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Home My WebLink AboutKNIK HEIGHTS BLK A LT 14Knik H ights Block A Lo1' 14 #017-032-32 Permit Number. SW020350 Start & Kathy Slagle 12501 Ridgewood 345-9215 Municipality or'Anchorage Development Services Department Building Safety Division On-Site Wate~ and Wastewale~ Program, 4700 S. Bragaw SL P.O. Box 196650 Anchorage. AK 99519-6650 w~.d.anchomge.ak.us (907) 343~7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PID Number. 017-032-32 WastewaterSystem: I--INew [] Upgrade LEGAL DESCRIPTION A 14 Knik Heights Well: ~q51t-i ~ I--I New [] Upgrade SEPARATION DISTANCES w, 110 124 NA NA ~w.~ NA NA NA NA ~. 85 18 NA NA F~,,~.~ 38 50 NA NA c,~,~ ~,.. NA NA NA NA General soil quality appeared better in trench Page I of ~) than in Test Hole. ABSORPTION FIELD 0.45 e~o~',' 7.13 - 9.~ ~,. 2.98 - 5.29 ~. 4.15 ~ o.1~-0.~ ~,. 110 ~. ~lu~ Homo Bo~l~ ~02 TANK r~SeptJc C]Holding r'IS.T.E.P. DOther. Sew~ Une Anchorage Tank 75 steel LIFT STATION NA c, BENCH MARK garage slab 100 F,. Inspections performed by: Cindy W. Ellis, P.E. Dates: 1" 9-18-02 2.~ 9-18-02 Development Services Department Approval ~R~e~w, ed and approved by:~~il Date: ,¢,/~"7 'P~rmit No. SW020350 Page 2 of 3 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 Wostewoter Disposal System and/or Well Inspection Report Legal Description: LOT 14, BLOCK A, KNIK HEIGHTS SUBDIVISION PID No.: 017-032-3.32 EXISTING WELL /~'k\ // 100' RADIUS'-~ \ / LOT 15 \ / 30' TEST HOLE ~ MT3 I EKISTIUC mENCH W/ /[ SHED5 7' ~FEC~, 45' LONG/~ R~NNED~ ~DCO1 ' m LOT 14 \ I 10' UllLI1Y EASEUENT / LOT 13 \\ ..~- -'~ ~-~.~ --. / GRND, PIPE MARK A B [LEV. ELEV. ST1 51.5 48.3 97.94 ST2 57.2 54.0 DC01 59.8 56.4 DC02 60.5 57.3 DV 62.0 59.2 COl 66.0 77.2 96.98 91.52 MT1 66.0 76.4 87.57 C02 119.8 128.2 95.32 91.52 MT2 120.0 128,7 87.47 C03 120.7 125.4 95.27 91,52 MT3 121.0 125.0 87.36 C04 69.7 73.6 97.42 91,52 MT4 68.6 73.9 87.37 ZABLE F.S. 75.7 84.3 SCALE: 1":50' WELL · ' · SW020350 Perm,t No. Page 3 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 545-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT 14, BLOCK A, KNIK HEIGHTS SUBDIVISION PID No.: O17-052-32 ,,.~- Fca ~--ST! ~ 97.94' _ w//92'94' /-DCO! /--ST2 / /--DC02/-DV/--ZABLE F.S. m 92.3T/ 1,000 GALLON ~92.13' SEPTIC TANK SEPTIC SECTION N.T.S. UT1% m/--CO1 /-r,NA GRABE 9s.32'- C02'-~ ~,~MT2 9s.98' b NOTE: ORIGINAL GRABE = 94.52' - 96.81' _~/--FILTER FABRIC 91.8T 87 37' , / ' 87.47' ZJ m,/--FINAL GRADE 95.27' - 97.42' ~- NOTE: ORIGINAL GRADE ___~-- FILTER FABRIC ~1.8T 94.50'-96.6~' MUNICIPALITY OF ANCHORA GE Development Sen/ices Department On-Site Water & Wastewater Program 4700 Soufh Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SrFE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Sep 16, 2002 Expiration Date: Sep 16, 2003 Parcel ID: 017-032-32 Total Bedrooms: 3 Site Address: 012501 RIDGEWOOD RD Lot Size: 43500 SQ. FT. Permit Bedrooms: 3 Permit Number: SW020350 Legal Description: KNIK HEIGHTS BLK ALT 14 Design Engineer: 0844 Watkins Engineering, Inc Owner Name: Stan& Kathy Slagle Owner Address: PO BOX 112661 ANCHORAGE, AK 99511-2661 [] Private Well [] Water Storage This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy Ail 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 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. Issued By: ~-'~~ ~ Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-032-32 Permit Number Property owner(s) Stan & Kathy Slagle Mailing address (1) 12501 Ridgewood Dr.. Anchorage, AK Mailing address (2) Legal description (Lot, Block & Sub'd.) Knik Heights, Block A. Lot 14 Legal description (Section, Township & Range) Lot Size 43,500 Day phone 552-4489 Zip Code 99516 A~,'/S q. Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only [] Well Only [] Sewer and Well [] Water Storage [] Sewer Upgrade [] THIS PROPERTY CONTAINS: Hot Tub [] Jacuzzi [] Swimming Pool [] Water Softening Unit [] Therapy Pool [] I certify that the a~bove information is correct. I further certify lhat this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of I:~operty owner or authorized agent) Waiver Fees: Date of Payment: Receipt Number. Watkins Engineering, Inc. P.O Box 110443, Anchorage, AK 99511 (907)349-1851 cwellis@gci.net September 6, 2002 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Knik Heights Lot 14, BIockA Subsurface Disposal Field Upgrade To Whom It May Concem: Attached please find the application and supporting documentation for upgrading the subsurface disposal field for the referenced 3 bedroom house. The original drainfield, a 45 ft deep trench with 7 ft of rock, was installed in 1975 and is currently surcharged. The existing 1000 gallon septic tank was installed in 1988, after a tank failure. We propose to inspect the tank and replace it only if necessary. It is also proposed to keep the leach field as a reserve system. The proposed design of the upgraded system is based upon a test hole dug on August 15, 2002. The TH was dug to a total depth of 16.5 ft, encountering one foot of fill, organics, silt, sand, and some gravel. A percolation test was run on a silty sand and gravel layer at 5.5 ft, with a result of 60 minutes per inch. Based upon this rate and the quality of the soil, an application rate of 0.45 gpd/~ is used in the design. The soil absorption system will be installed as shallow as possible in order to expose the sand layer observed in the test hole. No water was encountered in the test hole or the ground water monitoring tube. Proposed Design: 3 Bedrooms x 150 GPD/BR = 450 GPD 450 GPD I 0.45 GPD/square ft = 1000 sq. ft required System Type: Shallow trench (5-wide) Maximum Depth: 10.5 ft or 9.5 ft below any fill Effective Depth: 4.0 ft Reduction Factor:. 0.50 Length Required: 1000sq. ft/5ft x 0.5 = 100ff Proposed Length: 110 ft (2 x 55 ft) Sewer Upgrade Permit Application for Knlk Hts, Lot 14 BIk A Watidns Englneerlng, Inc.; September6, 2002; page 2 I am not aware of any adverse effect that this upgrade would have on any adjacent properties' water and wastewater treatment needs. Thank you for consideration of this permit application. If you have any questions or need further information, please call me at 349-1851 or 360-3389 (cell). Yours truly, ZC~Cindy W~' p.E.~ Attachments: Permit Application & Fee Site Plan, 100 scale Proposed Upgrade Plan, 30-scale Soils Log and Perc Test for one Test hole DESIGN CRITERIA: .3 BDRM X 150 = 450 GPD APPLICATION RATE: 0.45 GPD/SO. Fl'. 5.0' WIDE TRENCH 450/0.45 = 1000 SO. FT. REOURIED 1000/5 X 0.5 = 100' REOUIRED TRENCH: 10.5' DEEP 4.0' EFFECTIVE 5.0' WIDE (2) X 55' LONG = 110' \. ~MOUND OVER -,.o ~,~L ~.~ / .I -~6.5 -HUFFMAN ROAD- ~-'- £XI.S.'rlNC WELL Prepored By: Septic Des;gn Prepored For STAN AND KATHY SLAGLE LOT 14, BLOCK A KNIK HEIGHTS SUBDIVISION Watkins Engineering,/nc. DATE: SCALE: Cindy W. Ellis, P.E. P.O. BOX 110445 DRAWN: ANCHORAGE, ALASKA 99511-044.3 · CHECKED: PHONE: (907) .349-1851; FAX: (907) 349-19.34 EXISTI,NG WELL ~'~ LOT 15 ~, ~'~ 10' UTILII~ F~),SEMENT PROPOSED SEPTIC .......... '-. '~ ..... -"1 -- ..~ ......... ...- -... : > F° .~.!~, co ~ ~ / ~ / ~ ~ b .... ~ % LEXIS~N6 SPlg88 ~ ~ I ~ 1,0~N ~Pnc / ~~ / -- T~K TO BE INSPECTED fO BE RB~NED~ ~ LOT 14 LOT 1~ 100' RADIUS I lo, UTILFPF EASEMENT EXISTING WEE 100' RADIUS STAN AND KATHY SLAGLE ~.~.?,.- LOT 14. BLOCK A /~.~.----,~ ~lu,~, ''~'~'~, KNIK HEIGHTS SUBDIVISION Prepared By: Watk ns EnmneennE, Inc.' · ' DATE.' 8/,:30102 CmndyW. Ell,s, P.E. ~\ Cl yW. Ellis/~? P.O. BOX 110443 DRAWN: DJR ANCHORAGE, ALASKA 99511-0443 CHECKED: CWE ~~~' PHONE: (907) 349-1851: FAX: (907) 349-1934 Municipality of Anchorage ~ DevelopmentServlcesDeparlment ~.~r?,, 49__~~. ~,~ //,, ~.¥~\ Su~Uleg Safety OMslon [/ ~,&t...!,,,~ \~ On-Silo Water and Wastewater Program t"'"'~ ~--'~.....:-~ ~' · - ~\'~.<~,ig.,~/I P.O. ~ox ~6~.~0 ~nc~*ege, AK Soils Log Percolation Test pe~ro~d F~ Start Slagle Date Pedommd: Legal Desc~ptio~: Knik HelgMs. BIo~c A. Lot 14 Depth (Feet) FI LL 2, 3- Bark- .flag 11- 12- 13- 14- 15- 17- 18- 19- 20- Tovmship. Range, SocUon: sloj~e Site Plan bAT GROUND WATER F. NCOUNTERED? NO $ O FLAT' Reading Date Gross T~me Net Time Depth to Water Net Drop 1 8-16-02 3:51 0 6 NA 2 8-16-02 4:21 30 5.5 0,5 3 8-16-02 4:21 0 6 - 4 8-16-02 4:51 30 5.5 0.5 5 8-16-02 4:51 0 6 - 6 8-16-02 5:21 30 5.5 0.5 PERCOCATION RATE ~3 (mmute~',m:~) P~RC HOf. E DIAMETER TESTRUNBETWEEN SS ~ ~O 6 COMMENTS 4 ~ ~ ~f~ ~l PERFORMED IN AC~RD~CE WITH ALL STATE ~O MUNICIPAL GUIDELINES IN EFFE~ ON THIS DATE DATE- ~' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT .amc / mST^NCES SEPTIC ABSORPTION A~,~ TANK FIELD WELL LEGAL DESCRIPTION Township, Range, Section AS-BUILT DIAGRAM (Show location of well, septic system, prop~y ~Jnes. foundation, ~/O ~ ~ ~ ZJ '~ ~' dri .... y. water bodies, etc.) TANKS ~' SEPTIC ~ HOLDING Manufacturer Capacity in gallons /o~ ~ Material No, of Co~pa~menls TYPE OF SYSTEM ~epth to pipe bottom from~ ~T ' original grade ET Fill added above original grade Gravel~pe FT~ Gravol lenoth ~1 width N~ J Soil rating Pipe material Date Installed WELLS ~ PRIVATE ~ OTHER (Idenlitvl Classification (A,B,C) ~~o FT / Date Installed: Installer S~le: ENGINEER'S SEAL Date~ I ~ '/~ '~ cedily Ihal this inspeaion was pedormed according lo all Municipal and State Duidelines in elfecl on this date~ /~/?/~ 72-015 (3/85) Upq r' ade I,:Zn{'~'! 1neet' Designed NAT I OtxlAI.... BA'IxtK (.. r' ~LA,.. I..,. ANCFIORAGE~ AK 99510 i.~::~{ Legal: Subdivi~;:i. on'.' Kk, IIK HEIGH'TS Lc)t.~ J. 4 Bl(:~c:k: A Sect ion ~ 2::'7 '1 cx,.~rlsh ~p ~ 12'.N Range: L. crk S:i.:;.:e 4;55()0 (SCl,, lt.,, of Max Be~di'ooms: :lh:i,s Per'mit;~ 2~: ]'oral Capa. city: Day F'hor"~e ,:' {eeL, 'e?(:]uir'e~s ir~sulat:i.c)n o',,,~-:,?r' tank ..... ) .. ~:., ,' ~::.r'dl.I. t :IS .[,¥ii~SUED F'[)I::i'. THE EX-~""r"i'lr'. ,::, ,,'.~ :?.: BEDROOM !~.~]:NGL.~!i: k'AN.l.t...¥ I:.XF ~.l'd. :1. 2"./::!!; 1 / 8~ 8. ~ '!)i.j',u.u; £}Ni...Y I:-~ND ................... {,:::,~' Li~ by 'khe Hun:i. cipa], ity o{' ~r'ld"i~:mage (1"t0~) ~nd the St. ate oF A!aska~ ai3d J. 13 compliance with the design ci-iter'ia of this pePmi'k. 3,, I ~,,~i!]. adl~{..~r'e t.(::) a] :1 MOA and St.a'Le (:t{' A!aska r, equi]-ement, s ~'oc the set back dis'J:.artc:es f'r-om any e).(J, stJ. rig ~el:l~, wast. e~,~a'Ler' disl]oSal system sewc.}r'ag~:: ~::,yshem ar'~ this or' any adjacent ~:p n~apby lot. also undepstar'~d that the capac::i.'k.y o{ t. he ~'.otal system is 3 bedr'oo0~s arid ALASKA ENVIRONMENTAL' CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO, OF CHECKED BY. DATE oGREL .,R ANCHORAGE AREA Department of Environment81 Ouality 3330 C Street Anchorege, Aleska gUS03 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION LEGAL DESCRIPTION ~,~ I~, H~'~ PHONE ~/-~'/-'/ SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH ~ MANUFACTURER 5 "'"'"- INSIDE WIDTH NUMBER OF MATERIAL I v'~. ],~.~-- COMPARTMENTS LIQUID DEPTH ~ LIQUID CAPACITY[OO0 GALLONS. DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA FOUNDATION DISTANCE BETWEEN LINES ~')~ J SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE ':~ J-"'"J'' DEPTH OF FILTER MATERIAL BENEATH TILE NEAREST LOT LINE RO /'.OF TOTAL LINES LENGTH/.~(~ ! ~_ I TRENCH WIDTH ~,J~IN. TOTAL EFFECTIVE I "7 I~. ABOVE TILE /'~ IN. WELL: TYPE__ ;IA<:J;U~,~.'.~. J BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION DEPTH DISTANCE FROM: NEAREST LOT LINE OTHER SOURCES NEAREST SEWER LINE SEPTIC SEEPAGE TANK / 0.,.~",I SYSTEM DISAPPROVED REMARKS DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS: ~0 Form LQ-032 DIAGRAM OF SYSTEM G.A.A.B. GrE .~R ANCHORAge Area BO /Ch -- '~ DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT 3330 "C" STREET ANCHORAGE, ALASKA 99503 'SEWAGE DISPOSAL SYSTEM ~ APPLICATION AND PERMIT PINANCED THROUGH TO BE I~STALLED BY , sore r~ST ~SULrS ~aO 2 ~- 7~ NOTE, THIS .ER~IT IS NOT VALID WITHOUT SOIL 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. .,_ /1 __;/ ^ ~ ,./ ',,3.. r/--- 6 0' SEPTIC TANK SIZE . TYPE ~~ SEEPAGE AREA SIZE ~ / ~ TYPE ~G~ DIAGRAM OF SYSTEM FOUNDATION TO SEPTIC TANK ~ FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK .,SEEPAGE PIT TO NEAREST LOTLINE. {. WEll TO SEPTIC TaNK ~' DRAI. F,ELD / ,fOP0 t ., DRAIN FIELD SEEPAGE PIT · ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD SEPTIC TANK, ., SEEPAGE PIT ~RAIN FIEI TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OI EXCAVATION 5 FeET iNTO UNDISTURBED SOIL, 4 INCH DIAMETER CAST IRON SIPHON PIPES OH SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS I~EGARDINC~INSTALLATION, /O T, Y HAT AM A ,L, w, / ~/~ /~ I ORR F T I f M AR TH THE REQUIREMENTS OF GREATER/ANCHOR~AGE_=~~._AREA BOROUG~ ORDI~f~CE NO. 28-68 AND THAT THE ABOVE DATE· ~ APPLICANT'S SIGNATURE / _~ ~ GP, EATER ANCtlORAGE AREA DORO[J~'" Department of Environmental Quali 3330 "C" Street Anchorage, Alaska 99503 SOILS I,OG - PEROI,ATION TEST Lega 1 Des c ri p~i-o-n~]], t~_~z This form reports: ~oils log ~ t Percolation test Depth Feet 10 - 11 - 12 - 13 - Was ground water encountered? B ~ ___ If yes, at what depth? __ Reading Date Gross Time Percolation r-3 t--e ........ minute. '~Proposed installa~-~h-~- Seepage Pit Drain Field Depth of Inlet ................. · Depth to bottom of pit or trenci~ COMMENTS: ................................. pe~-o~-m~-d-'~?'Z- ~._~_-._~_'..~:_':~-__~_~-rti fi ed By: Date: Net Time Depth to Water Net Drop MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location'(add'~es~ or'directions) (b) Telephone: (home) ,~' Business-~ K- .7 (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here,l~, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-Family/l~' Number of bedrooms~ 3. WATER SUPPLY Individual Well ,~ Community [] Public [] Not~: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site,~ 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. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed.hereto and as of the validation date shown below, l verify that my investigation of this Health Authority Approval 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 flies and from 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 of Firm ,/~ ''-C ' ~ .~ -¢%~4' Telephone Address .//~//~ ~ ~ ~ ./ ~ ~ / / 6. DHHS APPROVAL Approved for ,.~ bedrooms by Approved ~ Disapproved Terms of Conditional Approval Conditional Date The Municipality of Anchorage Department of Health and Human Services(DHHS) issuesHealthAuthorityApproval cerificated 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. TheMunicipalityofAnchorageisnot responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: A. WELL DATA Well Classification ~l'2c-io~- Well Log Present~'~N) Date Completed Total Depth ,/~,3 Cased to / Static Water Level /.? ~> Casing Height Above Ground Electrical Wiring 'in Conduit SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot //~ To Nearest Edge of Absorption Field on Lot To Nearest Public SeWer Line To Nearest Sewer Service Line on Lot Water Sample Collected by /¢- ~'*¢~ · Water Sample Test Results /¢~¢ ./L,. If A, B, C, D.E.C. Approved (Y/N) ~/¢~ Depth of Grouting c~,o~-,,~,~-~. Pump Set At Sanitary Seal on Casing6{~/N Depression Around Wellhead ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ;Date Comments B. SEPTIC/HOLDING TANK DATA Date Installed /¢,/~/~-¢¢ Size / D~ Standpipes ~X~N) Air-tight Capsc('~N) Depression over Tank (YL/~ Pumping/Maintenance Contact on File (Y/N) /V~/',4¢ No. of Compartments Foundation Cleanout (Y~ Date Last Pumped ;for Holding '[ank;H'i¢l~-W'ater Alarm (Y/N) ,&','-//,¢ Temporary Holding Tank Permit (Y/N) SEPARATION DISTANC'E's'"FROM SEPTIC/HOLDING TANK: To Wbter~upPly*Well,:. ".'",~/., ¢ To Pr°pe'rt¢'t~i'h~"''" '-% Z ~'~ ! To w~te'k~i'n)s'.~i~e. Elbe' .... ' ..~ / To StN~am,'Rond, Lake o~ MajO'r Drainage Course /[,*z¢~.,( /~.~J/~¢,,_ /ag- ¢'-7~ Comments ~" ':.. To Building Foundation ~-~' J'-- / To Disposal Field /2_ 72-028 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~///~//? ,f'- ? Width of Field -¢ Square Feet of Absortion Area Depression over Field (Y/~ Results of Last Adequacy Test ,/¢ ~'~-~.u¢)~. SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well /.~ To Building Foundation Lot To Water Main/Service Line ~ ,¢¢ ~ To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field Depth of Field Gravel Bed Thickness Statndpipes Present ~'~'N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutback (if present) ~ /o~~ / Comments D. LIFT STATION Date Installed Dimensions / Size in Gallons Manhole/Access ~ "Pump On" Level at £ 2 .~~evel at High Water Alarm Level at ~'~ /,~.~//~"~'~ ' Vent (Y/N) _ Tested for ~,,~/~ / ~ Pumping Cycles during Adequacy Test. Meets MOA Electrical ~ 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 Company Date MOA No. Receipt No. (~ ,~ Date of Payment Amount: $ 72-026 (Rev. 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 ALASKA eFIUIROFImeFITAL COFITROL $1 RUlCe$, IFIC. ~n§ineeHnq 6 I~n~ironmenlal Studies NATIONAL BANK OF ALASKA P.O. BOX 107025 ANCHORAGE, AK 99510 OCT. 12, 1988 KNIK HEIGHTS SUBDIVISION LOT 14 BLOCK A ON 9-16-88 A 4 HOUR WELL FLOW TEST WAS PERFORMED. THE WELL YIELD IS 4.8 GALLONS PER MINUTE. TOTAL DRAWDOWN WAS 4 FEET WITH RECOVERY IN LESS THAN 5 MINUTES. THIS WELL MEETS FHA REQUIREMENTS OF 3 GALLONS PER MINUTE. i200 LUcsI 33rcI Auenue, Suite B · Ancho~a,:je, Alaska 99503 · (907) 276-1361 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. ANALYSIS REPORT' BY SAMPLE for Work Order # 9855 Date Report Printed: OCT l? 88 @ 15:46 Client Sample ID:L14, BA KNIK HTS PW$ID :UA Collected OCT 14 88 @ 14:05 h~s. Received OCT 14 88 @ 15:00 hrs. Preserved with :4 DEG. C Client Name : AECS Client Acct: AKECSRP P.O,# NONE REC'D Req % Ordered By : A. WIEN Analysis Completed :OCT 14 88 Send Reports to: Laborat~r~ Supe~~NEN C. EDE I)AECS Release y: ~;~-~C.~._.~/~ 2) Special Instruct: Chemlab Ref %: 3029 Lab Smpl ID: I Matrix: WATER Allowable Parameter Tested Result/Units Method Limits NITRATE-N 0.26 mg/1 EPA 353.2 l0 Sample ROUTINE SAMPLE Remarks: SAMPLE COLLECTED BY A, WIEN. 1 Tests Performed ' See Special Instructlone Above UA=Unavailable ND= None Detected "' See Sample Remarks Above NA= Not Analyzed LT=Lese Than, GT=Greater Than 825~ L Street, Anchorage, Alas~a~"%.99501 ~D~ . 279-2511, ext. 224 or 225 i /.~ _.-~,' h[-~,I-, , rTu~[' Date Received: April 19, 1977 ~1: Time ~,~.~ ~2: Time ~3: Time Date ~- Date Date Insp ~.__~3 ~i~ Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: National Bank of Alaska % Sherri Mailing Address: Post Office Box 3-3859 99509 Phone: 2. Property Owner: Doug ~'ell Phone: Mailing Address: 3. Legal Description: Lot 14 Block A Knik Heights Subdivision 4: e 279-2506 349-5225/333-6565 Single Family Residence: (x) Multiple Family Residence: Number of Bedrooms: 3 Number of Bedrooms: Well System: Permit # Construction Public/Community System: ( ) Individual Well: (x) Depth of Well Well Log on File ( ) Bacterial Analysis Sewage Disposal System: On-site ~y/~TZ~ Public Utility ( ) Permit # Installed 4976 InstallerJ~3~_ ~d0~/~ Septic Tank Size /~ Manufacturer ~L~ ~ ~_~//~Y~ Absorption Area 7~2g~ Soils Rate Distances: Well to Septic Tank to Sewer Line Nearest Lot line to Nearest Lot Line Material to Absorption Area Absorption Area r~ uP~I~IPALI]~ ~:: 6, , i ~:: ~:.: ,-,, ~..~ MUNICIPALITY OF ANCHORAGE , ' '' ~--- ' ' ~/ . , ~ .... " U:~I. : ~ "~,::~? :J :~Depa~tmen:~.of~-Heatth and Envmronmenhal: :, f~~%/ '825 L Street; ~chorage, Alaska 99501 : . . . ' Mailing Address: Phone 2. N~ o~ Bu~: ~ ~ ~.~ ~ Mailing Address: ~'~ [ ~-- ~ ~-~9~'~ Phone: Lending Institution: r~% ~ }~ ~'~ ~J~L~_~ C~: Mailing Address: ~ ~ ~ %-- .~-.~ C~_ ~%~0! Phone: e e Realtor/Agent: Mailing Address: Legal Description: Street Location: Single Family Residence: Multiple Family Residence: (L~ Number of BedroomS: ( ) Number of Bedrooms: (~/Public/community System If Community System, name of system Water Supply: *Individual Well If Individual Well, well depth ( ) Sewage Disposal. System: On-site System (~Public System ( ) If On-site System, date of installation: *NOTE: A well log is required on ALL wells drilled.since 6/75. MUNICIPALITY OF ANCHORAG,':' DEPT. OF HEALTH & ENVIRONMENTAL PROTEC[ION APR 1 9 1,977 RECEIVED 3/77 Page, ~wo '~.~ ,~ Department of Health and Environmental Protection : ' Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 14 Block A Knik Heights Subdivision Comments: Affadavit Attached: (i:) Disapproved: Letter Attached: ( ) Date: Department Worksheet: