HomeMy WebLinkAboutKIMPTON LT 7Kimpton
Lot 7
#051-072-70
Municipality o£Anchorage ~:.:', ',%
Development Services Department.,~:' '. ~:
Building Safety Division
On-Site Water and Wastawater Program, 4700 S. Bragaw St.~
P.O. Box 196650 A~chcrage, AK 99519-6650 Page of
www.cLanchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. $W010214 PID Number. 051-072-70
Horizon Ventures Wastewater System: [] New [] Upgrade
10900 Corrie Wav. Eaole River. Al( 99[i77 ABSORPTION FIELD
LEGAL DESCRIPTION s~ ,,~
7 Klmpton 1.49 - 1.46 ~,. 1.01-1.02
1.85 - 2.65 F,.102 (51 & 51)
Private 221 F,. 221 F~ 580 r~ D3034 & F810
Sullivan 712/2001 152 ~L South Fork Const. 10110/2001
7 Gm unknown F,.I 2
TANK
SEPARATION DISTANCES [] septic [] Holding [] S.T.E.P. [] Other.
Septic Abso~tion Lift Holding Public/IWivele Ma~ulac~'e~';
Tank Field Station Tank Sewer U~e Anchorage Tank 1000 c~.
wa 100'+ 100'+ NA NA 25'+ Steel 2
*none known BENCH MARK
Insulation over tank Door $111
100 Ft
Engineer's Stamp
Inspections performed by: KND EnRineerin.q Dates: 1~. 10110/2001 :~,,; 4~.~. ~
Development Services Department Approval . o -- ~'~" .........
AS-BUILT SYSTEM DETAILS/SITE PLAN Per-.it SVlOel4
KIMPTBN S/D, LOT 7 PID#051-072-70
,
~ ~CAL[~ 1' = 50'
B-G= 58.7''~lT~ TUK~(~ FINAL GRAD[
A-H: 31.~' SCALE, NTS ~
~ ~ ................. ~. ~ h PREPARED FDR:
'"' · MIK[ PARKER
EAGLE ~[V[R, AK.
C907) 688-9729 SCALE= NTS
ENGINEERING
~ ~~sst°~~ *~ ~[WA~D o,~: ~0/~6/0~ EAGLE RIVER, AK 99577-8736
~~~ ~ ~: ~ NWl 458 .': v v.v.'.v.'..v.'.-.v.v.v.v.-.-v.-.v.v.v-.'.-.v.-...-..v....v.'.......-....v..'...-...
~:01046.OWG ~: 01046 (907}696-6111/FAX (907}696-8111
Certi[ie rill[ing
by
SULLIVAN WATER WELLS
P.O. BOX r~02T2, CHUGIAK, ALASKA g~5~7 · TELEPHONE 6M.2750
DATE: "//~3//,aae, I
T~ IDE~IFICA~ NUMBER:
IS well I~at~ at ap~ ~it ~tlon? ~ 'J No
~th~ of ~lli~: ~t~ ~ ~b~ t~l
~pth of ~1: ..
~ing Type .~Wal
Diamet~ ~, Il Inches.
LinerType: tt~ beJ~
Casing Stickup A~e G~:
Stat~t~ ~: /~ ~
R~ ~te: ~ gpm
Met~ of T~t~: ~1~
feet
, ,. feet
Well Intake Opening Type: ~ end r..I open hole
,d Screened: Stat feet Stopped feet
GroutTyl~,,~Ro'J'~ ~"~ Volume~
Depth: from ~ feet, to ' 0~. 0"'~ feet
Weft Disinfected Upon Completlon? '~s 13 No
Method of Disinfectlon: ~ ~W'°~"~/'IF" ~ /~/vr
Comments:
Ddller's Name ~.~..~,~,..L-.--~
ATFENTION: It Is the responsibility of the property owner to submit a copy of tr~e well lOg to the proper authority. Mu~iclpallty
of A~chorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough:
Oeoartment of Environmental Consewation.
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Progrem
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Date Issued: Jun 28, 2001
Expiration Date: Jun 28, 2002
Permit Number: SW010214
Legal Description: Kimpton S/D Lot 7
Design Engineer: 0070 KND Engineering
Owner Name: Horizon Ventures
Owner Address: 10900 Corrie Way
Eagle River, AK 99577-
Parcel ID: 051-072-70
Site Address: NHN ROAD
Lot Size: 51688 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well
[] Water Storage
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 DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A.
B.
Io-/?-O/
Open and closed on the same day.
Covered, sealed, and heated to prevent freezing.
Issued By: ~ Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cLanchorage.ak.us
(907) 343-7904
ON-SITE SEWEPJVVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D.
5-/-- o'~p. -- -70
Permit Number ~W 0/0 Z/~'
Property owner(s) H(~rlzon Ventures
Mailing address (1 } 10900 ¢orrte Way. Eagle River, AK 99577
Meiti~address (2) /q HM '~o ~
Legal description (Lot, Block & Sub'd.) I(Impten S/D, I-0t ?
Legal description (Section, Township & Range)
Lot Size 51,687 ~'/b~'~' Acres/Sq. Ft Number of Bedrooms
- 'F_~tL.r~ ~ o.~-z,~,~vl J~} ~.~dlDay phone 250-V7~
Z~p Code
THIS APPUCATION IS FOR:
Sewer Only [] Well Only []
Sewer and Well [] Water Storage []
Sewer Upgrade []
THIS PROPERTY CONTAINS:
Hot Tub [] Jacuzzi []
Swimming Pool [] Water Softening Unit []
Therapy Pool []
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
Permit Fees:
Pate o, Payment:
Receipt Number:
(Rev. 12/00)
Waiver Fees:
Date of Payment:
Receipt Number:
]K~D ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907) 696-6111/FAX (907) 696-8111
October 10, 2001
Munidpality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Sewer Design Modification - SW010214 - Kimpton, Lot 7
Gentlemen:
Per septic system modification discussion and approval with DSD on the date of this
letter, please find the attached redesigned septic system. All other items on the
previous request will remain the same.
If you have any questions~ please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
~I~D Engineering
Attachments: Wastewater Absorption System Details/Site Plan
WELL 8, WASTEWATER DISPBSAL SYSTEM DETAILS/SITE PLAN
KIMPTBN S/D, LOT 7
~; )\ " ............. Ii: ..,~/ / % ~ ~'-.'"'-'"'~'"""-'-
I~,-~¢-~-''''~'- i ~ -'-" --\ /
,_ ..... ........... I I /
I
i ? .............. "..
DESIGN DETAILS
3 BDRM X 150 GPD = 450 GPO
450 GPD/O.8 GPD PER SO. ET. (6.32 MIN/IN.)-- 56:3 SO. irt
(563/5'¢V)) X .88(R0 (l.O' GRAVEL) = 99.1 FrT. TRENCH
USE: 2 TRENCHES - 50 (L) X 5' (V) X 1.0'(0)
TotoI depth oF system Is 2.5' Crom original grade.
m mm, mc ,-'~ct$ VIT.m m~' ~' Totol depth oF' gr'ovet below distribulion pipe Is I.O' .
,.*~,'*~c, s,s,c,, NOTES'
e~emca s,mc, [xc£P~ as .mc~. I. USE 1000 GAL. SEPTIC TANK. INSULATE Ir (4' DF' COVER.
NE3 SEPTIC: SV$1CN~ WlIHIN L~01T DJ' ~:~. INSULATE TRENCH VITH 2' HO BURIAL FOAM.
m)~mCO VCLL [XCCPT As
3. CONTRACTOR VILL ENSURE MINIMUM ~X SLOPE INTO SEPTIC TANK.
4. ADDITIONAL FRILL V[LL ~E ADDED OVER SYSTEM TO
MIN. 3' CDVER Ir
5. CDNTRACTDE VILL ENSURE ALL SEPARAT[DNS TO AOJACENT
~~ VELLS & SEPTICS.
EAGLE RIVER, AK. 99577 Sc~te: 1'= 100'
........................................ (907) 688-9~9 PAGE
~ SEWARD ~': ~O ENGINEERING
*~: SEWARD I~m 9/27/01 EAGLE RIV~R, AK 99577-8736
---~~ ~ -~ ~ NW~45e [I ',,'.-'....'.-'.-.-.'.'..'.-.-.'.'.-.'.'.'.-.'.'.'".'-'.'.'.'--'.'.'.'.'-.'-...,' ......... '----"..---"--'11
~mo46.OwG ~" mo,s ~90~6~-~/FAX
k,/ASTE~/ATER DISPDSAL SYSTEM DETAILS
KIMPTON S/D, LIlT 7
K~ D so TH~20~
TH~200~~
~' '. · IDgO0 Crl~I£ rAY
('907) 6ee-97,~9 PAGE 2 DF 2
~~ ~ ~: I ~ NW~ 45e II '-'""'-'-".'.'-'"-'.' '"'"'.'.'-'.'-".'-'.'."-.'.'.'.-'...- .......-..... .............. II
~ '': 01046.OWG ' ~ ~' 01046 (907)696-61 ! I/FAX ~907)696-8111
~x~D ENGINEERING ~. %...
20441 PTARMIGAN BLVD.
· cE 7,,4
SOILS PERCOLATION TEST
Peffo~ ~o: Horizon Ventures .Date PerformS:
Project:. Kimpton, Lot ? TEST tIOLE # 2001-3
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
14-
16-
17-
Depth
(Feet)
Org - black/red, overburden w/
organics
SM/GM- gray, sandy, gravel
w/silt and cobbies to 1'
mod. dense
silt, density, moisture
increasing w/depth
seeps
B.O.H.
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? Yes What depth? 12'
Depth to water after monitoring? 11.1' Date? 10/12/01
Reading Date Gross Net Depth to Net
Time Time Water Drop
1 10/I0/1 1:00 6" -
2 1:30 30 rain 3 8/16" 2 8/16"
3 * 1:31 6"
4 2:01 30 rain 3 6/16" 2 10/16"
5 " 2:02 6' -
6 2:32 30 rain 3 7/16" 2 9/16"
· Water Added
Percolation Rate 11.71 (m/n/in) Perc Hole Diameter 6"
Test Run Between 4 feet and ,5 feet
19-
HOLE PRESOAKED
20- PRIOR TO TEST
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
~D ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-6111/FAX (907)696-8111
June 19, 2001
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
· Subject: New sewer & exploratory well permit - Kimpton Lot 7
Gentlemen:
The owner has requested we proceed forward to obtain a well and septic permit on the
subject lot. On May 4, 2001 we dug one testhole for theproposed system. The results of
this test are attached. The general slope of this lot is from east to west at a grade of
approximately 4 - 7%. An individual well will serve the lot. We propose to install a 5'
wide shallow trench for the proposed 3-bedroom .house. Water was encountered
during the excavation at 9' and after monitoring at 8.5.
We are requesting an exploratory well permit at this time until we can perform the
additional testhole requested. Since we have already performed one testhole with
water monitoring within the area of the proposed septic system, we request in lieu of
an additional testhole that we be permitted to perform another percolation test at time
of construction.
There are no public or private wells within 200' of our proposed system location except
as noted. There is no surface water within 100' of the proposed system and there are no
known curtain drains within 50'. We do not expect there to be any adverse effect on
adjacent lots by the development of this system.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
1I~I~1~ Engineering
Attachments:
On-Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
WELL
K
3
WASTEWATER DISPOSAL
KIMPTON S/D, LOT
SYSTEM DETAILS/SITE
7
6
PLAN
i
I
DESIGN DETAILS
:3 BI]RM X 150 GPO = 450 GPO
450 GPD/O.8 GPO PER SO. IrT. (6,32 MIN/IN.)= 563 SO. IrT
¢563/5'(i/)) X .88(RF) (1.0' GRAVEL) = 99.1 rT. TRENCH
USE I TRENCH - 100 (L) X 5' (i/) X
Totot depth o? system is P.5° ?rom opiglnG( gp~de.
Tot~[ depth o~ g~ve( belo~ dlst¢ibution pipe Is 1.0' .
N~TES:
!. USE 1000 GAL SEPTIC TANK. INSULATE IF
~. INSULATE TRENCH WITH ~* HD BURIAL rOAM.
3. CONTRACTOR ~ILL ENSURE HINIHUH EZ SLOPE INTO SEPTIC TANK.
4, ADDITIONAL ~]LL ~ILL BE ADDED ~VER SYSTEM T~ ACHIEVE
MIN. 3' COVER IF REQUIRED,
I 51 CONTRACTOR I/ILL ENSURE ALL SEPARATIONS TO ADJACENT
......
· ~9,ru'~ '"'...: . ~
......................
I/ELLS & SEPTICS.
PREPARED FOR:
HIKE PARKER
10900 CORRIE VAY
EAGLE RIVER, AK. 99577
(907) 688-9729
SEWARD mu, m: VBG
SEWARD ¢~m¢o: KMD
SEWARD m,~: 6/1/01
~ NW1458
01046.DWC ~ ~: 01046
Score: 1'= 100'
PAGE I DF 2
]~ ~ I]~) ENGINEERING
;~0441 PTARMIGAN BLVD,
EAGLE RIVER, AK 99577-8736
(9o?)e96-elil/;Ax (9o?)soe-slll
WASTEWATER DISPF1SAL SYSTEM DETAILS
KIMPTON S/D, LOT 7
~ ' RBPDSED 1000 GAL
THN2 ~ .m. _~ SEPTIC TANK
~I~. ~ __
~I~.
~% OF A~4~ PREPARED FOR:
........... c907) 6ee-eTe9 PAGE ~ DF ~
'a~',~ ...... .~ ~ "~ S[WA,O "mm K~D 20441 PTARMIGAN BLVD.
.~--~2%'~'2 ..............~."['. ~ ~ SEWARD o*~= 6/I/01 EAGLE RIVER. AK 99577-8736
~ ~- ~ssto~ ~ [..:......~~..,,.....~.~..~~...........~......~~..~.~~~.~:~....~.~....:...~..~...~,:..~...~.:~.~...,~_ ............]
~~ ~ ~: ~ N~ 458
-- O~ A~. ~
~ ENG~EE~NG ~/~ ~ ~ .~ ~'~
2~1 ~A~IGAN BL~ ~~~~?~' ~
EAGLE ~R, AK 995~-~736 ~
SOILS ',
Perfo~ed [o~ Horizon Ven[ures Date Perform: 05/~/01
Project: Kimpton, Lot 7 TEST HOLE # 2001-01
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18--
Depth
(Feet)
Org - black/red, overburden w/
organics, moist
GP/GM- gray, sandy, damp
gravel w/silt
mod. dense
GM - gray, sandy-silty gravel,
moist, mod. dense
silt, density, moisture
increasing w/depth
seeps
B.O.H.
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO
Dep~ to water after monitoring? 8.5'
What depth? NA
Date? 5/11/01
Reading Date Gross Net Depth to Net
Time Time Water Drop
1 5/08/01 1:00 8'
2 1:30 30rain 34/16" 412/16"
3 * 1:31 - 8'
4 2:01' 30 rain 3 4/16" 4 12/16"
5 * 2:02 - 8"
6 2:32 30 rain 3 4/16" 4 12/16"
· Water Added
19-
20-
HOLE PRESOAKED
PRIOR TO TEST
IPercolation Rate 6.32 (rain/in) Perc tlole Diameter ..
Test Run Between 2 feet and ;~ feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
~,~ 1.~ ENGINEERING ,~:'
20~1 ~A~IGAN BL~,
SOILS PERCOLA~ON ~ST
Perfo~ fo~ Horizon Ventures De~e
Project:. Kimpton, Lot 7 TEST HOLE # 2001-02
Depth
(Feet)
SEE ATTACHED SITE PLAN I
FOR HOLE LOCATION
Was Ground water encountered? What depth? NA
Depth to water after monitoring? Date? 6/22/01
Reading Date Gross Net Depth to Net
Time Time Water Drop
1 6/22/01 3:15 9 4/16"
2 3:45 30 min 4 2/16" 5 2/16"
3 * 3:46 9 4/16" -
4 4:16 30 rain 4 2/16" 5 2/16"
5 * 4:17 9 4/16" -
6 5:47 30 rain 4 2/16' 5 2/16"
· Water Added
Percolation Rate 5.83 (min/in) Perc Hole Diameter 6'
Test Run Between 2 feet and ~ feet
4~
,%
6-
7-
8-
9-
10-
11-
12-
13-
14-
1,%
16-
17-
18-
19-
20-
HOLE PRESOAKED
PRIOR TO TEST
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Sita Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cLanchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D.. 051-072-70
Expiration Date: ] -' ! ~/- 0 ~
1. GENERAL INFORMATION
Complete legal description KIMPTON I-OT7
Location (site ~ddress or directions) NHN GLACIER RD., CHUGIAK, AK 99507
Current Property owner(s)
Mailing address
Lending ag~n, cy
HORIZON VENTURES Day phone .688-9729
10900 CORRIE WAY, EAGLE RIVER, AK 99577
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless othen~ise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
' Individual Well []
Individual Water Storage I-I
Community Class .__ Well []
Public Water System []
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public Sewer
[]
[]
[]
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional
civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the
transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal
and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health
Authority Approval are valid for 90 days from the date of issue for properties served by a' pdvate or Class C well
and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a
pedod of up to one year with valid water samples.) Certificates are valid for one year for properties served by
Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or
omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Health Authority Approval Guidelines for this
application, shows that the on-site water supply and/or wastewater disposal system is(am) safe, functional
and adequate for the number of bedrooms and type of structure indicated herein. I further vedfy that
based on the information obtained from the Municipality of Anchorage flies and from my investigation and
inspection, the on-site water supply and/or wastewater disposal system is(am) tn compliance with all
applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm KND Enqlneerinq Phone. 696-6111
Address, 2044'1 Ptarmiqan Blvd. Eaqle River, AK, 99577
Engineer's PHnted Name Kenneth M. Ouffus Date 10117101
Approved for ~ bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: / 0 ° /'~ -- 0 '/
Municipality of Anchorage
Development Services Department
Building Safety OMslon
On-Site Water & Wastewater Program
4700 South Bragaw 8L
P.O. Box 195650 Anchorage, AK 9951g-6650
www.cLanchomge.ak.us
(907) 343-7g04
HEALTH AUTHORITY APPROVAL CHECKLIST
Parcel ID: 05t.072.70
Klmpton Lot ~
Legal Description:
A. WELL DATA
Well b'pe I~dvate
Date completed 07/02/01
Total depth 221fL
If A. B, or C provide PWSID #
Sanitary eeal (Y/N)¥
Cased to 221fl`
FROM WELL LOG
Date of test 07/02/01
StaUo water level t52
Well production
WATER 8AMPLE RESULTS:
Coliform {I colonies/100 mi.
Date of sample: t0/16/0t
B. SEPTIC/HOLDING TANK DATA
Well Log (Y/N) y
Wires ~ protectecl (Y/N) y
Casino height (above ground) 2'
AT INSPECTION
ft. fl`
g.p.m g.p.m.
Nitrate ~.~4 mgJL
Callected by: KND Enalneeflna
Other becteda O colonles/10Oml
Tank Type/Material An~oraae Tank 18tasl
Date installed 10/t0/0t Tank size t000 gal. Number of Compartments L
Cleanoute Yas Foundafion cleanout Yea Depression over tank No Hlgh water alarm NA
Date of pumping NA.newtank Pumper
C. ABsoRpTION FIELD DATA
Date installed 10/t0/0t 8oll raUng (g.p.dJfl= or fl=rodrm) U
Length 2.3J1Ug2)~ fL Width ~
System type ShaflowTmnch
fl` Gravel below pipe 1.02
Depression over field No
For L bedrooms
gal. · .New depth
in. Nosorptlon rate >=
If yes, give date
Total depth ~ fl. Eft. absorption ama 580 fl= Monitoring tube Yea
Date of adequacy test NA. new system Resutte (Pass/Fall) Pass
Fluid depth In absorption field before teat In. Water added
Elapsed TIme: min. Final fluid depth
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
In.
g.p.d.
D. LIFT STATION
Date installed N~
'Pump on" level at __ in.
Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 10Q'+
Absorption field on lot 1QQ'+
Public sewer main
Sewer/septic sewlce line 25'+
Size in gallons Manhole/Access (Y/N)
'Pump off' level at m in. High water alarm level at
Cycles tested Meets almm & circuit requirements?
On adjacent lots 1QQ'+
On adjacent lots t00'+
Public sewer manhole/cleanout 1gQ'+
Holdlng tank tQQ'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation ~'+ Property line ~'+
Water main lQ'+ Water sen, ice line tQ'+
Wells on adjacent lots t0Q'e
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
Water Service line
Curtain drain
F. COMMENTS
10'+
G. ENGINEER'S CERTIFICATION
Building foundaUon 10'+
Surface water tQQ'+
Wells on adjacent lots 100'+
I certify that I have determined through field inspections and
review of MunicJpe/ records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Pdnted Name Kenneth M. Duffus
Date
Absorption field ~'+
Surface water 1QO'+
Water main 10'+
D~veway, parking/&mhlcle sterage
in.
HAA Fee $300
Data of Payment
Receipt Number
(P~v. 12mo)
Waiver Fee $
Data of Payment
Receipt Number
0CT-18-01 08:17 FROI/~CT&E ENVIRONMENTAL SRV 9015615301 T-951 P.01/01 F-481
CT&E Environmental Services Inc.
Laboratory Division
200 W. Potter Drive
Anchorage, AK 99518
Tel: (907) 562-2343
Fax: (907) 561-5301
CT&E Ref. #:
Client Name:
Project Name:
Client Sample ID:
Matrix:
PWS~D
Sample Remarks:
1017190001
KND Engineering
n/a
Kimpton Lot 7
Drinking Water
Client PO~: n/a
Printed Date/Time: 10/18/O1 07:45
Collected Date/Time: 10/18/O1 11:30
Received Date/Time: 10/10/01 12:25
Technical Director. Stephen Ede
Released
Parameter Results PQL Units
Total Coliform (MF) 0 co1/100 mi
Nitrate 2.24 0.5 mg/L
Allowable Prep Analysis
Method Limits Date Date Init
SM9222B 1 0/18/01
EPA 300 10.0 10/16/01
YAP
SCL