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Home My WebLink AboutSKYLINE VIEW BLK 1 LT 14Skyline View Block 1 Lot 14 #051-192-41 ~ 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 NAME J IPHONE ~oEW MAILING~DDRESS LEGAL DESCriPTION LOCATION / NO. OF BEDROOMS ,~ DISTANCE TO: IWell /0~ ( IAbs°rpti°nareaa~` Dwelli:~ , PE~I NOo~~ .... ~ ~ Manufacturer ~ ~ DISTANCE TO: Well Dwelling PERMIT O Z ~ Manufacturer ~ -- ~ Material Liquid capacity in gallons Q Well Foundatl ~ DISTANCE TO: f~O ] °~7/ NearestT~ire PER~ ~ ~ ~ No. of ,in~s/ Lengt~tlino Total ~o~ines Trenc~Otb, inches Distance__.~bet~een Top of tile to finish grade Material beneath tile ~ ~ ~ Total ~ a~ption area 0~ { 7~ inches ~ Length Width ~ Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ DISTANCE TO: Well Building foundation Nearest lot line ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANC~ TO: Building fouodatio~ Sewer line Septic tank Absorption 8rea(s) OTHER PIPEMATERIALS ~ ~ / REMARKS DEPARTMENT PERMIT NO. ( ~0~ ) APPLICANT JEROME HRLLIWILL LOCATION I=ILI T'T' 'DF RNCHI~iRRGE HEALTH fiND ENVIRONMENTAL ~TEF:TInN ~\/;; ,:-,,_\/-~-'~."~ STREET., ANCHORAGE., AK. '~95E~1 - 264-4720 O I'"-.I-- S I TE ~EI.,.II=i~'_ r=-r c.~.... T --,r- J ,1~"~,/~-,/', LEGAL Li4 I~I~;KYLINEVIE~I LOT SIZE '999999 SQLIRRE FEET TYPE OF SOIL ABSORPTION SYSTEM IS' TRENCH MAXIMUM NUMBER OF BEDROOMS = ~ SOIL RATING (SQ FT,.'"BR)= THE REQUIRE[) SIZE OF THE SOIL ABSORPTION SYSTEM IS' [:, E F' T H = t8 L E r-I G T H =z----'2 G R R'-.-' E L DEPTH = 6 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). ~:E[~.I_IIREE) SEPT I C: TR~IK SIZE= l£1El£1 ,]RLLC~FIS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. TI40 ," 2 ;) I I"-tSPEC:T I IDMS ARE REC4IJ I RED BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND RPF'ROVRL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM R PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO R COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS 8RE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I T E><P I RES [:.ECEI'-IBER 2~--1 .. :l.S.- 82 I CERTIFY THAT l' I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIF'RLITY OF ANCHORAGE. 2' I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH TH~ CODES. ~' I UNDERSTAND THAT THE ON-SITE SEWER S,c _~_,TEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED, TO INCLUDE MORE THAN ~ BEDROOMS. ~IGNED' .......... .¢z_-3~_~ ............. ~ ..... UED BY ATE .... - '¢4. O O & E ENE~4EERING & DEVELO~vlENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 Performed for: Name: Legal Description: ~_---~r~- SOIL LOG Mailing Address: ~:/ Earl Ellis 688-2280 Tel. No. ~ Depth (feet) Soil Characteristics 1 2~ 3~ 4~ 5~ 6__ 7~ 8~ 9__ 10__ 11~ PLOT PLAN 12__ 13__ 14 Ground Water Encountered: Yes Proposed Installation: Seepage Pit Comments: No If yes, what depth Drain Field Performed b~L PERC. TEST Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 Parcel I.D. 051-192-41 GENERAL INFORMATION Complete legal description SKYLINE VIEW, BLOCK 1, LOT 14 Location (site address) 19312 IRIS STREET, CHUGIAK, AK 99567 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING il iood COSA# ilion\ Current Property owner(s) KATHLEEN EHRHART & BRETT CAPRICO Day phone Mailing address PO BOX 671143, CHUGIAK, AK 99567 Lending agency Mailing address Day phone Real Estate Agent Mailing Address LES BAILEY & ASSOC. Day phone 694-1234 Unless otherwise requested, COSA will be held by DSD for pickup. NUMB~ROFBEDRoOMS: TYPE' OF wATER SUPPEY: Individual Well" . i' I nd ivid uai 'Water, Stbta ge Community Class' . Well Public Water" SyStem 3 TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [~ [] Individual Holding Tank [] [] Community On-site [] [] Public Sewer E] The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems 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 sample results. (Certificates may be reissued for a pedod 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. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I vedfy that my investigation, based on procedures outlined in the Certificate of On-Site Systems 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. Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3792 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 01/13/2011 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and se ptic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. DSD SIGNATURE ~ Approved for ~-~ Disapproved. Conditional approval for Attachments: bedrooms. bedrooms, with the following stipulations: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate-d~,dvisory X.-~ ~ Arsenic Advisory Maintenance Agreements Supplemental Engin~r's Report Other Original Certificate Date: //////£////// MunicipaliW of Anchorage Development ServiCes Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SKYLINE VIEW, BLOCK 1~ LOT 1,t Parcel ID: 051-I92-41 A. WELL DATA Well type ~'RW*ATE IfA, B, or C provide PWSID # Well Log (Y/N)N Date completed Unknown Sanitary seal (Y/N) y Wires properly protected (Y/N) Y Total depth 200+ f. Cased to 40+ ft. Casing height (above ground) I8+ in. FROM WELL LOG AT INSPECT. ION Date of test -- 3.2/29/2010 Static water level - ft. 194 Well production - g.p.m. 6.4 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100mLNitrate 6.08 mg/L Arsenic: ND .rng/I Date of sample: 3.2/29/2010 B. SEPTIC/HOLDING TANK DATA Collected by: ArcTe~ra Tank Type/Material Septic/Steel Date installed 10/13/3.982 Tank size 1000 gal. Number of Compartments _2 Cleanouts'(Y/N) ~ Foundation cleanout (Y/N) High water alarm (Y/N) N Date of pumping 3.2/29/10 Pumper IRs C. ABSORPTION FIELD DATA Date installed 10/I3/3.982 Soil rating (g.p.d./ft2 or ft2/bdrm) 85 System type Deep Treach Length 26 ff. Width 3 ft. Gravel below pipe 6___~. Total depth 8.67 f. (Measured 12/29/10) Eft. absorption area 255 fi2 Monitoring tube Y Depression over field _N_ Date of adequacy test '12/30/2010 Results (Pass/Fail) ]'ass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 650 gal. New depth 0 in. Elapsed Time: o__ min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N__lf yes, give date --_- D. LIFT STATION Date installed 'Pump on" level at__ Datum in. E. SEPARATION DISTANCES Size in gallons "Pump off' level at ~ Cycles tested in. Manhole/Access (Y/N). High water alarm level at in. Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/li~t station on lot **75' Absorption field on lot 100'+ public sewer main ~;'+ Sewer/septic sewice line Animal containment areas 50'+ On adjacent lots 10o'+ On adjacent lots 100'+ PubliC sewer manhole/cleanout 100'+ Holding tank 100'+ Manure/animal excrete storage areas lO0'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water Service line 10'+ Surface water 100'+ Curtain drain 50'+ (None Known) COMMENTS Water main 10'+ .Driveway, parking/vehicle storage 10'+ Wells on adjacent lots **96' (95' & '04) *Vacant system 2000-gallOn surcharge prior to testln~_ **p ' ' · . reviously Issued walve~ & current waiver requesf G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. ' · Engineer's Pdnted Name KENNETH M. DOFFOS Date 1/13/2011 COSA Fee $490.00 Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $1050.00 Date of Payment i '- t'5" II Receipt Number _(~ ~-~ ~'~' ~, Municipality of Anchorage Community Development Department Development Services Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Sysfems Approval # OSC 111011 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 14 of Skyline View subdivision. This inspection revealed a nitrate concentration of 6.08 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. Municipality of Anchorage P.O. Box 196650 · 4700 Elmore Road Anchora,qe, Alaska 99519-6650 · (907) 343-7904 · Fax (907) 343-7997 ,epartment http:llwww.muni.or.qlOnsite Development Services Department On-Site Water and Wastewater Program VARIANCE/WAIVER REVIEW WR#: OSPl11005 HA#: OSCl11011 PID#: 051-192-41 Legal Description: Skyline View, Block 1, Lot 14 Engineer: ArcTerra Permit~: Applicant: Kathleen Ehrhart & Brett Caprico Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is 75 feet. VI'his waiver approval applies to the existing septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: ~= _'. · ~=ame of Reviewer Rec~: 03568C Amount: $1,050.00 Date Paid: 1/13/11 **** VARIANCE/WAIVER REVIEW **** ¢ TERRA CONSULTING~ INC 212 E. 51st Ave, Anchorage, AK. 99503 Office (907) 868-3791, Fax (907) 868-3793 January 13, 2011 Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: SKYLINE VIEW BLOCK 1, LOT 14 - WELL/SEPTIC TANK WAIVER We are submitting a waiver request for the separation distance between the septic tank to the well located on the referenced lot. Per the attached redlined Shane Holt, LS as-built survey dated January 12, 2011 and available Municipality of Anchorage (MOA) record documents the septic tank is approximately 75 feet to the subject property's well. We are therefore requesting that a waiver to 75 feet between the referenced well and septic tank be granted at this time. This well is up gradient from the septic system and is located on the opposite side of the house. These on-site systems have been in operation for 28+ years. Per ADEC Separation Distance Waiver Guidelines for SCRO: · Water Table (194' static water level on 12/29/10) · Soil Sorption (Per area well logs) · Permeability (Per area well logs) · Water Table Gradient (5+%) · Horizontal Separation (75') 7.50 points 2.50 points 2.00 points 4.50 points 2.00 points TOTAL: 18.5 POINTS The point total indicates that the well would almost sure to be free or no contamination possible from any form of household sewage contamination. It appears that the elevated nitrate levels (6.08 mg/L) of the recent water analysis of December 29, 2010 are not just isolated to the referenced well, but to the local area in general. This encroachment was overlooked by Jeffery A. Garness, PE on the last HAA / COSA approved by the MOA in 2004. The area and subdivision consists of many small lots and waivers of this kind have been periodically granted over the years. SKYLINE VIEW, BLOCK 1, LOT 14 January 13, 2011 Page 2 of 2 We respectfully request that the waiver and the Certificate of On-Site Systems Approval be granted. If you have any questions or require additional information, please contact me at 868-3792 / FAX 868-3793. Respectfully, ArcTerra Engineering & Surveying, Inc. Kenneth M. Attachments: COSA SGS Water Analysis As-Built Survey Red-Lined Encroachments As-Built Survey 20441 PTARMIGAN BLVD · EAGLE RIVER, AK 99577-8736 · PH (907) 868-3791 ° FAX (907) 868-3793 .......... S_GS ....... SGS Reft# 1107393001 Client Name ArcTerra Engineering and Surveying Printed Date/Time 01/11/2011 8:09 Project Name/# Skyline Vw B1, L 14 Collected Date/Time 12/29/2010 14:40 Client Sample ID Skyline Vw BI, L14 Received Date/Time 12/29/2010 15:15 Matrix Drinking Water Technical Director Stephen C. Ede PWSID 0 Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 01/05/11 01/07/11 NRB Waters Department Total Nitrate/Nitrite-N 6.08 0.100 mg/L SM20 4500NO3-F B (<10) 12/29/10 AYC Microbiolo~ Laborator~ E. Coli Total Coliform Neeative 1 100mL SM20 9223B A 12/29/10 DLC Negative 1 100mL SM20 9223B A 12/29/10 DLC ? z~ j S OOOl'O0'E lOS.OD' m ~ · In 133~15 Sl~ll z> Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-192-41 HAA# ~q (~C) '~'~ 1. GENERAL INFORMATION Expiration Date: ~-'-- ~.. - (~ /7L Complete legal description SKYLINE VIEW SUBDIVISION; LOT 14, BLOCK 1 Location (site address or directions) 19312 IRIS STREET * EAGLE RIVER, AK 99577 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address JEFF HALLIWlLL P.O. BOX 11057 Day phone 248-0654 * ANCHORAGE, AK 99511 Day phone PAT WILLHOIT W/ PRUDENTIAL VISTA Day phone 689-6464 166,:35 CENTERFIELD DRIVE * EAGLE RIVER~ AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well · Individual On-site · Individual Water Storage [] Individual Holding tank [] Community Class Well [] Community On-site [] Public Water System [] 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 wastewater 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. 4. 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, 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. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone Address 3701 E, TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKI44/VC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance 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 authorized, nor will it confer any legal right whatsoever. Date 537-6179 DSD SIGNATURE [,,/"// Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: · ON-SITE Attachments: HAA Checklist Septic System Advisory Well Flow Advisory (Rev. 12/01) Manitenance Agreements ~ ~T S~h~,3xx Supplemental Engineer's Reod W/j))))) )}~ Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On,Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: SKYLINE VIEW SUBDIVISION; LOT 14~ BLOCK 1 Parcel ID: 051-192-41 A. WELL DATA Well type PRIVATE Date completed UNKNOWN Total depth 200+ ft. If A, B, or C provide PWSID# N/A Sanitary seal (Y/N) YES Cased to 40+ ff. FROM WELL LOG Date of test ~C~ ~ Static water level ft. Welt'iproduction g.p.m. Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) NO YES 18+ in. WATER SAMPLE RESULTS: Coliform 0 colOnies/100 mi. Nitrate 5.25 mg./L. Arsenic: N/A mg./L. Date of sample: 9/4/200,3 B. SEPTIC/HOLDING TANK DATA AT INSPECTION 9/5/2003 195 6.5 g.p.m. Other bacteria 0 colonies/100 mi. Collected by: AKWWC, INCo Tank Type/Material STEEL Tank size 1000 gal. Numberof Compartments 2 Foundation cleanout (Y/N) YES Date of pumping 9/19/200`3 ABSORPTION FIELD DATA Date installed lO/'13/'1982 Length 26 ft. Total depth .8.~, ,ft. Depression over tank (Y/N) NO Pumper. Date installed 10/13/1982 Cleanouts (Y/N) YES High water alarm (Y/N) N/A JR'S PUMPING FBELOW EXISTING GRADEI Soil rating ~r f¢/bdrm) 85 System type DEEP Width `3 ft. Gravel below pipe Eft. abSorption area 255 ft2 Monitoring tube YES TRENCH Date of adequacy test, 9/5/200`3 Results (Pass/Fail) PASS Fluid depth in absorption field before test ,,,DRY in. Water added 7`3,3 gal. Elapsed Time: 65 min. Final fluid depth 8 Any rejuvenation treatment (past 12 mo.) (YIN & type) in. Absorption rate >= NONE KNOWN 6 ft. Depression over field NO For 3 bedrooms New depth, ,1 `3 in. 450+ g.p.d. If yes, give date - D. LIFT STATION Date installed "Pump on" level at ,,Size in gallons ~ in. Pump off' ~n. H gh water alarm evel at · ,in. Cycles tested Meets alarm & circuit requirements?. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank N/A 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'+ Absorption field 5'+ Surface water. 100'-I- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water service line 10'+ Surface water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots *95' Water main N/A Driveway, parking/vehicle storage 10'+ F. COMMENTS * WE REQUEST WAIVER #WR890035 BE AMENDED TO 95 FEET G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name JEFFREY a. GARNESS Date Date of Payment It ~ ~C~ J 0 L.~ (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number STREET OO'C~O L 3,,00, L DoD S 5O. 4 1 O' UTILITY EASEMENT ('03~J) DO'gO L ('S¥31AI) [ 9'~'0 [ /V~ ,,00 ,LO O0 N D F Z J r~ 0 0 <z (DO LI LI 9--11--03; 8:26AM; ;907 5~15301 ¢ 2/ 3 SGS Ref.# Client Name Project Name/# Client Sample ID Matrix 103570OO01 AK Water & Wastewater Consultants Inc. Skyline View S/I) L14, B1 Outside Faucet Drinking Water Ali Dates/Times are Alaska Standard Time Printed Date/Time 09/09/2003 t5:09 Collected Date/Time 09/04/2003 16:30 Received Date/Time 09/05/2003.13:23 Technical Director ~ St.eph~a~de Sample Remarks: Allowable Prep Analysis Parameter Qualifiers Results PQL Units Method Container ID Limits Date Date Init Waters Department Nitrate-N 5.25 0.100 mg/L EPA 300.0 B (<= 10) 09/05/03 JS Microbiology Laboratory Total Coliform 0 col/100mL SM18 9222B A (<=1) 09/05/03