HomeMy WebLinkAboutNETTLETON LT 1CNettleton
Lot i C
#015-081-26
MUNICIPALITY OF ANCHORAGE A�
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL. SYSTEM AND/" WELL INSPECTION REPORT
NAMEC`YT,�e�,,'.-,��,}1f�n�
PHONE
EW
❑ UPGRADE
MAILING ADDRESS
I
LEGALDESCRIPTION
LOCATION
NO. OF BEDROOMS
kj_
_ ct)
We I
DISTANCE TO: Absorption araaa
�_�
Dwelling
PERMIT NO.
ry -y
-!4
a Q
Nf-
nufacturer
r�e.�
�Liq.
Material
Ste-e�
No of co partmentts /
Lou "
capacity in gallons Inside length
&LIF HOMEMADE:
Width
Li laid depth
0 z
2
DIST dCE TO:
Well
Dwelling
PERMIT NO.
O Q
2 F-
facture, aterial
Lit ' capacity in gallons
=
Well
DISTANCE TO:
-Foundation Nearest lot la's
PERMIT NO. ,,,,,� ��/,'
�,(-oz
,,,111,,,
cc
No�/off I ies / Length f eaf c1 111ige
Total _f/1�ij1 Trench vV id- h
4gi
Distance beety/yee nes
h
Top of i le to finish grade
Material beneath tile )
i E+neFler
Total effectivA312sorption are
Length idth
NO.
Type of cri
*DepthPERMIT
Crib diameterdepth
Total effecti ,sorption areaw°LDISTANCE
TO:
Well
ing foundation crest lot line
Class "TO
Depth
DrillerDistance to lot line
PERMITNO.G'
DISTA
Building foundation
Sewer line Septic tank
Absorption area (s)
OTHER
PIPE MATERIALS
/D 303SOIL
TEST RAT NG
�a
INSTALLER
REMARKS
U
rti
7
--
L
APPROVED�/DATE�,,�
/LEGAL
Q%
���
it -,it 11 V-4 . I� 1: oil K.. X -1F "W" 179 1F.1 11 P IC::g������ �
DEPHRTMENT O/ 9EHLTH HND ENVIRONMENTHL F. 'TECTION '
/
825 'L �TREET/ HNCHORRGE, HK� 995 � / �
�Eli: ST PIE: FQ to,"����
HPPLICHNT FRI�N�LY 99504
LOCHTION NEWII:
Y HVENUE
LEGHL L 1-C B J. NETTLETON S/D LOT SIZE
TYPE OF SOIL HBSORPTION SYSTEM IS: TRENCH
MHXIMUM NUMBER OF BEDROOMS = ]
'm/u-S,/�
55000 �QUHRE F7 EEE
SOIL RHTING (SQ FT/BR)- 125
THE REQUTRE) SIZE OF THE SOIL HBSORPTION SYST�M IS�
�P::::::u ..T... I 1.. 11 ���"It I ..-q =:--1 :;.:ED� �F:1, N..." 0 .. ..... �����I!.-- I�
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD
THE DEPTH OF H TRENCH M PIT IS THE DISTHNCE BETWEEN THE SURFHCE OF THE
GROUND HND THE BOTTOM OF THE EXCHVHTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES
THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GRHVE' BETWEEN THE OUTFHLL PIPE
HND THE BOTTOM OF THE EXCHVHTION (IN FEET)
�:91 p_..P�
PERMIT 8PPLICRNT HHS THE RESPONSIBILITY TO INFORM THIS DEPHRTMENT DURING THE
INSTHLLFI, ION INSPECTIONS OF HNY WELLS HDJHCENT TO THIS PROPERTY AND THE
NU OF RESIDENCES THHT THE WELL WILL SERVE.
��11":D', <� :)F ]F: CHIMS F01 Fit ES! Fit ��1(...) 1����
BHCKFILLING OF HNY SYSTEM WITHOUT FINHL INSPECTION RND HPPROVAL BY THIS
DEPHRTMENT WILL BE SUBJECT TO PROSECUTION
MINIMUM DISTHNCE BETWEEN H WELL HND HNY ON~SITE SEW�GE DISPOSHL SYSTEM IS
100 FEET FOR H PRIVHTE WELL OR 150 TO 200 FEET FROM H PUGLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL
MINIMUM DISTHNCE FROM H PRIVHTE WELL TO H PRIVFITE INE IS 25 F�ET HND
TO H COMMUNITf SEWER LINE IS 75 FEET�
WEI L I HND M1 TO THE DEPHRTMENT WITHIN
OF THE WELL COMPLETION
OTHER REQUIREMENTS MHY HPPLY. SPI HRE
H�HILF'BLE TO INSURE PROPER INSTHLLATIO�
T F, _1 �IC.,.- Ir.111 HE3, LF:.'..: F:;",!! ., ::-,PL-J!
I CERTIFY THHT
1� I HM FHMILIFOR WITH THE REQUIREMENTS FOR ONKSITE SEWERS HND WELLS HS SET
FORTH BY THE MUNICIPHLITY OF HNCH�RHGE
2� I WILL INSTHLL THE SYSTEM IN HCCORDHNCE WIT� THE [ODES
]� I UNDERSTHND THHT THE ON—SITE SEWER SYSTEM MHY REQUIRE ENLHRGEMENT IF THE
RESIDENC� IS REMODELED TO INCLUDE MO�E THHN ] BEDROOMS
SIGNED��~�... ..... .... �..... ........... ~..... ..... ..... �... �_~~~~~~~~~_�
HPPLICHNT GUODMHND �UILDERS
y /l�
ISSUED BY., ...... ..... ..... ..... ..... ..... .. ..... .... ... ~~~_�_`~�~��.�DHTE`l�1/L�1�_�~�~ V4.0
"^UNICIPALITY OF ANCHORAGE
Department Health and Environmental :otection
825 L Street, Anchorage, -AK. 99501
264-4720
# # HANDWRITTEN PERMIT
WELL AND/@A-ON-SITE SEWER PERMIT
Applicant: 60CLIA, G wecs . Mailing Address: I--(- e�,�.� /
Location: Q_ Phone Numbe
Legal Description: ��,�- �; �e�f�c= 1v�s Lot Size: %(p a30 S rA
Type of Soil Absorption System Is:
Trench: u,-' Drainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: �Soil Rating(sq.ft/br)
The Require i e tit Absorption Sys m
DEPTH LENGTH
FAV�-N
EL DEPTH '� 11-DTH—
The
length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the.surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
REQUIRED SEPTIC(�TANK SIZE _ . �Uc�� GALLONS # #
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
# # # TWO(2) INSPECTIONS ARE REQUIRED
Backfilling of any system without final inspection and approval by this department
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 this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 3 1
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 codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is remodeled to include more that 3 bedrooms.
ci
VSigned : Issued by
y, Appl ' (ant P v { �caI � / '��1
a ( 1 wl v.�� Ir 1l �^" Y ��i� X" � l' Date: �1���
S P/024
771` 5O,'�5 Yfsf
of
llva I
77 l I //
/vOT£ ; /�� t r�ofe So.�s // %uy 7` ,S Li0/P to Na C)ti �✓" w s Fv✓ c% a �7u v ar
MUNIC I IPAU TY tar= ANCHORAGE
n Dreu3epari., L Healfth and rrotetion
825 -4, Gtr—ae :., At"t<M:3f9raga, AK �----99501_
264-4120
e SIA:`'IDWR 11'TEN PIER I T
WELL AHDA*-0N:-S1TE SEW8R PERMIT
'. 34}. � w ...F�� {�.4-e�..F:.��i S 3�..t- ���t � Yt {r � L•1l� J. J. S 54� C-i�.,a'i1 6apM'I N • S ._u(L
rx--Atione Phone, NlMbia fffA}.j.:...� •i'v.� [' Lrvti � jy]
( � c
i ....—: 1...-..,�,..'eS 11 �� �� � � •a��'..-_.r a.q-..�_Jj.�e
I 1t;3p. t15cr"i r°lUl1: L} ,'rty}�c� S `_I
Type OC So 1 Absorption ;�y0t; em XG: _
Tench. [)rainfield; Seepage Boo; Y� iir,7dtill 'funk:
tM.a: tfo,t.m Number of Bedrooms! .�,soil, Ratinq(sq.ft/br)J
The � 'v
lZSLYkoti
Ci I TtI � LENGTH -`� �. _ riVEL nt=i'TH
�.
The l tangth d i.tt envolan is the 1 ngtY l Ln fuaak) of the trench h car dr ainf iald. Vi
y tjr_-p b -of a trench 6r pit i+8 the distance betwa*n the surface. of the ground ,'i
the bottom qtr: the �';"d�',�vat.ton fin €ot-;t) . There i. no' �pzf width for #:ranch��,'.
Tho -gravel depth is th(A mininir_itti dir p th of gravel between t}'n olAtyfatt, �lipe 'ar
tit( -t bottom of the
REQUIRED SEPTIC(tMWtm— rANK SIZE � �1_�c''rtf� -- GALLONS
Viauat,t: appLicant, haft the xic-,GponGibility to infoarM thi g ljepat:tmQnt_% d rig the
tnstalUattoa inspac pians of any WeLls adjacent to thi:3 pr:oixabrtr. atld, dhe nurnb(;j
r)f -r_=aSidenCea thl7.kt t'jjE2 w€.i_1 Will aj,- Vkk,
€: 1 � 3 t`t°l€a Ee".�I NS Ai R --AIRED �
j :err fi3_l i r of any 3y6tem wi'rholit final Inspection c7,titj %pproval by this depcirl
i11 lf1tat
to
Minin+_ n dis arrcu betiOs en a well and any oil- rite yew-acye d%.sposal system 15 10(.
fore 'a to ilEA-et from a publirc sl 1 dep,3nding Upon th,- t l�r{2
i
of puk 1 tc well. Mirt.imi.m distance Evora a private we'll tv a pvlvata sewer kir:
-.a 25 keeet and to a cc3rtuYtunity oewev „o-ewelite i,-' 75 feae_ Well logs -Ace requlro�,
and ftt_Wt;, be rJ_t.tlrnj_:A to this dalpartment: wi t IALtt 30 day! of hhe wetl complatki
other requIremento lite apply. ;lii ;i.fi<:•atL� ry nj oniarGi'+;ic 3{:]r3. c�L + r, _Ms a��
.av'ailal�l�ti ro .ti4�ur� ��r�k'�'� irx�Ftzil_i.ation.
PERMIT EXPIRES DECEMBER
Certify that:
r(1), r ,.§,m fw- it iar with the iT stquiretiienLc, for cin- aitn se-wers and welly ;A#`
:set forth by the lei+.iriicipalitdy 0� Anchorage.
(2) 1 wUl 'Lvstal,l, tbcs systam in accordance with eFotjs_�!'�S.
( l) 1 understand that. the on-eite . owar oystt.,ri may rcquir,- enlargement I
the res i tiR',f cf _- is remoadele d to i nc ],a;tie morn that 3 bodroonis .
wiled e Issued ur by: .'. n _. _ { a � .A
f/ till At,pl .int ,r . v f . , �r c t j
bt3! u�t - fjL cit E C),tQ)��- _/��t _L`d`i
)�p, j-jt� j�t�,�y L4�� t l
41-
4
�
'7 F 0 2 `3 l 1. Cl 3 �� �T Af .j1��7
/ JJ /nf f LYtJ
?))s!1-Kjf (l
i' 73%Sa lil� td F T��.. '3 ffa•,re };7ft?,�[ JJ<ct. v/`3Vr- � 7 '-girt_ �^ /!hr i •7f�`
3 �•P„` ! t) t�_ i e..� �1F,� r �}jiJ eF � tJ;FS'T� •�?tihl� r ..% z �Y_ .ae -" 9 t^'. 3•!�t('Y rt � f�7.f :. � t;
f i e ': ar 37F,, ' !
H h'3
xSOILS LOG
MUNICIPALITY OF ANCHORAGE
• ai` DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TERCOLATION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: GBOCIMA Q, Ui (2/ le erSt DATE PERFORMED: 7'/,IQ
LEGAL DESCRIPTION: --Lo— l e ,_ Quzi, aEm ao-rotv 546 _
^�j I SLOPE SITE PLAN
I"GC<.t � o�gawiCS.
Brow" l►otQpg
2
Date
Gross
Time
Net
Time
•s •!,�
^
VQrt,-.C[ \� f L ILS
-3:10�-
s:tv
MA felf v K4 01444 5 4L
3b
A0
/0
/3�
I
6
---so
/a
►�y So, L
7-
S: s•
o
v
/•
'
6 IWL
so
110
c
5=
11 l WAS GROUND WATER S
ENCOUNTERED? L
• 0
12 - ®— P
E
13
14-
15
16
17
18
19-
20-
COMMENTS
920
COMMENTS
PERFORMED BY:
72.008 (6/79)
t�.OF A�;q'sll
.*
'e -J,' 9TH •
IF YES, AT WHAT
DEPTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
-3:10�-
s:tv
/D
3b
A0
/0
/3�
I
No
---so
/a
S: s•
o
v
/•
foo
so
110
' PERCOLATION RATE
Y i ____(minutes/inch)
NO 2225-E •.;'TEST RUN BETWEEN _e FT AND FT
JU E 25, 1971
��L`\l. .'••.•••�A�1�\ems "//l win e_
CERTIFIED BY:
DATE:
177
K1
H
ITI
e
'77
~n
0
PTJ
a
z
z
C7
ni rn
� o
rn
o
Oil
til Ln
z
'0
a
ay
!ln :cQ
�Tl
I�
r
� H
H
y
z
O O O O
O
O
H N
: N
!N
;0 ?Jt co!
i I I
�-1
!N
H -3-J 0-3
H
--3
Oq 174 co KY ca : to
!p4
!d
!W tiiFiSvlJp7i�
iFi
iN
i ch iQ
;{)
p
;(D 0, CL: Q
; �
:tl N :N �,b :
: N
0
F :FJ kD
i I
i 1 NOh!
:Gul
.
' cn;(Do; A)!
o
m
N; N:
io
E
b .
(D
0
N
N
~n
0
PTJ
a
N
J
a
tr
A
W
V
a
z
z
C7
ni rn
� o
rn
o
Oil
til Ln
z
rA V)
a
ay
y
�'
70
rj 0-�
I�
r
a
e
;o
z
i I I
:H•
!N
i I� i l
i ch iQ
0
1
.
o
p
:HIM P)
i iN
unc
:N :y♦
\O
0
a
y
m
z
o
x
oo
o
rilITI
n
r
rn
£
z
_
rn
z
r
r
O
ITIE
n a
01\ :W
r19
:I-+
v1
: 4�-
i0
!ch
W : Li'i
i 0
:li
�.Eo
a
:0
0. :O
pn
o :;3
.O
:n
:O
i X71 i0
!�
:hh
if7iz
:;�
ca
O
i
!N
!Q
��'
:<D
N
!N
:N
:N
?w
a
N
J
a
tr
A
W
V
L, S.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program :
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D. 015- 0$1- 2fo COSA# OG0Ll4s
Expiration Date: O
1. GENERAL INFORMATION
Complete legal description at 441 J0 I LOA I C
Location (site address) _'730o Newby Ave.
Current Property owner(s) -Toy.% M;\deg- Day phone 229- `3-41
Mailing address
Lending agency
Mailing address
Real Estate Agent
Po 9.X i A.,c�4L i AK 215 11
Day phone
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.
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 Soua_kkr A £ %'" trlPhone 219-3516
Address 203 WAS"' Ave.,SVc. A AncLorw+r..AV, iii(
Engineer's Printed Name LABS Date I 9 o<r
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory ly
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
K�LABy: Z Original Certificate Date:
(Rw. 11105)
Municipality.of Anchorage .,
Development Services Department °
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore 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: _ Alt KI J,Loo - Ic- Parcel ID; 015-081- 210
A. WELL DATA
Well type Fres}a If A, B, or C provide PWSID # = Well Log (Y/N) y
Date completedI0 3' SI Sanitary seal (Y/N) y Wires properly protected (Y/N) y
Total depth _L10 -ft. Cased to I yy ft. Casing height (above ground) IZ+ in.
FROM WELL LOG AT INSPECTION
Date of test 10 3t $ I 5 2fS o
Static water level 98 ft. I o3 ff.
Well production 35 g.p.m. Co,2 9.P.m.
WATER SAMPLE RESULTS:
Coliform -9—colonies/100 mL Nitrate 5.% mg/L Other bacteria Rs colonies/100 mL
Arsenic: ug/L date of sample: 13 °g Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank TypelMaterial Gretr cc Date installed 41b 198
Tank size I250 gal. Number of Compartments Z- Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Depression over tank (Y/N) N o High water alarm (Y/N) N
Date of pumping 3 ra Pumper Mo D6 rQA Sty ;" 4
C. ABSORPTION FIELD DATA
Date installed 5 8 0 Soil rating (g.p.d./ft2 or =/bdr) I15 System type
Length 4Q ft. Width 2+ ft.. Gravel below pipe 5 * ft.
Total depth ft. Eff, absorption area ft Monitoring tube Y Depression over field /V
Date of adequacy lest 5 2d oct Results (Pass/Fail) ay55 For 3 bedrooms
Fluid depth in absorption field before test 55 in. Water added W gal. New depth 69 in,
Elapsed Time: 13!D min. Final fluid depth �i/ri. Absorption rate >= 450 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N& type) /Yakia known If yes, give date
N� o�4t, Belo., Top pipc
D. LIFT STATION
Date install>1evel
Size in gallons Manhole/Access (YIN)
'Pump on' in. 'Pump oft level at in. High water alarm level at in.
Datum Cycles tested Meets alarm b circuit regui ements7
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot loo'+ -
Absorption field on lot too {
Public sewer main NI_
Sewer /septic service line 5 t t
Animal containment areas Sot+
On adjacent lots too +
On adjacent lots too t
Public sewer manhole/cleanout
Holding tank NSA
Manure/animal excrete storage areas 1001+
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
I
t
Building foundation S +• Property line 5 f Absorption field 5
Water main tv.JA Water service line 10'+ Surface water foo �+
Wells on adjacent tots IDD 4 -
SEPARATION
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10 1 t' Building foundation l 0'+- Water main vVA
1 1 1
Water Service line t0 Surface water too •F Driveway, parking/vehicle storage 5 t
1 '
Curtain drain So + Wells on adjacent lots too t
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that I have determined through field inspections and
review of Municipal records that the above systems are in f
conformance with MOA COSA guidelines in effect on this date. r . • `�?TD t'
Engineer's Printed Name L ARS
lZuo9 '(tl `�fn2GJE9C'S�, rF..^
Date
c
COSA Fee $ Waiver Fee $
Dale of Payment l -a- — /6 — D 9 Date of Payment
Receipt Number Q Q Q.10-2, Receipt Number,
(Rev. 11105)
Municipality of Anchorage
•
Development Services Department
' Building Safety Division -
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
Septic System Advisory
Certificate of On -Site Systems Approval # 090445
During a recent adequacy test on the septic system for Block , Lot 1C
of Nettleton subdivision, 55 inches of standing water was observed in the
absorption field. This indicates that approximately 92% of the absorption
area is inundated. Although this system passed the adequacy test, the
remaining life expectancy may be limited.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Nitrate Advisory
Certificate of On -Site Systems Approval # 090445
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block , Lot
1 C of Nettleton subdivision. This inspection revealed a nitrate concentration
of 5.82 milligrams per liter (mg/L) was reported for the property's well
water sample. The Environmental Protection Agency (EPA) has established
a maximum contaminant level (MCL) of 10.0 mg/L for public drinking
water systems. While private wells are not subject to this regulation, EPA
standards are based on existing health information and can therefore be used
to gauge the relative quality of water from private wells. Please see the
attached "Nitrate Fact Sheet" for important information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
SCS Rerp
1096451001
Client Name
Spurkland Engineering
Printed Date/rime
12/102009 11:38
Project Name/#
Nettleton LIC
Collected Date/rime
12/032009 9:45
Client Sample ID
Nettleton LIC
Received Date/Time
12/042009 10:35
Slatriz
Drinking Water
Technical Director
Stephen C. Ede
Sample Remarks:
450ONO3 - Total Nitrate/Nitrite - The MS recovery is outside QC criteria (biased low). The LCS is within QC limits.
Allowable Prep Analysis
Parameter Results PQL Units Method Container ID Limits Date Date Init
Waters Department
TotalNitmtcMitritc-N 5.82 0.100 mg/L SN1204500NO3-t: D (<10) 12/09/09 RJT
Microbiology Laboratory
Colony Count 0 col/100mL SM209222B A (<200) 12/04/09 DLC
Total Coliform 0 col/100ml. Sh120 9222D A (<0 12/04/09 DLC
Fecal Coliform 0 col/100mL SN1209222B A (<I) 12/04/09 DLC
SCS Re EN
Client Natne
Project Name/N
Client Sample ID
Matrix
Sample Ronarks:
1092296001
Spurkland Engineering
Nettleton Lot IC
Nettleton Lot 1 C
Drinking N'attrr
Printed Date rime
Collected Dote/Time
Recehed Datorrime
Technical Director
00/11/2009 11:18
05282009 15:36
05129/2009 14:10
Stephen C. Ede
Allowable Prep Analvsis
Parameter Results PQL tlnits Method Container In Limio Date Date
Init '
Metals by ZCR/MS
Arsenic ND 5.00 ug1- EP200.8 C (<10) 06/02/09 06'1009 NRB
Waters Department
Total Nitrate Nitrite -N
Microbiology Laboratory
Colony Count
Total Coliform
Fecal Coliform
2of4
6.12
0
0
0
0.100 mg/L SM20450ONO3-F B (<10)
co1100mL SM209222B
col'IOOmL SM209222B
col'IOOmL SM209222B
06/O£U09 LCE
05/29'09 ULC
05 29 09 DLC
05/29/09 DLC
1A
NEWBY
N N 89'57'18" W
10' CEA EASEMENT
AVENUE
255.66'
O � StdrE WW' 0" I
r
z II
O
t
I
^ n -1a co n- -'- EXCLUSION NOTES: It is the owners' responsibility to determine
•�w��.v. .,� •-
THOMASE MILLER the existence of any easements, covenants, or restrictions 5/8 -RB w/CAPrI 5/B' RB O
which do not appear on the recorded subdivision plat. NOTE: 3.25' AL.MON. Q' MONUMENT
Under no circumstances should any data hereat be used for NUB k TACK 0
construction or for establishing properly lines. FENCE- —X— X —
SURVEY CERTIFICATION: LANTECN has conducted a OVERHAND- ® I,
physical survey of this property as shown on this ROOD DECKS-�
U ligi%- ;raring and that the improvements situated them CONCRETE- E�
hRf mi art within the property lines and no encroach- ASPHALT- O
® mMls exist other than noted. GRAVEL-
AS—BUILT OF: LEGAL DESCRIPTION: SEI'BC STANDPPES-
LAND k CONSTRUCTION SURVEYORS -PLANNERS -ENGINEERS .ATER WELL
440 WEST BENSON BLVD. p 103 LOT 1 C
ANCHORAGE. ALASKA 99503 (907) 562-5291
)RK ORDER NUMBER DArt SCK[
L1AY t9, 1994 1 1"-50' (fa X) 561-6626 N E TTL E TO N SUB D
94 -L -313A D^ W' Br: MCIX[D Or Na riuiixi243'9" 33\4Aq
DUD. t. 2439 333\46
76,r. S r o
VI
T-{'•
1
Q
Q
Ir
r
to
o-1`
N
I
D
O
M
N
o
Q
M
m
Un
LOT 1C
1B
I
0
Q
m
10' X 50' CEA ESM'1 J
104 CEA EASEMENT
50'
N 89'56'10" W 259.48'
I
^ n -1a co n- -'- EXCLUSION NOTES: It is the owners' responsibility to determine
•�w��.v. .,� •-
THOMASE MILLER the existence of any easements, covenants, or restrictions 5/8 -RB w/CAPrI 5/B' RB O
which do not appear on the recorded subdivision plat. NOTE: 3.25' AL.MON. Q' MONUMENT
Under no circumstances should any data hereat be used for NUB k TACK 0
construction or for establishing properly lines. FENCE- —X— X —
SURVEY CERTIFICATION: LANTECN has conducted a OVERHAND- ® I,
physical survey of this property as shown on this ROOD DECKS-�
U ligi%- ;raring and that the improvements situated them CONCRETE- E�
hRf mi art within the property lines and no encroach- ASPHALT- O
® mMls exist other than noted. GRAVEL-
AS—BUILT OF: LEGAL DESCRIPTION: SEI'BC STANDPPES-
LAND k CONSTRUCTION SURVEYORS -PLANNERS -ENGINEERS .ATER WELL
440 WEST BENSON BLVD. p 103 LOT 1 C
ANCHORAGE. ALASKA 99503 (907) 562-5291
)RK ORDER NUMBER DArt SCK[
L1AY t9, 1994 1 1"-50' (fa X) 561-6626 N E TTL E TO N SUB D
94 -L -313A D^ W' Br: MCIX[D Or Na riuiixi243'9" 33\4Aq
DUD. t. 2439 333\46
A,
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 I.D. # Q I l� — - I
1. GENERAL INFORMATION
HAA # _1� Q "� S 0:1 (on
Complete legal description Loi l C, N = -11 L e7 o N
Location (site address or directions) -7 ?..a c en LtLL=- W 6`/
Property owner I � & j&d u^ i �1�-w Day phone _ZX'6 " 7 Vg
Mailing address N 0. /1c)-73% 3q6,_
Lending agency (� PAC Day phone
Mailing add
Agent _
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
g' 1 1
NOTE: if community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATE13 DISPOSAL:
Individual on-site oy
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.
72-025 (Rev. 1/91) Front MOA W21
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_ I n��O eL-1
vrLCL% VLaq1�L Phone
Address 3 t.V 5 Lf
I' A
Engineer's signature
Date _
nc. (•)i ��e i.��7
Girl`( v.
P+fa +O P9V L011 Pti00009Y090n .Y. ,�
Fn •j
9A a ° a• a0a" ��
��g, •tobbcn S,nn1 land (v'
+�
6. DHHS SIGNATURE
�`— Approved for
Disapproved.
Conditional approval for
Additional Comments
0
bedrooms.
MITIe,
bedrooms, with the following stipulations:
Date _ / a — i�-o
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 it. the professional engineer's work.
72-025 (Ray 1/91) Back MOA M21
Municipality of Anchorage
.� Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Lo. lC IFIL=i i (_I_To rt &Cy2gSParcel I. D.
A. Well Data
Well type �Z, If A, 13, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) Date completed I to • ?� I , 8 1 DrillerS v•r -e !I
Total depth 14 D Cased to _( 4 0 Casing height 12 q tI
Sanitary seal (Y/N)
Date of test
Static water level
Well flow
Pump levell
Wires properly protected (Y/N)
FROM WELL LOG
RS
-3.h g.p.m.
2>O 44n,"
SEPARATION DISTANCES FROM WELL TO:
Septic/ham tank on lot 13a
Absorption field on lot
AT INSPECTION
r
=u C
(i 7
10Z
ttt
. `.7m.
g•p•
1-•f
.-�
{
rc
7
in c
O rn
On adjacent lots
z
; On adjacent lots ? ! o--- D
Public sewer main N //4 Public sewer manhole/cleanout Nl.\
Sewer service line > 1 Petroleum tank t. -I I o
WATER SAMPLE RESULTS:
Coliform 0 Nitrate Other bacteria
Date of sample: 12- • 0 `l ` 3 Collected by: g0rbo h b
B. SEPTIC/HOLDING TANK DATA
Date installed D 2 • vB • 8 1 Tank size t l9 G ® Compartments
Cleanouts (Y/N) __Foundation cleanout (Y/N) _Depression (Y/N) N
High water alarm (Y/N) t'{�%a Alarm tested (Y/N)
Date of pumping cr r q 2 Pumper C) e -V'
SEPARATION DISTANCES FROM SEPTIC/HTANK TO:
Well(s) on lot 1 �6C> On adjacent lots ---> /0-O Foundation 3E
To property line :2 % Absorption field
Surface water/drainage H,
72-026 (3/93)' Front
Water main/service line J -,:57 O
CONTINUED ON BACK PAGE
C. LIFT STATION 1\�/
Date installed
Size in gallons
Vent(Y/N)
High water alarm level
"Pump on" level at
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
D. ABSORPTION FIELD DATA
On adjacent lots
Manufacturer
Manhole/Access (Y/N)
"Pump off" Level at
Cycles tested
Surface water
Date installed O L9 h3 Soil rating (GPD/Ft2) —system type l P—,P-N -f
Length 4 cS, Width Gravel thickness h t Total depth 6?>
Total absorption area 4,1 &C Cleanout present (Y/N) Depression over field (Y/N)
Date of adequacy test 12- - D q - 'I3 Results (pass/fail) for 3 Bedrooms
Water level in absorption field before test
test '52--
Peroxide
5Z
Peroxide treatment (past 12 months) (Y/N) N If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot I aL 7 On adjacent lots > 'lqt Property line
c21- 7
To building foundation E I To existing or abandoned system on lot
On adjacent lots > 3,p Cutbank N0�1 �e_ Water main/service line % Z;-0
Surface water o V4 e- Driveway, parking/vehicle storage area l D
Curtain drain �� � D
E. ENGINEER'S CERTIFICATION
l certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
HAA Fee $ CJ Waiver Fee $
Date of �
Payment I
y � I -� Date of Payment
Receipt Number Receipt Number
72-026 (3/93)' Back
COMMERCIAL TESTING & ENGINEERING CO.
ENVIRONMENTAL LABORATORY SERVICES
SINCE 1909 -NII-XIMIT of ANAIX5111'
chcalliji) Ref 93 1
Client Scillij.).Le 11) -POTAME/1-DIT JC METTF&JUN,
matT. U : WATEU
('.Liant Niwe 'J'OBTIEN
Md.el-c'd Py -,T011BI.--N SPURKLAND
Project R:Ime-
L
11,781D :UA
SAV'P1,1,: C0T-.T1 C'rFP BY: T.f-i.
5633 B STREET
ANCHORAGE, AK 99518
TEL: (907) 562-2343
FAX: (907) 561-5301
WORK 01-61w
tte)7o i'1 cofllpi(A:A 1.7/13/93
CIA Lected 1 2/0 )/9'1 01 1-200 h -r
12/09/93, ((1 16-'00 111:s
Tedmix'O. D:ectoi 5711111l..'M C. [-;)y'
Relmi'llem'I 13V
Ext 1\n'-1 1.
I?(3y"EmIe 1:('r kwi1.11.1.-S Qt'vd. 141j. -t -s NcUjod Ldwit'; I V� t e I )nt 1.)1i;
M. Enn to -+T 1. 1 mg/r, Ii'PA 353.2/30(1,0 1.0 12/1.0 C1111
Above ljy)I-voj.Job 'e
1'
e InE> i.e Idem -.fks Abrwe MA Nlm
13 = Undeb:!(Acd, JRf'-"P(-)7-ted wilite 1- lj?e 1c;11. Limlt' 1-T Nes", Phim
1) = Secorldwr'v di.1131JOn' G111 Gtocit.cir
1*10 SGS Member of the SGS Group (Soci6t6 G6nbrale de Surveillance)
ENVIRONMENTAL SERVICES IN ALASKA, COLORADO, UTAH, ILLINOIS, 01-110, MARYLAND, WEST VIRGINIA, NEW JERSEY, SOUTH CAROLINA
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720 p
Application Date
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
7'�c� til
e- %.0 V
(b) Applicant Name -t r Telephone: Home 3—U ^ 3.iF4 Business SAD l _ I181
Applicant Address 7 3Ct-� N�-e.
(c) Applicant is (check one): Lending Institution ❑ ; Owner/lithe rX ; Buyer ❑ ; Other El (explain);
(d) Lending Institution 0 wi, L TelephoneV/_► M_l"AD_
Address a tiA"(
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
2. TYPE OF RESIDENCE
Single -Family / ` Multi -Family ❑ Other
Number of bedrooms
3. WATER SUPPLY
Individual Well Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
OnsiteqQ, Public ❑ Community 11 Holding Tank El
Note: f/community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 111/841
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
6.
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this ' s��pection``.
Name of Firm �L^��N�^r'f 04- _Telephone i271? _21/L
Address
Date
DHEP APPROV L C ��
i
Approved for bedrooms by
Approved DisapprovE
Terms of Conditional Approval
r 1 ,or•• ..' 1
D!
Engineer's Seal
P
dt N 2225-E
yt��.•• JUNE 25, 1971
,� fS ,,.• �rJ Rv
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 (11/84)
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264.4720
A. WELL DATA
MUNICIPALITY OF ANCHORAGE
[)EPL OF HEALTH &
ENVIRONMENTAL PROTECTION
:\I ob1'
RECEIVED.
Well Classification . Ras If A, B, C, D.E.C. Approved (Y/N) N!�
Well Log Present (Y/N) _ Date Completed _ 10 ' 3(' `a 1 Yield 3G
Total Depth 140 Cased to f o Depth of Grouting NO K E
Static Water Level . 10.5 Pump Set At la�=n M
Casing Height Above Ground Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) y Depression Around Wellhead (Y/N) N
Separation Distances from Well:
To Septic/Holding Tank on Lot - ; On Adjoining Lots > !6 0
To Nearest Edge of Absorption Field on Lot a — ; On Adjoining Lots
To Nearest Public Sewer Line —N0N4 To Nearest Public Sewer
Cleanout/Manhole _ No NE To Nearest Sewer Service Line
on' Lot > r0
Water Sample Collected by 1 S ; Date
Water Sample Test Results Sa Gds 1 a c fore
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed sci,G/TV Size l25c� No. of Compartments _ 1 tyx>
Standpipes (Y/N) 'r(YIa Air -tight Caps (Y/N) — Foundation Cleanout (Y/N) y
Depression over Tank (Y/N) N Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) _ ; for
Holding Tank High -Water Alarm (Y/N) _ N%A _ Temporary Holding Tank Permit (Y/N) W/A --
Separation Distances from Septic/Holding Tank
To Water -Supply Well 1130 To Building Foundation _ 35
To Property Line P97 To Disposal Field _ T
To Water Main/Service Line > r o To Stream, Pond, Lake, or Major Drainage
e
Course b N
Comments
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata yIZ5 Type of System Design / tQ EAG ff
Date Installed Sty l q8{ Length of Field
Width of Field 3c> " 4
Depth of Field 8
Gravel Bed Thickness b
Square Feet of Absorption Area Standpipes Present (Y/N) DNS
Depression over Field (Y/N) _� Date of Last Adequacy Test
Results of Last Adequacy Test ass 61 7LrcA &Wrcoge_s
Separation Distance from Absorption Field
To Water -Supply Well _
To Property Line A 7
To Building Foundation :5 1 To Existing or Abandoned System on
Lot /1/0 A /~_ ; On Adjoining Lots 7 5 d
To Water Main/Service Line > ,o To Cutbank (if present) ND NC
To Stream/Pond/Lake/or Major Drainage Course No N E
To Driveway, Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION fel Q
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
10
Dimensions
Manhole/Access (Y/N)
— "Pump Off' Level at
** Check Permitted Bedroom Rating Against HAA Request **
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
I certify that I have checked, verified, to all MOA and HAA guidelines in effect on the date of this inspection.
Signed Date _)_ �I i i
Company MOA No.
Receipt No. `?' ot(
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
•s
TH
€� :• 222.5-E l
�`��• JUN` 25, 1971
Engineer's Seal
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WATER SYSTEM:
SEPTIC SYSTEM:
DATE OF PUMPING:
DATE OF TEST:
'LOT 1C NETTLETON ,J)CR_Pj"
7300 NEWBY
TOM MILLER
SINGLE FAMILY, THREE BEDROOMS
ON SITE WELL
FROM MUNICIPAL RECORDS:
TANK: GREE;R STEEL,
ABSORPTION SYSTEM:
ABSORPTION AREA:
SOIL RATING: 125
INSTALLATION DATE:
7_225-E:• .,r,
( ;�1° JUN: 25. 1971
TWO COMP. 1000 GAL.
TRENCH
480 SQ. FT.
SEPTEMBER 1981
JUNE 4, 1986, ISAACS PUMPING
JUNE 4, 1986
TEST PROCEDURE: SYTEM WAS INSPECTED AND MEASURED. TANK WAS
FOUND WITH 4 FEET OF COVER. WATER DEPTH 48
INCHES. LIQUID WAS VERY CLEAN.
MONITORING TUBE AT END OF TRENCH WAS 8 FEET DEEP, WITH 9 INCHES
OF STICK UP. WATER DEPTH WAS 33 INCHES. THERE WAS NO CLEANOUT
BETWEEN TANK AND TRENCH.
WATER WAS ADDED TO THE SUMP AT A CONSTANT RATE OF 6.5 GALLONS PER
MINUTE. THE WATER LEVELS IN THE TANK AND SUMP WERE MONITORED
EVERY TEN MINUTES. A TOTAL OF 300 GALLONS WERE ADDED TO THE
TRENCH. NO WATER LEVEL RISE WAS OBSERVED IN THE TANK. THE WATER
LEVEL IN THE SUMP ROSE A TOTAL OF 7 INCHES.
THE INVILTRATION RATE WAS MONITORED FOR TWO HOURS. DURING THIS
TIME PERIOD 214 GALLONS WAS ABSORBED BY THE SYSTEM. BY PLOTING
THE MEASURED INFILTRATION RATES A 24 HOUR RATE OF 480 GALLONS WAS
OBTAINED.
TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF
THE MUNICIPALITY OF ANCHORAGE.
The operational life of all septic systems depends on the local
soil conditions, 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 this septic system. We can therefore not give any estimate of
how long the system will continue to meet the operational requi-
rements of the Municipality and State.
P
2 03 W 15ih AVE "C" SUITE 203
CONSULTING ENGINEER
®N ®
ANCHORAGE, ALASKA 99501
TELEPHONE. (907) 279-3916
S E P
T I C S Y S T E M
A D E
Q U A C Y T E S T
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WATER SYSTEM:
SEPTIC SYSTEM:
DATE OF PUMPING:
DATE OF TEST:
'LOT 1C NETTLETON ,J)CR_Pj"
7300 NEWBY
TOM MILLER
SINGLE FAMILY, THREE BEDROOMS
ON SITE WELL
FROM MUNICIPAL RECORDS:
TANK: GREE;R STEEL,
ABSORPTION SYSTEM:
ABSORPTION AREA:
SOIL RATING: 125
INSTALLATION DATE:
7_225-E:• .,r,
( ;�1° JUN: 25. 1971
TWO COMP. 1000 GAL.
TRENCH
480 SQ. FT.
SEPTEMBER 1981
JUNE 4, 1986, ISAACS PUMPING
JUNE 4, 1986
TEST PROCEDURE: SYTEM WAS INSPECTED AND MEASURED. TANK WAS
FOUND WITH 4 FEET OF COVER. WATER DEPTH 48
INCHES. LIQUID WAS VERY CLEAN.
MONITORING TUBE AT END OF TRENCH WAS 8 FEET DEEP, WITH 9 INCHES
OF STICK UP. WATER DEPTH WAS 33 INCHES. THERE WAS NO CLEANOUT
BETWEEN TANK AND TRENCH.
WATER WAS ADDED TO THE SUMP AT A CONSTANT RATE OF 6.5 GALLONS PER
MINUTE. THE WATER LEVELS IN THE TANK AND SUMP WERE MONITORED
EVERY TEN MINUTES. A TOTAL OF 300 GALLONS WERE ADDED TO THE
TRENCH. NO WATER LEVEL RISE WAS OBSERVED IN THE TANK. THE WATER
LEVEL IN THE SUMP ROSE A TOTAL OF 7 INCHES.
THE INVILTRATION RATE WAS MONITORED FOR TWO HOURS. DURING THIS
TIME PERIOD 214 GALLONS WAS ABSORBED BY THE SYSTEM. BY PLOTING
THE MEASURED INFILTRATION RATES A 24 HOUR RATE OF 480 GALLONS WAS
OBTAINED.
TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF
THE MUNICIPALITY OF ANCHORAGE.
The operational life of all septic systems depends on the local
soil conditions, 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 this septic system. We can therefore not give any estimate of
how long the system will continue to meet the operational requi-
rements of the Municipality and State.
3 W 15th AV"C" SUITE 203
V(o n o E�d�.l a -MyAu `�1�v ® CA ZOA CHORAGEEALASKA99501
CONSULTING ENGINEER_ TELEPHONE: (907) 279-3916
R E S I D
E N T I A L W E L L I N S P E C T I O N
LEGAL:
LOT 1C NETTLETON ACRS-.
LOCATION:
'7300 NEWBY
OWNER:
'.POM MILLER
TYPE OF WELL:
SINGLE FAMILY
WELL LOG AVAILABLE:
YES
INSTALLATION REQUIREMENTS
MET: YES
WELL YIELD FROM WELL
LOG: 30 GALLONS PER MINUTE
PUMP YIELD:
6.5 GALLONS PER MINUTE
DATE OF INSPECTION:
JUNE 4, 1986
TEST PROCEDURE:
WELL WAS PUMPED AT A CONSTANT RATE OF 6.5
GALLONS PER MINUTE WHILE THP: DRAWDOWN WAS
MONITORED WITH AN ACOUSTIC PROBE. THE WELL
WAS PUMPED FOR 45 MINUTES. STATIC WATER LEVEL
WAS E'OUND AT 105 FEET BELOW TOP OF CASING.
DURING 45 MINUTES OF PUMPING THE WATER LEVEL
DID NOT DROP.
`PEST FOR COLIFORMS:
WATER WAS TESTED FOR COLIFORM BACTERIA ON
JUNE 5, 1986. TEST WAS NEGATIVE.
TEST RESULT:
THIS WELL MEETS THE REQUIREMENTS OF THE
MUNICIPALITY OF ANCHORAGE.
C'
The Municipal requirement for well flow is
150
A
gallons of water per bedroom per 24
°•,
hours.This well surpasses this requirement.
<' ;-e' o: `'• 'v ''
r •' " .f•,,
The assessment of the condition of this well
applies Only to the conditions as of this
' N17 22?' E '
date. The flow rate of the well may change
JUNE 2b, .1971 :,r„
due to subsurface conditions that may not be
observed from the surface, and changes in
+�,',�,:�•.,. ,••`i^`?.;
land use and other_ factors that may impact
_' • - •-.
the conditions of the aquifer feeding the
well.
Time ne
J111130,
Date
,
Date
Date
n
Inspector
Inspector
Ipapt PAtITY
Defer. or QF AfNCH& RAGE
ENVIRo
Comments
Conditional Approval
1981
RECEIVED
Date Sewer Installed -.
Permit No.
Septic Tank Size
c__ €
Holding Tank Size
Soils Rating
Well To Absorption Area
Well Log Received
Well to Tank -
tuo
APPLICANT FILLS OUT LOWER HALF ONLY
Property Owner / /7-0077MV7 0
Phone
1 1
�lailing Address i—�l�-p— rf 1j`A11)1 r( /Q/VLlq �'T A, q 7f�1�
Buyer ! ;P1 it. r7e'�
Address
Lending Institution AtMhx Phone
Address A101? /W6-16144%
_
Realty Co. & Agent ��� Phone
Address
Legal Description z
Street Location Nl._ 1/V PJ ! H l4 C' )t -
/
P�
Type oj.Residence
L1 Single Family 3
❑ Multiple Family No. of Bedrooms _
ED other
Watef ,%pply
K Individual ATTACH WELL l_OG. A well log Is required for all wells drilled since June
❑ Community 1975. For wells drilled prior to that date, give well depth (attach log if
❑ Public Utility �� available.) �P
SewagQ,01sposal
L Individual Year Individual installed:
❑ Public Utility When Connected to Public Utility:.__
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.