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Home My WebLink AboutSCHROEDER LT 84� t c,hroecier 050 SIO Elosim , OWNER OF LAND ADDRESS LEGAL DESCRIPTION DATE - Started PERMIT NUMBER Ended DEPTH OF WELL. STATIC LEVEL OF WATER FT. DRAW DOWN FT. GALS. PER HR KIND OF CASING From --Ft. to — Ft. --------- From Ft. to----- Ft.------__--- From— Ft. to ---Ft. From to_ --_-_Ft. From-, ------- - Ft. to,----- Ft. From_ —Ft. to -- Ft. --------- From --Ft. to --------Ft ---- ----- ---- From_ - ---- - ----- Ft. to ----- ---- From Ft. to -----_-_Ft. From — 1, t. to--- Ft. -- Front Ft. to From --Ft. to--,--Ft------- Frorn--Fl. From --Ft. to---_ Ft.—__—_-- From -Ft. to_ ---Ft..— ---_ From- _-_Ft. to --_-_Ft. From —---Ft. From__ --_Ft. From__ —Ft. to --------Ft.---—------ From Ft. to---- Ft. From --.--Ft. to --------Ft. From-- —Ft. to --------- --_-_Ft. Frorn----Ft. to -------Ft.— From -.-,---Ft. to.----F't. ------------ Froni—Ft. From --._—_Ft. to -----_Ft. From_ ----Ft. to From--- Ft. to ----._—_Ft. ---- From_Ft. to --Ft, From---- Ft. to From --Ft. to —Ft. From --_—_Ft. to. -I%l- Vlt---'-- nu MISCL. INFORMATION: -i8-G lt4oll'D;10'6� 40 DRILLER'S NAME R -H U V-4 T :1!��T* �C`3 IEH-.: DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STRET, ANCHORAGE, AK 99501 264~4720 PERMIT NO: 840694 DATE ISSUED: 08/13/84 APPLICANT: ROYCE BM#w-FH ADDRESS: P"O^ BOX 773326 EAGLE RIVER, AK 99577 CONTACT PHONE: 694~^4217 LEGAL DESCRIP: SUBDIVIGION: SCHROEDER LOT: 84 BLOCK: NA SECTIONX 2 TOWNSHIP: 14N RANGE: 2W LOT SIZE: 10500 <SQ^FT^ OR ACRES) I certify that: 1" I am familiar with the requirements for on --site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of' Alaska. 2" I will sygtem in acccjrdance with all MOA codes and regulations� and in compliance with the desiqn criteria of this permit" 3" I will adhe)re to all MOA and State of Alaska requirOND OtS foP tha scit bk distances fro0 any existing well, waiiitewater diSpDFal system Dr �ubli� sewerage t djE[eOt or nearby lDt" SIGNED J//' DATE: APPLICANT: ROYCE ��MARTH ISSUED BY DATE: MUNICIPALITY Or ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) /egal�Description (in�lude lo�(ilock, subdivision, 'section, township range) / ) / ) I'T �� -i Location (address or directions) U (b) Applicant Name ��_AI_ Telephonne: Home �a?!-!/ Business Applicant Address IJI�ZIL/ll�� (c) Applicant is (check one): Lending Institution 0 ; Owner/builder;9 ; Buyer 17 ; Other E] (explain); _ (d) Lending Institution Y/7Vl�fLTelephone L_( -21 Address ,---L r i�_� Q.� P - (e) Real Estate Company and Agent Address _--- --__-- — _ -- --- TRlpnhnnp 2. TYPE OF RESIDENCE Single-Family,L�'( Multi -Family El Other Number of Bedrooms .J- 3. WATER SUPPLY Individual Well P� Community C7 Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite El Publicp Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025(11/84) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH DA1 « AND INFORMATION f. 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 arid State codes ordinances, and regulations in effect on the date of this inspection. Al_ )y 4'4 `62 i /-?J /, .5' / '<> r � i�c, `�a �i {LI mea Ye� ✓r_,5 , Name of FirmG� e o�ici4, v) fS '�� ,irzTelephone Address--�2i V �� Q V A V Y -- --- -- Date _L7_ DHEP APPROVAL \ ) Approved for _/ bedrooms by Date �' a � // ,f Approved _ Disapproved`) — Conditina�f`____ ---- - Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority { Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of 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 MUNICIPALITY OF ANCHORAGE. 264-4720 c DEPT. OF HEALTH & L S `r/ SC�6 Y 6e'deV J �, ENVIRONMENTAL PROTECTION Legal Description: _ 15 Z., 7-1 A. WELL DATA DEC 2 3 1985 Well Classification Y I"Y If A. B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N)_ Date Completed T ~ 6y — Yield /0"'7 I . it Total Depth e Cased to y% `? D th f G 4)A Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) z. �4 Separation Distances from Well: To Septic/Holding Tank on Lot t�/ h To Nearest Edge of Absorption Field on Lot All !11� ep o routing Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots r To Nearest Public Sewer Line L To Nearest Public Sewer p Cleanout/Manhole y To Nearest Sewer Service Line on Lot Water Sample Collected by (fo4sl' G �J Y,5 T ; Date Z - Zo Water Sample Test Results 14 2c4e, d Comments B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) Depression over Tank (Y/N) Size Air -tight Caps (Y/N) Pumping/Maintenance Contract on File (Y/N) _ Holding Tank High -Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well To Property Line To Water Main/Service Line No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped ; for _ Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field N To Stream, Pond, Lake, or Major Drainage Course Comments 7717 rs A-/ .5'a Yve,d Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field — Square Feet of Absorption Area — Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ��y � �c,, Sews' D. LIFT STATION Nlfq Date Installed Size in Gallons "Pump On" Level at -- High Water Alarm Level at Tested for Electrical Codes (Y/N) — Comments — Type of Systern Design Length of Field — Depth of Field _ Gravel Bed Thickness Standpipes Present(Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on On Adjoining Lots - To Cutbank (if present) — Dimensions Manhole/Access (Y/N) — "Pump Off” Level at —_ Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request "* I certifyth '�fj�eckod, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. ( Signed Date _— ., Company ��Sa� G/JS%�5 MOA No. E Receipt No. _ c„_' 1 Date of Payment Amount: $ -(a-' !7D 14 Page 2 of 2 72-026 (11/84) HENRY WILSON 91501 BUDDY WERNER DR. ANCHORAGE, AK 99516 (907) 3462000 Constructing Engineers, Inc. -- Engineers, Surveyors CHARLES A.LANDERS SR BOJ( 192•A, MYRTLE DR. EAGLE RIVER, AK 99577 (907)694.9098 December 23, 1985 MUNICIPALITY OF ANaIORA07F CFPT. OF HEALTH & ENVIRONMENTAL PROTEOI'I09 ON 2 ;1985 Re Lot 84 Schroeder_ S.D. � E � Waiver Horizontal Sept- ration between well. F< Absorption Field for IIAA Municipality of Anchorage Div. of Environmental health 825 L Street Anchorage, AIC Gentlemen: Subject property is being refinanced. Attached is the information that was supplied to the State DEC when the home was built, as well as a copy, of the waiver issued by the State DEC at that time. If any other information is needed, please contact us. Very truly yours, CONSTRUCTING ENJGINNEERS, INC. Henry II. Wilson MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE I. General Information Application Date (a) Legal Description (inc de lot, blpck subdivision, section, township, range) '`r � i,� ,i:L�s:� ' -% /_ ` ) .1J._ I •;- _�Eaf�iOb� �'.... Tl[l A� `�) '7 L11 �.:.I1 1 Locat on rections) (b) Applicants Name%' ' ��%l/ `f �� Telephone - IIom 'vusiness Applicants Address {X(�-Jd(%� I I.,,`_, ._r 4 - (c) Applicant is (check one) Lending Institution = Owner/builder Buyer = ; Other (explain); (d) Lending Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: IAhl fl( CA 2. Type of Residence Single -Family �Z Multi—Family Other (describe) Number of Bedrooms V :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. G. Sewage Disposal Onsite Public Kl Community Ej Holding Tank El Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. (Page 1 of: 2) ss�� C 5. Engineering Firm Providing Inspections�Teats, File Search Data and Information As certified by my seal affixed hereto and as of the verify that my investigation of this Health Authority vApproval nshows thatnthelowon-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, an re ula- tions in effect on the date of this inspection. 11sf�• L'tivi..nai ,v a.t �.,_ ��rC Name of Firm Address c rQr L ( / �r.(,t�e> r-_1�1eve, Date 6. DHEP Approval Approved for yZ� bedrooms Approved (ENGINEER SEAL) o: ,pf �`: x'60 ` • ,., l,1 9" ¢+ ur -•v,.' nuc., •.�e. s.i• r rano onrr v..o opnanu.c �- ',� )"no n' i vaa ate Disapproved Terms of Conditional Approval CAUTION Conditional THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 PROTECTION REPRESENT-- REGISTERED HOMES AND REQUIRE - BEFORE A FOR ERRORS [Page 2 of 21 7-19-84 A. WELL IATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 iloV 2 0 1934 1 10 I Legal Description: _ tL.88 S(-hr0eA--r" 5� Well Classification �PcIyla`Tc-, If A, B. or. C, D.E.C. Approved(Y/N) _ Well Log Present (Y/N) Date Completed 5r=?i- Yie1d 2 02' ` Total Depths i `Z'' Cased to t� 17Zi, Depth of Grouting Static Water Level �� Pump Set At Casing Height Above Ground Zq Sanitary Seal on Casing (yLNNe> Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) N� Separation Distances from ill: To Septic/Holding Tank on Lot N �' �; On Adjoining Lots To Nearest Edge of Absorption Field on Lot N ,A. ; On Adjoining Lots 96 To Nearest Public Sewer Line zl�� To Nearest Public Sewer Cleanout/Manhole 'Z`141 To Nearest Sewer Service Line on Lot Water Sample Collected By ; Date Water Sample Test Results `Sz i s ,C -:_c4 0 r/ Com ents Wet( to - Cklvm L -a 1 't—es ahh B. SEPTIC/HOLDING TANK DATA Date Installed N ' P' Size No. of Coapartments Standpipes (Y/N) Air -tight Caps (Y ) , Foundation Cleanout (Y/N) Depression over Tank (Y/N) Date Last Pumped Pumping/Maintenance Contract on File (Y/N) �; for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Nbll To Building Foundation _ To Property Line To Disposal Field To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course Y' Comments [Page 1 of 21 2--15-84 BILL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAL AL CONSER"'I'ION Telephone: (907) Address: ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 November 19, 1984 Constructing Engineers, Inc. 9601 Buddy Werner Drive Anchorage, Alaska 99516 274-2533 SUBJECT: Waiver Horizontal Separation between Well and Absorption Field, Lot 84, Schroeder S/D (8521 -.WA -066) Dear Mr. Wilson: The Department has reviewed the subject waiver request and hereby waives the horizontal separation between the well and septic tank to 96 feet on the subject property for a 2 bedroom single family residence only. Sincerely, ruce E. Erickson District Engineer BEE/dd _ Construou lsneers, Inc. HENRY WILSON Engin ; purveyors 9601 BUDDY WERNERDR. }{"�y R-, CHARLESA.LMIDFRS } , SR 80%,192-A, MYRTLE OR. ANCHORAGE. A000 K 99516 r E4C_0RWAN99577;- October 230 1984 Alaska Dept. of Environmental Conservation Anchorage Western District Office .437, r, Street Anchorage, Alaska, Re. L84 Schroeder,,,,S.ubdivis,on w Sec 2, T14N R2W 'SM: Attention of Mr. Druce Erickson Waiver Request Gentlement ,,-_ We, havebeen retained.to obtain Health Authority Approva,i forithel home on the subject -property which is a two-bedroom frame home ung der construction. Subject .property is served by a new drilled well 47 ft. ,deep, yielding 30 gpm.. The well log (Exhibit C) shows an impervious { strata (clay ,and grave].) from 25' to 43.' below grade. Water is t drawn from beneath 1:his impervious :strata. subject property iss('rved by publir.''sewer. The well has proper ' =f separation distances from the public sewer as shown on Exhibit B., Lot 83 which is adjacent to the subject lot (see.Exhibi,t`A)'is- served by an on-site a,:ic system. The crib pipe of this system,' is 96 ft. from the wet casing on subject lot,,.rather than the reg quired 100 feet Due to the small amount lacking in the separation distarioe (4 ft.') and the fact that the well draws water from beneath an impermiable: soil layer 16 ft. thick, we recommend and request a waiver for this separation distance. If any further,information is required, please contact this office. Very truly yours, 4% Henry f Henry H. Wilson AVP :J�� },I k, QNAt.� tip