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HomeMy WebLinkAboutMOUNTAIN PARK ESTATES #2 BLK 3 LT 7Mountain Pa k Estates Block 3 Lot 7 #0! 7-022- Municipality of Anchorage Page ! of 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: ~'bL) c/~i~-/J.¢ 0 PID Number: Name: '~4~lb ~. ~C'~ Wastewater System: ~ew ~ Upgrade *dd~,~: I ~ o(~0 ~ ~u~ ~/~ ABSORPTION FIELD Phone: NO. of Bedrooms: ~,.,~ OOeepTrench ~allowTrench OBed OUound Total Depth from original grade: LEGAL DESCRIPTION so,,~,,~:/~ s~ws~. ~,. /~/~' Lot: Z BIock:~_ ~/~' ~7~ubd' isis.n: ~ Depth to p,pe bottom~f~from origin.l., grade: Ft. Gravel depth be~ath~f .---- · Ft. Township: Range: Section: Fill added above original grade: Gravel length: Number of lines: Distaece belw~n lin~: WELL: ~/~. D New U Upgrade Grave~ width: ~ Ft. / Classification (Private, A,B.C): Total Depth: Cased To: Total absorption~ Pipe material:~ D '/~ ~Date Drilled: StabcWater Levek~ ' FL ,~~ ~~ Date/~/~_~/~ins.,led:. ' Yield:' Pump Set at: Casing Height Above Ground: SEPARATION DISTANCES ~p,c ~ Holding ~ S.T.E.P. TO Septic Absorption Lifl Holding p~5~c./Private Manufacturer: Capacity in gallons: Fro~ Tank Field Station Tank Sewer Lines ~. ~ /~ Material: Number of Compa~ments: s;~;;; ~ ~' >/F~ ~ ~ >/~' ' ~ LIFT STATION Fou.datJon ~ ~,:<~, ~I~ ~/~ ~ "Pump oh"level at: I"Pump off"le~ater alarm at: Remarks: BENCH MARK Location a~ Descript~n: m Assumed Elevation: ~.~ ~N~ER',~ SEAL Inspections performed by: ~ ~ Dates: 1st/¢Z7¢~ ~: ~~o~:% ............ Department of Heal'nd Hu~Services approval ~,>.,,~%'%~,. Reviewed and approve ~ate:/ 72-013 (Rev. 9/91) MOA 25 Permit No. ~ ¢-~7-~ ©~/~0 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 Inspection Report Legal Description: ~¢T-7/~¢'~ PID No.: 0170 Permit No..-~ b~ ~7..~ O 5Z/~ O Page Municipality of Anchorage : DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P:O. Box 196650 · Ahchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well I-nspection Report MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L".STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930460 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:CHEEZUM DAVID M OWNER ADDRESS:13000 SAUNDERS RD ANCHORAGE, ALASKA 99516-3239 DATE ISSUED:il/01/93 EXPIRATION DATE:il/01/94 PARCEL ID:01702219 LEGAL DESCRIPTION: MOUNTAIN PARK ESTATES #2 BLK 3 LT 7 LOT SIZE: 19800 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK 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 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAACS0). 3. THE ENGINEER MUST NOTIFY DHHS 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: DAT : // - / - ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, ALASKA 99524 October 20, 1993 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 7, Block 3, Mtn. Park Est. Subdivision, Addn. No. 2 Septic System Design Impacts to Adjacent Properties Dear On Site Services Engineer: The seepage pit on the subject lot failed a recent adequacy test and must be replaced with a new drainfield. Testholes on the lot indicate largely impermeable soils underlain by a very clean sand at a depth of 11' to 12'. No water was found during excavation or during the monitoring period. Since this is usually one of the wettest times of the year we are assuming the water table remains very low year round. Wells in the area are very deep with low yields further indicating a low water table. We are proposing to excavate to the 11- 1/2' level and place two 5' wide drain trenches each 35' long. We will then place 2' of drain rock below the distribution piping. In additiion, we are proposing to add another 3' of drain rock to provide additional capacity and to bring the distribution piping closer to the surface. The lots in this subdivision are narrow with barely 20,000 square feet of usable area. The septic area is further reduced by the number of wells in the area. We feel this design will serve the house currently on the lot. If the system is constructed as designed the following statements can be made: The system, if constructed as designed, will have no adverse impact on the wells currently in use or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will drainage patterns in the area. Sincerely, Michael E. Anderson, P.E. I"= 5;0' CHECKED BY DATE SCALE /" = 5-0' ~...~.~..~......~_...~ ................ i. ................................ ~: .............................. I ............. ?...~.!..~.~ ............ i......:,, .......................... i .......... ! ....................... i ............ ....i ! .......... ....... .ii J~J.......~ i _ ~ ~. _.. ~.L ~ ..~ ........... ~ L J J.~..~.~.....'~,~ ............. ......... .......... ......... ............ ~ .................. , ........ t~Z ....................... ] ............ ~. ............. ~...'.~ ......... j..t ............... : ............................... ~..'_.~ ............ ~ ......... ~.~...........~;~."~.~ ..... ............. i ............ t ........... ~ ............. ;'"'"'"~F-"~" ~-~'x:'"".~~:'dl .......... ~ ............ ['"': .................... ~ ........... ~~__..~ .............. ............. ?.....4....~ .................... 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'r* ~ - ~ ~' % ' CHECKED BY DATE SCALE f tt~_ ~1~ ~ Lot 7, Block 3, Mtn; Park Estates SubdiVision Addn. No. 2 DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Percolation Rate: 3 Min./Inch Application Rate: 1.2 GPD/SF Wide Trench System 1,250 Gallon Septic Tank Red. Factor (2') : .7 (4 Bdrms. X 150 GPD) / 1.2 GPD/SF = 500 SF 500 S.F. / 5 L.F. X .7 (Red. Factor) = 70 L.F. Therefore: Construct Wide Trench System with ,Two ...Laterals, EaCh 35 L.F. with 5'. of Gravel Beneath Pipe.- ...... Systerw"Des~gned"for 2' Gravel. Additional Gravel Added to ProVide Additional Capacity and to Shallow Up the Distribution Piping. Michael [E. ~-~der~on 4381 - ~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20- DATE PERFOJ Township, Range, Section: COMMENTS SLOPE WASGROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? ~- pO E SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop t / I -- TEST J:IUN BETWEEN __ (minutes/inch) PERC HOLE DIAMETER FTAND ( '~ ~/'~'"' FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) - ~'/~,~// DEPARTMENT OF ENVIRONMENTAL QUALITY /.. pERMIT NO. INSTALLATION OF: SEPTIC TANK FINAL IN~PECTIOHI J4 HOUR NOTI~ REQUIRED, B~CKFILLING OF ANY BY~TE~ WITHOUT FINAL IN~ECTION B? TH~ HEALTH DEPARTMENT AUTHORI~ WILL BE aUBJECT TO pROSECUTION, DIAGRAM OF ~Y~T~M 10 ft. SEEPAGE PIT ~ f~--~, DRAIN FIELD l0 ft. / .~-~1 SEEPAGE P,'; /~) f ALSO CONSIDER AREA WELLS. SEEPAGE PIT 10 BEPTIC TANK SIZE MINIMUM DI~TANC;ES, REQUIREMENTS 5 ft. FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT 20 l~te DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL ].5 ft,~ SEPT,C TANK 5 fl;, TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK l0 ftf DRAIN FIELD l0 ft. SEPTIC TANK, 25 f%e SEEPAGE PIT ].00 ftc DRAIN FIELD 50 ft, c I r~quir~d ~honove~ , ' under drive~'ay. 3ABLE) EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 10 I'll- CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. I'IU[LIC P~STU~[[~ T [.CAST IR0~ SIPIION PIPE ...... , S01L ~. / HEALTH AUTHORITY .,:',TE!R ;},hICHORAGL- ARF!X :!GROin, DEPAR'1',~!EHT OF EH~i!RONMEi'SiAL QdAL 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 C!\SE # Performed For Eex Cash Lemal Descriotion: Lot 7 Block . This Form Reoorts Soils Lo~XX Date Performed 26 seot. 1972 3 Subdivision Motmtain P~a~k E~es __ Percolation Test Oepth Feet Soil Characteristics 1 XOp- soil 3-- GTM 5 The sediments in this area were fairly compact with a moderate water content. The Gm to Gw was found in erratic layers. The contacts between the Gm ~ud Gm to Gw were gradational. 6 7 Gm 8 to Ow 9 ~ 10 ~-m Was Ground Water Encountered? No Yes, At what Depth? Slope- west L_J__ ! _] Reading Date Gross Time Net Time Denth to H20 Net Drool Percolation Rate Minute Proposed Installation: Se~n, aqe Pit .... ~ ......... Dra',~ Field Den. th of Inlet .... ~__-_~_..~e..e_t .......... Denth To Bottom Of Pit Or l'rench~l~F_eet Test Performed Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 O Parcel I.D. 017-022-19 1. GENERAL INFORMATION CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAHILY DWELLING HAA~ ~0,)~ .~'~ 7 Expiration Date: J Completelegaldescription MOUNTAIN PARK ESTATES SUBDMSION ~2; LOT 7, BLOCK 3, Location (site address or directions) 15000 SAUNDERS ROAD * ANCHORAGE, AK 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address WILLIAM DAY Day phone 345-0207 13000 SAUNDERS ROAD * ANCHORAGE, AK 99516 Day phone JANET BORDERJEUX w/ BYNAMlC PROPER~ES Day phone 3111 'C' STREET * ANCHORAGE, AK 99503 261-7614 Unless otherwise requested, HAA will be he/d by DSD for pickup. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well ~ Individual Water Storage Community Class Well __.~ Public Water System TYPE OF WASTEWATER DISPOSAL: individual On-site Individual Holding tank Community On-site 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 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewatar 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 samples. (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. Note: Alaska Water and Wastewater Consultants, Inc. shaft be paid $ to closing for the engineering services provided. STATEMENT OF INSPECTION BY ENGINEER at, or pdor I 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. NameofFirm ALASKA WATER & WASTE'WATER CONSULTANTS, INC. Phone 337-6179 Address 6901 DEBA~R ROAD, SUITE 2B "ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results desc~fbed the performance cf the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of ali we/ts and septic systems depend on the local soils condition, groundwater levels that may fluctuate duting the year, and the water usage of the family being served by the system. These conditions are outside the control of the eva/uator of the system. Satisfactory test results do not guarantee future pedormance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD, The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authotized, nor wi//it confer any legal tight whatsoever. 5. DSD SIGNATURE ~ Approved for L.~ bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory bedrooms, with the fllowing stipulations: , .. Manitenan~ Agreements l/iii Supplemental Engineers Reoff Other Original Certificate Date: Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program 4700 Soul~ 8ragaw St, P.O. Box t96650 Anchorege, AK ~J519-6650 www.cLanctmrage.stcss Legal Description: A. WELL DATA Co HEALTH .AUTHORITY APPROVAL CHECKLIST MOUNTAIN PARK EST, S/D ~12; LOT 7, BLOCK .3, Parcel ID: Well type pRrVA~ ff A, B, or C provide PWSID~ N/A Date completed UNKNOWN Sanitary seal (Y/N) YES Totaldepth 4.10 ft. Casedto 40+ ff. FROM VVELL LOG UNKNOWN Date of test Static water level Wel/production WATER SAMPLE RESULTS: Colifmm ~ colonies/100 nd. SEPTIC/HOLDING TANK OATA 1.1 g.p.m. Date of sample: 10/5/2002 Tank Type/Material Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 9/26/2002 Pumper ABSORPTION FIELD DATA Date installed 12/7-S/lg9~ ~'SE1..OW EXISTINO ORN)E~ Soil raUno (~or ff~rxlrm) 1.2 Width 5.0 ft. 017--022-19 we, Log (Y/N) Wires preparly protected (y/N) Casing height (above ground) AT INSPECTION 10/5/2002 212 ft. 1.3 g.p.m. NO 18+ in. Other bacterla_J:[~__colonles/100 nd. Collected by: AKWWC, INC. Date installed 12/7-9/199.3 Cleanoute(YIN) YES Hlgh wateralarm(Y/N) N/A CHUGACH PUMPING Total depth ,13.16 ft. Eft. absorpfion area 540 ft= Monitoring tuba YES Date of adequa~ test 10/5/2002 Results (Pass/Fall) PASS Fluid depth in absorption field before test 0 in. Water added 605 gal. Elapsed Tm'm: 0 min. Flrml fluid depth 0 in. Absorption rote >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN System type TRENCH Gravel below pipe 4.0-4..5 ff. Depression over field NO For 4 bedrooms New depth 0 in. 600+ g.p.d. If yes, give date - O. LIFT STATION Date installed "Pump on' level at in. Datum v'E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: SIZe In gallons "Pump off" lev9l at Cycles tasted Septic tsnkailt station on lot 100'+ Absorption field on lot 100'+ Public sewer matn N/A Sewer/septic sewice line 25'+ Manhole/Act~<~ (Y/U) in, High water alam~ level at in. Meets elanfl & drcult requirements?. On adlacent lots 100'+ On aclJaceot lots 100'+ Public sewer menhole/deanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:. Building foundation 5'+ Property line 5'+ Water main N/A Water service line 10'+ Wells on adjacent lots 100% SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10°+ Water service line 10'+ Curtain drain NONE KNOWN COMMENTS Building foundation 10'+ Surface water 100'+ Wells on adjacent Iot~ 100t+ G. ENGINEER'S CERTIFICATION Absorption field 5% Surface water 100'+ Water main N/A Driveway, paddng/vehide storage I certify that I have determined through field inspec~ona end revfew of Municipal mco~s that the above ~ystema em in conformance with MOA HAA guidelines in effect on this date. dEFT'RD( A. C, ARNESS Engineer's Prlnte~ Na Date Waiver Fee $ Date of Payment Receipt Number 10% OCT-IO-OZ 04:52P~ FI~U-CT&E ENVIROfd~f~TAt. Slav ,~'~ CT&E Environmental Services Inc. 9075615301 T-127 P.02/09 F-249 Cf&£ RefJf Olent Name Proiett Client Sample ID Matrix PWSID 0 Snmpte Remark: 102672500l AK Water & Wastewatcr Consullan~ Inc. Moum~in Park Est LT, B3 Mo~ta~ Park Est LT, B3 D~g Water All Dates/Time! are Ataska Standard Time Printed Date/Time 10/09/2002 16:10 Collected Date/Time 10/04/2002 14:30 Rtcelved Datefflme 10/05/2002 11:30 Re~gl~ J'QL Units AllowaBle P~ ~aly~is Limits Date Date Init Nitral~N 4.39 0.200 mill EPA 300.0 ~--10) 10/07/02 JDT M:l,c~*obtolog~' L~boz:&t:og]' To~al Coliform O. col/I OOmL SMI8 92221~ 10/05/02 SKW 'E ...:. ~'~ : ~~o" :~:~l~:~.~ '~ I ' - ~ -~- ...~, . · ., = ~1 , -. ,... ~ ~ ~ ~ ~.~ ..... -~:"" ~ ".:~. ~ . · 1 .~' .I ' ~.'- ~ ' ~ / ..... , ml~~ I ~ ' ; ' , ~ : /" ' ~ ~ ~ F ~ , , ~ , ........ !~::. :. :'~ . I · ~' :' ~_.['.", :'.:I_. . - . : ':.~: ..... ~_/ .......... ~ ...... I'- :.l.. i ', '1 ' ;. "'~:" 'o°/ . . :' ~ ' . P~T, A~E HOT SHOWN HEREON..~ ~ ~ ' ' [ ' ' ~ ~ - 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. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (site address or directions) / 3 OO0 ~J(~J~'~ ~?._S '/-~/~ Property owner Mailing address Lending agency Mailing address '~,q'x,/10 /V~. ~,~.C-~_OM Dayphone Day phone 72-025 (Rev. 1/91) Front MOA #21 5'6 z - 7 {- b-.3 NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water v NOTE: TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. Unless otherwise requested, HAA will be held for pickup. Agent --/"~oR,'r t)H tr-- ~DIZ~ P~'7~z.' --~ ~%/~cqC}/~ c ~o,,J b~Z. Day phone Address ~-5 Z~5 b '~-/~:~'~ _~utT-C'- /00 '~JOM SAOOU]~UO leUO!SSOjoJd eqi u! suo!ss!~uo ~o sjojjlB Jo~ elqiSuodsoJ ~,ou s! ol~Joqouv jo /q[18d!o!unl~ oq.L 'penss! s! e~eoW~eo ~ eJojeq ~ap.ez~leUe ~o suoBoedsu! lonpuoo lou ap SHHQ jo soO~oldU~=l 'sluetuoJ!nbeJ e~s pue I~Jopoj u!e~eo/gs!l~s o~ Jap Jo u! suoBnlBsu! bu!puol J[oq~ pu~ seu~oq jo sJos~qoJnd o~ AsaMnoo e ses!q~,soop SHHQ @q.L'e~SelV jo o~S eq~ u! pe~els[DoJ Jeou!Suo leUO!SSeJoJd ~uepu9depu! ue ~q o^oq~ ~ qd~JD~J~d u! ua^!8 suoB~uosoJdeJ oq~ uodn ,quo peseq so~eoWMoO I~^o~ddv ,~poq~nv qil~eH senss! (SHHQ) seoFueS ueLunH pue qll~eH jo lu@LuM~dOQ oOeJoqouv jo/q!led!o!unlAI oq.L s~uou~woo leuop,!PPV :suop, elndp, s 8UIMOIIO~L eqi. q~,!M 'SUJOOJpoq 'SLUOOJpoq JO~ leAoJdde leUOB!puoo 'poAoJddes!c] lOJ pe^oJddV ~.~//~ 3~lfl~VNl!)lS SHHa '9 __ f re, eCl ~ _~ .~-~2~/b~ eJn:jeuO!ssAeou!Guq euoqd 9 ¢V ke~?-~ ~/'g ~ (-vOStL.~ q ~j~y, w~!-I Jo OWeN 'uo!loedsu! s!Li1 ~o elep oLi~ ua loo~e u! suo!lelnl~oJ pue 'seoueu[pJo 'sepoo e~e),S pue led!o!unlAI lie ql!M eoue!ldUJoO u! s! wols/~s lesods!p JO),I3MO),SeM Jo/pue/~lddns Je1~.'M o),!S-UO OLI~ 'uop, oedsu! pue uop, e6p, se^u!/~LU LUOJ~ pue sew eEwJoLiouv jo ,9,!led!o!unlAi eLi1 LUOJJ pou!e~qo UOp, eLUJOJU! Oq~, ua poseq ~,eq~/d,!JeA JeLIlJn~ I 'u!eJeLi pm, eo!pu! oJnlonJjs Jo ed/9, pue StUooJpeq ]O Jequunu eLB Jo~ elenbepe pue leUOBOunj 'ojes s! Luels,~s lesods!p Jm, eMm, SeM Jo/pue ,~lddns JOleM eMs-ua alii ~eLp, SMOqS uo!leo!Idde leAoJddv ,~,!JoLi~,nv LilleeH s!Li1 ¢o uoBe6p, SeAU! ~LU ~,b~Lp, ,~J!JOA I 'MOIOq UMOLIS o~ep UOp, ep!leA eli), Jo se pue re, e JeLl poxwe leOS ~w Xq pewpeo sv EEI=INIIDN~] A8 NOIJ. O:~dSNI 40 J.N=IIN=U.V.1S Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. Well Data Well type/~/-/ Log present (Y/N) /%/ Total depth Parcel I.D. Sanitary seal (Y/N) y If A, B, or C, attach ADEC letter. ADEC water system number Date completed [/,/,.,//~A/ Driller Cased to ~ ¢/z2 / Casing height Date of test Static water level Well flow Pump level1 Wires properly protected (Y/N) AT INSPECTION FROM WELL LOG g.p.m. /. / .g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/hc!d!.".~, tank on lot Absorption field on lot Public sewer main Sewer service line ~ ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ~ Date of sample: /~/////~ B. SEPTIC/HOLDING TANK DATA Date installed /~,~/~/~ Cleanouts (Y/N) y High water alarm (Y/N) Date of pumping Nitrate .,~"/..,t~/~ Other bacteria Collected by: ~~ Tank size //-'¢-¢;' Foundation cleanout (Y/N) Compartments Depression (Y/N) J Alarm tested (Y/N) /4/~/// Pumper SEPARATION DISTANCES FROM SEPTIC/4.1~--~G TANK TO: Well(s) on lot ~ //~ ! On adjacent lots ~' /;~ / ~ ~/¢~/ To property line ~'-¢~ Absorption field Surface water/drainage J' /~-g2 / Foundation ~- /4/-¢_~ / Water main/service line /'/'/-~ 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed ./WL~/~ Size in gallons~~.~ Vent (Y/N) ~ High water alarm level Meets MOA electrical codes (Y/N) ~-~~ SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA Date installed /~///~%¢///~$ Length ¢'~/ ~ Width Total absorption area ~'~/~:¢ .,5 ~ Date of adequacy test ~' Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested System type kt'///~ Total depth ,// Depression over field (Y/N) /"/ Well on lot To building foundation On adjacent lots ~ ,¢¢' Surface water .~ Curtain drain for ~ Bedrooms After test Soil rating (GPD/Ft2) / ~ Gravel thickness Cleanout present (Y/N) /v- Results (pass/fail) ~ On adjacent lots Cutbank If yes, give date ~ / Prope~y line To ~xistin~ or abandoneO systom on Iot /~ ~/~ Water main/semice line / 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 effec~on:the~dat~o..f this inspection. Signature Engineer's Name Date /2 ~.1, . . .,~,~, ~. Date of Payment /~ //~:. Date of Payment Receipt Number ~¢~ ~/¢(~ ,~ Receipt Number 72-026 (3/93)" Bsck COMMERCIAL-TESTING & ENGINEERING CO. ENVIRONMENTAL LABORATORY SERVICES s,.c.,.o. RE3~ORTO£ ANALYSIS Chemlab Ref.# :93.5200-1 Client Sample ID :L7 B3 MOUNTAIN PARK EST. PRIVA%7~ WELL Matrix ~WA%TKR 5633 B STREET ANCHORAGE, AK 99518 TEL: (907) 562-2343 FAX: (907) 561-5301 Client Name =ANDERSON ENGINEERINS Ordered By Project Name Project# : PWSID :UA WORK Order =71620 Report Completed ~10/05/93 Collected ~10/01/93 @ il:40 hrs, Received :10/01/93 @ 12~30 hrs. Technical Director:STEPHEN.C. EDE Sample Remarks: ROUTINTE SAMPLE COLL~C77~D BY: A.H. Parameter Results Qual Units Allowable Ext. Anal Methc~t Limits Date Date Init Nttrate-N 0.85 mg/L EPA 353.2/300.0 l0 10/01 LLH * See Special Instructions Above UA = Unavailable ** See Sample Remarks Above NA = Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT = [,ess Than D = Secondary dilution. GT = Greater Than Member of the SGS Group (S0ci~t~ G~n~rale de Surveillance) ENVIRONMENTAL SERVICES IN ALASKA COLORADO UTAH ILLINOIS, OHIO, MARYLAND, WEST VIRGINIA, NEW JERSEY, SOUTH CAROLINA r ~ MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE ~ ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT, ©F '._ALF; & 825 L Street - Anchorage, Alaska 99501 J, c'~ £CTION ENVIRONMENTAL ENGINEERING DIVISION MAR 2 0 1980 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND gl RECTIONS: Complete all parts on page 1. Incomplete requests will not be proce~ed. Please allow ten (10) days for processing. 1. PROPERTYOWNER j PHONE MAI LING ADDRESS PROPERTY RESlbENT (If different from above)~ 2. BUYER PHONE MAILING ADDRESS 3, LENDING INSTITUTION ] PHONE MAILING ADDRESS 4. ~ALTO~JA~ENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STR E ET LOCATI ON 6. TYPE OF RESIDENCE SINGLE FAMILY [] MULTIPLE FAMILY 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY NUMBER OF BEDROOMS [] One []]~ Four [] Other__ [] Two [] Five .~)~ r,~,~,~ Three [] Six * ATTACH G. A well log is required for all wells drilled ~incqunef' ~975.j~r-wells drilled prior to that date, give well depth i~-tt~og'~---~'if available.) 8. SEWAGE DISPOSAL SYSTEM I~ INDIVlDUAL/ON-SIT~** [] PUBLIC UTILITY **If individual/on-site, give installation date if system is over two {2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQuEsT BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY }ATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE I NSP ~TOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS L~ SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVI DUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED []: PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER E~ INDIVIDUAL/ON -SITE DATE INSTALLED E~ PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or []Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAl.. ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line WELL TO: . Absorption Area to nearest Lot Line 5. COMMENTS PPROVED FOR '4~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) E~ DISAPPROVED DATE BY (Title) LEGX[' DESCRIPTION 72-010 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE I'~ t DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. 02 HEALTH & N,/~ ' 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL P&Cq ECTIO L-~ ENVIRONMENTAL ENGINEERING DIVISION NOV 2 9 1978 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWE~~I~S~ ~ DIRECTIONS: Complete aH parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing, 1, PROPERTY OWNER ~ PHONE MAILING ADDRESS ~ROPERTY RESIDENT (If different from above) PHONE MAILING ADDRESS 3.'" 'LENDING INSTITUTION , PHONE MAIL[NG ADDRESS 4, REALTOR/AGENT I ' -- .... ~ ~ ~RoNE~~ MAILING ADDRESS / ~' - ~ -~ ~ 5, LEGAL DESCRIPTION LoT. '7 BI\C. STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four [] Other [] SINGLE FAMILY [] Two [] Five [] ' MULTIPLE FAMILY [] Three [] Six ~.,~' ¢/a~.L 7. WATER SUPPLY [] INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY *ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) **If individual/on-site, give installation date ~q r7 6. . If system is over two (2) years old an adequacy test is required by this Department, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY '5~n:~ RECEIVED INSPECTION APPOIN-FMENTS FIME TIME 'TIME DATE DATE DATE I NT~E CTO R INSPECTOR INSPECTOR DIRECTIONS: NUMBER OF BEDROOMS 1. TYPE OF RESIDENCE SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3, SEWAGE DISPOSAL sYSTEM []INDIVIDUAL/ON -SITE []PUBLI0 UTILITY Connection Verified []Septic Tank or [] Holding Tank Size: If Tank is homemade give dimensions: [] ONE [] TFIREE [] FIVE [] OTHER [] TWO [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOIL8 RATING TYPE OF TANK MANUFACTURER TOTAt. ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line 5, COMMENTS ....... () ~' ' ~ ~' ~ . -'. ~ ~.- ~CONDITIONAL APPROVAL (letter must~a~mpany certificate) ~ D SAPPROVED ~ ,~ DATE , BY (Title) LEGAL DESCRIPTION 72-010 (Rev, 3/78) June 7, 1979 MUNICR.K~rII'9'c~F 85t~I~D~AOE DEPT. O? ~ ,,,..~,~.-u & ~I'~VIRONMENTAL ?~:O ~'~CTION Marston Realty 2804 W. Northern Lights Anchorage, Alaska RECEIVED Attention: Graham Young Re: Adequacy Test on Existing Sanitary, Sewer System; Lot 7, Block 3, Mt. Park Estates, Anchorage, Alaska. For Professional Services Rendered June 6, 1979. Dear Mr. Young: The following is our invoice for professional services rendered on the above referenced project. Professional Services Fixed Fee Invoice No. 851603-1 Total Invoice No. 1 Please note our invoice number on your remittance. concerning this invoice, please contact me or the Projec% Manager, Mr. Smith. Thank you, R&M CONSULTANTS, INC. C. J. Parisena~ Anchorage Offid~Manager CJP/dj $155.00 $155.00 Should you have any questions ANCHORAGE FAIRBANKS JUNEAU VALDEZ WA$1LLA June 7, 1979 R&M No. 851603 Marston Realty 2804 W. Northern Lights Anchorage, Alaska Attention: Graham Young Re: Adequacy Test on Existing Sanitary, Sewer System; Lot 7, Block 3, Mt. Park Estates, Anchorage, Alaska Dear Mr. Young: Per your request of December 7, 1978, we conducted a test of the sanitary sewer system on the above described property. During the test the liquid level in the seepage pit was monitored as 1000 gallons were removed and 1500 gallons were pumped back into the seepage pit to the inlet level. All liquid levels were measured below the top of the standpipe and are shown in the following table: Initial Liquid Second Water Third 24-Hour Total Reading Removed Reading Added Reading Reading Drop (gallons} (gallons} 4.55' 1000 6.4' 1500 2.85' 4.1' 1.25' The average specific capacity is 40 gallons per inch based on two sets of read- ings showing 45 and 35 gallons per inch. After twenty four hours the liquid level was measured again at 4.1 feet. It had dropped 1.25 feet or 15 inches. This indicates an average effluent acceptance rate of 600 gallons per day for the sur- rounding soils. If the 4 bedroom residence on the property is to house 8 people, the average load on the system can be expected to be 600 gallons per day. We can therefore conclude that the system is disposing of effluent at an adequate rate for a ~ ~adroom~.~sldence. ' ........................................ We appreciate this opportunity to be of service to you. Please contact us if you have any questions regarding this letter or if we can be of additional service to you. Very truly yours, R&M CONSULTANTS, INC. E. R. Rahai~. Staff Geolo~t ANCHORAGE FAIRBANKS JUNEAU VALDEZ WASILLA