HomeMy WebLinkAboutTIMBER RIDGE BLK 2 LT 9(',,,"\ WL
Municipality of Anchorage Page of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
' ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: Syv 9NO/7y PID Number:
Name:S
Wastewater System: ❑ New $Upgrade
�/ I% .¢
Address:
ABSORPTION FIELD
19y11
Phone:
69y-s 7 ve
No. of Bedrooms:
1;kDeep Trench O Shallow Trench Deed O Mound D Other
LEGAL DESCRIPTION
SOII Rating:
Total Depth from original grade:
14913
.Z CPO/Sq, FI.
Lot: Bk: Subdivision:
Depth to pipe bottom floor 0091"1 grade:
Gravel ddiepth beneath pipe
7e Ft.
T,: b..R,o' <
.L.2 Ft.
Township:
Range:
Section: 6
Fill added above original grade:
Gravel length:/-•�
V FI.
I H.✓
I w
1 Ff.
❑ New Upgrade
Gravel depth: Nr T
3,0
Number of lines:
Z
Disunce betvmnFnes:
70e Ft.
WELL: /�a❑
Ff.
Classification (Private, A,B.C):
Total peDln:
Cased
—
Total absorption area:
Pipe materlet:
303"1 S
OR1V.11W
Ff.
l�oy SO FL
Drlllec,
Dale Drilled:
static wale, Level:
installer:
ASMV55Cl# cmr
Date In fade4q
GCO t9/9(i
f-f,
Yield/Pump
Set al:
Casing Height Above Ground.
TANK
GPM
FI.
Ft.
SEPARATION DISTANCES
b(Sepllc 0Holding 0S.T.E.P.
To
Seplie
Absorption
Lot
Holding
:Private
Manufacturer:'�'
TalkI�loMaterial:
pacity In gallons:
From
Tank
Field
slallon
Tank
Sewer Linea
„c60fo c
+NBU
mber of Compartments:
GIL
'
LIFT STATION
Waters
N/A—
Lot
Line
C i
p 0
/O
0
Size in gallons:
Manufacturer
0
.
NlA
"Pump onlevel at:
"v111i" level at:
Hgn water alarm et:
Foundation
3O
6Q
Curtain,
//A
Pump Meke 6
Electrical Inspections performed by:
Drain
/'
BENCH MARK
Remarks: Boa jrV 1 P1VLr5101k1 hw6
ivSTrccE . 2" S� I. INSLXAMY1
Location and Description:
SW PD 0 I nI IN, PO!
EiY/v,�e �.�f rd 7,Vl^eof
CON n z So.w ru t
Assumed Elevet00, 0 FIL
ENGINEER'S SEAL
y Tt :lt TN •L
�?
,.+lei
�
Inspections performed by: Dates: ls Za
ry •••••.,r'
2nd 7 4H
.... .....jl
•. s... . r
T •
Louis A. Eutera /�'a
�dl cJ,��.•
Department of Heal a Hu ervices approval
CE,716 •>��o
41t4Ael
je,
��'"�
Reviewed and approved b Dal e`%L57
.-: ��d/,•,
72 013 17 /91) MOA T5
r
I
Permit No. SW 99011
Page Z- ot7---
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
1 anal nescrintinn: TTyBLe PlQbL LOr 9 BLK 2 PIDNo.: 050-37-/-Z7
1 I 1 !
I
I
I \T f M8f R��NF
Lar to I i
' Lo
T 9
jr
1 j
f6d� s! : LOT •
--- -" `:'� �'�•-may;
LOT 1
i
1
LOT Y
I 1
SCALE
Mo KMo•x
9ATTR CUNToAlws
Tq 1u•rAtt CA �
1
I
1 S.W. FONDATION. TOP or CONCRETE
ASSUMED [LEV • 100.00'
1
ELEVATIONS I i
(NOT TO SCALE) i
i 1
x
ORIGINAL 0
Fn
1' ADDED FILL LEVCLDQ 87:�
tZ. t
NO GVT
71.7'
TANK
90.1 9.8 85.5' 3
.5'
FIELD
72-013 A (212 1) MOA 25
i
SVING TIES
A -C • 30' A -J • 60.6'
0-[ • 667' 1-J • 605'
A -D • 316' A -K • 61.7'
1-D • 326' 1-K • 666'
A-E • 361' A -L • 601'
1-E • 602' II -L . 71.5'
A -r • 371' A -M • 36.1'
1-F • 620' 1--M . 61.6'
A -G • 383' AN • 369'
•-G • 132' 1-M • 60.6'
A -H • 39.7' A-0 • 26.71
•+1 . 66.3' 1-D • 364'
A-1 • NO' A -P • 33V
6-1 • 611' 3
-1 • 525'
Ad . 22.6',
1"=100'
• - xn •a[
Tmo• TUT
. Taw+ cvrrm '
Uf{LLM
-1
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE IDOL) P m
DEPARTMENT OF HEALTH AND HUMAN SERVICES in- au- q l
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650 M)b
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT m -a-)CA
PERMIT NUMBER:SW940174 DATE ISSUED: 6/15/94
DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES EXPIRATION DATE: 6/15/95
OWNER NAME : BUTCHART JAMES F & JUDY L
OWNER ADDRESS:19412 TIMBERLINE DR
EAGLE RIVER, AK 99577
PARCEL ID:05032127
LEGAL DESCRIPTION: TIMBER RIDGE BLK 2 LT 9
LOT SIZE: 28842 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 (24 HOURS) .
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED B
ISSUED BY:
DATE: a'11 Lo 9
DATE
r' n s le ° URTU' `' nor, Ilneawing SO (� AIM)z
Louis Butera, P.E.
Registered Civil Engineer
June 2, 1994
Jim Cross, P.E.
Manager, On -Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Timber Ridge Lot 9, Block 2
Narrative & Waiver Application
To Whom It May Concern:
The proposed septic upgrade will have very limited impact on adjacent properties for the
following reasons:
1. The surrounding lots are large, allowing sufficient room for septic sites.
2. Immediate neighboring septic systems are all +30' distance.
3. Reserve space is adequate, due to absorption capacity.
4. Drainage will not be affected and is not a major consideration in our design.
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
\C:\WPW IN60\WPDO CS\ 1994\94-014A.NAR
P.O. Box 773294 • Eagle Rim. Alaska 99577 • Telephone (907) 694-5195 • Fax (907) 694-3297
NO SURFACE WATER _ LA p,114 s LW�nrvcw
NO KNOWN CURTAIN DRAINS EASEMENT
SEPTIC SITE PLAN
LEGAL: TIMBER RIDGE, LOT 9 BLK 2
OWNER: BUTCHART
CONTRACTOR: RASMUSSON ENTERPRISES
JOB # 94-014A DATE: 05/31/941 SCALE 1" = 50'
EAGLE RIVER ENGINEERING SERVICES
AP.O. Box 773294
EAGLE RIVER, AK. 99577
(907) 694-5195 FAX: (907) 694-3297
A
i *,49 -
.,49TH*
*•i
i �
i...
c •• LOUIS A. BUTERA .•i
IA'rr •. CE -6736
�f 9ZO • ...... 4.=
14% pROFESSIO%A0-
(ENGINEER'S SEAL)
Municlpallty of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: "'y �NpT�nrT DATE PERFORMED:
LEGAL DESCRIPTION: !••Tir bei/1,4, 1-1 aIA 2 Township. Range, Section: 7-/qr,
F177 o<N�1 SLOPE SITE PLAN
1 �� �/o....r ��jc..,� Cao.•., TS
2
'o.:b`
•b'4i
Depth to
Water
3
�: ,
ye��, G�e��i, 611
15
4
�•
5
,.• o'a
..
loo,, G��y�G�y, we.!/ G�.•��/
6
,...
e ,• c
•/ea.•.•�
7
J .
8
h
54Hd w;76
lou:s A. r.urera r j
19
r '
C.-v7T5 >�eJ
e
'6
10 . ' Y, WAS GROUND WATER
• e ENCOUNTERED?
11 .�
IF YES. AT WHAT
o
12 DEPTH?
•.
13 ' ' Deplh to Water Neer
,i
Monitoring? Dolt
14
0 a
Depth to
Water
Net
Drop
Z:O .... /,(.<
15
•/ea.•.•�
18
A`p.
lou:s A. r.urera r j
19
r '
C.-v7T5 >�eJ
COMMENTS
D
Reading Date
Gross Net
Time Time
Depth to
Water
Net
Drop
Z:O .... /,(.<
JOS `
4 �
6"
PERCOLATION RATE ..fr��? � (minul.rvinch) PERC HOLE DIAMETER
TEST RUN BETWEEN 8 FT AND I FT
PERFORMED BY: ��•E % 1 � —Y""� CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE::!��''✓ sf+
a
12.W8 tRe°. 4.851
EAGLE RIVER JOe Timber Ridge Lot 9, Blk 2 / 94-014
ENGINEERING SERVICES SHEET NO. OF
P. O. Box 773294
EAGLE RIVER, ALASKA 99577 CALCULATED BY � DATE 05/31/94
Phone 694.5195 /f�GG ��//���� ��pp��
CHECKED DY_ LB.. DATE _�CV[vaLL1_
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTE51
LEGAL: LOT 9, BLK 2 T151BER RIDGE
A. GENERAL
1. The well and septic plan are for a single family residence only.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Health
requirements.
4. All soil tests are advisory to the design and are to be verified or modified in the
field by the engineer.
5. All excavations and depths are advisory and are to be verified in the field by the
contractor to meet Municipality of Anchorage requirements.
6. It is the responsibility of the owner to obtain all necessary permits or easements
and to locate any adjacent multi -family wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation
requires engineer approval.
8. It is always recommended that a surveyor locate the nearest lot line position and
the location of any easements.
B. TANK
1. The existing tank is to be uncovered to assess structural integrity and replaced
with a new 1,250 gallon steel tank to MOA requirements if necessary.
C. TRENCH
1. The trench is to follow the natural land contour to maintain uniform total depth
of the trench bottom.
2. The bottom of the trench shall be level, plus or minus 1.5".
3. The total depth of the trench excavation is not to exceed 10' at any point.
4. The sewer line is to tie into the existing sewer line that leads to the existing
field, utilizing a "Bull Run" diversion valve or equivalent upon approval of
engineer.
5. The trench gravel is to be covered with typar fabric material.
6. Soil or combination of soil and extruded board insulation to a depth of 3' or
equivalent is to be placed over the leachfield.
7. The area over the trench is to be finish graded to prevent ponding of surface
water runoff.
8. The septic tank and leachfield must not be closer than 100' to any existing private
well, 150' to any Class "C" well, or 200 feet to any community well.
RECOMMENDED LEACHFIELD DIMENSIONS:
TOTAL DEPTH= 10' GRAVEL DEPTH = 7'
TRENCH LENGTH = 36' TRENCH WIDTH = 3'
SOIL RATING= 1.2 GPD/ft2 BEDROOM CAPACITY = 4
SEPTIC TANK = 1,250 gallons minimum
NOTE: 2" 35psi burial insulation is to be placed over and around tank
Twenty-four (24) hours notice required for all inspections.
C:\WPWIN60\WPDOCS\1994\94-014A.SPC 1
\CC 1 MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
(' ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
J44r
- •
ONE
l/7 O 6T
�EW
1:1 UPGRADE
MAI N ADD0 i ESS Eno QC
LEGAL D SC TIO
LOCATION
NO. OF BEDROOMS
O
DISTANCE TO:
Well /
b
Absorpt nn area
Dwelling
?
P E H M rfoJ
We—Manufacturer
Q ��
Mater ee�
No. of tompartmentsn -
OC
wF
Liq. cap' 'n allons
IF HOMEMADE:
Inside length
Width
Liquid depth
d se
DISTANCE TO:
Well
Dwelling
PERMIT NO.
Oz
4
Manufacturer
Material
Liquid capacity in gallons
o
W =
DISTANCE TO:
WellFoundation
D6
CZ /
Nearest lot lin /
Jew IO
PERMIT NO.
G Gl
� �=
Z W
~
No. of lines
Length yne
Total le th f)ines
Trenc i th
Inches
Distance b t a lines
Q
-P
p
Top of tile to finish grade
Material beneath tile�� inches
Total effeo4 absorption area
C
w
Length
man
Depth
PERMIT NO.
Q t—
W A
Type of crib
Crib diameter
Crib depth
Total effective absorption area
N
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption areas)�+
OTHER
PIPE MATERIA � I
._ y
SOILTESTRATING I
INSTA ER
REMARKS
APPROVED DATE LEGAL
v
72-013 (R0"S/78) /78)
- MrJM1F I C I
F-;;--�IL I TY OiF nr-4Hr= FiGE
-
. ^ - DEPARTMENT
G HEALTH
AND ENVIRONMENTAL I JTECTION
- 825 'L'
STREET,
ANCHORAGE, AK. 99501
c+
`264-4720
Sys.
w% ADFyl—S
I TE
SEWER F=* EE FZ rwl I T
PERMIT NO''C 810143 >
3-21
�1
APPLICANT JOHN R. SHILLINGEP.
2901 MEADOWCREEf, E. R. 9951
694 -667
LOCATION
LEGAL L9 B2 TIMBEP.IDGE
S/D
LOT SIZE 45000
SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF.£EDROOMS = 4 SOIL RATING CSO FTISR)= 85
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
C+ERTH= .1 U LErJGTH= 2SN GRFik EL E>EF}TH= 'E, -
THE
THE LENGTH DIMENSION IS THE LENGTH CIN 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 (IF! FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION CIN FEET).
F?EIDU I FR E: E> SEF"T I C '7-n"K 'S I =E= 1.2.=.s 10 GFiLL.OFVS
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DUPING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
--- TWO C 2 ? I t4SF='E1=T I 0"J 3 FiFZE FRE[.0 I FZEa ---
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER. LINE IS 75 FEET.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
KErKt 1 I T KK&Fy I FRES &EZCTK YIE3EFZ ZEAL, IL&E31
I CERTIFY THAT
1: I AM FAMILIAR, WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TD,INCLUDE MORE THAN 4 BEDROOMS.
SIGNED:__ �"� -,---------
PLICANT JOHN R. ��S�� I,NGER
ISSUED BY_�L ----------- DATE- �`3L_�C______ V4.0
solLs LaG_'''��
i MUNICIPALITY OF ANCHORAGE
EI l\ PERCOLATION
j'\I DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST
825 L. Street, Anchorage, Alaska 99501 2644720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: l i h DATE PERFORMED: C
LEGAL DESCRIPTION: a^' / • !J ��I�=9e.r1ds -f /0�
nut SLOPE SITE PLAN
1 -
2•
3-
�4 .
5-
6-
7-
8
•6•7-8
9
—10
11
12
13
14
15
16
17
18
19
20
501 Z -
61i D
Ale
'yam.` ' • ti's `'t�2.
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH? _
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE (minutes/inch)
TEST RUN BETWEEN FT AND FT
l/L� // CERTIFIEDBY: d S EIIQ'j�C[�tin DATE:
PERFORMED BY: t7
72-008 (6/79)
f +�
� (u
1� �
;Ss �-
\
',
Q1,
L
b=- -o --- ---A
G
�zs-� eke
V.nC h �l
s
by MU IPALITY OF ANCHORAGE
DEPT. OF HEALTH 8
DOC Co. una ENVIRONMENTAL P:.OTECTION
SULLIVAN WATER WELLS APR 1 3 1981
P.O. BOX 272, CHUGIAK, ALASKA 99567 • TELEPHONE 688-2759
OWNER OF LAND . IvH''v S_C r//C< r -'J ,
ADDRESS S'^/ Mr�wr,0-V C L 19c, OT, K,
RECEIVED
DEPTH OF WELL
STATIC LEVEL OF WATER FT. MF,. c
LEGAL DESCRIPTION L /l'- ,? 7'r"r ?rr rCra'LrDRAWDOWN FT.
DATE • Started ' - /•/j ' ✓ / Ended /� ��I GALS. PER HR a O
PERMIT NUMBER �%1 KIND OF CASING Z
KIND OF FORMATION:
From Ft. to Ft. n 0 Eh
From Ft. to . Ft. 17e4 "t'0 6 e 04 " ^e
From Ft.to Ft. e/ it �, M iKte)
From F Ft. to-41—Ft. ld 'C C
From �.' Ft.to_2_t::_Ft. "sA"'� �O �!✓` `
From Ft. to Ft. S/ C c. 4 -e
From Ft. to !,�, Ft. S/A�✓� �n.f ✓:=�
From Ft. to?r__Ft.
From / Ft. to I S7 R_Ft. /fr.4n" of i._`_
From / 47 1 Ft. to—LL.LFt. "T e i- .1^'„ L , .-
From Ft. to Ft. --e h, -,'I
FromI (, A Ft. tot/ •7 Ft. 44klen, /!
From169 Ft.to17'r Ft II z29 eOc
From Ft. to Ft. (2 ",4,c
From / 74 Ft. to 1 70 Ft.
From Ft. to Ft.
From
'-' T'Ft. to .S ; Ft, 6r e, L /< From
Ft. to
Ft.
From
/ Ft.tof Ft.7 From
Ft. to
Ft.
From
Ft. to Ft. / n 1,4.e T Z From
Ft. to
Ft.
From
r ~ Ft. to-- -L—Ft. From
Ft. to
Ft.
From
`7 Ft. to 77 Ft. ec From
Ft. to
Ft.
From 7? Ft.to 101 Ft.
From r ( Ft. to /!f_Ft.
From " Ft. toy L Ft. ('Sr'p/roc /c 5,c1!,7
From Ft. to Ft.
From Ft. to Ft.
From Ft.
From ` - Ft. tote Ft. IIE4 /l oc. /< From Ft. to Ft
MISCL.INFORMATION:
r /r
TO G/� �•�f�.�J�
DRILLER'S NAME '
MUNI PFaL I TY OF= FaNCHOF2FiGE
DEPARTMENT f' ,HEALTH AND ENVIRONMENTALJ',-ATECTION
825 'L STREET, ANCHORAGE, AK. 95, j1
264-4720
WELL PF=FZM I T
PERMIT NO. ( 810041 )
APPLICANT JOHN SCHILLINGER 2901 MEADOW CREEK 694-2667
LOCATION MEADOW CREEK,
LEGAL L 9 B 2 TIMBERIDGE S/D LOT SIZE 43000 SQUARE FEET
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SE14AGE DISPOSAL SYSTEM IS
100 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER, LINE IS 25 FEET AND
TO A COMMUNITY SEWER, LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DRYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PERM I T EXP I PES DECEt7F :EFS 31s 1 X51
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR OM -SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
SIGNED ----------------------------------
APPLICANT JOHN SCHILLINGER
ISSUED BY_ 'i ` = -`__ J--------- DRTE_Z_ 10 _61 .-- V4. 0
MUNICIPALITY OF ANCHORAGE
• �- Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. fl t")•eo — •Iz' / HAA # 0 R9,.- C) L(,�c
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 9: Block 2: Timber Ridge Subdivision
Location (address or directions)
(b) Property owner Alliance Bank Telephone: (home) Business
Mailing Address Ben -g.• Blvd, Rranch
(c) Lending Institution
Mailing Address
Telephone
(d) Real Estate Company and Agent Re/Max of Eagle River— Virginia KnhfielA
r. a *=Ul-
Telephone 694-4700
(e) Mail the HAA to the following address: (or check here R if hold for pick up.)
. List contact person and day phone number below:
17034 Eagle River Loop Road No. 264
ag a aavar, AlaSka
2. TYPE OF RESIDENCE
Single -Family IR Number of bedrooms 4
3. WATER SUPPLY
Individual Well Q Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site f,7 Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72m5(n«.7/ee) Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by myseal affixed hereto and as of the validation date shown below, I verify that my investigatioh 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
Address
Date
Telephone 4��Z
5 & 5 ENGINEERING
t7934-Ea9 r/
Eagle River, Alaska 99577
Imo. l A. Mehr
N.. 14574
6. DHHS APPROVAL
Approved for —bedrooms by Date d.--7 7-
Approved—Disapproved Conditional
Terms of Conditional Approval
, - CAUTION I
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated based onlyupon the representations given in paragraph 5 above byan 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
oranalyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions
in the professional engineer's work.
73-025(Rw. WN) Beck Page 2 of 2
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
? s� CHECKLIST - FEBRUARY 191
343-4744
Legal Description.
A. W(dL DAT
Well Classifi, I r 61kh If A, B, C, D.E.C. Approved (Y/N)
Well Log Present N) Date Completed O - 13t Yield 2 61t_'1
Total Depth_k!b�Cased toP is Depth of Grouting
Static Water Level -1i Pump Set At
Il
Casing Height Above Ground )2 k `rSanitary Seal on Casing —ON) y
Electrical Wiring in Conduil§ N) y Depression Around Wellhead (Y&� / a
SEPARATION DISTANCES FROM WELL:
To Septic/Folding Tank on Lot I apt ; On Adjoining Lots 1 <:>01k
I
To Nearest Edge of Absorption Field on Lot '1gneo I-4' ; On Adjoining Lots
To Nearest Public Sewer Line r V A To Nearest Public Sewer Cleanout/Manhole t A
To Nearest Sewer Service Line on Lot \1Z_'% to
Water Sample Collected by Date
Water Sample Test Results
�i�'F/�
Comments 061L
B. SEPTIC/HOLDING TANK DATA
Date Installed Size No. of Compartments Z-
Standpipes'N) —Air -tight Caps®/N) Y Foundation Cleanout (Y,tO
Depression over Tank (Y69 ►J ate Last Pumped
Pumping/Maintenance Contact on File (Y/N) ; for
Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
I 1
To Water -Supply Well oto To Building Foundation
To Property Line c I To Disposal Field S
To Water Main/Service Line
To Stream, Pond, Lake or Major Drainage Course \ opl
Comments
72-M (Aw. 7/08) F,Mt Pagel of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata Type of System Design
Date Installed 3 t3 I Length of Field
Width of Field 'ii Depth of Field (�
Gravel Bed Thickness t7
Square Feet of Absortion Area '8�� Statndpipes PresentON) !/
/
Depression over Field (YAM Date of Last Adequacy Test �l —30—SPS
Results of Last Adequacy Test S?'ri
v
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water -Supply Well 14-/ To Property Line �/ 4 -
To Building Foundation To Existing or Abandoned System on
Lot P ; On Adjoining Lots A.
To Water Main/Service Line (� �-� To Cutback (if present) I.
To Stream, Pond, Lake, or Major Drainage Course I On -i-
To Driveway, Parking Area, or Vehicle Storage Area _- !!El o I -t:_
Comments
D. LIFT STATION Iv /A,
Date Installed
"Pump On" Level aft
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
'Pump Off" Level at
r Vent(Y/N)
Cycles during Adequacy Test.
"Check Permitted Bedroom Rating Against HAA Request"
certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect o
Inspection. 1
Signed Nt?tERtii6
Company 17014 Eagle River Loop Road No. 264
Date Eagle River, Alaska 99577
ice -MOA No.
o� 3
Receipt No. 4S i?
Date of Payment ./ d - i —
Amount: $ 1%D d0
72-M (Rw. 7/88( Beck
Receipt No. _
Waiver Fee: $
Date of Payment
Page 2 of 2
Ia
�a
14e74i r A
?R6FE'3 ""
CHEMICAL & GEOLOGICAL LABORATORIES OFALASKA, INC.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562.2343
FEDERAL TAX ID N 92-0040440
ANALISIS REPORT BY SAMPLE for Mork Order B 9560
Date Report Printed: OCT 5 88 8 13:03
Client Sample ID:L9, 82, TIMBER RIDGE S/D
PWSID :UA
Collected SEP 30 88 4 11:10 hre.
Received SEP 30 88 4 16:00 his.
Preserved vith :NONE
Analysis Completed :OCT 4 88
Laboratory Supero sor STEPHEN C. EDE
Released By : C.
Client Nana : S i S ENGINEERING
Client Acct : SNsEMGP
P.O.B NONE REC D
Req B
Ordered Ey
Send Reports to:
1)S 8 S ENGINEERING
2)
....................................................................................................................................
Special
Instruct:
Chemlab Ref B: 2838
Parameter Tested
NIIRATI-N
Sample ROUTINE SAMPLE.
Remarks:
Lab Smpl ID: 1 Natrls: WATER
Result/Units Method
2.0 sg/l EPA 353.2
Allowable
Limits
10
..............................................................................................................
1 Tests Performed See Special Instructions Above UA -Unavailable
IID. Nona Detected " See Sample Remarks Above
MA- Not Analyzed LT -Less Than, CT -Greater Than
MUNICIPALITY,.OF ANCHORAGE
+ ' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date 'S1/C_1-FC
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 9 Block 2 Timber Ridge T14N R1W Sec. 6
Location (address or directions)
2901 Meadow Creek
(b) Applicant Name John Shillinger Telephone: Home694-2667 BusinessN/A
Applicant Address 2901 Meadow Creek, Eagle River AK 99577
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder 1 ; Buyer ❑ ; Other ❑ (explain);
(d) Lending Institution NSA Telephone
Address
(e) Real Estate Company and Agent NIA
Address
Telephone
(1) Mail the HAA to the following address:
pickup by engineer
2. TYPE OF RESIDENCE
Single -Family b i Multi -Family ❑ Other
Number of Bedrooms 4
3. WATER SUPPLY
Individual Well ® Community ❑ Public ❑
Note: If community well system, must have written confirmation from the Slate Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL.
Onsite S] 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 r2-025(11,54)
1
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DAI.. 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.* with wavier of septic tank separation distance.
Name of Firm
Address EAGLE RIVER ENGINEERING sERVICF4
Date 7?e: EAGLE RIVER, AK 99577
4. .. W0
694-5195
Telephone
Louis A. Bitera
CE -6736
* 1,14 Engineer's Seal
6. DHEP APPROVAL
Approved for "F�"' bedrooms by �`'"`n'" A Date
Approved Disapproved Conditional
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 engineers work.
Page 2 of 2
72-025 n+r04)
MUNICIPALITY OF ANCHOW.,,E
}� i1 DEPT. OF HEALTH s
MUNICIPALITY OF ANCHORAGE (MOar ENV19DNVENTAL PROTECTION
HEALTH AUTHORITY APPROVAL (HAA) MAR 191986
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description: zz,, fAC ENID-,
T
A. WELL DATA
Well Classification P/? / !/A 7-f If A, B. C. D.E.C. Appioved (Y/N) y14
'Well Log Present (Y/N) — ,y _ Date Completed / Yield • v G P,1, Tex A,{
Total Depth ySv Cased to yz S Depth of Grouting 17'11'9
Static Water Level r%�ePe+� 3_ Pump Set At
Casing Height Above Ground Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) ,l' Depression Around Wellhead (Y/N) /V
Separation Distances from Well: y✓
To Septic/Holding Tank on Lot yS / '/ ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot w,0 ; On Adjoining Lots
To Nearest Public Sewer Line yam- To Nearest Public Sewer
Cleanout/Manhole tea- To Nearest Sewer Service Line on Lot T -7s
Water Sample Collected by �s1G le•l�l E'.r nd ;Date 311ZyAt6
Water Sample Test Results A G 7-'' 7we
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed S / Size 5-O G" / No. of Compartments a
Standpipes (Y/N) y Air -tight Caps (Y/N) IV Foundation Cleanout (Y/N) N
Depression over Tank (Y/N) N Date Last Pumped 3.'// Q ./8 'f
Pumping/Maintenance Contract on File (Y/N) /"/-4 ; for A;Zs
Holding Tank High -Water Alarm (Y/N) 4� Temporary Holding Tank Permit (Y/N) 'y1¢
Separation Distances from Septic/Holding Tank:
To Water -Supply Well 9s �' / To Building Foundation
To Property Line was To Disposal Field -:5-
To
"To Water Main/Service Line 1/0 To Stream, Pond, Lake, or Major Drainage
Course ;/e"P
Comments
Page 1 of 2
72-02611 U84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata �s �� Type of System Design Zie'nc A
Date Installed Z�1 / Length of Field - 29
Width of Field 31 Depth of Field Z19 11
Square Feet of Absorption Area
bpt• • Gravel Bed Thickness
7•
3 4'.i 91 Standpipes Present(Y/N)
Depression over Field (Y/N) N Date of Last Adequacy Test 31,�f8 F
Results of Last Adequacy Test S- >s f1; -:e: 4,,es,"Z^;r .4 rtr 7£. y
Separation Distance from Absorption Field:
To Water -Supply Well tAOa To Property Line �S
To Building Foundation __->0 To Existing or Abandoned System on
Lot 1Vd- ; On Adjoining Lots '` �� 11
To Water Main/Service Line `moo To Cutbank (if present) N"`e
To Stream/Pond/Lake/or Major Drainage Course YLX�o
To Driveway, Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N) _
Comments
Dimensions
Manhole/Access (Y/N)
— "Pump Off' Level at
•• Check Permitted Bedroom Rating Against HAA Request ..
Vent(Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
I certify that I have cher ed, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed �'/ Date AZAc'
CompanyMOA No.
Receipt No. 3"7Ic,:7SJIT
Date of Payment3-I+ SSL
Amount: $ SoSL-
Page 2 of 2
72-026 111.841
4C% q
IV J .
f ins�eaP• hd
,We*. ::� �...............
(��+`r^�,^;• Louis A. Butera
�, u, •_ CE -6736
n
Municipality
of
Anchorage
March 25, 1986
n
P.O.. JX 196650
ANCHORAGE. ALASKA 99519-6650
(907)264-4111
TONY KNOWLES.
MAYOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
Lou Butera, P.E.
Eagle River Engineering Services
P.O. Box 773294
Eagle River, Alaska 99577
Subject: Lot 9 Block 2 Timber Ridge Subdivision
Waiver Request, WR86-039
Dear Mr. Butera:
Your request for a waiver of the required septic tank to well separation
distance has been granted. This distance has been waived to 94 feet.
This waiver is valid for the existing four bedroom single family dwelling
only.
Sincerely,
Stephen S. Morris
Civil Engineer
On—site Services
SSM/ljw
EAGLE RIVER ENGINEERING SERVICES
Lou Buten P.E.
Q P.O. Box
Eagle River, Alaskalaska 9 9
9577
Telephone(907)694-5195
3/17/86
Mr. Steve Morris AtlN 10FAUTY OF ANCHORAGE
UffOF
Municipality of Anchorage DN HEA6
Department of Health and Human Services PROt[ti�ON
825 "L" Street MAR 191986
Anchorage, Alaska 995020650
Ref:Lot 9, Block 2, Timber Ridge RECEIVED
Dear Mr. Morris;
On behalf of my client, Mr. John Shillinger, I am applying
for a wavier of horizontal separation distance, well to septic
tank to 95'.
The septic installation on this lot was inspected by the
Municipality in 1981 and the well to tank distance was given
as 100'. Our actual field measurement shows a distance of 95
feet ±1'. It is not believed that the actual distance poses
a health concern due to the depth of the well aquifer (153'),
the protective bedrock layer above the aquifer and the 10% slope
away from the well toward the septic system. The system was
installed to Municipal standards at that time which called for
watertight couplings. This wavier request is being submitted
along with a request for Health Authority Approval.
If there are any questions or concerns please call me at
my office 694-5195.
Sincerely,
Lou Butera P.E.
S. LEGAL DESCRIPTION
of 9
RECEIVED
INSPECTION APPOINTMENTS
Hsu,
5 6/ e
TIME
TIME
NUMBER OF BEDROOMS
/SINGLE FAMILY
aV
DATE
DATE
DATE n
®'Three ❑ Six
Pkff
INSPECTOR
INSPECT
INSPECTOR
RnA
MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH 8
DEPARTMENT OF HEALTH d ENVIRONMENTAL PROTECIMNRONMENTAL KOTECTION
125 L Strom - AndwaW, Alaska 59501
•
JUL 2 8 1981
ENVIRONMENTAL SANITATION DIVISION
T9lophon9 264.4720 R E
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER ��I�v ITfFP
DIRECTIONS: Complete all parts on page 1. Ine s, w so requra will not M pracaasad. Please allow ten (10) days for processing.
1. PROPERTY OWNER
PHONE
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
MAI LING ADDRESS
I £.ifr4& RlyMM- 99�'t7
75 o
PROPERT RESIDENT (If different from above)
dlv
PHONE
L ad v
2. BUYER
PHONE
'30 It At 45CAr I I& 6C
MAILING ADDRESS
�► r
3. LIENOINGINSTITUTION
G e AAMC
PHONE
3 74 -7 Zo(o
MAILIN ADDRESS
CAI -6-1e- fltue K 19517
4. REALTORIAGENT
PHONE
MAILING ADDRESS
S. LEGAL DESCRIPTION
of 9
STREET I-OCATION
Nrde
Hsu,
5 6/ e
_46tie
6. TYPE OF RESIDENCE
NUMBER OF BEDROOMS
/SINGLE FAMILY
❑ One C3 Four ❑ Other
❑ Two ❑ Five
❑ MULTIPLE FAMILY
®'Three ❑ Six
7. WATER SUPPLY
INDIVIDUAL' '
ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
A SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE"
YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
-J
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72 010 (R.. 9/79)
toe dA 'C
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
Cl PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
INSTALLER
❑SepticTankor ❑Holding Tank
Size: If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL T0:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
V, APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE Q
BY
72010 (Rev. 6/79)
je
2.
47
71
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MW A.VFTY OF AfktiO'
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. . . . . . . . . . . .
11 j I 11mby ccrhfythat thave sun,"_cd th
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7:
7Z
that the raprove-,
e pro lines and do
jnc:nts sl=w I r
-Mt overLap or encroach as the propersy• ly id:accat there -
F
-;tip-that no Improvements -oir rmyperty lyin ediaent thereto
4t
0+:4 zncroach oii Ptbe -prc
d 11 -Liss U Isible eascmA�nts'ou'.
44, -
roadyrays,,. trawn Ion lines: c: c er. v
said yxoperty'ex}vz
wi Indicated licr6om.l-
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C..JOI=ON*i
t�rveydr "a. BCO
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