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Home My WebLink AboutNORTH WOODS PHASE 2 BLK 1 LT 14Onsite File North Woods Phase 2 Block 1 Lot 14 #051-801-07 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page I of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP1 91115 PID Number- 051-801-07 Dwelling: 01 Single Family (SF) E] with ADU ❑ Duplex (D) El Two Single Family Project: El New ❑ Upgrade Name Berry ABSORPTION FIELD EJ Deep Trench [I Wide Trench E) Bed ❑ Mound Site Address 22569'"+ hispering Birch Cir El Other Phone Number of Soil Rating Total depth from original grade 688-5835 13 GpDisd - Ft LEGAL DESCRIPTION Depth to pipe invert from original grade lGravel depth beneath pipe Ft.1 Fl Subdivision Block Lot NORTH WOODS PHASE 2 B1 L14 Fill added above original qradte lGravel length Ft.1 Ft Township Range Section Gravel voidth s: Number of Lines Distance between lines SEPARATION DISTANCES Ft. I - - F11 � i Sewer To`ion Lift Station Holding Se Septic Absorpt M Total absption area lNumber of trenches Dist. belween trench -es From Tank Field Tank Line R2 Ft Well 100,+1 na ` na I na TANK Septic ED S.T.E.P. El Holding E) Other Manufacturer Greer Capacity 1000 Gal $vriace Water 100'+ na na Material Number of compartments Lot Line 10'+! na na NA Steel 2 LIFT STATIONanUfacttlfer FOUndalion 10'+ na na M capacity RemarksSeptic, Tank Replacement Gal Alarm location �loctrjcal installed by PIPE MATERIAL House to lankD3034 Tankto 3034 drainfield Installer Dan Green Drainfield C04 -AT D3034 Inspector NorthRim Eng. BENCH MARK (Assumed elevation) 100 ft Inspection 5`23f19 5/23/19 Location and description dates: 21" Deck Y' 41" Conditional Approval: Date Septic System Approved dow# Date 11/17/90,20 1 Note: this approval does not include well permit requirements. Engineers Stamp or 491E Steve Eng 4VA - CE -6256 7 AS -BUILT MEASUREMENTS A B T1 13 34 ,#�ep-Lic i anK wiliUU's bircn i Decommissioned Old Circle Septic Tank Flat Slope PER UPC NOR THRIM ENGINEERING SteveEng. com PO Box 770724 Eagle Rlver, Alaska 99577 907.694.7028 '(Ict Slope )g :•'�� OF , NORTH WOODS PHASE 2 1 so *..49 ....1 * BLOCK 1 LOT 14 RECORD CE-� s WASTEWATER UPGRADE LAYOUT 11/13 / 2 0+ oat« SHET REPLACE SEPTIC TANK I 11/13/20 2 of 3 V) D F-1 z C-) T9 V F- D D Z (� 7C F -I PT �;0 Z o H F— F9 d F- 70 0 D z� D 3 d V) V T D V) FTI u () 3 ' ro OD0 < O �F-a—sl 0 c+ m >T O v ED , k vJ O ` Z Q < `+ v Q Q 0 rq J rr� O O Ty m Qo ,pN <o ci ® Z �< W _ Q � QQ N V) D F-1 z C-) T9 V F- D D Z (� 7C F -I PT �;0 Z o H F— F9 d F- 70 0 D z� D 3 d V) V T D V) FTI u () 3 ' ro OD0 < O -0 c+ m �Q C+ 1:5 fl D 0:35-- �o h Q < `+ v Q Q 0 o Q o� ID O < Q m �< W _ Q � QQ Q W ro 0 c+ LA F-1 < h Q < `+ o Qo ro o ro lD F o ro ID _ Q � (D lD U1 W Q 0 tDd ro Fri X_ Q <+ hn : roro (D o O _0 F- M n m m < ro -i Q :5 n Q c+ S o :3 90 LA o ro n S Tract B-2 7.3'x12.4' SAUNA / / 8.2'x8.2' SHED--,,, / TV2 / N *a, l 3B1Y / 31� 7.0'x10.3' GREENHOUSE Lot 13 HOUSE DETAIL Scale: 1" = 30' Lot 14 42,879 S.F. J5� SEPTI �Q \� PIPES 6 ORS�NgCT 3A' �qr Lot 15 ANCHOR EASEMENT \ \ =50.44 \ R=50.00 i � 50.0' 15' T&E EASEMENT AN NOTE: LOT IS SERVED BY A COMMUNITY WATER SYSTEM. PLOT PLAN ___ AS BUILT _X— SCALE _1=_= 60_— GRID _ NW 1559__ Project No. ____ 19_631ZA1--_ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, in c , (907) 522-6476 Phone 000��p4� (907) 522-4625 Fax o0Q Professional Land Surveyors kenOlangsurvey.com o OF A jonothan*langsurvey.com O S I hereby certify that I have surveyed the following described property: P OO LOT 14, BLOCK 1, NORTH WOODS SUBDIVISION — PHASE 2 (PLAT No. 82-204)pa 49TH Anchorage Recording District, Alaska, and that the Improvements situated thereon are 0....... it within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed KENN H• LAN premises and that there are no roadways, transmission lines or other visible Q c G easements on said property except as Indicated hereon. �O ��F :l Cl10 to {b P '•.LS -5202. 5�G 0 Dated this the __�--- Day of I_eLuY�1:�t<__L_,-1s__, at Anchorage, Alaska Q Oa �0 0 4�,OFESSIONAU o It is the responsibility of the owner to determine the existence of any easements,-"V4�OOc covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 ,0c..%!_tt 0 MUNICIPALITY OF ANCHORAGE On-Site Water&Wastewater Program , ., PO Box 196650 4700 Elmore Road "� I Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ,-N http:!/www.muni.org!onsite T"',, Department On-Site Wastewater Disposal System Permit Permit Number: OSP191115 Effective Date: 4/23/2019 Work Type: SepticTank Upgrade Expiration Date: 4/22/2020 Tax Code Number: 05180107000 Site Legal Address: NORTH WOODS PHASE 2 BLK 1 LT 14 G:1559 Site Mailing Address: 22560 WHISPERING BIRCH CIR, Chugiak Owner: BERRY ALAN D & EMILY A Lot Size in Sq Ft: 42879 Design Engineer: NORTH RIM ENGINEERING Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank 0 Privy 0 Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Date: I/ O� /7 Issued By: kyte4eA = /' Date: Art MUNICIPALITY OF ANCHORAGE •Development Services Department __. �. Phone: 907-343-7904 On-Site Water & Wastewater Section / Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-801-07 Property owner(s) Berry Day phone 688-5835 Mailing address 22560 Whispering Birch Cir Site address same Legal description (Sub'd., Block & Lot) North Woods Phase 2 BLK 1 LT 14 Legal description (Township, Range & Section) Lot Size 42,879 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial I I Single Family (SF) x (w/wo ADU) Septic Tank ❑ Upgrade [x ] Duplex (D) n Holding Tank ❑ Renewal I I _81r 'rigs Privy I I 's 1 n. . iks Private Well ❑ Q 3 Water Storage I I L ArN i b -tl, a x c` THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: \.1 n 4'\, �� 68L9 `' istance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signaure of property owner or authorized agent) Permit/Rush Fees: .9-V-5 Waiver Fees: Date of Payment: Lill'119 Date of Payment: Receipt Number: _ Receipt Number: Permit No. O5P(9 /115 Waiver No. G\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc JORTHIM ENGINEERING SteveEng.com Steve Eng, PE, PH 907-694-7028 SteveEngPE@gmail.com Date: 4/17/19 Number of Pages: To: MOA On-Site Services Subject: North Woods Phase 2 Block 1 Lot 14 Septic Tank Failure The subject septic tank has failed-a new tank will replace the old one. The existing trench appears to be working OK. Please issue a permit so the tank can be replaced. The existing trench will remain. Please review as soon as possible. If there is need for additional information or clarification please give me a call. Thanks-Steve TRIM ENGINEERING SteveEng.com North Woods Phase 2 Block 1 Lot 14 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 3-bedroom home. Most of the neighboring lots are developed. The current septic tank has failed-the trench still functions. These lots are near an acre and are served by the public water. No adverse impacts are expected from tank replacement. The easements are depicted on the lot. The slope is indicated in the area of the septic system. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • New 2- compartment, 1000 gallon septic tank. Watertight couplings on inlet& outlet. • 5' minimum between the tank and trench. 10' to property lines. • 4' of cover or insulation is required for tank; an equivalent of 1" insulation for 1' foot soil cover. Minimum of 2' soil with insulation. Tank & solid pipe must be set on well compacted, stable soil. • 4" diameter cleanouts with airtight caps are required 1' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment,and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) ``; o +.%.÷..17 Zl v� vl c — r. Eng ,•;t, "`TTT •1 t' ` � ,'"ROFESSW .= SII DESIGN NOTES: 1. Existing Trench Remains In Place. 2. Sewer Service Line minimum 2% slope. 3. Replace Septic Tank/Decommission Old Tank Per UPC. Connect New Tank To Existing Trench. 4. Lots Served by Public Water. 5. No Conflicts Within 200'. 6. Check Condition Of Sewer Service Line— Replace If Necessary. 7. Add Double Cleanouts Before Tank If No FCO. No Conflict No Conflict Flat Slope Flat Slope 3 Bdrrn q' Esnnt Anchor • No Conflict Flat Slope wQ y ' 15' T&E Easemen4.67e � New 1000 Gallon Whispering Birch Circle Septic Tank w/DCO's Decommission Old Septic Tank PER UPC Flat Slope • NORTHR/M _•+'E�°F�k'% 1• = 50' ENGINEERING 1.6;'•••• �y NORTH WEEDS PHASE 2 •*0. :49• ;49m BLOCK 1 LET 14 DESIGN SteveEng.com s PO Box 770724um" LAYOUT Eagle River, Alaska 99577 •.911. WASTEWATER UPGRADE 907694.7028 4723I19= REPLACE SEPTIC TANK Da t4/23/19 Is2lEETOf 3 Foundation Cleanout , / Tank Cleanouts Fin ^amide Opposing Cleanouts Between Septic Tank & Trench 4 Foot Cover or Equal 1---- _____......,.., 1000 Gallon 1----....._Trench SEPTIC TANK MOA-Approved lid Pipe Match Elevations To DESIGN NOTES Existing FCD & Line 1. Use Existing Trench. 2. Septic Tank & Solid Pipe to be Placed on Compacted, Stable Soil, Free from Boulders. 3. Sewer Service Line is Minimum 2% Slope & 3' Cover. 4. Water-Tight Couplings. 5. See Specification Sheet. 6. All Work To Conform to Municipality of Anchorage (AMC) Requirements & Specifications. 7. Decommission Old Septic Tank Per UPC. 8. If No FCC], Install DCO's. NORTHRIM _.gsZr ,�''� ENGINEERING !(0"- 4o, SEPTIC TANK PROFILE NORTH WOODS PHASE 2 i* :49111 *$ SteveEng. com , % PO Box 770724 ;; : # BLOCK 1 LOT 14 Eagle River. Alaska 99577 4f� 907.694.7028 4'' . •1(11 " TANK REPLACEMENT Date'4/17/19 BY: SE 1' = 5 ' SHEET:3 o f 3 IDn3" 1Sccde: I SE ) (INA 1�r/ Q O 53/7 1 72 /`1 5 6'1-//1_7--�• Zpr OAT( a++satit` II �r�Q-• •• , -. . v-):49TH ,op cv 7 0 ci ` P.- -‘. , v...w „......;;IKI ,.. t•....• a � /1 C� NOT t 1 : fe..rntnts not apptering I"1 eirnt4C } O+af Ort nal .Ao.• v�lttt Ctf Crrplrt Si D. P,,E N. provit.d by client. It % IAt rctpo.t r or budder. prior to constru<+ion, +o �, ' O� buI ldinQ grade relative to finish gra O ``c\ts"` COnn/CIIOnt, end +a 0tlermint uA1 t e G3 �l eostn•enrt• caveman/a, or Iestriclra SAUNA I�r r. I Qv -- opp.eer OA P. rtcerded wbdivtsles be, v OS S `0& zvx /6 Elevations toted en ettu+ed delves `e0 N) .1' POQCN (�-3 indiCeled, and DeerrnQt octal &stoats /t/ ,) <tot ‘, %,"" /� CA 2E 130 lv 6Qa •• ,.. -- A„„o2 .914, ��Q �6 • 3 s C i En SEM E 1 -r• .. 2 & g' f �`/ % �' -• ,•• tea tnl)JE.,GIEG /— h "t/ �� •' G Et- ..7 .1'-'1.-. t e e t EJ�C,LE Rn/fcQ -._. v-c3. , / (907)6 Cj W> ISPEIZIP` e LEGAL oEscal / D% G�I C{ CSE . PEESE . LOT /¢1,•. ®LOCK / - ,� t _LC (PLAT) /JQLTI-I WOODS ' r . LEPf/Qiti� 7 C- L -. f="- 7AA7; PAMM5E ; .ZE. PLAT N0. SC ALE - _ -- -- — — -- —_ _ -- 2- X69 �,� f0 NAME 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 MAILING ADDRESS LEGAL DESCRIPTION LOCATION Absorption area DISTANCE TO: Manufacturer Liq. capacity in gallons ............ DISTANCE TO: lWell Manufacturer DISTANCE TO: Top of tile to finish gra¢ ~ Width Type. of crib ISTANCE TO: Well J~ss ,/ Dep~h~ DISTANCETO~ Building foundation Inside le ngt h_~_. JDwelling Foundation Total lenqth of lines Material beneath tile Depth Crib depth Building foundation Dr er JSewer line PHONE Dwelling Material Width NO. OFBEDROOMS PER,lIT NO. No, of compartments Liquid depth PERMIT NO. Material Liquid capacity in gallons Nearest lot line .-,L [O / Trench width ~, ,~ inches I in~s PERMIT NO. _ 8,~/! 7'7 Distance between lines Total effective absorption area PERMIT NO. Total effective absorption area Nearest lot line Distance to lot line PERMIT NO. Absorption area(s) Septic tank [~UPGRADE OTHER PIPE MATERIALS b 3034 SOIL TEST RATING rcs INSTALLER REMARK~ APPROVED DATE LEGAL PERMIT NO. ~llJr~ IC:I~LIT'T' OF Ftr~E:H,r'!~.~F-IGE DEPARTMENT G. HEALTH AND ENVIRONMENTAL ~,,OTECTION 825 'L' STREET, ANCHORAGE, AK. 99581 264-4?20 L]FJ--SZTE S,E~L.~,ER PEF~FIZT ( 82t±?? ) APPLICANT LOCATION LEGAL STEVEN L SKAGGS CONST Li4 Bi NORTHNOODS II PO BOX D CHUGIRK RK ~95g? g88-28~1 LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT?BR)= 300 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEF'TH= _q- LEIqGTH= _q-Et LSRR"-/E L DEPT| :-~, t_'i THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD~ THE DEPTH OF R 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 OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). SEPT I E: TRICK] S I ZE= 'IE-,~E'~ ,3RLLL--I[-~S PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. Tb~O (2) I ~-~SPECTI £~NS FIRE RE~2L~IREC. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION RND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND RNY ON-SITE SEWAGE DISPOSAL SYSTEM IS i00 FEET FOR R PRIVATE WELL OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM R PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MRY APPLY. SPECIFICATIONS RND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTRLLRTIONo PEF~:I"-I I T E)-(F' I F~.'ES DEC:E~IE:FF;: _~- :.1_.. :.1__982 I CERTIFY THAT l: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS, O & E ENG.NEERING & DEVELO, MENT CO. Russell Oyster 694-2774 SOIL LOG Performed for: Name: Mailing Address: /'/-~" "~2gr~' D,/ ~"~/'/~'c~/"~7/~.Z Legal Description: j_~7'- Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Earl Ellis 688-2280 Depth (feet) Soil Characteristics 10__ 11__ PLOT PLAN 12__ 13__ 14__ 15__ PERC. TEST 16__ Ground Water Encountered: Yes Proposed Installation: Comments: Performed by: Seepage Pit No r If yes, what depth Drain Field 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING F)%I -R()I -~7 HAA # ~ ~c~ GENERAL INFORMATION Complete legal description Northwoods #2, Lot 14, Block 1 T15N R1W Section 4 Location (site addres§,.ordirections) 22560 Whispering Birch Circle, Chugiak Property owner James Hayden Day phone msg 694-5195 Mailing address ??~en ~rhi.~pP'r-ing Ri~c~h ~.i'~lP_, C, hugiak, AE;:: 9956'7 Lending agendy N/A Day phone Mailing address Agent Address N/A Day phone 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. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: Public sewer If community wastewater system, provide written confirmation from State AD£G attesting to the legality and status of system. 79-025 (Rev, 1/91) Front MOA #21 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. 694-5195 Name of Firm Eagle River Engineering Services Address P.O. Box 773294, Eagle River, AK Engineer's signature ~' 99577 Phone DHHS SIGNATURE Approved for Disapproved. bedrooms. Conditional approval for ./ Date bedrooms, with the following stipulations: Additional Comments By: / / The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 ~Legal Description:~J;o~r~5 ~- ~¢ i.~/; gZ./~') A. WELL DATA Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Parcel I.D. Well type /4 3g present (Y/N) Jepth Sanitar' (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed Driller Cased to Casing height Wires properly protected (Y/N) 7_ / FROM WELL LoG' AT INSPECTION Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main g.p.m. ; On adjacent lots acent lots Public sewer service line WATER SAMPLE RESULTS: Coliform Nitrate Other Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed /3./,5"/~' ~-- Tank size bO~O ~J-[ Compartments 7__ Cleanouts (Y/N) .~//~-~ roun(~ation c eanout (Y/N) ~ ~ ~epression (Y/N) High water alarm (Y/N) /~'/~ Alarm tested (Y/N) Date of pumping o7//.r /~3,- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s)onlotE;o~. P{~.O On adjacent lots ('0¢'~.~ H.,O Foundation //, To propertyline ~/~ ~ Absorption field ~ ~, 5 ~ Water main/service line Surface water/drainage '¢ /¢'~ i 72-026 Rev. 3/91 Front MOA21 CONTINUED ON BACK PAGE C. LIFT STATION D~ Manufacturer Size in gallons _ -~ Manhole/ACcess(Y/N) (Y/N) __- ~~'-...~- //J~--'~ ___ "Pump off" level at Vent High water alarm level ~ Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed /,,~ Length 9/; Width Total absorption area Depression over field (Y/N) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Soil rating .~oO ~ Gravel thickness ~ I Cleanouts present (Y/N) Date of adequacy test for ~' If yes, give date System type ~'R~[ ~f Total depth ~ I bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ¢O/-f//', /-/~, To building foundation On adjacent lots "/ /='4) Surface water '/' /'~¢~ Curtain drain /Vc~.~ On adjacent lots L'O/¥,~I. /-/:~ O Property line To existing or abandoned system on lot Cutbank ~///~ Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name Date Louis A. ~ufera ." ~ ~ CE-6736 HAA Fee $ /7 Date of Payment Receipt Number 72~)26 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, AK 99503 WALTER J. HICKEL, GOVERNOR June 23,1992 FOR: Eagle River Engineering PWSID # 213001 My review of th.el.reCords on file in this office reveals that the Northwoods Subdivision Class "A" Public Water System is in compliance with the routine coliform bacteria sampling requirements listed in Table C, and with the inorganic sampling (nitrate (as nitrogen) only) listed in Table B of 18 AAC 80.200. Sincerely, Rachel Clark College Intern RC/cf APPLIC- NT FiLLs OUT UPPER ONLY [~.~ Phone Pr0perty Owner Mailing Address Buyer ~ Address Zip Code Lending Institution ~ ~ ~ Phone Address Zip Code RealtyCo.&A~.t ~~ 5~[~ ~,~, Phone Address ~ Street Locati~ Type of Resi~nce ingle~mily ultiple Family No. of Bedroo~ ~ Other Water Supply ~ Individual A~ACH WELL LOG. A w~l log is required for all wefts drilled since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach log if available). Public Utility Sewer Disposal ~ Individual I~- ~ Public Utility When Connected to Public Utility: ~ Holding Tank ~ I I~ NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector MU qiC;PALiT'? RECEIVED ( ~APPROVED BEDROOMS *CONDITION8 OF APPROVAL ( ) DISAPPROVED ( ) OONDITIONAL APPROVAL* Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received [~/~ Well to Tank Septic T~E Size 72-023 (3/82}