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HomeMy WebLinkAboutPREUSS #2 BLK 3 LT 3Onsite File Municipality of Anchorage i- EB 0 5-12020 On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 1 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191530 PID Number: 050-572-19 Dwelling: K Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade Name LINDFORS. PROPERTIES, LLC ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ound Site Address 10109 PREUSS LANE, EAGLE RIVER, AK 99577 ❑ Other Phone Number of Bedrooms Soil Rating Total depth fr original grade 907-244-5398 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original gradeGravel EXISTING]JI depth beneath pipe Ft. Subdivision Block Lot PREUSS #2 3 3 Fill added above original gr Ft. Gravel length Ft. Township Range Section - - - Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total orption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well *80'+ EXISTING _ _ 25'+ TANK X Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer INFILTRATOR SYSTEMS, INC Capacity 1060 Gal. Surface Water 100'+ EXISTING — _ Material PLASTIC Number of compartments 2 Lot Line 5'+ EXISTING — — NA Foundation 10'+ EXISTING — _ LIFT STATION Manufacturer Capacity Remarks *WAIVER GRANTED (OSV191101). **FOR NEW PIPING Gal. *REQUEST REQUIREMENT FOR UPDATED AS -BUILT SURVEY BE WAIVED Alarm location Electrical installed by 7 (NO COSA BEING REQUESTED & NO ENCROACHMENT CONCERNS) PIPE MATERIAL House to tank **D3034 Tank to **D3034 drainfield Installer NORTHERN EXCAVATION Drainfield EXISTING CO/MT**D3034 Inspector JODY MAUS BENCH MARK (Assumed elevation) 100.00 ft Inspection15' 1/17/2020 - Location and description nd FRONT DOOR THRESHOLD 3rd _ 4,h _ ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp oo6oOp 0 Conditional Approval: Date o 9s�� C-).��oO * �D f rCE-7�G� ess. �O Septic System 0 �, � � X020 3 .J 0� 9 . ��oo Approved V LSM zl*(z Date pp C .. 4p P�-2.�.5-�`�c°o Note: this approval does not include well permit requirements. 4Pa Profession°Qo #AEcc 184''' 00�� (Rev 05/02/18) OSPi91530: RECORD DRAWING I I PHONE NUMBER: •`�,A � � ` �QO�' NEW 1060 INFILTRATOR TODD LINDFORS 907-244-5398 2 OF 3 1:, PLASTIC SEPTIC TANK. \ PREUSS S/D #2; BLOCK 3, LOT 3 AREA OVER TANK IS \ II �._ RECORD DRAWING OF SEPTIC TANK UPGRADE _-_�_ _ _ ;' �; �,.• g� MOUNDED TO PREVENT I \�1 •:Q: - j DRIVING OVER TANK ARE / I \ \ SEPTIC// ARE / I NOTE: THE OLD SEPTIC TANK WAS DECOMMISSIONED PER UPC ... EXISTING I / I PER THE CONTRACTOR. THE 80 FOOT WELL RADII WAS FLAGGED i / BY A REGISTERED LAND SURVEYOR PER THE CONTRACTOR AND I / / I I I GEG CONSULTANT, JODY MAUS CONFIRMED 80' WAIVER ' i I SEPARATION DISTANCE TO NEW SEPTIC TANK WAS MET. I NOTE: EXACT PERIMETER OF LOG CRIB IS UNKNOWN. 100' WELL RADIUS / I i I AND MR. EKLUND DISCUSSED THE TANK LOCATION IN RELATION TO �\ I EXISTING WELL I ' Y / 100' WELL RADIUS / I \\ I W / / I / � CONSULTANT, JODY MAUS, DID NOT SEE ANY INDICATION OF i / I F- I DRAINROCK DURING THE TOP OF TANK INSPECTION. U) \ : J W EPPEA EXISTING I \ \\ 3BEDROOM O HOUSE I ' I \\ � I PHONE NUMBER: •`�,A � � ` �QO�' NEW 1060 INFILTRATOR TODD LINDFORS 907-244-5398 2 OF 3 1:, PLASTIC SEPTIC TANK. \ PREUSS S/D #2; BLOCK 3, LOT 3 AREA OVER TANK IS \ II �._ RECORD DRAWING OF SEPTIC TANK UPGRADE _-_�_ _ _ ;' �; �,.• g� MOUNDED TO PREVENT I \�1 •:Q: - j DRIVING OVER TANK ARE ... EXISTING I / I LOG CRIB ; (SEE NOTE) I I i I I NOTE: EXACT PERIMETER OF LOG CRIB IS UNKNOWN. REPORTEDLY TIM EKLUND WITH MOA ONSITE DEPARTMENT WAS PRESENT DURING BOTTOM OF TANK INSPECTION. CONTRACTOR i I AND MR. EKLUND DISCUSSED THE TANK LOCATION IN RELATION TO i THE EXISTING LOG CRIB AND ACCORDING TO THE CONTRACTOR, Y / I MR. EKLUND APPROVED OF TANK INSTALLATION LOCATION. GEG / / I / CONSULTANT, JODY MAUS, DID NOT SEE ANY INDICATION OF i / I I DRAINROCK DURING THE TOP OF TANK INSPECTION. EPPEA � I I ' GARNESS ENGINEERING GROUP, Ltd 3701 E. TUDOR ROAD, SUITE 101 -ANCHORAGE, AK 99507' PHONE (907) 337-6179' FAX (907) 33&3246' WEBSITE: www.gamessengli PREPARED FOR PHONE NUMBER: PAGE NUMBER: TODD LINDFORS 907-244-5398 2 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: PREUSS S/D #2; BLOCK 3, LOT 3 J.L.M. TYPE OF WORK: DATE: �._ RECORD DRAWING OF SEPTIC TANK UPGRADE 2/5/2020 PARCEL ID NUMBER: 050-572-19 A B DBLi 27.0 7.4 DBL2 27.6 8.0 MH 30.8 11.9 ST1 34.9 17.1 DBL3 37.7 21.0 DBL4 38.5 21.9 CRIB 48.4 33.0 Ar AIF ......... ..........., J ff e A. Ga ess Ai Q AV CE- �i 4pfper,, LICE NS 4l#I4 FESS\ � #AECC884\\\� PERMIT RECORD DRAWING PARCEL ID NUMBER: 050-572-19 TOP OF MANHOLE LID = 100.78 -FINAL GRADE = 100.61-100.68 STI [Mf TOP OF TANK @ INLET= 96.51 2" OF INSULATION TOP OF TANK @ PER CONTRACTOR) F OUTLET = 96.55 INVERT OF PIPE @ INLET= 95.92 — ----Rm------- 41 ---- 1060 2 -COMPARTMENT r INVERT OF PIPE @ INFILTRATOR SEPTIC TANK f OUTLET= 95.74 GARNESS ENGINEERING GROUP, Ltd ENGINEERING o SALES o CONSULTING -- — -- --_ _ _ 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 • PHONE (907) 337-6179' FAX (907) 338-3246' WEBSITE: www.gamewangineadng.00m PREPARED FOR: PHONE NUMBER: PAGE NUMBER: TODD LINDFORS 907-244-5398 3 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: PREUSS S/D #2; BLOCK 3, LOT 3 J.L.M. TYPE OF WORK: DATE: RECORD DRAWING OF SEPTIC TANK UPGRADE 2/3/2020 OF c•o 1 �.....n . .�....... A, Gar Jd Gar ess Ar ff ♦iAW LICENSE 11�1yjyAlL _�••• #AECC884 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http:flwww.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191530 Work Type: SepticTank Upgrade Tax Code Number: 05057219000 Site Legal Address: PREUSS #2 BLK 3 LT 3 G:0056 Site Mailing Address: 10109 PREUSS LN, Eagle River Owner: LINDFORS PROPERTIES LLC Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: ❑ Disposal Field R1 Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date Lot Size in Sq Ft: Total Bedrooms: Na4 qz�c n t .Sc t llepartment 12/24/2019 12/23/2020 19643 ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing 3.. A Special Provisions: Septic tank shall be located outside of the driveway/parking area or barriers shall be provided to protect the tank from being driven over/parked on. �r Received B Issued By: i Date: Y• j� f r Date: byh I 3 P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section ��nent S C (� 1Jcparnnmit * * * * VARIANCE/WAIVER REVIEW -* * * * Waiver#: OSV191101 COSA#: Permit#:OSP191530 PID#: 050-572-19 Legal Description: Preuss #2 Block 3 Lot 3 Engineer: Garness Engineering Group Applicant: Todd Lindfors Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is 80.0 feet. See engineer's waiver request for justifications. This waiver approval applies to the proposed septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ........................................................................ 0 0. 0.. 1 Waiver is Granted: X Waiver is not Granted: Date: 1 7 Approved by:roura_fUl Name of Reviewer ................................................................. a a M M M K ....... I **** VARIAN C EMAIVE R REVIEW **** MUNICIPALITY OF ANCHORA Community Development Department Development Services On -Site Water & Wastewater Program Mayor Dan Sullit On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 050-572-19 Property owner(s) TODD LINDFORS Mailing address 7536 LAKE OTIS PARKWAY *ANCHORAGE, AK 99507 Site address 10109 PREUSS LANE 'EAGLE RIVER, AK 99577 Legal description (Sub'd, Block & Lot) PREUSS #2; BLOCK 3, LOT 3 Legal description (Township, Section & Range) Lot Size APPLICATION IS FOR: (® all that apply) Absorption Field ❑ Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Sq. Ft. Number of Bedrooms APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ Day phone 907-244-5398 3 THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: TYPE OF DEWELLING: Single Family (SF) (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) �e�+icv11� A ����e ��Distance: gO I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: -,29 �_ Waiver Fees: 11 / $0 Date of Payment: /o21,e2q I -1Q Date of Payment: a L-( 10 Receipt Number: 6 gq(A6 Receipt Number: 6 91?&q� C� Permit No. Os P! ` 1530 Waiver No. �y I ! /to (Rev. 01 /11) GARNESS ENGINEERING GROUP, Ltd :- ---- — -- - - - - ENGINEERING - SALES oCONSULTING ­---- ---- December 231, 2019 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic Tank Upgrade for Preuss #2; Block 3, Lot 3 To whom it may concern: The subject lot is served by a private well and septic system. Per conversations with Tim Ecklund at the MOA onsite department and the homeowner (Todd Lindfors), the subject tank collapsed during the earthquake resulting in a significant depression with ponded effluent over the tank (see attached picture provided by MOA). Due to this fact, we request that you department expedite this review as it is a concern to public health and safety. We are proposing to decommission the existing septic tank and install a new 1000 -gallon HDPE Greer tank. As can be seen on the attached design drawings, the proposed tank is approximately 80 feet from the existing well. We ask that your department issue a variance from well to tank from 100 feet down to 80 feet. Justifications for granting this waiver is as follows: • The existing tank encroaches on the well • The well is uphill from the proposed septic tank (see attached topo mapping) • The home is located between the well and proposed septic tank • Water samples were not pulled. However, given that the existing septic tank is collapsed, an HDPE tank would be a significant improvement on the current situation. • As can be seen on the attached design drawings, the septic tank cannot be moved further from the well without encroaching on the drainfield or requiring utilization of a STEP tank. " We are unaware of any adverse impacts this installation and/or waivers would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Sir'Fe a rely, s l Jeffrey Garn , P.E., M.S. Presit 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com I I I I PREUSS #2; BLOCK 3, LOT 4 ir / PREUSS #4; \ BLOCK 9, LOT PTIC 10\ ARE / �SEPTk ARP 00' WELL RADIU I I / I I \ WEL RADI I / 1 I `\ DAVID LAE 1 O'WELLRADIUS I LLUI \ � Z 5 1 w I \ SEPTIC PREUSS \ AREA BLOCK 2, LOT � a I \ PTIC PREUSS 2; SEI BLOCK 3, L T 2 AR� WELI R- S I � I / ` I / \ I / UPLANDS PHASE 2; TRACT 2 VACANT PER MOA RECORDS GARNESS ENGINEERING GROUP, Ltd -- ENGINEERING © SALES - CONSULTING 3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, AK 99507 • PHO9E (907) 337-6179- FAX (907) 338-3246 • WEBSITE: www.gamessengineedng.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: TODD LINDFORS 907-244-5398 1 OF 2 PROJECT/LEGAL DESCRIPTION: DRAWN BY: PREUSS #2; BLOCK 3, LOT 3 D.J.G. TYPE OF WORK: DATE: �, SEPTIC SYSTEM DESIGN UPGRADE 12/20/2019 - "VEGETATED DRAINAGEWAY" PER MOA WETLANDS MAPPING; PROPOSED SEPTIC TANK IS 100'+ N SCALE: 1" = 100' *04�17i......V �* .............. t..� ............� :............. .... .... Je pss •�O�J,•J CE -79 : •�? AVV �♦ • �� O. PROFESS\4NP LICENSE ,414Ik1% • #AECC884 , GEG, Ltd. HAS AN 8 PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN. BY PROCEEDING THE CONTRACTOR SHALL HAVE FORWARD WITH THIS INSTALLATION, THE THE 80' WELL RADIUS FLAGGED BY ENGINEER, WELL DRILLER, CONTRACTOR AND A REGISTERED LAND SURVEYOR PROPERTY OWNER AGREE THAT THEY HAVE PRIOR TO CONSTRUCTION READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. ;EPTIC ARR' \I 100- vvn \ I 80' WAIVER REQUEST \ \ o�J I W U) Lu ry j PREUSS #2; BLOCK 3, LOT 4 5'+ [SEPTIC AREA \ 1 \ I 1 I I "r -EXISTING 3 BEDROOM HOUSE 1 EXISTING SEPTIC TANK TO BE DECOMMISSIONED PER / UPC; INSTALL NEW 1000 GALLON HDPE SEPTIC TANK WITH DOUBLE CLEANOUTS BEFORE AND AFTER TANK. / EXISTING SEEPAGE PIT; CONFIRM 5' SEPERATION 7' 1 FROM SEEPAGE PIT TO SEPTIC TANK N \ [SEPTIC V=40' ARE�D Ar GARNESS ENGINEERING GROUP, Ltd I;........•..... .. `...••....... .� --� ENGINEERING o SALES o CONSULTINGi, ----- ------ 3701E. TUDOR ROAD, SUITE 101' ANCHORAGE, AK 99507' PHONE (907) 337-6179- FAX (907)338-3246'WEBSITE: www.gamessengineedng.com / ••••••••••••••••+•••••••••• PREPARED FOR: PHONE NUMBER: PAGE NUMBER:%(n ';� Jefifey r SS 0 W AV TODD LINDFORS 907-244-5398 2 OF 2 �j� ;; 1111 C 7953 :'AV PROJECT/LEGAL DESCRIPTION: DRAWN BY: •�♦ (�� •.�•� Z Z(7l �r�'•���� PREUSS #2; BLOCK 3, LOT 3 D.J.G.' 0�D PR•• •••••�•P�,�e� TYPE OF WORK: DATE: LICENSE 1, �; FESS\ .♦♦ DESIGN OF SEPTIC TANK UPGRADE 12/20/2019 #A C884 G"'~.,TER ANCHORAGE AREA.BORO ~ ~=PARTMENT OF ENVIRONMENTAL.OUAL~i¥ 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 EOCATION INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING LEGAL DESCRIPTION ~-~. ,?t SEPTIC : kNCE FROM WELL q ~,~' UID CAPACII'Y GALLONS, .... ,.. ~,, j!~.~.~ #.~.~, NUMBER OF MATERIAI~J(.~!::Jzt '~::yjr,.:-;:'. j .... COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID ~SEEPAGE SYSTEM: MBER OF PITS / , MATERIA~ J, C",'~ NEAREST LOT LINE /~'~ t '?TILE DRAIN FIELD: SEEPAGE PIT: OUTSIDE DIAMETER OR WIDTH ~'~? ~:~ DISTANCE FROM WELL ~ ,:.: .-' II TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) LENGTH '; ........ DEPTH SQ. FI, " TOTAL LENg1,H OF LINES ........... ............. ...... ' IN. TOTAL EFFECTIVE. DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA - FOUNDATION. NEAREST I~OT LINE DISTANCE BETWEI~N LINES TRENCH WIDTH SQ. FT, LENGTH OF I~A~ZH LINE? .............. DEPTH: TOP OF TILE TO FINISH GRADE, .DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE : WELL: DISTANCE FROM tl WATER ... TYPE ~ 'q,; ~" J ~' ~, , DEPTH , BUILDING FOUNDATION..~" ~ I~L~' SAMPLE NEAREST SEPTIC,,,'~ i · SEEPAGE ?' LOT LINE , SEWER LINE ., TANK ~/,%~ , SYSTEM_' '~'~'1(~/ / , CESSPOOL OTHER SOURCES DISTANCES: DIAGRAM OF SYSTEM ,.G.A.A.B, J~-W DRILLING, Inc. ~--/ P.O. Box 4-1728 · 2811 Dawson A C 9{)7-279-1741 ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner~~ Use of WeB Location (address of: Township, Range, Section, if known; or distance main road Size of casing_~_ ~t~ _Depth of Hole__'_" L_____-feet Cased to__ ' _feet Static water level Screen (-- - ~_.l~ ft. (above) (below) land surface. Finish of well (check one) open end ( 1~ ); (minute) fro'_ >© ~'with_ lO~/~ ft. Describe screen or perforation_ Well pumping test at 'tO gallons per of drawdown from static level. Date of completio~ ,~':~ :~'" t [k~/ WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 3 -- Contractor 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 May 19, 1986 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 3~ Block 3~ P~s Subdivision Location (address or directions) Third house on right side going up Pruess - wf~ite two story house with green trim Pruess Lane 694-3245 (b) Applicant Name Rose Swan 01son · Telephone: Home 694-9507 Business 279-9712 Applicant Address P.O. Box 770157, Eagle River, Alaska 99577 (c) Applicant is (check one): Lending Institution []; Owner/builder ~; Buyer []; Other [] (explain); ~. (d) LeDding Institution ..... A~l~'ess.., Telephone (e) }:.: Real Estate Company and Agent R¢IMax of Eagle' Riv~rlA1 or Maureen Address P.O. Box 770848. 'Ea~l~ River. Alaska 99577 "' Telephone 694-4~00 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 S & $ ENGINEERING Telephone ~ ~'~&._ ~.¢2~ ¢ SRB 196X Address Date EAGLE RIVER, AK 99577 MAY 2 2 1986 6. DHEP APPROVAL ,Z{,~- L~¢--'~".-' Approved for ~/¢'2~'(-~) bedrooms by ' - % ~ Disapproved Conditional Terms of Conditional Approval Date 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 ot Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 ~,~-~k~c~,C~I4UNICIPALITY,~,._ OF ANCHORAGE u~[CI?~;O~HE~1H & .HEALTH AUTHORITY APPROVAL (HAA) ~ DEP~ ~'" -~o~EC~O~ .:,~AL Y~ CHECKLIST - FEBRUARY 1984 . 264-4720 Legal Descr~tion: If A, B, C, D.E.C. Approved (Y/N) Date Completed /O - ! - '~ ] Yield Depth of Grouting Pump Set At ~'-~' Sanitary Seal on Casingd~N) Depression Around Wellhead (Y/I~i~ Well Classification Well Log Present ~YN) Total Depth ~.~_.~ t Cased to Static Water Level ~'/ ~ ' Casing Height Above Ground Electrical Wiring in Conduitd~N) Separation Distances from Well: To Septic/bi--Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line cleanout/Manhole Wate~ Sample Collected by ~ '~ ~:~ Water Sample Test Results Comments ~ ~J~---d~. ~/! ~ /~ '¢~ ¢' ; On Adjoining Lots /¢)~/ / ; On Adjoining Lots ! /~//~ To Nearest Public Sewer t~/~ To Nearest Sewer Service Line on Lot ~4/~~ ;Date B. SEPTI~G TANK DATA Date Installed '~ r/O,~ Standpipes ~'N) Air-tight Caps (~)'N) Depression over Tank Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/H~ Tank: To Water-Supply Well Size /~d::~ No. of Compartments ~ / Foundation Cleanout (Y/~) Date Last Pumped ~"'~ ] ; for /~/~ Temporary Holding Tank Permit (Y/N) To Property Line To Water Main/Service Line { Course /~//~ To Building Foundati.on To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 6.)~/~. Type of System Desig/ Date Installed ~' L~.~/-~:;>- -~ ~ ~' //~ Y'~ Length of Field~-( ~-~' ," Width of Field .~ ~' ~-'~' /~' 4,'/ Depth of Field Square Feet of Absorption Area ~ ~ ~ '~ ~ Standpipes Present.N) Depression over Field (Y/~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well / ~ 5/ j To Building Foundation ~/,c, / Lot t'J//~ To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Date of Last Adequacy Test To Properly Line / rD /,¢_ To Existing or Abandoned System on ; On Adjoining Lots To C~utbank (if present) Comments ~//~/,~-~Zfl, d%t,e/d /~-~--~,~.4 ~ ~ ~ ~~ ~/~ Date Installed Dimensions Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Manhole/Access (Y/N) /.~j,~ "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that 1have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. $ & $ ENGINEERING Date MAY 2 2 1986 Signed ~R R '~6X Company -- - MOA No. =~OLE RIVER, AK 99577 Receipt No. '~ ,'~ ~;' Date of Payment , Amount: $ Page 2 of 2 72-026 (11/84) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality ,3330 "C" Street, Anchorage, Alaska 99503 274-4561 ~'O,~bO.&/~u~ ,!'~ Date Received ~]L~ \C~ ,q~-q'~, L~ ~]~v~ .~ ~=,'~ Time of Inspection ~ Q'. ~ Date of Inspection ~ ~ / INDIVIDUAL SEWER & WATER FACILITIES ~',~ .... FOR ~ , 2. Property Owner:~(,~,~,,~, ~- On~q(.a. ~,,~e,,~ Phone: Mailing Address: ~c~ Oo~,~o~ ~ ~q{~ ~c~ 3. Legal Description: ~w~ ~ ~Ja~ g ~ ~n~ 4. Location: ~e~x~g~ ~2 - ~ 5. Type of facility to be inspected~o,-~m~,~,~ No. of bedrooms 6. Well Data: A. Type ~~ B. Depth C. Construction D. Bacterial Analysis Sewage Disposal System: ~])~-~ A. Installed ~)~)/~)/~Z~ B. Installer ~/9/~/~) C. Septic Tank: l. Size ~0~ ~. Manufacturer D. Seepage Pit: 1. Absorption Area Material ~- ~//~. E. Disposal Field: Total length of lines e Distances: A. Well to: Septic tank l~ , Absorption area /~). , Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank ~ , Absorption area C. Absorption area to nearest lot line I ~! EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - R~L. ?st for Approval of Individual ~er & Water Facilities Legal'Description Comments Approved Approval :~Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and tccurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA 2. Property Owner: Gordon E. Swan and Rose E. Swan FHA CONV )LC La Casita Restanrant Mailing Address: SRA box 176, Eagle River Alaska 3. Name of Buyer: Same Refinance Day Phone 279-9712 Mailing Address: same 4. Name of Lending Institution: Alaska Statebank 99503 Mailing Address: 310 E Northern Lts, Blvd, Anch Ak Phone 5. Name of Realtor or Agent: None Mailing Address: Phone Day Phone same 279-7637 6. Legal Description: Lot 3 Block 3 Preuss S/D Eagle River Location: Preuss Lane EaRle River 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Sinzle F~m~ly No. Bdrms. Public Utility Individual xx 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 Individual (on-site) Ope E0-037 (1/74)