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HomeMy WebLinkAboutGARRETSON LT 1Garretson Lot 1 #017-432-38 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report 171��Cj'j01 t Permit Number: PID Number: Name: Wastewater System: ❑ New Upgrade Address:�1 ;50� a� ,�� 9�5� � ABSORPTION FIELD Phone, i5 No of Bedrooms: JIDeep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: d• Total Depth from original1Dei S GPD/S . Ft. , Block. �Subdivision: Lot:I / Depth to pipe bottom from original grade Gravel depth beneath pipe ! & 1� Ft. Ft. Township: Range: Section: Fill added above original graded Gravel length: 12 Ft. '16 Ft. WELL: ❑ New ❑ Upgrade Gravel width: t Number of lines: ' Distance nes : Ft. Ft. Classification (Private, A,B(,C). Total Depth: Cased To: Total absorption area: Pipe material: �/Q \ %/PT -r. C Ft. FL 15-7 SO. Ft. P Driller: Date Drilled: Static Water Level: Installer: } Date installed 415)(C% X 1-441,0/,j Ft. r/ . IA-C�.� Yield: Pump Set at: I Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES Y(Septic�n(Ety ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding ublic/Private Manufacturer:/ingallons: �p_1 Capacity ' 0 From Tank Field Station Tank Sewer Lines '�N(/1T�/ 1G Ti_ w Well ' Q,1 �i — ZS tf Materijj! � L Number o�Lmpartments: ���� lco r `f — ^ LIFT STATION Water I� Lot Size Size in gallons: Manufacturer: Line Jc' Foundation 91 I "Pump on level at: ump off" level at: High water alarm at: Curtain r t� I P ake&Model Electrical Inspections performed by: Drain Remarks: BENCH MARK y,� Sue, - i T M i� t-^�� Location and Description: 'rCTk� � II F U.�-j -t < f Assumed Elevation: tom' X�S7t &JC FWVSA S 3 13R S b e Ft 1 21 wit vtito 13 rt1.10 TD 3 EN y1=Z*H%` °....�,Itll •�Y S & S ENGINEERING t : 4 17034 Eagle R•rvar Loop Road,I Inspections by: Mee : 1s512405 ..:. .........».. �.. . j performed _ 2nd bed A. Shofa' sI ���,=' Department of He and Human Services approval �•. �'r` Date:L%9.� ��•...:�.•"� Reviewed and approved by: 72-013 (Rev. 9/91) MOA 25 Permit No. SW9301 13 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: GARRETSON SUBDIVISION. LOT 1 col cot FINAL GRADE 99.6' NEN 1000 GAL SEPTIC 95.8' TANK N.T.S. 1 11_40' UTIL ESMT. I I I I I DRIVE SOME 1' - b' 7M13 A (Rev 9/911 MOA 25 PID No.: 01743238 MT C04 NEN 1000 GAL SEPTIC TANK 00 A 82' NO WATER FOUND A B FCO 11' 27.8' COI 12.8' 29.7' CO2 17.5' 33.5' CO3 34.9' 5 TH � NEN TRENCH A YE HOUSE A °O \C NT INSTALLED IN EXIST. TRENCH EXIST. TRENCH DECK — — — — ---- OF CONTAMINATION ` N VO 0' C04 79.5' 92.5' 11T 53.3' 88.3' DV 24.8' 99.7' TH � NEN TRENCH A YE HOUSE A °O \C NT INSTALLED IN EXIST. TRENCH EXIST. TRENCH DECK — — — — ---- OF CONTAMINATION ` N VO PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930113 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:WELLMAN PAUL OWNER ADDRESS:7130 HUFFMAN RD ANCHORAGE, AH 99516 PARCEL ID:01743238 LEGAL DESCRIPTION: GARRETSON LT 1 LOT SIZE: 48589 (SQ. FT.) NUMBER OF BEDROOMS: ,4Y THIS PERMIT: ,e 3 )AVq �L THIS PERMIT IS FOR THE CONTRUCTION OF: 110m is -as -93 DATE ISSUED: 5/21/93 EXPIRATION DATE: 5/21/94 DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: DATE: ISSUED BY: �,�� DATE: Z A 1 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 0 May 20, 1993 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage Alaska 99501 REFERENCE: Lot 1, Block 1, WilliamaW SID ROBERT SHAFER, P. E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 Request you issue a permit to upgrade the septic system serving the referenced property. An adequacy test performed on the existing system on May 4, 1993 for Health Authority Approval purposes found the existing system to be in a state of failure. A soils test and groundwater monitoring were conducted on the property and the attached design developed. If you have any questions or require additional information for your review, please contact us. Sincerely, SC TT WfEU�R ENVIRO T ENGINEER A. SHAFER, P.E. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 1" = 40' I UPGRADE DESIGN HUFFMAN ROAD O � 0M OA 1Zra o x� co .. o, o trJ a 0 0 z iflan °° OA 1Zra i v .. o, o trJ iflan °° $ A - � o x1 to 4 r� �i I•I..f yl' �w -zg'z m jo In x d OA 1Zra i .. $ A o / �i I•I..f yl' �w -zg'z wc--aC r- Z rq m {0IV X m LN j z I[ I 0 0 ;C1_4- o m x bo cn Ed It- mg$� -3 xo 1 z dz 1Zra i .. �i I•I..f yl' �w r a a Municipality of Anchorage ,,,;�„�� •,,,j,,, DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L” Street, Anchorage, Alaska 99502-0650 ;' i" ' """".•.,.•..p.. SOILS LOG — PERCOLATION TEST s No. 14571-E ' rk of •• III, aR o� J PERFORMED FOR: '_ AUI— �p�iJ� 1AAC-f:C/bJAW DATE PERFORMED: LEGAL DESCRIPTION: L67-1 Net Drop rtEScaA .L57 DEPTH (FEET) obt&pw /c, 2 D-3.5 3. 3 5�'Ilcc. 4 a\t .to 2:/ 5 %St A 6 �` q 0 7 i 8- 9- s10 10- 11 11 b ° `O t 12- 2 13 13 14- 4 15 15 ` 16 B-0. H. COMMENTS Range, Section: SITE PLAN WAS GROUND WATER /4XENCOUNTERED? S IF YES, AT WHAT N d L O o/ DEPTH? /� p E Oepth to Water Aller Monitoring? DRY Date:S % 3 Reading Date Gross Net Time Time Depth to Water Net Drop rtEScaA .L57 hbVK S 3 l:3o S D-3.5 3. 3 S3 1jr 2:/ PERCOLATION RATE 4•Zg (minutesimch) PERC HOLE DIAMETER TEST RUN BETWEEN F AND 6 FT �FT. VISuR1 iti! 66C 6�. S & S ENGINEERING 17034 Eager Roa�1��-1�,/ PERFORMED BY: WeR;y�� ACCORDANCE WITH At 1 STATF ANn Ui WiC10Ai ni unGi okwe w CERTIFY THAT THIS TEST WAS PERFORMED IN /11.1 TL�IC nATC nATC ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 1, Block 1, Garretson S/D 7130 East Huffman Road GENERAL: 1. The scope of this project includes the installation of a leachfield trench to serve the four bedroom residence located on the referenced property. If the integrity of the existing septic tank is found to be poor, the septic tank is to be abandoned and replaced with a new 1250 gallon septic tank. 2. Construction shall be in accordance with the approved site plan and design drawings; Municipal permit with any special provisions or conditions; and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. Page Two Lot 1, Block 1, Garretson S/D 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed - up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter and installed approximately in the locations shown on the design. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page Three Lot 1, Block 1, Garretson S/D INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre - construction meeting will take place on-site. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Ty -pe of Pine Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Page Three Lot 1, Block 1, Garretson S/D 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, it's gradation specifications must conform to AMC 15.65.060D. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 LStreet -Anchorage, Alaska 99501 Telephone 264-4720 . Ri csrTc: cr-wer.r: rICPnSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE EW ❑ iSPGRADE NAME 71 f � MAI LIN [tEs�o O 7 LEGAL DESCRIPTION� � I ��/ " NO. OF BEDROOMS LOCATION Well Absorp%i n�rea DISTANCE TO: DO ` 1 Manufacturer p/� Inside length Liq.cp it i Ilons IF HOMEMADE: Dwelling �, Mater�F-r��� / D' !� Width PER moi[ 2 No. of compartrM�ts Off, Liquid depth U Y IL Q W Well Dwelling DISTANCE TO: Material Manufacturer PERMIT NO. Liquid capacity in gallons O Y J 2 O F Well DISTANCE TO: fr>� No. of lines Length of 6 l Top of file to finish grade � Length Width Foundation Nearest lot line ( Total len o s Trench w h inches Material beneath rile /^ (Oinches C/ PERMIT NO. CJ" Li Distance be e . Total effectiv a6sp i ea �� p J= m j u. Z Z w Q ¢ F Depth PERMIT NO. W 0Total Q F CL Type of crib Crib diameter Crib depth effective absorption area Lu FL to DISTANCE TO: Well Building foundation Nearest lot line Depth Driller Distance to lot line PERMIT NO. J Class J Lu �+ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) P OTHER ERIAL \ T RATINGER` F REMARKS APPROVED DATE V1--) GAL V) MSU" I C I PRL I TY QF ANCHORAGE 3p 6 DEPARTMENT t-_� HEALTH AND ENVIRONMENTAL FNOTECTION t< 825 'L STREET, ANCHORAGE, AK. 99:,.,1 264-4720 E R PER M A L•1ELL RNC} X1'.1— I TE SEW L333 -8 d 80 PERMIT NO. { 800336 ) PPLICANT L H CONSTRUCTION INC 3220 CAMPBELL AIRSTRIP OCATION HUFFMANEGALLOT SIZE 48590FEES 'YPE OF SOIL ABSORPTION SYSTEM IS: TRENCH IAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR) = 260 jlL 'HE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: 7EP'TH= 10 LENGTH= 12',=; GR1=1%wPE1.__ E]EPTH= 15 THE LENGTH DIMENSION IS THE LENGTH CIN 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 CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL RIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). Rl- I AEC) SEPTI C TANK S I �E= 1250 GRILLONS 'ERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE VUMBER OF RESIDENCES THAT THE WELL WILL SERVE. TWO <:a> I NSPEGT I QNS RRE--- 3ACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS )EPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I T EXP I RES aECEMBER 3:1-, 19E30 I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED:----------------------- RPPLIGRNT L H ONSTP.UCTION INC ISSUED BY__���-- V4. 0 II C©N.'TKUCTION 180(, W. 48TK AVE: STI`, C TEST /� ANCHORAGE : �AtASKA "503 TES I LAB 248-1333 ERFCRMED-FOR, L & H- Construction- DATE PERFORMED:7/10-7 14/1988 EGAL--DESCRIPTION: Lot -1 Block Subdivision r'arrisnn 4L ASFORM REPORTS: O Visual Soils Examination >, "° M -Percolation Test,.-- DEPTH est, - DEPTH SOIL NOTES • - nccrn�crT1A1J - - 4" To soil- - Brown silt -w/ lenses of sand 41 .. and gravel -5' Brown gravel -seepage Brown silty sand w/ cobbles 17 !69t Brown gravelly sand - relatively dry —15' - 7 14 1 12-40 1fl 1 -1 1411 7/14 1 10 3 5 Hrs 11 1/ " 7/8" 7i1e I i.nn I A n urs 19 nit I 7/R" - S"DRAINAGE;REOUIREMENTS-_ 260 sq ft /bedroom %SEEPAGE PIT_ II DRAIN FIELD O OTHER DATA CERTIFIED BY: lamas R Ringst FEST- ED BYE.=..�e � Liza Sims _..__-___�.....�s dT -R P.E. '•••••' 7/15/80 ftn«<enN►� + DATE. *GE F A C a • a Y 0 a a v V a a r v J Q Y a � J = a W >Lu a y X m za W b LL LL w p conZ yOO I w in d A C O a o�c w w 0 Q z v t v za w p conZ v, vFi w in w w w o w w w O a o�c w w 0 Q z L w w w w w w w w w w w w O O O O O O O O O O O O F F F F F F F F F F F F cF4r. O O O O O O O O O O O O w w w w w w w w w w w w L ALPINE DRILLING & ENTERPRISES Permit Number. #SW Date of Issue: Parcel Identification Number: Date Started: 2-14-09 Date Completed: 2-14-09 is well located at approved permit location? E Yes ❑ No - Legal Description: Garretson Lot 1 Property Owner Name & Address: Roy & JoHanna Naylor 7130 Huffman Road Mn{,nr+�nn dlnckn n051R Borehole Data: Depth (ft) Method of Drilling E air rotary ❑ cable tool Soil Type, Thickness & Water Strata From To Casingsteel type: — existing well bedrock 0 120 120 246 Wall Thickness:.025 inches Diameter: 6 inches Depth: 46 feet Liner Type: H2O 190 220 Diameter: inches Depth: feet Casing stickup above ground: 3 feet Static water level (from ground level): 69 feet Pumping level: 246 feet after 2 hours pumping 2 gpm Recovery Rate: 2 gpm Method of Testing: airlift Well Intake Opening Type: ❑ Open End E Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: Volume Depth: Start feet Stopped feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? E Yes ❑ No Method of Disinfection: chlorine tablets Comments: Well Driller. Alpine Drilling & Enterprises P.O. Box 110496 Anchorage, AK 99511-0496 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property owner or the well driller shall provide a well log to the Development Services Department within 60 days of completion. Q Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bx Street ?.O. Box 196650 Mark Segich Anchorage, AK 99519-6650 Mayor w-., mum on/nns,re (907343-7904 Pump Installation Log Well Drilling Permit Number: SW_ . Date of Issue: Parcel Identification Number:_ Legal Description Gov✓c4SO-. at 1 Property Owner Name & Address: Roy undo'. -7130 E Num Pump Installatio Date: 8//Llaooy Pump Intake Depth Below Top of Well Casing: feet Pum Manufacturer's Name: �PJ�K£1- Pump Model: OCRs /(. V8 Php `3/-J Sze , Pitless Adapter Burial Depth: /D feet Pitless Adapter Manufacturer's Name: /1W -;P J5 IV 13 — 10Y—Pitless; Adapter Installer. Well Disinfected Upon Compledon"&Yes ❑ No Method of Disinfection: 7e-Ao Comments: Pump Installer Name: 0,1UL HAYD"J bran Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. 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 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FORA SINGLE FAMILY DWELLING ^� Parcel I.D. o17-432-38 COSA # (15 0 a /�� 7 Expiration Date: ZO -A7-10, 1. GENERAL INFORMATION Complete legal description Garretson Lt 1 Location (site address) 71�o E Huffman Rd., Anchorage Ak 99516 Current Property owner(s) Bryan & Carmen Trimm Day phone Mailing address 7i3o E Huffman Rd Anchorage Ak gg516 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA 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 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 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. Z 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 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 Pannone Engineering Services, LLC Phone 272-8218 Address P.O. Box 100217, Anchorage AK g95io Engineer's Printed Name Steven R. Pannone, P.E. Date t 7� Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe 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 soil condition, ground water OF levels that may fluctuate during the year, and the water usage of the family being served by the system. : �P� ••""""���,p'1♦♦ These conditions are outside the control of the evaluator of this system. All systems eventually fail and �o•' E satisfactory test results do not guarantee future performance of the system, nor do they guarantee that ? 4 N 6 Tt' ♦♦♦ there are no hidden defects or encroachments. PES can therefore not provide any warranty for future 00...... •• •••• •••• • • '•••^ j performance nor give any estimate of how long the system will continue to meet the operational requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed o. :Steven R. Pannone.' i above. An reliance upon or use of this ort b an other person or is not authorized nor will it ♦I c,) •. No. CE 8149 °• � Y P report Y Y P Par'h' 1♦J'P;•. •,.+moi confer any legal right whatsoever. ♦ �� , 5. DSD SIGNATURE ♦4�,1"�u�..•� Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: / ry tot Original Certificate Date: (Rev. 11/05) Municipality 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: Garretson Lt 3. Parcel ID: 03.7-432.38 A. WELL DATA Well type Private If A, B, or C provide PWSID #_ Date completed 21i4l2oog Sanitary seal (Y/N) Y Total depth z46 ft. Cased to —46 ft. FROM WELL LOG Date of test 2/2412009 Static water level 69 ft. Well production 2 g.p.m. WATER SAMPLE RESULTS: Coliform A2Cr,L_colonies/100 mL Nitrate o. 16q mg/L Arsenic: it) 1',j_ ug/I Date of sample: 7/16/20-12 B. SEPTIC/HOLDING TANK DATA Well Log (YIN) Wires properly protected (Y/N) Y Casing height (above ground) 28 in. AT INSPECTION 7/-16120-12 ft. 6.-1 g.p.m. Collected by: PES Tank Type/Material Steel Date installed 1;/2811993 Tank size 2000 gal. Number of Compartments z Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N/A Date of pumping 71-1212012 Pumper A+ Home Services C. ABSORPTION FIELD DATA Date installed s 28/-1992 Soil rating (g.p.d./ft2 or ft2/bdrm) o.8 GPD/SF System type Deep Trench Length 48 ft. Width ft. Gravel below pipe 6 ft. Total depth io ft. Eff. absorption area s76fe Monitoring tube Y Depression over field N Date of adequacy test 7/16ho-1z Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 23 in. Water addedA53. gal. New depth32 in. Elapsed Time: -1io min. Final fluid depth n in. Absorption rate >= 45o+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Datum Size in gallons Manhole/Access (Y/N) "Pump off" level at _ in. High water alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot ioo+ Absorption field on lot zoo+ Public sewer main _7c+ Sewer /septic service line 25+ Animal containment areas ioo+ On adjacent lots ioo+ On adjacent lots ioo+ Public sewer manhole/cleanout 200+ Holding tank ioo+ Manure/animal excrete storage areas ioo+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line —S+ Absorption field 5+ Water main io+ Water service line io+ Surface water 200+ Wells on adjacent lots Zoo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line zo+ Building foundation io+ Water main Water Service line io+ Surface water aoo+ Driveway, parking/vehicle storage io+ Curtain drain F. COMMENTS G. ENGINEER'S CERTIFICATION Wells on adjacent lots ioo+ 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 Printed Name Steven R. Pannone P.E. Date / Z" COSA Fee $ 490 . co Date of Payment %2, 5 7 /L1 � Receipt Number D (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number O ,en R. Pam No. CE 8149 0 in. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onske (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017.432-39 1. GENERAL INFORMATION COSA# n�f ODLI I Expiration Date: Complete legal description Lor 1, carretson subdivision Location (site address) 7130 E. Huffman Road Anchorage, AK 99516 Current Property owner(S) Roy and Joanne Naylor Day phone 3454757 Mailing address 7130 E. Huffman Road Anchorage, AK 99516 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup 2. NUMBER OF BEDROOMS: Three (3) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site R1 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 Onsite 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 Onsite 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 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 Certificate of Onsite 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Phone 522-M3 Date 4/1=009 OF At h_. MICHAEL E MMSON 6. DSD SIGNATURE �� ��•, CE -4381 . y4. ,_(_Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Well Flow Advisory Nitrate Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: '-t — %" 09 (R,. 1uos) �\ Municipality of Anchorage . ,.• • ") Development Services Department = Building Safety Division Onsite Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 . CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 1. Garretson Subdlvision Parcel ID: 017432-39 A. WELL DATA Well type Private If A. B, or C provide PWSID # _ Well Log (YM) Y Date completed 2114/09 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 246 fL Cased to 46 ft. Casing height (above ground) >18 in. FROM WELL LOG AT INSPECTION Date of test 2/14109 3/14109 Static water level 69 g 41.3 fL Well production 2.0 g.p.m. 4.2 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colcnies/100 mL Nitrate MCI mg/L Other bacteria 0 colonies/100 mL Arsenic: N/D ug/l • Date of sample: 2/25/09 Collected by: a Haraia B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 5126/93 Tank size 1.000 gal. Number of Compartments s Cleanouts (YM) Y Foundation cleanout (YM) Y Depression over tank (YM) N High water alarm (YM) N Date of pumping 8/12=06 Pumper Isaads Pumping Service C. ABSORPTION FIELD DATA Date installed 5126193 Soil rating (g.p.d./ft2 or felbdrm) .6 SF/BDRM 'System type "Deep Trona, Length 48 ft. Width 2.5 ft. Gravel below pipe 6 R Total depth 11.12 fL Eff. absorption area Sze ftp Monitoring tube Y Depression over field N Date of adequacy test 314109 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 In. Water added 1.139 gal. New depth _01n. Elapsed Time: a min. Final fluid depth 0 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) N If yes, give date D. LIFT STATION & fir: - * Date installed Size in gallons Manhole/Access (Y/N) 'Pump on' level at _ in. 'Pump off level at —In. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES 4� �r •.�fJ SEPARATION DISTANCES FROM WELL ON LOT TO: 941.V PROF Septic tank/lift station on lot >100' On adjacent lots >10a Absorption field on lot >700' On adjacent lots >100' Public sewer main NIA Public sewer manhole/cleanout NIA Sewer/septic service line >25! Holding tank NIA Animal containment areas None Manurelanimal excrete storage areas None SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >S Property line>s Absorption field >s' Water main NIA Water service line >70 Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >1a Water main NIA Water Service line >10' Surface water >100' Driveway, parkingtvehicle storage s Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS: Well Deepened on to 246' on 2/14/09. G. ENGINEER'S CERTIFICATION & fir: - * 1 certffy that I have determined through field inspections and 4918 J.0* �� review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. �, s Engineer's Printed Name Michael E. Anderson, P.E. 4� �r •.�fJ Date 4112/4009 941.V PROF COSA Fee $ f 0 Waiver Fee S i Date of Payment — /3-01 Date of Payment Receipt Number i7 f) 490,51 % Receipt Number (Rev. 11/06) . HUFFMAN r— — LN Ln N 89'58'00" W f 0' UTILITY EASEMENT 0 164.78' N 75.5 Lgti p� 'c 0 • S/$'RB W/CAP* 5/8' Re 0 O plat. NOTE: � Da used for CanatruCtiOnnder no r or for establishing EXIST N propety Iines.ID v�HOUS IV O SURVEY CERTIFICATION: LAN TECH ho! conducted o physical survey of this v rrl c z properly as shown on this drawing and that the improvements situated there WOOD DECKS - onart within the Property lines and no encroach— men Its exist other than noted. CONCREIE- ASPHALT_ I� AS—BUILT OF: LEGAL CESCRiPnON: URVEYORS—PLANNERS—EtJGINEERS ORAVEL— STANPPES�(S�= y 103 5 WATER WATER WELL - 99,03 o scr 193 1'-40• 7 440 WEST BENSON 8t ANCHORAGE. ALASKA WORK ORDER NUMBER: DARN UNE 8. 93—L-347A°Rw 6'1 SATTELITE _ DISH 10' UTILITY EASEMENT _ N 89'57'45" W 164.79- 6 ROAD W, m C4 Ln 2 'e?•` 49LH y' :,. ��- ...... :Kenneth L. Dreyer;' o` LS -8202 r ,°G 4p••......... essionot 5 3ED> s.: WICK EXCLUSION NOIES: It IS the owners responsibility to determine the existence of any LEGEND: SET FND TE COMPANY easements. co.•enonts. Or restrictions ehich do not appear on the reco ded luDdiWsion S/$'RB W/CAP* 5/8' Re 0 ie plat. NOTE: � Da used for CanatruCtiOnnder no r or for establishing TACx [3 propety Iines.ID HUB kA SURVEY CERTIFICATION: LAN TECH ho! conducted o physical survey of this OVERHANG- x x properly as shown on this drawing and that the improvements situated there WOOD DECKS - onart within the Property lines and no encroach— men Its exist other than noted. CONCREIE- ASPHALT_ I� AS—BUILT OF: LEGAL CESCRiPnON: URVEYORS—PLANNERS—EtJGINEERS ORAVEL— STANPPES�(S�= y 103 WATER WATER WELL - 99,03 (907) 562-5291 L 0 T 1 scr 193 1'-40• (fax) 561-6626 t_ 1 °r�°2839 "839 nA04" � GARRETSON SUBD 3/47 SGS ReLN 1090739001 Client Name Anderson Engineering Project Name/# Garrttsen SID Lot 1 Client Sample ID Private Well Water Matrix Drinking Water Printed Date/Time 03/09/2009 14:42 Collected Date/time 02/252009 16:40 Received Date/time 02262009 10:59 Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results PQL Units Method Container rD Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 03/03/09 03/06/09 NRB Waters Department Total Nitrate/Nitrite-N 0.196 0.100 mg/L SM204500NO3-F B (<10) 03/06/09 3DZ Microbiology Laboratory Colony Count 0 col/100mL SM20 9222B A (<200) 0226/09 DLC TotalColifonn 0 col/IOOmL SM209222B A (<I) 0226/09 DLC Fecal Coliform 0 eoVI00mL SM209222B A (<I) 0226/09 DLC MUNICIPALITY OF ANCHORAGE Ak DEPARTMENT OF HEALTH & HUMAN SERVICES AMM Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # O 11- J-13 a - 39 1. GENERAL INFORMATION Complete legal description Lot 1; :Garretson Subdivision Location (site address or directions) 7130 East Huffman Road, Anchorage, Alaska Property owner Jacquilin Wellman Day phone345-0863 hm Wk Mailing address 7130 East Huffman Road, Anchorage, Alaska 99516 Lending agency 0nr Day phone Mailing address Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. OW 2. NUMBER OF BEDROOMS: \1-7 J r, 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing 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, provide written confirmation from State ADEC attesting to the legality and status of system. 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 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 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 Address Engineer's signature S & S ENGINEERING Eagle River, 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments By: bedrooms. 11 ]TIC Phone Date Z lel---? •N° a� H • J n • I»rt A. Shafa, No. 1437-K m � t • bedrooms, with the following stipulations: Date 4�-%-E3 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 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. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:/_ l 9 / xG1rlP�S�s� Parcel I.D. A. WELL DATA F ON letter. ADEC water system number Well type (llt If A, B, or C, attach ADEC Log present (Y/ ) Date completed Z%g O Driller CJ/ Total depth 12 O ie5?' Cased to ¢ 6 -F- Casing height Sanitary seal (Y/ ) Wires properly protect (Y N) m FROM WELL LOG AT INSPECTION m� 8_21- g ca 3 M sC Date of test Lu rn c co 90' �Z > a E Static water level — = Well flow 4d !� g.p.m. A LLJ 9 -PAL) Z Tolf v r cc �f 79 . W �m Pump level pC 6..; =m DISTANCES FROM WELL TO: 0 SEPARATI � Septic/haNNFg-tank on lot On adjacent lots le 7L Absorption field on lot l� ; On adjacent lots /b0 f Public sewer main` A Public sewer manhole/cleanout • xJ/n Sewer service line Z� �f Petroleum tank (< WATER SAMPLE RESLII TS: C'r� Coliform 5 v Nitrate�� 441 Other bacteria S & S ENGINEERING Date of sample:/5P /y-9 Collected by: / Eagle River, Alaska 99577 B. SEPTICA98LOW TANK DATA Date installed L' Z 3 Tank size 1-n9 72 Compartments Cleanouto(`�/N) fFoundation cleanoutoN) Depression (Y& High water alarm (Y/N) N ` Alarm tested (Y/N) Date of pumping /) 6_7 Pumper" 1 SEPARATION DISTANCES FROM SEPTIC/Ila TANK TO: 47 r Wells) on lot //9 On e�iacent lots Ie D "'r Foundation To property line AO Absorption. field 3 Water main/service line Surface water/drainage 0 (� CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level Meets MOA electrical Well on lot "Pump on” level /N) DISTANCE FROM LIFT STATION TO: D. ABSORPTION FIELD DATA On adjacent lots Manufacturer le/Access (Y "Pump off" level at tested Surface water Date installed J2 Z93 Soil rating n' g SF System type TP%1�' L Length Width 30 Gravel thickness C ff Total depth /4 r ZZ Total absorption area Cleanouts present YON) Depression over field (YN),, Date of adequacy test i9 Results (pass/fail) P-) G for Peroxide treatment (past 12 months) (Y/N) /4 If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 2 Z/ /On adjacent lots /042 t Property line Z 64) � l To building foundation To existing or abandoned system on lot / O f On adjacent lots Zd Cutbank A) o Water main/service line Surface water ��D rf Driveway, parking/vehicle storage area 0410 Curtain drain e ✓Yo (L/n bedrooms E. ENGINEER'S CERTIFICATION vS/. 1 certify that 1 have the ed, verified, or conformed to all MOA and HAA guidelines in effect on the d��f�on. a Signature ,_• ",4.- 17094 Eagle Rlvor Loop Road No. 204 Engine ame !F n„T A,...r„fW l /z Date Yr HAA Fee$ 1�)OkUc) Waiver Fee: $ Date of Payment (o - L-1 -tel 31I Date of Payment Receipt Number Q��/ Receipt Number COMMERCIAL TESTING & ENGINEERING CO. ENVIRONMENTAL LABORATORY SERVICES SINCE 19 REPORT of ANALYSIS 5633 B STREET Chemlab Ref . # :93.2542-1 ANCHORAGE, AK 99518 Client Sample ID :Li Bi GARRETSON S/D TEL: (907) 562.2343 Matrix :WATER Fax: (907) 561-5301 Client Name :S & S ENGINEERING RUSH Order :66782 Ordered By :R. SHAFER Report Completed :06/04/93 Project Name Collected :06/03/93 @ 13:45 hrs. Project* Received :06/03/93 @ 14:10 hrs. PWSID :UA Technical Director :SED E Released By Sample Remarks: ROUTINE SAMPLE COLLECTED BY: S.S. QC Allowable Ext. Anal Parameter Results Qual. Units Method Limits Date Date Init ------------------------------------------------------------------------------------------------ Nitrate-N 0.16 mg/L EPA 353.2/300.0 10 06/03 CMR * See Special Instructions Above UA = Unavailable ** See Sample Remarks Above NA = Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT = Less Than D = Secondary dilution. GT = Greater Than %)� Member of the SGS Group (Soci6te G6n6rale de Surveillance) a 7 � r -yrs r �.� >. r,. r!'1 /l �? i -7 _� T_T7 '� TCA !� ` .=_, T=LEPFONE (007) 552-2343 5533 B Sir, --t Anchcrage. Alaska =9513 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COi:'PLETED BY WATER SUPPLER PUBLIC L'". -,TE.. S?S. - LD. PRIVATE WATER SY3 TEEM Nc;. TO BE CONAIPLETED BY LAZE—ORATORY Ila i I Analyss shows this V.. ater SAMPLE to be: 1 atisfa- ory E Unsatisfactory -;A » j? ❑ Sample too bng :n t,ans't; sa,^c!e stcu d I i no, be over 30 hours cEd at exami ;at:on to Ind',cate r0ab'e re'>7.is. Please sar.d S:a:a ZD Cxa = new sample via special da,i:very mail. La 3 SAMPLE DATE: L Date Received 1 Mo. Day Year SA",1PLE TYPE: Tim^ Received 4 y Routine Analytical Method: Membrane Filter '❑ Check Sample (for routine sample with lab ref. no. ) ❑ Treated Water ❑ Special Purpose ❑ Untreated Water I No. of colonies/100 mi. SAMPLE Time Collected Lab Ref. No. Resuft' Analyst No. LOCATION Collected By 1 �&T-1 %I G:4Rr2el Sdot1 ;1� /3:':�5 S� i3.7,14'2 — Z --r—!1 � Q l ( '' II INTTI 1 3 L W 4 o 5 I J L m `bus /� %�-- f-,gX BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS Membra Finer Direct Count Coliform/100ml A.D.E 9R���^ Verification: BGB Fecal Coliform Confirmation COLLECTING SAMPLE Final Membrane Filter sults (� Coliform/100m1 Reported By Date 6 r TNTC = Too Numerous To Count OB = Other Bacteria �pr��^a P#�RT ONE OF T�-/U ys♦P �l til arit0ef OI I�1P SGS G -c::? iSo REMAINDER T� FOLLOW 5. LEGAL DESCRIPTION ATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME NUMBER OF,BEDROOMS 0 DATE DATE fftA DATE PL Three ❑ Six 7. WATER SUPPLY INSPECTOR INSPECTOR INSPECTOR since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY MU 1 2. _ MUNICIPALITY OF ANCHORAGE EN✓IROp;,, C?;ON DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ^ 825 L Street - Anchorage, Alaska 99501 ❑ $5- INDIVIDUAL/ON-SITE" ENVIRONMENTAL Telep one N264-4720 ITATION DIVISION RECEIVED 0* ❑ PUBLIC UTILITY REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPE TY O NER % PHONE w h C " , MAI LI GADDRESS ,, �C /* N PROPERTY RESIDENT (If different from above) PHONE 2. BUYER�/PHONE —/7,,-, MAILING ADDRESS 3. LENDING INSTIT TION PHONE -3 r w MAILING ADDRES 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS El One ❑ Four El Other SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY PL Three ❑ Six 7. WATER SUPPLY A INDIVIDUAL* ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM $5- INDIVIDUAL/ON-SITE" /I 9a' -YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) (T�l.i 70r THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑Holding Tank Size: � If Tank is homemade give dimensions: SOILS RATING a (fe- c� TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELLTO: Septic/Holding Tank O 0 Absorption Area 166 Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS LAY APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE Z - zt-, - (/ t BY e v unici ali V % , 325 ,. L„ STREET ANCHORAGE, ALASKA 99501 (9071.264-411 1 nchewy d ` u ;E M. SULLIVAN, CEPIIRT'-.'.ENT OF HFA' i -R i;%` r_NIARONNIENTAL PROTECTION February 12, 1981 L H Construction, Inc. 3740 Boniface Parkway Anchorage; Alaska 99504 Subject: Lot 1 Garretson Subdivision Approval for your individual sewer and water facilities cannot be granted until the following items have been completed: (1) A well log_ submitted to this department for our review. (2) The water analysis report submitted to this office from the Chem Lab, 5633 B Street, for our review. If there are any further questions; please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/l jw- cc: First National Bank of Anchorage Post Office Box 4 2090 99509