125!sq. ft./BR 13 "~Fottom of pit° :l. 6 Ground Water Encounter.,d. depth Proposed Installation. S.,,,F~L, Pit Ora~n Fie~d XX Co,me,ts: Pit measured approximately 3' x 12' in p].au area. All sides of the pit logged 'the same° · AUG o19/'6 perfontled~'''b., O,,zte: 21 Jun~9T6 O 8- E GEOh ~CHNICAL ~' DEV,: ,~,r IVJ:NT CC). Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russefl Oyster Earl Ellis 694-2~74 .S_O :~ L, L0~ Soils ~ Foundations Land Development Performed for: Name: Mailing Address:___1.345 w. 9~h Ave. ~ohor~~.~_~_ Legal Description:~ot p~h (feet). ,S~i,1 Characteri~l~ M1 - Silt topsoil wit,,h roots and organics. 1 275 sq. fto/BR. 4 ~ GW - Sandy Gravel with cobbles to 12 ineheso Very clean and loose. Overall very porous. 85 sq. ft./BRo 8 ]LO 11 12~ 13 16 GW - Sandy Gravel with some cementing with silts. Occasional 6 inch to 12 inch lenses of olean sandy gravels as above, ---BOttom of pit° Ground Water Encountered: Yes .... No XX Propossd Insl~altal:ion: 5e~v,~, Pit Dry, in Fle~d xx pit logged the ssme. 125!sq. ft./BR Performed ~d PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ~LNCHORAGE, ALASKA 99519-6650 ON--SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970276 DESIGN ENGINEER:DUMMY COMPANY OWNER NA~E:TUCKER-SHEPHERD TRACY OWNER ADDRESS:20640 OLD CRANBERRY DR CHUGIAK, ALASKA 99567 PARCEL ID:05109330 LEGAL DESCRIPTION: T15N R1W SEC 8 LT 52B DATE ISSUED: 8/26/97 EXPIRATION DATE: 8/26/98 LOT SIZE: 45077 {SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND i5.65 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 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 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: WATER STORAGE FACILITY SHALL MEET ALL PROVISIONS OF ANC SEC. 15.55.07, SUBSECTION C1 THROUGH C8. Convenient to Fill, Drain Quality 11/2" gate valve is mounted on 8" PVC extension pipe for easy draining. Big 10" diameter flexible sleeve on top makes tank simple to fill. Compact, Easy to 5tore Even the largest Kolaps-A-Tank can be folded up and stored in an 18" x 18" x 18" carton. SPECIFICATIONS Approx. Shipping Wt. Model No. Approximate Size Gads. Liters Lbs. KG FDA 50MT 40" x 50" x 12" (102em x 127cm x 30cm) 73 276 11 5 FDA 73MT 80" x 73" x 16" (203em x 185em x 41cm) 275 1040 23 10.4 FDA 98MT 65" x 98" x 18" (165cm x 249cm x 46cm) 525 1987 33 15 FDA 610MT 6'xlO'x2'(1.83mx3.05mx.61m) 800 3028 42 19.1 FDA 712MT 7' x 12' x 2' (2.13m x 3.66m x .6lin) //~40~. 4315 58 .26.3 I1340~_ 5072 64 29 FDA 714MT 7'x14'x2'(2.13mx4.27mx.61m} FDA-approved models meet Food and Drug Administration2 ICFR121.2514' of subpart F of the Food Additive Regulation, making it safe for drinking water used for humam consmnption. From covered wagons to turkey saddles, . . Butch Manufacturing has been making quality textile products for agriculture, industry, and more for almost 100 years. If a product you need can be made of canw~s or vinyl coated nylon -- chances are we can sew it, heat seal it, or silkscreen it. Send us your specifications and we'll be happy to provide you with a free estimate. Sides and Se~wice: URCH ~MANUFACTURING COMP.4JVY, INC. 618 Fir,st Avenue North Box 876 Fort Dodge. Iowa 50501 Phone: (515) 573-4136 1:~ 1-515-573-4138 ^OKT 81 Manufacturers of canvas and synthetic textile products since 1882. Z 0 0 ~ 0 0 mr* 0 o 0 © 0 South 0 0 · : kO 0 ~ -- o!o -q o !D~ rn !0 !1--~ 0 0 . 0 fJJ 0 0 0 0 0 Burch hlanufacturlng Compang, Inc. 616 let Avanue North, Fort Dodge, Iowa Phone 615/673-4136 1~0501 FAX: 515-573-4138 Suggested Liist Price Sheet KOLAPS-A-TANK MODEL FDA-50MT FDA-73MT FDA-98MT APPROXIMATE SIZE 40" x 50" x 12" 80" x 73." x 16" 65" x 98" x 18" SUGGES.t~D GALS.* LITERS LBS. LIST 73 276 11 $275.45 275 1040 23.:. 4.Q6.95 525 198'7 3~ ~'3.'7~ FDA-610MT. 6' x 10' x 2' 800 3028 40 570.25 .~M~ . · __72_~v~-tz2~2~_~____ 1140 4315 58 786. FDA mee~s Food and i~rug Administration 21 CFR 121.2514 of subpa~t F Of. ~he Food AddJtiw, Regulation, making it safe for drinking'wate~ used 'for human consumption. REPLACEMENT PARTS No. 1000 Repair Kit ..... $ 43.35 ~,5.'~-~ ~ No. 2005 Gate Valve. · . 28.65 No. 1508 1-1/2" x 8" Nipple. 6.85 '~g~C, No. 1416 1-1/2" Tank Fitting 26.20 25% REPACKING & REHANDLING CHARGE ON ALL ~TU~ED.-UNITS .' Minimum Billing - $25.00 Effecr. lve September 15, 1996 F.O.B, ~ort Do~ge, Iow;) -- Terms not 30 days. Prices are subject to change without rtotlco. Quotations for tarpaulins and canvas products gladly furnisl~ed .-- please ~end SPecificafiofla. Manufacturers of Canvas and Synthetic 'rextila Products since 1882~ Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTME:NT 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 DWFLLING 1. GENERAL INFORMATION Complete legal description Lot 52B; Sec 8; ']?lSN; R1W Location (site address or directions) NHN Old Cranberry Chugiak, AK Property owner Mailing address Lending agency Mailing address_ Agent Address Tucker Shepherd P.O. Box 670433 Chugiak, Day phone AK 99567 Day phone. Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WA'I~ER SUPPLY,: Individual well LJnless otherwise requested, HAA will be held for pickup. 3 NOTF: Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. T'YPE OF WASTEWATER DISPOSAL: NOTE-'_: Individual on-site Holding tank Community on-site Public sewer XXX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) From MOA #21 5, STATEMENT OF INSPECTION BY ENGINEER · .. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. S & S ENGiNEERiNG Name of Firm ~70~4 Ea~;e River L~ap R~ad i4o. 20z~- Address Eagle River, Alaska 99577 Engineer's signature Phone Date ~ //, / ~ 7 DHHS SIGNATURE ./~/_ Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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. 724)25 (Rev. ~/91) Back MOA ~1 '~ (/~--"~.~)) DEPARTMENT OF HEALTH & HUMAN SERVICES .~.'~ Environmental Services Division ~ 825 L Street, Room 502. Anchorage, Alaska 99501. (907) 343-474~ ~ Hea~th Authority Approval Checklist ~A WELLDATA T~,= ~'~u~e,} ~/~7 ~ P~'~'"'~ ~ ItI FROM , ~ Static water level __ ~/ u/~ WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: d;~'-c~ SEPTIC/HOLDING TANK DATA 60. i )11~¢/Z~--- Other bacteria _ Collected oy:__ ~ ~ Date installed / :),¢Z... Tank size Foundation. eleaneut ~) Date bf Pumping _ /~ ': '~,2,, _ t~o0 Number.. of Compartments. '2- Cleanouts ~¢J~) y _ Depression [Y~ ,'~ High water alarm (Y/N) '~/^ Pumper ...7'~,,E. ABS'ORPTIO~ FIELD DATA Date installee /~'¥ ~ _ Soil rating (g.p.d./ft2 or tt2/bdrm) /042 ~'= System type Length ~'? ' ~Nidth ,,~, ~ ' . Grave th ckness below pipe ~ / _ Total depth Effective absorption area-~ 2 ¢ (,~<t Monitorin,j Tube oresent~,,,~N)._/~.__ Depression over fiela (~.~ _ ,.,.,h Date of adequacy test _ ? ~//-- ~ ? _ Results ¢]~ail) _,P,4¢3 ' For :~ Fluid depth in absorption field before teat (in,~;. 4::;} "' Immediately after-~'~c' gal water added (in.): Fluid depth /~ ~' (ins) Minutes later: /-o ~ ,/J Abserption rate ~//J'~ ~ ' = _ g.p.a. Perexide treatment (past 12 months) (Y~ .,0O/J~ ~4 ~'~),,t) If yes, give date .~O/~ bedrooms 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Size in gallons "Pump on" level at* .~-uml~ a-~~' ' E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: I-~- Septic/holding tank on lot I ~ ~ Absorption field on lot I ¢ c~ Public sewer main ¢{ ~- Sewer/septic service line ¢~"~ ~ 'p On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION. ~ISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation ~ I .-F- Property line ~ I~ Absorption field Water main/service line / c, ~'~ Surface water/drainage /O ¢ /'/~Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line i¢, I ~- Building foundation 1~ / ¢- Water main/service line / ~ /¢' Surface water ! ~ ~ ! ~ Driveway. parking/vehicle storage area ~:~'"-o IG- Curtain drain ~/,4,- Wells on adjacent lots F. E.G,,EER'S CERT,F,C^ 'ON ~ ~ertify that ~ have determined thru fie~d inspe~ti~ns and review ~f M~nicipa~ rec~rds ~;~Y~ ~..t~_ ~re in conformance with ~0~ HAA gu~de~nes ~n effect on this date. Signature ~X~ L-' ~ Date HAA Fee $ Date of Payment ¢///,,~' Receipt Number 72-026 (Rev, 3/96)* . Waiver Fee $ Date, of Payment Receipt Number Services Inc. CT&E Environmental La b o r a t o ry D i vis i o n Drinking Water Analysis Report for TOtal Coliform Bacteria 200 w. Anchorage, AK 99518-1605 I~EA~ INSTR UC~7ON$ O.,Y REPERogE &tDE BEFORZ COLLECTING SAMPLE 'tel: (907) 562-2343 Fax: (907) 561-5,tOl MUST BE COMPLETED BY WATER SUPPLiER 'Ic0~EI'~-,0~IPLETED BY LABORATORY PUBLIC WATER SYST!eM LD. # PRIVATE WATER SYSTEM 17034 Eafllo River Loop Road, No. ~ Mouth Day Year SAMPLE TYPE: ,' with lab rcf. no, ) O Special Purpose Time Collected SA NLPLE LOCATION Collected By ll~tysis shows this Waler SAMPLE to be: Satisfactow O Unsatis facto~ o Sampe over 30 hours old results may be unreliable Sample too long in transi~i sample shoold not be OVer 48 hour~ old at examination to iodlcate reliable resulB. Plea*e send new sample vla Speoialflelive~ mail. Date Receiv,d Analytical Method: ~MembraneFi}tcr ~ MMO-MUG _* _Number c~feelonies/100 mi_ Result* Analyst 97.5334 [~-J] ~ Client noti!icd'otut~sadsfaetory rosulls: Phoned Spoke wilh Coloni,~s/lO0 mi BACTERJOLOGICAL WATER ANALYSIS RECORD iHblO-MUG Result: Total Co[]~'orm E, Coil Member',ne Filler: Direct Count · Veri~aflom LTB BGB --__ COLIFIRM Fecal Coliform Confirmatlon Final ,Membrsne Filler' Results Coli{~f.m/100 mi SEP-10-1997 13:38 CT&E ESI ANCHORAGE ~1~1. CT&E Enviro.m..tel S.rvic,~ Ino, 90?5615301 P.02/02 CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID Sample Rem~ksi 975148002 $ & $ l~ngineering N/A Lo~ 52B Sec ~ TISN RlW SM Drinking Water 0 Client PO# Printed Date/Time 09/04/97 16:23 Collected Date/Time 09/02/97 15:15 Received Date/Tim~; 09/02/97 16:55 Technieel Director: Stephen C, Ede 0.100 O PQL 0.100 mgic Attowabte Prep Aneiysia S~18 &500-gO~F 10 ~x 09/03/97 de(. $H18 92~B 09/0~/97 THU TOTAL P, 02 MUNICIPALITY OF ANCHORAGE DSPAR'I'MENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL H[;ALTH CERTIFICATE OF INSPECTION FOR I-lEA[TH AUTHORITY APPROVAl.. OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date April 29, 1986 GENEFIAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 52B; Sect:ion 8.~ T15N; R1W I..ocation (address or directions) Cranberry Drive off North Birchwood; second house on right (b) Applicant Name Janet M:ischler lelephone: Home707-557-0229 Business Applicarlt Address 1019 Carolina Street, Vallejo, California 94590 (c) Apf)licant is (check one): Lending Institution []; Owner/builder I~[; Buyer []; Other [] (explain); (d) Lending Institution Western Mortqaqe Telephona Address ____An_c_h_ora_gg3_ Alaska ATTENTION: Jan Sheperd (e) Real Estate Company al]d Agent Ta~qet Realty/Marcia Outcalt Telephone _ (I) ~le HAA to the lollowing address: S & S Sngineering SRB ]96X Eagle P, iver, Alaska 99577 NOTE: Call Marcia Outcalt when ready TYPE OF RESIDENCE Single-Family ~ Mulli-.Family [] Otber Number ot Bedrooms _ 2 __ WATER SUPPLY i;~ Individual Well [] Community [] Public [3 Note: If community well syste~n, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite ~ Public [] Community [] Holding Tank [] Note: if community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72025{ib84) ENGINEERING FiRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as ot the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional a~d adequate for the number of bedrooms and type ol structure indicated herein. I further verily that based on the information obtained from the Municipality of Anchorage files and h'om my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with ali Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name ol Firm --$-&$'EN61NEERING Address __ S~,-B-]9~X Date EAG LEEIV EliF, A1~)957~7 Telephone Approved to, ~'~"¢'/.-.¢~ bedrooms by Approved ~ Disapprovec¢ Terms of Conditional Approval CAUTION 'The Muncipality of Aechorage Departmeet of Health and Environmental Protection ([)HEP) issues Health Authority Approval certificates based solely upon the represei]tations given in paragraph 5 above by an independeut professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or ornissions in the professional engineer's work. Page 2 of 2 7~-o25 (u/84) WELl.. DATA Well Classilication Well Log Present MU NICIPA[.ITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: Lo,l- _~-Z-'~ I ~'E..C_,.~-.~j Tota Depth ~ ¢ Static Water Level Casing Height Above Ground Electrica Wiring in Conduitd~N') Separabon Distances from Well: To S6 3tic/Holding Tank on Lot To Nearest Edge of Absoretion Field en Lot To Nearest Public Sewer Line AZ"¢I-~/ Cleanout/Manhole ~ Water Sample Collected by Water Sample Test Results Comments If A, B, C, D.I=,C, Approved (Y/N) [)ate GomDleted -~'-' ]:~" ~ "~ Yield Cased to ~'/"'~' ' "' Deoth of Grouting /Z. ' Pump Set At I?-." "~ Sanitary Seal on Casing ~N~ Depression Around Wellhead ,/'~ '~ · '¢- On Ad.oining Lots . f~PD ~'¢' /~ '~ ""-- : On Adjoining LOtS ./~ a "'~' To Nearest Public Sewer To Nearest Sewer Service Lin(; on L.o! B. SEPTIC/HOLDING TANK DATA Size Date Installed Stanc 3ipes ~/N-)- Air-I ght Caps Depression over Tank (.Y~'~ Pumping/Maintenance Contract on File (Y/N) Holding Tank H~gh-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line TO Water-iV~.i~/Serwce Line ~'~ No. of Comnar[mems Foundation Date Last Pure ~ed '~"'~ Course /~/~- ; for ~ Temporary Holding Tank Permit [Y/N) To Building Foundation To Disnosal Field __ /O ~' To Stream Pond Lake, or Major Drainage Comnlents Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field..(-Y;'~ Results of Last Adequacy Test Separation Distance from Absorption Field: //00///~,~- Type of System Design To Water-Supply Well To Building Foundation Lot To Water4Cl~mr/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Length of Field Z~7 Depth of Field /0 Gravel Bed Thickness ~ Standpipes Present 6N~ Date of Last Adequacy Test "5~"-~' To Property Line ,/o /'~- To Existing or Abandoned System on ; On Adjoining Lots ~(:~ /4-.- TO Cutbank (if preset/ Comments D. LIFT STATION :!' Date Installed Dimensions Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Manhole/Access (Y/N) ,~/p Off" Level at Vent (Y/N) /../A~._ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed S & $ [:NGINEERIN. G Date ~4~,V, ! 9 !986 Company $~B l~6X MOANo. GLE Receipt No. ~0 ~ Date of Payment ~-~O- ~ Amount: $ ~ %'~ Page 2 of 2 72-026 (11/84) CItEMICAL & GEOLOGICAL LABORATORIES OF ALA,~KA, INC. , , , Anchorage, A _laska 99518 Dnnk~ng Water Analysm Report for Total Cohform Bacteria TO BE COMPLETFD BY WATER SUPPLIER .~PR~VATI-' ~JA'rER SYSTPM Name CRy State SAMPLE DATE: Mo. Day Year ' Phone No. Zip Code SAMPLE '1'¥ P E: E~---Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose _) [] Treated Water L'~-4Jnt reated Water SAMPLE NO. LOCATION 4 L J ~ b J Time Collected Cgl?cted J TO BI-- COMPLETED BY LABORATORY Ana. lysls shows this Water SAMPLE to be: tlsfactory ~'[~ Unsatisfactory [-] Sample too long in transit; sarnple should not be over 30 hours old at examination to indicate rallable results. Please'send new sample via special delivery mail. ~,ate Received _ ',-,'-"o,-', . Time Received Analytical Method: Membrane Filter * No. of colonies/100 mi. Lab. Ref. No. Analyst, I Result* l-VI I-5] I=~ACTERIOLOGICAI. WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Membrane Filter: Direct Cpunt. Verlllcatlon: LTB BGB TNTC == Too Numberous To Count OB = Other Bacteria Time: Collform/100ml SHE1LA GALLAGHER Lawyer 4749 Business Park Blvd., Bldg, K Anchorage, Alaska, U.S,A. 99503 Telephone: (907) ~.~.,.7~1~ March 21, 1983 Dr. Rodman Wilson Manager Municipality of Anchorage Health & Environmental Protection Department Pouch 6-650 Anchorage, AK 99502-0650 561-1613 I;IEka DJ:B:, OI~Q Dear Dr. Rodman: Pursuant to Anchorage Municipal Code ~ 15.05.130, notice is hereby given of the intent of Ms. Janet Mischler to co,hence an action against Jay Williams Drilling and Star Group Construction for violation of Anchorage Municipal Code § 15.55.060(L). On or about November 22, 1982, Janet: Mischler purchased a single family residence from Star Group Construction located on the following described property: Lot 52-B, SUBDIVISION OF BLM TRACT LO[~ 52, according to Plat No. 77-264, Records of the Anchorage Recording District, Third Judicial District, State of Alaska. (Cranberry Rd., Peters Creek, AK) (T15N, R1W, Section 8) The well on the premises was drilled by Jay Williams Drilling. 9?he well was inspected and certified by the Municipality on November 22, 1982. A copy of the inspection report is attached. The well failed to yeild the 150 gallons per bedroom per day, as required by Anchorage Municipal Code ~ 15.55.060(L). Therefore, Ms. MJ_schler intends to institute action against Jay Williams Dr;[tling and Star Group Construction for violation of Anchorage Municipal Code ~ 15.55.060(L). Sincerely, SHEILA GALLAGHER Attorney for Janet Mischler SG:SAP:sm Encl. APPI. I( NT FILLS OUT IJPPER HA[ ONLY Property Owner ,.~% .~-~ I~. I ¢OLt.(; Phone Lending Instllutlon ~:,~ (X. ~hX~.~(&~ Phono Realty Co, & A~nt Phone Address Zip Code Type of Resi~nce [~ Multiple Family No. of Bedroo~ ~ Individual ~ ~o~ ~Z~ La~L., ~3~ ¢ A~ACH WELL LOG. A w~l log Is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach log if available). [3 Public Uglily NOTE: THE INSPECT*ON FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN B~ INITIATED. Time Time Date Inspector Field Notes: Da'e i[,--- I G~ Inspector Time Date Inspector 0 Inspector ~F^t.ITF OF ~,, ,~440~, RECEIVED ( ~-"~APPROVED BEDROOMS "~-- ) DISAPPROVED ) CONDITIONAL APPROVAL' 'CONDITIONS OF APPROVAL Soils Rating Date Sewer Installed Well To Absorption Area Well Io Tank Well Log Received 9eptlc Tank Size 72-023 Ou:,'er Janet Mischler Len,~lng ~.smu~lon Alaska Mu%ual Savings Bank APPLICANT FILLS OUT UPPER HALl:: ONLY Stargroup Cont u¢.%lo 7'7-2681 Zip Code Legal Description St~eel Location T15N R1W Section 8 Lot 52B ~!~ingle Famdy Ded~ooms~WO Water Supply ~ Community [] Public Utllily . Sewer Disposal [] Public Ulility [] Holding Tank ATTACH WELL. LOG. A w~l log is required [or ali wells drilled since June 1975. For wells drilled pflor to that date, give well deplh (attach log il available). Year Individual Installed: _ When Connected Lo Public Utility: NOTE: THE INSPECTION PEE MUST ACCOMPANY [!ACH REQUEST BEFORE PROCESSING CAN BE INFFIATED. MUNICIPALITY OF ANCitORAGE DEPARTMENT OF HEAL. TH & ENVIRONMENTAL PROTECTION Enwronmental Saturation Division 825 t. Street · Anchorage, Alaska 99501 · Telephone 264-4720 CERTIFICATF OF INSPECTION ON-SITE SEWER AND WATEF{ FACILITY 1. Property Owner Mailing Address 2. Legal Description S%argroup Construction T15N R1W Section 8 Lot 52B 3. Type of Dwelling 4. Sewage Disposal 5. Water Supply XQ~ Single Family ~ Individual '~ Pub{lc {D Public Utility [] Multiple Family [~ Other [] Holding Tank [] CommunUy (shared) 'CONDITIONS OF APPROVAL APPROVAL FOR 19 8 tWO BEDROOMS [] CONDITIONAL [] DISAPPROVAL DATE: ~c, vember 22, THIS APPROVAL NOT VALID WITHOUT DEPARTMENT SEAL O 8- E GEC CHNICAL 8 DEVEL,. IVtENT CO. Box 90, Davis SI., ~a,(lle River, Alaska 99577 694,2774 or 68~-2280 SOIL LOG ........ 6P.,8-Z280 Land Developrnen! Perfom~ed for: Name: DR. J. C. Falconer ............. NMling Address. ._ 134'5 W._~th Ave, Anohora~ ............ e, ~la~a ~ ~.~ .... ~0~.. Legal Description:~&~~ ~i~N RtW S.~, 0 1. ......... N1 -. 811t topsoi1 with ~oots a~ 694-2774 275 sq. ft,/SR, GW - Sandy Gravel ~th cobbles to 12 inches° Very clean and loose. Overall very perous. 85 sqo ft./BRo GW ~ Sandy Grave]. with some cementing with silts. Occasional 6 inch to 12 inch lenses of clean sandy gravels as above, ]¸3 --~ --~ttom of pit° 16 i25 sq. ft./BR Ground Water Enco{mtered, Yes No X× ' . ......... . ....... yes, t,¢hat depth Proposed Installation: Ssq}a,S; Pit ........ Drain Field. x~_ C0m~ents:.__ Pit measured approximately 3' x 12' qm m] -- ................................ :'~--*-~.~l~.~ A~ sides of the pit logged the same~ .... 4 l 5 8 AUG Per'fon;~ed byt