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HomeMy WebLinkAboutPREUSS #2 BLK 3 LT 2Preuss #2 Block 3 Lot 2 #050-572-18 � GRE' ER ANCHORAGE ARA IM' 3UH i Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME E4f (06U'/EVC15 MAILING ADDRESSvj°�+ �/ ;a rVe-%Q PHONE LOCATION LEGAL DESCRIPTION Z SEPTIC TANK: DISTANCE FROM WELL — INSIDE LENGTH NUMBER OF MANUFACTURER tk) q //Q CR MATERIALC-6-0eV et COMPARTMENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY 1(9c GALLONS. SEEPAGE PIT: 30x z K /" /3,X & R6 s// (� 17Q ✓ i 1M11 R r C9 W i �� NUMBER OF PITS c�c' i i �l PC� � AE—T �/� OR WIDTH—, LENGTH DEPTH .( //__ eve -y' T11P rtOJJ LINING MATERIAL c✓r� Jin p_ CRIB SIZE: DIAMETER DISTANCE FROM: WELL A f TOTAL EFFECTIVEC� BUILDING FOUNDATION Z0 NEAREST LOT LINE 3o ABSORPTION AREA (WALL AREA) s© / SQ. FT. ADDITIONAL ABSORPTION WELL: woi of )Pjyec�t'on TYPE BUILDING FOUNDATION CESSPOOL APPROVED DISTANCES: CONSTRUCTION NEAREST LOT LINE , OTHER SOURCES DISAPPROVED INSTALLED BY: "v a 11 � C e PIPE MATERIAL: LOT SLOPE: REMARKS: Form No. EQ -031 N NEAREST SEWER LINE DEPTH SEPTIC TANK_ DISTANCE FROM: SEEPAGE SYSTEM REMARKS DIAGRAM OF SYSTEM clean 3 fid✓ wi - - �— ( 0V v e 4)0 30 - '•.';• N 0 to .°. e r n A DATE �-3� —73 APPROVED G. .A. B. l r uv GREATER ANCHORAGE AREA BOROUGH J g` DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. YI 11/I"I IIC) 3330 "C" STREET ANCHORAGE, ALASKA 99503 Y0119 ✓ r✓ TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM ® APPLICATION AND PERMIT NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION E INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED l MAILING ADDRESS _� SS SLS SEEPAGE PIT L� DRAIN FIELD _ TO BE INSTALLED BY 4"'� PHONE OTHER , 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 Znoa' TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK 2� FOUNDATION TO SEEPAGE PIT O ! "Cdn`AZNPAGE AREA SIZE DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT �0 DRAIN FIELE rL //(,/} TO�/ NJEE REST LOT LINE. WELL TCO SEPTIC TANK SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WATER MAIN TO SEPTIC TANK / SEEPAGE PIT DRAIN FIELD SEPTIC TANK, SEEPAGE PIT O DRAIN FIELD TO RIVER, LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROS EXCAVATION 5 FEET INTO UNDISTURBED SOIL, 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. (-�V'z-� G.A.A.B. OR LICENSED DESIGNER TYPE DIAGRAM OF SYSTEM 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. /O DATE APPLICANT'S SIGNATURE _ FORM NO. EQ -016 -- _ " u'i F ,yC i 9 ] n _sl56 Y .:�Gr,u is ..r'G asgf? opmfom �t wa :JNC >- s�YpucY - P02 fd TUDOR S1OAQ ALMA 09007 0 YF"Pmom¢ £i2B.0 4 P Date Per armed9--73 1.0t2-,B10ck � �-�d1vis:ion 1prueS$ Eagle River Eav s i 11)rm f;ar;cs Sf3i1s LorF �, t�f%ercc>iEAi.ie-n 1es5:.,�_.m.._,..n. - ! S 'I Oil f u C.c'Pti f i Pr, Plyr i. o j pf:i . • ��r r < �- `"11ru To pen �.t� tin !I„U qtr' i [;i oI) I I -.. L,. _. ' ... •.{1 111 f i .)-�I �'�(.� i{� I nil .. ...� ... f” �- {1 i7 os i? i iii 5 O Y'? 1 n Fie to BL off f)i P 0r IrT,— C,tip FAFf S C, Ue10e01)9gG r -' .... _... . Oil f u C.c'Pti f i Pr, Plyr i. o SUN ECT: Lot 2, Block 3, Preuss Subdivision Dear Mr. Parker: ,.e 4ave _..e...._ your sitGcticn in l i•cht of the interpretation e{, '' Q r - '" r -•-s"O CC`S r_ot e.1riW17a , YSe '3r YC -r NrS050• .._S, -"aT ThiS .=rtic"ler SeZjjC--t -A27erVi., is 1CI:le it your Cas'. We would however advise you that of course all Acrouah Regulaticns are in effect and are applicable in c" .,:.o_ except where State requirements are more strirgent. Yours truly, Kyle J. Che ry Regional Envircnmental Engineer cc: &Q -DEQ F1; WILLIAM A. EGA„ E..r, GORAOR Lrv, '",• �� rl; _` "�����' �„ ,rye ,� € r r-F._fl>' SOui HCENTRAL REGIONAL OEfiCE MACKAY BLDG. - 338 DENAU STREET ANCHORAGE 99501 March 7, 1973. SP ttot�� Parker �( )$u Mr. Doug o+� �A INS Box 612 �`��y���t� Eagle River, Alaska E 1 SUN ECT: Lot 2, Block 3, Preuss Subdivision Dear Mr. Parker: ,.e 4ave _..e...._ your sitGcticn in l i•cht of the interpretation e{, '' Q r - '" r -•-s"O CC`S r_ot e.1riW17a , YSe '3r YC -r NrS050• .._S, -"aT ThiS .=rtic"ler SeZjjC--t -A27erVi., is 1CI:le it your Cas'. We would however advise you that of course all Acrouah Regulaticns are in effect and are applicable in c" .,:.o_ except where State requirements are more strirgent. Yours truly, Kyle J. Che ry Regional Envircnmental Engineer cc: &Q -DEQ lv QI• /q�®�tl9® � � • •' V Jy 491- 1 ••0•0•••q• feysy••s+•4 •• Louis A. Butera CE -6736 ����pROFESSIONP�+E Sc AL! /" r SO* *septic plan only J a AM,0004LO WL.•. {lett I hereby certify that I have surveyed the following described property. LOT 21 BLOCK 31 PREUSS SUBDIVISION, UNIT NO. 2 `- -- -- Anchorage Recording Precinct, Alaska 'and that the improvem®nf OF 4%l situated thereon are within the property lines and do not �,`p : •• "• , ��:1� over -lap or encroach on the property lying adjacent there- to, that no improvements on property lying adjacent .4gTN.......—....a.........:... thereto encroach on the premises in question and that •,,,,•,,,,,,,,` ,,,,,,-�„� there are no roadways, transmission lines or other Rkhard P. Hankins ; mor visible easements on said property except as indi- �P0yf•.,•NO.9U7•S•.CJH�°� cated hereon, �41�\ES 10MM Dated at Eagle River, Alaska, this to"I day of W DRILLING Inc, � ,aIUNIUFALI I r Ur �✓ DEPT. OF '-ALT:: a, P. O. Box 4-1224 o 13100 International Airport Road ENVIRONMENT,'.'_ -CTION (907) 274-461] i ANCHORAGE, ALASKA 99509 0 98 I lJ DRILLING LOG R 0� �Y1E___M. DOM. e Evans, Edward C Well owner--- nge, Section, if known; or distance main ro Location (address of: Township, Ra Lot 2 Bloc�Yeuss, Eay,le River bff Depth of Hole 378 feet Cased to 37 7 feet Size of casing— ft. (al (below) land surface. Finish of well (check one) open end Static water level_ Screen ( ); Perforated ( ) erforation ld / P 10 V Describe screen or p minute) for 1 hours wit1L in test at 10 gallons per Well pump g of drawdown from static level. Date of comp letion 8 1 / 7 9 __-_- WELL LOG of material, color and hardness Depth in feet from Give details of formations penetrated, size ground surface Casin _stickup___— 02 TO 3 2 _TO _ 65 Gwggravel____---- 3 TO Gravelly h��'an 65 _TO— 9 3 — __93 To 100 Silty sand — -- 100 _To— 155_ Grave -ii -Y hardpan 15.5 To 170---1�`= _TO — \ _ S i —s -an U` _170 180—T01B-L- 355 TO — 375-- sand Si— — 1 —CUSTOMER 262 TO 300 TO 325 Weeping hrd__pan- Gravelly hard_�an — - _320 TO -340 340 TO 355 Hard Pam---- Gravelly hard pan — 355 TO — 375-- sand Si— — 1 —CUSTOMER 375 378 Water gravel - Municipality of Anchorage ' Development Services Department i E •. Building Safety Division \—� On -Site Water BWastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907)343-7904 V1 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. ? j 7� 2, COSA# 1. GENERAL INFORMATION Expiration Date: /0 ' 07 Complete legal description PREUSS #2, LOT 2 BLOCK 3 Location (site address) 10047 PREUSS LANE • EAGLE RIVER AK 99577 Current Property owner(s) KAREN FRENCH Day phone 622-7335 Mailing address 10047 PREUSS LANE • EAGLE RIVER AK 99577 Lending agency Day phone Mailing address Real Estate Agent PAM REYNOLDS w/ PRUDENTIAL Day phone 242-9975 Mailing address 16635 CENTERFIELD DRIVE * EAGLE RIVER AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well K Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ 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 samples. (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. I further verify that based on the information obtained from the Municipality of Anchorage riles 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 GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD. SURE 101 • ANCHORAGE, AK 99507 Engineers Printed Name JEFFREY A. GARNESS. P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the fast, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for listedthe sole beriefir of the owner liance upon or use of this port other person or party Is not authorized, nor will It ct onfer an legal right whatsoever. any 5. DSD SIGNATURE _,Z� Approved for Z bedrooms. Phone 337-6179 Date G h c; k Disapproved. Conditional approval for bedrooms, with the thawing stipulations: Attachments: COSA Checklist Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineers Reort Nitrate Advisory Other 6y: O'er v Original Certificate Date: �� (Rm. 11105) Municipality of Anchorage Development Services Department Buckling Safety Division On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 995196850 WwW.muni.org/onsits (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: PREUSS k2 LOT 21 BLOCK 3 Parcel ID: 05-0 - S -71, -! $ A. WELL DATA Weil type PWT _ If A, B, or C provide PWSID# N/A Date completed _§ZIZ 1979 Sanitary seal (Y/N) YES Total depth 378 ft. Cased to 377 ft, FROM WELL LOG Date of test 8/j/ Static water level UNKNOWN ft, Well Log (Y/N) YES Wires properiy protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 6/12/2007 335 ft Well production 10 9,p,m. 4.7 g.p.m. WATER SAMPLE RESULTS: Coliformcolonies/100 ml. Nitrate NO mg./L. Other bacteria colonies/100 ml. Arsenic: Mug./L. Date of sample: 6 2 2007 Collected by: GEG Ltd. S. SEPTICIHOLDING TANK DATA f4/21/01;L Tank Type/Material CONCRETE Date installed 8/30/1973 Tank size 1000 gal, Number of Compartments 1 Pa Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N)N/A Date of pumping 6/19/2007 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA Date installed e/32/1973 Soil rating (g.p.d./ft°o !bd 155 Length 30 X 21 ft, Width 14 X 13 X 6 ft, System type SEEPAGE PIT Gravel below pipe 6 ft. Total depth *_ft, Eff. absorption area 504 ft' Monitoring tube YES Depression over field NO Date of adequacy test _ 6/12/2007 Results (Pass/Fail) PASS For 2 bedrooms Fluid depth in absorption field before test 0 In. Water added 615 gal, New depth 6 in. Elapsed Time: 320 min. Final fluid depth 2 in. Absorption rate >= 300+ 9,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date --_=__ D. LIFT STATION Date installed Size in gallons Manhole/Access High water alarm level at in. "Pump �Ievelt_in.�*''Puiimirp)�110:� 9Datu Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100 + Absorption field on lot ►74' On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout N/A ' N/A Sewer /septic service line 25+ Holding tank Animal containment areas 50'+ Manureianimal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line 10�—'+ Building foundation '+ 10Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicie storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots ►80' F. COMMENTS ► WAIVER #: 86-159 G. ENGINEER'S CERTIFICATION ���c .• '� ' I certify that 1 have determined through field inspections end ; : .... ... ..... review of Municipal records that the above systems are in conformance with MOA COSH guidelines in effect on this ... . ... ............. date. y A. orness. JEFFREY A. GARNESS • CE 79 Engineer's Printed Name ,•� •..`lygpc� Date COSA Fee 31 3a' oy Waiver Fee $ _ Date of Payment i1 7 Date of Payment Receipt Number ^h 0 f_ (_ Z Receipt Number (Rev. 11105) SGS ReLR 1072704001 Client Name Garness Engineering Group, Ltd. Project Name/N Prcuss #2 Lott, Block 3 Client Sample ID Prcuss #2 Lott Dlock3 \lams Drinking Water P1% SID 0 Sample Remarks: Parameter Results PQL Metals by ICP/MS Arsenic ND 5.00 Waters Department Total Nitmtc/Nitritc-N ND 0.100 Microbiology Laboratory Total Coliform TNTC O0, No Coli All Dates/Times are Alaska Standard Time Printed Dale/rime 06/262007 16:38 Collected Date/time 06/122007 12:00 Received Dale/rime 06/132007 12:00 Technical Director Stephen C. Ede Allocable Prep Analysis Units blctlad ContainerlD Limits Date Date Init ug/L EP200.8 C (<to) 06/15/07 0625/07 TK mg/L Shf20 4500NO3-F D (<10) COVl00mL S%f209222D A (<I) oft 06/19/07 IDS O6/13/07 DLC SCS ReEN Client,Name Project Name/# Client Sample ID Matrix PR'SID Sample Remarks: Parameter 1072906001 Garncss Engineering Group, Ltd Prcuss 82 Lot 2 Block 3 Prcuss #2 Lot 2 Block 3 Drinking Water 0 Results Microbiology Laboratory Total Coliform 0 All Dates rimes are Alaska Standard Time Printed Date/Time 06/272007 13:32 Collected Date/time 06212007 14:00 Recehed Datelrime 06222007 16:10 Technical Director Stephen C. Ede Units Method col/l00mL SM209222B AIIoHable Prep Analysis Container ID Limits Date Date Init A (<I) 0622/07 DLC 2,o QF,—sAMo(E. JRs Pumping PO Box 773415 Eagle River, AK 99577 (907) 694-6454 BILL TO: Garness Engineering Group 3701 E Tudor Road Suite 101 Anchorage, AK 99507 1 Contractor Job T... ki.. e Payment Terms Net 30 Last Se n7m7 nn 65 Invoice Number. 23259 Order Num Date: 20 -Jun -2007 Serviced P.O. Number. Job Description: 100og JOB SITE Benny 10047 Preuss Lane Eagle River, AK 99567 Amount Tax $140.00 No -m rule Tax Description $0.0o 0 $0.00 Payment Adjustment $0.00 $0.00 23259 21 -Jun -2007 Manifest �Atenston $140.00 Subtotal NonTaxed .00 Subtotal Taxable: $0.00 Late Charge Subtotal Tax: $0.00 $0.00 4114u.00 Pump TANK Only NOT Crib! Checked and pumped lank For your added convenience we accept; American Express, Dicover, visa and Master Card payments over the phone. After 30 Days account Wit be timed Over to COLLECTIONS. $30.00 For NSF Checks Returned. om• Please detach here and retum tha bottom portlon with your payment. Games Engineering Group 3701 E Tudor Rosi Suite 101 Order No. Invoice No. Anchorags,AK 99507 Date Amount Due 23259 23259 20 Jun -2007 To: $140.00 JRs Pumping PO Box 773415 Eagle River, AK 99577 M AS -BUILT DRAWING 05057NUMBER: RE-ROUTED M20 LINEi e'4 DEEP WITH 4' OF : ''i::t•, :�. BLUE BOARD INSUUTX)N... • : �,�, I 4' NIDE . •,^•• aN: c GARAGE H2O UNE WAS RE-ROUTED BY GEG ON 12/9/2005. atiIb,_0 Z M e N / I CONNECTED TO EXISTING M20 SERVICE UNE AT A DEPTH OF APPROXIMATELY 14' DEEP r IO GALLOG N SEPTIC TANK OF PIT _ --- ---------------- �.«�-ate. �.�r_. w 1`�. • • � � • •-y�;��0 GARNESS ENGINEERING GROUP, Ltd. �;�: g ` y' CONSULTANTS 6 GENERAL CONTRACTORS 0....: ... J,Dt C TAa11 IGD. 11M 101. • ..... ......... ... NOIGeraG wt enm . wlps; M1DIIA!- I" . W D*7)33° 1. v®In ....e.I PREPARED FOR PHONE NUMBER: PACE NUMBER: DANIEL MICHAUD 694-3724 y A. """"""' 1 OF 1 p' f y A amess. LEGAL DESCRIPTION: DRAWN BY: OQa°o 53 I PREUSS f2; LOT 2, BLOCK 3, B.F.M. �4 to '' iz�lb JcS cq`F� TYPE OF WORK. DQedP E AS -BUILT FOR SEPTIC SYSTEM 12/14/2005 �D�Opoo�� (Re,. DUDS) 08:48 z9� 1 Iew FROWPudential Jack White Eagle River S9Q/ /o litiY. Er.Y.h•' 9076996499 T-600 P.002/002 F-977 b t4 to CeaNec -fie. ASBUILT I HEREBY CERTIFY THAT I HAVC SURVEYED THE SWARD FOLLOWING pESCRIBED SCALE: �j.F�1 fv PROPEHTY� / zo AND THAT . ENCROAC4ENTS EYIST EXCEPT AS DATE. INDICATED. IT IS THE RESPOMIDILITY OF THE NER 717 DETERMINE TH, CEMENTSXI57 ENCE OF ANY GRID: WHICH DO Nt7 CO�AppE S+ OR R=STRICTIONS ON THE R -CORDED yw`s 6 VISION PLAT. UNDER NO CIRCUM3TANCES�BDf- ANY DATA HEREON BE USED FOR CONSTRUCTIpSHOULD N D FB OF FENCE LINES, OR FOR ESTAI LISH►NG ARY LINES. BOUND - DRAWN: Duage Merv. Swnd LS 6918 74 4•�TkX1�tT Municipality of Anchorage S/D X12: LOT 2. Development Services Department a e Building Safety Division ' On -Site Water & Wastewater Program Location (site address or directions) 4700 South Bragaw St. LANE • P.O. Box 196650 Anchorage, AK 99519-6650 Community Class Weil www.ci.anchorage.ek.us Community On-site (907) 343-7904 Public Water System CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. &D' " /9 HAA# QJrij�Cj� 1. GENERAL INFORMATION Expiration Date: O 6_ Complete legal description PREUSS S/D X12: LOT 2. BLOCK 3. Individual On-site 0 Location (site address or directions) 10047 PREUSS LANE • EAGLE RIVER, AK 99577 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address— DANIEL MICHAUD Day phone 694-3724 10047 PREUSS LANE * EAGLE RIVER, AK 99577 Day phone PAM REYNOLDS w/ PRUDENTIAL J.W. Day phone 242-9975 3801 CENTERPOINT DRIVE #200 • ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Weil ❑ Community On-site ❑ Public Water System ❑ 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 samples. (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 (les 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 Finn GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE JefL� Approved for ;2� bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory v Phone 337-6179 Date 1 2 °-S— bedrooms, with the following F O stipulations,TY OF: Q, Aid Q,ME WATER AND PROGRAM Maintenance Agreements Supplemental Engineer's Report Other By:—O"e al / Original Certificate Date: (R". 17/01) 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.WW www.ci.anchorage.ak.us (907)343.7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: PREUSS S/D /2: LOT 2. BLOCK 3. Parcel ID: 06'0 --3- ?2-- /g A. WELL DATA Wall type PMTE If A, 8, or C provide PWSION N/A Date completed 8/1/1979 Sanitary seal (Y/N) YES Totai depth 378 ft. Cased to 377 ft, FROM WELL LOG Date of test 8/1/1979 Static water level UNKNOWN ft, Well production 10 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 0.1 mgA. Well Log (YIN) YES Wires property protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 10/19/2005 335 ft, 4.5 — g -p.m - Other bacteria colonies/100 ml. Arsenic: N/A mg./L. Date of sample: 10/19/200 Cctlected by: GEG. LtD. B. SEPTIC/FIOLDINGTAinK DATA 11/3/2005 Tank Type/Material CONCRETE Date installed 8/30/1973 Tank size 1000 gal. Number of Compartments 1 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (YM) NO High water alarm (Y/N) N/A Date of pumping 7/7/2005 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA Date installed 8/30/197:3 Sob rating (g.p.dJft'or((� 155 System type SEEPAGE PIT Length 30 X 21 ft. Width 14 X 13 X B ft. Gravel below pipe 6 ft. Total depth __$ _ft. Eff. absorption area 504 to Monitoring tube YES Depression over field NO Date of adequacy test 10/19/2005 Results (Pass/Fail) PASS For 2 bedrooms Fluid depth In absorption field before test 21.5 In. Water added 615 gal. New depth 30.5 in. Elapsed Time: 270 min. Final fluid depth 25 in. Absorption rate >= 300 g.p.d. Any rejuvenation treatment (past 12 mo.) (YM &type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed Size in gallons "Pump on" level at _in. E. SEPARATION DISTANCES High water alarm level at in. Cycles tested Meets alar 8 circuit requirementsY SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/Oft station on lot 100'+ Absorption field on lot •74' Public sewer main NSA Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water service line 10'+ Water main t o'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT M. Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots •80' F. COMMENTS • WAIVER #: 86-159 LmJ� WAS --LOCO-3� G. ENGINEER'S CERTIFICATION 1 certify that I 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. Engineers Printed Name JEFFREY A. GARNESS Date HAA Fee E Date of Payment Receipt Number. (nw.12001) Waiver Fee $ Date of Payment Receipt Number w g AS -BUILT DRAWING Paso 1572`n18 • RE-ROUTED H2O UD*.*",. 6'+ DEEP WITH 4' BLUE BOARD WSUUIT 4' WIDE____ H2O UNE WAS RE—ROUTED BY GEG ON 12/9/2005. 611 e N / `CONNECTED TO EXISTING H2O SERVICE UNE AT A DEPTH OF APPROXIMATELY —14•� J SHAPE OF SEEPAGE PR GARNESS ENGINEERING GROUP, Ltd. per? 9 : CONSULTANTS 6 GENERAL CONTRACTORS Q"'•' ••• .. ani G awa two. curt .o1 a wncrac ax -n Owr mr In / rax (nn} a / � I PREPARED FOR: PHONE NUMBER: PACE NUMBER: ••••• ......•••;••• 694-3724 1 �v amess:DANIEL MICHAUD LEGAL DESCRIPTION: DRAWN BY: Q� o, 3 PREUSS #2i LOT 2. BLOCK 3. B.F.M. �Q�e��' IZ I .1,6 GS Eo� TYPE OF WORK: ' �04'p000000ll �� AS—BUILT FOR SEPTIC SYSTEM 12/14/2005 (Rw.OIMS) 11-04-05 11:13A1t FRO"T&E ESI. SGS ENV SERVICES —WA— SCS ROLA 1057047001 Clieat Name Garness Engineering Group, Ltd. Project Namem Preuss SD No 2 L2 E)3 Client Sample 1D Preuss SD No 2 L2 93 Marta Drinking Water PWSID 0 Sample Remarks: 9075615301 T-185 P.02/04 F-727 All Dates/Times are Alaska Standard Time Printed Datentme 11/032005 13:16 Collected Date/Time 11/192005 16:20 Received DateMme 10/202005 12:40 Technical Director Stephen C. Ede Allowable Prop Analysis Parameter Reaalts PQL Units maw Container ID limits Date Date )nit Nitrate -N 0.1000 0.100 mg/L EPA 353.2 D (<-10) !0!20105 AZS Microbiology Laboratory Total Coliform 135 O8. No Coli coV100mL SM209222B A (<-)) 1020/05 TLF Ar... Y.',rne••< ?p .r I 06 ol. S Of'tf'L /X/.oc �fPrDr♦�.-._ice tOe•.}.e /r hov5c �"'1 a4! 0 V SttNj! P"A v s�7 r— C7� r W 1 io' yr f I ry r r•i.•i- r .= OF q N of'tf'w /to.os L 2 se.4A.e Imo. yo' tic plan only Soy �AMyDMLt w<c. Ltr / rig" I hereby certify that I have surveyed the following described property. L07- 21 BLOCK 3, PREUSS SUBDIVISION, UNIT NO.2 Anchorage RWdording Precincl, Alaska'ana that the- iinproveme6173 It situated thereon are within the property lines and do not . ovor-lap or encrooch on the property lying adjacent there. to, that no Improvements on property lying -adjacent ,3 thereto encroach on the premises In question and that ,..� there are no rcadwoys, transmission lines or other �� �, Rlcf.ard t. Henkfn. t,,o Visible easements on said property except- as indi- s No. 31AI.3 tt t le �oh.r cated hereon. ttb1�i�s�_�"ed� Dated at Eagle River, Aieska,'this lot' day of t Yi�A'I•I/L I • I ii Iwo C Q e Y C J Soy �AMyDMLt w<c. Ltr / rig" I hereby certify that I have surveyed the following described property. L07- 21 BLOCK 3, PREUSS SUBDIVISION, UNIT NO.2 Anchorage RWdording Precincl, Alaska'ana that the- iinproveme6173 It situated thereon are within the property lines and do not . ovor-lap or encrooch on the property lying adjacent there. to, that no Improvements on property lying -adjacent ,3 thereto encroach on the premises In question and that ,..� there are no rcadwoys, transmission lines or other �� �, Rlcf.ard t. Henkfn. t,,o Visible easements on said property except- as indi- s No. 31AI.3 tt t le �oh.r cated hereon. ttb1�i�s�_�"ed� Dated at Eagle River, Aieska,'this lot' day of MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date July 18 , 1986 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 2 Blk 3 Press' #2 T14N RlW Sec 8 Location (address or directions) (b) Applicant Name Nancy 0' Conner Telephone: Home Business Applicant Address 1525 W. Lemon Ave. , Lompac California 99436 (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ® ; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Rainier Bank Alaska Telephone 276-8080 Address P.O. Box 7007 Anchorage, Alaska 99510 (e) Real Estate Company and Agent N/A Address Telephone (f) Mail the HAA to the following address: Pickup by engineer 2. TYPE OF RESIDENCE Single -Family ® Multi -Family ❑ Other Number of Bedrooms 2 3. WATER SUPPLY Individual Well ® Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite ® Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025(11/84) 6 r 5. ENGINEERING FIRM PROVIDINU INSPECTIONS, TESTS, FILE SEARCH, Dkrr 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. *leachfield requires wavier of separation distance to wells Name of Firm on lot 1&2, Blk 3 • Telephone Address EAGLE RIVER ENGINEERING SERVICES / EAGLE RIVER, AK 99577 Date /d/O&Z 694-5195 F 1 � �000000�°� r, Ei gineeks5ea C� ✓�� ° JC3 oWLOQOO cano L� L't 'rry �Jd J L°OO COF009001Ci 6. DHEP APPROVAL �1 / (� Approved for bedrooms by -_"o ate Approved X Disapproved Conditional Terms of Conditional Approval r�R CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11 /a4) UJIII.J✓.J%II 111� MUNICIPALITY OF ANCHORAGE (M64 d� nOry HEALTH AUTHORITY APPROVAL (HAA) N01133104d lt/1N3WNObIAN3 CHECKLIST - FEBRUARY 1984 264-4720 V H11VRH 40 'ldga r -C 64 /� 90VM0HJNV 40 A111WIJINniN 2 f 7 �l�i 3 �✓ l S Legal Description: A. WELL DATA Well Classification ��y�/� If A. B, C, D.E.C. Approved (Y/N) zj`i Well Log Present (Y/N) %V Date Completed. �f,,l 7�F Yield Zlj-s- ` 1 Total Depth � 7� Cased to '-� � � Depth of Grouting N `` Static Water Level �y/r�' mor'�S Pump Set At Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot _ a62 Sanitary Seal on Casing (Y/N) — Depression Around Wellhead (Y/N) ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot %Z/ ; On Adjoining Lots f-140 / *100 ` To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot �-/ Water Sample Collected by 5 �""`ei �" S"�^"� ;Date Water Sample Test Results ism' Comments W4 ✓ /C r' c / S s. �< fsos, r�i,$ fL •,� �Q i"e-- c. B. SEPTIC/HOLDING TANK DATA Date Installed 73 Size %aDv L�No. of Compartments Standpipes (Y/N) IV Air -tight Caps (Y/N) Foundation Cleanout (Y/N) W Depression over Tank (Y/N) 'IV Date Last Pumped 0Ut. I Pumping/Maintenance Contract on File (Y/N) ;for � S Holding Tank High -Water Alarm (Y/N) � Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well lU!' To Property Line /U To Water Main/Service Line °/0 Course Comments Pagel of 2 72-026(11/84) i To Building Foundation a To Disposal Field Y/ /I To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA �S Soils Rating in Absorption Strata ��� Type of System Design Date Installed – 73 Length of Field ly Width of Field✓mak Depth of Field Gravel Bed Thickness 6 Square Feet of Absorption Area rG`/ Standpipes Present (Y/N) i Depression over Field (Y/N) /✓ Date of Last Adequacy Test /%� Results of Last Adequacy Test S4 _? Separation Distance from Absorption Field: To Water -Supply Well Tq To Property Line �3 To Building Foundation aU To Existing or Abandoned System on Lot %^/,%G ; On Adjoining Lots --,? e� , To Water Main/Service Line /� To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area s Comments Sig .. to c1 s /4 cE off' ke) Wq v1 ems, ZY D. LIFT STATION W/4 Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed.— Date G Company MOA No. Receipt No. 6)0,0 0L Date of Payment- � / 16 —S -Amount: $ e;� S` U U Page 2 of 2 72-026 (11/84) Engit1Qer's Seal IV (.�,•J Op �G GUGu¢Ucb�0.e0eocao�er ^ „J Louis.N. Butora ij,•, .G QCE-6736a v cP o V p00 November 19, 1986 Edward Evans S. R. 177 Eagle River Road Eagle River, Alaska 99577 Department of Health & Human Services Daniel J.Roth Civil Engineer On -Site Services P.O.Box 196650 Anchorage, Alaska 99519-6650 Dear Mr. Roth: Please accept this letter as my approval of the waiver of distance from the seepage pit on Lot 2 Block 3 Preuss Subdivision to my well on Lot 1 Block 3 Preuss Subdivision to 80 feet. Sincerely, Edward Evans Owner Lot 1 Block 3 Preuss Subdivision Notary Public Date My Commission Expires LOOM] o Anchorage November 20, 1986 P.O. k�df 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Lou Butera P.E. Eagle River Engineering Services P.O.Box 773294 Eagle River, Alaska 99577 Subject: Lot 2 Block 3 Preuss Subdivision Waiver Request WR86-159 Dear Mr. Butera: Your request for waiver of the separation distance from the well on Lot 1 Block 3 Preuss Subdivision and the well on the subject lot from the seepage pit on the subject lot has been granted. The required 100 foot separation has been waived to 80 feet and 76 feet respectively. The owner of lot 1 block 3 Preuss Subdivision has given D.H.H.S. approval of the 80 foot separation distance of the septic system on the subject lot to the well on his lot. This waiver is only good for this existing septic system. Any upgrade in the future will require another waiver from D.H.H.S. sincerely, /� i7 Daniel. J. Roth Civil Engineer On -Site Services EAGLE RIVER ENGINEERING E VICES Lou Butera P.E. P.O. Box 773294 Eagle River, Alaska 99577 Telephone (907) 694-5195 October 24, 1986 Mr. Steve Morris Civil Engineer, On-site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 REF: Lot 2, Block 31 Pruess Dear Mr. Morris: On behalf of my client, Mrs. Nancy O'Conner, I am submitting the information necessary for your determination of a waiver of separation distance, private well to leachfield, to 74' for the above referenced lot and a separation distance of 80' to the well on neighboring lot 1, Block 3 Pruess. This approval is necessary for Health Certification. The septic system absorption rate has been tested and found adequate for a 3 bedroom use. The leachfield was installed in 1973 by Wallace Construction and was inspected and approved by the Municipality at a time prior to construction as per the inspection report enclosed. Our field measurements approximating the location of the seepage pit confirm the nearest edge to be at 74' and 80' from the referenced wells. The enclosed well log for lot 2 block 3, shows that the well draws from a confined aquifer at a depth of 375-378'. From information contained in the well log the well casing passes through several layers of soil containing silt.and a 20' layer of soil called hardpan. Many well drillers use the designation hardpan to mean a tight compacted soil containing clay or silt. The casing is continuous to 377', with and open end at the water bearing strata. The static level of the water supplying aquifer is 341' and remains at this level when pumping at 5.4 GPM. Wells in this area are typically at depth greater than 250'. The surface topography is such that ground slope is from the septic system toward both wells at a 7-15% grade. The subsurface soil is a ML -SM type with a pert. rating of +225, this soil rating is common to the area. A water sample for coliform bacteria was satisfactory. The area in question has a low population density. If there are any questions or if additional information is required, please feel free to contact me at 694-5195. Thank You, Lou Butera, P.E. Y 5. LEGAL DESCRIPTION /c,17 i - MUNICIPALITY OF ANCHORAGE ` ION '.r DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION L Street Anchorage, Alaska 99501 825 - ENVIRONMENTAL ENGINEERING DIVISION fj,- Telephone 264.4720 �� f.. s y– f REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER E mAIA2-D L, C= V,� ✓5 PHON E 6 4_zz, MAILING ADDRESS —17-_ C ��✓ n' ,/tr� t1'L, PROPERTY RESIDENT (If different from above)99PHONE ��C:�Lbs:S �H�L✓� * ATTACH WELL LOG. A well log is required for all wells drilled 2. BUYER � i ALf/ jG�� PHONE -633 MAI LINGADDRESS f2PiLcJ J� L K 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4. REALTOR/AGENT - d /JL PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION /c,17 L�t�S STREET LOCATION �L'titss �,1fG;� 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ One ❑ Four ❑ Other LAY SINGLE FAMILY U1--`fwo ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUP Y 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 l !LL 1 9t L id ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM **If individual/on-site, give installation date E� 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. r 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 ❑ MULTIPLE FAMILY 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 DATE INSTALLED 13 INSTALLER ❑Septic Tank or ❑ Holding Tank�� Size: 1000 If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER ^ �J W C�XJCQn-cx.-. 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 ZJ APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must acc mpa certificate) /DISAPPROVED DATE BY (Title C_ LEGAL DESCRIPTION 2-U lu IHev. 3//81 DAVID A. SEEN KAMP MECHANICAL ENGINEER 6940055 Novemver 1, 1979 I ROBERT A.SHAFER CIVIL ENGINEER 6940979 Mr, and Mrs. Edward Evans SRB 177 Eagle River, Alaska 99577 Dear Mr. and Pius. Evans, Reference: Lot 2, Block 3; Pruess No. 2 Subdivision A sewer system adequacy test was performed on the system located on the referenced property. The test was performed on October 26 and 27 at your reouest. The septic tank was pumped and found to have a capacity of 1000 g<^llons. The static level_ of the water in the seepage pit eras recorded. The pit was, then charged with 1000 gallons of water. The level w�is agnin recorded. At the end of a 24 hour period the water level was again recorded and it w --,s determined that _percolation from the nit was adenuate,for a two bedroom home. It can be concluded from the above test that the sewage system is adenuato' for the two bedroom residence located on the referenced property. If we can be of further assistance, please do not hesitate to call. Sincere , BERT A. SHAPE , P. E. AS/ss cc: Municipality of Anchorage Denartment of Health and Enviornmental Protection Alaska State Dank ATTENTION: Mary Lee Hillier SREI196X EAGLE RIVER, ALASKA