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Home My WebLink AboutEAGLE RIVER HEIGHTS BLK 5 LT 8 (c) OF ANCHORAGE ENVIRONMENTAL PROTECTION' DIVISION 0'F ENVIRONMENTAL HEALTH IFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ON-SITE SEWER AND WATER FACILITY Application Date' Suly include lot, block, subdivision, section, township, range) ' Location,(address or directions) Applicant Address P · 0. Box Telephone: Home 694'3196' Business 770843 Eagle River, Alaska 99577 ~ Applicant is (check one): Lending Institution []; Owner/builder [~]; Buyer []; Other [] (explain); (d) Lending lnstitution Security Pacific Address 2550 Denali~ Suite 615 (e) Real Estate Company and Agent N/A Address (f) Telephone 258-6¢31~ Anchorage, Alaska 9950~ Telephone Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family [] Multi-Family [] Number of Bedrooms . :~ Other WATER SUPPLY Individual Well [] Community [] Public ~-"1' Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Note: If community Well ayetem; muat have wr tten confirmation from the 8tare Department of Environmental attesting to the aBd status. Page 1 of 2 ~"~ Z_2-025 (11/84 : Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, function ~s certified by my seal affixed hereto and as of the validation date shown below, i verify that myinvestigatii~aO~~~ 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 fi~es 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?with waiver of septic tank to creek horizontal distance to 80 ' Name of Firm EAGLE RIVER ENGiNEERiNG SERVICES Telephone Address Date ~- ~6 P. 0. BOX 773294 N.~cO~2~ ....... ~;~ Eng neer's Seal DHEP APPROVAL Approved for '/~(~)bedrooms by Approved ~ 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 of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 · 72-025 (11/84j A. WELL DATA MUNICIPALITY OF ANCHORAGE (MO~ HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: ~-o¢2 Well Classification Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments MUfqJCIPALITY OF ANCHORAQF DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 1986 If A, B, C, DEC. Approved (Y/N) Date Completed Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B. SEPTIC/HOLDING TANK DATA Date Installed Size Standpipes (Y/N) /Y Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~ ~x.~\~ c_.- To Property Line To Water Main/Service Line Course ~f,~-0 f Air-tight Caps (Y/N) No. of Compartments .)/ Foundation Cleanout (Y/N) Date Last Pumped ,7-', ~, I /~'/,4 ; for Temporary Holding Tank Permit (Y/N) To Building Foundation I ~ To Disposal Field ~ ] ' To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /~ ? ~ Width of Field '~ / Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot II/'/A To Water Main/Service Line /cs ' To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field '~' ~ / Depth of Field 2¢' / Gravel Bed Thickness ~- ' Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line / To Existing or Abandoned System on ; On Adjoining Lots ~' -f~' ' To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~--;~--~ Date ~ ~ ~.Z ¥ -¢¢~ Company ~'-/¢/'~J' MOA No. Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Eagle River Engineering Services P. 0. ~ex 773294 Eagle River, AK 99577' 694-51~5 Seat August 12, 1986 Lou Butera, P.E, Eagle River Engineering Services PO Box 773294 Eagle River, Alaska 99577 Subject: Lot 8 Block 5 Eagle River Heights North Subdivision Waiver Request, WR86-110 Dear Mr. Butera: Your request for a waiver of the 100 foot separation distance required between the septic tank and the stream (Meadow Creek) has been granted. This distance has been waived to 80 feet. Sincerely, Civil Engineer On-site Services SSM/ljw EAGLE RIVER ENGINEERING SERVICES Lou Butera P.E. P.O. Box 773294 Eagle River, Alaska 99577 Telephone (907) 694-5195 July 23, 1986 Mr. Steve Morris Civil Engineer, On-site Services Municipality of Anchorage P.O. Box 196650 Anchorage, Alaska 99519 REF: Lot 8, Block 5, Eagle River Hts. North Dear Mr. Morris, On behalf of our client, Mr. Harold Wiley, I am submitting the information necessary for your determination of a waiver of horizontal separation distance, surface water to septic tank, to 80' The septic system has been tested and is adequate for a 3 bedroom usage. The tank and leachfield were installed in 1976 with inspection and approval by the Anchorage Borough at that time. The soil at the leachfield and septic tank site is a GW type rated 85. The creek in violation is Meadow Creek, a major drainage channel for the Eagle River Area. The creek is located approximately 5' vertically above the septic tank location with a 6% grade away from the creek toward the south. The tank was full at the time of the test and pumped for a capacity of 1000 gallons. The house is located between the creek and the tank. If there are any questions, or if additional information is required, please feel free to contact me at 694-5195. Sincerely, Lou Butera, P.E. ANCHORAGE AREA BOR~tGH Department of Environmental QualiW 3330 C Street Anchorsge, Alaska ggS03 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM INSIDE LENGTH INSIDE WIDTH ,~/~ NUMBER OF MATERIAL -~ ~ ~'-/C COMPARTMENTS 2_ LIQUID DEPTH LIQUID CAPACITY GALLONS. D,STANCE FBOM WELL' 'J/" OUNDAT,ON ~' TOTAL LENGTH NEAREST LOT LINE__ ~'~ ~' OF LINES '~ TRENCH WIDTH .~ IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH LINE ~ ~': /' TOP OF TILE TO FINISH GRADE ~3 / DEPTH OF FILTER MATERIAL BENEATH TILE ~'~- IN. ABOVE TILE '~ __ IN. NUMBER OF LINES / DISTANCE BETWEEN LINES ABSORPTION AREA 25~''-/ DEPTH: WELL: , ypE/ _ /' ONS RUCTION BUILDING NEAREST FOUNDATION LOT LINE ~'~,]~'~' , CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DEPTH NEAREST SEPTIC , SEEPAGE SEWER LINE "~/,'~} , TANK~'~;~/,'~. SYSTEM REMARKS DISTANCE FROM: DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS: DIAGRAM OF SYSTEM Form LQ-032 AS-BUILT I hereby certify that I have' surveyed the following Anchorage ~c~ng 'P~eeinct, Alas~ and that the improvemen~ ~i~uat~ ~hereon.are wi~in the p~perty Iin~ and do not overlap ~ en~ach on ~e p~rty l)fing adja~nl ~e~lo, that no imp~vemen~ on prop- erty lying adja~nt the~to encroach on the premiz~ question and thai there a~ no ~dways, ~anzmission li~es or oth~ vlMble e~emen~ on said pro~?ty except Dnted at Eagle ~iver, Alaska · SCALE: ~er~ ~d S~eyor No. P~ne 694-~ . - ~ REQUEST FOR APPROVAL OF ~ _ , INDIVIDUAL SEWAGE AND WATER FACILITIES person requesting approval , ' ~~ Numb~ ~,~ bed~oms in house Wate~ Analysis: a. 5ac'te~.~a] b, Detergent w~] ] data: a. 'lype b. Depth c. Casing Size Distance from well to closest existing or proposed: 1. Sewer line 2. Septic tank 7e 3. Seepage Area 4. Cesspool' 5. Property Line houses, barn, drainage ditch, etc. Sewage disposal system. a. Age of system b. Septic tank capacity in gallons Other sources of possible contamination, i.e.~ creeks, lakes, c. Name of septic tank manufactumer 1. If "home made" show diagram on reverse side of this form. Disposal field or seepage pit size and type 1. Distance to property line to house foundation Percolatic~ Test f. Percolation Test performed by ~ Use the reverse,side of this form to show diagram. Diagram should include /,~he following information: .p~operty lines;.well location, house location, ~tlc tank location, disposal area location, location of percolation test, and direction of ground slope, 9. The h~fox~tion on this form is true and correct to the best of my knowledge. $ign~ture 'of Applicant Date Signed T~O BE FILLED OU'r BY HEALTIt D£PART~ENT PERSONNEL ~----~[e above described sanitary facilities are hereby approved, subject to the ........ '~611owing cond~ions ' The above described sanitary facilities are disspproved for the following reasons: 'Signature bf Approval is valid for one year following the date of approval. CPJ: cw