HomeMy WebLinkAboutPREUSS #1 BLK 1 LT 7 REMPreuss #1
Block 1
Lot 7
#050-571-03
p Municipality of Anchorage Page / Of o`
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: 5077 0OMP PID Number: 650-5�j_&3
Name: KEN SNG
El System: New Upgrade
Address: of
E ABSORPTION FIELD
94151 (4 ✓E
KT5V-1V6
Phone: 45q�
No. of Bedro s:
❑ Deep Trench ❑ Shallow Trench Cl Bed ❑ ouncf ❑ Other
LEGAL DESCRIPTION
Soil Rating:
Total De from original grade:
GPD/Sq. Ft.
Syb
Lot: Block:divisi n `
Depth to pipe bottom from original grade:
avel depth beneath pipe
Q
Ft.
Township:
Range:
Section:
Fill added above original grad e•
Gravel length:
�---
Ft.
R.
WELL: F�x f ❑ New ❑ Upgrade
L ZS 7,v o
Gravel width: Ft
Numberoflines:
Distance between lines:
Classification (Private, A,B,C): Total De
Cased To:
Total abso ion area:
Pipe material:
Ft.
Ft.
SO. Ft.
Driller: Date Drilled:
Static Water Level:
In ler:
Date installed:
Ft.
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION
DISTANCES
Xseptic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer: /_
1/q/1��(
Capacity in gallons:
/5'0
From
Tank
Field
Station
Tank
Sewer Lines
Well-
p, t
rod +
�[ t1
X
STFF� Material: -
Number of Co rtments:
Surface
(OorF
16dr
LIFT STATION
WaterLot
r
r
Size in gallons:
Manufacturer:
Line
(0
Foundation
/
'Pump on" level at:
mp off' level at:
High water alarm at:
Curtain
0
//
�1
Pump &Model
Electrical Inspections performed by:
Drain
Remarks: 9- 'Al S ; irrG- S ¢ -ort C-
BENCH MARK
Location and Description:
�u ,u /O 6 r /f ,S 49 f c L r,..�
4- y} g N n ),v fq ..
Assumed Elevation: /gOO
Ft
E
9
49th Vis*
^
Dates: 1s '4L 17-
.. M
Inspections performed by: g&3_EN tNEEUNQ
17034 Eagle River Loop ROO ftM 2nd 0 -a�- Y7
Eagle River, Alaska 99577
a ROPERT C. COWAN
CE - 8801 Jjtw
Department of Heath and Hu an Services approval
I.a,..M•N\,
Reviewed and approved by:,/ Date:`,
72-013 (Rev. 9/91) MOA 25
PERMIT NO. SW970026
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 LOT 7, BLOCK 1, PREUSS SUBDIVISION P.I.D. NO. 050-571-03
10' UTILITY EASMENT
---------------------------
WELL RADIUS WELL
4
EXISTING CRIB N
NEW 1250 GAL. IW�
SEPTIC TANK
BL4
IC �1 DBL3
SL2
BLI
EXISTING ST2o o A B
Q
TRENCH i i a DBL1 25.5' 39.0'
4 BDRM Y DBL2 26.0' 37.5'
ARAG HOUSE w ST1 47.5' 17.0'
to ST2 55.0' 15.0'
PORCH DBL3 56.5' 15.0'
CO DBL4 58.0' 15.0'
a
WSCALE 1" = 40'
E
ANP•s�,,,........., •qs�
10' EASMENT C7}°y'•,4-9:1
EAGLE RIVED ROAD , .w,: ......ROBERT C. COWAN
...i
�ci� CE - 8801 2�
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:SW970026
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:KING KENNETH W & SANDRA L
OWNER ADDRESS:20251 EAGLE RIVER RD
EAGLE RIVER, ALASKA 99577
PARCEL ID:05057103
LEGAL DESCRIPTION:
PREUSS #1 BLK 1 LT 7 REM
LOT SIZE: 25180 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONSTRUCTION OF:
SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED: 2/25/97
EXPIRATION DATE: 2/25/98
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 HOUR^
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT)
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:
RECE
ISSU
DATE: d '-°'2' w % 7
DATE: 2 -2S= /'7
S&S
HEALTH AUTHORITY
APPROVALS
SEWER&WATER
MAIN EXTENSIONS
SEWER&WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
ng
February 24, 1997
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Lot 7, Block 1, Preuss Subdivision
ROBERT C. COWAN, P.E.
ROBERTA. SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
Request you issue a permit to replace the septic tank
serving the four bedroom house on the referenced property.
We request you expedite the issuance of this permit due to
the collapsing of the septic tank serving the referenced
property which is creating a health hazard.
The proposed 1250 gallon septic tank is to be placed
outside the well protective radius. Attached is a site
plan which depicts the location of the proposed tank.
We do not anticipate any adverse effects on neighboring
wells, septic systems or drainage patterns by the
installation of the proposed septic system.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P.E.
RCC/gk
Enclosure
:; ul'�15;OfY
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
LEGAL
/ BLOCK Il 1T RE lJ .7S S D
OF �S
"
DRAWN
CKD. DATE SHT.
R.C.C. 02-24-97 1 OF 1
„��►
.q3
p
'8
"1,o,y
S & S
EnGinCCRinG
STRUCTURES,, EASEMENTS, OR ENCROACHMENTS
SHOWN ON THIS SITE PLAN ARE AS SHOWN ON\
h9t 4 I
EAGLE
ANS
AN AS—BUILT SURVEY DRAWN BY:
RICHARD P. HANKINS
�o ROBERT C. COWAN �f
IT IS THE RESPONSIBILTY OF THE CONTRACTOR
CE.8801
TO VERIFY EASEMENTS, REQUIRED SEPARATION
d' cam`yy
LOT 13
RTY LINES PRIOR TO
ISTANCN
DISTANCES,
S,CONSTRUCTION.D PROP
STIR LOT 1
�i3fE$Sl4�'
100' WELL RADIUS APPROX. WELL LOT 11
LOCATION CONTRACTOR IS REQUIRED TO
OBTAIN
UTILITY LOCATES______
_ _________________
PRIOR
TO ANY EXCAVATION
10' UTILITY EASMENT
z—
— — — — — — — — — — — — — — — — — — — — — — — —
'2�
—------------------� ---
WELL RADIUS WELL
------------
LLJ
�S 4SA
��
o
loo,
100' WELL RADIUS
aRox. D
ee
�2
LOT 7
APPROX. WELL
ocnnoN PROPOSED
1250 GAL.
LOCATION
SEPTIC
TANK
INSTALL
DBL. CO EXISTING 1250
GAL.
LOT 6
SEPTIC TANK
EXISTING CRI
TO BE PUMPED, EXCAVATED.
CRUSHED, AND ABANDONED
Z
Q
C J Coco o AunoN:
LOT 8
OL
C o CO GAS UNE
LLJ
co SEE NOTE
EXISTING TRENC
ri
4 BDRM Y
GARAG HOUSE w
100WELL RADIUS
a—
APPROX. WELL
LOCATION
I I Q
II
I I PORCH
L
NOTE:
COVERIFY >-
F NO FCC
CLEANOUT. �O
�41
Q
INSTALL DOUBLE CLEANOUT
PRIOR TO THE SEPTIC TANK.
O
Lil
>
APPROX.
LOCATION
�
-----------------------
--
— — — — ---------------------
-------'---_..
----------------
10' EASMENT
ALL PORTIONS OF SYSTEM
THE ENGINEER MAY VARY THE
WITH LESS THAN 3.5' OF
EXACT DIMENSIONS AND DESIGN
CLIENT PARAMETERS IN THE FIELD, IF
EAGLE RIVER, ROADNECESSARY, TO MEET SITE
COVER REQUIRE INSULATION.
CONDITIONS.
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
NAME
PHONE
❑NEW
_ -y
UPGRADE
MAILING ADDRESS
LEGAL DESCRIP 10
LOCATIONj� y`��
I� led
NO. OF BEDROOMS
Absorption area
Dwelling
PERMIT NO.
Uy
DISTANC O:
I- Z
LU
Manufactur r ,�/
Material
No. of compartments
y
Liq. capacity in gallons
IF HOMEMADE:
Inside lenA
Width
Liquid depth
O y
J Z
DISTANCE TO:
Well
Dwelling
PERMIT NO.
2 F
ManufacturerMaterial
Liquid capacity in gallons
Well V �
Fo ation�
Near t lot I�he
;I
PER O.
y
DISTANCE T0:C
; O
7
Z
No. of lines / Length liiife,
Total le h o lijie Trench th r
Distance bet�}�n l es
H w
ccTop
I.-<
(—_
of tile to f'sh/gradf
, inches
M� -rlal bene ile / r
-
�Q
/�-'
Total effective sorption area
2 Z Z�'--*L inches
Length
Width
Depth
PERMIT NO.
w
(7
Q F
Type of crib
Crib diam r
Crib depth
Total effective absorption area
to
w
Lu
y
Well
Building foundation
Nearest lot line
DISTANCE TO:
Class G��j
D pth /y
fL
Driller
Distance to lot line
PERMIT NO.
W
Building foundation
Sewer line
Septic tank
Absorption area(s)
DISTANCE T0:
OTHER
V
.,
PIPE MATERIALS
L�
SOI L TEST RATI NG
o
INSTALL
REMARKS
:Sj "� JAa PcrJOra,; `4 Cyt.,
Y C' '
are
u:t
i�
nail ��%±•
t
-. •GMK aG. �5`<s�i
ML
ZYZ
APMRD DATE LEGAL H
,Gaa
IVER, ALP rah
�.'
Q P p
72-r/Rev. 3/78) f r . / .. .-
Ea Department ea En Environmentz Protection`
825`--L Street, Anchorage, AK. `99501
f 264-4720
# # # HANDWRITTEN PERMIT
Permit # t ON-SITE SEWER PERMIT
Applicant. t Mailing Address: 95; 4�
Location: Phone Number:
Legal Description: AD l / f,) / -- Lot Size:
Type of Soil Absorption System Is:
Trench: Drainfield: 4,, Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: Soil Rating(sq.ft/br) 1.5,r,
The Required Size of the Soil Absorption System Is:
DEPTH LENGTH. GRAVEL DEPTH Sm WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = 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 department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
# * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3
I certify that:
(1) I am familiar with
set forth by the M
(2) I wil i st 11 the
(3) I u er th
th , re
Signed:
ant
SWP/024(1/81)
the requirements for on-site sewers and wells as
�n cipality of Anchorage.
ystem in accordance with codes.
he on-site sewer system may require enlargement if
modeled to include more that 2,bedroom .
Issued by:
Date: q -I / ��
Aqe copy
❑ SOILS LOG
0
MUNICIPALITY OF ANCHORAGE
a.c DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR:r�/�^jJ DATE PERFORMED! f
L`_EGAL DESCRIPTION: 7 '/� / / l�J_j ; —�—
DEPTH
(FEET)
2/L . /L T4,/ �,CWEZ_ (fieo
u
414 a l r7a l
4 � �
s Q /j�rC
4
t9�
WAS GROUND WATER
ENCOUNTERED?
12 �
D IF YES, AT WHAT
DEPTH?
SLOPE
13
14
15
20
I
SITE PLAN
_ If
7D L
0
P
E
i
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
_0,e
■■■■■■■■■■
)
7 j
■■■■■■■■■■
l�
m ' it
7D L
0
P
E
i
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
_0,e
)
7 j
l�
m ' it
G,
PERCOLATION RATE
TEST RUN BETWEEN
COMMENTS ,S7
z.1/nutes/inch)
FT AND _ f FT
r
PERFORMEDBV��, /!// -;4} 'once ,siaA ,.
CERTIFIED BY; y-� � (�1`111>_ DATE:
A'.�t� 1,> '��� /' 'rte I z 5
72-008 (6/79)
GREATF ANCHORAGE AREA BOROI,,_ Ji
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
f� `INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME db& -f Otf L "46-/1C ® MAILING ADDRESS &A 4 L� 4A &-f7 94(Z,
d PHONE �
LOCATION 64 K"4 „OXY LEGAL DESCRIPTION ``7 / 94(Z, I Auii's ;4
SEPTIC TANK: uuIt 1%qol
DISTANCEy , NUMBER OF
FROM WELL S MANUFACTURER tiC S�tr MATERIAL feat COMPARTMENTS 2 -
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY iZiz GALLONS.
SEEPAGE PIT:
NUMBER OF PITS � DIAMETER 100 OR WIDTH_, LENGTH_, DEPTH 61 ,
LINING MATERIAL CRIB SIZE: DIAMETER DEPTH v DISTANCE FROM: WELL jq/
1 i TOTAL EFFECTIVE
BUILDING FOUNDATION 2 l , NEAREST LOT LINE �Z ABSORPTION AREA (WALL AREA) Gov SQ. FT.
ADDITIONAL ABSORPTION
WELL:
A �If�l 5+•x..1
TVCF ��
TYPE �� �
fl1NCTPIIfTifiN
CONSTRUCTION
nce�ru
DEPTH
BUILDING EG1
NEAREST NEAREST
SEPTIC
FOUNDATION U U
LOT LINE -,SEWER LINE
TANK
aad
CESSPOOL
APPROVED
DISTANCES:
OTHER SOURCES
DISAPPROVED REMA
DIAGRAM Off -SYSTEM
INSTALLED BY:
PIPE MATERIAL:
X
g
R
LOT SLOPE:
�
REMARKS:
DATE
F„
Form No. EQ -031
DISTANCE FROM:
SEEPAGE la
SYSTEM
APPROVED
rl
R&M
Civil Engineers
ENGIN RING-_& GEOLOGICAL ,CONSULTANTS
229 EAST 51st. AVE. - P.O. BOX 6087 - ANCHORAGE, ALASKA 99503
TELEPHONE 907-279-0483 TELEX 090-35419
Geologists
JAMES W. ROONEY, P. E.
MALCOLM A. MENZIES, P.E., L.S.
JAMES H. WELLMAN, P.E.
September 25, 1973 SEP 197+ A
R & M No. 36670
GREATER ANCHORAGE AREA BOROUGH
GFPT, OF F.NYIRONMFNTAL QUALITY
Mr. Robert Fitzpatrick
General Delivery
Anchorage, AK
Re: Test Hole and Soil Log Report for Sanitary System, Lot 7,
Block 1, Pruess Subdivision
Dear Mr. Fitzpatrick:
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
September 21, 1973, 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.
Land Surveyors
RALPH R. MIGLIACCIO
Engineering Geologist
A single test hole was put down within the Lot 7 area for the purpose
of defining general subsurface sail"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 14 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
James W. Rooney
JWR:ph /
xc: GAAB I
ANCHORAGE FAIRBANKS
JUNEAU
J
T. H. 1
9-21•-73
0
o
. Gravelly Sand with Some
:®
Silt (SP)
0.0,'
D '
0b
0�
D, D
D0
'0. o•
o
Sandy Silt, Trace Gravel (SM) l
o
i•
•%
j
f
Silt, Trace Sand (ML)(2-75)
g
Silty Sand Trace Gravel
(SM) <74-0
.B
. •o
No Water Table
NOTE: Test hole excavated with tractor -mounted backhoe.
Engineering 6E Geolog!eat Consultants
ANCHORAGE FAIRBANKS ALASXA JUNEAU
DATE 9-21-73 SCALE In = �r OWN BY TDQ CHKD BY
M
7.0'
zso)
9.0'
10.5'
_4.0' T.D.
ROBERT FITZPATRICK
LOG OF TEST HOLE
Anchorage Alaska
PROJ. NO. l[c7n DWG NO. . „_
Municipality of Anchorage r
V
On -Site Water and Wastewater Program q .
(907) 343-7904 r E r
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 050-571-03 __
Expiration Date: J 0�
1. GENERAL INFORMATION
Complete legal description Preuss #1 Block 1 Lot 7 P,E[v\
Location (site address) _2_Q2.5-1 Eagle River Rd, Eagle River, AK
Current Property owner(s) Sai Sadasivan Day phone
Mailing address 589E Dowling Rd #49., Anchorage, AK .
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
❑
Community Class _ Well
❑
Public Water System
❑
WaiverNariance request for:
TYPE OF WASTEWATER DISPOSAL:
Individual
Holding Tank
❑
Community
❑
Public Sewer
❑
Received by: Date: 9
COSA to be released to the engineer, unless othe nested by the engineer.
COSA Fee $_550 Waiver Fee $
Date of Payment-S_=2Date of Payment
Receipt Number ��� . Receipt Number
COSA # OSC211147 Waiver #
istance:
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems 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 ARCTERRA_CONSULTING, INC. Phone 696-6111
Address 20441_ PTARMIGAN BLVD.,, EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS
_ Date
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA
regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate
during the year and the water usage of the family being served by the system. 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,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can ArcTerra guarantee that no unseen
,v
encroachments, deficiencies or discrepancies exist.
,
AV>
6. DSD SIGNATURE
System #1 Approved for bedrooms.
��� "L".«r°; M. D`FF` S
System #2 Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
,\N`llK```(�tOF ALA.(t,,._
o�-SV�
JATER-AND____.___
AST[ v,!ATER o
PROG
F'An- �,-n\l IN1�1
By .__ _.N�_..__ _ _ Original Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
COSA blue sheet -10-10-12 doc
Nitrate Advisory
Arsenic Advisory
Other -T-Q,e k e_- Gaal v 5 o y, X
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904
On‐Site Water and Wastewater Section Fax: 343‐7997
www.muni.org/onsite
Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org
Septic Tank Advisory
Certificate of On‐Site Systems Approval # OSC211147
Subdivision: Preuss #1 Block:1, Lot: 7 REM
The septic tank for this property is 24 years old. The average life for a steel septic
tank is 20 years. Typical replacement costs range from $7,000 to $11,000.
This advisory must be attached to all copies of the subject Certificate of On‐Site
Systems Approval.
This is an example of what the metal of a 30 year old steel tank MAY look like.
epartment
P.O. Box 196650 b 4700 Elmore Road
Anchorage, Alaska 99519-6650 0 (907) 343-7904 ® Fax (907) 343-7997
http://www.muni.org/Onsite
Development Services Department
On -Site Water and Wastewater Section
XxxK /WAIVER ARIANtr-jxXX?C
Waiver#: COSA#: OSC211147 Permit#: SW970026
PID#: 050-571-03
Legal Description: Preuss #1 Block 1 Lot 7 REM
Engineer:
Applicant: Sai Sadasivan
A waiver of the required 10.0 feet horizontal separation from the absorption field to the
foundation has been approved. The approved separation distance is 3.0 feet. This condition
appears to have existed since at least 1997 with no known negative impacts.
This waiver approval applies to the existing absorption field only. Any future upgrade to the on-
site wastewater disposal system will require all separation distances be met or another approval
from this department.
M a M a a a a C a a i i a a a a a a a a■■ a c a a a a a a a a a n a a v a a a a a a V a a a a a a a a a a a a n a a a a a a e a a a e e a a a e a a a 1
Waiver is Granted: X Waiver is not Granted:
Date: 02�� 1 _ Approved by: a&cc,� —ds�&—
Name of Reviewer
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Municipality of Anchorage
On-Site Water and Wastewater Program
(907) 343-7904 < esti'i
Certificate of On-Site Systems Approval
Parcel I.D. 050-571-03 Expiration Date: ( -1 ^(
1. GENERAL INFORMATION
Complete legal description Preuss#1 Block 1 Lot 7
Location (site address) 20251 Eagle River Road
Current Property owner(s) VFW Day phone
Mailing address
Real Estate Agent Steve Skinner Day phone
(V7 8 9---10
77
2. TYPE OF DWELLING:
Q Single Family (w/wo ADU)
❑ Duplex °' 19g&3 0._., n
❑ Multiple Dwellings (Single Family and/or Duplex) -Q
ti
3. NUMBER OF BEDROOMS: 4 ii Ol 6 8 L 9���
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well 0 Individual 0
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request : nOn -r Distance:
Received by: / Date: /7P/S
COSA to be released o e engine ess otherwise requested by the engineer.
COSA Fee $ 5).4' Waiver Fee $
Date of Payment 701/(2 Date of Payment
Receipt Number dr�r -3 D Receipt Number
COSA# (3J04(U`i 7 Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems 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 C&M Engineering Phone 854-5558
Address 20182 Tulwar
Engineer's Printed Name Charles Balzarini Date 8/28/18
OF AL;ikkkh
9T :>`t, • ¢�
6. DSD SIGNATURE . • s
System #1 Approved for -T bedrooms "
5
System #2 Approved for bedrooms �HARLESGLZARI���
Disapproved • t <4; •,�
�F OEES NA , .
— --,� onditional approval for � bedrooms, with the following sty -
S Y1. `:( \ i G �'J-�vl lC ( S 2( ',eat 0`
tiii) a6 -
ON-SITE
WATER AND '
WASTEWATER
-. PROGRAM
By: t.,_r`— ' Original Certificate Date: q -1 Z r
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet_c -
If more than 1 septic system is on the lot:
COSA Checklist# 1 of1
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: PREUSS#1 BLOCK 1 LOT 7 Parcel ID: 050 571 03
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# Well Log (Y/ ) VO
Date completed UNKNOIt Sanitary seal (Y/N) YES Wires properly protected (Y/N)YES
Total depth 120 ft. Cased to +40 ft. Casing height(above ground) +12 in.
FROM WELL LOG AT INSPECTION
Date of test UNK 8/23/18
Static water level UNK ft. 80 ft.
Well production UNK g.p.m. +2 g.p.m.
WATER SAMPLE RESULTS:
Coliform �� colonies/100 mL Nitrate I 5‘g mg/L
Arsenic Al ug/L Date of sample: W /a Collected by: C&M ENGINEERING
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 2/26/97
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) NO
Date of pumping 9//07`$ Pumper ALf45KA- O✓AGITy Sc'i 2G
C. ABSORPTION FIELD DATA
Date installed 73/83 Soil rating iztra.44f#2 or ft2/bdrm) 155 System type t
Length 35/8 ft. Width 2.5/8, ft. Gravel below pipe 5/6 ft.
` '
Total depth 9/10 ft. Eff. absorption area ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 8/24/18 Results (Pass/Fail)PASS For 4 bedrooms
Fluid depth in absorption field before test 27 in. Water added 6000- gal. New depth 29 in.
Elapsed Time: <14If min. Final fluid depth 25 in. Absorption rate >= 600 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N &type) NONE If yes, give date N/A
D. LIFT STATION
Date installed NA Size in gallons -- Manhole/Access (Y/N) --
"Pump on" level at-- in. "Pump off' level at -- in. High water alarm level at -- in.
Datum -- Cycles tested -- Meets alarm&circuit requirements?--
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot +100 On adjacent lots +100
Absorption field on lot +100 On adjacent lots +100
Public sewer main +100 Public sewer manhole/cleanout +100
Sewer/septic service line +25 Holding tank +100
Animal containment areas +100 Manure/animal excrete storage areas +100
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation +5 Property line +10 Absorption field +10
Water main +10 Water service line +10 Surface water +100
Wells on adjacent lots+100
ABSORPTION FIELD ON LOT TO:
Property line +10 Building foundation +10 Water main +10
Water Service line+10 Surface water +100 Driveway, parking/vehicle storage +5
Curtain drain +50 Wells on adjacent lots +100
F. COMMENTS
* TANK IS 21 YEARS OLD AND NEARING END OF USEFUL LIFE,. 4EVE1-5 /61"44-•
** SYSTEM PRE-SOAKED PRIOR TO ABSORPRTION TEST.
G. ENGINEER'S CERTIFICATION 4.oF Ak
Amy I certify that I have determined through field inspections and ,r�r sc�, ,'' "
review of Municipal records that the above systems are in »» •„
conformance with MOA COSA guidelines in effect on this date. ;`:!: •»
»
Engineer's Printed Name CHARLES BALZARINI » » ' FA
Date 8/30/18 ' . •' ' " ` " " . ` • ` ` " ' » »
I C,1ARLES G BALZARINI
CE-13854
AlaPe
k\AFD 1°ROFESStOOa .i:"""
COSA canary sheet_2-6-15.doc
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT • �� 907-343-7904
On Site Water and Wastewater Section ` Fax: 343-7997
www.muni.org/onsite
Septic Tank Advisory
Certificate of On-Site Systems Approval # 0SC181447
Subdivision: Preuss#1 Block: 1, Lot: 7
Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for
this property is 21 years old. Typical replacement costs range from $6,000 to $9,000.
This advisory must be attached to all copies of the subject Certificate of On-Site Systems
Approval.
This is an example of what the metal of a 20 year old steel tank MAY look like.
tot
thl
:s Y 1Str
Mailing Address: P.O. Box 196650 * Anchorage,Alaska 99519-6650 * www.muni.org
Parcell.D.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program s . 9 T V
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
050-571-03
1. GENERAL INFORMATION
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
COSA # HA lq 03 5O
Expiration Date:
Preuss 111, Block 1, Lot 7
20251 Eagle River Road
Ken King
20251 Eagle River Road
Larry Ross
Buyers Real Estate
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
928-692-6554
Day phone
Day phone
561-2227
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding Tank ❑
Community On-site ❑
Public Sewer ❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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 Certificate of On -Site Systems 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. 1 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 NorthRim Engineering . Phone 694-7028
Address P.O. Box 770724
Engineer's Printed Name S+exte Eng Date 9/2'i n9
5. DSD SIGNATURE
_Approved for L/ bedrooms.
Disapproved.
�
�F
W.
rP"C' Steven W. Eng
^ �•. f 62 6
>tp; AtiS. 'V
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By ' Original Certificate Date: I D
(Rev. 11NS)
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
i
Legal Description: Preuss #1, Block 1, Lot 7 Parcel ID -050-571-03
A. WELL DATA
Well type P If A, B, or C provide PWSID #
Date completed Unknown Sanitary seal (YIN) Y
Total depth 120' ft
Date of test :
Static water level
Well production
Cased to 40' fd-
FROM WELL LOG
WATER
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL Nitrate q.AAmg/L
Arsenic: ND ug/L date of sample: 9/4/09
B. SEPTICIHOLDING TANK DATA
TankType/Material Anchorage Tank (steel)
Tank size 1P.9 gal. Number of Compartments P
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N
Well Log (Y/N) N
Wires properly protected (Y/N)Y
Casing height (above ground) 12' in.
AT INSPECTION
Ell,
Other bacteria 0 colonies/100 mL
Collected by: GEG
Date installed 2/26/97
Cieanouts (YIN)
High water alarm (Y/N) N
Date of pumping 1/20/09 Pumper JR's
r
C. ABSORPTION FIfflJ4D/J5
Date installed' 4/14/83Soil rating (g.p.d./fe or felbdrm) 155 System type Trench/S.P.
Length 3 G 5 & 8 ft. Width 2.5 & 8 ft. Gravel below pipes & 6 ft.
Total depth 9/1Q. Eff. absorption area 350 ft=, Monitoring tube Y Depression over fielcN
Date of adequacy test 9/14&15/09 'Results (Pass/Fail) Pass For 4 bedrooms
i
Fluid depth in, absorption field before test 5 in. Water added 145�I. New deptlal in.
2—tPa y s
Elapsed Time: 126. Final fluid depth 9 In. Absorption rate >=700+ g.p.d.
r
Any rejuvenation treatment (past 12 mo.) (YM & type)
unk
If yes, give date
D. LIFT STATION
Date installed N/A
'Pump on' level at N/qn.
Datum N/A
Size in gallons N/A Manhole/Access (Y/N) N/A
'Pump off* level at N/4h. High water alarm level at N/A in.
Cycles tested N/A Meets alarm & circuit requirements? N/A
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100' + On adjacent lots 100' +
Absorption field on tot 100' + On adjacent lots 100' +
Public sewer main NA Public sewer manhole/cleanout NA
Sewer /septic service line 25' + Holding tank NA
Animal containment areas 100' + Manure/animal excrete storage areas 100' +
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5' + Property line 10' + Absorption field 5' +
Water main NA Water service line in, +Surfacewater inn' +
Welts on adjacent lots 100' +
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main NA
Water Service line 10 + Surface water. 100' + Driveway, parking/vehicle storage 5' +
Curtain drain NA Wells on adjacent lots 100' +
F. COMMENTS
G. ENGINEER'S CERTIFICATION �• ' •••� �•.;rjy '3'
I certify that I have determined through field inspections and r x ' 49 ta♦ .�� n A
r...�. :...a
review of Municipal records that the above systems are in � "• �
conformance with MOA COSA guidelines in effect on this date. ...............
`
Steve Eng `a' C_i jirve9 W.Eng ': `"
Engineers Printed Name t rf ;625
Date % r
Date 7/27/09'
UDateCOSA Fee $ 4q -0 -
Date
of Payment 9 Z
Receipt Number C41 150 cG
(Rev. tiros)
Waiver Fee $
Date of Payment
Receipt Number
lo' t.4; (;fy C-irtnf.
ZZ'
A
,Jer.. me
f-C-fi CA.
Lln/i{.tint• _. � 1��'-CSC, �
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1
i
t. -CI(,/
Cl• 0
Z0Z-F/
EAsL-E R(veF. ROAD
AS -BUILT
I hereby certify that I have surveyed the following described
property: L o 7- 7, f %o o {: (�
Anchorage Recording Precinct, Alaska, and that the improve-
ments situated thereon are within the property lines and do not
overlap or encroach on the property lying adjacent thereto, that
no improvements on property lying adjacent thereto encroach
on the premises in question and that there are no roadways,
transmission lines or other visible easements on said property
except as indicated hereon.
Dated at Eile River, Alaska
this —4Lday of — F. {.f 2pp 4 .
ROBERT C. JOHNSON 17 0! 4`
ry
SCALE: Registered Land Sueyor No. 880 -LS
1" - 7 d" Box 77.0456, Eagle River, Alaska 99577
Phone (907) 6942547
Sap-18- 2009 I:OOPM Garness Engineering Group. Ltd.
c+W
tics RcL4
1093699001
Client \amt
Garness Engineering Group, Ltd
Pruicct N'amc/a
Pruess 91 Bl,L7
Client Sample ID
Pruess kI B1,L7
Ntatri%
Drinking Wuler
sainplc Rcmarks:
Microbiology Laboratory
09/09/09
F"Wwwr
Results
Collected DateMme
Metals by ICP/M3
Received Date/Time
Ancnic
NU
Waters Department
mg/L
Total Nitratc/Nilritc-N
3.88
Microbiology Laboratory
09/09/09
IU I'
Colony Count
0
Towl f. uliform
0
fecal C'olifonn
0
0
No -7237 P. 6
t
Printed DateMme
09/172009 15:55
Collected DateMme
09/042009 8:00
Received Date/Time
09/042009 15:05
Technical Director
Stephen C.Edc
U
Allowable Frep Analysts
K)I. Urals hiedwd Container ID Limits hate Dom Init
5.00
ug/L
P.P200.8
C
(<10)
09/14.109 09/16/09
NRB
0.100
mg/L
SM204SOONO3-F
R
(<10)
09/09/09
IU I'
col/100mL
SM209222D
A
(<200)
wU100ml.
SM20922211
A
(<ll
coUlMmi.
SM209222B
A
(<I)
09/04/09 ULC
09/04/09 DLC
09/04/()9 DLC
From: Jim Sullivan <apw@gci.net>
To: steve Eng <northdmeng@aol.com>
Subject: 20251 eagle river rd
Date: Sat, Oct 3, 2009 10:49 am
Casing40'+ with no preforatins
Thanks
Will bill realitor
Sent from my (Phone
MUNICIPALITY OF ANCHORAGE
• Department of Health & Human Services y
DIVISION OF ENVIRONMENTAL SERVICES}i
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel 1. D. # i1�� - ��l HAA #
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 7; Block 1; Pneuaa Subdivision Addition 61
Location (address or directions)
20251 Ea 2e Rivex Road
(b) Property owner Bnuce Daeke Telephone : (home) 696-0560 Business 562-7372
Mailing Address 20251 Eag-2e Riven Road Eagle Riven A2a6ka 99577
(c) Lending Institution
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone
Telephone
(e) Mail the HAA to the following address: (or check here MD if hold for pick up.)
List contact person and day phone number below:
S & 5 ENGINEERING
17034 Eagle River ooP oa No. 204.
Eagle River, Alaska 99577
2. TYPE OF RESIDENCE
Single -Family Xx Number of bedrooms 4
3. WATER SUPPLY
Individual Well 1Xx 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 Rx 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 Telephone 61? 4��Z r/2
5 & 5 ENGINEERING
Address
-17034 E4.- �T-r 7 on Road Nn 504
Date Eagle River, Alaska 99577
� a0
ce�Y ¢aa a ,nns•rcnsn ucn��ar
�.r��r 4..e••.o •�<... BJP.
ti5vrt A. Shaw[' iL
6A C
6. DHHS APPROVAL ./
Approved forbedroomsby v Date
Approved ri Disapproved Conditional
Terms of Conditional Approval
CAUTION..
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending
institutions in orderto 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. 7/88) Back Page 2 of 2
MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES N MUNICIPALITY OF ANCHORAGE (MOA)
• � Health Authority Approval (HAA)
JUN 2 ® 199 T CHECKLIST - FEBRUARY 1984 -
343-4744
RECEIVED
Legal Description: Lof
A. WELL DATA rr -'� I
Well Classification :S'101 1p 1—r4 M I I H If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N) AJDateCompleted L) L<
Total Depth I ZO'f Cased to4P t_ Depth of Grouting
Static Water Level `a /
Pump Set At
Yield
Casing Height Above Ground 12 to
+ Sanitary Seal,on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) -
SEPARATION DISTANCES FROM WELL
Depression Around Wellhead (Y/N)
To Septic/Holding Tank on Lot * 88 / ; On Adjoining Lots / 00 '-f
To Nearest Edge of Absorption Field on Lot / D ; On Adjoining Lots
To Nearest Public Sewer Line _ S r� To Nearest Public Sewer Cleanout/Manhole 100 4 -
To Nearest Nearest Sewer Service Line on Lot
Water Sample Collected by d S /- NG to C--C-ILlAM4 ; Date
Water Sample Test Results aA i it 6 f A x-40 d — �'A( ', er(lQ
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed Q Size —'2.tWD Al No. of Compartments
Standpipes (Y/N) _T Air -tight Caps (Y/N) — g Foundation Cleanout (Y/N)—
Depression over Tank (Y/N) /I Date Last Pumped Zo ` 9 9
Pumping/Maintenance Contact on File (Y/N) A) ; for ti 1;4
Holding Tank High -Water Alarm (Y/N) &)1A Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: /
To Water -Supply Well g8 To Building Foundation
g z
t i
To Property Line 5) To Disposal Field — 20
To Water Main/Service Line
To Stream, Pond, Lake or Major Drainage Course
Comments
72-026 (Rev. 7/88) Front
Page 1 of 2
'S
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata / `a t 8F Type of System Design Seo qA = f_ Z 1 fe u,
Date Installed -(y- 83 iQ Length of Field 5P8(3S I�eeroc
Width of Field IR 3 O Depth of Field (_Q_ j e&ck
Gravel Bed Thickness /n S.P S 1 ,eeJC_A
Square Feet of Absortion Area 6000 � ?� SSO Statndpipes Present (Y/N') �
Depression over Field (Y/N)
Results of Last Adequacy Test
Date of Last Adequacy Test D
U 2x14 ,/'HIAA
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water -Supply Well 5, A /a 3', / PN / 30, To Property Line /0 f
To Building Foundation -2 1 1 To Existing or Abandoned System on
Lot &J 1A ; On Adjoining Lots 3C),
To Water Main/Service Line
To Stream, Pond, Lake, or Major Drainage Course -
To Driveway, Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
To Cutback (if present) t )bq
Dimensions
Manhole/Access (Y/N)
"Pump Off' Level at
Vent(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
inspection.
Signed
5&5E
Company 17034 EagL River Loop Road No 2()r1
Date Eagle River, Alaska 9957 �Z.o l y�
MOA No.
Receipt No.
Date of Payment
Amount: $ / 26 s
Receipt No.
Waiver Fee: $
Date of Payment
72-026 (Rev. 7788) Back Page 2 of 2
YY..
r.e+
gab®6ngire,ws
p ®� No, 1457•C c R
(`�C� .eVVUY W VU4Y Dye ��� n
$ t4,�wff 0FESSO�PAzy
=c'0, _ CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
LABORATORIES
5633 B STREET • ANCHORAGE, ALASKA 99518 • TELEPHONE (907) 562-2343
FEDERAL TAX I.D. #92-0040440
ANALYSIS REPORT BY SAMPLE for Work Order # 22273
Date Report Printed: JUN 15 90 @ 13:33
Client Sample ID:L7, B1, PREUSS S/D #1
Client Name
S & S ENGR
PWSID :UA
Client Acct
SNSENGP
Collected JUN 5
90 @ 16:10 his.
P.O.# NONE
RECEIVED
Received JUN 6
90 @ 13:10 his.
Req #
Preserved with
:AS REQUIRED
Ordered By
: R. SHAFER
Analysis Completed :JUN 13 90 Send Reports to:
Laboratory Supervisor -HEN C. EDDE 1)S & S ENGR
Released By ��%� 2)
Special v
Instruct:
Chemlab Ref #: 901731 Lab Smpl ID: 1 Matrix: WATER
Parameter Tested
---------------------------
NITRATE-N
Result Units
----------------------
1.10 mg/l
Sample SAMPLE COLLECTED BY RDJ. ROUTINE SAMPLE.
Remarks:
Allowable
Method Limits
----------------------------
EPA 353.2 10
1 Tests Performed See Special Instructions Above UA -Unavailable
ND= None Detected See Sample Remarks Above
NA- Not Analyzed LT=Less Than, GT=Gxeatex Than
O',,RO"'"07
Hr
O �y
J A
4"
A
-
APPLI` ' NT FILLS
OUT UPPER HA ONLY
Time
Time (l, 7�
GL{�� A4 j �I. 0
Date
Date
Property fl°mer
t --t �,�—{-� (-�(
A r
Phone
Mailing Address
g
s22 1LI C�
i Zi Code
(- v� p
Buyer
i
ri
Address
( ) APPROVED BEDROOMS
Zip Code
( ) DISAPPROVED
Lending Institution
( *CONDITIONAL APPROVAL`
Phone
Address
Zip Code
Realty Co. & Agent
- - �-
Phone
Address �, < ��_. �j U
Zip Code Y -
Legal Description
L) L� -'.- f ?7 "
S - �p �"' �¢ v Q ,.✓
Well A Absorption Area / G =1
Street Location'
Septic Tank Size
Type of Residence
Well to Tank R'-
-
,5�—Single Family
A Multiple Family
No. of Bedrooms
❑ Other
Water Supply
'"Individual
ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975.
d Community
For wells drilled prior to that date, give well depth (attach log
if available).
❑ Public Utility
Disposal
Sewer Disposal
y individual
Year Individual Installed:
❑ Public Utility
_
When Connected to Public Utility:
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Time
Time (l, 7�
GL{�� A4 j �I. 0
Date
Date
Date
Date
Inspector
Inspector
Inspector
-
InspectorD _' 1
,
Field Notes:
ANCMUKAGI
DFpT C° =' �_ .
11 '�._�.11J1'i
i
ri
RE CE I VE UA
( ) APPROVED BEDROOMS
I ^, � *CO,N,DITIGONSOFAPPROVAL
L-l,—'`tA
( ) DISAPPROVED
-
( *CONDITIONAL APPROVAL`
�0-,
DATE
BY:
Soils Rating
Date Sewer
Installed
Well A Absorption Area / G =1
Well Log R ceived
Septic Tank Size
Well to Tank R'-
72023 (3182)
J�
VaAS
q
EXCAVATION
A WORK
February 15, 1983
Garth Reid
SRB 1446
Eagle River, Alaska 99577
Dear Mr. Reid,
Reference: Lot 7, Block l-, Pruess _lkl Subdivision
ROBERT A. SHAFER
CIVIL ENGINEER
694-2979
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 had to be located and the
stand pipe had to be cleaned out and installed in the crib.
After this work was done an adequacy test was performed on
the seepage pit by filling the crib with 800 gallons of
fresh water and after a period of 24 hours the water measured
that had percolated out of the crib equaled approximately
347 gallons.
it can be concluded from this test that the septic tank is large
enough for the four bedroom residence, however, I regret to
inform you that the seepage pit appears to be only percolating
sufficient water for approximately two bedrooms. It will be
necessary to have this system upgraded before it can be con-
sidered adequate for all four bedrooms. An estimate for up-
grading the system has been attached, as you requested.
If we may be of any further service, please do not hesitate
to contact us.
P. r.
cc: Re/Max Realty
ATTENTION: Eliot chamberlain
�nui��cl�Au-r of A�, woe
DFar C,- TChfp
. ..ii. ='-TION
Municipality of Anchorage rt
Department of Health and Environmental Protection U
SRB 196X EAGLE RIVER, ALASKA
November 26, 1973
Votera'ns Administration
429U Street
Anc'norage, AK 99501
SUED ECT: Lot 7, Block 1, Pruess Subdivision.
Dc-ar Sir:
Public sewer is not available to the subject property. At this time
sewage disposal on this lot would hatiT to be by septic tank, soil
absorption system, installed in accordance with applicable codes and
regulations.
It is not economically feasible to serv,(- the lot With public sewer at
this time.
Sincerely,
John R. Lee, R.S.
Eagle River District Santarian
sr
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road, Anchorage, Alaska 99507 279®8686
Date Received Nov 19, 1973
Time of Inspection 2:30 pm
Date of Inspection Nov 26, 1973
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & MATER FACILITIES
FOR
VA
1. Approval Requested By: Don Zimmerman
Address: Box 596 Eagle River AK Phone:
2. Prooertv Owner: SAME Phone:
3. Legal Description. Lot 7, Block 1, Pruess Subdivision
4. Location: Eagle River Road
5. Type of Facility to he Inspected: Single Family Dwelling
Number of Bedrooms: Four (4)
6. Well Data:
A. Tvne Drilled 8. Depth 135'
C. Construction Standard D. Bacterial Analysis Satisfactory
7. Sewage Dis13osal System:
A. Installed 1973 B. Installer Frontier Excavating
C. ~Septic Tank: 1. Size 1250ga?. Manufacturer Stack Steel
D. Seepage Pit: I. Size 2. Material Log
E. Disposal Field: Total.Length of Lines
8. Distances:
A. Well To: Septic Tank � 81 Absorption Area 103' , Sewer Lines
Nearest Lot Line Other Contamination
B. Foundation to Septic Tank ;. Absorption Area
C. Absorption Area to Nearest Lot Line 22'
2eq.aest for Approval of I� ,.vidual Sewer & Water Facilitie
Page Two
9. Comments:
Aonrovec� « • 4 Disapproved
Date L/2���3
UApproval Valid for One Year From Date Signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGPADA OF SYSTEM?
T certify that the information contained in this requestforapproval to be a true
and accurate representation of the suhiect sewer and .nater facilities located ato
Signed Date