HomeMy WebLinkAboutDENSIL THOMPSON LT 137A 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
1PHONE I ,J~NEW
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION. NO. OF BEDROOMS
Well / Absorption area Dwelling
~ DISTANCE TO: ~ ~/ ~
N Z Manufacturer Materiel No, of compartments
~ ~ Liq. capacity in 9allons inside length Width Liquid depth
~ ~ IF HOMEMADE:
~ ~ DISTANCE TO: Well Dwetling PERMIT NO.
M.t.ri. iqu U .p.cit in . ons
~ ~~ No. of lines / Length o~ I~ne Total length~¢., li~es_ Trench widths, inches Distance beck. lines
~~ ~ ~ Top of tile to finish grade~ t ~¢~. Material beneath tile Total effective absorption area
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
m DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO.
~ Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
PIPE MATERIALS OTHER
INSTALLER
R EMAR KS
~, ~ ,. E.~ P. Ellis ~ ,~ ~
APPROVED ~ ~ DATE LEGAL
72-,)13 (Rev. 3/78)
PEI:;?.I'1.1; 'T' I",10.
I":'R I:::1N 1<: C: H FII'.~[> L.. Et:;?.
I"1 ! ;.:.!:. 4 [?:: :[ F.:C:HI.,.IOC¢> L. OOP
L.:t2¥?'F! E:,EI'.~::EL.. "['HOMF'%ON '.3,-"[:,
T'T'PE OF :!!i;[31 L R[3~i;OF:'.E!F[ I ON ?.~."..:.-.';TEP1 I :a;: "['F~:Et',IC:H
'T'HEi: [...EI'-,IGTH [> I ME.:I'.,I~!; l ON I $3 THE I...[TN~."!i"I"H < I I",1 FEET ::, OF' THE
TH[L:' [':,EF"T'H Cfi: F:I 'T'~:[.:.:I",IC:H OFi: F']:T I.'.:3 THE E.',I':~;TFIt'.,tCE E:ti.:.:"['l.,.ll'.:.'".[!!:l",l THE :!!~lJl:;i:l:::'FIC:[ii: Cfi:: THE!!:
I'.'iil?.CII.Jl'.][> I::11",1[> 'THE: F. ii:OT'T'OI"I OF THE [~:::.::C:F:I',,,'IZtTIC~I'.,! ,::].'N F'E:".ET?.,.
'T'HEf~.:F: I'..::!; I",10 :!i!;ET !.,.II[>TF.I t::'OF?. 'T'F.:EI"~C:HES.
'T'H[::.' I::~it:;?.l::lV[~:[... [:,EI::'TH .1:5.'; THE r,lIl'-,ltlqurq [:.',EF:"TI-..I OF qil:;i:l::l',,,'[~:L. E;E!:'T'ME[.:.:N ]'1...11:!!: iDI...I'T'I:::'i:::IL.I .... I:::'l'l:::'t!!i:
t.'::!1'.,![::, 'TI-..I[:.:: E',CFt"TOI'q OF THE E ::-:: C: FI ',,,' FI T :[ Cd'..I ,:.' I t",1 I::'E:E"I" .':,.
F:'EI:~:I'q I '1" F:IF:'F::'L I C:P~I",IT IqF:l:!ii: THE: RESF::'CIN~}i; I E: I L. I T":" TO I I"$::'O1:~:1"t TH :[ :S!; I:::'EF:'FIR'I"t'"tENT [:, I...t F;?. I I",IG TH[i!:
I I",I:!!!;'T'I'::IL.I....I:::tT I Ol'-,I I I",I:i3F:'EC:T .t.' O1",1'.:~; OF' I:::lt"]"r' [,.I [.:.'1.... I.... :'3 F'I[:,JI'":IC:E:':I",IT 7'0 "1"1'"1 :[ % F'I;::C$:'EF?.T'T' FIN[:' "!"HI:ii:
t",tI...tME:E!:I:;i: OIF" ~:F..T.:!i!',IE:,E:.I",IC:E!::!~ TI'"IFIT THE I.,.IEt...I....
I'"i I lq ]: i'"ILIM D I ::.'i;'T'F:II'.,I[:::E [3ETI.,.IE:EI",I F:I I.,IEL.[._ FIN[:, FtI'-,I¥ Ol',l'....:!ii; I TE ['.'7, FZI.,.tFtGE [:, I :~;F:'O~.:;F:I!... :.?T':!!!;'T'I.:.:.':M ].' :!ii;
::l.X~ii!) I:::E.E'T' F:'O[~: FI I::i:~:I',,,'FIT[:Z [,.IELL..; O[~'.
.'.'1..5~':3 TC~ ;i!:~.".'!~[!.~ FEET F'E:OM I:::1 I::'LIE~t....IC: I.,.IEI....L. [>Et:::'I:~:I'.,I[>.T.N[:!i LIF:'Cff.,I THE 'T'T'F:'E.: OF: F:'I...I[31....IC: I.,.![ii:L.! .....
CFl"!ql.:.'i:i? I:',i:F..'~[.:~I...i Z E'.E:I"IEI",ITS; i"II::PT' FII::'F'[..."~'. '.:.'!;F'EC: .1: [: ]: C:FtT .1:. O1",1:!~; FIN[>
I::I',,,'!:::11' L.l::l[~:L.[ii: "['O 1' 1"~'SUF.:E': Pf~:OPE":I;i: I 1",I:!3TF:II....I...Ft'I" ~ O1'-,I.
]; C:ti.:: i:~: T I F'"r' T I'"11:::t T
:1..: I I":t1"1 F:F:IMII...I'I::I~: I.,~.I:TH THE Fi:[.:.'X:.:!UIF~:Et"I[~:I"~T'Z, FOF.: OI",I'""~'~;ITE ::":i;El.,.tEl:~:::i3 FIN[:, I.,lEi:l....I....'.:.:.';
F:OF?.TH [3'T' THE MLII",Ii'CII:::'F~LI'T'"r' O1:::'
;;.~:: I t.,.I I I....t.... I I"~:;'TI::IL.L. THE ::'~;'T':i!i;Tl:"£1"l I I",1 FI[.::C:Cff~:[:'I::INC:E ~,.t I TH 'T'HE C:Cl[."E'::ii~,.
::i~:: I I.JI",I[)E[?.:i.:.';TI:::INE:, 'T'HI::IT THE [:)I",I'""::.Z';ITE '.!ii;Eb.lEFi: :.::..;'~-'~;TE:r,1 I',IF:I? Fi:EC.:!I..I]:I;i:E ENI....I:::IFi:[:!i[!!:I',IEI'.J,T ]:1:::' THE!:
f;i:E:!ii; :I: E:,Ef'-,I[:::[!!: I :i!!; I:~:[.:.':I','ICI[:,EI....E[;, TO .1: NC:I....I...IDE: I',IOFi:E 'T'HFtN ,4
December 29, 1978
#780683
Frank Chandler, Jr.
Post Office Box 492
Chugiak, Alaska 99567
Subject: Lot 137A Densel Thompson Subdivision
A permit issued by this department for well and/or
sewer system has expired.
Permits are issued on a calendar year basis, as stated
on the permit, by authority of Municipal ordinance.
If you have drilled the well, a well lo9 should be
sent to this department to document the installation
date.
If there are any further questions, please contact
this office at 264-4720.
Sincerely,
Les N. Buchholz, R.S.
Senior Environmental Specialist
LNB/1 jw
enc: copy of permit
[::,EF't~RTMENT
825 '"L." S;TREET.,
FI P P !.... t C F:IN T
L O C FI T ]: O I'.,!
L..E 31qL
F F-..HNI-.. CF.II::IN[:,LEI;.: ..IF.:
M :[ ;.:?.. ,:I. 81 RC:HI4C¢9[:, LOOP
L..::I.::~:TF1 [)EI'.,tSEL. THOMF':-SOI'-~ 'E,,.."I}
F'O [: f"r,:,~: 4.:i~2 '." ?..ll.lf'~ :[ FIE I::iK
~ '~.-c, ..-:.,T,...TE:,rl IS 'T'RENCH
t','IFI::.::]:Mt.IH NtJHE:ER OF: E:F.!:[:,ROOH:':'!; =
SO!t_..
THE RE).:.:!UIRIED SIZE OF THE :SE I! FiESOF.:PTION ?'r"E;TEH IF.T,'
'TFIE LENG'FH [:' :[ MENS I ON I .':S 'THE L..ENGTH ':: I I",1 FEET ::, (iF: ]"HE: TRENC:H OF.: [:,RFI I ?-,.[':' I .E! ..r',
'T'HE E.,E, F1H OF Fl. TRENCH OR PIT TS; THE DISTRNC:E E'.E'f'I,.tEEN '1"HE ':::t F.'FFIr'I:-:' OF' .....
GF:OJNE:, RN[:, THE E;OTTOM (:iF' THE EXCFIVFtTtOI",I ,:: IN FEET).
]HE.F..E I::S NO E;ET HI[:,TH.. F'OR TF, EN_.FtE...-:,.
'['HE .~ n, ~ .... [:,EF'TH I :i:.; THE H ! N ]: MUM [:,EPTt"~ OF bF:.H',' E.I .... F:[:'T
FIN[:, "['HE BOT]"I]I'd r' F 'T'HE [:~:?:).".::FI'v'F-tT ): t':. I",t "1 t'4 F:'E:ET
l: E.F..fl ! I I:::IF'F:'I... ! '7 F:II'.,!T' HFI% THE RE'qP - N'::; I D I t.... 1' 'T'"r' 'f'f"~ 1' NFriF.'H "tH ! :!'.:.; E:,EF'FtF.:'T'HEN"f' !)UF.: I r.,!(:~/ "r~.., 1:::
I f.,I:.::i;TI::It...LFIT I 0!'.,I ! NF;I::'ECT ! C f.,IE OF Flt",l"r' HELL. S; F:IDJFtCEI"4T TC TH I S; F'F: ]q:::'[':'I:;:T'T' RH[) THE:
..:,[:.[',..,
NLIHE'~ER OF RE:'S!:DE'IqC:ES ]"HFrT' ]"HE t.,.IEI...L. I,.IILJ .... ~ ..... '' "'
BF:ICKFILL..INC'4 OF I:::II',t'T' S"r'%TE:M WITHOUT F'I!"4FIL tNE;PECTIO?',I
[)EPF:IR'T'MEI",IT kl I L.I_ E:E ':;I IE;..TEL'3T T'O F'F.' 7 ~:;F..:" UT
r,IINIML.~r,'I E:,ISTFiI'.~CE: 8F..':TI,IEEN I-] WELL FiND RIq'¢ ON-'..:;ITE :i.::;EHR(~iE r,"'"<Pr'~':::Ft[ 'F.,t.:!i;Tt.!'t '""
::I..OE~ FEET' FOR FI F F..I ,,-, I'E. P.!E'L.L.',
::LSO TO 200 FEE'T FF.'.OM F! F'UE',L. IC HEL..I .... D[:.::F'EI'-4[:,~t"4G !. F'9I".~ THE T'.:"F:'E OF F:'...Ft
()'T'HER REL.-.!U I REMEN'r's:; t"IFt'T' FIF::'PL"r'. SPEC I F' I CRT :[ ONE;
R'v'l::l I L..f:IE:LE TO T I',,t'~ iRE F'F.: ]F'F'I:;.: !. N,::, t HI.. L..H [ I C N.
I CER'I'IF'¥ THRT
:1.: I RM F:I:::tr,'III._IlaR I,.IITH 'T'HE RE6!UIREME:NT'.E; FOR ON-'F...:tTE :SE:FIEF:::}!; FIN[:, .I-,.tF.":L.I_S F!:!;-; SET
FORTH 8'T' THE MUNIC':I PRL. I'T'T' OF FtNCHORFtGE.
2: :r. HIL. L. INSTFtL..L. THE ':S'~"..STEM IN RC.:C:OR[:,RNC':E HITFt 'T'H.E
]:: I I...tNDER%'T'RN[:, THF:I"r THE
RES; I [:,ENC:E I ::5 REMC~[:,EL. EE:, TO
S 1: (:iiN Fi [:, '. - ................
I 'E '.SL EE:, ........................... [: F!TE .................................
M~r. Densil Thompson
2467 Tulik Drive
Anchorage, Alaska 99503
4040 ."B" STREET,
ANiCHORAGE, ALASKA 99.503
PHONE: 907-~79-2581
JanUary 17, 1977 ~
Subject:
Subsurface Investigation
Lot 137, Sec. 8, T.15N., R.1W., SM.
Dear Mr. Thompson:
Transmitted herein in accordance with you~ instructions are t~e
results of the above referenced investigation as performed by us
on January 12 and 13, 1977. The scope of this project is investigation
for ~uitability of an on-site sewerage system. Included in this
transmittal are:
Vicinity Map
Test Hole Logs
Explanatory Information
Figure 1
Table A
Sheets 1-3
The exploration was conducted using a Nodwell mounted Mobile
Drill Model B-50, drill rig with a continuous flight solid stem
auger. The rig is bwned and operated by Denali Drilling, Inc.
Drilling was supervised and the test holes logged by Mr. Terry
Barber, geologist with Alaska Testlab.
Test hole #1 was placed approximately 165' north and 50' east of
the SW corner of the above mentioned lot. Test hole #2 was
placed approximately 165' north and 85' west. of the SE corner.
The ]~ogs of these test holes are included in Table A of this
' re'port. In interpreting the logs, it would be helpful to utilize
the explanatory information contained in Sheets 1 to 3 of this
report.
When drilling was completed a 3/4" slotted PVC pipe was inserte~
in each hole to aid in determining the free water level. For the
percolation test,.the test hole was filled with water and left
overnight to saturate. On returning the next day, the hole
was refilled with water and the drop in the water level carefully
monitored over the next 60 minutes.
~l~~uary 17, 1977
ge. 2!~
This procedure is not standardized percolation test, however, we
understand that the Anchorage Department of Environmental Quality
prefers tests performed in this manner to evaluate a site for a
proposed on-site sewerage system.
Using the above test, the observed minimum percolation rate was:
Test Hole #1
Test Hole #2
14 minutes/inch.
20 minutes/inch
No water table was observed during drilling, but it should be
noted that the free water level normally fluctuates seasonally
and with precipitation.
We hope this report meets your.present needs. If we can be of
further service, please feel free to contact us.
Very truly yours,
ALASKA TESTLAB
R. Ma~k Hansen
APPROVED:
~lvin R.¥~ichols, P.E.
RMH: MRN: g f
13 i i~(,-H 'vV 0 0 D LOoP RD.
TE51" HOLE /...OcATI 0 fl
r~. ~
i ·
Test Hole #2
Table A
Log~
By:
Terry Barber
WO #17962
D_epth in Feet
From To
0.0 1.5
1.5 10.0
10.0 16.0
Soil Description
F-4, brown silt, ML, damp to wet, with roots
and organics.
F-2, brown very silty gravelly sand, SM, dry,
medium to high density, all sand sizes, cobble
at 5'.
F-4, brown, g~avelly, sandy silt, SM, dry, hard,
all sand sizes, rounded and subrounded particles
to 1/2". ~.
Bottom of Test Hole:
Frost Line:
Free Water Level:
16.0'
0.0' - 1.0'
None Observed
_Sa~le Depth.
1 5'
2 10'
3 16'
Blows/6"
M%
Type of
Sample
G
G
G
Dry ~
S~rength Group
Unified
SM
SM
SM
· Remarks: 1.
2.
3.
Type of Sample, G=Grab, SP = Standard Penetration,
U = Undisturbed.
Dry Strength, N=None, L=Low, M=Medium, H=High.
Group refers to similar material, this study only.
A & L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE694-2588
OWNER OF LAND Fff~
ADDRESS ~O ~ofl
LEGAL DESCRIPTION Zo~ t3
DATE-Started ~
/ ",
PERMIT NUMBER 7
DEPTH OF WELL
STATIC LEVEL OF WATER FT.
DRAW DOWN FT.
GALS. PER HR ~ Oc.~
KIND OF CASING
KIND OF FORMATION:
From O Ft. to ~ Ft. O
From b9 Ft. to 2 ~ Ft.
From 3~" Ft. to oc'.~-' Ft.
From-.~-ot''~ Ft. to ~ O Ft. ~'~q~aO 6 ~-,.~'~.
From ~` ~ Ft. to ~' Ft.
From__Ft. to Ft.
From___Ft. to Ft.
From__Ft. to Ft.
From Ft. to Ft.
From__Ft. to.__Ft,
From__Ft. to Ft
From__Ft. to Ft
From Ft. to Ft,
From__.Ft. to Ft.
From Ft. to Ft.
From__ Ft. to__Ft.
From Ft. to Ft
From Ft. to Ft.
From__Ft. to_____Ft
From__Ft. to__Ft
From Ft. to Ft
From__Ft. to Ft.
From Ft. to Ft
From__Ft. to Ft __
From__Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft.
From__Ft. to__Ft.
From Ft. to Ft
From.__Ft. to Ft.
From__Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft
MISCL. INFORMATION:
~$/,oc- P,er~-o~
PERM I T NO.
DEF'I::~RTMENT CIF' HEFII_TH I=IND EN',,,'IRONMENTI~L PF,::OTEC'I"ION
'="='=,_,, ._ '" I_'" ::'!;TREE'I'., FtNCHORFtFiE., RI':::. '.:.'.'~:'.:.'50:Z '~
264-47'20
~.,..~ [=' I._ ~__ F:' E: IF~.:..". "'"'1 ]7. '"r
,:.' 780c~6:1. )
i=tP P L. I C FI N'T'
L 0 C I=1T I 0 N
LEGF~L
I='F;.:FINK CHFINDLER .JR.
M I ':2. 5 B I RCHt.,.IOOD L_OOP
L_:I.~:7'Fi DENS I I_ TIqOMP$ON S,.'"[:,
PO 80',:.-', 49:-.:: C:IqLtGIFIK 9956'7'
L 0'1' 2=; I Z [:'
c:] C":8
5:L00[.'3 E.;LT.!LII=tRE F:'EE'T'
MINIMUM [)ISTSNCE 8E'I-1.qEEN 8 WELL FIN[:, FtN'T' ON-'_:.]I]"E SEI.,.IFiGE DISPOE.;F:IL "2;'T'STEM I.?.:;
:tO~:3 F'EET FOR F~ PR IVFITE I.qELL OF:.'. 200 FEET FOR Fi PUBLIC [,.IELL..
WELL L. OGS FIRE RELT.!UIRE[:, FIN[:, MI_I':.=,T BE RETURNE[:, 'FO THE DEPFIRTMENT WITHIN 30 [:,FI'.r'S
OF I"HE [,~ELL C:OMF'LETII]N.
O'T'HEI:~.: REI.:~UIREMENTS MFI'T' FIPPI_'T'. SPECIFICFITIt-INC; FIN[:, I:::ONSTRUCTION [>IFll]iRFIML::~ FIRE
W,,,'F:I I LFIBLE TO I NSLIRE F'ROPER I N'=-';T[aLLF~T I ON.
I C E R T I F"P T Pi FI T
:t.: I F:IM F'F~H I L. I FIR I,.I I TH THE REQLI I REMENTS FOR CIN-S I TE SE~qERS I=IND NEt..L.'."~; I=IS SET
FORTH B"r' THE MUNICIPBL. ITN' OF ~NCHORf~GE.
2.: I WILL INSTFILL THE SYS;"FEM IN ~C:CORDflNCE I.,.IITH THE CODES].
""I C~NE[::, ~~~.~.~.
........................
V 2.::. O
F::'Et::iJ'"I '.[ T NO.
DE]PFtF?.TMENT 01:: HEFIL.'I"H FIND EN'v'II;.'.ONI"]EhFFRL. PI;..'O'I"ECTIOF~
825 '" L. '"
2~5;;4-' 4';::' 2:0
~.,,.11 E b b IF:::" E IF,.:.: ~,~ 3[: "'1t ....
,:; 7 8 0 0 6:L ;:,
Ft F' F' L. ]: C FI N 'T'
LOCRTI ON
LEGf::IL..
F'O BO::.:', 492 E:HUGIRI'::: 9956';::'
L. OT :51
688
5 i. 0 0 0 5.:; 6! U t.~ F.': E F E E"I"
M :[ N ]: t','lI.Jl',l D I '.2;]"FtNC:E BI.'ETHEEN FI HELL. RND RN"r' ON-:E; I 'T'E SE:HFtGE [:, I :E;PO::SFIL :!'~;h"S'f'EP1 I.".5
::LO¢'l FEET FOF:: FI I::'RI',,,'R'TE HELL 01':: 200 F:'EET FOR FI PUBLIC HEL. L.
I.,.IE:LL LOG"2, FIF.:E F.:EQLIIRIED RND MUST BE RETLIRNEE:, 'to 'T'HE [:,EPF:IRTr"IENT H ITIqlN ]i:O [:,t::l'-r':5;
01:: "I'I'-IE HEI_L C':OP1F'L. ET I ON.
CFT'IqEF~'. I:;.:E¢:!UIF:':EP1EN"F':S r,IFIh.' RPF'L't'. :F:;PEE:]:FtCFI]"IC~N':_:; HND C:ON':'~TRI.JC"I"IEtN [.':,It::IGF.:FIH'.S
FI'v'FI I LF:IBLE 'T'O I NE;UF.:EE Pi'(:OI::'ER I N'_=;'f'FILLFI'T' I ON.
If::::" E.: F::: ['"1t ][ 'T' E ::-:: F' Y[ [~: [£ :5 [::. EE C: E tr"ll E: EE 14E- ::~: :211_ .... ::L .".:5;~ ';::" Ei~,~
I C.:E':;f¥'I" I F"¢ THRT
i.: 1' I::~ P1 F FII'"I :[ L ]: la R H I T I"t '1" H E R E O U I I:;i: E f'lE N T 2; F' 0 Fi'. 0 N- :51' '[' E 'S E I.,.I E 1:4: S R N [.', H E L. L.. 5'i; F:I :ii.'; S I.'i.: T
FORTH B"r' THE: P1UNICIF'RLZ T'¢ OF FINC:HORRGE.
2: I I.'.11L.L. I NS'I"FILL ']"FIE S'¢S"FEH l N FICCORDRNCE I.,.I I TH THE
MUNICIPALITY OF ANCHO
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 051-152-17 Expiration Date: 5--2_q
1. GENERAL INFORMATION
Complete legal description DENSIL THOMPSON LOT 137A
Location (site address) 19954 S BIRCHWOOD LOOP ROAD, CHUGIAK, AK 99567
Current property owner(s) TRAVIS & LINDSEY SILKO Day phone
Mailing address
Real estate agent
19954 S BIRCHWOOD LOOP ROAD, CHUGIAK, AK 99567
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
3
.
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER
DISPOSAL:
Private Well
®
Private Septic
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for:
Distance:
Received by:
Date:
COSA to be released to the engineer, unless otherwise
requested by the
engineer.
COSA Fee $ S50
Waiver Fee $
Date of Payment 1 Z
Date of Payment
Receipt Number —2 %1 1
Receipt Number
COSA # 05 C Z.) 10 q
Waiver #
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, 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. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Address 13030 SUES WAY, ANCHORAGE, AK 99516
Engineer's Printed Name CURTIS HUFFMAN, PE Date 2/13/2021
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
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 in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. 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 i
well and septic system. Therefore, any estimate of how long a system will function satisfactory g�Q: • • • . �9 ���
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting & FWN * . TH • , • ,•;*
6. DSD SIGNATURE• ' Curtis Huffman
bedrooms
j
CE 128991 .`��r
System #1 Approved for } sT
�1 Fop ROFESS0
OF S �l1P��`�A'
System #2 Approved for bedrooms 1���\
Disapproved
Conditional approval for bedrooms, with the following stipulations:
WASTLVATER z
PROGRAM �;
)))W
[_& Original Certificate Date: Z — 2 `t _V
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
Legal Description: DENSIL THOMPSON LOT 137A Parcel ID: 051-152-17
If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _
A. WELL DATA
® Well log is filed with Onsite (or attached)
Date drilled 3/9/1978
Total depth 82 ft
Cased to 82 ft
® Sanitary seal is functioning correctly
® Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 2/11/2021
Static water level at beginning of test 55 ft.
Well production at time of test 3.9+ gpm
Comments
B. TANK DATA
Age of tank(s) 16 years
Tank type/material SEPTIC / STEEL
Measured operating fluid level in septic tank 49"
® Standpipes/foundation cleanout per record drawing
Date of pumping 2/11/2021
Water storage tank volume NA gallons
Well disinfected for coliform test? ❑ Yes ® No
® Coliform bacteria is Negative
Nitrate 3.32 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ® Arsenic less than MRL (ND)
Collected by
FW'E;S
Date of Sample 2/9/2021
C. LIFT STATION
❑ Required maintenance completed
Age of lift station _ years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 4/15/2005 Adequacy test date 2/11/2021
® ALL standpipes present per record drawing Results E Pass For 3 bedrooms
Total measured depth from grade 14.3 ft (max) Fluid depth prior to test 40 in
Measured depth to pipe invert from grade 5.8 ft (min) Water added 450 gal
❑ N/A — pressurized field
New depth 45 in
® Monitor tubes go to bottom of effective. If not, state
depth into effective 8.5'— 8' RECORD ED Elapsed time 90 min
®Code -required soil cover over field
Final fluid depth 40 in
❑ System presoaked Absorption rate 450 gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N
date of test) If yes, enter date
.Gallons introduced gallons
FWComments/Deficiencies: ` rs,
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
® Yes
if No ft
Neighboring Tank > 100'
® Yes
if No
ft
Private Sewer/Septic Line > 25'
® Yes
if No ft
Absorption Field on Lot > 100'
® Yes
if No
ft
Holding Tank > 100'
® Yes
if No ft
Neighboring Absorption Fields
> 100'
Animal Containment > 50'
® Yes
if No ft
® Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75'
®Yes
if No
ft
® Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances
if less than required)
Building Foundations > 10'
® Yes
if No
ft
Surface Water > 100'
® Yes
if No ft
Property Line > 5'
® Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
® Yes
if No
ft
Private Wells > 100'
® Yes
if No ft
Water Main > 10'
® Yes
if No
ft
Community Wells > 200'
® Yes
if No ft
Water Service Line > 10'
® Yes
if No
ft
If septic tank is under driveway
comment
below
From Absorption Field on Lot
to: (Please enter distances
if
less than required)
Building Foundation > 10'
® Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
® Yes
if No
_ ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells > 100'
® Yes
if No ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200'
® Yes
if No
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that 1 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.
•••.
•TH ;*
r Curtis Huffman
��$ �'�c�•. CE 128991 .•��`��
� OFESSIO�'�C��
MUNICIPAL TY OF ANCHORAGE :;,~ ::-: ,
',TMENT OF HE,ALTH & HUMAN SERVICES EnvIron n ;e ntai s~rvic~s
;ervices SectiOn
051~152~
)RMATION ::~
CATE OF HEALTH AUTHORITY·
'address
Cha~er Day phone 279'1020
~670~92 ChUgiak, AK 99567-0492
' Day ~hone
- : "{Day phone
~NUMBER OF BEDROOMS:
TYPE OF WATER ·$
ECTI'
· . ::investigation ofth
that tl~;on'site water supply
~ate forthe number of bedrooms
2-7773-~i.~
-. 6. :?~bHH6: SIGNATURE.
rooms.' ....
,,.:. ,.~.,:
Conditional )rOval
Municipality of Anchorage RE (~ E ! V E D ~~
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division APR 2 ~; 1999
825 L Street, Room 502 'o Anchorage, Alaska 99501 · (907) 343-4744
~ Municipality Of A~chorage
uept Health & Human Services
Health Authority Approval Checklist
Legal Description:
A. WELL DATA
Lot !37A, Densil Thompson Sub. Pamel I.D.: 051-152-17
Well type Private
Log present (Y/N)
81'8"
Total depth
Sanitary seal (Y/N)
Y
Y
If A, B, or C, attach ADEC letter. ADEC water system number
3/9/78
Date completed
Cased to 81 ' 8" Casing height (above ground)
Wires properly protected (Y/N)
3
Y
Date of test
Static water level
Well production
FROM WELL LOG
3/9/78
AT INSPECTION
3/12/, 99
56' 50'
10 8.6
g.p.m.
g.p.m.
WATER SAMPLE RESULTS:
0
Coliform
Nitrate
4.01 mg/L
Other bacteria
Date of sample:
3/12/99
Collected by: T, Y~m~rouqh
B. SEPTIC/HOLDING TANK DATA
Date installed 8/9/79
Foundation cleanout (Y/N)
Date of Pumping 3/99
Tank size ~__ Number of Compartments 2 Cleanouts (Y/N).__
Y Depression (y/N) ~q High water alarm (Y/N) N
Pumper Shaz~ock Septic
Y
ABSORPTION FIELD DATA
Date installed 8/9/79
Length 50 ' Width _ 2.5 '
Effective absorption area 800 SF
Date of adequacy test 3/12/99
Fluid depth in absorption field before test (in.); 64
Fluid depth 71 (ins) Minutes later: 20
Peroxide treatment (past 12 months) (Y/N) N
Soil rating (g.p.d./fF or fF/bdrm) 190 SF
Gravel thickness below pipe
Monitoring Tube present (Y/N) Y
Results (Pass/Fail) Pass
System type
Deep Trench
8 ' Total depth
Depression over field (Y/N)
For 3
Immediately after 431 gal. water added (in.):
Absorption rate = GT 450 q.p.d.
If yes, give date N/A
12'
bedrooms
92
72-026 (Rev. 3/96)*
- None on Lot
D. LIFT STATION
Date installed
Size in gallons
Manhole/Access (Y/N)
"Pump on" level at*
"Pump off" level at*.
High water alarm level at*
*Datum
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
85 ' (See Waiver)
102 '
N/A
GT 25 '
On adjacent lots GT 100 '
On adjacent lots GT 100 '
Public sewer manhole/cleanout
Lift station N/A
N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation GT 5 ' Property line GT 5 '
Water main/service line GT 10' Surface water/drainage GT 100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line GT 10 ' Building foundation GT 10'
Surface water GT 100 '
Absorption field GT 5 '
Wells on adjacent lots GT 100 '
Water main/service line ~ . .
Driveway, parking/vehicle storage area C~T 5 '
Curtain drain None Observed on Lot
Wells on adjacent lots Gm lOO '
F. ENGINEER'S CERTIFICATION
Signature
Engineer's Name
Date
Michael E. Anderson f P.E.
4/23/99
I certify that I have determined thru field inspections and review of Municipal t ~s~tems are
in conformance with MOA HAA guidelines in effect on this date.
Waiver Fee $ [~ ~C4J
HAA Fee $
Date of Payment
Receipt Number
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
MEMORANDUM
DATE: May 17, 1999
TO: Dan Roth
FROM: Mike Anderson ''~ ~'' ~
SUBJECT:
Lot 137A, Densil Thompson Subdivision
Certificate of Health Authority Approval
Attached is a picture showing the sanitary seal recently placed on the well head at Lot
137A, Densil Thompson Subdivision. This should complete all requirements for
issuance of the certificate. Thank you for your assistance with this matter.
/t~l, CT&E Environmental Services Inc.
CT&E Ref.#
Client Name
Project Name/#
Client Sample ID
Matrix
Ordered By
PWSID
990941001
Anderson Engineering
Lt 137A Druksil Thompson SubD
Outside Spigot
Drinking Water
0
Sample Remarks:
Client PO#
Printed Date/Time 03/18/99 16:51
Collected Date/Time 03/12/99 11:00
Received Date/Time 03/12/99 12:55
Technical Director: Stephen C. Ede
Released B~
Parameter
Results PQL Units
Allowable Prep Analysis
Method Limits Date Date Init
Total Coliform
Nitrate-N
0
4.01
co[/lOOmL
0.100 mg/L
SM18 9222B 03/12/99 KAP
EPA 300.0 10 max 03/12/99 03/12/99 SCL
RECEIVED
APR 2 G 19 9
MUrliC~pahly o'f ,qr, c:~o~age
Dept. Health & Human Ser~;ices
0
0
0 .rT.
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WRg~L~k~ PID~ 051-152-17
Date Received: April 26, 1999
HA9 ~~%~ Permit
Legal Description: Lot 137A Denstl Thompson Subdivision
Engineer: Michael E Anderson~ PE. Anderson EnKineerin~
PO Box 240773, AnchoraKe~ Alaska 99~24
Applicant: Frank & Carol Chandler
Waiver Requested: Private well on lot to the septic tank cleanout R5.2 and
from the body of the tank of 83'
Criteria: 1. Geology: Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Waiver is Granted: Waiver is NOT Granted:
List Conditions or Reasons for above:
Date-.
By:
Name of Reviewer
Rec ~: 04800/3083 Amount: $ 625.00 Date Paid: Apri$ 2§, 1999
NOT T~
~00
~4
C~4C~4C~E
C.4C~4C~4
~Z
2.0
TOTAL
17, o
April 23, 1999
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject:
Lot 137A, Densil Thompson Subdivision
Separation Distance Waiver
Septic Tank to Well
RECEIVED
APR 2_ 6 19S9
Municipahty o'~ At~cnorage
Oept. Health & Human Services
Dear On Site Services Engineer:
The well on the subject lot is located 85.2' from the septic tank cleanout and
approximately 83' from the body of the tank. A separation distance waiver is therefore
required from the 100' separation distance mandated by Municipal Ordinance. We are
hereby requesting a waiver be issued allowing the septic tank to continue to function
within the 100' protective radius of the well.
The septic system was constructed in August of 1979 and the well was installed in
March of 1978. The as-built of the septic system clearly indicates the tank was only 87'
from the well. It is unclear why the septic tank was placed within the required 100'
separation distance from the well. It is also unclear why a waiver was not required at
that time or at any time since. A Health Authority issued in November of 1979
specifically indicates the distance between the tank and the well as 87'. This certificate
was signed by Rolf Strickland, the director of DHHS at that time. It is apparent from his
signature that he was aware of the separation distance problem.
The well is located approximately 10' upslope from the septic tank. The total depth of
the well is 82' with casing thought to extend the entire depth of the well. The well log
indicates soils at the site include clay, gravel and sands with a 33' lense of clay at a
depth of 2'. The presence of hardpan normally indicates a very tight soil which would
prevent effluent from the septic tank to migrate to the aquifer serving the well. Static
water was recently found in the well at the 50' level. Contamination appears highly
unlikely.
A recent water sample taken from the well indicated the absence of coliform and other
bacteria. A minor amount of nitrate (4.01 mg/L) was found, but well below the
acceptable amount for human consumption. The neighboring well on Lot 137 B was
tested in December of 1993 and indicated a nitrate content of 3 mg/L. Obviously the
effluent from the septic tank is not causing any major contamination to the water
produced in the well and the minor nitrate content is coming from another source.
Lot 137A, Densil Thompson
Separation Distance Waiver
April 23, 1999
Page Two
Separation Distance Waiver Guidelines
Water Table 38' Below Abs. Trench 4.8
Soil Type SM/GM 2.5
Permeability Medium 2.0
Water Table Gradient Slopes Away +5% 4.5
Horizontal Separation 85' 2.4
Total 16.2
The conclusion based on the aforementioned point totals is that almost surely no form
of contamination can be expected from household sewage.
The overwhelming argument to grant the separation waiver is the fact the well water is
not showing any significant sign of nitrate content. The tight soil surrounding the well
from a depth of 2' to 35' also provides significant protection from contamination. The
current separation distance of 85' is adequate to prevent any contamination from the
septic tank. I therefore recommend the waiver of the separation distance to 85' be
granted in this instance.
Sincerely,
Michael E. Anderson, P.E.
Attachment
LEGEND:
N 90'00'00"
O
LOT 22
TARIKA
NOTE:
W
LOT 136
N 89'54' W
175.00' I
LOT 137-A
51,617.1,3 sq.ft.
DAYLIGHT I~AeEI"IENT
(2' F-_.~,'V~E TTPIC.,aJ_)
· 175.00' :o, Ut~L-~Y £ASE.~.T
N 89'52'27" W
BIRCHWOOD LOOP
I
~J-L 15EAf~ING~5, DI~T/~,NC.E.~ ~J41:::) ARE~ .~4-1~ ~I~IE RECORI:), UNLESS NOTED OTWERI..II6E.
LOT 137-B
EXCLUSION NOTE:
IT 16 THE I:~JE.~PON$1151LIT¥ C~ TI-IE Ot~INER T~DETE~I~ T~ EXI~E ~ ~T E~E~NT~
CO~T~, OR ~TRICTI~5 WHICH DO NOT AP~AR
E~T~Lt~I~ ~DA~ ~ FENCE
DEITZ LT 7B
01818121
49
DELBERT LT 42A 01809259 223
DEL'S LT 1 01549201 192
DEL'S LT 2 01549202 207
DEL'S LT 2 01549202 207
:)EL'S LT 4 01549204 158
DEL'S LT 4 01549204 158
DEL'S LT 4 01549204 158
DELUCIA LT 5 05114147 125
DELUCIA LT 6 05114121 203
DELUCIA LT 6 05114121 203
DELUCIA LT 7 05114122 400
DELUCIA LT 10 05114136
DELUCIA LT 13 05114133
DELUCIA LT 21 05114138 440
DELUCIA LT 21 05114138
DELUCIA LT 23 05114142
DELUCIA LT 32 05114116
DELUCIA LT 37 05114124 24~
)ELUCIA LT 37 05114124 245
DELUCIA LT 38 P-684 05114123 165
DELUCIA LT 43 05114106 250
DELUCIA LT 45 05114104 98
DENALI HEIGHTS LT 3 06803103 145
DENALI HEIGHTS LT 4 06803104 260
DENALI HEIGHTS LT 6 06802103 320
DENALI HEIGHTS LT 7 06802104 320
DENALI LT 124B 05114462 260
DENALI LT 124B 05114462 260
DENALI MEADOWS LT 5B-1 01546147 261
DENALI VIEW BLK 2 LT 2 01546117 200
DENALI VIEW BLK 2 LT 6 01546113 118
DENALI VIEW BLK 3 LT 1 01546102 342
80
DENSIL THOMPSON LT 137B
05115218
01528362
180
DEVONSHIRE#1 TR A
DICK'S LT 1 01524238 100
DONAHO HOMESTEAD #1 BLK 2 LT 1 05021123 335
DONAHUE LT 1 01549408 201
DONALD C SCHROEDER #1 TR 4C 05052127 440
DONALD C SCHROEDER ¢1 TR 4C 05052127 440
DONALD C SCHROEDER ¢1 TR 4C 05052127 440
DONALD C SCHROEDER #1 TR 5A 05052117 353
DONALD C SCHROEDER ¢3 UNIT 1 BLK 1 LT 2 05048106 150
DORA¢2 LT 6 01425123 111
DORA¢2 LT 8 01425125 111
DORA¢2 LT 9 01425126 109
DORA¢2 LT 11 01425128 108
DORA ¢2 LT 12 01425129 98
DORA¢2 LT 13 01425130 98
DORA#2 LT 13 01425130 98
DORA¢2 LT 14 01425131 114
DORA¢2 LT 15 01425132 110
DORA¢2 LT 15 01425132 110
DORA¢2 LT 18 01425135 110
DORA ¢2 LT 19 01425136 108
DORA#2 LT 21 01425138 100
DORA LT 4 01425119 107
MOA Well Data
3/23/92 4
5/20/94 8
7/26/91 5
9/19/95 6
8/9/96 6
3/27/90 7
5/14/91
1/29/97 6
4/14~93 5
7~28~89 0
5/13~97
11/9/94
12/8/89
2/22/91
12/1/92
4~24~97
11/23/92 1
5~29~92 0
3~24~95 1
10~29~98 1
11/25/92 1
10/10/94 6
9/20/93 25
3/27/91 6
4/4/95 1
2/17~94 I
9/16/93 1
10/10/91 6
8
2/26/91 2
5/28/92 3
11/9/94 4
9/8/94
12/23/92 4
12/27/91 2
3~29~89 2
7/14/92 5
8/25/93 6
511191
12/30/92
9/10/98
6/6/94
11/3/94 5
9/18/92 10
2/16/95 3
2/16/95 5
9/18/91 4
1/17/95 6
3/29/89 5
12/9/93 6
7/8/98 4
8/1/90 8
1/29/92 6
3/21/89 5
6/29/89 7
4/28/92 6
11/13/89 6
Page t
NADA
-~- TARIKA
I
I
CYRUS ST.
TOFFSON ST.
IV~-W DRILLING, Inc.
P,O, Box 10-378 · 10300 Old Seward Highway
(907) 349-8535
ANCHORAGE, ALASKA 99511
DRILLING LOG
Well Owner,
.Use of We]]
Location (address of: Township, Range, Section, if known; or distance main road
Size of casing, f"" Depth of Hole 76 feet Cased to ..... ~.~ .feet
Static water level F;! ft. (~b~t) (below) land surface. Finish of well (check one)
Screen ( ); Perforated ( ).
Describe screen or perforation
Well pumping test at 5 gallons per (imnr)
of drawdown from static level.
Date of completion
(minute) for ! hours with ~ ,"';:'
open end ( :c,: );
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
0 .TO 2 Cas~m~ stid~)
':' .TO
'3 .TO. !.0
i0 .TO. 22'
,-, ,~
..... .TO.
38 .TO. ,','~ 1.
55
d! .TO.
%5 TO. 70
70 .TO 75
TO.
TO.
TO.
.TO.
TO.
'ft.
?ravel
Si].ty
Sandy gravel
Silty ?.ravel
Sanay gravel
S~&,r waterbe, at-lng ?ravel
3 -- CONTRACTOR
02/14/94 17:~1 CTC5
CT&E Ref.~
Commercial Testing & Engineering Co,
Environmentel Laboratory Se~ vices
5633 E
RE~3RT o~ ANALYSIS Anchoraga, AK 99618-1600
: 94.0652-9 Teh (907) 562-2343
Client Sa~.ple ID :L168B CENTRAL BIRCMWOOD S/D
Matrix :WATER
Client Name :S & S ENGINe. lNG
Ordered By :R.
Project Name
ProJect~
PWSlD :UA
Fax: (907) 561.5301
WORK Order :75758
P~inted Date :02/14/94 @ i5:46 hfs,
Collected Date :02/09/94 @ 14:00 hfs,
Received Date :02/10/94 @ 15:45 hrs.
Technical
Released By -
Sample Remarks: ROUTINE SAMPLE COLLECTED BY: RAY,
QC Allowable Ext. Anal
Parameter Results Qual Units Method Limits Date Date Init
Nitrate-N 1.32 mg/L ~?A 353.2/300.0 I0 02/11 LLH
* See Bpecial Inst~uctions Above UA = Unava£1ab~e
** See Sample Remarks Above NA = Not Analyzed
.... U = Unde~;ected, Reported value is the practical quant~fication l~.mit, ~T = Less ~n
":~ D = Secondary dilution. GT = ~rea~er T~n
r? Member of th~ ~ G~oup ($oci6~ ~ne~ale de ~urveillan0e)
ENVIRONMENTAL FACILITIES 1N A~SKA, COLORADO, FLO:%i~',/. '.~ t. INOIS, MARY~ND, NEW JERSEY, OHIO, UTAH, %% r: ST VIRGINIA
Well (hvner_-P'°_d Sch~:iger
M-W DRILLING, Inc.
~ O. Bo~ 4 1224 ·
(907) 274-461
ANCHORAGE, ALASKA
DRILLING LOG
.Use of WelL_Dom.
(address of: Township, Range, Section, if kr,-.wn: or di~:tanc,.., main
Seczion Lot 167 Section
$:.:~ ~,'.' (:~'s,:~!;_. __.(~L__Depth of tiulc..220 ........... £eet
Cased t .... i-, ~. .... fut.:
S:a:lc x,.':,i¢.: ]~,veL ..... _61___ft {'{'~NgL') (below) land :;urface. Fm:A. of well (check ~ ;:r.) ~i,:~un uric: (li}D:l'
Screen ( ); Perforated ( ).
Describe screen or perforation-.,_qaa-~'-~Sl' ,~Ld.!i_~u.~¢m~mm~.~Z'_ t-r- 30,~'
Well nu::.r, fng* " _ ~.
. . .es, :~1~7 gallons per ~,~ (minute) f~r._~: ....... bm:rs with .... ~D. fi['. ~'.'
~f ,]:';nvdown from static level.
L~at,:. cf c'c r pietion_ 5_/2..-_/.2 8?
WELL LOG
· _ -: ....TO
2 ~,. 35
3, 5 ,;.(~ 39
:'o ...... P___
~' 155
' 2 TO
155 _TO 169
1 7 2 TO 3!`3
__!_7 3___TO. 18 3
___l s_A_ ~o 198
__l.gS. _To ....
22_o_ _To .........
........ q'O .............
TO .........
Cas ins SJ:_i_cJ;r_Lk~
Silt';' ~:rave! '..:ith occasional co::pbe!s
.........................................................................
Gray ClaI .-- ,./- ~...
'~' /: "~ ~'/t'l~/ '
brave.~y uzay _
S an d s t Olle__ N~,VWA C4,rHli¢(l (_:~mt-~':~dt~
Coal
Brovm Shale
...... _C-r a_~x.:_ .Shale
uNICIPALITY OF ANCHORAG~
I~ - ^F HEALTH
.... Bm:tam of_lo&e_ ___ ,',~:~T. u
......................
'l--CUSTOMER
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
5633 B STREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343
FEDERAL TAX I.D. #92-0040440
ANALYSIS REPORT BY SAMPLE £or Work Order $ 27816
Date Report Printed: OCT 8 90 6 16:4~
Client Sample ID:L1 SCHWINGER S/D
PWSID :UA
Collected OCT 3 90 @ 13:30 hrs.
Receiyed OCT ~ 90 @ 13:45 hrs.
Preserved with :AS REQUIRED
Client Name : S & S ENGINEERING
Client Acct : SNSENGP
P.O.~ NONE RECEIVED --
Ordered By : R. 2H~FER
Analysis Completed :OCT S 90
Special
Instruct:
Send Reports to:
1)S & S ENGINEERING
Chemlab Ref ~: 904064 Lab Smpl ID: I Matrix: WATER
Allcwable
Paramete~ Tested Result Units Method LZmlts
NITRATE-N ND(O.iO) mg/1 EPA 353.2 I0
Sample ROUTINE SAMPLE.
Remarks: COLLECTED BY RAY.
Tests Performed ' See Special Instructions Above UA=Unavailable
None Detected "See Sample Remarks Above
Not Analyzed LT-Less Than, GT=Greatez Than
'~, - D A"l'l~ RECEIVED
TIME TIME TIME
DATE DATE DATE
I NSPECTJ;;}R INSPECTOR INSPECTOR
MUNICIPALITY OF ANCHORAGE /VlUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~viRONMENTAL PROTECTION.
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL SANITATION DIVISION NOV ? 1979
Telephone 264-4720
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER, . I PHONE
MAI LH~T-G ADD,ESS
PROPERTY RESlDEl~T'(If'differen~'from ai~o~) - PHONE
2. BUYER PHONE
~AILING ADDRESS
3, LENDING INSTITUTION I PHONE
MAILING ADDRESS
4, REALTOR/AGENT ,/ - "'" " ~ PHONE
MAI LING ADDR ESS
S. LEGAL DESCRIPTION
STREET LOCATION ....
6. TYPE OF RESIDENCE ~' ~' ,~NUI~BER,'OF~BEDROOMS
[] One ~ Four
SINGLE
FAMILY
~ [] Two t_.u Five
[] MULTIPLE FAMILY [] Three [] Six
[] Other
7. WATER SUPPLY
INDIVIDUAL*
[] COMMUNITY
[] 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.)
8. SEWAGE DISPOSAL SYSTEM
.1~ INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
f,97,9
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
2. WATER SUPPLY
[] INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTILITY
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
i--~INDIVIDUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
[]Septic Tank or [] Holding Tank
Size: I o~..5"'O If Tank is homemade
give dimensions:
TYPE OF TANK
TOTAL ABSORPTION AREA
4. DISTANCES
WELL TO:
Absorption Area to nearest Lot Line
[] ONE
[] TWO
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
NUMBER OF BEDROOMS
[] THREE [] FIVE
[] FOUR [] SIX
DATE INSTALLED
INSTALLER
SOl LS RATING
MANUFACTURER
MATERIAL
Septic/Holding Tank
IAbsorption Area ISewer
Line
[] OTHER
JNearest Lot Line
5. COMMENTS
DATE
I
~ APPROVED FOR Z~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
72-010 (Rev. 6/79)
November 5, 1971
mrs. C. W, Valtne
~ox 4-199
Spenard, Alaska 99509
Subject: Property at 2811 E. 46th Avenue.
Dear Mrs. Valtne:
An JnspectJon at the subject property revealed that an
Individual sewer system ts servtng t~e house. Publlc sew-
er ts available to the house. The construction of the well
is approved.
Before this Oepartment's approval of the sewer and water
systems can be gtven, you will need to connect to the
available public sewer.
[f you have any questions regarding the above, please do
not hesitate to contact this office.
Sincerely,
Lynn $. Coad
Environmental Specialist
cc: CMRO
St