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Home My WebLink AboutMOUNTAIN SHADOWS BLK 1 LT 2 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: S~~___-- PID Number:_ Name: --<~-~bJ ~ '~//~l~JlrO~' OL,~'~.,) Wastewater System: D New ZUpgrade ~: ~2~ ~~ ~d ABSORPTION FIELD No of Bedrooms: Phone: ~ EJ Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other Soil Rating: Total Deplh frol~o?ginal grade: LEGAL DESCRIPTION (),~ ~sq ~ ~ Block: Subdivision: Depth to p~pe bottom from original grade Gravel depth beneath pipe Towns,,~: ~ange; ~section: F,i ~dded above o.ginal g~ade Gravel,el~t~: .... ~ Number of lines: O~stance between lines: ~ ~ Gravel width: WELL: E X tS?~ew B Upgrade 5 Ft ~ Ft. Ctassificabo~r~vale, A,B,C): Tolal Deplh: Cased To: Total absorption area: Pipe material: ~ Yield: I PL,,np Set at: Casing Heighl Above Ground: TAN K GPM Ft Ft -- SEPARATION DISTANCES Ls~p~io ~ Ho~i~ ~ S.T.~,P. . -- ~-~ = Manuf cmrer: CapaciW in gallons: TO Sept,(: Absorption Ldl Hold,rig Pubhc/Prtvate ~ T~ :rom Tank Field Slatton Tank Sewer L,nOs ~C~ Material: Number of Compartments: Size in~ Line ~' I~ ~ "Pump on" level ~at: i h water a,arm at: o ,nd t,o ~, ~~ ~Electricallnspectionsperformedb Curtain ~o~6 ~ ~~ Drain _~(~ K~ .......... ~-- ~ BENCH MARK .ocation and Description: ~67C ~ ~ Assumed Elevation: Reviewed and approved by: ~ : ~ - - ¢' 72 013 (Rev 9/91) MOA25 Permi: No..~,Vv/C~ ~O ~'~-- Page ,,~ of ~ 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 Legal Description: /~O(~"/A',~,' ~HAo~.t ~c~,~,, ~,'r ~.: &L,~-. I PID No.: 0/~0//(~ --HO' J..'~AF~-~I-~ ~ HO. 82~5 72-013 A (Rev. 9/91) MOA 25 Permi! No. ?.~'t/l~ ~,_~.(~¢,~ Page ,-~ of -~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 e Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: L//~f~U~7,~hu .SN.4-Oo/~S ,~t~/~r~: ~oT,~., /~d~ ] PID No.: 0/~'¢¢Dl/~ Co~ /v~Tt Fou~o 72-013 A (Rev 9/91) MOA25 PAGE 1 OF 1" MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920252 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:OLSON JOHN E II & DIANNE L OWNER ADDRESS:12936 JEANNE RD ANCHORAGE, AK 99516 PARCEL ID:01740116 LEGAL DESCRIPTION: MOUNTAIN SHADOWS BLK 1 LT 2 DATE ISSUED: 8/28/92 EXPIRATION DATE: 8/28/93 / LOT SIZE: 29106 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: August 3, 1992 ROBERT SHAFER, PE. ROGER SHAFER. P E. CIVIL ENGINEERS (907) 694-2979 FAX 694 1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99501 REFERENCE: Mountain Shadow Subdivision, Block 1, Lot 2 Request you issue a permit to upgrade the septic system serving the referenced property. The existing system is in a state of failure. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. Attached is the proposed upgrade design with an alternate site depicted. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic upgrade. If you have any questions or require additional information for your review, please contact us. Sincerely, ROGER G. SH~.FER, P.E. RJS/LSU/lsu 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 /"= 40' SCALE UPGRADE JEANNE ROAD GR' JR ANCHORAGE AREA BOROU DEI'ARTMENT OF ENVIRONMENTAL QUALI'I ¥ 3500 TUDOR ItOAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ..... ADDRESS ~-~'(? / Ii,,! ,3-9' '/j~ ~.z'~ z~-~ PHONE LOCAI'ION '~, ' ' ' ~ SEPTIC TANK: DISTANCE EROM WELL /~_(0~ ; LIQUID CAPACITY / ~] ()(~ ..... GALLONS. · ~, '~ _. ..~.. NUMBER OF MATER AL ~/c~( ~ .%/~cf~/ COMPARTMENTS LIQUID INSIDE LENGTH. INSIDE WIDTH DEPTH__ SEEPAGE SYSTEM: NUMBER OF PITS L LINING MATERIAl. / /~ NEAREST LOT LINE.__ SEEPAGE PIT: OUTSIDE DIAMETER OR WIDTH(/ ' ' ; 6 ' "' ~.~J~ LENGTH /(J , DEPTH ~' DISTANCE FROM WELL_ /~ ~ , BUILDING FOUNDATION (/~'" TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)___~_~.~).-~) SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TiLE TO FINISH GRADE FOUNDATION ,NEARES[ LQLLIN~ ~.' DISTANCE BETWEF~bJ-Ld~ES TRENCH WIDTH ..-/~SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE__ WELL: TYPE_//UI)/I/ LOT LINE /~' 't , DEPTH /7-"~ z NEAREST SEPTIC , SEWER LINE , TANK DISTANCE FROM 2 WATER , BUILDING FOUNDATION .... ~ .... SAMPLE / SEEPAGE / ~(f; , SYSTEM /~;c~ , CESSPOOL , NEAREST OTHER , SOURCES DISTANCES: I '/~,~}: &;5'>'- ,~DI_~AGRAM OF SYSTEM DEPARTMENT OF ENVIRONMENTAL QUALITY ' FINAL INSPECTION~ 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPT,C TANK S,.E I000 TYPE SEEPAGE AREA SIZE TYPE ~ ., DIAGRAM OF SYSTEM MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE P,T WALL SEPTIC TANK ,SEEPAGE PIT TO NEAREST LOT LINE, WELL 'FO SEPTIC TANK DRAIN FIELD , DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK. (~'z'-~'> .. SEEPAGE PIT ;-7 dP / , DRAIN FIELD , SEEPAGE Pit //'-~ / DRAIN FIELD. CAST IRON INTO AND OUT O.~F.~.T~JC~ TANK AND INTO CRIBCROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT rEMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION, HEALTH ;~THORITY LICENSED DESIGNER I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE FROM FORMATION ! ON BIT I FORMATION I SpEeD j ON BIT , eB WEIGHT TIME ~ECORD FT FT =T Parcel I,D. # 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 4~/ ~ /~, ',, HAA# GENERAL INFORMATION Complete legai description Location (site address or directions) Property owner ,~./¢~7'74-~ /~',~/~?~'~¢-,4-z3'T- Day phone Mailing address /.Z¢.~¢, ?~7~,:P/V,W.~ ~__/3.... ,,4¢,z C/'¢~2--,'¢¢G'-~ ,._/z~ ~ ¢¢_~/ g~ Lending agency Day phone Mailing address Address Day phone -,~(-~-- ~ B~'/~- Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWA'rER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72K)25 (Rev. 1/91) Front MOA~I 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 vedfythat 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 Address 17034 Ea.qle River Loop Road No. 2~. Eagle RJYer, ,~la~ka,~957,7 Engineers signature Phone Date ?/, /~/~ DHHS SIGNATURE P""' Approved for Disapproved. ·/-~) ~//~ bedrooms. Conditional approval for bedrooms, with th~ following stipulations: Note: The well for this property meets existing State and Municipal Codes. There are nitrates present. It is suggested that periodic testing he performed to insure the wells continued suitability. Current nitrate concentration is 5.39 mg,/1. EPA maximum concentration i~ !0.0 ~/~ More information on nitrates is available from the On-site Services Program, DHHS, o,.~ Additional Comments 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-e25(Rev. 1/~1) ~ack MOAi¢21 Municipality of Anchorage JUL 0 I 1999 ~ DEPARTMENT OF HEALTH & HUMAN SER~,tGE~u'rY o~ Af'qCHURAG[: Environmental Services Division ENVIRONMENTAL SERVICES I)IVISI( 825 L Street, Room 502 · Anchorage, Alaska 99501 ° (907) 343-4'744 Health Authority Approval Checklist Legal Description: LOT' 2 ) ~-~. L~OdAz. /'j /t'/O&//'VT%)-/A) Parcel I.D.: A. WELL DATA Well type '~,'~ Log present 0/N) YES Total depth Sanitary seal ¢.~/N) _ If A, B, or C, attach ADEO letter. ADEC water system number Date completed Cased to ~-~/('"'22-~f'.-¢),~0(.1~.) Casing height (abeved~ound) Wires properly protected ~.,~/N) i/_~ ;4¢ Date of test Static water level Well production FROM WELL LOG AT INSPECTION ¢o / &Z/ g.p.m. WATER SAMPLE RESULTS: Coliform ~' Nitrate Date of sample: B. SEPTIC/HOLDING TANK DATA Date inst ailed _~///~/~- Tank size Foundation cleanout ~'N) [)ate of PU i ABSORPTION FIELD DATA Date installed Length/X/¢~?;/Xz¢ Width -/3~, ~¢ ~////~ Other bacteria ,,~ / Collected bg: /~-~)~ (~ ~',//~x/ Number of Compartments ~ Cleanouts(~/N) Depression (Y/~t ,/'~/¢ High water alarm (Y/N) ,/V' / Pumper . Soil rating ~ or f¢/bdrm) (~¢/-~ System type Gravel thickness below pipe ~o ~- '~Total depth. Fffective absorption area -~-~)/,2¢ Monitoring Tube present (~N) ,~/~..g Depression over field (Y/~ ~O Date of adequacy test I/ Fluid depth in absorption field before test (in.); ~ Immediately after ~ gal. water added (in.): Fluid depth _/':~'~/~ %ns) = .* ' Minutes later: ~ Absorption rate ~.¢ '¢~ g.p.d. Peroxide treatment (past 12 months) (Y/N) ,&/L)¢~- ~<:~6,,,M If yes, give date ¥1'~ ,¢ ~.¢¢ ~1 b., j F ~-I I~l T- ~ T ~ ~ ) ~i.. ~ . [~ ~'~ I l//;,¢ '7" !~,~)',J~4-. bedrooms 72-026 (Rev, 3~96)* LIFT STATION Date installed ?'"/ / Manhole/Access (Y/N) "P,gm~vel at* *Datum High water alarm level at* Cycles tested E. SEPARATION DISTANCES Size in ~[¢Jons-~-~ - "Pump off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot /¢_]~ / ~- Absorption field on lot (/{.~(~ / 7~ On adjacent lots On adjacent lets Public sewer main ,%/ Sewer/septic service line Public sewer manhole/cleanout SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation ~- /'C- Property line / 0 /7L Absorption field Water main/service line /('~ ~- Surface water/drainage ,,/,(¢~/~ ~- Wells on adjacent lots /O/¢- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line / ~ / Building foundation ~-~) / -H Water main/service line Surface water /~)(:~ Driveway. parking/vehicle storage area Curtain drain ,"'~'/~¢,"¢~ .,/<//¢& I%//~,,/ Wells on adjacent lots ,/~(~ ENGINEER'S CERTIFICATION I inspections Municipal certify that I have determined thru field and review of recordsJ~,~a~e.aoov~sw~ns~_ ..o...-----~ :~ in conformance with MOA NAA ouidelines in effect on this date. ~&~t,, .... ' '"?.~'?~ Engineer's Name_ ~¢~g,,c~ L. L 6 ~¢~ Date ~ // / ~ ~ HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O, Box 196650 Anchorage, Alaska 99519-6650 343-4?44 Parcel i.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING - 'LL~/ - /l~ NAA# GENERAL INFORMATION Complete legal description Lot 2; Block I; Mountain Shadow Subdivision Location (site address or directions) 12936 Jeanne Road Property owner Mailing address Lending agency -- Mailing address Agent Address John Olson 12936 Jeanne Road Anchora~e~ Day phone Alaska 99516 345-0383 Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: _ ×X . Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: XX individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA II21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that ~ny investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address S & S ENGINEERING 17034 Eaqle River Loop Road No. 204 Phone Eagle River, Alasl(a g~2577 Engineer's signature Date DHHS SIGNATURE Approved for ~-~z/~ ~) Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: /~~ ~ Date / 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. i/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescripti0n:_/~Og~7/~,/'J ~ ..~¢:~ ~Or2, Parcel I.D. ('} I-~ ~ I1~ A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal if A, B, or C, attach ADEC letter. Y~-.~ Date completed I~Eor Casedto ~"S' To FROM WELL LOG Date of test ~- /- 2,2` Static water level (~ O Well flow Pump level /~ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot /~0 ¢ Absorption field on lot /(~ ' Public sewer main /~///~r Sewer service line ~ ~ '~ WATER SAMPLE RESULTS: Coliform C) Date of sample: ADEC water system number ~- '~ -:~- D rille r ~LR:sC4.- ~ /+,, ~60 1~ Casing height__ Wires properly protected t~N) g.p.m. ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank /O0 //- Nitrate 4~4/- t~/~ Other bacteria ~ {/-~2- Collected by: %~ ~ ~-c~P'3G'r~-I'~' B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (~/N) High water alarm (Y,~ Date of pumping /~//)- To property line Surface water/drainage 72-026 (Rev. 7/91) Fronl Tank size /~O ~A-¢_ Compartments Foundation cleanout (~/N) ~ F~'5 Depression /k J//} Alarm tested (Y/~} /~-,)~.t/,ft' "~,,~ ~--- Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot J00 ~ _On adjacent lots Absorption field lO I-o ~:,E. PTIc Foundation Water main/service line_ C. LIFT STATION Date installed--.~¢u/'/~ Manufacturer Size in gallons~-----.., ,~, Manhole/Access (Y/N) Vent (Y/N) ~ '~ j~level at ____ High water alarm level ~s tested Meets MOA electrical codes (Y/N) ~ SEPARATION~STATION TO: Well on let¢~- On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length Total absorption area Depression over field (Y/~) Results (pass/fail) Peroxide treatment (past 12 months) (V/~_.~ C:~.~_c( ~_ Soil rating O,~ GPP~r= System type ~t./l~E- I)lT-,"r,~ Width Gravel thickness ~'~ ¢ Total depth ~ ~ SF Cleanouts present ~N) ~ Date of adequacy test ~,¢ ~W ~ ~ ~. for ~ bedrooms If yes, give date ~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation To existing or abandoned system on On adjacent lots Surface water ICC 'f Driveway, parking/vehicle storage area Curtain drain ~Oru~-~ E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA goidelines in effect on the date of this inspection. $ & $ ENGINEEI~ING Signature '17334 E~..gle [.~iver Loop Road No, 204 ,? p .~, ,:,~ ,~: ~ive:' A~aska 99577 ~'~ * ' Engineer's Name Date ~ ~ ~ ¢~ No, ,b. t:h 7 HAAFee$ /7~ Date of Payment Receipt Number 72*026 (Rev. 3/91) Back MOA Waiver Fee: $ Date of Payment Receipt Number g &, $ J~NGINEERINI(~ ~EALTH AUTHORITY [PPROVALS ~EWER & WATER ~AIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS SO~L TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN October 23, 1992 RECEIVED OCT 2 6 1992 Susan Oswalt Municipahty of Anchorage Municipality of Anchorage Dept. Health & Human Services DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 - REFERENCe:~- Lot 2, Block 1 Mountazn Shadow Subdzvzszon ~ 12936 Jeanne Road Dear Susan, CIVIL ENGINEERS (907) 694 2979 FAX 694 !211 Sincerely, ROGER J. SHAFERt P.E. RJS/tv Attachment 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 ROBERTSHAFER, P E ROGERSHAFER. PE If you require additional information, please contact us. Note the date on the photos of October 14, 1992. The improvements were completed on this date. The attached photos show the driveway improvements that were performed to allow a septic pumping truck to be placed alongside and to the rear of the garage per our previous agreement. MUNICIPALITY OF ANCHORAGE ~ ' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI()N 825 L Street - Anchorage, Alaska 99501 F. NVlRONMENTAL ENGINEERING DIVISION ,: .. '; Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on ~age 1. ncomplete requests will not be processed, Please allow ten (10) days for processin0, 1. PRO~Y OWNER ~ PHONE MAI L,I~G AD'DR ~SS ~ ,~ PROPERTY RESIDENT (If different ~rom aDovel PHONE . ,~ PHONE MAINNG ADDRESS 4 RE~L~OR/AGENT : , 1~ . ).AIs. I qs. . . LEGAL DESCRIPTION STRFET LOCATION NUMBER OF BEDROOMS 6. TYPE [~/RESIDENCE SINGLE FAMILY MULTIPLE FAMILY 7. WATEI~,~S~JPP LY ~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE/DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY [] One [] tour [] Other Two [] Five Three [] Six ' ATTACH WELL LOG. A well log is required for all wells drilled since June 1975, For wells drilled prior to that date, give well depth (attach log if available.) ** If individual/on-site, give installation date./d'~/-7,.~ . If system is over two (2) years old an adequacy test is required by this Depar[men[, NOTE: THE 72-010(3/78) INS ~ECTION FEE MUSTACCOMPAN' EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR I NSP ECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER EZ]INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [~] Holding Tank Size: /~)~1~1 If Tank is homemade 8OILSRATING give dimensions: ~;~.,~ ! TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line X; P.OVED FOR BEDROOMS [] CONDITIONAL APPROVAL {letter must accompany certificate) [] DISAPPROVED DATE BY (Title) '~__ LEGAL DESCRIPTION 72-010 (Rev. 3/78) August 7, 1978 R&M No. 851575 Century 21 SRABox 393-K Anchorage, Alaska 99507 Attention: Christy Vincent Re: Adequacy Test on Existing Sanitary Sewer System; Lot ~, Block 1, Shadow Subdivision, Anchorage, Alaska Dear Ms. Vincent: Mt. Per your request of July 26, 1978, we conducted a test of the sanitary sewer system on the above described property. The septic tank was pumped prior to the performance of the test on the see- page pit. During the test the liquid level in the seepage pit was measured before and after the addition of 700 gallons of water. The total depth of the crib was 6.5 feet. All liquid levels were measured below the top of the standpipe and are shown in the following table: Initial Water Second 24 hour Total Reading Added Reading Reading Drop (gallons) 5.0' 700 3.8' 4.9' 1.1' The meter used during the~test was a Neptune 1½" standard water meter which had previously been calibrated by R&M Consultants, Inc. The water level rose 14.4 inches with the addition of 700 gallons of water, indicating a capacity of 48.6 gallons per inch. Twenty-four hours later the liquid level was again measured and found to be 4.9 feet. It had dropped 1.1 feet or 13.2 inches. This indicates an average effluent acceptance rate of 632 gallons per day for the surrounding soils. If the 3 bedroom residence on the property is to house 6 people, the average load on the system can be expected to be 450 gallons per day. We can therefore conclude that the system is disposing of effluent at the adequate rate for a 3 bedroom residence. August 7, 1978 Century 21 Page -2- We appreciate this opportunity to be of service to you. Please contact us if you have any questions regarding this letter or if we can be of additional service to you. Very truly yours, R&MCONSULTANTS, INC, Lynne Kosikowski Staff Geologist Smith Project Manager GS:LK/kky/12-K GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality " ~treet, Anchorage, Alaska 99503 274.-4561 %0~ Date Received March 8, Time of Inspection 1976 9:30 a.m. Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR March 9, 1976 · Les - Tues. Conv. 1. Approval requested by: Alaska Mutual Savings Bank Mailing Address: Pos t Office Box 1120 2. Property Owner: Thomas A. & Z~mly D. Reaves Mailing Address: Star Route A Box 393K 99507 4. 5. 6. Phone: 274-3561 x 230 Phone: 272-5537 Legal Description: Location: Jeanne Road - see map Lot 2 Block 1 Mountain Shac!ows Subdivision Type of facility to be inspected Single Family Well Data: Individual A. Type ~.c~c.~O~ C. Construction Sewage Disposal System: A. Installed 1973 No. of bedrooms B. Depth 165 D. Bacterial On-site system. ~ B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank Nearest lot line , Absorption area , Other contamination , Sewer Lines B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re st for Approval of Individual F er & Water Facilities Legal DescriPtion Lot 2 Block 1 Mountain Shadows Subdivision A'pprdved ..... Disapproved Date Approval~lid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) IV1UNICIPALITY OF ANCHORAGE Iit'x~VIECI,..~Fj,,~'IAt, DEPARTMENT OF ENVIRONMENTAL QUALITY --~3@(~'zC~"-Stl~eet, Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO 2. Property Owner: Mailing Address: 3. Name of Buyer: "/'~//~-- VA FHA CONV Mailing Address: 4. Name of Lending Institution: ~:(~:b-/{;/~~ Mailing Address: ~?~ %-~.. //~' 5. Name of Realtor or Agen[:. ~/Z~/ Mailing Address: Day Phone Phone -Y ~/' Phone 7. Type of Facility to be inspected: 8. Water Supply Legal Description: ~/':z~; , ' - ~,~q~ 4~ (~.~ No. Bdrms. Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well Individual / 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site) ~./ EQ-037 (1/74)