HomeMy WebLinkAboutEAGLE RIVER HEIGHTS BLK 8 LT 4Eagle River
He40
ights
Block 8
Lot 4
#050-281-19
_ MUNICIPALITY OF ANCHORAGE
+_'S
DE ITMENT OF HEALTH AND HUMAN SER'
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name
DISTANCES
rr T4 `
TO
FROM
SEPTIC
TANK
ABSORPTION
FIELD
WELL
Address
•70 Lee Ste•-eer t�LP/✓�
Phone(s) Permit No. No. of Bedrooms
WELL
6�v-I//yx SS aCt? 3
LOT LINE
LEGAL DESCRIPTION
Lot Block
Li t
Subdivision '
Eos/e �ciiPiJ /ye< �;Oil
FOUNDATION
Township. Range. Section
AS-BUILT DIAGRAM
(Show location of well,
septic system, property
lines, foundation,
driveway, water bodies,
etc.)
TANKS
SEPTIC ❑ HOLDING
Manufactwer
Capacity in gallons
txrrt,-,
/oo o-
Material
No of Compartments
S i•ce /
/
H
E
,.,,o ,
,
A
TYPE OF SYSTEM
'TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER
Depth to pipe bottom from
Total depth from original grade
original grade
6 FT
e�
FT
_
e ,
/�S�
FII added above ongrnal grade
Gravel depth beneath pipe
O FT
3's` FT
-e
y ,.
Gravel length
Gravel width
/ FT
3 FT
Total absorption area
i Distance between lines
Ll `T 7 SQ FT1
A/Lj FT
Number of lines
Soil rating
Pipe material
I
(S SO FT
I il oi 3�3v
Installer
Date Installed
Sf y— Un �/` rF�{c4 ✓c i
WELLS
PRIVATE ❑ OTHER (Identity)
Classification (A,B.C)
Total Depth
Cased to
c
/ ✓s'?t
FT
FT
Installer
Date Installed'
REMARKS:
�v..m/ %`• lam.✓G/i � p� �4G .� �� GJC
Scale:
Inspections
Eagle
Performed
River
Engineering
by:
Services
�F§
R, "� AL
C %rM„ CX.s fi —. T,*.dl ir.rtc A/Ca'
- —
Date-
`%�a�/dS'
Eagle
River,
694-5195
AK
99577
� � ��
/lJe,.✓ �8'r t,.,P Of ccd �r Vie-, l`z,•.ti- 4
t o / SeP , a� rt iJ . ', �..r e ,
certily that this inspection was performed according to all
Municipal and State guidelines in effect an this date:
a.'
Health Department Approval: ti }
72-013 (3/85) ll
9-1 Q ..... p UNA I Jr. �lr:`� 0 1 -1 4-:3 F= t,,.J C-- V-1 C.] F�". r-� C-3 E.'.
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREET, ANCHORAGE, AK 995O1
264-4720
��F-- Z F� 1�0 I
'
PERMIT NO: 850587
DATE ISSUED: 09/12/85
APPLICANT: JERRY TANDE
ADDRESS: P.O. BOX 773294
EAGLE RIVER, AK 99577
CONTACT PHONE: 694-5195
LEGAL DESCRIP: SUBDIVISION: EAGLE RIVER HRTS. LOT: 4 BLOCK: 8
�
SECTION: 12 TOWNSHIP: 14N RANGE: 2W
LOT SIZE: 1.25A (SQ.FT. OR ACRES)
MAX BEDROOMS: 3
Listed below are the options avail`Able to you in designing your septic
system. Choose Lhe option that best fits your site.
** TANK MUST HAVE AT LEAST TWO COMPARTMENTS
I certify that:
1. I am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria or this permit.
3. I will adhere to all MOA and State of Alaska requirements the set back
distances from any existing well, wastewater disposal system or, public
sewerage system on this or any adjacent or, nearby lot,
4. I understand that this permit is valid for a maximum of 3 bedrooms and
any enlargement will require an additional permit.
lF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
]HEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRICAL WORK MUST BE DONE 8Y A LICENSED ELECTRICIAN.
SIGNED
--^___
APPLICANT1JERRY ';NDE
lSSUED BY
DATE:
^`-~---a--, ~
DATE: 4 / / - -
'- FIZ F%-1 C:�
Ec EE 13
Lmi~ 113 F�. lr-*4 .1 A -1j
DEPTH TO PIPE BOTTOM (FT
4.0
4.0
GRAVEL DEPTH (FT.)
0.5
3.5
TOTAL DEPTH (FT.)
9.5^
4.5
7.5
GRAVEL WIDTH (FT.)
v�
2.5 ���
20.0
5.0
GRAVEL LENGTH (FT. >
44k�
38"0
54.0
GRAVEL VOLUME CU. YDS.
25.0
28.2
40.0
lANK SIZE (GALS)
1,000.0 ** 1,000.0
**
1,O00.0 **
SOIL RATING (SQ.FT./BR)
165
165
165
** TANK MUST HAVE AT LEAST TWO COMPARTMENTS
I certify that:
1. I am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria or this permit.
3. I will adhere to all MOA and State of Alaska requirements the set back
distances from any existing well, wastewater disposal system or, public
sewerage system on this or any adjacent or, nearby lot,
4. I understand that this permit is valid for a maximum of 3 bedrooms and
any enlargement will require an additional permit.
lF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
]HEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRICAL WORK MUST BE DONE 8Y A LICENSED ELECTRICIAN.
SIGNED
--^___
APPLICANT1JERRY ';NDE
lSSUED BY
DATE:
^`-~---a--, ~
DATE: 4 / / - -
X 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: Te { r
LEGAL DESCRIPTION: L o t y d/OGft g
1
2 c .
3 a
D
4
5
6 G=
7 b
9 ,7
v
10
r
11
12
D
13
13 r7
14
15 -I
OR6-itr)rc
I (G m )
Loose -/a �5e /eoc lCr
l 6 G 41,3 +it�,
fw
• qs e e
®% ;.
18
�e
® 'J'„ :
_
Louis A. Butera
CE
19-
Depth to
Water
-6736
4`
"80FESS1'PFm��
DATE PERFORMED:
// is . T /,Iv R--2,.,
fec /d
SLOPE SITE PLAN
WAS GROUND WATER ^ ,�
ENCOUNTERED? /t/
IF YES, AT WHAT
DEPTH?
■■■NEEM■■■
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
■11■iim��7■1■■
011■EME11
!■IN■
■„■■■■,T101
011■■■■■■IN■
10
■,1■■■■■MEN
011■■■■■■1N■
NEMMMMNE
ENEEMEMENE
■■■■■■■■■■
■■■■■■■■■■
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
20 �0v®o°���°'
PERCOLATION RATE
(minutes/inch)
C Uf<v s/fir TEST RUN BETWEEN T AND �' FT
COMMENTS VAPP -'re f lea,A it—ee Ire ep
a
/j'P�{nor.s (3) 7rg rr has sr���ttier r.sx7f reg" �I. f SQiaS�StiN res. p
Eagle River Engineering Services
PERFORMED BY: CERTIFIED BY: DATE: q�?/ Imo.Y-
E291e River, AK 98577
$94-5195
72-008 (6/79)
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
O KsFAi Goes Co.
Name_ , k S;ji n kiSpaj Mailing Address &V- /y �em,
/3 Ph.#
Location Legal Description Lo 5i r-.24_
SEPTIC TANK: Distance from well i Material S�A&/ Number of compartments
Liquid capacity jtipp gallons. Inside length Inside width Liquid depth
SEEPAGE SYSTEM: Seepage Pit: Number of pits / Outside diameter or
width /Q length depth «� ' , lining material ra ✓� Distance from
well /0 :Z , building foundation V-7 , nearest lot line � � Total effective
absorption area (wall area) ilo U sq, ft.
TILE DRAIN FIELD: Distance from well , foundation , nearest lot line
"total length of lines Number of lines Distance between lines Trench
width in. Total effective absorption area sq, ft. Length of each line
Depth: Top of tile to finish grade Depth of filter material beneath
tile in. Above tile
WELL: Type j < m , depth UkAj , distance from building foundation ;)S ' , nearest
lot line Sorg, nearest sewer lin 2J'', septic tank_, seepage system /0.1
cesspool "' , other sources ----
DISTANCES:
5 �_o c , Ho
DATE: &0 5 Q,4- -
DIAGRAM OF SYSTEM
3 bt d elwAl
AVUU
7
er I
k
APPROVED `�
Health Authority
C
G CJ
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. o50 -281-1Q COSA # D� l j lo'ln
Expiration Date: 16-2
— /�-
1. GENERAL INFORMATION
Complete legal description Eagle River Heights Block 8, Lot a
Location (site address) 10211 Lee Street
Current Property owner(s) Beniamin Wade Day phone
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
10211 Lee Street Eagle River Alaska 99577
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well M
Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
M
Individual Holding Tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Pannone Engineering Services LLC Phone 272-8218
Address P.O. Box 100217, Anchorage AK g4S10
Engineer's Printed Name Steven R. Pannone P.E. Date 17� _,
Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with MOA DSD Guidelines & Regulations. The reported results describe 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 soil condition, ground water
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 this system. All systems eventually fail and
satisfactory test results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. PES can therefore not provide any warranty for future
performance nor give any estimate of how long the system will continue to meet the operational
requirements of the 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 parry is not authorized nor will it
confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: Original Certificate Date:
(Rev. 71105J�/
y
Municipality of Anchorage 6? Bp
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Eagle River Heights. Block 8, Lot Parcel ID: 050-283.-3.9
A. WELL DATA
Well type Private If A. B, or C provide PWSID #
Date completed Unknown Sanitary seal (Y/N) v_
Total depth ft. Cased to ft.
FROM WELL LOG
Date of test
Static water level ft.
Well production 9.p -m.
WATER SAMPLE RESULTS:
Coliform QE& colonies/100 mL Nitrate CQ ; rng/L
Well Log (YIN)
Wires properly protected (Y/N) Y
Casing height (above ground) %8 in.
AT INSPECTION
6/25/xo3.z
Fil
4.9+ g.p.m.
Arsenic: _L24 ug/I Date of sample: 6 -a5 -Jo t3 Collected by:S
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic Steel Date installed al3o/3.968
Tank size 3.000 gal.
Foundation cleanout (YIN) Y
Number of Compartments i
Depression over tank (YIN) N
Cleanouts (Y/N)
High water alarm (Y/N) N
Date of pumping 73 — I? X)1') Pumper —IT SZ '-S TCA0)"Y1St
C. ABSORPTION FIELD DATA
Date installed 913/3.o8s Soil rating (g.p.d./ftZ or ft2/bdrm) 3.65 SF/BR System type Deep Trench
Length 73. ft. Width
ft. Gravel below pipe a.5 ft.
Total depth %5 ft. Eff. absorption area 497 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 7/3.a/203.2 Results (Pass/Fail) Pass For3bedrooms
Fluid depth in absorption field before test io in.
Elapsed Time: 3.20 min. Final fluid depth 3.o in.
Water addedr5o gal. New depthz_z in.
Absorption rate >=4co+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at _ in.
Datum
E. SEPARATION DISTANCES
Size in gallons
"Pump off"level at —in.
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 64
Absorption field on lot 100+
Public sewer main 7q+
Sewer /septic service line 25+
Animal containment areas 50+
Manhole/Access (Y/N)
High water alarm level
Meets alarm & circuit requirements?
On adjacent lots zoo+
On adjacent lots ioo+
Public sewer manhole/cleanout 100+
Holding tank 100+
Manure/animal excrete storage areas ioo+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation c+ Property line io+ Absorption field 5+
Water main 10+ Water service line io+ Surface water zoo+
Wells on adjacent lots 100+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line io+ Building foundation 10+ Water main 10+
Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+
Curtain drain
F. COMMENTS
G. ENGINEER'S CERTIFICATION
Wells on adjacent lots ioo+
I certify that 1 have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Steven R. Pannone P.E.
Date 7/20/2012
COSA Fee $
Date of Payment
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
143
,en R. Panni
No. CE 8149
in.
SGS,
SGS Ref.# 1122548001
Client Name Pannone Eng. Srv,
Printed DatelTime
07/02/2012
16:49
Project Name/# Eagle River His, Blk 8 Lot 4
Collected Date/Time
06/25/2012
19:00
Client Sample ID Eagle River His, B8, L4
Received Date/Time
06/26/2012
8:30
Matrix Drinking Water
Technical Director
Stephen C. Ede
Sample Remarks:
Allowable Prep
Analysis
Parameter Results
LOQ
Units
Method Container ID
Limits Date
Date Init
Metals by ICP/M3
Arsenic ND
5.00
ug/L
EP200.8 C
(<10) 06/28/12 07/02/12 NRB
Waters Department
Total Nitrate/Nitrite-N 0.503
0.100
mg/L
SM21 4500NO3-F B
(<10)
06/28/12 CMA
Microbiology Laboratory
E. Coli Negative
1
100mL
SM21 9223B A
06/26/12 MEM
Total Coliform Negative
1
100mL
SM21 9223B A
06/26/12 MEM
JUN -26-2012 02:00 FROM:JR'S SEPTIC PUMPING 9073449021 TO:2723211 P.1
JRs Pumping
PO Rox 773615
Engle River, AK 99517
(907) 696.6456
LQ1111no_Information
Benjamin & Lisa Wade Job Description: 1000g
10211 Lee Street P.G. Number.
Eagle River, AK 99577 Terms: Net 30
(907) 696.0509 Salearep: Dawn -Dawn
Map Book:
Service Agreement
Number.
035341
Order Date:
17 -Mar -2012
Service Date:
17 -Mar -2012
Technician:
Hoover
Tax %: 0
Job Type: Repeat
Map Grid: 98
Croes Streate: JoEagle River Road b Site Information____,__,__ _.,,_.
Lisa Job comments: Last Service '12/05/2007'
10211 Lee Street Lisa - 224-2013 Cell #
Eagle River, AK 99577 tank full
(907) 696-0509 lots of solids
688.1012 back flushed
1000g
Additional Location Comments: Diagram: aad1aorsm9l17031.bmo Gallons Planned: 1000
A lot of mailboxes at and of dw,
6th house on your right - little log
home w/ red metal roof & circular dw,
noVe a -70e
Pipes are northeast back of the *e TW:
home : single access tank w/ no
house Go
Service Type
Septic Sery 1000K
Same Day Call Out Fee
Gal. Actual:
Hose Length: 2.5
Gam.
Double Tank: (�
Pump System: I
Baffles Inlet: LJ
DW Baffles Outlet: ❑
qty Price Each Tax?
1 $200.00 No
1 $75.00 No
Extension Actual
$200.00
$75.00
NonTaxable Total Taxable Total Tax Total Grand Total
Estimated Charges: $276.00 $0.00 $0.00 $275.00
Actual Charges:
Customer agrees to the terms and conditions shown. THIS IS A BINDING AGREEMENT.
Signature and Title of Cuatomer Representative Date
Accepted by JRs Pumping Data Accepted
For your added convenience we accept; Dloover, Visa and Master Card payments over the phone.
After 30 Days account will be turned over to COLLECTIONS. $30.00 For NSF Checks Returned.
AAROW PUMP & WE[[ SERVICE, LLC
P.O. Box 110496
Anchorage, AK 99511
Office: (907) 346-9355 • Fax (907) 333-8976
Eagle River: (907) 622-9335
CUSTOMER
F-4in"W Yl6 E -n 1 2ef i ✓t
loo
i .._ nv nn�,_
r -
JOB SITE
0 O ME
1061ME,1.11]
!jYVWrQY,�j n� n i►u
L I L J
INVO ATE
WELL DEPTHSWL
qg�
CHLORINATED
Y�
EPTH
SALESPE ON
h,
dIUANTITY
DESCRIPTION -
PRICE
AMOUNT
/
t,a an
In c�o,,
3a
Yt oh f
664
}�
T;aw
no a
Ci VCIO
s
CA
G 2
LABOR
HOURS
RATE
AMOUNT
TOTAL MATERIAL
/5
TOTALLABOR
WORK ORDERED BT
DATE COMP.
TOTAL
LABOR
PAY THIS AMOUNT
Thank You
SIGNATURE
(I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that if above work is not paid for in 90 days I agree to allow Aarow
Pump & Well Service, L.L.C. the right to remove unpaid for equipment and charge for labor already performed & labor to remove unpaid for equipment.)
TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE.
SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS.
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WILDWOOD STREET
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D. R. DAYTON, P.E., R.L.S.
�� Chugiak, Alaska 99567 (9071
20210 Donalar St. 696-_17
March 1, 1993
WELL FLOW TEST
Legal Description: Lot 4, Block 8, Eagle River Heights
Date of Test: February 23, 1993
fe.!ell Depth: 87 + ft.
Static Water Level: 08 ft.
Requirements: 3 bedroom - 450 gallons per day
Test:
The well was pumped at varying rates in an attempt to stabilize
the drawdown with the well ouyput. The atabilized level was not
determined in the length of time required for the well to produce
more than the daily requirements.
The well produced 700 gallons in 3 hrs. S minutes for an average
pumping rate of 3.8 gallons per minute which exceeds the daily re-
quirement for a 3 bedroom home.
The water was lab tested for Coliform, other bacteria and Nitrat�_z.
The results are as follows:
Coliform - 0, Maximum Allowed 0
Other Bacteria - 0, Maximun Allowed 0
Nitrate - 1.15mg/l, btaximum Allowed 10 mg/l
0
ResLThe well is currently producing adequately for a 3 bedroom home.
i mr� u� 7J LL• 1G f:L� �n: v. LnV�L r.l vr.
r.o
D. R. DAYTON, P.E., R.L.S.
Chugiak, Alaska 99567 (907)1NM�
20210 Donalar Street 696-2417
March 1, 1993
ADEQUACY TEST
Legal Description: Lot 4, Block 6, Eagle River Heights
Date of Test: February 23, 24, 1993
Septic Tank: 1000 gallon, 1 compartment, steel tank
Absorbtion System: Seepage pit or unknown volume and
71 ft. ionc x 3.5 ft. effective depth trench.
Soils Rating: 165 sq. ft. ;er bedroom
Requirements: 3 bedroom - 450 gallons per day
Test:
As the house has been vacant, the system was pre soaked with 700
gallons of water and allowed to sit for 24 hrs. Water was then
injected into the absorbtion sysTe:n until it accepted 1� times
the daily requirement.
Results:
As the system accepted lid times the daily requirement, it is
currently functioning adequately for a 3 bedroom home.
Note:
Since it is unknown how long it has been since the septic tank
was pumped, we recommend the tank be numped soon and at least
once every 2 years hereafter.
i InfC c.:.� 7J ice• LO r:L� I inr� of Ln'JLL i -.i -:R
r . ,
CHEMICAL & GEOLOGICAL LABORAT0R7
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562.293 FAX: (907) --
- 3 1
Chemlab Ref.# :93.0719-1 REPORT of DULTSI3
Client Semple ID :L4 88 EAGLE FIVER HGIS
matrix : NATER
Client Name :DAVID 01IION, P.E.
ordered By
Project Name
Pr of ectl
PNSID :Ul
1e ROUTIH SIOLE COLLTCTED BI: D.H. DITTOV.
mks:
C011eCced :02/21/93 a 16:.: his.
Received :02/23/93 a 10:.5 his.
Nat Order :63412
Report Completed :02/261•93
Technical Director :SI PE;Ii C. DB
Released By T
QC Allouable
Parameter Results Qual. Units method Limits
------------------------------------------------------------------------------------------
HITRAIB-b 1.15 mq/l EPA 353.2/300.0 10
Exude: Analysis
Dace Data !nit
------------------------
02/26i93 L:.3
...........•...........................................................................................................................
Sae Spacial Instructions Above Ill - Unavailable
"' Sae Sampla Ramarks Above DTA - Not Analyzed
D - Undetected. Reported value is the practical quantification limit. LI - Less Than
D - Secondary dilution.��+-� GI - O:eater Then
���7v7S Member of the SGS Group (Societ6 Gdnarale de Surveillance)
MUNICIPALITY OF ANCHORAGE
t
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION /J 5
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date 148RCH 27, 1987
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
FAGTF. RTVF.R HFTGHTS: Lot 49 Block 8; T14N, R2W, Section 12
Location (address or directions)
10211 LEE STREET
(b) Applicant Name JERKY TANnY Telephone: Home 694-5195 Business n/a
Applicant Address c/o EAGLE RIVER ENGINEERING, P.O. BOX 773294, EAGLE RIVER, AK 99577
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder OC; Buyer ❑ ; Other ❑ (explain);
(d) Lending Institution p,/a Telephone
Address n/a
(e) Real Estate Company and Agent FnR 1VIARTTM — ARFA, INC. REALTORS ((-nTDWFJJ - BANKER)
Telephone (�QZI-9555
(f) Mail the HAA to the following address:
YiGk up by Eagle River EtiglAer'ring ReT'Yires
2. TYPE OF RESIDENCE
Single-FamilylX Multi -Family ❑ Other
Number of Bedrooms R
3. WATER SUPPLY
Individual Well KX 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(11,94)
5. ENGINEERING FIRM PROVIDIK NSPECTIONS, TESTS, FILE SEARCH, DA 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 EAGLE RIMER ENGINEERING SERVf S Telephone 694-5195
Address P-0- BOX 775294, EAGLE E R= , ALASKA 99577
Date MARCH 27, 1987
1
ir_"
, .. EnAc gineer's Seal
` Y Louis A. Butes % Qj
s • i
s°.a CE -5736 500.
6. DHEP APPROVAL &.111ZApproved for - bedrooms by 0 !� Date
Approved
Disapproved
Terms of Conditional Approval
Conditional
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 (11/84)
A.
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE (MOA)
ENVIRONMENTAL SERVICES DIVISION HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
MAR 31 4987 ssa-a�2o
Legal Description: S� 1C"
RECEIVED `/ cf Tiy Ile au/ JCAar-
WELL DATA
Well Classification ��/�lT�= If A, B, C, D.E.C. Approved (Y/N)�/4
Well Log Present (Y/N) Date Completed /715AI Yield
Total Depth teY7 Cased to IS 7 Depth of Grouting /✓�4
Static Water Level 7$ /elo�..-1k'f ckr""r Pump Set At "
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
/V
To Septic/Holding Tank on Lot EZ "�L✓ar`t. S =WJ ; On Adjoining Lots 2/ov'
To Nearest Edge of Absorption Field on Lot /uy ; On Adjoining Lots r�a�
To Nearest Public Sewer Line To Nearest Public Sewer
Cleanout/Manhole
�� To Nearest Sewer Service Line on Lot 7 �s
Water Sample Collected by Isle e C" s" ""5 Date -3,/ 'VAS
Water Sample Test Results 7�1s'�Gh
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed �V-57- Size No. of Compartments
Standpipes (Y/N) r Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N)
Depression over Tank (Y/N) N Date Last Pumped '?/ 7
Pumping/Maintenance Contract on File (Y/N) ; for r�q
Holding Tank High -Water Alarm (Y/N) /,,4. Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water -Supply Well
To Property Line
t /e�' /
To Water Main/Service Line
Course y�
Comments
Page 1 of 2
72-026(11/84)
t/o '
To Building Foundation —
To Disposal Field * 30
-2SS /
To Stream, Pond, Lake, or Major Drainage
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata ��� �� Type of System Design
Date Installed elf s Length of Field 711
i
Width of Field
Square Feet of Absorption Area 15f 9 7
Depth of Field 9 S
Gravel Bed Thickness
Standpipes Present(Y/N)
i
Depression over Field (Y/N) A,/ Date of Last Adequacy Test :�A- 7
Results of Last Adequacy Test J 1-4 �/a, 7W :3 dS�✓e LC,S-e-
Separation Distance from Absorption Field:
To Water -Supply Well /L'0
To Building Foundation
Lot 1.5 /
3o '
To Property Line
; On Adjoining Lots
--,/o I
To Existing or Abandoned System on
T SU �
To Water Main/Service Line ,-Zo To Cutbank (if present) ��
To Stream/Pond/Lake/or Major Drainage Course Nil
To Driveway, Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
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 havecheOed, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed Date .3�Z?/�7
Company �^ r' MOA No. S %^'ZG .S-
Receipt No. L52 _ U O d6 S�
Date of Payment
Amount: $ �b a
O �
Eagle River Engineering Services
Page 2 of 2 P. 0. Box 773294
Eagle River, AK 99577
694-5195
72-026 (11/84)
Seal
Municipality
of
Anchorage
October 10, 1985
P.O. BOX 6650
ANCHORAGE, ALASKA 99502-0650
(907)264-4111
TONY KNO WLES,
MAYOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
Lou Butera, P.E.
Eagle River, Engineering Services
PO Box 773294
Eagle River, Alaska 99577
Subject: Waiver Request WR85-039, Lot 4 Block 8 Eagle River Heights S/D
Dear Mr. Butera:
This department has granted your request for a waiver to the minimum
required separation distance between the well and septic tank on the
referenced lot. The required 100 foot separation has been waived to
64 feet. This waiver is valid for the existing septic system only.
Sincerely,
vvStephen S. Morris
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
9/30/85
MUNICIPAkRy OF ANCHORAOe
Susan Oswalt DEPT. OF HEALTH &
Municipality of Anchorage ENVIRONMENTAL PROTECTION
Health Departmentn-r
825 L street o1, I 1 1985
Anchorage, Alaska 99501 RECEIVED
Ref:Lot 4, Block 8, Eagle River Heights
Dear Susan;
On behalf of my client, Jerry Tande, I am applying for a
formal wavier of well to septic tank horizontal separation dis-
tance of 64'.
The well and septic system were installed and approved in
1968 by the Borough of Anchorage under the existing codes at
that time. The well has no log but is reported to be 68' deep
which is common for wells in that area. The ground slopes away
from the well toward the septic leach field directing any possible
sewerage away from the well. Soils in the area are GM type with
increasing hardpan layers at greater depths. The septic leach
field has been upgraded to 100' distance and the connection to
the septic tank was vertified as water tight.
We are requesting a letter granting approval of this previous-
ly approved separation distance.
If there are any questions or concerns please call me at
my office 694-5195.
Sincerely,
Lou Butera P.E.
` -
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME
6. TVP OF RESIDENCE
TIME
TIME
❑ One ❑ Four ❑ Other
® SINGLE FAMILY
❑ Two ❑ Five
m
DATE
7. WATER SUPPLY
DATE
DATE
* 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
❑ PUBLIC UTILITY
INSPECTOR
8. SEWAGE DISPOSAL SYSTEM
INSPECTOR
INSPEC�7
-jept-196&EAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
Installed by Tuck Construction Co.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
MUNI PALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE DEPT. OF : - ,':
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEfffflkbN,ME;Ni;;L _CTION
825 L Street - Anchorage, Alaska 99501
•
UC'w 1980
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720 V E D
REQUEST
FOR APPROVAL OF INDIVIDUAL WATER AND SE CILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTYOWNER
PHONE
Joyce T. EY:nrietU l'1-277-7234
1-594-9857
MAILING ADDRESS
C/o xJEaExtiqxa
xkRathHX 72 Lee Street Eagle River, Ak 99577
PROPERTY RESIDENT (If different from above)
PHONE
2. BUYER
PHONE
MAILING ADDRESS
3. LENDING INSTITUTION
PHONE
MAILING ADDRESS
4. REALTOR/AGENT
PHONE
1,11ary Dee Henderson
d' Jack V' ' to Co
27? -1553
MAILING ADDRESS
3201 C_ Street
Anchorage, Alaska
5. LEGAL DESCRIPTION
Eagle River
Heights
STREET LOCATION
6. TVP OF RESIDENCE
NUMBER OF,BEDROOMS
❑ One ❑ Four ❑ Other
® SINGLE FAMILY
❑ Two ❑ Five
❑ MULTIPLE FAMILY
LxJ Three ❑ Six
7. WATER SUPPLY
L23 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
❑ PUBLIC UTILITY
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
K7 INDIVIDUAL/ON-SITE**
-jept-196&EAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
Installed by Tuck Construction Co.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
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
INSTALLER
❑Septic Tank or ❑ Holding Tank
Size: If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
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
APPROVED FOR --5 BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
BY h
72-010 (Rev. 6/79)
ALASKA RUIROWnTAL COnTROL SERUJC61SPA&F ANCHORAGE
DEPT. OF
Enqineerinq & 6nuironmeptal Studies ENVIRONVIN-1.,L , _,fLCTION
1 6
JACK WHITE CO
3201 C STREET
A N C HOR A, G _E AK 99503
GELLER -- JOYCE EMMETT
SUBQIVISION--EAGLE RIVER HIEGHTS
THE TYI::'E OF' ABSORPTION SYSTEM IS A
THE SYSTEM IS CAPABLE OF ACCEPTING
BASED UPON THE 'TEST DATA THE SYSTEM
3 BEDROOM HOME+
"y1
RECEIVED
JANUARY 15 1981
BLOCK. -B LOT -I
PIT WITH AN UNKNOWN AREA.
150 GALLON,':') OF WATER PER DAY.
IS ACCEPTABLE FOR A
THE" WAS PUMPED ON 1-..14....81 +
W
4 49 7
oz
or Deco aucoa o
Leroy c. Reid,
T'u'b'?, No. 225"
.0c
04�
09OFr�,Sko
1220 West 25th Auenue e Anchoraqe, Alaska 99503 9 (907) 276-1361
G41 1A(%01AGf AAAI � '
G
u ;
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received 6/19/74
Time of Inspection 10:00 am
Date of Inspection 6/20/74
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Approval requested by: Area Realt
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank 64' Absorption area 1021
, Sewer Lines ,
Nearest lot line lo'plus, Other contamination
B. Foundation to septic tank 12' Absorption area 60'
C. Absorption area to nearest lot line
EQ -034 (1/74) Page 1 of two pages
Mailing Address:
Phone:
2.
Property Owner: Peter Page
Phone:
Mailing Address:
3.
Legal Description: Lot 49Block
8 Eagle River Heights
4.
Location: IPP Rnad
5.
Type of facility to be inspected
Single No. of bedrooms 3
6.
Well Data:
A. Type Drilled
B. Depth 68'
C. Construction Standard
D. Bacterial Analysis Satisfactory
7.
Sewage Disposal System:
A. Installed 1968
B. Installer Ed Tuck
C. Septic Tank: 1. Size 1000 gals 2. Manufacturer Steel
D Seepage Pit: 1. Absorption
Area 10'xl5'x8' 2. Material Logs
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank 64' Absorption area 1021
, Sewer Lines ,
Nearest lot line lo'plus, Other contamination
B. Foundation to septic tank 12' Absorption area 60'
C. Absorption area to nearest lot line
EQ -034 (1/74) Page 1 of two pages
Pane 2 of two pages - Re�,_.'-st for Approval of Individual , er & Water Facilities
Legal Description lel-,l yoi 00
Comments
Approved
7fG* /l.
Disapproved
Date (o Z
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
EQ -034 (1/74)
Date
;BEATER ANCORAGE AREA BOROUGH
!TALTF; MPARVENT
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
279-2511
DATE RECEIVED
INSPECT:
TI"4E :
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWAGE AND WATER FACILITIES
J FOR
1. Approval Requested BY
Address
Phone
2. Property Owner ! " ' Phone
3. Legal Description
4. Type of Facility to be Inspected-, ,' STREET:
Number of Bedrooms
S. Well Data:
A. Type
B. Depth
C. Size
D. Construction
E. Bacterial Analysis :GL 21
6. Sewage Disposal System:
A. Septic Tank (I£ homemade, show diagram on back)
1. Size
2. Age
3. Manufacturer
4. Installer
Approval Request for St $ Water Facilities
Page Two
B. Seepage Pit
1. Size
2. Lining
C.. Disposal Field
1. Number of Lines
2. Total Length
7. Required Measurements
A. Well to Septic Tank f- el
B. Well to Seepage Pit
C. Well to Sewer Line
D. Well to Property Line j1'
E. Well to Other Possible Contamination
F. Foundation to Septic Tank /a 1
G. Foundation to Seepage Pit
H. Seepage Pit to Property Line
8. COUNTS:
APPROVED: ? y�,�, rC�=Z,! DISAPPROVED:
DATE: i 1 DATE:
APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT
ED1170
June 2, 1571
First vatIonji Ank
3OX 72 )
AnOo,i.,, 1113;l 9PIC?
1"! " j . :
Action of Pjtvo- A,
I rainWictior of th" "oll ,t
or Junell, 1-11,
the �jc Th" Nall c"ll W19 1 U"i :,nuv ut,
well hal not vet )?In
Art. 110"0131 Cap I 110,n fo, t,,
the -?!! well,
'I 41111A In,ua to th- r ... j
Lynn o. joaH
Sanitarian
kr
GREATER ANCHORAGE AREA BOROUI
1 7� HEALTH DEPARTMENT�y�
327 EAGLE STREET [[[
ANCHORAGE, ALASKA 99501
279-2511
INSPECT;
TIME: lQ.
.�
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWAGE AND WATER FACILITIES
1 FOR v
U
i I
1. Approval Request")e t' "�L>xll t�t�'�t.:�CQ y C
Address�y ,t -Z:5 5
Phone
2. Property Phone ? % ".xt
3. Legal Description ��^ t
4. Type of Facility to be Inspected
Number of Bedrooms
S. Well Data:
A. Type �L1(f
B. Depth ) •�`
J�
C. Size
D. Construction L^
E. Bacterial Analysis
b. Sewage Disposal System:
A. Septic Tank (If homemade, show diagram on back)
1. Size le��rr
2. Age //yam/ try
3. Manufacturer ,7,
4. Installer
Approval Request for
Page Two
ye $ Water Facilities
B. Seepage Pit (�
1. Size /Q
2. Lining
C. Disposal Field
1. Number of Lines
2. Total Length_._✓/�
7. Required Measurements
A. Well to Septic Tank
B. Well to Seepage Pit 02
v'
C. Well to Sewer Line
D. Well to Property Line
E. Well to Other Possible Contamination
i
F. Foundation to Septic Tank
G. Foundation to Seepage Pit (p
H. Seepage Pit to Property Line
8. COFINIENTS :
APPROVED:
DATE:
C1. (M
DISAPPROVED:
DATE:
APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT
ED1170