The URL can be used to link to this page

Home My WebLink AboutSCHULZ LT 2JGhu 40 , aSa � a MUNICIPALITY OF ANCHORAGE Dl, RTMENT OF HEALTH AND HUMAN SER :ES Environmental Health Division 825 "LI Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT � —� Name DISTANCEES -==C' --- Address — TO FADm SEPTIC ADSORPTION Z WELL Phone(s) i _ TANK FIELD WELL Pei mit No No of Bedrooms LOT LINE FOUNDATION /f �, I % / ��• LEGAL DESCRIPTION—�` _ Lol Block Su btlwision Township. Range, Section � Z� GZYr 1 \ 1 AS -BUILT DIAGRAM (Show location of wen. septic system. properly hies, low iUahron. ,. — driveway, water bodies. etc.) TANKS — — - — - , --- �4—SEPTIC ❑ HOLDING ManedCtwer Capaaty In gallons -- - - MateGnel��,,(� No. of Compartments OF SYSTEM J RENCti ❑ ICED ❑ W. DRAIN F1 OTHER Depth to pipe bottom from original grade FT- Total depth bola original grade - PoI added above original grade Ciavul depth beneath pipe FT (-,2 FT � Gravei tenyf h �� FT_ -- - - —I - - - — Gravel vndih �7 FT Total absorption area Distance between Ines (ae,ej' SO FT I2" FT Number of hies Sod rating Pipe rnatenal Inssalld Date e '1 ��I Installer 11k I� C i s - - WELLS ®� PRIVATE — El OTHER (Identifv) - 1 Classi Gcairun (A, B.C) Iota[ Depth Cased to FT FT �. — _ In5latlel Date Installed_ --� —� m L REMARKS: - : Lzvx,�—-1_"��`— SCale: I t 2•o Inspections Performed by. ENGINEER'S SEAL sy,";nt'hA�gjy; 0�•4'O FSa'�, �`' 1�� G��r� �/•�y-�I�--_G= J`�� •, o f� r S$� S ENGINEERING _4 170WE8gI�jyer—LoOp_12ood-N®,•d9r4----�.-s-- c ly th this inspection was perlormed according to all . . ............. �. •, g:. n� /� {,.g 1jg5yry hinnl Cll�1 ID$IHII��1f�L'fR �(PCIIECf ITf('IZ, mac: �_ r� L d. fhxxE,n • ; v Ff GI �e No. tf-� —� �. i r //%� �// o u �e /.�� Health Department Approval: G�e /�`_C_�l4,� ✓ 9��e..'. essan`�� Ya 10 ,ROFE��rtplKy.'^o _ -- Date'-�C::� ��_ma iZ;xar I— c]:cc) p� MUNICIPALITY OF ANCHORAGE Department of Health & Human Services �`~----~ ON^SITE SEWER PERMIT Permit Number: 880092 Upgrade Date Issued: O6/22/g8 Engineer Designed Owner Name: ALASKA HOUSING FINANCE CORPORATION Day Phone: Owner Address: P^O. BOX 101020 694~5500 ANCHORAGE, AK 9951O-1020 Parcel Id24 Lot Legal: Subdivision: SCHULZ Si/BDIVISIONLotT's lc) c:kx`� Secticin : 11 Township: 14N Range: 2W Lot Size 16123 (sg,ft. or acres) Max Bedrooms: This Permit: 3 Tc)tal Capacity: 3 SEPTIC TANK: Minimum total septic tank capacity: 1,000 gallons" Each septic tank must have at least 2 compartments. Depth to top o( septic tank(s) < 4.0 {eet requires insulation over tank(s)" INFORM D,H"H.S" PRIOR TO 1ST & 2111) INSPECTIONS BY ENGINEER, IF AFTER OFFICE HOURS CALL 343`4681 AND LEAUE A MESSAGE CONSTRUCT PER ENGINEERS ATTACHED APPROVED DESIGN THIS PERMIT EXPIRES 12/31/88 THIS PERMIT VALID FOR A SINGLE FAMILY RESIDENCE ONLY I CERTIFY THAT: 1. I am familiar with the requirements for on^site sewers and wells as set forth by the Municipality oK Anchorage (MOA) and the State o[ Alaska. 2. I will install the system in accordance with all MOA codes and regulations� and in compliance with the design criteria of this permit. 3, I will adhere to all MOA and quire(it ents [or the set back distances from any existing well, wastewater dispogal system or public sewerage system on this or any adjacent or nearby lot" 4^ I underst d -Lhaf t h is permit is valid for a maximum of 3 bedrooms. I a]so unde jr,the capacity of, the total system is 3 bedrooms and Signed: (Uwne INANCE CORPORATION Issued By: ' '/ Jy—�----------�~�-��- DATE: DATE: ' �NGlNI I klNG 1/034 E, R. LOOP #204 �Ai A. AK 995}/ PHUNE #694~29/9 **********1�*******UN—SllE SAWWK PERMIT APpd. lLA|lUN***************** UA|E: 6—l3-88 APPi lt �AN[: A.K.1- JHCK KOH llE CO. AD08ESS: 1092� i 8LE HIVER ROAD 1: roil 101VLR HLASK: 9957/ CONIAC7 PHUNE: 1191-55O0 L (AUNUl|lUNS LA lNS}kUC[]ONS: EX(S|{NG �::EP1lU 8E EXt-AVAlED. SIZE AND [N|�GRi[Y VAR1�1�D. CNh RE1 UCAl1 :D SlDE iHE RUT":t' :TIVE WB -L KAUIl. Municipality ®f Anchorage OITA! Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 July 12, 1988 S & S Engineering 17034 Eagle River Loop Road Eagle River, Alaska 99577 Subject: Waiver Request for Lot 2 Schultz Subdivision Waiver Request #WR88-028, Permit #880092 Dear Mr. Shafer: Your request for waiver of the required 10 foot separation between a septic system and a lot line has been approved. The waived distance is 5 feet. This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sincerely, I - Daniel J. Roth Civil Engineer On-site Serivices DJR/ljw#7 //5i-,/7' \t / I1 D N \t / I1 0 a w ° X31 1 157/7 L i Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG s PERCOLATION TEST PERFORMED FOR: �f-'�v 1 w• DATE PERFORMED: LEGAL rrDESCRIPTION: ,6E Pik-- 1 j 2 - m 3 4 O 5 6 7 t � � 8 9 10- 11 0 11 Y 12 d 13/�� SPL 14 rte% 15 16 17 18 19 20 COMMENTS Township, Range, Section: -1 SLOPE !Le— WAS GROUND WATER ENCOUNTERED? �_ Q S IF YES, AT WHAT L DEPTH? 0 P E Depth to Water After Monitoring? ^�_ Dale: SITE PLAN Reading Date Gross Time Net Time Depth to Net Water Drop v2 z 1' 1 H PERCOLATION RATE 1(minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN.-� FT ANDy FT S & S ENGINEERING PERFORME=D BY��1��7,,,0��3��ApplijagggCClp_IZjXB'�(x-Lqq[zflp (ipa�_N�.M _ �_ ACCORDANCE 7lTFW'&VglhtaAND MyUNICIPAL GUIDELIN 1 72-008 (Rev, 4/85) / CERTIFY THATTHSTEST WAS PERFORMED IN > ON THIS DATE. DATE: O F5 0 F cn oIAJOO U -L"-4" O 77 O O '000 A, . U Jim Sullivan 688.2510 or 258-2510 745-2510 SYSTEMS SM1LES & SERVICE COMPLETE WRTER �__ \IIF JU111 2 0In it, Ancnorag�' 1511 --Dopf.-f1-04(.ii U Hurnan Services Alaska Distributor EMPSiF > P.O. Box 197 Eagle River, Alaska 99577 NWWACERTIFIEDPUMPINS-TALLER NO �J�J6 ,*c made. • vlua-� r-• THANKYOU 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 SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW910149 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:LEE HAROLD L OWNER ADDRESS:P.O. BOX 772073 EAGLE RIVER, ALASKA 99577 PARCEL ID:05025224 LEGAL, DESCRIPTION: SCHULZ LT 2 LOT SIZE: 15400 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 6/12/91 EXPIRATION DATE: 6/12/92 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 1_5.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: WELL SHALL CONTAMINA' RECEIVED 1 ISSUED BY -- - ---5 OF W(ri- D"/z h q DATE: �.G'/LrIJ/o("/f DATE : (O -/2 7/ � _ _. _ I i I �,, i i � � /. ,�.... � �,r %`` I /. i tALASKA> S Tho Grantor CHARLES GLYNN SCHULZ, (Place of residence) Anchorage, Alaska — I; Ten Dollars (610.00) for and in consideration of _ �u-- --in hand paid, conveys and warrants to ROBERT E. REAMER and PEAR L--PIi.--R�AMB{ hNgj2a aj__and7 w i fP} as T:P,DIATS F2 THE i ENTIRETY, WITH RIGHT OF SURVIVORSHIP. the followin dDmAbed real estate: t 2 SCHULZ Sti TVISION according to Plat 72x119, excep in g therefrom cello 1, gas and other minerals as reserved unto the United -States by that Patent', recorded in Book 141, page 12 recorded December 12, 1956, being within the Anchorage Recording District, Third Judicial District, State of Alaska. TOGETHER WITH, ALL AND SINGULAR, the tenements, hereditaments and appurtenances thereunto belonging to or in anywise appertaining, subject, however, to existing easements of record. i. . ij TO HAVE AND TO HOLD said property, with the appurtenances, unto the Grantees,.as TENANTS BY THE ENTIRETY, and not otherwise, and with the right of survivorship, and to their assigns and the heirs of the survivor, FOREVER. j! `.CHIS PROPERTY.HAS NEVER BEEN USED AS A HOMESTEAD OR DOMICILE. ji s; �i GREATER ANCHORAGE AREA BOROUGH 3500 Tudor Road Anchorage, Alaska 99507 S-2720 PLAT STATUS: Final BOROUGH: Platting Engineer Public [forks Department Department of Environmental Quality Fire Department Street Names Tax Appraisers School. District OTHER: DATE: May 23, 1972 CITY OF ANCHORAGE: Fire Marshal Municipal Light & Power Department Property Management Officer Public Works Department Telephone Utility Traffic Engineer Wager Utility Alaska Department of Highways GAB Telecommunications, Inc. Alaska Railroad Matanuska Electric Association Anchorage Natural Gas Corp. Matanuska Telephone Association Central Alaska Utilities Assistant Superintendent of Mails Chugach Electric Association Alaska Department of Fish & Game DESCRIPTION OF PROPERTY: Sctwlz Subdivision, Lots 1 & 2 OWNER: Charles G. Schulz Gentlemen: A petition has been received by the Greater Anchorage Area Borough Planning Department for the proposed subdivision of subject property for the June 21, 1972 Planning Commission Meeting. Attached is a copy of the proposed plat, Will you please submit your comments in writing, specifying any easements or other requirements that your department or agency may need. If we do not hear from you by June S, 1972_ we will assume that you do not wish to submit any comments. If you have no further use for the attached print, please return it with your comments. Planning Department Enclosure MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Bcz 196650 Anchorage, Alaska 99519-6650 343-4744 G' ` TIi=Ik`,'\ ' OF HEALTH AUT'--IORITY APPROVAL FOR,-.. SINGLE FAMILY uWELLING Parcel I.D. # 050-252-24 — HAA # 41/9 � /21/ 'I. GENERAL INFORMATION Complete legal description Lot 2 Location (site address or directions) 16340 Side Hill Lane, le River_ Proper owner _—Harold Lee ___._. _ Day phone 694-8687 Mailing address Laao'iCitation Rnad, Fag1 R :V27,_ AK 99577 Lending agency F"iyBA, Stephanie Kuhno pay phone 276-6300 Mailing address P.O. L1ox 100720, Anchorage, AK 99510 Agent — --�v[a — _- Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEnOROOMS: 3 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. 1 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xx - Holding tank Community on-site Public sewer NOTE: If community vvastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Flev. 1/91) Front MOA M21 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 furtherverify 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 Eagle River Engineering Services Phone 694-5195 Address p o BQx 773294 Eagle River AK 99577 Engineer's signature ®ate �1- �- 9 6. DHHS SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for Additional Comments :v rj pl9 eaFlG pvp 4� YdH r i P d'4 ;fi d SAI d x Pn%>•3tl�Yi.il6II2YtlRiY !-:":.1 bedrooms, with the following stipulations: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates. based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA N21 ,, Municipality of Anchorage' �,/ DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division (� 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907)NA-4744 �� Municipality of Anchorage Dept. Health & Human Services Health Authority Approval Checklist Legal Description: �( /�ULZ AUT- _ Parcel A. WELL DATA Well type ��!?1G'/> �G _ If A, B, or C, attach ADEC letter. ADEC water system number y� Log present Y N) Date completed Total depth LW3 _ Cased to a03 ` Casing height (above ground) Sanitary seal (Y/N) S Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Ow %S VI Q,V2•�/ y f Static water level /00 91v_ Well production g.p.m. 0--g-P.M. WATER SAMPLE RESULTS: Coliform Nitrate �� /�% CY��_. Other bacteria Date of sample: U Nv Collected by: — /� " B. SEPTIC/HOLDING TANK DATA Date installed 0'// Yt _ Tank size w0(� _ Number of Compartments _ l -- _ Cleanouts (Y/N) yam' S Foundation cleanout (Y/N) Y4-7`:;, Depression (Y/N) _NO High water alarm (Y/N) _ NLA Date of Pumping 06910f19& Pumper -J-P"3 C. ABSORPTION FIELD DATA Date installed Soil rating (g:.p:d:/ftzor ft`/bdrm) % Z System type -16ee N&H i 1 � Length `� Width _ Gravel thickness below pipe Total depth f Effective absorption areaf�� / f� Monitoring Tube present (Y/N) ytj Depression over field (Y/N) NO Date of adequacy test 03 ' 1Y1U Results (Pass/Fail) _%�`�� For ��a bedrooms Fluid depth inAabsorption fieldtlbefore test (in,); % Immediately aftergal. water added (in.):3 O Fluid depth °� O (ins) Minutes later: 0 Absorption rate = _ tyro g.p.d. Peroxide treatment (past 12 months) (Y/N) N/A __ If yes, give date _ 72-026 (Rev. 3/96)' D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* .. Cycle�sted�__` E. SEEPARATION DISTANCES *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot //Z Size in at* "Pump off' level at* On adjacent lots '/ loo / i On adjacent lots _ f X00 Public sewer main M Public sewer manhole/cleanout kV1_4 Saw,9+/septic service line 9o' _ Lift station ^_ &1A SEPARATION DISTANCES FROM SEPTIC/Hato►NG TANK ON LOTTO: Foundation f /O Property line a �(� _ Absorption field. -//0 _ � / Cj / Water main/service line o Surface water/drainage 110 Wells on adjacent lots _ •� /G f /,50 / SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line S ' W/I/VI�KBuilding foundation /8/ Water mainfservice line +r ° 1 Surface water Driveway, parking/vehicle storage area �D Curtain drain NaN�j:YZ/1114T-6 ('_iASS Wells on adjacent lots _ /--/0( F. ENGINEER'S CERTIFICATION r4%i iN�i�R I certify that l have determined thru fleld inspections and review of Municipal records t�'at M6,aC�b'verjsybtems are in conformance with MOA HAA guidelines in effect on this date. `SFr a ^ " " 1, j ��I tr�� Signature ` �` Ct « Y14.1 Engineer's Name _��0/_s U %C=/2 /1 /It cr ; =*e • �s 1•� �.J Jihls vF�t [i a ..�j. Date 9 7 Fact HAA Fee $ _)C)O. Ul • Waiver Fee $ Date of Payment L` -: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES II pp 2 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL HeRS_ A 6� 1'z OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date 1-2� - oo _ 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) �-o r 2_ SUS t,� ��o•. \1 . ��4r�1 Z� Location (address or directions) (b) Property Owner Telephone: Home Business _ Mailing Address 01 (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent L�— �1c 1 � Address �>- Le- ?-1yru7— Qom. —IEP -z5 L--�� F:no(z: -7 Telephone (e) Mail the HAA to the following address: or: Check here,9,-if hold for pick up. List contact person and day phone number below. S & S ENGINEERING 170-14 c i llvec-Laap Ronal No. 204 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family Number of Bedrooms 3. WATER SUPPLY Individual Well,' Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of E=nvironmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsitea Public ❑ 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 1 72-025 (Rev 8.861 Front 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 inspection. Name of Firm& S ENGINEERING 77034 Telephone Address e„ Claske 99577 Date Wr 6. DHHS APPROVAL Z40 ��Approved for `> bedrooms by--' Date> — Approved _ Disapproved Conditional _ Terms of Conditiona Approval CAUTION 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 courtesyto 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. Page 2. of 2 72-025 (Rev 8'861 Back &E OF P��Ct�UQ�J�S�ON \QP��I 4 G MUNICIPALITY OF ANCHORAGE (MOA) _ MUQ�O qP HEALTH AUTHORITY APPROVAL (HAA) pN��N 19�� CHECKLIST - FEBRUARY 1984 k� 2 264-4744 Legal Description: A. WELL DATA 1 Well Classification 1t-��1tJ��J If A, 8, C, D.E.C. Approved (Y/N) Well Log Present t� Date Completed Yield �\2- e=i?h l Total Depth 0YY-Cased to � 14- Depth of Grouting t Static Water Level Pump Set At u Casing Height Above Ground — Sanitary Seal on CasinTADN) Electrical Wiring in Conduit PN) _ U Depression Around Wellhead (Y/rte IJ Separation Distances from Well: `` i To Septic/HntdiQq Tank on Lot 1 �2 On Adjoining Lots �I To Nearest Edge of Absorption Field o t_ot —, p ) ; On Adjoining Lots t To Nearest Public Sewer Line T To Nearest Public Sewer Cleanout/Manhole _ To Nearest Sewer Service Line on Lot . Water Sample Collected by ; Date S�=. Water Sample Test Results Comments B. SEPTIC/140k@1N19-TANK DATA Date Installed _:I -�65 Size \ 1�70 1� No. of Compartments Z- Standpipes6(PN) Air -tight Caps6(VN) _ Foundation Cleano�N) �T Depression over Tank (Y(Sp 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 SepticrHu ding. Tank: I To Water -Supply Well _ 1Z To Property Line I To Water Main/Service Line — _L o k Course Comments Page 1 of 2 72-026 (Rav R'861 Front To Building Foundation To Disposal Field Z1( 5 To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata .22 6CL — Type of System Design I Date Installed Length of Field � I Width of Field Depth of Field r Gravel Bed Thickness k -e Square Feet of Absorption Area _ _ (e Standpipes Present �_VN) _ Depression over Field (Ya A Date of Last Adequacy Test 2s Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well __�� f I r To Building Foundation Lot �� i To Water Main/Service Line 1 0 4— To Stream/Pond/Lake/or Major Drainage Course _ To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION \ 1 f Y Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments To Property Line To Existing or Abandoned System on i On Adjoining Lots -4— �S To Cutbank (if present) Dimensions Manhole/Access (Y/N) — "Pump Off' Level at nt (Y/N) Pumping`. C i ** Check Permitted Bedroom Rating Against HAA Request ** Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA an HAA guidelines in effect on the date of this inspection. Signed S & S ENGINEERING Date17034- 0 ago rvar oofa � ao d 140, s„� Compan�ayleRiver-rAlaa�,a_4g577 — MOA No. Receipt No. AV ( Date of Payment r� . , 7Q 0C) P ♦ N . ,r Y .ry'r Amount: $ as C-'_1 ns -V 7 Page 2 of 2 72-026 (Rev P"M Rack oOn Pxs {4RT F <. MUN'f.C"r.PAr.T,j.,y 9-l' ANCHOPAGp DI';'SIO'L\l Op p I RONME:N—AL HEAU[Ij DEP[ ZTMENTF (.)b-- �jn,� - -:�� -f u A 0 . x AND t v RONMENTA'L, PROTEC-1�10N llil IJCArJON [OR HEALTH J�jyj,HOR TY watel, Sup -P Individual -olal), C-cf,"Iminity put.).lic 1— _J — I Note-* Tf-- SYStOM, MLI,9i-. havo ar ter cc, -irrfjat j,cl, fl:cm the St,--ILe Depart7r,,?I:t iL -rlvlrc)1*lImr,tal. Conservat:LDn t.'Ta lc(.' lif-Y 11ld St--lLus, Is the adeqLML(-, f C)JV the rU_nll-,er of jDeC_jZ.,( J. Xfl)z) �-J!X--)ci-'ied in i -his HAA Onsite F).1olic Community Hoidi.ng TarA IS tN) wastewater J:LSTX;Sal. System adequate cor e J- -h -,.urk.er of boljI, (Page I of 2) ApplicjitAGI) I)ate .10tr blcri,,, Subdivjj.:.� n, rec,tionr t(7"r.Shjp, LocaL,I(Lr, (a(j(.Ij_,Oss Cr Ap.P lical,t-9 Nana --- ---- r(, e hone r A[)I i(arts Addre-c,, (C) Buy,�-,-r Tonding j.-.ji�-,Litutic;r, other Xpi a i n) (d) f0lndirg Instjtution Addr-ss -J� ESUIU-1 CO, & Agent: Address �c Telephr T Sir"910-Family L'POtl!f (or Numtx-r of watel, Sup -P Individual -olal), C-cf,"Iminity put.).lic 1— _J — I Note-* Tf-- SYStOM, MLI,9i-. havo ar ter cc, -irrfjat j,cl, fl:cm the St,--ILe Depart7r,,?I:t iL -rlvlrc)1*lImr,tal. Conservat:LDn t.'Ta lc(.' lif-Y 11ld St--lLus, Is the adeqLML(-, f C)JV the rU_nll-,er of jDeC_jZ.,( J. Xfl)z) �-J!X--)ci-'ied in i -his HAA Onsite F).1olic Community Hoidi.ng TarA IS tN) wastewater J:LSTX;Sal. System adequate cor e J- -h -,.urk.er of boljI, (Page I of 2) S, 1_ti_l A .r i.nc f'i1 m "I yo ricl.r.cl L �--�2y-_.ions, l cr, l_if � that effect on }he T haVe, checked, verified, ca , at tYl cr. r_rn, ornrd to a1.1. MDA i,.�,r� Gt.i(�.lir cf s in-'-Pecti.cr.. Signad Nafln of 1 __ra 01 P,ddress 0- - Signed by q Date. (1_NGINCER SEAL) 6, HEP Approved o r> IP- do rcrn Approved 1- ppro,r-d r __.. 'Perms CE Ccrdit.ional Apprcval OF • ,' •'tom n Lee � •' > en 4, ..� JG tE 25, 1911 IJJ ..J_�_ Lhiltz9 C:pt�:dit.iona:l. f "`i c� il�akLi 'The Mur.ic"ipal. f t r (-rAn hc;r tc� 17 az!tln,nt r„ . rll `'• ��P.'.1' I.`,'f:'71rGidi�jttal PZ^.�t_ect"7::n d t s not gllal'afit�(:? t 'GI't t.f r ':i�J,ti to -Wit „ �•YC'E? -1 t o 1,/ILe supply 'iEd oY the ter disposal s(�,stem. This approval t.r;dlcatns that, nuc ct the 7a' l dat. or ( �: 51'IC17(7 ) C:4f tk�SE'C] Un t.h;? cl,?tct ,ind INcruot.ion flul."Iiished ty an engineer the state of Alaska, the `+ia tc. i. suppJ and 47d ��J;:n4Ja t_(.?, :Ji,,,:�c!]. system 1.s Safe and i=I�YI(�•. t: onal rcr t;.c r,(tmtx r o:E }:edr ;Cms and tyPa Q st:;r: ucture indicated. (OHEP SEAL) 7q Mail the HAA to the following address: Xl e Page 2 of 21 61 it 2-15-A4 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 A. WELL DATA Legal Description; -C y , Well Classification _ kIvA rLl If A, B, or C, D.E.C. Approved(Y/N) _ Well Log Present (Y/N)' NU Date Completed N/.� Yield *V4=* Total Depth/✓ Cased to N Depth of Grouting N _� Static Water ]:revel _ /� ~ ° Pump Set At Casing Height Above Ground°' �� Sanitary Seal on Casing (5INLZ Electrical Wiring in Conduit(Y/N) yP.s Depression Around T%llhead (Y/N) IV Separation Distances from 4qe11: To Septic/Holding Tank on Lot 7100/ On Adjoining Lots 7 14a To Nearest Edge of Absorption Field on Lot 7/av ' On Adjoining Lots To Nearest Public Sewer Line TO Nearest public Sewer •✓/ Cleanout/Manhole N To Nearest Sewer Service Line on Lot Water Sample Collected By L, , d -e, e, /a1 Date M Water Sample Test Results _5c, f -is fr. frY_ Comments ` / Lam. 'I L• GIn G(-�/ /. C�Sf !✓ilG'/'M1 �/dlil /hGY-1°.al... L l'C� �U •� f �!%'1 l B. SEPTIC/HOLDING TANK DATA Date Installed !�� /V- 1.,,,`( .Size /L:��> Gam;//.�, No. of Ccxnpart�nts / Standpipes (Y/N) 0�„f Air -tight Caps (Y/NLYej Foundation Cleanout (Y/N) id2, Depression over Tank -LK/N) n/a Date Last Pumped t14q,��o;� r / .3 o, Pumping/Maintenance Contract on File (YIN) /V for Holding Tank High -Water Alarm Temporary Holding Tank Permit Separation Distances from Septic/Holding Tank: To Water -Supply Well _ i�v To Building Foundation_ _. To Property Line a To Disposal Field — 7 / � Po Water Main/Service Liney% To Stream, Pond, Lake, cr Major Drainage Course /',�/I Coimients [Page 1 of 21 .N011031OUd 1V1NdWN041AN# '8 H11VdH dO 'dd39 idMOHDNV dO AMWdIDIW1 . 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Al, 4 - e, c/ Width of Field Iva �-e., ( Type of System Design ! �" Length of Field _ IVIA Al, Depth of Field --- -tjo Gravel Bed Thickness y/2- Square Feet of Absorption Area G °+ Av1-"- 6 1, � Standpipes Present (Y/N) y�J� Depression over. Field (Y/N) rJ Date of Last Adequacy Test / 5J Results of Last Adequacy lost �3 E. f /,'IV Separation Distance from Absorption Field: To Water -Supply Well _fes S- To Property Line To Building Foundation To Existing or Abandoned System on Lot IV,14 On Adjoining Lots N /A- To Water Main/Service Line A -,/To Cutbank(if present) To Stream/Pond/Lake/cr Major Drainage Course--A//z) ,—_��,- To Driveway, Parking Area, or Vehicle Storage Area -s -3 Comments D. LIFT ,13,` PrT-ION----- date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for J Dimensions Manhole/Access (YM) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes(Y/N) Comments * Check Permitted Bedrocm Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed _ Date4-1 Company %' o6b MOA No. S % p// KB1/d5/s [Page 2 of 21 2-15-84 4°0D D �� IJWUUISG^�1UVl�J �o ANCHORAGE,VALASKAIT995203 01 CONSULTING ENGINEER 0 TELEPHONE: (907) 279.3910 Al Romaszewski Box 770848 May 3, 1984 Eagle River, AK 99577 SEPTIC SYSTEM ADEQUACY TEST LEGAL: Lot 2 Schultz Subdivision LOCATION: Eagle River OWNER: Jim and Lana Scott RESIDENCE: 3 bedroom home, single family WATER SYSTEM: On site well SEPTIC SYSTEM: From Municipal Records No record of system design is available. An adequacy test performed in July of 1982 states that the system contains a 1000 gallon septic tank and a seepage pit. DATE OF TEST: April 30, 1984 TEST PROCEDURE: The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was charged with 1000 gallons of fresh water and after a period of 24 hours all the water which had been added to the crib had percolated out. TEST RESULT: The septic system is adequate for the described property on this date, May 1, 1984. OF �AA�• fp, •.B0i0.• U. „a 1.222a,U. E2b, 971 •.Iw*1I ,A. . S�.J 6�I Tobben Spurkland P.E. Mr. Al Romaszewski Box 770848 Eagle River, AK 99577 WELL INSPECTION May 3, 1984 LEGAL: Lot 2 Schultz Subdivision TYPE OF WELL: Private CASING ABOVE GROUND: 40" WIRES IN CONDUIT: Yes SEPARATION DISTANCES: 100+ to septic and crib SURFACE GRADING: Satisfactory LAB TEST: Satisfactory WELL STATIC LEVEL: 105' WELL YIELD: 1 GPM for 4 hours DEPTH OF WELL: Unknown >175' The sustained 4 hour yield of this well is adequate for the residence described on this date. (� AF RH 't 1P •••40 s e o. 2225-E. .`r9.,�• 4�_ 1UNk 25, 197; N LAI AS- Bull,q, hereby (VrtifY that I have mlrvtrycd ll;c following described property: Lot 4" J.' /e Anclagage R41cordjl 19 �P r,ecinrtAlf—.1..__' __ _ meats lawMents SitOated thereon are WIthfil thp r,,,jj(1yp tiyt L11bU.0PAjando ,onOt ONTTIAP or ene-ru8uh on the property 1*jrlj adjacent there .to, 11t no improvements on property JYM9 adJacent theretoencroach301 opt tho pr mists i, question and that there jre, no roadway::, frfmarnim!on lines o! Officl vis b?c acid property except'14, indlep-lel hereon. or, Dated ll,--, a thii". clay of SCA I -F V. lio X, -p 1lal. ti. (11u 11543 APPLir NT PILLS OUT UPPER HAI ONLY Property Owner Mailing Address . ,1 Buyer .--=-�- Zip Code Address Lending Institution Zip Code Phone I Address Phone Realty Co. i£Agent _ Zip Code Address - - _ - Phone Legal Description I Zip Code a Street Location Type of Residence r _ 'Single Family Eli Multiple Family No. of Bedrooms ❑ Other Water Supply - Individual - Community _ _ ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. j ❑ Public Utility:. _ For wells drilled prior to that date, give well depth (attach log if available). Sewer Disposal Individual ❑ Public Utility Year Individual Installed: ❑ Holding Tank When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATE D. Time Time Date Date Inspector Inspectar Field Notes: - APPROVED BEDROOMS (� ) DISAPPROVED ( ) CONDITIONAL OVAL' DATE BY: Soils Rating 72023 (3182) Time Time Date Date Inspector nsp Ior ect Date Sewer Installed Well To Absorption Area Well to Tank 'CONDITIONS OF APPROVAL Well Log Received Septic Tank Size e EXCAVATION WORK Re/Max Realty ATTENTION: Al Romaszewski Pro. Box 848 Eagle River, Alaska 99577 Dear Mr. Romaszewski -July .5, 1.982 Reference: Lot 2; Schulz Subdivision ROBERT A. SHAFER CIVIL ENGINEER 694-2979 A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity Of 1000 gallons. The seepage pit was charged with 1000 gallons of fresh, water and after a period of 24 hours approximately 629 gallons of water had percolated out of the crib. It can be concluded from this test that the waste water disposal system serving the three bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failure. If we may be of further service, please do not hesitate to call.. Sin>'er A. /ss F, . First Alaska Mortgage Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA