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Home My WebLink AboutNORTH WOODS PHASE 2 BLK 2 LT 3slc P h sc, Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231407 PID Number: 051-741-30 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name CHARLES E TETREAULT ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 22315 WHISPERING BIRCH DRIVE, CHUGIAK El Other Phone Number of Bedrooms Soil Rating depth from original grade 3 GPD/SF JTotal Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot NORTH WOODS PHASE 2 2 3 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft' Ft. Well 200'+ __ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer INFILTRATOR (IM -1060) Capacity 1094 Gal. Surface Water 100'+ -- Material PLASTIC Number of compartments 2 Lot Line 10'+ __ NA Foundation *8, 1'+ __ LIFT STATION Manufacturer Capacity Gal. Remarks ST has 4" of 40 PSI insulation. 'ST outside soil bearing prism. Alarm location Electrical installed by Installer NORTHERN EXCAVATION PIPE MATERIAL House to tank 3034 d a nfie d Tank 3034 Drainfield CO/MT Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection 151 01/17/24 dates: 2na 01/18/2024 Location and description 3rd 4`h BOTTOM OF SIDING ON-SITE WATER AND WASTEWATER SECTION APPROVAL low l� Conditional Approval: Date ' • : �,�,�} ....... � ..... .......... . ' • • Curtis Huffman Septic S St Y Approve - G ��1�isl..,CE,1928991••..�� Date PROFESSO��-~ Note: his approval does not include well permit requ'ements. 7D/uZ1 10) PID:051-741-30 PERMIT:OSP231407 FIRST WATER CONSULTING NORTH WOODS PHASE 2, BLOCK 2, LOT 3 FIRST WATER CONSULTING NORTH WOODS PHASE 2, BLOCK 2, LOT 3 FOUNDATION TO TANK KEY BOX AND SERVICE LINE LOCATION BY SKETCH STREET - 31,059 (12/77) -.L_EY .u.i ..T- M) -L I I t MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231407 Work Type: SepticTank Upgrade Tax Code Number: 05174130000 Site Legal Address: NORTH WOODS PHASE 2 BLK 2 LT 3 GA 559 Site Mailing Address: 22315 WHISPERING BIRCH DR, Chugiak Owner: TETREAULT CHARLES E Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date Expiration Date r� urpaI- tmeiit Lot Size in Sq Ft: Total Bedrooms: 12/20/2023 12/19/2024 30473 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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 Special Provisions: • Prior to construction, the bed is to be located to ensure the tank remains 5' away. -ReBeived-By: C - Issued By: Date: Date: Z 17-0 1-" 3 MUNICIPALITY OF ANCHORAGE Development Services Department p p Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-741-30 Property owner(s) CHARLES E TETREAULT Day phone Mailing address 22315 WHISPERING BIRCH DRIVE, CHUGIAK, AK 99567 Site address 22315 WHISPERING BIRCH DRIVE, CHUGIAK, AK 99567 Legal description (Sub'd., Block & Lot) NORTH WOODS PHASE 2 BLOCK 2, LOT 3 Legal description (Township, Range & Section) Lot Size 30,473 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 Septic Tank 0 Upgrade nX (w/wo ADU) Holding Tank ElRenewal ElDuplex (D) El Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 2i25 Waiver Fees: Date of Payment: ) Z V 4 Z 3 Receipt Number: Permit No. 0'+ Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! December 15, 2023 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: NORTH WOODS PHASE 2, BLOCK 2, LOT 3 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install an IM-1060-gallon plastic tank per the attached design to serve the existing 3-bedroom residence. We would recommend a 1500-gallon tank be installed for current functionality and future consideration or flexibility. No groundwater was noted in the MOA on-site file, but if groundwater is encountered during installation an epoxy coated steel septic tank or anchoring may be required. The lot and area are served by public water and any encroaching waterlines, wells, easements, … must be staked prior to construction. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231407, Deb Wockenfuss, 12/20/23 FIRST WATER CONSULTING NO WELLS WITHIN 200' OF PROPOSED SEPTIC TANK. AREA SERVED BY PUBLIC WATER. NORTH WOODS PHASE 2, BLOCK 2, LOT 3 DESIGN DETAILS: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231407, Deb Wockenfuss, 12/20/23 FIRST WATER CONSULTING NORTH WOODS PHASE 2, BLOCK 2, LOT 3 FOUNDATION TO TANK Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231407, Deb Wockenfuss, 12/20/23 ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: NORTH WOODS SUBDIVISION PHASE 11 LOT 3 BLOCK 2 PLAT 82-204 AW SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a 0 41 A % �' 1, 1, A 'N" and that the 0 D vel physical survey of this property as shown on this drawing 1p improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance should Z •49TH any information on this drawing be used for construction of fences, 0? ...... •........... ........ structures, improvements, or for establishing boundary lines. OFA ?A ? EA X,CLUSION NOTES: It is the owners responsibility to determine _�o L •0 the existence of any easements, covenants, or restrictions which J HN L. SCHULLER. do not appear on the recorded subdivision plat. #14 LS -10408 4 e; 1831 Talkeetna Street .z 0 1 *a, WORK ORDER NUMBER: DATE- SCALE. E-MAIL- ki 0 .. .4'. � Anchorage, Alaska 99508 V 6 A1W DEC 15, 2023 1 40' schullerOak.net '\ \'0 ,®, (907) 227-1455 office 23-121 DRAWN BY. CHECKED BY. GRID NUMBER; B00K,7 Llssionc JLS N W1 559 230363 (907) 274-49,92 fax / O / LOT 4 B LK 2 Q) 4� QQ/ �D O 00 F • SEPTIC PIPE (tYP) _ OMH • % 0 do �6 PAVED 76 � O- D/W:O '°' 1zal Qj o RO o . 0, � OJ LOT 3 B LK 2 o �� o 2 � � 3� 40 °O LOT 2 B LK 2 ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: NORTH WOODS SUBDIVISION PHASE II LOT 3 BLOCK 2 PLAT 82-204 SURVEY CERTIFICATE: I John L. Schuller Ha �•ik'�O F `� L U� ve conducted aN AW .. •'.•,•AL �Pti physical survey of this property as shown on this drawing and that the � ' • • . , o s�1� / �':• �' improvements situated hereon are within the property lines and no �,.. enchroachments exist other than noted. Under no circumstance should/49TH / � •'. any information on this drawing be used for construction of fences, ..... structures, improvements, or for establishing boundary lines. 'A G c ..... .. EXCLUSION NOTES: It is the owners responsibility to determine y ..... : ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' CD %JOHN L. SCHULLER.• o / = the existence of any easements, covenants, or restrictions which �. �, •,y � .• � � •- • . do not appear on the recorded subdivision plat. LS -10408 , � 1 c�,, ' • . , _ . , . • ' �J / 1831 Talkeetna Street WORK ORDER NUMBER: DATE: SCALE » E-MAIL- , moo, .. 22 , ,Z�� Anchorage, Alaska 99508 JAN 22, 2023 1 =40 chullerakOgmall. Ar Ota DRAWN BY: OiECKED BY GRID NUMBER: BOOK/PAGE ofe a\ �- •�► (907) 227-1455 office 23-121-2 JLS N W1559 240106 ��\ ,Qlwzm� (907) 274-4992 fax �� MUNICIPALITY OF ANCHORAGE t DEPARTMENT OF HEALTH & ENVIRONMENTAl. PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WEI. L INSPECTION REPORT NAME PHONE I [~'i~ W MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS I P ERMITNO. Absorption area Dwelling _O~ DISTANCE TO: ~ ,f ~ I- Z Manufacturer ,/~ U Material -- No. of compartments Liq. capacity in gallons Inside length Width Liquid depth //'~'~ ~.) IF HOMEMADE: ~ '~ DISTANCE TO: Well Dwelling PERMIT NO. .~r.9z O z ~ Manufacturer Material Liquid capacity in gallons 1~ W~ll Foundation Nearest lot line PERMIT NO. ~ -r DISTANCE TO: ~ No. of lines Length of each line Total length of lines Trench width Distance between lines ~ inches F- Top of tile to finish 9fade Material beneath tile Total effective absorption area ID inches m Len gthN/~.~/.! Width ~)! Depth c~"' PERMIT ~ ~;~ ' ' ' ter . ~1~ ~./~/ ,~,~J:¢ ~.~/~,~/./, C~J~3 de~th Total effective absorption area Building_foundation Nearest lot line /~ co DISTANCE TO: o~f ~-~- ~/~//)/~ ~,~.~a~ C~ss../~/)~. ~ .L' ! ,~/--~-~Dept~ ,/.--- Dril,er Distance to lot line PERMIT NO. ~ - - ~/ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS -- SOIL TEST RATING INSTALLER REMARKS APPROVED DATE LEGAL 72-013 (Rev. 3/78) ~.,~_UNICIPALITY OF ANCHORAGE.~, Department ' Health and Environmenta~ ~rotecti~?.~.~n. ~/~ . 825 ~ Street, Anchorage, AK. ~950 ~ ~ ' 264-4720 · ~V33'~ ~--' WELL AND/OR ~N-SITE SEWER PERMIT / Applicant: ~/~ ~~ ~_ f Mailing Address: ~. ~ Location: Phone Nu~er: Legm7 Description: ~ ~2 ~W~~S~/D ~~Lot Size: T~e of Soil ~sorption System Is: Trench: Drainfield: Seepage Bed: / Holding Tank: Max~um N~ber of Bedrooms: Soil Rating(sq.ft/br) The Required Size of the Soil ~sorption System Is: DEPTH ~ LENGTH ~ GRAVEL DEPTH ~/ WIDTH The length dimension ~s 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 seu width for trenches. The gravel depth is the minim~ depth of gravel between the outfall pipe and the bottom of the excavation(in feet). ~ ~ REQUIRED SEPTIC(HOLDING) TANK SIZE = /~DO GALLONS Pe~it applicant has the responsibility to info~ this department during the installation inspections of any wells adjacent to this property and the n~ber of residences 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. Min~um 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. Minim~ distance from a private well ~oa private sewer line is 25 feet and to a co--unity sewer line is 75 feet. Well logs are required and must be returned ~o this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to ~nsure proper installation. "" PERmiT EXP R S DECE SR 1 9 2 I certify that: (1) I ~ f~iliar 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 unde~tand that the on-site sewer system may require enlargement if t~idence is~led to include more that 3 bedrooms. S igne~: Applicant SWP/024 (1/81) O & E ENG~JEERING & DEVELOF.~ENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 688-2280 Performed for: Name: ~-~'/,/~'/~/ /-" .~/~/~,7,J' ~)A/~'~-. TeI. N0. ~&~-~/ Mailing Address: ~ ~' ~0 X ~ w ~/~/~/ ~/~ ~ 7 Legal Description: L~ ~/ ~'/~ 2/ ~/~ ~ ~, ~~ ~ Depth (feet) Soil Characteristics PLOT PLAN 11__ 12__ 13__ 14__ 15__ 16__ PERC. TEST Ground Water Encountered: Yes / No Proposed Installation: Seepage Pit Comments: If yes, what depth Drain Field Performed by: Date: 7/'~///~'' Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-741-30-000 Expiration Date: 1/18/2025 Legal description NORTH WOODS PHASE 2 BLK 2 LT 3 Site address 22315 WHISPERING BIRCH DR Chugiak AK 99567 Current property owner(s) TETREAULT CHARLES E X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for Comments or advisories: bedrooms, with the following stipulations: Original Certificate Date: 1/29/2024 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-741-30 Complete legal description NORTH WOODS PHASE 2, BLOCK 2 LOT 3 Location (site address) 22315 WHISPERING BIRCH DRIVE, CHUGIAK AK 99567 Current property owner(s) CHARLES E TETREAULT Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ® Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ® Plastic ❑ Concrete ❑ Fiberglass Age 0 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ® Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ X50 Waiver Fee $ Date of Payment�//e5h_C-) Date of Payment COSA#. 05 C L-1 18 1(5 Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: NORTH WOODS PHASE 2, BLOCK 2, LOT 3 Parcel ID: 051-741-30 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA - PUBLIC &/OR CLASS “A” WATER Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank NA Date of pumping NEW TANK Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 8/31/1982 ALL standpipes present per record drawing Total measured depth from grade 3.6 ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective (ED)*. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 12/05/23 date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 12/06/2023 Results Pass Fluid depth prior to test 1 in Water added 600 gal New fluid depth 5 in Elapsed time 1430 min Final fluid depth 1 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 6 in (MOA 0.5’ ED) Effective depth used 1 in (Final Fluid Depth) Effective depth remaining 5 in Comments/Deficiencies: *Approximate total measured depths from existing grade – No invert & only MT per MOA docs with ED per visual observations, available record documents, measurements & appears approximate. MOA record docs (HAA/IR) show 3.5’ total absorption field depth. We measured 3.6’ at MT at the shallowest end of the bed. There have been no known frost issues per the client and there is approximately 3’+ of cover over the field. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & 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, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 01/19/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 01/19/24 MUNICIPALITY OF ANCHORAGE 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 IMUST B'E COMPLETED PRIOR TO SUBMITTAL) (a) Legal De~sC~ption (include lot, bi'ock, subdivision, section, township, range) Location (address or directions) Mailing Address Business (C) Lending lnstitution ~L~/,~.~'.,~,~//Cr)-,"~'~~' Telephone Mailing Address - , ., . Real Estate C~'mpar~y a~d'A;ent ~~/~ ~~/~~ ~~ d TeJephone ¢ 9~' ~ (e) Mail the HAA to the followino address: or: Check here~ if hold for pick up. List contact person and day phone numDer below. $ & $ ENGINEERING ;7034 EagJe ~iYer Loop Road No. 204 Eaqle River. Alasl~a TYPE OF RESIDENCE Single-FamityJ~ Number of Bedrooms WATER SUPPLY Individual Well [] iCommunity[] Publi Note: If community welt system, must have written confirmation from the State Department of Environmental Conservation 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 Environ mental Conservation attesting to the legality and status. Page 1 of 2 72-025 fRev 8/861 Front ')~JOM leUO!SSetoJd eql u! suo!ss!uJo Jo sJoJJe Jo~. @lq!suodseJ lou s! e58Joqou¥ jo ,~l!lBd!o!unlAi eq/'penss! s! m, Boy!~JeO ~ eJojeq e~p aZ,~l~Ue Jo suo!~oedsu! lgnpuoo lou op SHHQ jo see~oldLU:l 'siuaLueJ!nbeJ ellis pue leJepej u!~lJeo XJs!lBs ol J@pJo u! suo!inl!isu! 5u!puel 4aql pub seuJoq to sJesBqoJnd oj ~se~noo e.~ s]qj seop SHHQ eq.L '~sBI¥ ~o e),~,S eql u! paJels!SeJ Ja@u!Sua iBuo!ssejoJd luepuedepu! u~ ~q e^oqB ~ qde~SeJed u! ue^!5 suo!je~ues@JdeJ eql uodn ,~lUO pes~q sm, eoy!~Jeo leAmddv/qpoqln¥ qll~aH senss! (SHF-IQ) S~I9!AJeB ueu~nH pu~ qllBeH Jo lUeLU~de(3 @SBJOqOU~' ~O ,~l!l~d!o!un~ @qJ. NOIJ. n~D le^oJdd¥ teuo!l!puoo lo sLUJel leUO!l!puoc) penoJddes!C] /~ peAoJddV euoqdelel WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) MUNICIPALITY OF ANCHORAGECHECKLiST . FEBRUARY 1984 ENVIRONMENTAL SERVICES DIVISION 2 1 1988 RECEIVED Well Classification Well Log Present (Y/N) Total Depth Static Water Level Cased to Casing Height Above GroUnd Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot "~c~;~ To Nearest Edge of Absorption Field on Lot. To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments ("~t~ ~-~ I/'~ 264-4744 Legal Descriptiqn: ~ ''~ '~"~-' ~ If A, B, C, D.E.C. Approvec~N) Date Completed Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B. SEPTIC/I-1~'=~.~.~.SG TANK DATA Date installed ~ -'~ ~ ~ ~'Z.- Size \ ~ No. of Compartments ~' Standpipes ,~N) y Air-tight Caps(~U) ~r Foundation Cleanout (Y/~ Depression over Tank (Y/~) ~'~ ~ Date Last Pumped ,~-I ~ ~:~ · t'3/~'~ ; for ~ ' ~/~ Temporary Holding Tank Permit (Y/N) To Property Line To Water Main/Service Line Course Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/l~ Tank: To Water-Su pply Well To Building Foundation To Disposal Field ~,~ To Stream, POnd, Lake, or Major Drainage Page 1 of 2 72 026 Rev 8/86~ Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~ ~'~ ~ ~ ~"'/'""~ Width of Field "~2~:;~ Square Feet of Absorption Area Depression over Field Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation~//~Lot To Water Main/Service Line Type of System Design Length of Field Depth of Field Gravel Bed Thickness LO Standpipes Present tf~N) Date of Last Adequacy Test "'~o 14- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line \ To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) Comments Size in Gallon-"S""---~ ,,pu m p On,, Level at~"'~~ High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) lng Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MO,~ and H~A guidelines in effect on the date of this inspection. Signed ............. Date ~//~.~ ~l~/,~Y' Com~ EB~Ie RiY~ L~ R~d No. 2~OA No. ~~ Eagle River, Alaska ~5~ ~ /P~ Receipt No. Amount: $ / ~0 ~ O Page 2 of 2 72-026 (Rev 8/86~ Back ......... ApPLIV-'~NT FILLS OUT uPPER"HA~ ONLY Property Owner ~+P~.~ " Buyer Zip Code Address Phone Lending Institution Realty Co. & Aoont Address Zip Code Typ~e o_~esidence b~'Single Family [] Multiple Family No. of Bedrooms [] Other Water Supply n ~,~ivi,~ual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ~--I,~'"Community"L~ ~ For wells drilled prior to that date, give well depth (attach log if available). [] Public Utility Sewer Di~posa~ J~'~¥idual Year Individual InstaNed: [] Public Utility When Connected to Public Utility: [] Holdin~ Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date ~ Inspector Inspector Inspector Inspector ~iUNICIPALITY OF ANCHORAGE Field Notes: DFPT C~~ fJEA~.TI'~ ~, ENVI~ ),~M.!i',,A. ! ~O ~ ;'~: .-I S E P 1 5 1982 RECEIVED ( ~ APPROVED BEDROOMS *CONDITIONS OF APPBOVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE ~j~ BY: ~ C~ Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received ~;~ /~/ Well to Tank Septic Tank Size 72-023