HomeMy WebLinkAboutDONALD C SCHROEDER #2 TR 5 REM
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 . ~-~).~ ~~/~ ~ ~~ IPHONE NEW
~- ~GRADE
LOCATION NO. OF BEDROO
Well , AbsorPtion area Dwelling PERMIT NO.
DISTANCE TO: ~ ~ I ~ .-- ~ / ~
~Z Manufacturer~~ /~ / // r ~ Material No. of compartments
Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth
~Z~ ~ DISTANCE TO: Well~/~/. Dwelling PERMIT NO.
O ~ ~ Manufacturer
~ -- ~ ~ Material Liquid capacity in gallons
Well ~ ' '~ Foundation~ /+ Nearest lot ,i~ /~ PERMIT NO.
~ ~ DISTANCE TO: ~
~ · ~ No. of line Length of eRe ~ine Total length o~ lines Trench w, Distance between lines
~ ~ / '5~ '+ ~' ~ inches
; ~ ~ Top of tile to finish grade I Material beneath tile Total effective absor~ea
Length Width ~ Depth PERMIT NO.
~ Type of crib Crib dia Crib depth TotaJ effective absorption area
m Well t ' Building foundation Nearest lot line
~ DISTANCE TO:
~ CJass Depth Driller Distance to lot line PERMIT NO.
~ .~_~/ ~. ~// ,.
m ~/I ] ~ ~ui~i~ ~un~on Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER ~
PIPE MATERIALS ~ ~
SOIL TEST RATINGJ /
REMARKS
' __
' DATE LEGAL
,
72-07 [Rev. 3~78)
D L~ox 10-378 o 10300 (Did Soward Highway
(907) 349-8535
ANCHUI.~AGE, ALASKA 99511
DRILLING LOG
4ell Owner_ Teressa Nelson __.Use of Well_I~___~.~tic
Location (addres. s of: Township, ~ange, Section, if knownl or distance main road . ~,(" Schroeder Subd ~j~__I~5~,_Eag_le Pd.v~r
Jize of casing ~ _Depth of Hole_
Static water level .... ___/t. (above)
Screen ( ); Perforated (
Describe screen or perforation
Nell pumping test at_~__.gallons per
of drawdown from static level.
Date of completioD 9/12/83 _
/~1 feet Cased to_ ..feet
(below) land surface. Finish of well (check one) open end ( XX
o
);
(minute) for__~ .. _hours with_____, ft,
WELL LOG
Oepth in feet from
ground surface Give details of formations penetrated, size; of material, color and hardness
0 TO. 175 Existing Well
175 TO. 441
Bedrock
TO.
TO
MUNICIPALITY OF ANCHORAOE
TO) DEPT. OF HEALTH &
~ENVJRONMENTAL PROTE--CTION
10 t988
- .TO
,'to
TO
........... TO_:_ ........
¸TO
· --CUSTOMEi:
Permit
Applicant
Location:
Legal Description: ~--~F ~. b,~--. S~~/~_.~/~ Lot Size:
Type of Soil Absorption System Is:
MUNICIPALITY OF ANCHORAGE
Department Health and Environmenta 'rotection
825 ~ Street, Anchorage, AK. ~9501
264-4720
* * * HANDWRITTEN PERMIT * * *
WELL AND/OR_ON-SITE SEWER PERMIT~ \.
Phone Number:
Trench: ~-~.Drainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms:l~ Soil Rating(sq.ft/br) /S~'--~/~
The Required Size of the Soil Absorption System Is:
DEPTH ,,_ LENGTH GRAVEL DEPTH 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 = ~/~7--/"V/~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 8 3 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the~ .;~,~residence ~eled to include more t.~~ed~
Signe~: {/--;'~--1 L,~ , l/I Issued by: ' ~
Applic~t x~ r Date: ~'2~/]__0/{/~ ~j~
swP/024 (1/81)~T~/~
~SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION [] PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9'
lO
11
12
13
14
15
16
17
18
19
2o
/5--o
SLOPE
SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
I
,-- PERCOLATION RATE . (minutes/inch)
~ TEST RUN BETWEEN AND FT
PERFORMED ~':~a~ ~ ~a ~ ~ CERTIFIED DATE:
72-008 (6/79)
GAAB-' I
Git~' "~ ANCHORAGE AREA BOROI''
Dt.~..~,,I'MENT OF ENVIRONMENTAL 0. UALI ~,
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
LOCATION
SEPTIC TANK:
MAILING
ADDRESS
3~' -
PHONF~.~-77
LEGAL DESCRIPTION
DISTANCE FROM WELL
LIQUID CAPACITY /'~
GALLONS.
/'~"~ ~'~'~J~J"~-'- NUMBER OF /
MATERIAL ~--~'~"~'~~ COMPARTMENTS
LIQUID
INSIDE LENGTH INSIDE WIDTH DEPTH__
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS ./
LINING MATERIAL ./~'/',
NEAREST LOT LINE
OUTSIDE DIAMETER
~ OR WIDTH // LENGTH / ~ , DEPTH
DISIANCE FROM WE[[ /./,~ ~5' BUILDING FOONDAIION
TOTAL EFFECTIVE ABSORPIION AREA (WALL AREA)
SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL ~-~-'~'~"'O~NDATION
NUMBER.OF ~ DISTANCE BETWEEN LINES
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE
NEA~E
TRENCH W I1]kT~
TOTAL LENGTH
, OF LINES
IN. TO~FECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL:
LOT LINE
TYPE~*~'/",:/~'/~'~~ , DEPTH /'~-~--f~
NEAREST SEPTIC
SEWER LINE .,/~,9 ~- .TANK
DISTANCE FROM
, BUILDING FOUNDATION.
///~ / SEEPAGE
, SYSTEM.
WATER
SAMPLE /i/'~,,K__/z-~, NEAREST
OTHER
CESSPOOL/f,~~'-~ , SOURCES'/~4r~-/~/
DISTANCES:
DATE
DIAGRAM OF SYSTEM
APPROVED ~1~. ~'. ~'~'' ' ''~ ~'''~
UG.A.A.B.
GReaTEr ANChORAGe ArEA bOrOUgh
DEPARTMENT OF ENVIRONMENTAL QUALITY
~330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT
PERMIT NO..
PhONE. ' -
TO BE INSTALLED BY
FINANCED THROUGH
SOIL TEST RESULTS ~¢~/'~ NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TE$1'
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: Z4 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 - /~0 TYPE ~~ SEEPAGE AREA SIZE /~ ~//~ TYPE /~~ ~
MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM
FOUNDATION TO SEPTIC TANK
~.6~
FOUNDATION TO SEEPAGE PIT DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL '~/~'
SEPTIC TaNk ., SEePage Pit ~/E~/' ., DRAIN Field
TO NEAREST LOT LINE.
/00"
WELL TO SEPTIC TANK SEEPAGE PiT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD
'
SEPTIC TANK, ., SEEPAGE PIT .... DRAIN FIELD
TO RIVER, LAKE. STREAM.
CAST IRON INTO AND OUT OF SePTiC TANK ,AND ~NTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 iNCh DIAMETER C/~;T IR_ON ~i~N PlP~ ~N ~:I~DTIP. TAN~ AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKF'ILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
LICENSED DESIGNER
I CERTIFY THAT I AM FAMiliar WiTH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIB~YSTEM IS IN ACCORDANCE WITH SAID CODE.
MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES JUN c) 1988
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVALS)
OF ON-SITE SEWER AND WATER FACILITY ,- E C E IV E D
Application Date May 25, 1988
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Descripti,~n (include lot, block, subdivision, section, township, range)
Tract ,~F Oonald ¢. Schroeder S~bdivi6ion #2
(b)
Location (address or directions:)
Mile 6, Eagle River Road - Log chalet with detach~.d garage
Property Owner Ted Carl6on Telephone: Home 694-2575 Business
Mailing Address ~- O, ~ "7 7 ~-~ ~"°~ ~ (~ /~ ~'~'¢J "~ ~ -~'- '~' -~
(c) Lending Institution Telephone
Mailing Address
(d) Real Estate Company and Agent RE/MAX OF EAGLE RIVER - Virginia Kohfield
Address 16600 Centerfi~d Drive, Suite 201, Eagle River, Alaska 99577
Telephone
694-4200
(e)
Mail the HAA to the foIIowina address: or: Check here E~, if hold for pick up.
List contact person and day phone number below,
$ ~ S ENGINEERING~694-2979
17034 Eagle. River Loop Road, Suite 204
Eagl~ Riv~.r; Alaska 99577
TYPE OF RESIDENCE
Single-Family I~
Number of Bedrooms
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.
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 IRev 8/86~ Fron~
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.
Address
Date
Name of Firm Telephone
S & S ENGINEERING ~
17034 Eagle Ri.vet L .a<~p Road No. 204
=_-_g!e _g_!var: Alalka 99577
APPROVAL
Approved for /I4-x'L~-'~ edrooms by
Approved --/~' , Disapproved Conditional
Terms of Conditional Approval
Date
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
certificates based only upon the representations given in paragraph $ above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in
order to satisfy certain federal and state requirements. Employees of DHHS do 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-o25 (Rev 8/86) Back
WELL DATA
Well Classification
Well Log Present {~)
Total Depth '~'d~ I
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit~N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
MUNICIPALITY OF ANCHORAGE
E ............. L SERVICES~vI~~''~ALITY OF ANCHORAGE (MOA)
r~wK,~-~r~,~,'-,', HEAL~'I~I'AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
JUN 9 ]988 264-4744
Legal Description:
RECEIVED
~ Date~~~}~ ~ - Yield
uased to uepth~f Groudng
~(~. ~ ~'. Pump Set At
~" Sanitary Seal on Casing~N)
~ Depression Around Wellhead
!
[ ~, ~ ; On Adjoining Lots
To Nearest Edge of Absorption Fiel~.d~o~_L_ot I '7~-(;2 ! ; On Adjoining Lots
To Nearest Public Sewer Line I- I/'~' To Nearest Public Sewer
Cleanout/Manhole ~/A To Nearest Sewer Service Line on
Water Sample Collected by ~'~.~ ~b::::~.!~~,..~ ; Date
Water Sample Test Results ~/~1--tc'~'¢~'¢--~"~"'~ '~ ~~'~
Comments ¢_¢¢J...4~ ~-'~z:.~o~Jl[~.~, ~'~.~
-
B. SEPTIC/~TANK DATA
Date lnstalled ~'"]'"J"~""~ Size
Standpipes (~N) 7 Air-tight Caps
Depression over Tank (Y/~ I
Pumping/Maintenance Contract on File (Y/N)
/
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Hl=tctj~3~Tank:
To Water-Supply Well I ~ ~
To Property Line \
To Water' Main/Service Line
Course
Comments
No. of Compartments t
Foundation Cle~
te Last Pumped ~~' ~.~'"'/'
~.5 · for ~ ~
Temporary Holding Tank Permit (Y/N) r"~/'~
To Building Foundation
To Disposal Field '
To Stream, POnd, Lake, or Major Drainage
Page 1 of 2
72-026 fRev 8/86~ Front
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ~:t~..~ '~ ~'/~"0
Width of Field ~ ~
Square Feet of Absorption Area
Depression over Field (Y/~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation~
Lot
To Water Main/Service Line
Type of System Design
Length of Field
Depth of Field"
Gravel Bed Thickness
{~"~i'~'"1"-'-~-' Standpipes Present.N)
Date of Last Adequacy Test
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
j/
To Property Line .~ ~_,.~1 ~
To Existing ,or Abandoned System on
· On Adjoining Lots
To Cu~ank (if present) ~ t/~
LIFT STATION [,,,~//~
Date Installed Dimensions
S~s Manhole/Access (Y/N)
"Pump On" L~~ "Pump Off" Level at
High Water Alarm Level at ~""""'-'~'"-------.~ Vent (Y/N)
Tested for ~quacy Test. Meets MOA
Electrical Codes (Y/N) ~~
Comments ~
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MO/A an,¢HAA guidelines in effect on the date of this inspection.
Signed ...... Date ~i ~-/~-"/~
$ & S ENGINE~-K~ '
Compa~c34 E~g~e River L~ R~d No~ No. ~ ~ ~
R ~le Rivet, Alaska 995' ~/~ ~ ~ ~0 ~)
eceiptNo.
Date of Payment ~/ ~,, ~ ~' %'
Amount: $ ~ - ¢ -~
Page 2 of 2
72-026 (Rev 8/861 Back
CHEMICAL & GEOLOGICAL LABORAIORIES OF ALASKA, INC.
/ ~'~,'~, 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343
FEDERAL TAX ID # 92-0040440
ANALYSIS REPORT BY SAMPLE for Work Order # 7022
Date Report Printed: JUN 7 88 @ 15:27
Client Sample ID:TRACT 5, DONALD C. SCHROEDER
PWSID :UA
Collected JUN 2 88 @ 15:50 h~s.
Received JUN 3 88 @ 14:30 hxs.
Presezved with :4 DEG. C
Client Name : S & S ENGINEERING
Client Acct: SNSENGP
P.O.# NONE REC'D
Req #
Ordered By : R.S.
Analysis Completed : Send Reports to:
Labozatory Supef~lsoL_LSTEPHEN C. EDE 1)S & S ENGINEERING
Released By :~ ~.~ 2)
Special
Instruct:
Chemlab Re£ #: 1261 Lab Smpl ID: 1 Matrix: Water
Allowable
Parameter Tested Result/Units Method Limit~
NITRATE-N ND (O.lOJ mg/1 EPA 353.2 lO
Sample ROUTINE SAMPLE
Remarks: SAMPLE COLLECTED BY RJS.
feets Pezformed ' See Special Instzuctions Above UA-Unavailable
None Detected "See Sample Remarks Above
Not Analyzed LT-Less Than, GT-Greater Than
APPLI¢ IT FILLS OUT UPPER HAL ONLY
Mailing Address ["') .r--~ J~/' "i "~ /~-, -~ '~ / /~'J r'~ ~ ~ ~,~ Zip Code
Zip Code
Address
Lending Ins~itution .~- PhOne
Address Zip Code
Realty Co. & A~nt ~)~'-) ~('~ ~r ~'~.~L.~(~ /,~:~(.~.(~ ~ ~, )~ , Phone
Legal De'ripen .. ~ ~ ..... , ~
Street LOcati~. , ¥, ', ~' z.~ / ,. (", ....... /~, /0 ..... Y) ..... ~?
Type of Resi~nce~
Family
le Family No. of Bedroo~
~ Other
Water Supply .
~vtdual ~/~ ~j, ~Y~ A~ACH WELL LOG. A wall log is required for all wells drilled since June 1975.
~ Community ~'~ - ~ For wells drilled prior to that date, give well depth (attach log if available).
~ Public Utility
Sewer Disposal~
bividual Year Indiv~ual Installed:
lic Utility When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Date Date Date ~..., 2~,{~ ~ Date~'
Inspector Insp~tor Insp~tor Insp~tor
APR 2
( CONDITIONAL APPROVAL*
Soils ~ating Date ~wer Installed Well To Absorption Area W~II Log ~oeived
~11 to Tank S~plic T~k Size
72-023 (3182)
EXCAVATION
ROBERT A. SHAFER
WORK
August 8, 1983
CIVIL ENGINEER
694-2979
Teresa Nelson
SRA 139 3C
Anchorage, Alaska 99502
Dear Ms. Nelson,
Reference: Tract 5:. Donald C. Schroeder Subdivision
A sewer system adequacy test was performed on the system located
on the referenced property as you requested. The septic tank
was ~and verified to have a capacity in .~cess of 1000
gallons. The seepage pit was charged with 800 gallons of
'~resn water and after a period of 24 hours approximately 160
gallons had percolated out of the crib.
It can be concluded from this test that the septic tank is
adequate for the three bedroom residence located on this
property, however, I regret to inform you that the seepage
pit appears only to be adequate for one bedroom.~ it will be
necessary for you to have-the system'~~d before at can
be considered adequate for the three ~room residence.
If we may be of further service, please do not hesitate to
cont~ us. /
S.£'~cer~ 1~, ~/~/
,/ ~,'/
~s/ss
cc: Municipality of Anchorage
Department of Health and Environmental Protection
Linda Parker
Dynamic Realty
SRB 196X EAGLE RIVER, ALASKA