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Home My WebLink AboutEAGLE RIVER HEIGHTS BLK 3 LT 3B(,Vo (Lu�� 4AcCA6hAqS "SSD •a4l--l-N� 72-013Wv. 7178) 1\ 1 MUNICIPALITY OF ANCHORAGE 1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street • Anchorage, Alaska 99501 Telephone 264-4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PRUNE W ��-^ PCRADE MAILING ADDRESS LEG/,L DESCRIPTIO 3/ G LOCATION O NO. OF BYOOMS DISTANCE TO: Abso/Pt nQeaC Dwell PE�/ O Y 04615-zs— _2 Manufacturer , Materi s „ No. of co rtments W Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth bD2 le DISTANCE TO: Well Dwelling PERMIT NO. J _ FQ- Manufacturer Material Liquid capacity in gallons O DISTANCE TO: Well Q Foundation Nearest lot Ime PERMIT NO. w= Q 0ZS J W Z No. of lines Length of each ine Totat length o lines Trench d Distance bet n, lines r = W Inches ' ¢ f Top of tile to finish grade Material ben at t the Total effecYv tion area o inches Length W.dth Depth PERMIT NO. W 0 C F_ Type of crib Crib diameter Crib depth Total effective absorption area W 1 to DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. J W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area (s) OTHER PIPE MATE LS VQZ -0 o 3 SOIL T EST RATING INSTALLER . WONc REMARKS Jell APPROVE DATE LEGAL 1 72-013Wv. 7178) 1\ ML_1r-4 I C= I FHL_ I T'T nF Hr-Jll: H ClF't=!t3E DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, AK. 99501 264-4720 CLr�!—�• I TE � El•_IEf= 1JF"r F'F-,iC•E F•ERr�1 x T � u�. PERMIT NO. C 790655 ) APPLICANT ROBERT E CHRISTY 50 TON_IHA CT EAGLE RIVER 694 2:72 LOCATION 603 TONSINA CT LEGAL L3 E2 EAGLE RIVER HEIGHTS SID LOT SIZE 22000 SOURRE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER: OF BEDROOMS = > SOIL RATING (SO FTIBR)= 150 THE REQUIRED SIZE OF THE SOIL AB=ORPTION SYSTEM IS: CEF'TI-I= LEF.I'3TH= 157' r; F= L=1'•. EL L�EF•Tt-1= --1 THE LENGTH DIMENSION I_ 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 (IPJ FEET). THERE I5 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). F E7QLJ I F'E=E> QEF T I C TRr,Jt< = I =E= 1f-IC1►_, 13F=11 L_nr.[ 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. --- TLAID { ;2 ] I I CLr--1_• f 1F E F'EG L_l I --- 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 DISPOSIL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR: 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC: WELL. OTHER: RERUIREMEJTS MAY APPLY. SPECIFICATIONS AND CON_TRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER: INSTALLATION. F•EF:1.1 I T C-EL3Er•1E ER T1s I CERTIFY THAT 1: I AM FAMILIAR WITH THE REOUIREIENTS FOR: ON-SITE SEWER= FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL THE SYSTEM IPJ ACCORDANCE WITH THE CODE:. I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REOUIRE RESIDENCE IS REMODELED TO IPU_ SIDE MORE THAN = BEDROOMS. SIGPJED#,- ------------------------ RCRtJT ROBERT E CHR r ISSUED J----C;RTE_/ - 10 0 --- 1=+ : __+ AND WELLS AS SET ENLARGEMENT IF THE V4. 0 Russell Oyster 694-2774 O & E ENGINEERING & DEVELOI AAENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG Earl Ellis 688-2280 Performedfor. Name: �� V� � �tlCr=�� Tel. No. &'?</-ZIPY7z. Mailing Address: Legal Description: 4Le" 3 Depth (feel) Soil Characteristics 0-- 3 _ 3 SP :$,4ti0 J GPa-(�3 PAkzrc- 4 e er-4 k) 4 �d Iso 5- 6- 7- 8- 9 6 6 g c .� r� srTt d( r •c air 10 11 _ ��sr 12 3 Vat_c+tX i— Cfr'f PLOT PLAN 13 — PERC. TEST 14 15 — 16 _ r Ground Water Encountered: Yes No If yes, what depth i Proposed Installation: Seepage Pit_ rain Field rPCAQOE , Performed by: Date: 4LUj i7 /`>7C% vo �L o 1arist c:a - S(d Amcl rni 2tb W — aall ALLLUC en q ksG 1 - Q.c.t� Lam! dDLt.�L tOtttpme.��1 �� Ar tom/ __ -- — -v4 GAAB,HPI •..-.. GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279.2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM /71LTC� !C/� (.'SE,G�DMAILING ADDRESS r� ��' NAME $o PHONE 34/Z LOCATION LEGAL DESCRIPTION LF 316?4 3 N464 Za:'ct luta. .2 r SEPTIC TANK: NUMBER OF DISTANCE FROM WELL `f' MATERIAL aX4eE%L` AlCeCC COMPARTMENTS t'• LIQUID -7 LIQUID CAPACITY !o cc GALLONS. INSIDE LENGTH S INSIDE WIDTH 7 DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS ! OUTSIDE DIAMETER I OR WIDTH 13 , LENGTH / I , DEPTH b I � LINING MATERIAL (Cnt4ET� rA�L-K . DISTANCE FROM WELL /-7/ , BUILDING FOUNDATION, NEAREST LOT LINE ?S" . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) 200 SO. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL , FOUNDATION , NEAREST LOT LINE , OF LINES , NUMBER OF LINES / _.RTANCE BETWEEN JONES �— TRENrH WIDTH TOTAL EFFECTIVE ABSORPTION AREA SO. FT. LENGTHZFEACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL; /l C/ C DISTANCE FROM WATER TYPE DEPTH ,�ByUILDING FOUNDATION. SAMPLE NEAREST • NEAREST /�7 A SEEPAGE /,;t/.4 OTHER LOT LINE , SEWER LINE , TANK / SYSTEM , CESSPOOL , SOURCES= DATE 'o ^� �/� I z� a !SEWAGE DISPOSAL SYSTEM - APPLICATION E -PERMIT a 69y Name of ,Applicant f��°N 76 IUAJF, Atj) Hailing Address 31 ,Cl- IkxFo Ph s Residence Address Location of Installation x71J7, ce'- Al, A::i 91fyY r SCI...,- -77777 Legal Description Application to Install: Septic tank X , Seepage pita , Drain field.* Other To Serve the Following Facility_ 1~rer runiL, Financed Through To be Installed p,./bey_ Sn I P, Percolation Test ResultPoi I CONd. AQF- �!r'AaticgpAted Date of Completion Q PdT 4� � ►n � N N C:i BELON TO BE PILLED 0 BY HEALTH DEPARTMENT This is to serve as_ Elt, I NVAI�F-M b , permit to install a S r e.u, a ra[. s1'J�tor/1 as described below. Size of unit to be served • optic tank size 1U0D Typeetpm�veep ge Are81j�� 2��° rj e Ce�1ENi �(1L DISTANCES: TD M _11-yllpfu,[ — B Tfi-ux. I 3 vht - rou 14 ov L t AWor I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. 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. N 050-281-70 �� HAA N �� F1 �' �' '-~ 1. GENERAL INFORMATION Complete legal description Lot 3B; Block 3; Eagle River Heights Subdivision Location (site address or directions) 10239 Chain of Rock Eagle River, AK Property owner Tim CASSELL Day phone Mailingaddress C10 Remsx of F.aglp Rivpr 16600 r'Pnt-Prf4lP1A nr_ Eagle River AK 99577 Lending agency Mailing address Day phone Agent Bob Wambolt/Remax of ER Day phone Address _ Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: Individual well xx Community well Public water 694-4200 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 xx NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-MMw.1/01) From MOA821 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 Iurtherverify 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 AIS-^' ..••... « - «•• ----._ Phone 3 3 %— (e 17 9 o:cnTER CONSULTAR. INC. ;. Address Mai ANCHORAGE, Ak 99504 Engineer's signature Date fs 9S Alaska Water & Wastewater Consultants, I= Shall be PAID $ Doo at, or prior to, closing for the ': EfiglMocriny t : r.;.. o Previte; 6. DHHS SIGNATURE _ Approved for '\)E bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: Date 22 9 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 orderto 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. pass(P...IM) 8.k uwm RECEIVE Municipality of Anchorage APR 15 19 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MUN1GPAUTv OF 825 L Street, Room 502 a Anchorage, Alaska 99501 a (90MIQ8417RL Salyer lalytslON Health Authority Approval Checklist Legal Description: _ Ea.c.l a R1vErc. "E100S SIO; Parcel I.D.: OSo - 261 -76 Lar ;6 � BLecK ' 3 A. WELL DATA t Weli type f R1J Arc If A. B, or C, attach ADEC letter. ADEC water system number +► Log present (YO f,o Date completed P41o,t To 117a 1 Itt Q�J w)r. Total depth _IOt HAR. N Cased to Sanitary seal &N) `les FROM WELL LOG 401+ Date of test Static water level Id x Well production g.p.m. WATER SAMPLE RESULTS: Casing height (above ground) IS u4, Wires property protected JDN) yes AT INSPECTION La 4", -74 1 2.5 t Coliform -fT Nitrate /-95 r" Other bacteria Date of sample: 1+ /a 4'1 Collected by: A • w. a.r. c . 4 l B. SEPTIC/HOLDING TANK DATA PdB L 1 L. SEW"' Date installed Tank size Number of Foundation cleanout (Y/N) on (VIN) Date of Pum ' Pumper C. ABSORPTION FIELD DATA Pv fSL t c. S e rlcx< Date Length Effective absorption area Date of adequacy test Soil rating (g.p.dAt° or ft'/bdrm) Gravel thickness below (Y/N) alarm (YM) Total depth Depression over field (Y/N) Fluid depth In absorption field test (in.); Immediately atter Fluid depth (ins) Minutes later. Absorption rate = (past 12 months) (YM) 72-026 (Rev. 3198)• For bedrooms If yes, give date water added (in.): D. LIFT STATION Date installed High water alarm (Y/N) Size In Ell at* "Pump otr level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT, TO: Septic/holding tank on lot Pot 4e— Seo te— On adjacent kits I Oo I t Absorption field on lot - Qut41c- saW On adjacent lots 10011 Public 0011- Public sewer main 19 1 f' Public sewer manhole/cleanout too + Sewer /septic service line u 1+ Litt station loelf SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Qogt,t L S ewEft- Foundation Property line Water main/service li u acs water/drainagen adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: QJ g u c - S t Prone lira Building foundation ater main/service line Surface water F. ENGINEER'S CER1 I ceMty that I ve in confo Signature Engineer's N Date 4� Driveway, parkin e Wells on adjacent kNs specllons and review of Munidpal in effect on this dale. HAA Fee $ 3 *�-o ' Ub Waiver Fee S Date of Payment / 5 7(c l Date of Payment Receipt Number 790 1 / Receipt Number 72-026 (Rev. 3/98)' APR -14-99 17:26 FRW-CTE ENVIRONKNTA: 1615331 AL. ME Environmental Services In:. CT&E 1W.r 991490001 Cuero Name AK We= & Wastewater Consultants Inc. ProloctXame/M lot 3B Block 3 ER Flu Client Sample FD tat 3B Block 3 ER Hu Matrix Drinking Watcr Ordered By rwsw o T-015 P.02/03 F-746 Ment POI FrintedDate/ITme 04;1419913:15 Collected Datc/Pime 04;08199 14.06 Rovelved Date/time 04109!99 11:05 Technical Director: Stephen C. Ede Released By Allovatte Prep Anatysls /artneter Results ML Unita Neraotl OOTS tau gate Init Tout to:lfora 0 tot/1004 fM13 92228 04/09199 KAP sltrterM 1.85 0.500 e5/L CPA 300.0 10 saw 04/09/99 04/09/99 M RECEIVED APR 15 1999 Municipally u1 N.wnJ, nvu Dept Health & Human Servicos APR -14-90 17:16 FRW-M ENVIRONKNTAL :615301 T-015 P.03/03 F -T46 • ,/1�� ME Environmental Services Inc. i Laboratory Division 200 W Porter Drive Drinking i P Nater Analysis Report for Total Coliform Bacteria Anchorepe. AK 99518.1605 READ I.VSTRL'CTID,VSO.VREVERSE SIDE 6EFOR£COLLECTLYGS4bIPL£ Tei. [907) 562.2343Fa4 19771SGt-530t —"(IST BE COMPLE: ED BY WATER SUPPLIER TO BE COMPLETED 6Y LADORATORY O PLBLICWATERSYSTEM I.D.r t0 PRIVATE WAURSYSTEM Sao Resaat C Send lew.sV M.Y u -Mm r r. Rl SAMPLE DATE: ® En E— MonthD_ Year SAMPLE TYP& iK Routine t0 Treated Water C Repeat Sample (for routine sample n Uotrrsttd Water Nlth lab ret. no. ) a Special Purpose Time Collected SAMPLE LOCATION Collected By LolA3g Bt's 3 ESP ge egi1&—? z -F" ✓) Mas Ree ainalysts shows this W a:cr SAMPLE w be UnsaUsfacto-y Sample over 30 hours cid, resAw may be untehable 0 Sx.np!e too long in transit, sample should not be over 48 bours old at exem:aan:m to Indicate reliable results. Please send new sample via speeta del very mall Data Received Time Received (�OS Analysts Began Analytical Mribod: Membrane riper a MNIO-MUG • :�utrherafeoiontev'COmI. Result, Aaalysi 991490 -F FbUa Jun ❑ Fa.<e Dale Time. Client notified of absawfartor) results: ❑ ❑ Pboad spoke r,m Fixta Dam Tan - BACTERIOLOGICAL WATER ANALYSIS RECORD m MMO-'MUC Re.ald Tout Conform E. cou Q ,Membrane Filter. Direct Count � Coiooir✓l0o ml L`LJ m 0 y Vertflcahon: LTB _ 3G8 COLIFIRM rree�.,..,,Q...rsir�, ALJrA<,IMM1e ., FeeaIColllbrmCuntirtnadoa ._ a7 Final Mmr1 Membrane Filter Ftrtulrs _ Collfor00 ml W a m -C !Y R am Reported By � Date Z1110T, me _ J YOU segs e 2 Commend: S `G Memoer9ftra509GrouolSoe416GanaraioeNSurvenunat _ ENVIRONMENTAL FAC UTSS IN ALASKA. CAL.PORNuk FLORDA tWNO a MARTI.."O. M,ChIGAN. KISDURL NEw JASEr. ON,O. VAST WRGINA MUNICIPALITY ANCHORAGE • �' DEPARTMENT OF HEALTT H &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. # HAA # GENERAL INFORMATION Complete legal description Lot 38; Block 3; Eagle River Heights Location (site address or directions) 10239 Chain of Rock Eagle River, AK Property owner Jerry & Betty Stanley Day phone 696-7744 ;Mailing address 10239 Chain of Rock St. Eagle River, AK 99577, Z Lending agency Day phone Wailing*address Agent= Kathi Geraci/ Greatland Realty Day phone 694-9125 Addres§* Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 5 y 3. TYPE OF WATER SUPPLY: Individual well XXX 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 XXX NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. narsm«.�Ai� Fm t uoAm 5. STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, l 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. S 8 S ENGINEERING Name of Firm o.Phone `► y — �9 `1 Address Eagle River, Alaska 99577 Engineer's signature 6. DHHS SIGNATURE .� Approved for Disapproved. a S bedrooms. Conditional approval for Additional Comments Date -/a' /9 7 JW bedrooms, with the following stipulations: Date 17di 9 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 purchasersof 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-M MW. iml 6a MOA m 7IS N,oh!CIPALITY OF ANCMORAGE ^.Nv iKUNMENTALSERVICE$gM3jgN Municipality of Anchorage JUL 02 19" DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division REr . VEDA 825 L Street, Room 502 a Anchorage, Alaska 99501 • (907) 343-'lyd Health Authority Approval Checklist Legal Description: L&T 3 S y 9 LOLtG 3 k Rive Ik kParcel I.D.: 0 S- O – S-) – 7 O A. WELL DATA awn! Well type � iv1 a' p } A, B, or G, attach ADEC letter. ADEC water system number Log present 0& L Date completed UK Total depth foal Cased to ft r + Casing height (above ground) 1 � � + Sanitary seal(DN) NES Wires property protected 4t!N) l i ES FROM WELL LOG AT INSPECTION Date of test — I30197 Static water level 8 (' Well production — g.p.m. 3•Z g.p.m. WATER SAMPLE RESULTS: Coliform O Nitrate I • S 1 Other bacteria Date of sample: 6 13 c / q 7 Collected by: 13. SEPTICNOLDINO TANK DATAQQ J r�-(G`or— Date Installed Tank size Number of mpanmenffi Cleanouffi (YM) dation cleanout (YM) Depression (YM) High water alarm (YM) �.. Date of ing C. ABSORPTION DATA Dato4nstalled Length Width Effective absorption area Date of adequacy test Pumper Soil rating (g.p.dJW or tt°/bdrm) '�_ Gravel thickness below pipe System type Total depth (Y/N)_ Depression over field (Y/N) Results (Pass/Fail)� For bedrooms Fluid depth In absorption field before test (in.); Immediately atter��, Fluid depth (ins) Minutes later: Absorption rate = - Permdde treatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3196)' water added (in.): D., LIFT STATION �V L4 L U1 U -- Date i�1aN� Manhoie/Aocess (Y/N) High water alarm level ar _ Cycles tested E. SEPARATION DISTANCES Size In gallons "Pump on" level at* "Pump off" level at' SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot WIn On adjacent lots 141A Absorption field on lot 91A On adjacent lots alai Public sewer main }5� t Public sewer manhole/cleanout )()O'++ Sewer /septic service line % J } Lift station' +, ) PARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: L-) S� - I C� Foundation Property line Absorption field P�-1 Water main/service line _Surface wateddrainage Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTIONFtE6D-ON LOTTO: Property line Surface water Curtain drain F. ENGINEER'S CERTIFICATION Building foundation Driveway, parking/vehicle storage area Wells on adjacent lots I certlly that I have detemdned thru field inspect/ons and review of Municipal in conformance with MOA HAA guidd Ines in effect on this date. Signature /a + ✓'�-- Engineer's Name R J,3,*A T C. Co wq ✓ Date -7/;k, / G 7 HAA Fee $�! 0-0 ' Date of Payment Receipt Number 72-026 (Rev. 3/98)' Waiver Fee S Date of Payment. Receipt Number • line ?�* a COWAa CE -8801 are JLL-08-1997, 13:49 CT8E ESI ANCHORAGE 9MG15391 P.04/05 CT&E Environmental -Services Inc. j.. Laboratory Division ri��✓iiiiririiiiiirr iiiii rrii��.rriiiii�iiiiiii Drinking Water Analysis Report for Total Coliform Bacteria 200 W. Potter t r Drive 99518-1605 READ /NSTRUC7I0I:SONREVERSESIDE SEFORECOLLECTINGSAdfPLE Tel: (907) 562-2343 FaL(907)561.5301 MUST BE COMPLETED BY WATER SUPPLIER O PUBLIC WATER SYSTEM I.D.0 i�, PRIVATE NATER SYSTEM Sen ai(Jq [[[ ��r O Send /wvotn �ir•Y�.\ �+T � j s lD1Y' /�IL, M i W / k. 0 Srad Results O Send lnvirke q Y.f V Y SAMPLE DATE: Month SAMPLE TYPE: A Routine 0 Repeat Sample (for routine sample with lab ref. no. ) O Special Purpose SAMPLE LOCATION L36133 E,�e Fro -1 B Day Y ar O Treated Nater O Untreated Water Time Collected Collected By Ct• . J nf,\f TO BE COMPLETED BY LABORATORY Aylysis shows this Water SAMPLE to be: Satisfactory r O Unsatisfactory 0 Sample over 30 hours old, results may be unreliable Sample too long in transit: sample should not be over 48 hours old at examination '1 Z to indicate reliable results. Please send new sample via special delivery mail. Date Received 7 2" Time Receivcd Analysis Began Anaiytical Method: Membrane Filter O NIMO-MUG Number of eoloniesl100 ml. Lab Per. No. Result* Analyst 7 4F0111 M 9735234 O° &1/0 "!r Scene n.\/.c.+.. - Anch Fbk+ J.. ❑ Fried Date: rime: Client notified or unsatisfactory results: ❑ ❑ Phoned Spokewiih Faced Date: Time: BACTERIOLOGICAL WATER ANALYSIS RECORD NINIO-hrUG Result: -Total Coliform ' ' {/ E. Coli h=lembrane Filter: Direct Count ng a C"61r Colonlceloo m1 Verification: LTB BCS �f COLIFIRJI rvrc'-► w..,,..Yrr.r.../ Fees] Colirorm Confirmation Ulf ire+e trYf..tY Finsiblembrang Filter RS{J1uult_ssr/ ,_ q 1lJ Colirorm/100 ml RcporteJ By `J�� "GJ 7 Time —�n� hrs Comments: _ lYl Member of the SCS GtouD lSocidtd Glndrole de Surveillaneot ENWIOHMENTAL FACILITIES IN ALASKA, CALIfORNW FLORIDA. ILLINOIS MARYLAND. MICHIGAN. MISSOURI. NEW JERSEY. OHIO. WEST VIRGINIA .JUI_-08-1997. 13:40 ME ESI ANCHORAGE ��'ME Environmental Services Inc. LLL��A��e ws�.e.r CT&E Ref.# Client Name Project Namd# Client Sample W Matrix Ordered By PWSW 973523001 S & S Engineering N/A OB B3 Eagle River His Drinking Water A 9075615301 P.02i05 Client POA Printed Date/Time 07/08197 12:58 Collected Date/Time 06/30/97 18:30 Received DateMime 07/02/9710:35 Technical Director: Stephen C. Ede Released By Allowable Prep Analysis Parameter Results POL Units Method limits Date Date Init Nitrate -pi 1.52 D.100 "/L SM18 4500-M03F 10 lax 01/03/97 JBL Total Coliform 1 ce Y/0 COLI Sal$ 922ZB 07/01/97 TRW MUNICIPALITY OF ANCHORAGE • ~� DEPARTMENT OF HEALTH 3 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. # FISn - .SRI - "IC) 1. GENERAL INFORMATION HAA # V� Cy1-S Complete legal description fe' oL.oc,� Location (site address or directions) f2,ape Property owner Day phone Mailing address Lending agency Mailing address Day phone Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. n O 2. NUMBER OF BEDROOMS:C. b 3. TYPE OF WATER SUPPLY: e Individual well Community well Public water NOTE: It 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 r. NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-M JR". 1N1) front MOA 421 S. 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 (hat 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. Nameof Firm fir•'<c.�s i. c�Eti: �_FY Phone Address Engineer's signature 6. DHHS SIGNATURE —(,d Approved for 5 bedrooms. 0 0 _ Date 97 -%N'*Wk\ _� I's. OF, A4.1111 f CE 9176 Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments azuEo t:lPU&IC 'E'ER 1IITIC 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. 72WSM..L91) ewk M011R1 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 0 m P1 —' 7 rn Health Authority Approval Checklisto' C G rn Legal Description: L SG 0e.3 E.oscr .;,dae //max, Parcel I.D.: r .. 1 o A. WELL DATA Well type fSe 41,4rO If A. B. or C. attach ADF..0 letter. ADEC water system number Log present (YIN) .✓ Total depth / 49.0 _ Date completed Cased to "/0 ' F-1 Casing height (above ground) / G ,.J . Sanitary seal (Y/N) Y Wires prosy protected (YM) — FROM WELL LOG AT INSPECTION Date of test A)' -tier Ot r, , i 9t s Static water level Well production WATER SAMPLE RESULTS: g.p.m. Coliform _ 14" Nitrate /• z 72 . /,r/. 9— p.m- Other bacteria 14" Date of sample: c4e r /:ii / 4 96 Collected by: X�C.Vo 'r% ..lco%J W/ B. 1C/HOLDING TANK DATA Date i Tank sue Number of Compartments Cleatwuts FoundatZ cleanou Depression (Y" High water alarm ( _ Date of ping Pumper C. ABSORPTION FIELD DATA Date installed Length Width Effective absorption area Soil rating (g/ft` or_0611rm) System qpe pipe Total depth Tube presenr(Y/N)� Depression over field (Y" Daze of adequacy test Results (Pass/Fad) Fluid depth in abso n field before test (m.); Immediately after_ gal. Fluid dceovt (ins.) Minutes later: Absorption rate - treatment (past 12 months) (YM) I If yes, give date (in.): FT STATION Date itutalled Size in gal Manhole/Access (Y/N) High water alarm E. SEPARATION DISTANCES *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 't% at* "Pump off' level at* On adjacent lots A11,4 Absorption field on lot b n adacent lots Public sewer main /f5f1- Public sewermanholdcleanoW Sewer /septic service line XSW. Lift station Building TION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Property line Absorption Water maidservice line 3 e water/drainage ^ jYetl on adjacent lots SEPARATION DISTANCE FROM ABSORPTION ON LOT TO: Building foundation Water main/service Surface water Driveway. parking/vehicle storage area C n drain Wells on adjacent lots Property line F. ENGINEER'S CERTIFICATION / certify that/ have determined thru field lnspecdonc and review of Municipal�`+r`p''/hat the b in conformance with MO.4 HAA guidelines in effect on this date.() TH Y`1 Signaturerr % /. y�'' Engincer'S Name Dated 2�t �4g� /rt�►:�o ES 170 HAA Fee S Dace of Payment lJ tf�jzlp(0/ sic Receipt Numbs Rev. 8/95 OSS: haa.wk.doc Waiver Fee S Date of Payment Receipt Number are RECEIVED. { . QC -r 2 51995 Municipality of Anchorage " opt. Health & Human Services . •. +--'-ref-r---Z•rr--r MUNICIPALITY OF ANCHORAGE •--. 'SEWER 87,0M CONNECT PERMIT-,"'�? • DATE OF APPLICATION SCHEDULED COMPLETION DATE WATER 6 WASTEWATER UTILITY; SINGLE FAMILY ❑ MULTI -DWELLING, 3000 ARCTIC BOULEVARD - - WELLING -. PHONE 786-5557 .. _ ..' " - _ No. APTS LOTRRAcT �T B BLOCK O COMMERCIAL susolVISION /2K/qS TAX CODE' 01'0 •�%'I' 03 GRID •Z 7S' / AS -BUILT No. STREETADDRESS./a/ o /t�lri�C S. _ • ., OWNERI%.iy.�C/. PHON MAIL'ADDRESS XON PROPERTY ONLY ❑ Main extension agreement ❑ MAIN TAP=TO PROPERTY LINE ONLY ❑ Improvement District - . (MOA or State ROW Permit Required) ❑ Extend Connect agreement -....❑ MAIN TAP E ON PROPERTY CONNECT ❑ Pending MOA or State ROW Permit Required) - ❑ R -O -W NO. - PERMIT ISSUED BY: CONNECTION SIZE CHARGE $ J7jAK� INSPECTION FEE $ 149, ✓ M PAID . ❑ CASH --PERMIT - _: _ "_ _FEE _ _ $ r IN E ED BY NUMBSCKN'S'��f y REIMBURSIBLE `�' NUMBER DEPOSIT j -- --TOTAL'--$'�5---__I DATE:'%--/ %-�,i- H[MAHRS: PHONE N RSE S,OE OF HISP ANDAGREE i" .. PERM 51GNAIDRE � � _ " I 'PUST• IN'A-CONSPICUOUS:P"L•ACE'AT THE JOB $ITE eum, m« ,,,ee, : � ;AWIMU WSPECTOH • I< 9 .w H Z z t L O O Z Z liJOd3H N01103dSNI H3M3S z, REPORT of ANALYSIS CT&E Ref.* :95.4538-1 Client Sample ID :L3B BLK3 EAGLE RIVER HTS Matrix :WATER Client Name :DOUGLAS KENL.EY,P.E. Ordered By Project Name Project* PWSID :UA Sample Remarks: SAMPLE COLLECTED BY: FRED KENLEY. Parameter Nitrate -N WORK Order Printed Date Collected Date Received Date Technical Director Released By :18844 :10/16/95 @ 09:22 hrs. :10/11/95 @ 15:30 hrs. :10/12/95 @ 11:30 hrs. QC Allowable Ext. Anal Results Qual Units Method Limits Date Date Init 1.2 mg/L EPA 353.2 10. 10/13 CMR * See Special Instructions Above UA = Unavailable ** See Sample Remarks Above NA = Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT = Less Than D = Secondary dilution. GT = Greater Than A&L CME Environmental Services Inc. Laboratory Division>01/d/d/S/O/OO//s/j0/ddi�sdyyd///////d///s'di Drinking l ater analysis Report for Total Coliform Bacteria :0' f' Pc W D::ve RL -LD L\STRL'CTIO.NSO.VREVERSES,DEEEFORECOLLcCTI.�'GS.L11PLc' Anchcra;.AK9?51S•1505 Te.: (=07) Sa-.23=3 ;:ax: (:07} 551.5301 .: 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 Parcell.D.# n6l)-Q9,L')(-) HAA# iAPIS tn2L2A 1. GENERAL INFORMATION Complete legal description Lot 313• Btock 3: Eagte R.CveA Heiaht6 Subdivi.6i n Location (site address or directions) 10239 Chain of Rock S.tAeet Property owner ffoaarP 9 Edna Buem _ Day phone 694-4966 Lending agency Day phone Mailing address Agent lark GniAF.c,th SELLERS REALTY Day phone 278-1000 Address 907 FRA? Nnx?henn liyhtA RYud #119 A hn 4P. Ah. 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 5 Xx 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 XX NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rw. 7191) Front MO. 121 I t.ron m.a a611'" lzutL •Njom s�aau!6ua leuo!ssa;ad eyj ui suo!ss!wo jo siona jo; elq!suodsaj jou s! a6ejoyouy;o Ajped!o!unpy ey1 panssf si ejeo.1piao a ejolaq elep Wpm jo suo!loodsui lonpuoo jou op SHHO to saaAoldw3 •sluawai!nbai ale;s pue lejapaj u!euao A;s!les of iapio u! suo!lnj!;su! 6u!pual rayl pue sawoy jo siaseyomd of Asalinoo use s!yj scop SHHO ay1 •eNsely;o ajejS ayj u! paials!6ai jaau!6ua leuo!ssa;ad juepuadopu! ue Aq anoge 9 ydwBeied ul u9A!6 suo!jejuasaidai ayl uodn Aluo paseq sajeolplia3 lenaddy /ll!joylny ylleaH sanss! (SHH(3) sao!AiaS uewnH pue ylleaH to juawvedap 96ejoyouV;o Al!led!o!unVj e41 :suo!lelnd!js 6ulmollo; eyj yl!m 'swoojpaq S�3d6""! a -L;71 'oN •pl'4s Y Wq ales sluowwo0 Ieuoll!ppy Jo; lenoidde Ieuo!3!puo0. •panoiddes!Q •swoapaq Jo; panaddV LLS66 a jSLj ''GAM ej8e3 :A8 3Fuf11VNJIS SHHO '9 einjeu6!s siaau!6u3 ssajppV auoyd wJ!d;oaweN •uo!joodsui S1141 10 elep ayj uo loope ut suo!jeln6ai pue 'saoueu!p/o 'sapoo ejejS pue Iedlolunj/y ile yllm aouelldwoo ui sl walsAs IEsodslp Jajemalsem 10/pue Alddns Jajam ej!s-uo ayj'uo!joadsu! pue uo!1e6!lSanu! Aw woj; pue sap; o6ejoyouV;o Aj!led!o!unyy eyl wojl pou!elgo uollewiolui eyj uo paseq jeyl AjuaAjay>Jn; I •u!aaay paleo!pui ainjonils;o adAl pue swooipaq;o jagwnu ayl jol elenbape pue Ieuo!joun;'a;es s! wajsAs Iesods!p aalemalsem Jo/pue Alddns aalem ells-uo ayl jeyj smogs uo!jeo!ldde IenaddV AjuoyinV ylleaH SNI 10 uo!jE61isanu! Aw jeyj AluaA I 'molaq umoys alae uo!jep!leA eyj;o se pue oja/ay pax!;;e Zeas Aw Aq pa!l!lyao sy F133NION3 AS N01103dSNl d0 LN3W31VIS 'S Municipality of Anchorage Department of Health S Human Services Rt tWEN:ALs.., HEALTH AUTHORITY APPROVAL CHECKLIST '''N 18 1991 Legal Description: l_an' $5 gL_K-3 5�6,46,LF Qw"rcel I.D.iC / A. WELL DATA �� y D Well type pa-(VLvrI�- If A. B, or C, attach ADEC letter. ADEC water system number �b Log present (Y® N Date completed uK DrilleryK Total depth 1D2.1 Cased to 4D r~ Casing height Z �+ Sanitary seal ON) Date of test Static water level Well flow Pump level Wires properly protectedOYN) V FROM WELL LOG g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot a�_ Absorption field on lot 41.4- r AT INSPECTION 3.0 g.p.m. . ; On adjacent lots On adjacent lots ( Public sewer main S Public sewer manhole/cleanout l oo % - Public sewer service line 2•5 Petroleum tank J� WATER SAMPLE RESULTS: Coliform O /°°mNitrate d•`� � Other bacteria -- /,%ai✓E Date of sample: 4-/1-9/ Collected by: S t .5 B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) High water alarm (Y/N) Date of pumping Tank size Foundation cleanout (Y/N) Compartments Depression (Y/N) Alarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well (a) on lot On adjacent lots Foundation To property line -Absorption field Surface water/drainage p�¢�I� -02° (Rev.9/9 � f,ont MOA21 Water main/service line CONTINUED ON BACK PAGE C. LIFT STATION Date Installed Manufacturer Size in gallons Manhole/Access (Y/N) 1; .Vent (Y/N) "Pump on" levet at"Pump off' level at High water alarm level Cycles tested Meets MOA electrical c (Y/N) SEPA N DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date Installed Soil rating System type Length Width Gravel thickness Total depth Total absorption area Cleanouts present (Y/N) Depression over field (Y/N)Date of ade y test Results (pass/fail) f bedrooms Peroxide treatment (Past 12 months' (Y/N) If yes, give date SEPARATION DISTANCE FROM AS PTION FIELD TO: Well on lot On adjacent lots Property line To building foundati To existing or abandoned system on lot Onadjacent I Cutbank Water main/service line Surfa ater Driveway, parking/vehicle storage area Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checke , verif d, or conformed to all MOA and HAA guidelines In effect on the date of this Inspection. Signature%�y 0` Jht Engineer's me;'SENGINFERING Po•..:. ....•i. 1734 Eagle River Loop RoadNo..204 �.. ... ............r:. Date A.1.4st— 92977 0 A ....R. sh.f" w �, t7 ( 0 L / I s�•� No. 1437-E �-,• HAA Fee $ ,-1 Q Date of Payment —(40 l 8 Receipt Number ZZQ2�}�70- 72-M (Aw.'yp1) Reck MOA 21 Waiver Fee: $ — Date of Payment Receipt Number C /Y&7o se- "no `F.Ze,767 ASBUILT-NO CORNERS SET THIS DATE. SEWARD S ASSOCIATES LAND SURVEYING 688-4566 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE' FOLLOWING DESCRIBED PROPERTY: Lot 3B, 1" = 40' A�q Block 3 Ea le'RiVer'Heights'Subdivision DATE: AND THAT N�ENCROACHMENTS EXIST EXCEPT AS 6/10/91 1''�`P' •• '&'! INDICATED. IT IS THE RESPONSIBILITY OF THE ::qg .M v••• ;1'; OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: ••� EASEMENTS, COVENANTS, OR RESTRICTIONS NW53 i WHICH DO NOT APPEAR ON THE RECORDED SUBDI- 0. Dua,. Mark $�w� d •• j VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: IAr ANY DATA HEREON BE USED FOR CONSTRUCTION 21-35 • '••- is-6918AV EO OF FENCE LINES, OR FOR ESTABLISHING BOUND- 4� ARY LINES. DRAWN' �a�''�0'�V.• DMS CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE. ALASKA 99518 TELEPHONE (907) 562.2343 FAX: (907) 561-5301 ANALYSIS REPORT BY SAMPLE for 1NIRIordarl $5172 Data Report Printed: JDN 15 91 1 12:49 Client Sample IDA31 13 EAGLE RIPER HIS. Client Nana :3 G S ENGINEERING PNSID :UA Client Acct :313INGP Collected JUN 11 91 1 18:30 his. BPO I PO 1 NONE RECEIVED Received JUN 12 91 4 14:30 bra. Req I Preserved vith :13 REQUIRED Ordered By :R. BRAISE, Analysis Completed :JUN 14 91 Sara Reports to: Laboratory Super isor STEPHEN C. IDE 1)S G S ENGINEERING Released By : �G � 2) .................................................................................................................................... Chemlab Ref 1: 912678 Lab Smpl ID: S Matti:: MATIR Parameter Tested NITRATE -N Sample ROUTINE SAMPLE COLLECTED BY: RAY Remarks: lllovable Result Units Method Limits --------------------------------------------------- 0.94 mg/1 EPA 353.2 10 .............................................................................................................. I Tests Performed See Special Instructions lbove UA -Unavailable ND- None Detected " See Sample Remarks Above NA. Not Analyzed LT -Lass Than. CT -Greater Than '3%e' r=S Member of the SGS Group (Socl6t4 GdnArale de Surveillance) ,y/./. l•�L f\��.1 Z,. A._. `aw�.:i�:� `r•.. .. •: �'v�_. .r;'• .._.v t :dl' SIILL 1fa51oX.4OM tol IJq),A2 It TAMA 2IZTJANA 9:11 1 1? 21 MPC :belnix4 3fog9P e1e0 ONL413N:0N3 2 8 2: emeN 1[10110 .27:I 13VIA 31JA3 Cl AEJ:CI elgre? tiet10 42N1?M?: fooA fried) AT CIT.:Ii MIMI SIM 1 04 1 oil .81d OE:81 ! 1? !I M0: bo1391100 1 Peg en! OE:l1 1 le 11 MUC bov1e3e1 HIM .A: 48 benbfo OIAIUgH 2A: dtty bevneel4 :01 e110ge.4 hate le P1 MUC: be2elgro3 efe4lenA 0NIA13NION3 2 H 2(1 EA .0 X11.41'2: lamitloqu2 41o1e1odel r ARAM :a11eK 2 :OI lgr2 deJ OTHS1? :1 lea delxb.l eldevollA e1L113 6041eM 11mu tlue9A belecT lefeeele9 --------------------------------------------------------------------------------------------------------------- 01 S.C2C III 11pr. F?.0 M-ITAATIX 119 :f1 o1I-J3JJO0 SMA! 3NITU03 elgn6;: :1A:ereA ........................................................................................................ *Idolteve.:U-AJ evodA enoll%niml !et»q2 toe brnloi:e4 efeoT 1 evodA the ia.4 elgre2 toe " beloeleU 0a0m -OP. na.IT ialaax0-T: ,nse.T 11al-T1 be:4lenA fo% .A'; CHEMICAL & GEOLOGICAL LABORATORIES OFALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street0. r _ �, ♦ ..- Anchorage, Alaska 99518 J'ater Analysis Report for.Total Coliform Bacteria ;_- e,... TO BE COMPLETED BY WATER SUPPLIER, TO BE COMPLETED BY LABORATORY O PUBLIC WATER SYSTEM LD.N Ana 19 shows this Water SAMPLE to be: @� PRIVATE WATER SYSTEM _ q / f -2.9 7, Satisfactory + ❑ Unsatisfactory Name Phone No. S 3 5 ENGINEERING ❑ Sample too long in transit; sample should Mailing add: No.rw not be over 30 hours old at examination Eagle River, Alaska 99577. to Indicate reliable results. Please send + new sample via special delivery mail. City---- i state zip Code Date Received 6 SAMPLE DATE: CO � f Mo. Day Year Time Received �� SAMPLE TYPE: e?§' Routine ❑ Check Sample (for routine sample with lab ref. no. �► ❑ Treated Water ❑ Special Purpose ❑ Untreated Water SAMPLE -, • ... .. - Time Collected ... NO. - LOCATION Collected By Ili- �g �ir.3 I 11,31)p� 2 L �a�� i? ��r �T I 31 1 41 I L Analytical Method: Membrane Filter No. of colonies/100 ml. Lab Ref. No. Result* Analyst U m BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS Membrane Filter. Direct Count D Colifovnnoo mt BEFORE Verification: LTB -BGB D COLLECTING SAMPLE Final Membrane Filter Results Collforrnno0 ml Reported By - - •♦ Date 4 -/?4/ Time: Hoe) a.m. p.m. TNTC = Too Numerous To Count OB = Other Bacteria PART ONE OF TWO REMAINDER TO FOLLOW REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER. FACILITIES (Fill out in Triplicate) ,., 'tame .of person requesting approval !/�S ��2. �,Wame of property.. owner, " a torr Legal description 4, Number.of..bedrooms in house. S. Uater.Analysis: a. Bacterial �j O b. Detergent 6, We11 data: 17 a. Type b. Depth. C. Casing Size�� d. Distance from well to closest existing or proposed: 1. Sewer line 2. Septic tank, 3. Seepage Area / 4. Cesspool* S. Property Line ZO / 6. Other sources of possible contamination, i.e., creeks, lakes, houses, barn, drainage ditch, etc. 7. Sewage disposal system, a. Age of system. b. Septic tank capacity in gallons c. Name of septic tank manufactuupr 1. If "home made" show diagram on reverse side of this form. d: Disposal f ield or seepape pit size and type 13 x / /' �AL ' 1. Distance to property line fs / to house fomdation n a. Pereolati= Test `results , f. Percolation Test performed by Use the reverse.side of this form to show diagram. Diagram should include hs following information: ppoperty lines; -well location, house location, .~ septic tank location disposal area location location of po , percolation test, and direction of Fround slope. 9. The �hrformatica on this form Is true and correct to the best of my knowledge. \Sirnature of Applicant Date S Fns TO BE FELLED OUT BY HEALTH DEPARTKENT PERSONNEL the above described sanitary facilities are hereby approved, subject to the ..161lowinp conditions: Conditions 12 The above described sanitary facilities are disapproved for the following reasons: STATE OF ALASKA ACHw. u8.4w De ARTMENT OF HEALTH AND WEL^RE DIVISION OF PUBLIC HEALTH BACTERIOLOGICAL WATER ANALYSIS DATE - �— Lab. No. Records in this office indimle this WATER SUPPLY 1. be of: Saii limlory Q 0 ... Gam e Q U.,wiJoctory Sanitary Status. Analysis shows this Water SAMPLE fes be: Satisfactory Q Guetthonable Q Unsatisfactory. 8 an '•Unsohsfmfory'• a, "O.eston.M." status is indicated above you slrouW take immediate action as recommended below. —1. Notify consumers water is pollufed. Rail or dvemimlly heat this water at outlined in the enelosed IeaRet '*Drink IT Pure" '/ " !'r' 10cc IN( SAMPLE COLLECTED BY J ^ --' - _y, In„ease chlorination sufficiently to meet re<ome ended residual standards. PUBLIC SEMI-PUBLIC ❑ INDIVIDUAL [ OTHER Samek Co11«I•d From - U GLbee Top ❑ 8.01 Top' ❑ B... -.m Toe REPORT t?ESV LTS TO functioning properly. COMPLETE THIS SECTION UNLESS OT14ERWISE INSTRUCTED —4. If alter shocking equipment a disinfecting residual is not obtained, please wi,o this *Hier lar emergency ...;stance or advisory services. NAME —S. This is o seei water source and suhisia to pollution by man and animak. SOURCE: C Spring C C.ee,n - C Other� ' An approved water supply source should be developed. Dug Well or Cistorn ComtrucHo.: Q Wood Q Ceecr.I. Q Meal Q Id. Q C eV.I. Improve your -. Q spring Q dog well ❑ driven well Wolk . Top - Q Woad Q Cevres. Q Mewl"Q Dye- Top ll Q Q drilled wecistern. LOCATION: Q In Basement Q Batsmen, other Q Under Home 7. Relocate you, well to o sale location in relalic..Np to your F..age Q In Yard Q Oliver disposal system. ❑ see eaclosun DISTANCE 10: w 3V,S-=v P. F..I. tcnku Feet. 9. w 8. Sample foo long in transit: sample should not be over 48 hours old at T.I. S•.page C..s. F.et. Feel. Pool Leet. hivy Feet _ w irerion Is indkob retable rosette, please sand naw sample. Fuld Pit n C.bl. Q Belt& &o6n in Transit. please send now sample. Swiminarion CITY /• I,��/_C- ii '/�'C: .�"� / /� levet Mab,;ol ^Iva msislence. GENERAL: Does Water Become Muddy o, Discolored' Q Yat Q No SANITARIAN'S REMARKS AD'URFSS / Dioni.1 Well D.pth — F..” OF SOURCE Well caning DiryDepth t.Marmot d roW.I. Depth pe Tram Banom Feet. DropGFrom DropD Lab. No. Records in this office indimle this WATER SUPPLY 1. be of: Saii limlory Q 0 ... Gam e Q U.,wiJoctory Sanitary Status. Analysis shows this Water SAMPLE fes be: Satisfactory Q Guetthonable Q Unsatisfactory. 8 an '•Unsohsfmfory'• a, "O.eston.M." status is indicated above you slrouW take immediate action as recommended below. —1. Notify consumers water is pollufed. Rail or dvemimlly heat this water at outlined in the enelosed IeaRet '*Drink IT Pure" '/ " !'r' 10cc IN( SAMPLE COLLECTED BY J ^ --' - _y, In„ease chlorination sufficiently to meet re<ome ended residual standards. / '/ �' - / < �'�' Determine source d contamination and lobe action necessary to maintain 11 (pen DATE COLLECTED ' � ' TIME COLLECTED o wM wales of all limes. uP{h1Y Samek Co11«I•d From - U GLbee Top ❑ 8.01 Top' ❑ B... -.m Toe s. Check chlorin.6m, and elk., me,honiml equipment. Make certain it is Q 0*., 1601 < functioning properly. COMPLETE THIS SECTION UNLESS OT14ERWISE INSTRUCTED —4. If alter shocking equipment a disinfecting residual is not obtained, please wi,o this *Hier lar emergency ...;stance or advisory services. Well . L) D., Q Driven 13 Drilled Q swi d —S. This is o seei water source and suhisia to pollution by man and animak. SOURCE: C Spring C C.ee,n - C Other� ' An approved water supply source should be developed. Dug Well or Cistorn ComtrucHo.: Q Wood Q Ceecr.I. Q Meal Q Id. Q C eV.I. Improve your -. Q spring Q dog well ❑ driven well Wolk . Top - Q Woad Q Cevres. Q Mewl"Q Dye- Top ll Q Q drilled wecistern. LOCATION: Q In Basement Q Batsmen, other Q Under Home 7. Relocate you, well to o sale location in relalic..Np to your F..age Q In Yard Q Oliver disposal system. ❑ see eaclosun DISTANCE 10: w 3V,S-=v P. F..I. tcnku Feet. 9. w 8. Sample foo long in transit: sample should not be over 48 hours old at T.I. S•.page C..s. F.et. Feel. Pool Leet. hivy Feet _ w irerion Is indkob retable rosette, please sand naw sample. Fuld Pit n C.bl. Q Belt& &o6n in Transit. please send now sample. Swiminarion MAIFRIAI: Building Sewer - ❑ lou❑Wed ❑ Tn. Q Fibre Q -Aliev.� 9. Contact you, nearest C Local Health Dspanmmt or Q AI.A. LI Masi Division d Public Health, sanitation dace for bulletim, <omalMion and levet Mab,;ol ^Iva msislence. GENERAL: Does Water Become Muddy o, Discolored' Q Yat Q No SANITARIAN'S REMARKS When? Dioni.1 Well D.pth — F..” Well caning DiryDepth t.Marmot d roW.I. Depth pe Tram Banom Feet. DropGFrom DropD PUMP tOCA110M Q In Well Q Mn wm�m Q M Rat.mont Q R�'My On lop irtier Q Ol Vi Q Dirtier— 1 / PURPOSE OF EXAMINATION: Illness Suspected' ❑ Yes ❑ No PURPOSE New Source .1 S ... Iv? ❑ Yo Q No Repein To Sve•m? Q Yo Q No - '1 Signa1V11 1 BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS _ ` Data Received r / <�� Time Received( ` "�b. No. ON - REVERSE SIDE BEFORE COLLECTING SAMPLE 1 C.L lactose 8rolh 10cc IN( 10<e 10,c 10,c 1.0ce 0A'c 24 hours 48 haus Brilliant G,een 74 hours 48 hours EMB AGAR Lactase Broth• 24 h's 48 h,s. G,am's stoin Calif.,. Density (Most probable No. per IOOc< ) MF results Reported 6y r? Desk b.. _ n Com1 ' This ...lysis mid r6at., Cokbrm Organisms to be: �Abwnl 1 Present 4 DIRECTIONS FOR COLLECTING SAMPLES OF WATER FOR BACTERIOLOGICAL EXAMINATION Read Carefully and Follow Instructions Exactly Bear in mind that water analysis deals with materials present in very minule quantities. The least carelessness in collecting and handling may give rise to results which are misleading. Arrangements should be made to have water samples reach the laboratory as quickly as possible. After 48 hours the significance of the bacteriological analysis is impaired. For obvious reasons the laboratory prefers to receive samples in the early part of the week but is willing to accept samples at any time. In collecting samples from TAPS or PUMPS proceed as follows: (a) Thoroughly flush tap or pump by allowing water to run freely for live minutes. (b) Shut off water and flume the outlet with torch or burning paper. The flume should not be merely passed over the oullel but should be applied until fixture shows indication of being hot. Flame should be directed against inside edge. (c) Open fixture so that a small stream flows. (d) Remove bottle from mailing tube. Hold bottle by the lower half in one hand and wilh the other remove the screw cap with the fingers, leaving paper protecting cover in place. Fill the bottle to the shoulder. Replace cap with paper cover, screwing firmly into place but do not apply pressure which will split cap. (e) Pack bottle carefully in mailing lube enclosing this completed information sheet. In collecting samples from STREAMS and RESERVOIRS proceed as follows: (a) Remove cap and Bold bottle as described under (d) above. (b) Collect sample by holding bottle in a slanting position and sweeping it below the surface in such a mon: er that water that has been in contact with the hand is not introduced into the bottle. Avoid collecting surface scum and bottom sediment. o�==------�—�—====—=--�—�=—�---�---�---�—_ DO NOT COLLECT" SAl11PL&S FROA1 FIRE HYDRANTS, YARD HYDRANTS, DRINKING FOUNTAINS OR SIA11- ii LAR OUTLETS 117HICH ARE DIFFICULT TO DISINFECT PROPERLY STERILE WATER SAMPLE BOTTLES ARE AVAILABLE UPON REOUEST FROM Dept. of Health 8 Welfare Dept. of Health & Welfare Dept. of Health 8 Welfare SOUTHEASTERN REGIONAL LABORATORY SOUTHCENTRAL REGIONAL LABORATORY NORTHERN REGIONAL LABORATORY POUCH J 577 EAST 4th AVENUE 606 BARNETTE STREET JUNEAU, ALASKA 99801 ANCHORAGE, ALASKA 99501 FAIRBANKS, ALASKA 99701 .r 0 July 8, 1970 Federal Housing Administration P.O. Box 480 Anchorage, Alaska 99501 SUBJECT: FIA 1111-01-0983 for Lot 3 Bldg. 3 Eagle River fits. Dear Sir: Water for the subject lot is served via an individual well 102' deep. Construction of the well is in compliance with Borough regulations and a water sample taken from the well was satis- factory. Sincerely, CLIFFORD P. JUDKINS, R.S. Administrative Director + BY: ztt-- n R. Lee, R.S. itarian JRL:eh cc: Associate Bidrs Hilton Townsend