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Home My WebLink AboutNORTH WOODS BLK 1 LT 16 IVIUAIIUIP'ALI I ¥ U~ ANCHORAGE D ,E~RTMENT OF HEALTH AND HUMAN SER.__/~S ,-' Environmental Heallh Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES Address TANK FIELD WELL /~c/ ~, ~, ~h ~,~,~ ~/~7~ WELL Perm NO. ' ~ ~No. ~*~ ~sc...~o. LOT LINE / I ~o~ ~ltJ~¢ FOUNDATION Township. Range, Sec0on AS-BUILT DIAGRAM IShow Ioca on of well, septic system, property lies. foundahon TANKS ~ ~ ~EPTIC ~ HOLDING MateriaI No. ol Compadments ~t TYPE OF SYSTEM ~ / ~epth to p~pe ~ottom kom ~ , lotal Oepth from ob~mal 9raOe .~ I~ original grade ~ F~ ~ ~T Fd( adOeO above obgmnal grade Gravel depth beneath p/pe -- J~ Gravel leng[h Grsvel wmd[h Total absorption area Dislance belween Ii es Numberofl .... JSoffrahng P,pemaleria, .. _ ~.~ Installer Date Inslalled ~ WELLS ~ PRIVATE ~THER (Identify) ~ ~, ~ ~= ~ FT REMARKS: ~L> / -- Scale: ~ ~ . 5N~.EE.R'S SEAL ............ c~nily.mal thio inspecfi0n~was ped0rmed according t0 all Health Depa~ment Approvak Date: 72-013 (3185) ROBERT A. SHAFER June 18, 1987 CIVIL ENGINEER 694-2979 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 ATTENTION: Dan Bolles REFERENCE: Lot 16; Block I; Northwoods Subdivision A conditional Health Authority Approval was issued for the referenced property on December 4, 1986. In accordance with the terms and conditions of the conditional HAA the on-site wast~water disposal system on the referenced property was upgraded under Municipal permit #870076. Attached is a copy of the on-site wastewater disposal system inspection report. Request you issued a final HAA at this time. AS/ss ~NVMi~No I~IPALITY oF · . "~ ~CE3 DiViSioN JUN 9 ]987 RECEIVED SRB 196X EAGLE RIVER, ALASKA 99577 ::' c, 9957?' I ....... ., ,, AK C:Oiq i' A(.;'I ' I' I Iix . 67.q.'""-q-:;!!;5 ]. ~IJNICIPALII'Y OF ANCNORA(~B DEPT. OF HEALTH & rr.N~IRONMENTAL PROTECTION [jUN 1 5 1,q87 RECEIVED :ORA :~:: :i: I:LL. D S & S ENGINEERING 17034 iF]~ R. LOOF' ~!~204 EAGLE RIVER; AK 99577 f~C}U'i'H I::'ORK CONS'I'.. :[70:2!.4 E!:.R., [..[::' E.R., AK 99577 i;C:llq'f AC:'I PHC)NE:', 694-2979 L.Et?~AL.. DE-'.'!~-'.']:R I P"I' :i: (:)iq: L.Ei '1' 16 BL.K i NOR'TH i.,,..IOODS SUBD. SE(:] 4 ,~ '[' :t 5N ,: R 1. LEiT SIZE: 27630 (SQ FT (:)R ACRIES) MAX. NUMBER []1:::' :(JlEDROOMS'.', 3 SC!ZI.. RA"t'It',.I(3: 2.25 ,'-:.",(~:! f::I'/BF~, ~F.';C~ l I... 't'l!ii.S'l DEI:::"i'H ',',J. :3 1:::]' / ¢. TI::;~EIii~ii'I BED -~. W. / .UF.'A :i: f',.ll:: :t: ELD :';;l:::'I::' [: '~ Al i'":l~'iN)) 'i: 'i :i: ONS (:)R :l: IqS'f F;:L..IE::] :1: OiqS: AN AIxlCHCff.~AGE "l'Al'ql< 500 GAI....LON L..IFT SYSTEM Ti] BE USED. ,o/, = ,7 PERFORMED FOR: LEGAL DESCRIPTION:_.J~oT /(' o 2 3 4 5 7 2-25' 8 9 10 11 12 13 14 15 16 ~7 18 19 20 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFO ~LI~' 1%Jo/~.7/~ ~x~ Township, Range, Section: //5'~/ , /:~/vv / SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT DEPTH? P E Depth to Waler After. MonitorinD? ~ ~ C~ Date: Gross Net Depth to Net Reading Date Time Time Water Drop "/" PERCOLATION RATE ~__O (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN zT/ FT AND ,G" FT COMMENTS ' 7034 ~agl. E~ [~ Road NO ~~//// CERTIFY THAT THIS TEST WAS PERFORMED IN AGGORDANOE WITH ALL STATE AND MUN C PAL ~UIDELINES~FFECT ON THIS DATE. 72-008 (Rev. 4/85) pa . ty P.o. ,x .~"~U4r~A~.C~. ANCHORAGE, ALASKA 99519-6650 O~ :'~ ~' (907) 264~k~ 4744 Anchorage MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES January 23, 1987 Dana and Debra Hahn PO Box 1441 Eagle River, Alaska 99577 Subject: Lot 16 Block 1 North Woods Subdivision The Department of Health and Human Services wishes to take this opportunity to thank you for your cooperation and assistance with the septic system related problems facing the North Woods area. With your help we have been able to ascertain which areas of Phase I are most likely to have a shallow groundwater problem. Our next step in this process is to determine to what extent the shallow groundwater has affected your neighbors throughout North Woods Phases II through V, as welt as the surrounding area. We will then proceed along a similar course in those areas where groundwater contamination is a definite possibility. After reviewing the specific tests and the results provided by our engineering consultant relating to your lot, we have drawn the following conclusion: your septic system is discharging into the groundwater and will require immediate attention. Therefore, you will need to contact this department to obtain a permit for the upgrading of your system as soon as possible. Our office is located at 825 L Street, Room 502; our phone number is 264-4744. It is our sincere hope that we will be able to insure a clean and safe community in which you and your neighbors can live. To this end we wish to once again express our gratitude for your under- standing and unselfish cooperation. Sin)cere~y, Dan Bolles Engineering Tech On-site Services '~:~x' 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/-~i~:L INSPECTION REPORT NAME MAILING ADDRESS LEGAL DESCRIPTION LOCATION ~OC~'~ ~, ~-4-~ C"~ NO. OFBED.OOMS I w~ ~/~o4~d Absorption area OweUin~ ~ ~ Manufacturer ~ Material ~ ~_~ No. of compartments Liq, capacity in gallons Inside length Width ~OO ~ IF HOMEMADE: Liquid depth ~ ~ Z DISTANCE TO: ~ Dwelling O Z ~ Manufac~ ~ /~ PERM IT NO. ~ -- ~ ~ Material ~/ ~quid capacity in gallons O ~ op of tile to finish grade ~ ~ ' Material beneat~ile' Total effective absorption area Length Width ~' Depth v ~ PERMIT NO~ ~ ~ Type of crib / Crib diameter Crib depth Total effective absorptio ~ ~N Well / Building f~n Nearest lot line ~ DI CE TO: . Class ~]~ ~ Depth Driller Distance to lot line PERMIT NO, ~ DISTA~E TO: Building foundation Sewer line , Septic tank Absorption area(s) OTHER PIPE MATERIALS - REMARKS , J APPROVED DAT~ LEGAL PERMIT NO. ( 8:1.8559 ) RPPL I CRNT LOCRT I ON LEGRL FRRNK BETHRRD PETERS CREEK L 16 B 1 NORTH WOODS [:'EPFIRTMEN!? g~./HERLTH RND FN',,,"[Rr~NMEN'f'RL .... C TE" T I ON 825 '"L."' STREET, RNCHORRGE., BK. 99501 264-,4.728 STR BOX :1.698K 975E17 LOT SIZE T'¢F'E OF SOIL FIBSORPTION S'¢STEM IS: TRENCH MRXIMUM NUMBER OF BEDROOMS '_:::45-1615 27888 SQURRE FEE]'.' SOIL RFITING (SQ FT/BR)= 2t. 75 THE REQUIRED, SIZE OF THE SOIL RBSORPTION SVSTEM IS: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE 'FRENCH OR DRRINF'IELD. THE DEPTH OF FI TRENCH OR PIT IS THE DISTFINCE BETWEEN THE SURFRCE OF THE GROUND FIND THE BOTTOM OF THE EXCF%'RTION (IN FEET.'.". THERE IS NO C;E'f' WIDTH FOR TRENCHES. THE GRR'.',,'EL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE FIND THE BO'f'TE~M OF 'THE E',:':',CR","FITION (IN FEET:). PERMIT RPPLICFINT HFIS THE RESPONSIBILITV 'TO INFORM THIS DEF'RRTMENT DURING THE INSTFILI.FITION INL=;PECT!ONS OF FIN"r' WELLS F"fDJRCENT TO THIS PROPERT'¢ FIND :'PIE NUMBER OF RESIDENCES THFIT THE WELL WILL SERVE. BFICKFILLING OF FIN'¢ S'¢'-;TEM WITHOUT FINRL INSPECTION FIND RPPROVRL BV THIS DEF'FIRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL FIND FtN'-r' ON-SITE SEWRGE DISPOSFIL S'¢STEM IS ~L88 FEET FOR FI PRI',,,'FITE WELL OR :l_SFl TO 2El8 FEET FROM FI PUBLIC WELL DEPENDING UPON THE T'¢F'E OF F'UBLIC WELL. MtNIMLIM [:,ISTFINCE FROM R PRI',,,'FITE WELL TO Ft PRI',,,'FITE SEWER LINE IS 25 FEET FIN[:, TO FI COMMUNIT'¢ SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MR"r' FIPPLV. SPECIFICRTIEINS FIND CONSTRUC'FION DIRGRFIMS FiRE FIVFIILI:'tBLE TO INSURE PROPER INSTF!LLRTION. F'EF-:~.t l; 'T E::-::F" ][ F.:E2G K:,E-]C:E[c."!BEF: 2-:1., I CER]'IF'¢ THFIT i: I RM FRMILIFtR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FIND WELLS FIS SET FORTH B'¢ THE MLINtCIPFILIT'¢ OF FINCHORFIGE. 2: I 1.4ILL INSTFILL ]'HE S"r'STEM IN FICE:ORDFINCE WITH THE CODES. ]:: 'I UNDERSTFIND THFIT THE ON-SITE SEWER S"r'STEM MR'¢ REQUIRE ENLFIRGEMENT IF' THE RESIDENCE IS REMODELED TO INCLUDE MORE' THFtN 2: BEDROOMS. SIGNED: ............................................... FIPPLICFINT FRFINK BETHFIRD Applicant: Location: Legal Description: C IG ~ ~ ~(~(~'~9¢~0~¥ Type of Soil Absorption System Is: Trench: ./....~" Drainfield: Maximum Number of Bedrooms: '3 L JNICIPALITY OF ANCHORAGE , Department 8~z~Health and Environmental"~kotection 825 L Street, Anchorage, AK. 99501 264-4720 * * * HANDWRITTEN PERMIT * * * WELL AND/OR ON-SITE SEWER PERMIT f~ ~ _~' E~f%,~ Mailing Address: ~ ~ Lot Size: Seepage Bed: Holding Tank: Soil Rating(sqoft/br) DEPTH The Required Size of the Soil Absorption System Is: LENGTH ?J~ ! GRAVEL DEPTH ~" WIDTH The length dimension is 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(in 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(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = ~O(k9 GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residenges that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * 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. Well logs are required and must be returned to this department within 30 days of the well completion° Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31~ 1 9 8 t * * * 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 codes. (3) I understand that the on-site sewer system may require enlargement if the residence is reD~odeled S igne'd: to include more th,~a~ bedrooms. SWP/024(1/81) , ~_,AUNICIPALITY OF ANCHORAGE >../~ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-550, Anchor&ge, Alaska 99502 276-222~ SOILS LoG -- PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 2 3 5 6 7~ 8 9 DATE PERFORMED: SLOPE SITE PLAN 10 11 , _____.~ 12 "13 14 15 16 17 18 19 20 COMMENTS PERFORMED BY.' WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? L O P E Gross Net Depth to Net Reading Date Time Time Water Drop 4 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 HAA # ~'NiC~PALITY OF ANCHONAGI: ENVIRONMENTAL SERVICES DIVISION AUG 08 1997 GENERAL INFORMATION Complete legal description Lot 16; Block i; Nort.h Woods Subdivision Location (site address or directions) 22774 Northwoods Drive Chugiak, AK Property owner Mailing address Lending agency Mailing address Agent Address John & Melinda Glass Day phone 688-6800 P.O. Box 671643 Chugiak, AK Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: 4 XXX If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: xxx Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72~25 (Rev. 1/91) Front MOAff21 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 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 /~ Phone S & $ ENGINEERIN.,G/ Address 17(32P. I=,~la_lTJw.~(~ m~,4 ~ O~ Engineer's signature ~~ DHHS SIGNATURE ,/ A: ')roved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: 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~)25 (Rev, 1/91) Back MOA #21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist LegalDescripti0n: lb #! Parce.,.D.: A. WELL DATA Well type Log present (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number _.~/.~ Total depth Sanitary seal (Y/N) Date of test Static water level Date completed Cased to Casing height~(~0ve ground) · ~ Wires p~rope~ly protected (Y/N) FROM WELL LOG~'"~'~AT INSPECTION g.p.m, g.p.m. Nitrate Other bacteria Collected by: Well production WATER SAMPI_.~ESULTS: '~Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed (a/J:3r'/~' Tank size I~.~) Foundation cleanout (~N) [_J~C$ Depression (Y~) Date of Pumping ~1 ~/¢ ~ Pumper C. ABSORPTION FIELD DATA Number of Compartments ~- Cleanouts (~N)~ High water alarm (Y/{~) b~'~ Date installed {o[l::~l{~l I Soilrating (g.p.d./fForfF/bdrm)~.?--$%_ Systemtype Length ~-~/ Width ~ Z / Gravel thickness be~ pipe O, ~ / Total depth ~ / Effective absorption area t~ ~ ~Monitoring Tube present ~)~ Depression over field (Y~ ~O Date of adequacy test ~/~ ~ Results ~ail) ~ For ~ Fluid depth in absorption field before test (in.); Immediately after ~ gal. water added (in.): ~T b~ = g.p.d. Fluid depth ~ n (ins) Minutes ater ~/~oo Absorption rate (~ ~ Peroxide treatment (past 12 months) (Y/N) ~)~ ~e~ If yes, give date ~ bedrooms 4 Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES F. Size in gallons off" level at* "Pump *Datum '~ SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ~¢ ~ -F On adjacent lots z.¢o ~ -4- Absorption field on lot Public sewer main On adjacent lots Public sewer manhole/cleanout Sewer/septic service line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~/th Property line ,2.0 ~ ~k Absorption field Water main/service line ~0¢''~ Surface water/drainage !~O/ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line Building foundation JD Surface water Driveway, parking/vehicle storage area Curtain drain .Kf,.[_~¢~ Wells on adjacent lots I certify that I have det. e~'m~ned/hru field inspections and review of Municipal re¢orcl.¢,~i in conformance~ H¢,~ guidelines in effect on this date. bng~neer s N a,~m e ../. , Date Eagle River, Alaska ENGINEER'S CERTIFICATION _ Wells on adjacent lots Water main/service line HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON~SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Lot 16; Block I; North Woods Subdivision; Location (address or directions) 7547 North Woods Drive (b) Property owner Mailing Address (c) Lending Institution Mailing Address Dana Hahn HC80 Bnz. 7547 Telephone:(home) 685-$955 Chugi~, A~ 99567 Telephone Business 276-6191 (d) Real Estate Company and Agent Address Telephone ':" (e) Mail the HAA to the following address: (or check here [~xif hold for pick up.) List contact person and day phone number below: S & S ENGINEERING 17034 Eagle River Loop Road No. ~agle River, Alaska 9957Z, 2. TYPE OF RESIDENCE Single-Family [~X Number of bedrooms. 4'-~ 3. WATER SUPPLY Individual Well [] Community I~ 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 I~X 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. 72-025 (Rev. 7/88) Page I of 2 5, ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation oftt, 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. Telephone . Name of Firm Date 6. DHHS APPROVAL Approved for Approved Ter'ms of Conditional Approval ____ bedrooms by _~ O t-4 t-,.!. ~, '¢P¢, Date //lO/c// Disapproved Conditional The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 DHHSdo not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsibleforerrorsoromissions in the professional engineer's work. 72-025 (Rev. 7/88) Sack Page 2 of 2 A. WELL DATA Well Classification MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST- FEBRUARY 1984 343-4744 Well Log Present (Y/N) Date Completed Legal Description: If A, B, C, D.E.C. Approved (~N) W-- Yield Total Depth Cased to __ Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot 7--4-~ t '~ To Nearest Edge of Absorption Field on Lot ~-o~ *' ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by ; Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed Lo~\"l -'~"J Size ~'-z~ Standpipes ON) '~ Air-tight Caps~)'N) k~ Depression over Tank (Y~ ~ Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: No. of Compartments Foundation Cleanout ~)/N) Date Last Pumped ~,~-, , for Temporary Holding Tank Permit (Y/N) -- To Building Foundation To Disposal Field To Water-Supply Well To Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments ~"PO r~? 17.-~ 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absortion Area 1 ~z-~'q L~ ~ Depression over Field (Y/~ /~ Type of System Design Length of Field Depth of Field Gravel Bed Thickness ~-'~ Statndpipes Present~) Date of Last Adequacy Test Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well ~o~ 4' To Property Line To Building Foundation Lot 7-~ ~ To Water Main/Service Line To Existing or Abandoned System on ; On Adjoining Lots ~ ~ To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION '-D..~.e Installed Size in Gallon--~s-~ ~ "Pump On" Level at High Water Alarrn Level at Tested for Meets MOA Electrical Codes Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ~ Pumping Cycles during Adequacy Test. Signed Company Date MOA No. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines ~n inspection. ReceiptNo.22'~ ~?/~~_ Date of Payment / r~ ~ / Amount: $ 72-026 (Rev. 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 STEVE COWPER, GOVERNOR 563-6775 November 26, 1990 FOR: S & S Engineering Attn: Ray PWSID: 9213001 According to the records on file in this office, the ~huqiak ~tilities Northwood Deerhorn Subdivision Water System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, vERA E. cRAiG ( / Environmental 5~'ec i a! i s t VEC:pf ""~"/ MUNICIPALITY OF ANCHORAGE 0 ~ DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 16 Blk. 1 North Woods T15N R1W Sec. 4 Location (address or directions) (b) Property Owner _Dana Hahn .Telephone:Home 688-3985 Mailing Address PO Box 1441 Eaqle River¢ .Ak. 99577 (c) Lendinglnstitution Lomas & Netteleton Telephone Business 2 7 6- 61 9 1 Mailing Address (d) Real Estate Company and Agent Address Telephone Mail the HAA to the followin(~ address: or: Check here ~, if hold for pick up. List contact person and day phone number below. (e) TYPE OF RESIDENCE Single-Family r~x Number of Bedrooms Four (4) WATER SUPPLY Individual Well [] Community CgX Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite [~X 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 72-025 fRev 8/861 Front ~ ~.o ~ eS~d L86I ~EE @unD ale(] le^oJddv leuo!l!puoo jo st,uJaj. leUO!l!puoo Pe^°Jddes!Q××X××X××××× pe^oJddv -I~'AO Udd¥ SHHO '9 · paao~dde ~ou sT pue sp~epuegs IedToTunN H~T~ s~ea~ X~edo~d 3oe~qns aq~ '~eau~Bua eq3 Xq pa~ald~oo ueeq seq uoT~oadsuT ue pue p~qsTidmoooe uaeq eAeq SUOT~Oe~aoo aR& '986I ~ aaq~aoa~ ~o IeAo~dd~ ieUOT~TpuoD eq~ BuTpzeBa~ reaSs,Jeau!~u3 L._/ 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 ~ovember 24, 1986 ... GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 16; Block 1; Northwoods Subdivision Location (address or directions) Northwoods Drive (b) Applicant Name Dana Hahn Telephone: Home _688-3985~ Business 276-619__~1__ Applicant Address SR 3, Box 7547, Chuqiak, Alaska 99567 (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [] (explain); (d) Lending Institution- Lomas and Nettlehon ...Telephone (e) Address A~chora e Alaska Real Estate Company and Agent none/refinancing (f) Address Telephone ~l~he HAA to the following address: SRB 196X Eagle River Road Eagle R~v~r, Alaska 99577 TYPE OF RESIDENCE Single-Family ~ Multi-Family [] Number of Bedrooms 3 3. WATER SUPPLY Other ~\,~ tl if~1 Individual Well [] Community [] Public [] · ' ' ' ' i Note: If community well system, must have written confirmation from the State Departm.en!' of Enwro?m.e ,ntal Conservat on attesting to the legality and status. SEWAGE DISPOSAL Onsite~/. 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. ~ 72-025 (11/84) Page I of 2 ENGINEERING FIRM PROVIDIN,.~.,~ISPECTIONS, TESTS, FILE SEARCH, DA.~jAND INFORMATION As ?,ertified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ~ ~ ~ ~NGT~RR~T~ . Telephone ~ Rq4-2979 Address - ~ 1~ ~g!~ R~ve~ Roa~ ~e R~ve~, A]a~~ 9q577 Date _ Nove~ 25, 1986 ~sorption area is in non-co,ii--ce and will require replacement next spring. Water s~ples should be taken monthly to be sure the water table re~ins non-cont~inated mtil system is replace. //'~2~ ~z.~ .t.~' Approved for -~ _ bedrooms by ~,~. ate - ' - Conditional App ved Disapproved~ ' Terms of Conditional Approval .-- . 2'$ - ~ / - '/ '.~ - ,/ / - / ~ ~ ~ ~,~' ,.~ ~ ~ ~ t././ l Lt ,'- CAUTION The Muncipality of Anchorage Depa~ment of Health and Environmental Protection (DHEP) issues Health Authority Approval ce~ificates 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 cou~esy to purchasers of homes and their lending institutions in order to satisfy ce~ain federal and state requirements. Employees of DHEP do not conduct inspecti°ns or analyze data before a ce~ificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) M~ ~ .r.a.~,! 1TY OF ANCHO~G[ '.:F HEALTH & IN ,}[AL pROTECTIO~ WELL DATA MUNICIPALITY OF ANCHORAGE (MO~--~ HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: Well Classificatic[~' ~' C ~VED If A, B, C, D.E.C. Approve7, _/N)d~ Well Log Present (Y/N) Date Completed t...,/ Yield Total Depth~'"'"~ Cased to Depth of Grouting Static Water Level ~ Pump Set At Ground~'""-~ Casing Height Above ~ /Sanitary Se~/N) Electrical Wiring in Conduit (Y/N) // / D, epressicfCAround Wellhead (Y/N) Separation Distances from Well: /~/ /.~ TO Septic/Holding Tank on Lot ~. / /' ./ ;O~ng Lots __ To Nearest Edge of Absorption F~.~1_ot __ __;On Adjo. i.ni. rig_ Lo't~...~ To Nearest Public Sewer Lin~.~ L;T° Nearest PubLic S¢_w?r ...... Cleanout/Manhol~ To Nearest Sewer Ser:~e Line on Lot Water Samp~y _ ; Da Water Sample Test Results B. SEPTIC/H~'.:2;;',IC TANK DATA Date Installed ¢'¢4~.../O /~/' Size Standpipes (~N) Air-tight Caps,/N) Depression over Tank (Y/~ Pumping/Maintenance Contract on File (Y~ Holding Tank High-Water Alarm (Y(~) Separation Distances from Septic/~ Tank: No. of Compartments Foundation Cleanou, t (Y~ Date Last Pumped /~/~ ~/~ ~ ; for Temporary Holding Tank Permit (Y~ ~/~ To Water-Supply Well To Property Line To Water Main/Service Line Course To Building Foundation To Disposal Field ~ To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(1]/84) ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~,] C~ ~. / 42 Width of Field ~ b< Square Feet of Absorption Area Depression over Field (Y,(~) Results of Last Adequacy Test /d/,~ Separation Distance from Absorption Field: To Water-Supply Well ~, ~0 ' To Building Four~dation .;~_,..~. Lot /'L,r To Water -M4..~WService Line /~ / To Stream/Pond/Lake/or Major Drainage Course Type of System Design "'~/"¢/4 Length of Field "~ ~' / / Depth of Field Gravel Bed Thickness Standpipes Present (~/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) /,.J ~2 ,,....r~' To Driveway, Parking Area, or Vehicle Storage Area Comments ,~'J-/. ~ /~ ~ 7~ ~ c ~ 0 LIFT STATION Date installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y~N) Dimensions Manhole/Access (Y/N) //,_"Pump Off" Level at , V, ent'(Y/N) '_ Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guideiines in effect on the date of this inspection. Signed --/ Compar~B 196X MOA NO. EAGLrE RIVER, AK 99577. , ~'C. Receipt No. ~ ~ Date of Payment '~-~-~ Amount: $ ._ ~. ~ ~' ~ Page 2 of 2 72-026 (1 Date Date Date Inspector inspector Inspector Comments Conditional Approval Date Sewer Installed Permit No. T Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Buyer Address Realty Co. & Agent ~ .. Phone Address Street Location Type,pf Residence ~ Single Family ~ Multiple Family No. of Bedrooms ~ Other Water Supply ~ Individual A~ACH WELL LOG. A well Icg is required for all wells drilled since June Community 1975. For wells drilled prior to that date, give well depth (attach Icg if ~ Public UtilitX available.) Sew~e Disposal ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility:. ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ALASKA enUlraOFimerITAL COi TISOL $613UIC65, IBC. ~nclineerincl 8 Enuironmcntal $1udics December 29,1981 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIP, ONMENTAL PROTECTION JAN 5 ' 982 RECEIVED Bethard Construction SRA Box 1698-K Anchorage, Alaska 99507 Dear Mr. Bethard: On December 21,1981 I checked the level of water in the seepage trench standpipe on Lot 16 Block 1 Northwoods Subdivision. According to your records the house has been occupied since October 13, 1981. The DHEP records show the trench to be 8 feet of rock with 3 feet of cover. Our measurements show the depth of water to be 2.6 feet below the distribution pipe. (5.4 ft. of water in trench). This depth of water seems excessive for the period used° It seems possible that surface water may be running into the system. Myladvice would be to monitor the water depth several times this winter. Sometime just after breakup several test holes should be drilled to determine the reason for the liquid buildup. A curtain drain may be necessary for the lot. If you have any questions please let me know. Sincerely; 'CONTROL SERVI~; INC. 1220 West 25th Avenue ANCHORAGE, ALASKA 99503 Phone 276-1361 JOB "- SHEET NO. CALCULATED DY CHECKED BY SCALE DATE DATE