HomeMy WebLinkAboutPREUSS #1 BLK 1 LT 6 REMPreuss #1
Block 1
Lot 6
#050-571-04
Municipality of Anchorage Page / of 2 -
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: S1J94o/y3 PID Number; 4Sa5?iay
Name: i`
Wastewater System: ❑ New %Upgrade
<�ffGE�J6 L /
Address:
Z02?3 CrJGLG 21 E '2a.410.
ABSORPTION FIELD
96-77
No. of Bedrooms:
y
❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mo ❑Other
LEGAL DESCRIPTION
Soil Rating:
Total Depth original grade:
GPD/Sq. Ft.
Lot: Block: £ division:
Depth to pipe bottom from original grade:
avel depth beneath pipe
�
t.
Ft.
Township:
Range: Section:
Fill added above original gr
Gravel length:
Ft.
Ft.
WELL: El New ❑ Upgrade
'
Gravel width:
Number of lines:
Distancabetween lines:
Ft.
Ft.
Classification (Private, A,B,C): G'xiS 71/
Total Depth:
Cased To:
Total sorption area:
Pipe material:
Ft.
Ft.
SQ. Ft.
IqS7,* /�.303G PVG
Driller:
Date Drilled:
Static Water Level:
Installer:
Ca
Date installed:
Ft.
arty i-orz,� usr:
S 26 9y
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION DISTANCES
0septic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer:
Capacity in gallons:
From
Tank
Field
Station
Tank
Sewer Lines
,
/ z 6-v
Material:
Number of Compartments:
WeIN
//v'
/DO
—
—'-'
25 a-
STeEz__
2_
SurfacWater
'
—
—
—
LIFT STATION
foo
.00'
LotSize
'f-
in gallons:
Man urer:
Line
ZS /
/O
—
—
"Pump on" level at:
"Pump off" leve
High water alarm at:
Foundation
�d /
S "t"
`"—
Curtain
KNoWj
L--
Pump Make & Model
Electrical Inspections performed by:
Drain
BENCH MARK
Remarks:
Location and Description:
%or' oma' riav WALL
Assumed Elevation:
/po. vv
Ft
ENGINEER'S SEAL
17034 Eagle River Loop Road, No. 204
Inspections performed by: Eagle River, Alaska 99577 Dates: 1 st r z6
2nd 612- 6 9 41G.
-
": ql A
Department of Heal and Hu n Services app,
/
Reviewed and approved by:� Date:
-
72-073 (Rev. 9/97) MOA 25
Permit No.. SW940143 Page 2 of 2
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: PREUSS SUBDIVISION ADD.##1, BLOCKI, LOT 6 PID No.:05057104
SCALE 1' _
72-013 A (2/91) MOA 25
—NEW 1250 GAL.
SEPTIC TANK
i
ENGly.Es 'S SEAL
� t
�`r c•, � ire
9C- Oe. A. .�.rt-a...,. 'tet
z
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:SW940143
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:WHITEHEAD RICHARD G & DALENE L
OWNER ADDRESS:20233 EAGLE RIVER RD
EAGLE RIVER, AK 99577
PARCEL ID:05057104
LEGAL DESCRIPTION: PREUSS #1 BLK 1 LT
LOT SIZE: 23838 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
6 REM
THIS PERMIT IS FOR THE CONTRUCTION OF:
SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED: 5/24/94
EXPIRATION DATE: 5/24/95
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 (24 HOURS) .
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY:
ISSUED BY:
J-, w ,
DATE•
DATE : '5 Z
May 24, 1994
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
HEALTHAUTHORITY
APPROVALS
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 'L' Street
SEWER &WATER P.O. BOX 196650
MAIN EXTENSIONS Anchorage, Alaska 99519-6650
SEWER&WATER REFERENCE: Preuss Subdivision #1; Lot 6; Block 1
INSPECTION
ENGINEERING STUDIES Request you expedite issuance of a permit to replace the septic system
ANDREPORTS serving the four bedroom house on the referenced property.
THE EXISTING 1250 GALLON SEPTIC TANK HAS COLLAPSED AND SEWAGE IS
SPILLING ONTO THE PROPERTY.
WELL INSPECTION Because of the unsanitary conditions and safety hazards, we would
&FLOW TEST appreciate you expediting a permit to replace the existing septic tank.
If you have questions, or require additional information for your
review, ase c ntact us.
SITE PLANS i
Si erely,
ROAD DESIGN
K. Shafer, P.E.
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
jk
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
"
30'
SCALE'
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ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
REFERENCE: Preuss Subdivision #1; Lot 6; Block 1
GENERAL:
1. The scope of this project includes the installation of a 1250 gallon
septic tank to serve the four bedroom residence located on the
referenced property. The existing 1250 gallon septic tank is to be
excavated, pumped, crushed, and removed.
2. Construction shall be in accordance with the approved site plan and
design drawings, Municipal permit with any special provisions or
conditions, and all applicable State and Municipal Wastewater Disposal
Regulations.
3. The contractor shall be responsible for obtaining any necessary
underground utility locates.
4. Unless specifically agreed otherwise, the property owner shall be
responsible for final grading areas subsequently depressed from soil
settling.
5. Contractors installing wastewater disposal systems must be certified by
the Municipal Health Department for system installations. Owners
installing their own systems must also receive prior approval from the
Municipal Health Department.
SEPTIC TANK INSTALLATION:
1. A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts for pumping
access.
2. The septic tank shall be sufficiently bedded to prevent settling or
shifting of the tank.
3. All standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
4. Septic tanks installed with less than 4' of cover shall be insulated.
Page Two
Preuss Subdivision #1; Lot 6; Block 1
May 24, 1994
5. A foundation cleanout shall be installed one to four feet from the
building foundation. In the line between the tank and the leachfield
there shall be two adjacent cleanouts (unless an effluent pumping system
exists within the septic tank). These cleanouts shall be located on
undisturbed soil not more than 10 ft. from the tank. The first
cleanout, in line, shall be to clean toward the leachfield. The second
cleanout shall be to clean toward the septic tank.
6. Final grading over the septic tank shall be such that a positive slope
exists away from the septic tank.
@9Ij1 MUM MATERIAL
1. Any septic tank proposed for installation must be constructed by a
Municipally approved septic tank manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Type
of Pipe
Perforated
Solid
Cast
Iron
Yes
Yes
ASTM
D3034 (PVC)
Yes
Yes
ASTM
F810 (HDPE)
Yes
No
ASTM
D2662 (ABS)
Yes
Yes
Use of a type of pipe other than listed above must be approved by the
inspecting engineer.
3. Insulation shall be at least 2" thick extruded direct burial polystyrene
(Dow Chemical Company Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Fernco, or equal).
5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140/N, or equal)
must be installed between the final leachfield gravel layer and the
native soil backfill.
6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel
with less than 3% passing the #200 sieve.
7. When sand is being used as a filter material, its gradation
specifications must conform to current M.O.A. or D.E.C. requirements.
Page Three
Preuss Subdivision
May 24, 1994
INSPECTIONS:
#1; Lot 6; Block 1
Typically there will be a minimum of three (3) inspections required during the
installation of the wastewater disposal system. These inspections will occur as
follows:
1. The first inspection must be conducted after the tank has been set;
lines, cleanouts, standpipes, and insulation are in place and prior to
backfilling.
2. The final inspection is to occur upon final grading of the property.
Often there will be more than these 3 inspections required, especially with the
installation of multiple trenches, sand filters, pressurized distribution
systems, etc. Thus, the inspecting engineer is to be contacted at least 24
hours prior to the start of construction. If necessary, a pre -construction
meeting will take place on-site. The inspecting engineer will not coordinate,
direct or control in any way the contractor's activities.
The owner shall contract with the contractor to perform the work outlined in
these specifications and plans and in accordance with the attached M.O.A.
permit. There will be no contractual arrangement existing between the
contractor and S & S Engineering. S & S Engineering shall be the owner's
representative and will inspect the work as stated above to document the
contractor's activities. Final acceptance of the contractor's work rests with
the owner and the M.O.A.
S & S Engineering shall have no liability to the owner or to others for acts or
omissions of the contractor or any other persons performing work on this project
or the failure of the contractor to carry out the work in accordance with these
construction documents. S & S Engineering's inspecting engineer will not be
responsible for the construction means, methods, techniques, sequence,
procedures or the safety precautions incident to this project.
CONTRACTOR/INSTALLER
MUNICIPALITY OF ANCHORAGE JJ
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
J
_....._'
NAME. '-
�E� E
❑
,.NEW
UPGRADE
MAILING ADDRESS i
LEGAL DESCRIPTION
L
LOCATION�< ^� ray ...._...._..-•.._......_..-�_ ...____._.---._._.___._
/� G:11
,eetl M,
. OF BEDRO MS
Well
Absorption area
Dwelling
PERMIT.N .
DISTANCE T0:
Uy
a Z
Manufacturer �j j�
Material
No. of compartments
w a
y�
Liq. capacity in gallons
IF HOMEMADE:
Inside length
Width
Liquid depth
6 y
DISTANCE TO:
Well
Dwelling
PERMIT NO.
JUZ
02 F
Manufacturer
Material
Liquid capacity in gallons
Well f .�
Foundatio J.y4
Nearest leek 4-
PERMIT.
DISTANCE TO:
%
..–
/
L'
Lull:
U
No. of lines
�
Length of ea in�
Total le h ofd, wl
Trench < <
�
Distance bXtf7e n Ines
Fw
•—
�
inches
F
Topof 'le tb f ish grade
6
' 1ayIaI berg ath�tile �J �/
Total effec ive absorp ' area
,L �, �t�" inches
Length
Width
Depth- - -
PERMIT NO.
w
f7
Q F
Type of crib
Crib diameter
Crib depth
Total effective absorption area
wa
Lu
rn
Well
Building foundation
Nearest lot line
DISTANCE TO:
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
w
DISTANCE TO:
Building foundation -
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATERIALS
A
r
SOILTESTRATIN-
-�
/
INSTALLER
>Gk-,-
REMARKS
�n 4
n E;
y�
IOU
ROVE'9 DATE LEGAL
•
nury 11.1 rHL1 I Y Ut' ANCHORAGE
Department f Health and Environments ?rotes ion
8251- Street, Anchorage, AK. 9501
264-4720
Permit_ # # HANDWRITTEN PERMIT # # #
WELL
ANDA" ON-SITE .SEWER PERMIT 14j0G-440A-
Applicant:C-GIY (�S®4US�% Mailing Address: s'/e2 d P'4/4_000 01p,
Location: Phone umber: °lb's 67
Legal Description: �p%�p - �L Size: --
Type of Soil Absorption System Is:
Trench: Drainfield: Seepage Bed: Holding Tank:
Maximum Nur of Bedrooms: _ Soil Rating(sq.ft/br)
1' e Required $�e9o0�the Soil Absorption
DEPTH LENGTH_. GRAVEL DEPTH
WIDTH /v
The length dimension is the len g th (in feet) of the N $1+ 9r
. 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 _ EX/S�/Y6r 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 residences that the well will serve.
# # # TWO(2) INSPECTIONS ARE REQUIRED # # #
Backfilling of any system without final inspection and approval by this departmen
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 fee
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 311 1 9 3 3
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 remodeled to include more that bedroom
Signed: X 4/Qd r Issued by:
Applicant 2
Date:
SWP/024 (1/81) �`�{'�Q� Jam, Z� L/YJQ// /l ��
'r
LA �i , ti'
€; � , d
�a.M .. (�
n nd kj�
j �Fi-, PAY C::: DEPHRTMENT HE�TH HND
�IO�N
p-, / &,O
' HNCHORHGE'
STREET "K ^
/' 99501
^ X W EE: KEE
14 E.— F- u r;=, E>�
PEF1,11T
HPPLICHNT HL
LOCHTION SR '`' Pb
LEGAL L�7'6 BLK1 PRUESS �/D
� LOT SIZE 20000 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM TRENCH
MHXIPIUM NUMBER OF BEDROOMS = 4 SOIL FORTING (SQ
THE REQ8IRED SIZE OF THE SOIL. ABSORPTION SYSTEM IS:
��F T.. h 4 == �
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRf�INFIEL_D
THE DEPTH OFH TRENCH OR PIT IS THE DI -STANCE BETWEEN THE SURF8CE OF THE �
GROUND AND THE BOTTOM OF THE EXCHVHTION (IN FEET)
THERE IS NO SET WIDTH FOR TRENCHE�S. �
THE GRAVEL DEPTH IS THE 11INIMUM DEPTH OF GRHVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET)
PERMITAPPLICHNT HAS, THE RESPONSIBILITY TO INFORM THIS DEPHRTMENT DURING THE
�L
�m�|�A| iUN INSPECTIONS OF HNY WELLS HDJHCEMT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WEL_ WILL SERVE.
--------- �W PC0 �_221 I Phi K=x 1" EE=:-. 7- 1 1:101 m: 1=1 lot EEL �? E:---. 0:.,:! 9_9 I F E�
BHCKFILLING OF ANY SYSTEM WITHOUT FINAL. INSPECTION Hr�D HPPROVHL BY THIS
DEPHRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN H WELL
AND ANY ON-SITE SEWAGE
DISPOSAL
SYSTE�4 IS
1U0NFEET FOR H PRIVHTE WELL OR
150 TO 200 FEET FROM
H PUBLIC WELL
DEPENDING
uPV THE TYPE OF PUBLIC 14ELL
THE MUNICIPHLITY
OF HNCHORHQE,
MINIMUM DISTANCE FROM H PRIVATE
WELL TO H PRIYHTE
SEWER L.INE IS
WITH THE CODES
TO M COMMUNITY SEWER LINE IS 75
FEET.
ON-SITE SEWER SYSTEM
25 FEET AND
OTHERREQUIREMENTS MMAYHPPLY.
SPEC: IF! C8TIONS AND
CONSTRUCTION
DIRGRHMS ARE
r�
�vILHBLE TO INSURE PROPER INSTALHTION�
�� F-��������
I CERTIFY
THAT'
1� I HP! FHVIILIHR
FORTH BY
WITH
THE REQUIREMENTS FOR
ON --SITE SEWERS HND WELLS HS sET
THE MUNICIPHLITY
OF HNCHORHQE,
2: I WILL
INSTALL THE
SYSTEM IN PC. ORDANCE
WITH THE CODES
IUNDERSTHND
RESIDENCE
THHT THE
IS:
ON-SITE SEWER SYSTEM
MAY REQUIREENLH��GEMT E�IF THE
F.EMODE�ED
TO INCLUDE MORE THAN
4 BEDROOMS
SIGNED:
------
ISSUED B DHTE_ ��
--�—�....-. Wm
@GRE' -ER ANCHORAGE AREA BOf 'JGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
SEEPAGE PIT:
NUMBER OF PITS DIAMETER OR WIDTH Z�+ , LENGTH 2S, DEPTH
LINING MATERIAL L�06 CRIB SIZE: DIAMETER_DEPTH DISTANCE FROM: WELL
1 TOTAL EFFECTIVE
BUILDING FOUNDATION, NEAREST LOT LINE 20 ABSORPTION AREA (WALL AREA) &00 SQ. FT.
ADDITIONAL ABSORPTION
WELL: ll�or MW[d /Pr of 6tyeckel',
TYPE CONSTRUCTION
BUILDING NEAREST
FOUNDATION -,LOT LINE
CESSPOOL
I19=i10x7
DISTANCES:
INSTALLED BY:
GU liucC Ccn s l
PIPE MATERIAL:
GSI SA 1'y4wi
LOT SLOPE:
REMARKS:
Form No. EQ -031
, OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE
REMA
DEPTH
SEPTIC
TANK_
DIAGRAM OF SYSTEM
DISTANCE FROM:
SEEPAGE
SYSTEM
2
W
INSPECTION REPORT
ON-SITE SEWAGE DISPOSAL
SYSTEM
NAME'a&1 LK4mC
�r
MAN MAILING ADDRESS +90KEAGLCTPUW
PHONE 6gy-Z5'1j
LOCATION
/�
LEGAL DESCRIPTION `rr % 1311C
�('�
SEPTIC TANK:
UL'# I$4g0.3�
DISTANCE
FROM WELL
MANUFACTURER S7gGrc
STC -SL MATERIAL CTSS1--
NUMBER OF
72
COMPARTMENTS
INSIDE LENGTH
INSIDE WIDTH
LIQUID DEPTH LIQUID CAPACITY
125-0 GALLONS.
SEEPAGE PIT:
NUMBER OF PITS DIAMETER OR WIDTH Z�+ , LENGTH 2S, DEPTH
LINING MATERIAL L�06 CRIB SIZE: DIAMETER_DEPTH DISTANCE FROM: WELL
1 TOTAL EFFECTIVE
BUILDING FOUNDATION, NEAREST LOT LINE 20 ABSORPTION AREA (WALL AREA) &00 SQ. FT.
ADDITIONAL ABSORPTION
WELL: ll�or MW[d /Pr of 6tyeckel',
TYPE CONSTRUCTION
BUILDING NEAREST
FOUNDATION -,LOT LINE
CESSPOOL
I19=i10x7
DISTANCES:
INSTALLED BY:
GU liucC Ccn s l
PIPE MATERIAL:
GSI SA 1'y4wi
LOT SLOPE:
REMARKS:
Form No. EQ -031
, OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE
REMA
DEPTH
SEPTIC
TANK_
DIAGRAM OF SYSTEM
DISTANCE FROM:
SEEPAGE
SYSTEM
2
W
u �
NAME OF APPLICANT
INSTALLATION LOCATION
LEGAL DESCRIPTION L
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM ® APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
COMPLETION DATE_ ANTICIPATED
MAILING ADDRESS
PERMIT NO.
�4.-_ PHONE 6 ` L2
SEEPAGE PIT_, DRAIN FIELD OTHER
TO BE INS''fALLED BY
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE / 2'3-V TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT vy r DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL /y
SEPTIC TANK SEEPAGE PIT V" , DRAIN FIELD
TO NEAREST LOT.LINE.
SEEPAGE AREA SIZE
G_.WELL TO SEPTIC TANK SEEPAGE PIT /0
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD
r r
SEPTIC TANK, `� SEEPAGE PIT �, DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING 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 SACKF'ILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
re �k
�
G.A.A.B.
OR
LICENSED DESIGNER
TYPE
DIAGRAM OF SYSTEM
1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTE IS IN ACCORDANCE WITH SAID CODE.
(l
DATE �2_ J APPLICANT'S SIGNATURE
FORM NO. EQ -016
-\ I
229 EAST 51st. AVE. -- P.O. BOX 6087 - ANCHORAGE, ALASKA 99503
TELEPHC IEE07-2 9—'tg3 TELEX 090-35416
Civil Engineers Geologists Land Surveyors
JAMES W. ROONEY, P. E. -- _ RALPH R. MIGLIACCIG
MALCOLM A. MENZIES, P.E., L.S. Eng;neer!ng Gaoloa_ist
JAMES H. WELLMAN, P.E.
February�'!��
8 1974 1}74 R & M No. 462003
-,H
k1v65,d. !ty
OF
PvgEATER ti�1R�'lnard` - - -
Mr. Don Zemmerman
Box 596
Eagle River, Alaska 99577
Re: Test Bole and Soil Log Report for Sanitary System, Lot 6, Block 1,
Puress Subdivision
Dear Mr. Zemmerman:
We are submitting herewith the test boring results and our comments
regarding soil conditions encountered at the subject site. This
investigation was performed in accordance with your request of
February 5, 1974, and those procedures outlined in a letter dated
September 13, 1971 by Mr. Rolf Strickland of the Greater Anchorage
Area Borough Department of Environmental Quality.
A single test hole was put down within the Lot 6 area for the purpose
of defining general subsurface soil conditions for the proposed sanitary
system. Excavation was accomplished witha tractor --mounted backhoe and
the test hole was extended to a total depth of 17.0 feet below ground
surface. The final log prepared for the tett hole has been included in
Drawing A-01.
Ground water was not encountered in the test hole.
We a1,i>'eciaLe ue1_iig g:i.Veti this or:2oLtuit__1_y Lo be OE service CO you.
Should you have any questions with regard to the above, please do nor:
hesitate to contact us.
Very truly yours,
R & M ENGINEERING & GEOLOGICAL CONSUL7A TS
rn c
611 James W. Rooney
J tlx: ph
xc: GAAB ✓
R&M ENCI,_,IEERING & GEOLOG9C..l,L CONSULTANTS
J 229 EAST 51st. AVE. - P.O. BOX 6087 - ANCHORAGE, ALASKA 99503
t; I TELEPHONE 0—,N.83 TELEX 090-35419
Civil Engineers Geologists Land Surveyors
JAMES W. ROONEY, P. E. RALPH R. MIGLIACCIO
MALCOLM A. MENZIES, P.E., L.S. Engineering Geologist
JAMES H. WELLMAN, P.E.
February 8, 1974 �VA R & M No. 462003
F-' .H -
A" ITY
Mr. Don Zemmerman
Box 596
Eagle River, Alaska 99577
Re: Test Hole and Soil Log Report for Sanitary System, Lot 6, Block 1,
Puress Subdivision
Dear Mr. Zemmerman:
We are submitting herewith the test boring results and our comments
regarding soil conditions encountered at the subject site. This
investigation was performed in accordance with your request of
February 5, 1974, and those procedures outlined in a letter dated
September 13, 1971 by Mr. Rolf Strickland of the Greater Anchorage
Area Borough Department of Environmental Quality.
A single test hole was put down within the Lot 6 area for the purpose
of defining general subsurface soil conditions for the proposed sanitary
system. Excavation was accomplished with a tractor -mounted backhoe and
the test hole was extended to a total depth of 17.0 feet below ground
surface. The final log prepared for the test hole has been included in
Drawing A-01.
Ground water was not encountered in the test hole.
We appreciate being given this opportunity to be of service to you.
Should you have any questions with regard to the above, please do not
hesitate to contact us.
Very truly yours,
R & M ENGINEERING & GEOLOGICAL CONSULTANTS
vi
James W. Rooney
-�
JWR:ph
xc : GARB /
ANCHORAGE FAIRBANKS JUNEAU
3.0'
5.0
030
10.5'
17.0'
No Water Table
NOTE: Test hole excavated with tractor -mounted backhoe.
R Engineering a Geological Consultants Inc. DON ZEMERMAN PROPERT`I
4 ANCHORAGE FAIRBANKS ALASKA JUNEAU LOG OF TEST HOLE
Anchorage Alaska
DATE 2-0-74 SCALE OWN 9Y SRS CtiKD 8Y WED PROD- NO•. 462004 OWo NO. _ A-01 -
0042273
-_-J
ORGANICS
of
0 • •.
°
SANDY SILT w/Some
Gravel (SM)
•
SAND, Trace Silt
(SP)
I'
o.
SILTY SAND w/Some
Gravel (SP -SM)
o •
.o•:o
'•o:
SANDY GRAVEL Trace
Silt (SW)
a 0.
v.:o
SILTY SALAD Some Gravel (SP -SM)
o•
O .
'l9 •
SAND, Trace..Silt -&
_Gravel (SP)
•
0I•
O
3.0'
5.0
030
10.5'
17.0'
No Water Table
NOTE: Test hole excavated with tractor -mounted backhoe.
R Engineering a Geological Consultants Inc. DON ZEMERMAN PROPERT`I
4 ANCHORAGE FAIRBANKS ALASKA JUNEAU LOG OF TEST HOLE
Anchorage Alaska
DATE 2-0-74 SCALE OWN 9Y SRS CtiKD 8Y WED PROD- NO•. 462004 OWo NO. _ A-01 -
0042273
Municipality of Anchorage
Development Services Department
j Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519.6650
www.ci.anchorage.ak.us
(907)343-7904
A CERTIFICATE OF HEALTH AUTHORITY APPROVAL Iry
l9 FOR A SINGLE FAMILY DWELLING
Parcell.D. HAA# • /)5701&q -
Expiration Date: 7- ;2_3 -05
1. GENERAL INFORMATION
Complete legal description (ARE U55 # I L- 01-6 TUK 131
Location (site address or directions) 20233 PA Gi-yr RI VHt2 Rel • EAGLE RIVER, ft
Current Property owner(s) QAGEn,E 4r Ri_-pArzn Wh`mi+Cj pay phone 6 — LS%H
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: W
3. TYPE OF WATER SUPPLY:
Individual Well C5
Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
a
Individual Holding tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B wells or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. 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 Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewater disposal system is(are) 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(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm Eagle River Engineering Servioes Phone1W1 VFW
S
Address Eaale River. AKQQg-n
Engineer's Printed Name C NA'ImPf%R R. Lf oe+� Date Y Iz 7/041-
5.
/ds
5. DSD SIGNATURE
Approved for __Lbedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: 0":;& , f Original Certificate Date:
(R., QJM2)
I
j Municipality of,Anchorage
• Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: f R'E U SS 0 1 1-6 01 RE/)? Parcel ID: CSO- 57/'OLj
QWZ1*1t47_V
Well type SM Ate If A, B, or C provide PWSID #�
Date completed mak. Sanitary seal (YIN)$
Total depth JLC3 ft. Cased to ft.
FROM WELL LOG
Date of test U PK ,
Static water level V Nk , ft.
Well production V NK. g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 ml. Nitrate mg./l.
Arsenic: mg./I. Date of sample: Ov*61f
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material S" P q1.
Tank size 1250 gal. - Number of Compartments 2
Well Log (Y/N) No
Wires properly protected (Y/N) YCS
Casing height (above ground) 2 (_in.
AT INSPECTION
Apr'i1 7, 05
613 ft.
3,7 g.p.m.
Other bacteria C? colonies/100 ml.
Collected by: Soi+r, 14Ayr>s1V
Date installed S &24 Z_q Lf
Cleanouts(Y/N) YES
Foundation cleanout (Y6) rvv' Depression over tank (YO O High water alarm (Ye NQ
Date of pumping APRIL G . O Pumper '7- RAS
C. ABSORPTION FIELD DATA
Date installed It LOW Soil rating (g744it? or f?lbdrm) i2.S System type TRe NC4f
Length Sl ft. Width 30" ft. Gravel below pipe 6 ft.
Total depth _IQ_ ft. Eft. absorption area 6jZ-fe Monitoring tube YDepression over field 1yQ
Date of adequacy test /Allo/. S. Result (Pas ail) A _5-_ For bedrooms
Fluid depth in absorption field before test_ in. Water added gat. New depth in.
Elapsed Time:1310min. Final fluid depth ' -L-3 in. Absorption rate >= 6114 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N 0 If yes, give date ��
0—'IFT STATION
Date instailed
"Pump on" level at _ in.
Datum
E. SEPARATION DISTANCES
in
"Pump off" level
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot I Oo �*
Absorption field on lot 1001+
Public sewer main 7.5,+
Sewer /septic service line 25 �+
Manhole/Access (Y/N)
water alarm level at
Meets alarm &
i
On adjacent lots t� +
On adjacent lots t p0' t
Public sewer manhole/cleanout 100'4-
Holding tank —755-755i 't
SEPARATION DISTANCES FROM SEPTIC/110t9141GTANK ON LOT TO:
Building foundation Jr e+ Property line 5 �+ Absorption field c -
Water main
Wells on adjacent lots 100'+
Water service line 10 /+' Surface water 100 0
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line IDr� Building foundation ���� Water main iI?
Water Service line 10 +' Surface water 100 + Driveway. parking/vehicle storage +I
Curtain drain 50 + Wells on adjacent lots ISD +
F. COMMENTS
G. ENGINEER'S CERTIFICATION
r certify that 1 have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name C#0r5?nPJF6'n Q. CHROTOPMIt
Date y �z �/a 5 ., C''M
HAA Fee $ y SO
Date of Payment 41X7 /or
Receipt Number
(Rev. 12101)
4W9*,,e Fee $ 175 -
Date of Payment 91 Z 1 10S'
Receipt Number
Ti'J77
in.
4-20-06:/2:16PM:
SCS ReU
1051807001
Mat Name
Eagle River Engineering
ProjectName/N
pre= NI L6 B)
Client Sample ID
Preuss 1/1 L6 Bl
Matrix
Drinking Water
:807 6616301 0 A- 2
All Doletrnmes are Alaska Standard Time
Printed Daterrime 0412012005 8:02
Collected Dsterrime 04/062005 16:30
Received Daterrmte 04/072005 13:44
Technical Director Stephen C. Ede
Sample Remarks:
EP300 - Sample rerun outside of hold to confirm original concentration. Concentration confirms.
Allowable Prep Analysis
Parameter - Results PQL Units Method Container M Limits Due Date [nit
Waters Department
Nitrate -N 0.750 0.100
Kicrobioloav Laboratory
Total Coliform 0
mgt EPA 300.0 B (o-10) 04/0905 CAM
coV100tnL SM20 9222B A (<-q . 04/07/05 TLF
04/11/2005 14:34 9073449021 JRS SEPTIC
JRc Pumping
PO Box 773415
Eagle River, AK 99577
(907) 694-6454,
Sating IMormatbn -.. 1
Dean Malay Job Description: 12009
Po Box 6700a5 P.O. Number.
Chupek AK 99567 Terms: Net 30
(907) 66&1021 Soleerep: Nikole
Map Book:
-• •1 Cross Streets: ad Glenn Hwy
Job slit Infernatton _
Dean for uncle. Larry kladay
..
Jab Comments:
Last service
21311 GtrW Los Drive
wed an
In tank
Chu0sk,AK 99567
(907) 688.2379
Tax Percent:
68&1021 fax
0
Servw Type
Oty Prloe Each It 2
Men Tax
Septle Service Under 2K
1 5120.00
No N0
AddlMonel Loa0w Comments:
5th house on left
Septic M back
Diagram:
PAGE 02
Service Agreement
Number: 014476
Order Date: 01 -Sap -2004
Sella Dale: 04 -Sap -2004 12:009m
ToehnkJan: Tony
Job Type Repent
Map Grid: 22
pumped tank - busts normal, son" light. Light gravel
.._..— --Extension Actual
$120.00
Gallons Planned: 1000
Y
Gallons Actual:
Hose Length: 2.5
Double Tank: ❑
Pump System:
Baffles Inlet•. C7
Baffles Outlet: ❑
N"Taxable Total Taxable Total Tax Total Grand Toni
Estimated Chargee: $120.00 $0.00 $0.00 W0.00
Actual Charges:
Customer apses to the terms and condl6ons Whited on the beds. THIS IS A BINDING AGREEMENT.
Signature and Title of Cuslamer Reprseenteeva Dat
rte•
Accepted by JRs Pumping Dab Accepted
For your added convenience we accept: Ammon Express. 0100ver, Visa and Master Card payments over the phone.
After 30 Days accounts w0I be fumed over to collections. $25.00 For NSF Checks Returned.
ASBUILT—NO CORNERS SET THIS DATE. SLiiARD b ASSOCIATES LAND -SURVEYING 688-4566
I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE'
FOLLOWING DESCRIBED PROPERTY: 1"=20'
Preuss Subd.,Addn. No. 1 Lot 6 Blk. 1 DATE, (�L,�F.A�q ��
AND THAT NO ENCROACHMENTS EXIST EXCEPT AS11-10-90 i�e.
INDICATED. IT IS THE RESPONSIBILITY OF THE f.
OWNER TO DETERMINE THE EXISTENCE OF ANY GRIP: o * -' 4 H' ` ••••.� *0
EASEMENTS, COVENANTS, OR RESTRICTIONS �is
/
WHICH DO NOT APPEAR ON THE RECORDED SUBDI- 56 ��
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB+ : ° '^• ""'*-"d •
ANY DATA HEREON BE USED FOR CONSTRUCTION 17-49 �t���'•, LS • 6910 .11i
OFFENCE LINES, OR FOR ESTABLISHING BOUND- DRAWN: +1 �' `co
ARY LINES. �lki;n�w V.
DMS
MUNICIPALITY OF ANCHORAGE
• Department of Health & Human Services M� i
DIVISION OF ENVIRONMENTAL SERVICES —
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. # 0 v — % /— 0 4 HAA #
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 6• Block 1• Preuss Subdivision J'�
Location (address or directions)
(b) Property owner
Mailing Address
(c) Lending Institution
Mailing Address
%e•��it.i.��a. ia.aC�014w 4awil-._...-_spa
AHFC #56370
Telephone: (home) Business
Telephone
(d) Real Estate Company and Agent HERITAGE REAL ESTATE CORPORATION/Hal Jackson
Address 18550 Eagle River Road, Eagle River, Alaska 99577
Telephone
(e) Mail the HAA to the following address: (or check here N, if hold for pick up.)
List contact person and day phone number below:
S & S ENGINEERING/694-2979
17034 Eagle River Road, Suite 204
Eagle River, Alaska 99577
2. TYPE OF RESIDENCE
Single-Family4X
3. WATER SUPPLY
Number of bedrooms 4
Individual Well U Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site ® Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72-025 (Rev. 7/88) Page 1 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 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
5u511
Address _Oop �oaa No. 204
Date
Telephone ��f�z�r 7 7
6. DHHS APPROVAL
Approved for bedrooms by Date lll,�7%
Approved �- Disapproved,� Conditional
Terms of Conditional Approval v v
CAUTION,
The Municipality of Anchorage Department of Health and Human Services (DI -IHS) 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 DHHS do notconduct 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. 7/88) Back Page 2 of 2
r. S._,...,,....
6. DHHS APPROVAL
Approved for bedrooms by Date lll,�7%
Approved �- Disapproved,� Conditional
Terms of Conditional Approval v v
CAUTION,
The Municipality of Anchorage Department of Health and Human Services (DI -IHS) 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 DHHS do notconduct 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. 7/88) Back Page 2 of 2
A� 90t
•f u��MEN� P� � 9®
e b
A. WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)'
CHECKLIST- FEBRUARY 1984
343-4744
Legal Description: �oT 1JtALJL� l
Well Classification1 ti1��,v 7O�
Well Log Present (Y& Date Completed UK
Total DepthCased to Depth of Grouting
If A, B, C, D.E.C. Approved (Y/N) '1 A -
Static. Water Level -7O' Pump Set At
Yield Z CsPH
tt +
Casing Height Above Ground 1Z- Sanitary Seal on Casing &N)
Electrical Wiring in Conduit Y)N) Depression Around Wellhead (YQ
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot tom t
; On Adjoining Lots
100 t }
To Nearest Edge of Absorption Field on Lot t O o k � ; On Adjoining Lots \moo �`
To Nearest Public Sewer Line Ar To Nearest Public Sewer Cleanout/Manhole r -A
To Nearest Sewer Service Line on Lot ZS
Water Sample Collected by S i S Date 14 -`-10
Water Sample Test Results SA-- i r� 1TT2_.N_T15_S
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed Size �Zsb No. of Compartments
Foundation Cleanout (Ya
Date Last Pumped Ik- 15.'l o
Standpipes ()'N) —I_—Air-tight Caps &N)
Depression over Tank (YQ
rI
72-
Pumping/Maintenance
L
Pumping/Maintenance Contact on File (Y/N) ktf ; for '
Holding Tank High -Water Alarm (Y/N) 4 IP-- Temporary Holding Tank Permit (Y/N) A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water -Supply Well `�
ao To Building Foundation `� L+
�
To Property Line t 0 Jr- To Disposal Field �2}
To Water Main/Service Line b `}
To Stream, Pond, Drainage Course
Comments
72-026 (Rev. 7/88) Front Page 1 of 2
a%Y
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata �ZSIi3r�
-Type of System Design
Date Installed Ip - 6C> -83
Length of Field _ 51
Width of Field
Depth of Field — l
Gravel
Bed Thickness
Square Feet of Absortion Area Le 17-
Statndpipes Present &YN)
\
Depression over Field (Y,A rJ
Date of Last Adequacy Test
Results of Last Adequacy Test �?cT1SFnsC�D(L�/
Foe- 4 3QS
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water -Supply Well Imo
To Property Line t a'
To Building Foundation Ic>'}
To Existing or Abandoned System on
Lot 1C)`- ; On Adjoining Lots -5b't
To Water Main/Service Line
To Cutback (if present)
To Stream, Pond, Lake, or Major Drainage Course
�Ot>' *
To Driveway, Parking Area, or Vehicle Storage Area
Sa '-
Comments
D. LIFT STATION
Date Installed
Size im s
"Pump
Or
Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Cod
Comments
Dimensions —
Manhole/Access (Y/N)
"Pump Off" Level at
ent(Y/N)
Pumping Cycles during Adequacy Test.
"Check Permitted Bedroom Rating Against HAA Request"
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this
inspection.
Signed
Company
Date Eagle River, Alaska 99577�� z r�gineer's-Seal
MOA No.
Receipt No.
Date of Payment
Amount: $
72-026 (Rev. 7/88) Back
D , CL
Receipt No.
— Waiver Fee: $ -
- Date of Payment
Page 2 of 2
� t,.
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
5633 B STREET • ANCHORAGE, ALASKA 99518 • TELEPHONE (907) 562-2343
FEDERAL TAXI. D. #92-0040440
ANALYSIS REPORT BY SAMPLE for Work Order # 30198
Date Report Printed: NOV 19 90 @ 09:08
Client Sample ID:L6 B1 PREUSS S/D
PWSID :UA
Collected NOV 14 90 @ 17:30 his.
Received NOV 15 90 @ 17:35 his.
Preserved with :AS REQUIRED
Analysis Completed :NOV 16 90
Laboratory Supervise PEEN C. EDE
Released By
Special
Instruct:
Chemlab Ref #: 904868 Lab Smpl ID: 1
Parameter Tested
----------------------------
NITRATE-N
Sample ROUTINE SAMPLE.
Remarks: SAMPLE COLLECTED BY RDJ.
Client Name S & S ENGINEERING
Client Acct SNSENGP
P.O.# NONE RECEIVED
Req #
Ordered By : R. SHAEER
Send Reports to:
1)S & S ENGINEERING
2)
Matrix: 91ATER
Result Units Method
------------------------------------------------------
0.14 mg/1 EPA 353.2
1 Tests Performed See Special Instructions Above UA=Unavailable
ND= None Detected See Sample Remarks Above
NA= Not Analyzed LT=Less Than, GT=Greater Than
Allowable
Limits
10
pF,�NDFOFNpF
Ht
G
APPLIG -IT FILLS
OUT UPPER HAL+ . ONLY
Property owner tin ; f,J %1•-_:, .ji,: �=A r
Phone
Time
Zip Code
Mailing AddreS
Buyer -7e" .,� i_ / i A �¢r !J
Date
>t_
Date
Jd
Address �-" ' ! - > p _ 1 i) f
�i ZiP Code
N . ,• - i
Inspector -
Lending Institutionu r / 1,
Phone
/ i
Zip Code
Address -.
Co. & Agent-�'...-
t._
Phone
Realty
ENVIROti7•h2NTAL PROTECTION
Zip Code
Address
Legal Description ;% 1 � . f,;:, / �� "r �0 I
f- - -- —
7
• /
Street Location
/i i
Type of Residence - -
-
V2 Single Family
RECEIVER
❑ Multiple Family No. of Bedrooms
❑ Other
Water Supply I
ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975.
R Individual
al
For wells drilled prior to that date, give well depth (attach log if available).
El Communi y \may. t
O Public Utility
-
( ) CONDITIONAL APPROVAL'
v`D2:3>�
Sewer Disposal •
Year Individual InQtalled: (`j.r -'• '
Individual
When Connected lic.Uiility'
❑ Public Utility :.
❑ Holding Tank
--
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
rr�
/r i. 7-
rvr+cc r u cru
C -)cod; Z'
Time
Time
Time
Time
Date
Date
Date
Date
Inspector
Inspector
Inspector -
Inspector
Field Notes: po � C)
c�2gt
M-Q�
Ca \
,� p„ - -
Qs?� MUNICIPALITY OF ANCHORAGE
ll- pEPT, OF Flc!-' TI i
ENVIROti7•h2NTAL PROTECTION
RECEIVER
( )APPROVED BEDROOMS
'CONDITIONS
OF�PPROVAL
c� Z p
• -
\
( ) DISAPPROVED
-
( ) CONDITIONAL APPROVAL'
v`D2:3>�
DATE
BY:
Soils Rating
Date Sewer Installed
Well To Absorption Area
Well Log Received
Septic Tank Size ) 2 U S
Well to
Tank
72 02 3 13102)
-:,ovember 3, 1983
j,eon osoasTKA
103Falcon Drive
Chugiakt AK 99567
Subject: !cit �, dock it 1,-42 on A 'd
Uludivis U
Approval :Or th(� individual *�ewer and water Lacilities cannot
7 itemn
s ave been coi-tipleted;
be granted until. the L01101Ying
This ujepart, (%,,Itno recocc. J of an on - sItO perfAt being
upgy-adod t�jit�)out a pOr
i S s u -_ d this Vear. if t�he syste:�.j
then you will neod co subl-mit Ongiiieer as-builts of the
C� flit 0 ice.
it fro,11 this Oft
upgrade installation Plur, 00tain a der""
0 hl,xposed electrical wirk--s to the W011. i`lca' are 1I1"Olat 0
the Municipalitv Of Anchorage codes ayli' lvut be enCaSe
in conduit.
The se-�?tic tank pupated with a recc-ipt Submitted to this
A 'Partlllent.
0 A our (4) inch cleanout needs to be installed to the Sep-
tic tank.
p� fourns�-alld to the
-1) illc,- cleanout needs to OC' ij
act
area.
-'orfiaie'A on t e n, -xi ting
An adeqluacy test needs to be 13c a 0
11 determine ij. the systemis
ii�
I 1,eac1in1 area. This tUFt v7I u tandards. A Iisting of. -
r L
adequate DccOrdi",g 0 National 0
I)rivato t),,Is erf
porming the test is enclosed. This repo't
e.
Ilecels to be submitted to this Of'ice for our rcv'--"j
Pleane notify t1liF, 1)aparu-iient for a reinsPectioll x7hen th-
a if there are any
cOrrectu
noted discrepancios navtD
further qu est,orls, Please call this office at 264--4720.
sincerely,
cory ' iliisr R-S-
Ficting Se%wQr & VVator
Program i4anager
Ow6/ei/El
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION MHN H URAUL
825 L Street - Anchorage, Alaska 99501 DEPT. OF I-iEPLTH &
ENVIRONMENTAL.GiECTION
•
ENVIRONMENTAL ENGINEERING DIVISION
SF• , 1 J '90"1
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FR g1kgsV -
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTYOWNER -
J
PHONE
v -'9(i i
e'() / ._
MAILING DDRE,�SS�
PRO ERTY RESIDENT (If different from ab6ve) i ,-
PHONE
2. BUYER
PHONE
MAILING ADDRESS
3. LENDING INSTITUTION
PHONE
MAILING ADDRESS
4. REALTOR/AGENT ,
CL
PHONE
(Ll NjG ADpRESS
Mf_11
'. �/
LPL/ /.
5. LE./ �CRIPTIO , 7� ) /
STREET_ LOCATIOG'N
���
r
G2 C Cf GC'
6. TYPE" ESIDENCE
NUMBER OF BEDROOMS
SINGLE FAMILY
E] One 1;S Four ❑ Other
❑ Two ❑ Five
❑ MULTIPLE FAMILY
❑ Three ❑ Six
7. WATER SUPPLY
�n INDIVIDUAL*
*
ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if availabled ,
8. SEWAGE DISPOSAL SYSTEM
**If
individual/on-site, give installation date `fV,
INDIVIDUAL/ON-SITE**
If system is over two (2) years old an adequacy test is required
❑ PUBLIC UTILITY
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
INSPECTION APPOINTMENTS
DATE RECEIVED
TIME
TIME
TIME
DATE
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
1. TYPE_ OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLEFAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATEINSTALLED
INSTALLER
❑Septic Tank or ❑ Holding Tank
Size:_ 0 O If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL ,
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
❑ APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
BY (Title)
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
Municip-ality
of
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 2644111
GEORGE M.SUL ( IVAN,
MAYOR
DEPARTMENTOF RFALM AND ENVIRONMENTAL PROTECTION
September 25, 1981
Leon J./Arlette M. Osowski
Star Route Box 162
Eagle River, Alaska 99577
Subject: Lot 6 Block 1 Preuss Subdivision #1
Approval for the individual sewer and water facilities
cannot be granted until the following items have been
completed:
(1) The water analysis report needs to be submitted to
\ �tJ this office from the Chem Lab, 5633 B Street, for
our review.
(2) The septic tank pumped with a: -receipt submitted to
this office for our review.
(3) An adequacy test needs to be petformed on the existing
leaching area. This test will determine if the system
is adequate according to National Standards. A listing
of private firms performing the test is enclosed. This
report needs to be submitted to this office for our
review.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
cc: Helga Larson
% Area Inc. Realtors
Post Office Box 249 99577
EXCAVATION
Area Realty
ATTENTION: Hel-& Larson
P.O. Box 249
Eagle River, Alaska 99577
Dear Mrs. Larson,
WORK
ROBERT A. SHAFER
CIVIL ENGINEER
694-2979
October 28, 1981 MUNICIPALITY OF A !CHORAG'
DEPT. 0=
ENVICCTION
RECEIVED
Reference: Lot 6; Block 1; Pruess Addition #1 Subdivision
A sewer system adequacy test was performed on the system located
on the referenced property as you requested. The septic tank was
pumped and verified to have a capacity of 1250 gallons. The seepage
pit was completely full of water with water extending upward into
the cleanout pipe. The water could not be removed from the .seepage
pit as the standpipe or cleanout appeared to be centered over a
crack between two logs which would not allow the pumper truck
hose to extend down into the crib. The water level in the stand-
pipe was monitored and after a period of 24 hours with the septic
tank empty the water level in the standpipe was again monitored and
it was found that the water still extended up into the standpipe.
As a result of this check it appears that the seepage pit is not
functioning adequately and will require upgrading.
If we may be of further assistance, please do not hesitate to call.
Sinc ely,
i
4S"RBERT
A. SHAF P.E.
/ss
cc: Alaska USA Federal Credit'Union
Municipality of Anchorage
Department of Health and Environmental Protection
SRB 196X EAGLE RIVER, ALASKA
Eagle River Area
GREATER ANCHORAGE AREA BOROUGH��
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received May 17, 1976
Time of Inspectior
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
V.A.
1. Approval requested by: Alaska Mutual Savings Bank o Chris Anderson
Mailing Address: Post Office Box 1120, 99510 Phone: 274-3561
2. Property Owner: Leon Osowski Phone:
z,�
Mile 3 Ea le River Road 70� 7 0/j[06"
Mailing Address: g
3. ,Legal Description: Lot 6 Block l Preuss Subdivision
4. Location: Mile 3 Eagle River Road, on left past Eagle River lane
5. Type of facility to be inspected Single Family No. of bedrooms 4
6. Well Data: Individual — serving one
A. Type B. Depth
C. Construction D. Bacterial Analysis
7. Sewage Disposal System: On—site system
A. Installed B. Installer
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank CC) Absorption area /11151— Sewer Lines ,
r
Nearest lot line Zd. Other contamination
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 - Rei st for Approval of Individual 2r & Water Facilities
w
Legal Description Lot 6 Block 1 Preuss Subdivision
Comments
Approved a isapproved Date '
Approval:;Va'lid for one year from date signed
Gr ater_Anchorage"Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this reauest for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED �l
Date
EQ -034 (1/74)
1
2
0
9
5.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C Street, Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
Type of Inspection: CMRO VA xxx FHA CONY
Property Owner: Leon OSOWSKI
Mailing Address: Mile 3 Eagle River Road Day Phone 277-1313
Name of Buyer: Patrick Richard Maitland
Mailing Address: 301 Airport sleights Dr. Day Phone 274-2984
Name of Lending Institution• Alaska Mutual Savings Bank ---Chris Anderson
Mailing Address: P.O. Box 1120 Anchorage, Ak Phone 274-3561
Name of Realtor or Agent: *alone
Mailing Address:
6. Legal Description:
9
4
Location:
Lot 6 Block 1 Pruess S/D
Mile 3 Eagle River Road
On left past Eagle River Lane
Type of Facility to be inspected: SF
Water Supply
Type of Supply: Public Utility
If Individual, number of dwellings presently served
If Individual, depth of well
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
One
Phone
Individual
No. Bdrms. —4
xxx
Individual (on-site) xxx
**' Please indicate volume of water as acceptable to purchaser. Thank you.
EQ -037 (1/74)