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LINTNER (PLAT 84-484) LT 1
Lintner Lot 1 #051-151-37 Municipality of Anchorage Development Services Department \ Building Safety Division On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907)343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO10146 PID Number. 051.151.37 """' THEWS Wastewater System: [:]New ® Upgrade 7965 JAYHAWK DRIVE MGM, AK 99567 ABSORPTION FIELD Phww• µ•veer Of So N Dtap Trench O snaosw Trwrth a BW O MwW O ouw. LEGAL DESCRIPTION sae RauN: 7cte Depth ham ong + wW: 0.6 Gpox? 7.0 Ft. Modc LM swmwmm: Depth to pya hotlam ham algw CrW: Grave deem tmnmth PSP•: 1 LINTNER 2.0 Ft. 5.0 FL 7o 1p: Rept: ssemn: F/ WOW .fon Ong" Craft: Grave Largm: 0.25 Ft. 100.0 Ft. Well: ❑ New ❑ Upgrade04 2.0 � 1 Ft. FL cumake" lames. Aa.Ck Tae Dean: caae t W. Tae abso"M eta: Pat M tterW: Private Ft. I FL 1016 Fr D3034 & FBI Drear. Des Dmw: sutw waw Lew: m tmi a .. Dau Vj Y : FL CAULKINS CONST. 7 001 Yam: Pamp se at: G&" llw"M Aeovs Grmai¢ TANK GPM FL FL SEPARATION DISTANCES 0 Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Ltlt Holding PublwPrivat •"10d11°` From Tank Field Station Tank Sewerune EXISTING— G". WON 100'+ 100'+ NA NA 25'+ Meta W: Steel R.nP. aLPmp.nmwaa: S&eaoawew 100'+ 100'+ NA NA LIFT STATION W Lim 5'+ 0'+ NA NA. W: Gr. 5'+ 10'+ NA NA •PwW en tr. at. •Pump ar r a „ph waw earm OL Foundation m. m. In. GaM,mDmein I NA h50'+ NA NA FmmMBkeamo" "NipsC001epwk-mdW R LOOTT LIN WAVER REQUEST 8WR010029, APPROVED ON BENCH MARK 5!30/01, BY DAN ROTH Lam Dm. BOTTOO M OOF F SSIDING 100 FL Engineer's Stamp OF At Inspections performed by: KND Engineering Dates: 1M 7//9/01 f4c L •7t •••�••� •.�� Development Services Department Approval %/L3 �( : Keanu:n l.1. Lul:u •: i . CE 7116 �f;rF9 Reviewed and approved by: Date 2—a •.• •.• ,���� ••. lar. swot 1, ► % \OFESSI ��P AS -BUILT SYSTEM DETAILS/SITE PLAN Permit SWO10146 LINTNER S/D, LOT 1 PID#051-151-37 KNp �, �Po B -C= 37.4' SCALE: NTS A -D= 38.2' B -D= 42.3' W O PO BOX 672377 B-E= 69.5' CHUGIAK. AK. 99567 A -F= 37.7' (907) 830-9002 THI 93-2 FIELD BOOKS canurzu B -F= 56.1' T 2001-1 A -G=126.6' STS FLEMING oc«E¢ KMO B -G=136.8' •sewn FLEMING DAR: 7 1 0 D.C.nr: Ca. NW1257 :-:::-:-:::::::::...... :::::::::::.... ... Awn: 01051.OWG " "" 01051 (907)696-6111/FAX (907)696-8111 DIVE TER 1 .................... O TH�1 93-0 y SEPTIC , T 93-1 Do lve N c°E IC 7 k-50 VACANT 2 n A -C= 33.3' B -C= 37.4' SCALE: NTS A -D= 38.2' B -D= 42.3' W A-E= 63.5' PO BOX 672377 B-E= 69.5' CHUGIAK. AK. 99567 A -F= 37.7' (907) 830-9002 FIELD BOOKS canurzu B -F= 56.1' "Ou"O' FLEMING 0"": A -G=126.6' STS FLEMING oc«E¢ KMO B -G=136.8' •sewn FLEMING DAR: 7 1 50' Y 6 g �...OF.. 494 .........CE-9118A: ll �eAr �FESSION", A �' SCALE: NTS PREPARED FOR: LONI MATHEWS PO BOX 672377 CHUGIAK. AK. 99567 (907) 830-9002 FIELD BOOKS canurzu 1K ID "Ou"O' FLEMING 0"": ENGINEERING STS FLEMING oc«E¢ KMO 20441 PTARMIGAN BLVD. •sewn FLEMING DAR: 7 1 EAGLE RIVER, AK 99577-8736 D.C.nr: Ca. NW1257 :-:::-:-:::::::::...... :::::::::::.... ... Awn: 01051.OWG " "" 01051 (907)696-6111/FAX (907)696-8111 �p�q D OF 04 lt�lV ENGINEERING Net Time 20441 PTARMIGAN BLVD. Net Drop EAGLE RIVER, AK 99577-8736 t • •J!�«••••�• nannc... .... . SOILS PERCOLATION TEST I��JJ` CE 7116 1 Performed for. Loni Mathews Date Performed: Project: Lintner Lot 1 TEST HOLE # 2001-01 Depth (FQet) SEE ATTACHED SITE PLAN Org/ML — red/brown, moist 1�overburden w/ organics Y GM/SM —med dense gray, damp 5- sandy, silty gravel 1 w/cobbles to 1' 9- density increasing w/ depth 10- 11- 2- 13- 0-11-2- 13- B.O.H. 14- I5- 16- 17- 18- 19_ �Rlo2 'ID QST 2o- FOR HOLE LOCATION Was Groundwater encountered? NO What depth? NA Depth to water after monitoring? NO Date? 6/25/01 Reading Date Gross Time Net Time Depth to Water Net Drop 1 6/15/01 3:00 - 6" - 2 3:30 30 min 414/16" 12/16" 3 3:31 - 6" - 4 4:01 30 min 414/16' 12/16" 5 4:02 - 6" - 6 4:32 30 min 414/16' 12/16' • Water Added Percolation Rate 26.67 (min/fn) Perc Hole Diameter 6• Test Run Between 6 feet and 7 feet 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 On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SWO10146 Legal Description: LINTNER (PLAT 84-484) LT 1 -71/9 Date Issued: May 30, 2001 Expiration Date: May 30, 2002 Parcel ID: 051-151-37 Design Engineer: 0070 KND Engineering Site Address: 020905 JAYHAWK DR Owner Name: LONI MATHEWS Lot Size: 44360 SQ. FT. Owner Address: 20905 JAYHAWK DRIVE Total Bedrooms: 4 Permit Bedrooms: 4 CHUGIAK , AK 99567 - This permit is for the construction of: Disposal Field F� Septic Tank E] 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. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 'S. The following special provisions. ,AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL PERFORM AN ADDITIONAL PERCOLATION TEST AT THE NORTH END OF THE PROPOSED ABSORPTION TRENCH. Received By: Issued By: Date: 5-- 3 /—d / Date: 5--30-01 WR#: WRO10029 Date Received: 5/30/ 01 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.ci.anchorage.ak.us (907)343.7904 Waiver Review Worksheet PID#: 051.151-37 HAM Legal Description: LINTNER SUBDIVISION LOT 1 Engineer. KENNETH M. DUFFUS Permit#: SWO10146 20441 PTARMIGAN BLVD., EAGLE RIVER, ALASKA 99577.6736 Applicant: LONI MATHEWS Waiver Requested: 0 FEET BETWEEN THE WEST LOT LINE AND THE ABSORPTION TRENCH Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Points: Waiver is Granted: ^ Waiver is not Granted: List Conditions or Reasons for above: $ E E E A, C. Mem, E iP 3 C E 77' Pr R O F Ju Sr/Plciar/ON Via rF_0 S — 30 —0/ Date: 3--30-01 By : P4" Name of Reviewer Rec#: 05095 Amount: $115.00 Date Paid: 05/30101 05/30/01 Municipality of Anchorage George F. IVuerch, Mayor Department or Public Works Building Safety Di-s7sion P.O. Box 1196650 a 4700 S. Bragaw SLrcct Anchorage, Alaska 00510.6050 e (907) 313-&'301 h tq,://�����e.c�.muhnragc.ak.us Kenneth M. Duffus, PE 20441 Ptarmigan Boulevard Eagle River, Alaska 99577-8736 Subject: Waiver Request for Lintner Subdivision Lot 1 Waiver Request #WR010029 Parcel ID #051-151-37 Permit Number SWO10146 Dear Mr. Duffus: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 0.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, J Daniel J. Roth Civil Engineer On -Site Water & Wastewater Program Municipality of Anchorage -..� Development Services Department Building Safety Division On -Site Water and Wastewater Program 4 4 016111 4700 South Bragaw St. " P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051.151.37 Permit Number SW 010146 Property owner(s) Loni Mathews Day phone 830.9002 Receipt Number: Mailing address (1) p.o. box 672377 chuglak, ak. 99567 (Rev. 12/00) s/rr fi�ngaddress (2)20905 1404WR DR. zip Code 99567 Legal description (Lot, Block & Sub'd.) Llntner lot 1 Legal description (Section, Township & Range) LotSize44360 Acres/ q.F Number of Bedrooms 4 THIS APPLICATION 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 Dyveiling and is in accordance with applicable Municipal Codes. of property owner or authorized Permit Fees: Waiver Fees: Date of Payment: Date of Payment: Receipt Number: OS09S 51Z 0 1 Receipt Number: L110fir (Rev. 12/00) K N D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER. AK 99577-8736 (907)696-8111 May 30, 2001 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Sewer Upgrade Re -Design & Lot Line Waiver — Lintner S/D Lot 1 Gentlemen: Per our conversations regarding the proposed subject property's sewer upgrade, we have had the lot line surveyed and have determined it is feasible to construct the septic system as shown on the attached re -design. However to do so, we are requesting a waiver to lot line of 0.0 feet. The system is still located within the testhole radius and we do not expect there to be any adverse effect on adjacent lots by the location of this system. 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'. An additional percolation test will be performed at the north end of the trench during construction. All other items of the previous design will remain the same. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, MUD Engineering Kenneth M. Duffus, P.E. Attachments: Wastewater Absorption System Details/Site Plan 57/90/01 1,4+ L FC. -L ins �* 509r L, it 010027 KND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER. AK 99577-8736 11/FAX (907)696-8111 May 16, 2001 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Sewer Upgrade — Lintner SID lot 1 Gentlemen: The owner has requested we proceed forward to obtain a septic permit to upgrade existing septic system for the subject lot. The existing septic tank will be inspected to verify its integrity and its accordance with municipal standards. We are using the original testholes that were dug on the subject property. The results of the tests are attached. The general slope of this lot is from north to south at a grade of approximately 2-3%. However the septic area that we will be utilizing is flat. We have designed our system utilizing the testhole that was excavated for the 4 - bedroom house. The lot is served by an individual well. We propose to install a 2' wide shallow trench. 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, KHD Engineering Kenneth M. Duffus, P.E. attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test WELL & WASTEWATER DISP❑SAL rararn cin SYSTEM DETAILS/SITE PLA I nr , ------------ JfiYNfiWK-.-.------- NO PUDLIC WELLS WITHIN 200' K PROPOSED STSTEN NO PRIVATE WELLS WITHIN 200' Or PROPOSED %VSIEN EXCEPT AS NOTED. NO SEPTIC STSTCHS WITHIN 200' Or PROPOSED WELL EXCEPT AS NOTE& 1'�`C� �F..A.. TH /.....} .............................. _...nl ( nonnora-a.tirarr w::: 1 •., CE -7118 y(TV4�i/� .2/ \ SstDN�V •--------------- ------------ i i 111 DESIGN DETAILS 4 BDRM X 150 GPD = 600 GPD 600 GPD/0.8 GPD PER S0. FT. (4.21 MIN/IN.)= 750 S0. FT (750/(2'(W) X 40)) (4.0' GRAVEL) = 93.75.0 FT. TRENCH USE 1 TRENCH - 94 (L) X 2' (W) X 4.0'(D) Total depth of system Is 6.0' from original grade. Total depth of gravel below distribution pipe Is 4.0' . NOTES: 1. USE 1250 GAL. SEPTIC TANK. INSULATE IF (4' OF COVER. 2. INSULATE TRENCH WITH 2' HD BURIAL FOAM. 3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INTO SEPTIC TANK. 4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN. 3' COVER IF REQUIRED. 5. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS L SEPTICS. PREPARED FOR: LONI MATHEWS PO BOX 672377 CHUGIAK, AK. 99567 C907) 830-9002 FIELD BOOKS COMPUTED: saPn.Rr. PA o" SPANGLER °'ECNM- •SBUah SPANGLER DATE: D.C. ME: ENO: Am F"' 01051.DWG i "NN: 01051 Scale: 1'= 100' PAGE 1 OF 2 ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 11 II WASTEWATER DISP❑SAL SYSTEM DETAILS LINTNER S/D, LOT 1 K ❑ 00 MT O TH#1 93-2 PROPOS D P DIARY SYSTEM Li w SLOPE FROM ❑P OF F— T ❑TT❑M HILL >- AN 25% No LD M Z � OJ PR❑ CSD DIVERT X v Li W11HURM MT ao CI I n F=F1 AT fr 1 n000�,n w. ✓vrr� 1�. CE -7116 / 4; a "KESSIDN�� TRENCH = LESS TH#1993-3 °PPR❑XIMAT ❑CATI❑N ❑F 1=�> GAL SEPTIC lso� PREPARED FOR: LONI MATHEWS PO BO% 672377 EHUGIAK, AK. 99567 (907) 830-9002 F:ELD BOOKS cowxo, 0"C"r SPANGLER 0".: VQQ STA-* SPANCLER CKCKto, KMD ASPA'*. SPANGLER Oft: 1 V a ru: tree NW12: Am re -L' 01051.OWC I " ` 01051 TAt Scale: 1'= 20' PAGE 2 OF 2 1,1\1 LW ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 I Municipality of Anchorage Page of a 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 Permit Number: 5� 85r PID Number: CST l l S-Q7 Name: _(-oNy Wastewater System: '6 New El Upgrade Sp,�Nvc�n Address: -770C� -P, O • �6x�o% �ACyLE Rt�E¢, Ak 99617 ABSORPTION FIELD Phone: No. of Bedrooms: p Dee Trench Shallow Trench ❑ Bed ❑ Mound ❑ Other p LEGAL DESCRIPTION Soil Rating: C7g Total Depth from original grade: GPD/S Ft Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe LI NTN E2 3r Ft. 3' - - -- Ft. Township: 1 N Range: Section: n Fill added above original grade: I Gravel length: l r? T U1 S4 - Ft. Ft. WELL: 9 New El Upgrade Gravel width: 45 Number of Distance between lines: Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: ASTM / D3n3 T'6 ivATE —200 Ft. 06+ Ft. I sao SO. Ft. ASID Driller: 50LLl,,ArJ A-199. lw0� 1I & Date Drilled. 'Oq3 Static Water Level: 6.0 Ft. Installer: -povt3L&r M CONST Date installed: 9 as g3 Yield: Pump Set at: Casing Height Above Ground: TANK '2`J GPM /go Ft. t/t Ft. SEPARATION DISTANCES Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines I •'} Material: Number of Compartments: Well I p I' I ^ 3' � �� ST>=E L Surface rfa loo'{ — LIFT STATION e WatLota Conte- — Size in gallons: Manufacturer: Line "Pump on" level at: p off' level at: High water alarm at: Foundation 38' 33' _.-- Curtain KtJO Pump M Model Electrical Inspections performed by: Drain t1..tONe BENCH MARK Remarks: S CO"-PLre-TmO A3.8utc.T Location and Description: (�.7b2IC Kot _t), Q_ __X-_)A T•vN oN �- 101 -'IS- fJoR7N Cr'r5T 00kejE12 or- k�2�t1e`nfN' w.oRK 1 atio INg aT1�S HovsE—3oTTOWv v � D11J6 A-i To(�o Assumed Elevation: A-L-t- S `IC) Tvv> TAT toN 100.0 to ENGINEEWS SEAL SlT1sVISIT CN Too Y_ ELEV.stioTs Af4-* Swlf.v6"TtE-S - . �''."� S a s E 17034 Eagle River Loop Road, No. 204 Inspections performed byEagggiver, Alaska 99577 Dates: 1st CS-iq-95) 2nd 9 _ag g3 f�,: ...-......._,._t,-,^.... - ROBERT C. COWAN Q Department of Heal an um Services approval +cE -asoi 1/ ���`` tti�'FROiiSS1�e�4. Date: 8-21— Reviewed and approved by: 72-013 (Rev. 9/91) MOA 25 Permit No. SW930285 2 2 Page of — 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 LOT 1, LINTNER SUBDIVISION Legal Description: PID No.: 05115137 72-013 A (Rev. 9/91) MOA 25 C04 = 101.1' C)5 = 99.2' ST1 ST2 MT C04 1 1.1' MT C05 FIN kL GRADE t5N I SULATION 97.5' GAL 97.3' COt & C05 SR 97.2' MTJ = 94.1' MT = 94.3' Mr C05 ♦ gQ.l' NO ATER FOUND NEW TRENCH B (I C01 35' 37' ST1 3 ' 42' (( ST2 4 ' 52' CO2 5 ' 55' ( (� CO3 5 ' 57' , (I (I cos qEW 1500 L 47 COz SEPTIC TAN COS 1 1 ' 125' N ° ST2 MT2 120' 126' ( ° ST1 MT1I col 0 FCO HOUSE yv ME 00 ROBERT C. COWAN'• f �� WEL I.y • CE -8801 8801 = SCALE 1" 40' ,r'ti v� r1v�••..• ...• •'�, t�ROFCSS 72-013 A (Rev. 9/91) MOA 25 6-24-1996 10:31AM FROM EHS-ALASKA.INC- 9876941382 06/24/1996 10:14 9073458765 HAPQLD GETTY (gatifirb lBrilling ung PAGE 01 WE ODE! Co- dna SULLIVAN WATER WELLS t P.o.80X6711272,CHUGIAK,ALASKA 99567 • TELEPHOHE9662759 r z r ter. II.F ✓1 F)EPTH OF WELL Jv _ OV-] r,g OV LAND Y r � eID! FiE�G. o ! .. '-7 %- STATIC LEVEL OF WATER FT. s� LEGAL Oft RdPCIO "r J 7"rl. ' . DATE . 5t✓eitj Ended _ PERMIT C+IUMUER KIND OF COR?AAT'ION: Fran+ `" Fi. r to 19 Fsxrrra�i-t®—:72 Ft.. P•tD���+ � � ��n:��a_ 1z'¢. tvFt. �t.L`•�? �.d�iilF/S FrotaY 9 Fx. t Ira f12> Ft. to zi _IFt, VJA c� story._'�e. to.py From—ft tv Ft jF%G'kii ,r(' %oma Ft. DRAM' DOWN FT -- --- '-- GALS. PER HR _ -- KINP OF CASING b a G From . Ft- tv Ft- From Frorrt,,,._,,.._Ft. - Ft. From, vt. Frnra Ft - o From DRAM' DOWN FT -- --- '-- GALS. PER HR _ -- KINP OF CASING b a G From . Ft- tv Ft- From Frorrt,,,._,,.._Ft. - Ft. From, vt. Frnra Ftom� Ft. Tv Ft From From __—Ft. ry - Ft. Frnra --Ft• ro.,..,,..,...Ft. From Ft. to—Ft. From -Fl- to—Ft. Ftvm -Ft. to Ft. Fmm �Ft. tv....._..._Ft. From FL to Ft- - JUL 29 1996 FromFt.t4_-Ft._ From Ft. to. �-- Ft•t+�ut>i�'paiity of Anchorage Dept. Health & Human Services Ftom FL. tv Ft. DRILLER'SNAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW930285 DESIGN ENGINEER:DAVID R. DAYTON, P.E. OWNER NAME:GETTY HAROLD T OWNER ADDRESS:4011 SE 14TH ST. DEL CITY, OK 73115 PARCEL ID:05115137 LEGAL DESCRIPTION:iLINTNER (PLAT 84-484) LT 1 LOT SIZE: 44360 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 8/10/93 EXPIRATION DATE: 8/10/94 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 B ISSUED BY: DATE: DATE: _ /� SGS-vtrc S.�STg/'1v. +3tM nor 9Co S8-Prl� S4 S fCitH- -- \._ }7..1lt Alt - 100" rs'C - � �y U N o EvBa.a I rso '� %-Id 113 +�: Sg vnc L. T = , \ - rgJSa .. 1� PJ�..f1c Zi/or N N cwr � N 2,go I i II IE I�Zovoseo t'j! . wcw f]� 5UA .2ta, i � /50•Q'! ;� hl Z Ay 1+AW yy, _ TJ2 , .- rr • 7 9 �o•• a eo••a°•�.• � .- � _ 1X/ek. � SGP'T'I („ Sit SI$M VA � G2 WigQz . David R. Dayton f4i--- ----- -- ��3 ---- • Lor 1 _ L t..+�-NCZ dJ s •� NO. 2205-EDavid R. Dayton or `e®®aa� y� as• E 20210 Donalar St. Chugiak, Alaska 99567 4 32 — CPO c'::,' cd pj ir- TE%r i -1a a 11' Ca, St z.jg 0.8 La 0 �ti 3' Ct2MtiR.� ll5� S8 / oR �ra•.,a�� �.��c.-nt- 8-7t 60' ��� w� 3 e r 0 NJ oal8C006'(- et) -I. S' 'a �g too L6+'tl uo U.7hT-C'rt- �JVfl ��a � � : •Sh ?fY see Y �p ,49'- 0-91 �a a es.w//.pper• �40ea•Yaasaea ae aaa•..afiffffe e.. as a..� ,3 #; David R. Dayton e w� if, UP- : NO. 22 0 as • �/ '�� ryi''.na '` �•�av `� a•...o.•e° L s David R. Dayton P.E 20210 Donalar St. Chugiak, Alaska 99567 S��r- 2 / Z D.A. DAYTON, P.E., R.L.S. ffQX2NM=r Chugiak, Alaska 99567 (907) INN&I 20210 Donalar 696-2417 Proposed Wastewater system for Lot 1, Lintner Subdivision The proposed wastewater system will serve a 4 bedroom home. The system will be situated on the higher portion of the lot to avoid relatively high ground water found in test holes #2 & #3. (Relative elevation of the test holes is shown on the site plan). The site is above a 25% bank which is approximately 10 ft. high. The bank is a natural bank with heavy vegetation. Although the normal set back from the bank is not maintained, the septic system should pose no seepage problems. There are no community wells lithin 200' or private wells within 100' cf the septic system. There will be no measurable impact on wells or waste water systems on adjoining lots. There will be no measurable impact on reserved areas or on drainage. OF Z tat' F=ii + Guv;d R. Coy9on i -. � e•. NO. 2205-E `,• � � Y �•! i`p •O0o •o+�•+���c9 4h .0.. •e. ee o•e , �, rco .. Municipality of Anchorage r* :/Y..T �.. DEPARTMENT OF HEALTH & HUMAN SERVICES s• .o ....s . . ® o.e... 825 "L" Street, Anchorage, Alaska 99502-0650!./ ; .... Ni0.6 0•p..... ......... 9 riz SOILS LOG — PERCOLATION TEST n ; David R. Dayton a „A �^ �T '// r / �! a NO 2205-E / H�<� PERFORMED FOR: L �'vy �P�Jx�tie ���-- DATE PERFORMECiJRr�"*riJ'i�4'��� LEGAL DESCRIPTION: �""' / �" /'�'� 5g-10. Township, Range, Section: ,i✓ /j Aj , �% ru SLOPE SITE PLAN Q,3 1 J7 2--- DEPTH (FEET) v4e-4. j� SJcry 5A-V� Ji RAI SAN OyJ �11.+i�fe"� Net Drop z —314 3- 345 j 3•'o Z. it %/(. 4- -'u3 7'3'1 5 6 03 r' wA.� 7 7 41.'31% 5A7\Jn.l C7/z'1-v0A- /d% 3% 8 9 10 WAS GROUND WATER N /d ENCOUNTERED? S 11 L IF YES, AT WHAT O DEPTH? P 12 E 13 Depth to Water After, Monitoring? iva,v& Date: l 43 14 15 16 17 18 19 Reading Date Gross Time Net Time Depth to Water Net Drop z —314 77/8 j 3•'o Z. it %/(. 3'/rte -'u3 7'3'1 03 G UV 7 41.'31% 30 /d% 3% 20 I " IUI PERCOLATION RATE 9' 2 (minuses/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS ��lq /tJ� � i� a' Z J 1+� Ji�}C 7-H*%_3 T1+ -3 9 ' �V,)G hJ-2z1L �T7 ,v l`7a `L Z - nn rl� CERTIFY /LX FY THAT THIS TEST WAS PERFORMED IN PERFORMED BY- T' K` '"� r�'J I y l/ 11 ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4785) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES ( • • •6 eeo••000 ma ommoo o �', 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST'°®«•`���" 94 • David R. Dryton PERFORMED FOR: �/Vy J� Gil c�lZ DATE PERFORM LEGAL DESCRIPTION: 4r/N� N Jt ��� 3 Township, Range, Section: �J�✓ �ru� SLOPE SITE PLAN DEPTH 2 3 4 5 d S, S&IJO 'Yck"33"�s 6 7 8 9 wATE2 7E' y, f 10 11 12 t2•a - 13 14 15 16 17 18 19 WAS GROUND WATER YL j ENCOUNTERED? IF YES, AT WHAT DEPTH? 5, i Depth to Water Atter Monitoring? 9.3 Date: 93 Reading Date Gross Time Net Time Depth to Water Net Drop 3.106 3z 13 3 37 -�3© 2 i3.L S 3.'37 '/G. t o 7 YL 3 arc. 201__j(o" PERCOLATION RATE - ,3 (minutes/inch) PERC HOLE DIAMETER 7 TEST RUN BETWEEN 3' FT AND Ir- FT COMMENTS K i� fYT / V EGc�V.ronJs l {� tc�H£�C_ 71tR� 1 F 3 PERFORMED BY: —0' )?' a � -aC'xj P. y I Lc:�� 7�1 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: f1-41,57,3 72-008 (Rev. 4/85) Municipality of Anchorage �;° �e DEPARTMENT OF HEALTH & HUMAN SERVICES go °a 9TP700640 40800 a low 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST �q...a° "�®°°"'° o° ® David R. Dayton ry PERFORMED FOR: �/ .J/U`i CJi��i�'-�C�'Q DATE PERFORME[R9:i7 LEGAL DESCRIPTION: 5,,6p Township, Range, Section: 50--p., SLOPE SITE PLAN DEPTH p�,�/}r�/�G 0,3 SLOPE z 5,I Vj 3 4 j 51,,7.4 5w., D W/ c'05 -a 5 4 r)CC.A5/4rj1*L a6LAt_OHeS vJA-'e' 6 t A3«c/L • r7tr DiN- 1" '7.1 7 E 9 101 i ckj 11 12 13 14 15 16 17 18 19 I WAS GROUND WATER Y62-5ENCOUNTERED? S L IF YES, ATWHAT O DEPTH? S P E Depth to Water After , Monitoring? —L� Date L Reading Date Gross Net Depth to Net Time Time Water Drop 6 20 ILII PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS t2�J�,•�? i(jdr,&jA/ — O PERFORMED BY:7 +"'y✓i`F'S/i�� �G I —�� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72 -DOB (Rev. 4/85) • • �£ 94 •r .� Municipality of Anchorage On-Site Water and Wastewater Program ,aa' (907) 343-7904 s A c T Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-151-37 Expiration Date: 1 1. GENERAL INFORMATION Complete legal description LINTNER LOT 1 Location (site address) 20905 JAYHAWK DRIVE, CHUGIAK, AK 99567 Current Property owner(s) RICHARD KNOX&KAREN POLSTON-KNOX Day phone Mailing address 12110 BUSINESS BLVD., STE. 6-108, EAGLE RIVER, AK 99577 Real Estate Agent Day phone _ 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class _Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: Received by: /�/y ; I Date: 0 )9 /17 COSA to be released to the engineer, unless oto//requested by the engineer. COSA Fee $ 6.?'(o Waiver Fee $ Date of Payment to `!3 H Date of Payment Receipt Number 05q55 Receipt Number COSA# 05G1`7144 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING,INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 10/11/2017 THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen .0.--441"-`\ encroachments,deficiencies or discrepancies exist. i OF Az,/ AY / }14 TIT I\ '7 6. DSD SIGNATURE r System #1 Approved for I bedrooms. rF KENNET-H.47 1 System #2 Approved for bedrooms. 1 cc zt1� Disapproved. )11,, acFF,Ss1.-.` Air Conditional approval for bedrooms, with the following stiR4lipimif1, ' N.c (r J� ON-SITE oc WATER AND R` m WASTEWATER oz PROGRAM F/VTS v�~�5 By � � Original Certificate Date: J I b 1 7 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_10.10-12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system , Certificate of On-Site Systems Approval Checklist Legal Description: LINTNER LOT 1 Parcel ID: 051-151-37 A. WELL DATA Well type PRVT If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 8/1993 Sanitary seal (YIN)Y Wires properly protected (Y/N) Y Total depth 200 ft. Cased to 200 ft. Casing height(above ground) -6* in. FROM WELL LOG AT INSPECTION Date of test 8/1993 9-28-2017 Static water level 50 ft. 48 ft. Well production 2.5 g.p.m. 3 g.p.m. WATER SAMPLE RESULTS: Coliform Net,- colonies/100 mL Nitrate N mg/L Arsenic: NO ug/L Date of sample: 9/28/2017 Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 9/29/1993 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 9/27/2017 Pumper ONE STOP C. ABSORPTION FIELD DATA Date installed 7/23/2001 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.6 System type DEEP TRENCH Length 100 ft. Width 2 ft. Gravel below pipe 5 ft. Total depth 10.8 ft. (Measured 9/28/17) Eff. absorption area 1016 ft2 Monitoring tube Y Depression over field N Date of adequacy test 9/2812017 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 34 in. Water added 600 gal. New depth 45 in. Elapsed Time: 1400 min. Final fluid depth 33.5 in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N &type) N If yes, give date D. LIFT STATION 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 WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ _ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 19, 0" ►r+:t- Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+ F. COMMENTS *Well below grade covered by manhole with new sanitary seal,conduit and checked for drainage per MOA direction. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance �`.` with MOA COSA guidelines in effect on this date. � OF �,�‘ Engineer's Printed Name KENNETH M.DUFFUS / � Date 10111/2017 * �� V ___ �� COSA canary sheet_2-6-15.doc KENNETH WI7 4� / y5 FU • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 77 j Parcel I.D. 051-151-37 Expiration Date: % yoC / 3 1. GENERAL INFORMATION Complete legal description Lintner, Lot 1 Location (site address) 20905 Jayhawk Drive Chugiak, AK 99567 Current Property owner(s) Brandon & September Shed lock Day phone Mailing address 20905 Jayhawk Drive Chugiak, AK 99567 Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADu) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual El Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public .grate• System ❑ Public Sewer ❑ WaiverNariance request for: Distance: }_ Dater ' �r Received by: �tL> COSA to be released t6 the engineer, unless otherwise requested by the engineer. COSA Fee $ 4/Q6,. ze Waiver Fee $ Date of PaymentG (1�V ��� Date of Payment Receipt Number -(��/ I'? _ Receipt Number COSA#�l (LJi�/ �G Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date912�3 A J. 49 18fN" 6. DSD SIGNATURE c-' System #1 Approved for bedrooms axascH:lr�ocusori ; System #2 Approved for bedrooms CE Disapproved ®® ROFESSI�M ®®' Conditional approval for bedrooms, with the following stipulattiil ®®®®�'® Original Certificate upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible forerrors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet f L, c If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Lintner, Lot 1 A. WELL DATA P 'v t Well type a e If A, B, or C provide PWSID # _ Date completed 8/1993 Sanitary seal (Y/N) Y Total depth 200 ft. Cased to 200 ft. FROM WELL LOG Date of test 8/1993 Static water level 50 ft. Well production 2.5 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate N/D mg/L Arsenic N/D ug/L Date of sample: 914/13 B. SEPTIC/HOLDING TANK DATA Parcel ID: 051-151-37 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >12 in. AT INSPECTION 9/12/13 83.6 ft: 3.0 g.p.m. Collected by: Anderson Engrg. Tank Type/Material Septic/Steel Date installed 9/28/93 Tank size 1,500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression overtank(Y/N) N High wat alarm (Y/N) N Date of pumping Pumper � C. ABSORPTION FIELD DATA Date installed 7/18/01 Soil rating (g.p.d./if or fC/bdrm) .6 GPD/SF System type Deep Trench Length 100 ft. Width 2.0 ft. Gravel below pipe 5 ft. Total depth 10 ft. Eff. absorption area 1 10 16 fl? Monitoring tube Y Depression over field N Date of adequacy test 9112/13 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 50.5 in. Water added 1,050 gal. New depth 58 in. Elapsed Time: 1,440 min. Final fluid depth 50.5 in. Absorption rate >= 600 g p.d Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons _ "Pump off" level at Cycles tested Manhole/Access (Y/N) in. High water alarm level at in. Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot > 100' On adjacent lots Absorption Feld on lot >100' On adjacent lots >100' >100' Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line • >25 Holding tank N/A Animal containment areas >50 Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5 Property line > Water main >10, Water service line >10' Wells on adjacent lots >100, ABSORPTION FIELD ON LOT TO: 0'** > 10' Property line Building foundation Water Service line >10' Surfacewater >100' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS **Lot Line Waiver Granted. G. ENGINEER'S CERTIFICATION l certify that l 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 Michael E. Anderson, P.E. Date 9/21/2013 COSA brown sheet -1 0-10-1 2.doo Absorption field >5 Surface water >100' Water main N/A Driveway, parking/vehicle storage >10, OF 4 ,, .MICHAEL E. ANDERSON=,,O; CE - 4381 ®®�opROfES510�A. Municipality of Anchorage ' Development Services Department.°: Building Safety Division On -Site Water 8 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 051-151-37 HAA#iu� 1 1. GENERAL INFORMATION Expiration Date: - .1 a— a 4— 0 3 'L( n-4-n(I - Complete legal description SUBDIVISION: LOT 1. Location (site address or directions) 20905 JAYHAWK DRIVE * CHUGIAK, AK 99567 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address JEFF DAMS Day phone 688-5357 20905 JAYHAWK DRIVE * CHUGIAK. AK 99567 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: 0 Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 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 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certirred by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone Address 3701 E. TUDOR ROAD, SUiTE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: in conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will It confer any legal right whatsoever. S. DSD SIGNATURE Approved for bedrooms. Disapproved. Date 337-6179 Conditional approval for bedrooms, with the fllowing stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other `QQ,........ ..yo ON-SITE WATER AND WASTEWATER pPOGRAM- By: Original Certificate Date: (Rev. 12107) Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.d.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST 4 f B• C Legal Description: L.LT,6E SUBDPASION; LOT 1, Parcel ID: 051-151-37 A. WELL DATA Well type PRIVNIX If A, B, or C provide PWSID# N/A Date completed 8/1993 Sanitary seal (Y/N) YES Total depth2.�0 ft. Cased to 200 ft. FROM WELL LOG Date of test 8/1993 Static water level 50 ft. Well production 2.5 g,p,m, WATER SAMPLE RESULTS: Well Log (YM) YES Wires properly protected (YM) YES Casing height (above ground) 12+ in. AT INSPECTION 7110/2003 46 ft. 2.67 g.p.m. Coliform 0 colonies/100 ml. Nitrate 0.10 mgJL. Other bacteria 0 colonies/100 ml. Arsenic: N/A mgJL. Date of sample: 7/11/2003 Collected by: AKWWC, INC. S. SEPTICIHOLDING TANK DATA Tank Type/Material STEEL Date installed 9/28-29/1993 Tank size 1500 gat. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (YM) YES Depression over tank (YM) NO High water alarm (Y/N) N/A Date of pumping 7/7/2003 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA RUN E=507RM Date installed 7/19-23/2001 Soil rating 0230or Mbdrm) 0_6 Length 100 ft. Width 2.0 ft. System type TRENCH Gravel below pipe 5 ft. Total depth •ta.a ft. Eff. absorption area 1016 ft' Monitoring tube YES Depression over field NO Date of adequacy test 7/23/2003 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 14 in. Water added 972 gal. New depth 28 in. Elapsed Time: 1040 min. Final fluid depth19 in. Absorption rate >= 600+ g,p.d, Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed Size in gallons "Pump on" level at in. E. SEPARATION DISTANCES High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 1006+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line •0'+ Building foundation 10'+ Water main N/A 6 Water service line 109+ Surface water 100'+ Driveway, parking/vehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ EP F. COMMENTS "WAIVER GRANTED ff G. ENGINEER'S CERTIFICATION i certify that I have determined through field inspections and review of Municipal records that the above systems are in """"" """ """"' conformance with MOA HAA guidelines in effect on this date. O ... of e a ...93:... Engineer's Printed N me JEFFREY A. GARNESS QO 79 .� Date % ! 4vi e P ..... • • a �p4 �— �ofeveio� f— HAA Fee $ _ Waiver Fee $ Date of Payment 1 OU -05. Date of Payment I Receipt Number �� Receipt Number (r:er.12J01) S 89054'32"W 1 50.00 In N E39°59' 57" E 1 50.00 _ JAYHAWK___DRIVE____ in m ui m N 3 C7 0 10 0 VA AS -BUILT SURVEY SCALE: 1" • 40 1 HEREBY CERTIFY THAT I HAVE PERFORMED A MORTGAGEES INSPECTION OF THE FOLLOWING DESCRIBED PROPERTY. LOT 1. LINTER SUB. INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT TING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE 1CTURES OR FENCELINES. WITHIN THE PROPERTY LINES AND THAT NO VISIBLE :MENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PLAT. ARE NOT SHOWN HEREON. ENCROACHMENTS EXIST OTHER THAN NOTED. 1: ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINE DATED AT ANCHORAGE. ALASKA THIS 14TH_ DAY OF 03 20 OCATE STRUCTURES _AUGUST HOLT LAND SURVEY -NU 9097. F8107-45 PAVING SHOWN MAY BE APPROXIMATE DUE TO SNOW CONDITIONS. TEL. 345-5513 01-16-03 03:1OPLi FROM -CUE ENVIRONLENTAL SRV scs SCS RetR 1034140001 Client Name AK Water & Wastewater Consultants Inc. Project Name/11 Litner S/D Lot 1 Client Sample ID Litner S/D Lot 1 Matrix Drinking Water Sample Remarks: 9015615301 T-396 P.02/03 F-913 All Dates/Times are Alaska Standard Time Printed Date/Time 07/15/2003 10:02 Collected Date/Time 07/11/2003 8:15 Received Date/Time 07/11/2003 15:30 Technical Director /J Stephen C de Release Allowable Prep Analysis Parameter Qualifiers Results PQL Units Method Container ID Limits Date Date Inst Waters Department Nitrate -N 0.1000 0.100 mg/L EPA 300.0 D (<=10) 07/12/03 JJD Kir obiology Laboratory Total Coliform 0 col/I00mL SV118 J222D A (<-I) 07/11/03 IS 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.cl.anchorage.2k.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING,/ Parcel I.D. 051.151.37 HAA # 04-C I D'V 9 Expiration Date: % i — 3 — 0/ 1. GENERAL INFORMATION Complete legal description _UNTNER LOT 1 Location (site address or directions) 20905 JAYHAWK DRIVE Current Property owner(s) _LOW MATHEWS Day phone 830.9002 Mailing address Lending agency Mailing address Day phone Real Estate Agent JOE FISHER WITH REMAX E.R. Day phone _230.3300 Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 1� �V 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING,/ Parcel I.D. 051.151.37 HAA # 04-C I D'V 9 Expiration Date: % i — 3 — 0/ 1. GENERAL INFORMATION Complete legal description _UNTNER LOT 1 Location (site address or directions) 20905 JAYHAWK DRIVE Current Property owner(s) _LOW MATHEWS Day phone 830.9002 Mailing address Lending agency Mailing address Day phone Real Estate Agent JOE FISHER WITH REMAX E.R. Day phone _230.3300 Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 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 private or Class C well and may be reissued with new water sample results less than 30 days old. (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 engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto. and as of the validation date shown below, I verify that my Investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 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 KND Engineering Phone 696.61 11 Address Engineer's Printed 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: WATER AND i += ,. Additional Comments ,.�,1....—_ _ Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: (Rw. IZM) Municipality of Anchorage ' Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LINTNER LOT 1 Parcel ID: 051.151.37 A. WELL DATA Well type Rdio Date completed IM Total depth _227 ft. Date of test Static water level If A. B. or C provide PWSID # A Sanitary seal (Y/N) Y Cased to 4(r+ ft. FROM WELL LOG 50' ft. Well production 2.5 9 -p.m WATER SAMPLE RESULTS: Coldor 0 colonies/100 ml. NltmteQ mg.A. Well Log (Y/N) Wires properly protected (Y/N) Y Casing height (above ground) AT INSPECTION Date of sample?/25/01 Collected by: KND Enalneerina 54 ft. 2.7 9 - p.m - Other bacteria? colonies/100ml B. SEPTICIHOLDING TANK DATA Tank Type/Material STEEL rsoo Date Installed 9129193 Tank size 13ft gal. Number of Compartments Z Cleanouts YFoundation cleanout YDepression over tank hIHigh water alar Date of pumping 5111/01 Pumper _JR'S C. ABSORPTION FIELD DATA Date installed O/ Soil rating (g•p•d•fle or ft2/bdr) U System type DEEP TRENCH Length 100 ft. Width 2 ft. Gravel below pipe _L_ ft. Total depth Z ft. Eff, absorption area 1016 ft' Monitoring tube Y Depression over field N Date of adequacy test Results (Pass/Fail) For _ bedrooms Fluid depth In absorption field before test _ in. Water added_ gal. Elapsed Time:_ min. Final fluid depth _ in. Any rejuvenation treatment (past 12 mo.) (YM & type) _ Absorption rate >= New depth_ in. If yes, give date MI! O. UFT STATION Date installed Size In gallons Manhole/Access (Y/N) 'Pump on' level at _ In. 'Pump oft' level at _ in.High water alarm level at In. Datum Cycles tested Meets alarm b circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanknift station on lot 1001+ On adjacent lots _ 1001+ Absorption field on lot 1004 On adjacent lots 1001+ Public sewer main 754 Public sewer manhole/cleanout 1001+ Sewer /septic service line 251+ Holding tank 1004 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation T+ Property line '+ Absorption field 5'+ Water main 101+ Water service line 101+ Surface water 1001+ Wells on adjacent lots 1001+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line O.S+ Building foundation 10'+ Water main _10'+ Water Service line 10'+ Surface water 1004 Driveway, parkinglvehide storage 25+ Curtain drain 501+ Wells on adjacent lots '+ F. COMMENTS G. ENGINEER'S CERTIFICATION �,�p��;••«••„s f I certify that I have determined through f7eld inspections and �* f� '49, review of Municipal records that the above systems are in ..z .. 3 conformance with MOA HAA guidelines in effect on this date. / ~ Engineer's Printed/N me Onnelh M. DuffusKh?i! ` c:;ns ' Date % ��.`9�. HAA Fee $ _2,F0. 00 Date of Payment 3 / o/ Receipt Number SM 12xq Waiver Fee $ _ Date of Payment Receipt Number. JUL-30-01 15:48 FROM -CUE ENVIRONFCNTAL SRV CUE Environmental Services Inc. �Ya��• �ir�rrrrrrrrrrrrirr� CPB:E Ref.# Client Name Project Name/9 Client Sample ID Matrix Ordered By PWSID Sample Remarks: 1014659001 KND Engineering Untner, Lot I Untner, Lot I Drinking Water 0 9075615301 T-773 P.02/03 F-282 Client PON Printed Date/Time Collected Date/Time Received DateMme Technical Director Released By /may 07/30/2001 14:09 07/25/2001 14:30 07/25/2001 15:50 Stephen C. Edema/ /,j p Allowable prep Analysis Parameter Results Allowable Units mct wl Limits Date ate Init 9ratere Department Nitrate -N 0.500 U Microbiology Laboratory Total Colirorm 3 OD, No Coli 0.500 mg/L EPA 300.0 (<10) 07/25/01 SCL coV100mL SM199222D (<1) 07/25/01 KAP MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES 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 l.D.# 66/ /5/ -7 HAA# 1. GENERAL INFORMATION / Complete legal description Lza�&2or 2. Location (site address or directions) Property owner oa Day phone Mailing address; D ,5 67 Lending agency Day phone Mailing address r // Agent i';r�M c)A�Q Day phone Address ��rl1LiC�—'l / �� Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: �z - 3. TYPE OF WATER SUPPLY: Individual well 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 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 F..NGINEER. 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 —KND Engineering Phone 10� —4�/111 Address r.�t n,,m9 an Blvd. =*0 Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments By: L/ CIA14 Date ,WfngsY��• Neo •,Ooo4�V"�®� a ®�0! •e7No•;• fin, ••• Kenneth XA. Loffo--. �k ef�i p�Va Fsu •••e• y`���A pRQFESS\©N bedrooms. aUTIC bedrooms, with the following stipulations: Date 7 - 24 - �79 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 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. RECEIVED 0 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERWEW 1998 Environmental Services DivisicLL IPALITY OF 825 L Street, Room 502 • Anchorage, Alaska 91 bA �JQ,4SION Health Authority Approval Checklist Legal Description: 41✓ 17e/,- /o r ' Parcel I.D.: ds1151-57 /aA49411111111ZAFe1 Well type✓ d� e.' If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed D t15 Total depth `� Uo Cased to Casing height (above ground) z / Sanitary seal (Y/N) Y Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test g/93 Z/9g // Static water level 57073, Y ' Well production 2,5- ,5 g.p.m. Z' 5- g•p•m• WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed 9 Tank size 1500 Number of/Compartments Z Cleanouts (Y/N) Y Foundation cleanout (Y/N) Depression (Y/N) High water alarm (Y/N) i✓/a Date of Pumping Pumper Jze,5 C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) D• System type m7wl Length Width 5 Gravel thickness below pipe 3 Total depthMl'02 85' Effective absorption area Monitoring Tube present (Y/N)J— Depression over field (Y/N) Al Date of adequacy test Results (Pass/Fail) For _bedrooms I is1T3 �/ � 'aE' A7T / / Fluid depth in absorption field before test (in.);AI' 4 Z" Immediately after gal. water added (in.):mT*Z 3/ . 7'At 3r,Yz " -X- Fluid dept0f 2%" (ins) Minutes later: /y/C% Absorption rate = 6'o g.p.d. Peroxide treatment (past 12 months) (Y/N) A If yes, give date IVp -X_ 14 �iiea/es/,lo Imuie)me_&5a✓e.5 /USI �eepe✓ ��' as�u o t.�✓ hlT. 72-026 (Rev. 3/96)` / 'q11/I .n�su"'-en e'n/j cmas-is/cep, 1, (.v'Lfk /D,,'/' �G✓ � D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum "Pump off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot /00 On adjacent lots IDO Absorption field on lot _ /00 i On adjacent lots /Z) 0 + i Public sewer main + Public sewer manhole/cleanout IV4 Sewer /septic service line ,25 r Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation /D + Property line /O 'i Absorption field Water main/service line _ ZS 4 Surface water/drainage Wells on adjacent lots /DU SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: i Property line f Building foundation /CU Water main/service line ZS Surface water _fib/ f Driveway, parking/vehicle storage area /� f Curtain drain f' V2e Ai2011L)kl Wells on adjacent lots F. ENGINEER'S CERTIFICATION I certify that / have determined thru field inspections and review of Municipal in conformance with MOA HAA guidelines in effect on this date. Signature12/ Engineer's Name iqL4 f �t J2r Date HAA Pee $ Waiver Fee $ Date of Payment '� Date of Payment Receipt Number Q/ �� Receipt Number 72-026 (Rev. 3/96)* �"�+ cords Mems are aay0944 *tab as 999 B8EE70vro oma - aF'f^Kf $ZeYJTnD,1* At. iDIgl iu .. � �fJE�����yj-v m�f' RPR 10 '98 02:39PN NTL ANCHORAGE P.1i2 NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-3116 - FAX 456.3125 �• G 8005 SCHOON STREET ANCHORAGE, ALASKA 99518 (907) 349-1000 • FAX 349-1016 POUCH 340043 PRUDHOE BAY, ALASKA 99734 (907) 659.2145 • FAX 659.2146 ,I KND Engineering Report Date: 4/10/98 20441 Ptarmigan Blvd. Date Arrived: 4/2/98 Eagle River, ATC 99577-3736 Sample Date: 4/1/98 Sample Time: 10:00 Attn: Collected By: km Client ID: Lintner Lot 1 ** Legend ** Client Project #: MRL - Method Report Levet $OULCe: LDL 1 MCL a Max. Contaminant Levet B - Phzent to Method Blank NTL Lab#: A154745 E = E€6mated value Sample Matrix: Water M Matrix b9ftf renee Comments: It - Above MOL D — LoatTODilutlon Date Date Method Parameter Units Result AML Prepared Analyzed SM 4500 E Nitrate -N Re By: Jorma k Kuusisto Chemistry Supervisor mg(L <MMRRL 0,10 4/10/98