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Home My WebLink AboutBUBBLING BROOK LT 6 ubbling Brook Block 1 Lot 6 #015-492-10 i~ ~_ 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 IPHONE / NEW MAILING~DDRESS ' LEGAL DESCRIPTION LOCATION J NO, ~ DISTANCE TO: ~ ~ ~-~ Mate I No. ofcom~ments Liq. capacity in gallons - ~. ~O IF HOME~DE: Ins~ ~Width Liquid depth Q Well . ~ ~ Foundation Nearest lot line PERMIT NO. ~ DISTANCE TO: -- Length of each ~ ~ Total length of linesL~,~ Trench inches Distance between lin~ ~ ~ ~ Top of tile to finish grade Material beneath tile Total effectiv~bsorption area Length Width Depth PERMIT NO. ~ Well ~uilding foundation Nearest lot line DISTANCE TO: ~ Cla~~'" Depth Driller Distance to lot line PERMIT DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TE~RATI NG I N STA L~ REMARKS , APPROVED DATE LEGAL 72-013 --M-W DRILLING, INC. Well Owner Location DRILLING LOG Gunnarson Construction Use of Well Dom (address of: Township, Range, Section, if known; or distance main road L6, Bubbling Brook Size of casing. 6 Static water level Screen ( Describe screen or perforation Well pumping test at 40 kgallons per of drawdown from static level. Date of completion 13 Feb 79 B2, Depth of Hole 125 ft. ); Perforated ( 213 feet Cased to 212¥4 feet (below) land surface. Finish of well (check one) ). None (minute) for 1 hours with 100% WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 TO 2 Casing 2 .TO. 3 Fill 3 .TO 4 4 .TO. 18 18 TO 50 50 TO. 90 90 .TO 103 103 .TO. 118 118 TO 145 _L45__TO~ 165 TO 175 Sand 1,75 TO 184 184 TO 199 199 TO 213 TO, open end ( X ); Organics Silty Gravel Hardpan Loose Sandy Gravel Sand: clean Silty Hardpan Sandy Gravel Silty Clay Wet Gravel: C1 ay wouldn't clean up Water Gravel 1 -- CUSTOMER .t AS-BUILT NO OORNERS SET THIS DATE ,r¢4z£ /"SD' ! ~A~M£NT$ OP RECO~O, OTHER THAN SHOWN ON THE RECOR~E~ ARE NOT SHOWN HEREON. PERMIT NO. MUNIClI :iLI TN-' OF R~ICHk ,~-R6E j DEPGRTMENT O~ HERLTH RND ENVIRONHENTRL P~OTECTION 825 ~L ~ STREET., RNCHORRG& AK. ~5~i ] 264-4720 NELL AND 0~4--S I TE SEP~ER PER,'1 I ( ~80945 ) APPLICANT LOCATION LEGAL GREG GUNNERSON BUBBLING BROOK L6 Bi BUBBLING BROOK BOX i0432 LOT SIZE ]44 5875 50999 SQUARE FEET TYPE OF SOIL 8BSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT?BR>= 175 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: D, EP1-H= '_9 LENGTH---- 5] GRR'-/EL E~EPTH= 5 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 OUTFGLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET>. RELqU I RED SEPT I C TAF~K S I ZE= 4000 GALLC~I'-.I_C_. ~ERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE ~UMBER OF RESIDENCES THAT THE WELL WILL SERVE. TWO ( ::~ > I NSPE'_-~-T IONS ARE RE _F4m_m I RED ~ACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APP~VAL BY THIS >EPARTMENT WILL BE SUBJECT TO PROSECUTION. qINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELb OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. qELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS IF THE WELL COMPLETIOK ]THER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE ~VAILABLE TO INSURE PROPER INSTALLATION. PER~4 I T EXP I RES DECEMBER 31, 1978 [ CERTIFY THAT L: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS 8ND WELLS AS SET ~ORTH BY THE MUNICIPALITY OF ANCHORAGE. ~: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY RE~UIRE ENLARGEMENT IF THE ~ESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. U~IOn~-~O-.Wt L z '7o ~IUNICIPALITY OF ANCHORAGE DEPARTMENT OF' HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6. G50, AncJ~orage, Alaska 99502 SOILS LOG -- ?ERCOLATION TEST SOILS LOG PERCOLATION TEST SLOPE SITE PLAN WAS GROUND WA]- ER ENCOUNTERED? IF YES, AT WHAT DEPTH? NO. ! 823..E PERFORMED BY: , PI O'P · {minules/inch) PERCOLATION RA-I-E ...... ~-~ ~'~ TEST RUN BETWEEN -- 7 -- FT AND --~ . FT CERTIFIED BY: DATE: 72 008 (7/76) December 5, 1977 · Hr. Buster Newton 411 East 36th Avenue Anchorage, Alaska 99503 Re: Proposed Bubbling Brook SubSivision Subsurface Soils Investigation [)ear ~;r. tiewton: This report: presents the results of our soils investigation for' the proposed subdivision of a lO acre tract located east of Birch Road and just west of ' Ravenwood Subdivision. The investigation was conducted on [~ovember 15 and 16, 1977. The results of this investigation are included in this report as follows: Vicinity Map Test Hole Location Sketch Test Hole Logs (Sheets i through 9) Standard Explanatory Information Drilling was acc~plished utilizing a mobile drill B-50 mounted on a flex track Nodwel vehicle, owned and operated by Denali Drilling, Inc. lest holes 'were logged and perculation tests conducted by our firm. The purpose of the investigation was to provide soils data and perculation tests for establishing the feasibility of on-site disposal of sanitary wastes using seepage pits. 'To accomplish this, we drilled 9 borings distributed across the site with 1 test hole on each lot at the probable septic system 'location. The test hole locations are sho~ on the attached location sketch., All borings were drilled to a depth of 16 feet. During thedrilling, our engineer was present to log the materials encountered and obtain grab samples of the soil types. All soils were visually classified in the field in accord- ance with the unified soil classification system as described in the standard explanatory information attached herewith. Since the site is fairly small and readily accessible from both sides, per- culation tests were conducted in all holes at the completion of the drilling and logging.. The perculation tests were conducted from the 6 to 12 foot levels in each of the holes in accordance with the Manual For Septic Tank Practice published by the PHS. A ground water table was encountered in test hole Number 9 at the 12 foot level. Therefore, the perculation test in this hole was conducted between the 4 to 8 foot level. P.E. LEO SCHEBEN, JR.,PE.,L.S. EARL D. KC~YNTA, P.E. Hr. Buster Newton December 5, 1977 Pa:.qe Two SITE AND SOIL CONDITIONS The site is a 660 foot square parcel having access from Rockridge Drive on the east and Ravenwood Subdi'visi5n on 'the south. The site is dissected in a southeasterly/northwesterly direction by a fork of the Little Campbell Creek. The parcel slopes uniformly from southeast to northwest at an approximate 6% to E:~ average slope. A small knoll is located in the southeasterly corner. ther~ are no areas with slopes in excess of 25%. The parcel may be divided into two very distinct soil map units for purposes of identifying perculation characteristics. A 300 to 400 foot wide band centered on the creek channel is ch~racteristic of old alluvial deposits and consists primarily of well graded sands and gravels with good perculation characteristics. Test holes 2, 8 and 9 are typical of this deposit. Beyond this band, the.materials are much siltier and tighter as demonstrated by test holes 1, 3, 5, 6 and 7. CONCL US IONS The minimum perculation rates observed in'the field for the.following holes Test Hole Number 1 - 30 minutes per 'Test Hole Number 2 - 13 minutes per Test Hole Number 3 - 30 minutes per Test Hole Number 5 - 35 minutes per Test Hole Number 6 - 45 minutes per l-est Hole Number 7 - 60 minutes per Test Hole Number 8 - 5 minutes per Test Hole Number 9 - 5 minutes per nch rich '~nch '~nch 'inch 'inch 1 nch rich )n-site ~aste disposal systems appear feasible on all lots. An aerated package larit or other treatment process is advisable for the lots with high percula- ~on rates. hope this is sufficient for your present needs. If we can offer further l~rification, please do not hesitate.to contact us. Very truly yours, Earl . y ta, P.E. - ~ t a ch~:ent.,; !K/c 1 r' ,, ! i Y / / / / / ' suRV EYO WS Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Envlmnmental Sen. ices On-Site Services Se~on P.O. Box 196650 Anchorage, AJaska 99519-6650 (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING 015-492-10 GENERAL INFORMATION .~.le~aldescription BUBBLING BROOK S/D: LOT 6. BLOCK 1. Complete Location (site address or directions) 6300 BUBBLING BROOK CIRCLE ANCHORAGE. AK 99516 Property owner CHAR[ES HURST Dayphone~ Mailingaddmss 6300 BUBBLING BROOK CIRCLE ANCHORAGE. AK 99516 Lending agency. Day phone Mailing address Agent {~AROL BUTLER w/ REMAX PROPERTIES Dayphone {907~ 276-2761 Address 2600 CORDOVA STREI-I-I-I-I-I-I-I-I-I~T. SUITE 100 . ANCHORAGE. AK 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: 3 xxx If community well system, provide wdlten confirmation from State ADEC at, est- lng to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Xxx Holding Tank Community on-site Public sewer NOTE: If community wastewater system, provfde wdtten confirmation from State ADEC lng to the legality and status of system. 72-025 {Rev. 1/91) Front MOA ff21 Comp,...te~ Version Note; Alaska Water and Wastewater Consultants, Inc. shall be l)aid $1000.00 at.I I or prior to, closing for the engineering servfces prot~ded. - · ' ' I 5. STATEMENT OF INSPECTION BY ENGINEER As ~ertified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system Is safe, functional and adequate for the number of bedrooms and type of - sffucture Indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage tiles and from my Investigation and Inspection. the on-site water supply and/or wastawater * disposal system Is In compliance with all Municipal a. nd State codes, ordinances, and regulations In effect on the data th,s,nspec, on, . ' Name of Fim~ ALASKA WA.T-ER & I¢/~S'rE~C, TER CONSULTANTS, INC. Phone f907)'337-6179 Address 69°1DEBARR R<CAD' i~,~I¢/B/f~?~RAGE' ALASF'A 99504 ./ / Engmeer'sSignature ~. ~-',P'I.~'F-./I --T- Date t~/l~"/Oo ' ,n condu ng this ,' ,uetion. ,ne./¢4m4ed to thoroug,, conse,entioUS of the system In accordance ~fth ADEC and MOA DHHS Guidelines & Regulations. The reported results described the performance of the system under the condiEons 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 Iocal soils condition, ground water levels that may fluctuate dudng the year, and the water usage of the family being served by the system. These conditions are outside the control of the e~aluator 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. AWWC, Inc. can therefore not provtde any warranly for future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DHHS. 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. 6. DHHS SIGNATURE / Approved for. '~ Disapproved Conditional approval for bedrooms ess.: bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues Health Authority Approval Certificates based only upon the representations given In paragraph 5 above by an Independent professional engineer registered In the State of AJaska. The DHHS does this as a courtesy to purchasers of hemes 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 certJticate Is Issued. The Municipality of Anchorage Is not responsible for errors or omissions in the professlonal engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Computer Vets[on legal [~:d~on: A. WELL DATA Well Type ?RrVATE Log present (Y/N) Total depth 213' Sanamy seal (Y/N) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental 8endco~ Division 825 "t." Street. Rm 502 Anchorage. Naska 995O1 (907) 343-4744 Health Authority Approval Checklist BUBBUNG BROOK S/D; LOT 6, BLOCK 1~ Parcel I.D.: IfA, B, or C, attach ADEC litter. ADEC water system number YES Date completed C~sed to 212' 015-492-10 FROM W;! · LOG 2/13/79 Date oftest Stello water level 125' Well production 40 WATER ~a~IPLE RESULTS: Collfon~ 0 Nitrate Date of eample: 12/13/2000 B. SEPTIC/HOLDING TANK DATA Date Installed 10/9/78 Tank size FoundaUon deanout (Y/N) YES Date of Pumping 12/5/2000 C. ABSORPTION FIELD DATA g.p.m. 2/13/79 Casing height (above ground) ~Mms property protected (Y/N) AT INSPECTION 12/8/oo 1,30' 7.35 1 YES g.p,m. 0.5 mg/L Other bacteria 3 Collected by: A.W.W.C.~ INC, 1250 Number of Comparlments 2 Cteanoute (Y/N) Depression (Y/N) NO High water alarm (Y/N) N/A DatelrlStelled 10/9/78 Length 55' Wldm ~abeo~Uonama 550 SQ. FT. Dateofadequacytest 12/6/00 Pumper ISAAC'S Soil mtlr~l (g.p.dJfl2 o~)~ ~m type.~TRENCH Gravel lhlckness below pipe ~' Total depth -12.5' Monitoring Tube present (Y/N) YES Depression over field (Y/N) Results (Pass/Fall) PASSED For 3 Fluid depth in absorption field before test On.); Fluid depl~ ~4 (Ins) Minutes later. Peroxide tmalment (past 12 monlhs) (Y/N) 26 immedteteN after 949 1270 Absoq~onmte= NONE KNOWN IfYeS, glvedate gal. wateradded(In.):__ 450+ YES D. UFT STATION ~ Date ~tsllnd ~ Manhole/__~__~ (Y/N) /~...~on' level at* 'Pump off' level et* High wate;atm level 'Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic aendce line 100'+ On adjacent lots 100'+ 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A 25'+ LIE station 100'+ N/^ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Water matn/sewlce line 10'+ Surface water/dralnege 100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Surface water 1 oo'+ Curtain drain NONE KNOWN Absorption field 5'+ Wells on adjacent lots 100'+ Water maln/sen,,lce line 10'+ Driveway, perldng/vehlcle storage area 10'+ Wells on adjacent ets 100'+ Signature ~~___.~ ~ Engineers Nan~a/~L JEFFREY A. GARNESS Date of Payment, Number Waiver Fee $. Date of Payment Receipt Number IZ-15-00 13:01 FI~Ill--CTE ENVIROfl~f(TAL CT&E Environmental Services Inc. $615301 T-4SZ P.02/05 F-210 CT&E Ref.~ Client lqame Project Na med~ Client Sample ID Matrix · Ordered By PWSID 100767S001 AK. Water & Wastewnter Consultants Inc. N/A Bubbling Brook S/D L6 BI Drinking Water 0 Sample P.~mnrks: Client Printed DatetTIme 12/15/2000 10:26 Collected Date/Time 12/13/2000 13:45 Received Date/Time 12/1312000 13:45 Technical Director Stephen C, Ede Released By ~~ Romlu PQL Units M~hod Allow~bh: Pr~ Analysis Limi~ I~.tc D~te Init Nitrate-N 0.$0O U 0.$00 mg/L EPA 300.0 10 rn~ 12/I)/00 SCL Mic~:obiolog¥ Laboratory Total Coliform 3 OB, No Coli coUlOOmL SMIg9222B 12/13/00 KAP -- MUNICIPALITY OF ANCHORAGE - DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ~'~//~ ~/~" 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) APplican'tNameg~'~'~L~ /~)"~'f':?" Telephone:H°me-~'4~'-~o~'-] ~ Business ~- Applicant~Address ~t~}' ~~ ~,'~ ~/~. ~,/ ~. ?'~/~ (c) Applicant is (check one): Lending Institution ~; Owner/builder~; Buyer ~ · Other B (explain); (d) Lending Institution ;" Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the,,J~A.A to the following address: (Z/4-g-L ,4. TYPE OF RESIDENCE Single-Family~l~ Multi-Family [] Number of Bedrooms Other WATER SUPPLY Individual Well~J~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite~ Public [] Community [] Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Page 1 of 2 ENGINEERING FIRM PROVIDIN"'~ INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ,,~c'-~ Telephone i Address Date .~/2- Approved Disapproved Conditional Terms of Condition~tl Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEI~do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-02s (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: ~-~ MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 1 g 1988', RECEIVED WELL DATA If A, B, C, D.E.C. Approved (Y/N) Date Completed Cased to ~ !~ Well Classification Well Log Present~__.~/~) Total Depth ~/~ / Static Water Level Casing Height Above Ground Electrical Wiring in Conduit~)'4) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments ~. ! I I-~ Depth of Grouting Pump Set At Sanitary Seal on casing~yY'~) Depression Around Wellhead (Y~.,~ · On Adjoining Lots /~"C) 131 ' ' · On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ~¢Uf~X/ 'Date ~-/'¢ ~'~ B. SEPTIC/HOLDING TANK DATA Date Installed StandpipesCN) Air-tight Caps i~N) Depression over Tank (Y6 Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Size /,Z-~"~ ~,~/,,- No. of Compartments ~ Foundation Cleanout(~N) Date Last Pumped ~--//¢-~f~ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: TO Water-Supply Well ///~ / To Building Foundation To Property Line ,~5'" / -r- TO Disposal Field To Water Main/Service Line Course To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) Co ABSORPTION FIELD DATA Soils Rating in Absorption Strata / ~ Type of System Design Date Installed //~ ~z,}_ ~..~ Length of Field Width of Field ~ / Depth of Field Square Feet of Absorption Area Depression over Field (Y~'"~ Results of Last Adequacy Test Separation Distance from Absorption Field: /3/ 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 Gravel Bed Thickness Standpipes Present'N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on · On Adjoining Lots -~'~; "/- To Cutbank (if present) ,'~//~ Comments LIFT STATION Dimensions Manhole/Access (Y/N) "Pump Off" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments ent (Y/N) ~ ** Check Permitted Bedroom Rating Against HAA Request I certify that I hav~., ecJ~d, verif~d, or conformed to all MOA and HAA guidelines in effect on the date of this inspection· Date of Payment Amount: $ ~0 50_~.. Page 2 of 2 72-026 (11/84) ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO OF CA~C,LATED,~ ,4. ~/~?/ DATE CHECKED BY SCA,E ?: )'0 DATE ALASKA eTiUIRO[lmelhTAL CO[/TROL ~nqineerinc} $ [~nuiromentd Studm O-t/hrtLES HURST 6300 BUBBLING ERCIZ~ CIRCLE 99516 SELLER- SAVE SERUIC $, IFIC. Ma~CH 21 1986 WILL PICK UP ~ CUR OFFICE 60061 LEGAL:BUBBLING BRCEK SUBD/LOT 6 ADF_.~J,~CY TEST lq2R SEA't~ SYSTEM ADF_.QIJ,~L'Y TEST DATE-FEB 13 1986 THE TYPE OF fiI3SCRPTION SYSTEM IS A TREIqZH WITH AN PREA OF THE SYSTEM IS CAPABLE OF 31BZEI:rI'ING #50 C_dkLLONS OF WATER PER DAY. THE SURGE CAPfCITY OF THE SYSTEM IS 682 C, AL~S. BASED UPON THE TEST DATA THE SYSTEM IS /sOZEPTABLE FCR A SEPT I C TA1W, THE EXISTING SEPTIC TAI~K VOLIAVE OF 1250 IS ADEQJATE FUR THIS 3 BEDR(X2M I-IZUSE. THE SEPTIC TAbK/P~ PLANT WAS PLrvPED ON FEB 1# 1986 THIS REPCRT DOES NOT VERIFY THE INTECRITY OF THE PIPING ~ THE WATER SUPPLY CR WASTEWATER SYSTEM. FLO~ TEST ON ~Fr_i,L '~_LL FLOW DATE-FEB 13 1986 AND THE STATIC WATER LEVEL WAS THE ~Fr_,LL I S 3DEQJATE FUR TH I S 3 A FLO~TEST WAS PERFCRkW_.DON THE~r_LL. 682 PUMPED AT A RATEOF 7.6 GFMOVERABORATIONOF THE DRAXliX210ONWAS 3.2 ' WITH AREODVERY TIk~EOF 12#.2 FEET. BEll--E 1YE. GALLONS OF WATER WAS 1.5 I'[I. JRS. 10 MINUTES 1200 U,Jest 33rd Auenue, Suite B. Anchoroqe, AIc~skc~ 99503 .(907) 561-5040 MUNICIPALITY C:: ?b,'CHORAGE MUNICIPALITY OF ANCHORAGE ' ~/~~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION, m,-,k,,'.-~ 825 L Street - Anchorage, Alaska 99501 .... vl~,,~t ~ : ~,.~L ~ ~: CTION ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW~~IVl~ DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be proc~sed. Please allow ten (10) days for processing. 1. PROPERTY OWNER ~ PHONE 2. BUYE~ 3. LENDINGIN~TITUTION J PHONE I MAILING ADDRESS 4. R~ALTO~IAGENT PHONE MAILING ADDRESS 5. LEGAL DESCR' '? J S T LO IO ' 6. TYPE OF RESlDENi~E SINGLE FAMILY [] MULTIPLE FAMILY 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY NUMBER OF BEDROOMS [] One [] Four [~ Two [] Five Three [] Six [] Other * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) ~/~ ~ 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE~ [] PUBLIC UTILITY i individual/on-site, give installation date '/ 7 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 . DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: NUMBER OF BEDROOMS 1, TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX [] OTHER 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTI LITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified I-]Septic Tank or E~ Holding Tank Size: ~'~ If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG R EC El ~(F~p,..~ PERMIT NUMBER DATE INSTALLED INSTALLER SOl LS RATING MATERIAL Septic/Holding Tank ]Absorption Area Sewer Line INearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS [~PPROVED FOR ~.~'~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED LEGAL DESCRIPTION 72-010 (Rev. 3/78) June 8, 1979 Buster ~ewton 411 East 36th Avenue Anchorage, Alaska 99503 Subject: Lot 6 Block 1 Bubbling Brook Subdivision Approval for your individual sewer and water facilities will not be granted until the following items have been completed: (1) (2) The 4epression or pit around the well casing should be filled with impervious type soil ~o that it slopes away from the well casing. The water analysis report be delivered to this office from Chem Lab, 5633 B Street, for our review. Notify this department for a re-inspection when descrepancies have been corrected. If there are any further questions, please contact thig office at 264.-4720. Sincerely, Robert C. Pratt, R.S, Associate Specialist RCP/lJw cc: Security National Bank M~rtgage Loan Department 880 H Street 99501