HomeMy WebLinkAboutEAGLE RIVER HEIGHTS BLK 8 LT 5 S2Onsite File
Ea!gle
Ricver
Municipality of Anchorage
On -Site Water and Wastewater Program • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP191348 PID Number: 050-281-21
Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade
Name:
DONALD & CATHERINE MCQUIGG
ABSORPTION FIELD - EXISTING
❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
Address
10111 LEE STREET, EAGLE RIVER
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
GPD/SF
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
Ft.
Gravel depth beneath pipe
Ft.
Subdivision Block Lot
Fill added above original grade
Ft.
Gravel length
Ft.
EAGLE RIVER HEIGHTS 8 5S2
Township Range Section
Gravel width
Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
Line
Ft'
--
-- Ft.
Well
100'+
NA
NA
NA
NA
TANK ® septic ❑ S.T.E.P. ❑ Holding ❑ other
Manufacturer
GREER
Capacity
1250 Gal.
Surface water
100'+
NA
NA
NA
Material
HDPE
Number of compartments
2
Lot Line
5'+
NA
NA
NA
NA
Foundation
101+
NA
NA
NA
LIFT STATION
Manufacturer
Capacity
Gal.
Curtain Drain
NA
NA
F NA
NA
Remarks Existing septic tank decommissioned
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
per code.
Pump make and model
Electrical Inspections performed by
PIPE MATERIAL House to tank 3034 Tank to 3034
drainfield
Installer NORTHERN EXCAVATION
Drainfield co/MT 3034
Inspector FWCS / MNA
BENCH MARK (Assumed elevation) 100 ft
Inspection 1s 8/22/19 8/23/2019
Location and description
2nd
3rd 4`h
BOTTOM OF SIDING
COMMUNITY DEVELOPMENT DEPARTMENT APPROVALlaw,
OF A
®<5��......... .4��,
Conditional Approval: Date
/4c '--"
�*
49THW *�
,A MICHAEL N. ANDERSON.•
G� No. CE 9489
8/23/19
Approve � n n,
pp t't-. ~ Date 't r �r� lssio�Pti
�........• � o
s
®®a®o
Inspection Report_9-1-12.doc
EAGLE RIVER HEIGHTS BLOCK 8, LOT 5 S2 PID: 050-281-21
PERMIT: OSP191052
S 89°59'00"E 263.90'
x
Ln
4.0' CANT
A -C=58.4'
B -C=57.3'
A -D=63.0'
B -D=61,5'
35.8'
8
00
N
6.3' W
U
�
�z
M W
0
BM
W
25.7;
GR PVE'�
111.8' °
w
H
Ln
N
0
z
�_
�CO ',
o
NEW 1250 -GAL S. T. I
--I LINE JETTED / CLEANED
10.0'x16.2' SHED
SCALE: V = 30'
SEPTIC SECTION
PREPARED FOR: SUPPORT®SERVICES:
DONALD & CATHERINE MCQUIGG ��� OF ALBA
EAGLE RIVER HEIGHTS BLOCK 8, LOT 5 S2 I
10111 LEE STREET, EAGLE RIVER, AK 99577 491H 1Y*
Michael N. Anderson, P.E. DATE: 8/23/2019 MICHAEL N. ANDERSON
N. CE 9469 ��
4661 Natrona Ave. DRAWN: FwCs � S�
Anchorage, Alaska 99516 '�dD 8/23/19 0
(907)727 8864/FAX: (907)345 1391 SCALE: 1" = 30' '�FESStO��
MUNICIPALITY OF ANCHORAGE
Ori -Site water & wastewater Program
PO 1 �UU�G 4700 Fb ore Rgac
Anchorage, Araaka 99519-6650 Fr.one: (907) 343-7904 Fax: (907)343-7997
hlIp A.%ww.muni.crgoralte
On -Site Wastewater Disposal Syslem Permit
Pormit Nurnbot, OSP191345
Wo rk Type; Septi cTarik Upgrade
T, -IK �9dip N%mrh4or: OtX0:18121 1)
Site Legal Add res a,. EAGLE RIVER HEIGHTS 13L 3 LT 5 $2 0;0053
Site Mailing Address: 10111 LEE ST, Eagle River
Owner: n1IOQUIGG DONALD & CATHERINE
DesFgn Engineer. ANDERBON GON TRUCTION & ENG INEERrNG
This perrnIt Is fir the constru Won of,
Effective D ala
Expiration Dake-.
Lot Size in SSI Ft:
Total Bedrooms=
IM01 g
IZ2020
43560
LJ Disposal Field L%A Seplio Tarek L7 Holding Tank L Priyy ❑ private Nell ❑ Dater 8Wa ge
AI] emstruC66rr !AKaII bQ 1 r a"Ordarl�o With;
1. The attached approved d eaig n.
2. All req ulrements spe-cified in An ahQrage M un IQIpa1 code Chapters 15.55 and 15,65 and the B1ata of Alaska
1 avowatbr Di a pO&AI Rsgu la.tions � 18AA 72) snd Drinking Weser Regulali ons (h 8AA080 )
S. Thqp wsatawatar coda f%quir-pg IngpWtlpng �j6jrin9 the inelalla6Dn, The en:glnaer shall notify lhv Dovoloprnont
-Services Departnenl per AMC 15-65. Provido notification by calling (907) UX7904 (2417)-
4. 1•rom October 15 to Agrll 15, a suburface soil absorplion system under construction during freezing weatber
sh alll be a ether;
a. Opened and Closed on the same day, or
b. Qpvered, sealed, and hsatod to prevent freezing
SpLieial Provislons' Bedroom count shall be resolved with MOA Property AppraisQl prior to inspoQtion report
a pprovn .
811 411 9
Received By: f Issued By; ('ana-a Date= h -01
4
F.PZAAIS
MUNICIPALITY OF ANCHORAGE
A -W.
Development Services Department � ,.� ..
Phone: 907-343-7904
On -Site Water & Wastewater Section �`� Fax: 907-343-7997
ON-SITE SEPTICIWELL PERMIT APPLICATION
Parcel I.D. 050-281-21
Property owner(s) DONALD & CATHERINE MCQUIGG Day phone 9072276794
r\Aailinn arlrirPq_ 10111 LEE STREET, EAGLE RIVER, AK 99577
Site address 10111 LEE STREET, EAGLE RIVER, AK 99577
Legal description (Sub'd., Block & Lot) EAGLE RIVER HEIGHTS BLOCK 8, LOT 5 S2
Legal description (Township, Range & Section)
Lot Size 43,560 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial El
Single Family (SF)
(w/wo AD U)
Septic Tank
®
Upgrade ®
Duplex (D) ❑
Holding Tank
❑
Renewal ❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES
A WAIVER REQUEST FOR:
Distance:
certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
FWCS - Brent Western
(Signature of property owner or authorized agent)
Permit/Rush Fees: 01Z
Date of Payment: )VIL?
Receipt Number: �i 9a
Permit No. j5P�
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc
Michael N. Anderson, P.E.
Civil/Structural Engineering and Construction
4661 Natrona Ave. Anchorage, Alaska 99516
Phone 345 -3377 / Fax 345 -1391
Support Services
Brent M. Western
907-440-4601
August 7, 2019
Municipalities of Anchorage
Departments of Health and Human Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Fax 249-7847
RE: SEPTIC TANK UPGRADE PERMIT
LEGAL: EAGLE RIVER HEIGHTS BLOCK 8, LOT 5 S2
To whom it may concern:
The owner has requested we proceed forward to obtain a septic permit to upgrade the
aged septic tank on the subject lot. The proposed upgrade will serve the existing 4-
bedroom house.
The lot and adjacent lots are served by private wells. The proposed design will not impact
any of the neighboring properties due to the lot layout. Please contact Brent M. Western
or me if you have any questions.
Sincerely,
Michael N. Anderson, P.E.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191348, Rebecca Carroll, 08/13/19
Michael N. Anderson, P.E.
DONALD & CATHERINE MCQUIGG
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191348, Rebecca Carroll, 08/13/19
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
LEGAL DESCRIPTION ~ ~ _
Absorption area Dwelling
I Material
Inside length W dth
PHONE [] NEW
Well
DISTANCE TO:
Manufacturer
ILiq. capacity in gallons IF HOMEMADE:
DISTANCE TO' Well
Manufacturer
DISTANCE TO: I
No. of lines Length of each liBt~
Top of tile to finish grade ~
Length WidthL'
Type of crib Crib diameter
DISTANCE TO:
IClass Depth
DISTANCE TO
Building
foundation
Dwelling
Foundation
Total length of
Material beneath tile
Depth
Crib depth
Building foundation
Driller
Sewer line
OTHER
PIPE MATERIALS
SO~ ~ TEST~R~T~ NG
I NS~.A I~LER
REMARKS
Material
Nearest lot line
Trench width-,
~5~inches
(.NO. OF BEDROOMS
PERMIT NO.
No. of compartments
Liquid depth
PERMIT NO.
Liquid capacity in gallons
PERMIT NO.
Distance be~7~ nes
Total effectivd abs~:~barea
PERMIT NO.
Total effective absorption area
Nearest lot line
Distance to lot line PERMIT NO.
Septic tank Absorpt on area(s)
APPROVED /, DATE
72-01'3 (Re~3/78)
LEGAL
I-I SOILS LOG
~tevem A. Johnson
P,O. Box 76
Chugiak, AK 99567
Phone: 907-688-3085
PERCOLATION
TEST
SOILS LOG - PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
11
12
13
14
15
17
18
19
2O
COM M E N TS
m
r
i
15-'
WAS GROUND WATER
ENCOUNTERED?
SITE PLAN
L.E Et..
E
IF YES. AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Dele Time Time Water Drop
I io/~Jl~ ~4 ~,~ ~4~,~
PERCOLATION RATE
TEST RUN BET~NEEN
13, (0 (minutes/inch)
FT AND ~1 FT
PERFORMED BY:
72-OO8 (7/76)
DATE: i0 /
GREI""C.R ANCHORAGE AREA BOR' 'JGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYST
LOCATION
MAILING ADDRESS.
LEGAL DESCRIPTION
PHONE
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
MANUFACTURER
MATERIAL
NUMBER OF
COMPARTMENTS
INSIDE WIDTH
LIQUID DEPTH
LIQUID CAPACITY '";
GALLONS.
SEEPAGE PIT:
NUMBER OF PITS __.
LINING MATERIAL *~ ~.
BUILDING FOUNDATION
ADDITIONAL ABSORPTION
DIAMETER
CRIB SIZE:
NEAREST LOT LINE ~"
OR WIDTH LENGTH DEPTH
DIAMETER ¢~' DEPTH ~ DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA) /' '
SQ. FT.
WELL:
TYPE
BUILDING
EOUNDATION __
CESSPOOL
APPROVED.
CONSTRUCTION
NEAREST
LOT LINE
OTHER SOURCES
DISAPPROVED
DEPTH DISTANCE FROM:
NEAREST SEPTIC SEEPAGE
SEWER LINE TANK SYSTEM.
REMARKS
DISTANCES:
INSTALLED BY:
, r
PIPE MATERIAl ·
LOT SLOPE:
REMARKS:
Form No. EQ-031
DIAGRAM OF SYSTEM
DATE
APPROVED ? ~ ':
/ G.A.A.B.
GReaTEr ANChOragE Area BOROUgh
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-456 I
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
COMPLETION DATE ANTICIPATED
PERMIT NO.
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.
1000
SEPTIC TANK SIZE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK ~'1
FOUNDATION TO SEEPAGE Pit ~.{~ t
lC'
SEPTIC TANK TO SEEPAGE PiT WALl
SEPTIC TANK ., SEEPAGE PIT
TO NEAREST LOT LINE.
DRAIN Field
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
DRAIN FIELD
.,DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PiT
TO RIVER, LAKE, STREAM.
DRAIN FIELD
CAST IRON INTO AiNi? OUt Of SEPTIC TANKI AND INTO CRIB CROSS!,NG GaP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHgN PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
TYPE
DIAGRAM OF SYSTEM
I CERTIFY THAT ] AM FAMILIAR WITH THE REQUIREMENTS OF ~.~'
GREATER ANCI"[ORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
Performed For
'One res1 is ~or~h a ~ho~sand o~mions"
· S828 TUDOR ROAD. ANCHORAGE, ALASKA gg'~O? · TELIPHON[ 333-8472
C~r~t~ ~T~mbin~ ~ m Date Performed 3/10/75
Leaal Descrintion: L~35-Dlocl~,-~2 Subdivision Eagle River Heights
This Korm Renorts So ls L~Q
li~__ =~- YES ~' Percolation Test
Qe~th
Feet
Soil Characteristics
15
Reddish Silt
Dry Brown Silty Sandy
Gravel
225 S.F./B.R.
BOTTOM OF TEST PIT
Was Ground Water Encountered? NO
Yes, At what Depth?
I
Reading Date Gross Time Net Time Depth to H20 Net Drop
Percolation Rate Ilinute
Proposed Installation: Seeoaae Pit YEs Drain Field
Deoth of Inlet Depth To Bottom Of,Pit Or Trench
C~N~ENTS: ~ Bedroom house. No qround water, or bedrock encountered.
Grab sample takeh for gradation
15'
~est Performed By NmR1 ~. ~Tn,~nnm
Data Certified By: CONSTP.UCTIO!~I TEST L
Date: 3/11/75
GREATER ANCtlOkt\G~ At<LA UOROU(,~
iJepartmen~ of [_l~vironmenLa] Quality
3330 "C" S[reet
Anchorage, Alaska ~9b03
· '4()11,S I,()(;I~'EROI,ATION TEST
Perforn~d for / ~ - ~, ' T~'~ ~te
.. ~,_ ..... ~'~,'~_ __~ _~S~]~-~-Z .......................
Legal Description:
This form reports: Soils log ................. Percolation test
Depth
Feet
lO-
ll -
12-
13-
14-
t~a~"~round water encountered?
If yes, at what depth?
Reading Date Gross Time Net Time
Depth to Woter [let Uroy
Percolation rate minute.
-Proposed installation: Seepage Pit .............. Drain Field
Depth of Inlet Depth to bottom of pit or trenci,
COMMENTS:
040 (6/74)
ert ifiei rillhtg
by
OOC Co. ao&
~:' :~"" /~.o ~ ~ LEE ~r
~DDRESS .
,eton ~VMS£R ,? '~/ 0 6'? 6' .
1~CIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
EIII~RONB4EN TAL PROTECTION
OCT 1_ 2 1979
SULLIVAN WATER WELLS
P. O. BOX 272, CHUGIAK, ALASKA 99~7 · TELEPHONE 688-2759
RECEIVED
DEPTH OF WELL /,/
STATIC LEVEL OF WATER Fr.
DRAW DOWN FT. ~ !
GALS. PER HR
KIND OF CASING
/!
fiND OF FORMATION:
From_ ,Ft. to ,. Ft.
From FI. to Ft
From _ , Ft. to ,,_Ft.
From , , Ft. to ,_Ft.
From Ft. to Ft.
From ,Ft. to Ft.
From Ft. to Ft.
From
From ~
From
From
From ._
From __
From
From __
From .-
From
From.
From__
From __
From
FI. to--Ft.
FI. to .Ft.
FI. to Ft.
.Ft. to ,Ft.
FI, to FI
FI. to_ _Ft.
FI. lo Ft.
FI. to Ft.
FI. to Ft.
FI. to Ft.
Ft.t~ Ft
Ft. to~-Ft
_ Ft. to Ft.
.FI. to ' Ft.
FI. to__Ft.
.FI. to Fl.
Ft. to FtL
MISCL. INFORMATION:
DRILLER'S NAME
MUNICIPALITY OF ANCHORAGE
a`
Development Services Department P p Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 050-281-21
1. GENERAL INFORMATION
Expiration Date:
Complete legal description EAGLE RIVER HEIGHTS BLOCK 8, LOT 5 S2
Location (site address) 10111 LEE STREET, EAGLE RIVER, AK 99577
12-S_iy
Current property owner(s) DONALD & CATHERINE MCQUIGG Day phone
Mailing address 10111 LEE STREET, EAGLE RIVER, AK 99577
Real estate agent Day phone
2. TYPE OF DWELLING:
❑ Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
®
Private Septic
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 6-5-D
Date of Payment $` 211 �� C)no�._
Receipt Number "1501 tN
COSA # 04j(__n�j�g
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
5. 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. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377
Address 4661 NATRONA AVENUE, ANCHORAGE, AK 99516
Engineer's Printed Name MICHAEL N. ANDERSON, PE Date 8/19/2019
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by !p and Anderson Construction & Engineering.
6. DSD SIGNATURE
System #1 Approved for
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
bedrooms
01 :4 9
1�
1111CHAEL N. ANDMMOR.
1 No. CE 9488 /
8/19/19 'V
eslo�=
bedrooms, with the following stipulations:
ff�
By;
Original Certificate Date: �!
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
mom"111111IF_T01:Vil�'ll,1&_3
COSA Checklist X
Septic System Advisory
Well Flow Advisory
COSA Checklist blue sheet
Nitrate Advisory >61
Arsenic Advisory
Other
Legal Description: EAGLE RIVER HEIGHTS BLOCK 8 LOT 5 S2 Parcel ID: 050-281-21
If more than 1 septic system on lot: COSA Checklist # _of Structure served by this system _
A. WELL DATA
® Well log is filed with Onsite (or attached)
Date drilled 1979
Total depth 116 ft
Cased to 116 ft
® Sanitary seal is functioning correctly
® Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 5/14/2019
Static water level at beginning of test 78 ft.
Well production at time of test 3.6+ gpm
Comments
B. TANK DATA — 8/22/2019 - NEW 1250 -gal
Age of tank(s) 0 years
Tank type/material SEPTIC / HDPE
Measured operating fluid level in septic tank
® Standpipes/foundation cleanout per record drawing
Date of pumping NA — NEW TANK
Water storage tank volume NA gallons
Well disinfected for coliform test? ❑ Yes ® No
® Coliform bacteria is Negative
Nitrate 8.5 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ® Arsenic less than MRL (ND)
MI
Collected by '•
Date of Sample 8/19/2019
C. LIFT STATION - NA
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA — Trench: 80'L x 3'W x 5'ED — 193 SF/BR = 800 SF
Which system tested (date installed) 10/1979 & 1975
Adequacy test date 5/14/2019
® ALL standpipes present per record drawing
Results N Pass For 4 bedrooms
Total measured depth from grade 9.75 / 11.1 ft (max)
Fluid depth prior to test 29 / *12 in
Measured depth to pipe invert from grade **see below ft
Water added 600 gal
(min)
❑ N/A — pressurized field
New depth 40 / *6 in
® Monitor tubes go to bottom of effective. If not, state
Elapsed time 1380 min
depth into effective 4'+/- Trench 14.8' Crib
Final fluid depth 29 / *13 in
® Code -required soil cover over field
Absorption rate 600 gpd
❑ System presoaked
Any rejuvenation treatment (past 12 months) N
(Required if vacant for greater than 30 days prior to
date of test)
If yes, enter date
Gallons introduced gallons
FWES
Comments/Deficiencies: Trench / Crib interconnected.
*Below top of crib. No inverts — data inferred based'�
on observations / measurements & MOA docs. Bottom
1-1.5'+/- ED in MTs appear not measureable No backing into
tank during test. Absorption system (Crib / Field) is operating in the top half of the effective depth (ED)
COSA Checklist.docx
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
® Yes
if No
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
® Yes
if No
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' ® Yes
if No
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ® Yes
if No
Neighboring Absorption Fields > 100'
Surface Water > 100'
® Yes
Animal Containment > 50' ® Yes
if No
® Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® Yes
if No
ft
® Yes
if No
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ® Yes if No ft Wells on Adjacent Lots:
Property Line > 5' ® Yes if No ft Private Wells > 100' ® Yes if No
Absorption Field > 5' ® Yes if No ft
Water Main > 10' ® Yes if No ft
® _
Water Service Line > 10' ®Yes if No ft Community Wells > 200' Yes if No
Surface Water > 100' ®Yes if No ft If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
® Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
® Yes
if No
_ ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells > 100' ® Yes if No —ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200' ® Yes if No
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
OF Z4
G. ENGINEER'S CERTLFICATION
1 certify that 1 have determined through field inspections and review ®* 'L�9 TH
of Municipal records that the above systems are in conformance
with MOA COSA guidelines in effect on this date.
p MICHAEL N. ANDERSON.
`Grp No. CE 9469 .• �7
COSA Checklist copy.docx' ..$/22/19•,�'�
�F'ESSSO��'
ft
ft
ft
ft
ft
ft
ft
ft
/ I N 1/2 of Lot 5 j
WOODEN FENCE
I o I
S 8'59'00" 263.9,0'
in
WELL 111.8'
35.8'
CONCRETE
I, s3• o: z o .' PATIO I LLI
4.0' CANT o,,, ! SEPTIC
1r� 'cRf`4 .; PIPES a
LJ
nNW3.8 �f}
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O N.
119.9' T
V �25.
' WOODEN FENCE—`o '
L&J 0\ N
�: 10.0'x16.2' SHED o
LAJo \ O
N
o
S1/2 of Lot 5 GR00-
43,544 S.F. 12.1'x20.5'
Z r GREENHOUSE
N 89'59'00"W 263.90'
i I I WOODEN FENCE I
33.0' i I 33.0'
Lot 6A I Lot 6B I
I
PLOT PLAN ___ AS BUILT X SCALE 1" 50' GRID NW 0053 Project No. 19-425/A2
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, fnC. (907) 522-6476 Phone oOOOoop
(907) 522-4625 Fax _a4 Q A
Professional Land Surveyors ken6longsurvey.com v
Jonathan®longsurvey.com 0�'� ,• S Q
I hereby certify that I have surveyed the following described property:
SOUTH 1/2 OF LOT 5, BLOCK 8, EAGLE RIVER HEIGHTS -1957 ADDN. (PLAT No. P-588)
Anchorage Recording District, Alaska, and that the improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that
no improvements on the property lying adjacent thereto encroach on the surveyed
premises and that there are no roadways, transmission lines or other visible
easements on said property except as indicated hereon.
Dated this the Day of�t�` e , i� °� at Anchorage, Alaska
It is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat.
49TH .7
KENN i cr
t
��{� 4S-520 . •'' y�G
VO�O�SIONA`•Q,,�Q
4000`0
AECC963
I'll I MU.,
"v,. ' 3. z
r
DEVELOPMENT DEPARTMENT
• and Wastewater Section
r
Nitrate Advisory
Certificate of On -Site Systems Approval # osc191388
Subdivision: Eagle River Heights , Block: 5, Lot:S S2
A water sample revealed a nitrate concentration of 8.5 milligrams per liter (mg/L).
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
0M,50 ---mg
om
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filterthat contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
o5o281 \
Parcel I.D. #
1. GENERAL INFORMATION
Complete legal description $ 1/2,
L5, B8
EAGLE RIVER HEIGHTS SUBDIVISION
(1957 ADDITION)
Location (site address or directions) 10135 LEE STREET
Property owner· JOHN T. BECKHAM
Mailing address 101!i LEE STREET
Day phone 753-2583
EAGLE RIVER, AK 99577
Lending agency AK [LqA CRRF)TT []NTON
Ma'iling address ANCHORAGE, AK
Day phone
Agent
Ad dress
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community welt
Public water
NOTE:
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
XX
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21
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 of this Health Authority Approval application 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.
Eagle Riv.. ngL':ccA, ' Sen ices
P.O. ~ox 773294, Eagle Ri~r, AK 99577-~2~
Name of Firm
Address
Engineer's signature
Phone 694-5195
Date 7/29/97
DHHS SIGNATURE
'/ Approved for
bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 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.
72~25 (Rev. 1/91) Back MOA f¢21
Legal Description:
A. WELL DATA
Well type /~,A",~d,4T&~
Log present (Y/N)
Total depth /i~ ~
Sanitary seal (Y/N)
Munici ali o MuNiCIPALITY OF ANCHORAGE
~^r-, ........ P ty fAnchorage ENVJRONMENTALSF-RVI~-~S,~N
DEr~n/IVll:N/(JF HEALTH & HUMAN SERVICES -, '~ ~9~
Environmental Services Division JUL o
825 L Street, Room 502- Anchorage, Alaska 99501-(907) 343-~7~t E IV E D
Health Authority Approval Checklist
y
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed r~ ~'~"~-,~v~"~ "~'
Cased to I/~; ' Casing height (above ground)
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform
Date of sample: ~7 -
B. SEPTIC/HOLDING TANK DATA
Date installed /'~ ? 5;' Tank size
Foundation cleanout (Y/N)
Date of Pumping '7-
C, ABSORPTION FIELD DATA
Date installed /~/~
Length ~ Width
Effective absorption area
Date of adequacy test
Wires properly protected (Y/N)
FROM WELL LOG AT INSPECTION
i ~'~5 ~-/~ -'~ 7
! ;i~ g.p.m. ~o 3' g.p.m.
Nitrate ~. ?/ '~,~/~ Other bacteria
g--,.z~' ~'~ 7 Collected by:
/'~> Number of Compartments '~ Cleanouts (Y/N) _
Depression (Y/N) /V High water alarm (Y/N)
Pumper ']/~ £
Soil rating (ff~o~-or fF/bdrm)
~ Gravel thickness below pipe
~ Monitoring Tube present (Y/N)
Results (Pass/Fail)
Fluid depth in absorption field before test (in.);
Fluid depth ~ (ins) Minutes later:
Peroxide treatment (past 12 months) (Y/N)
72-026 (Rev. 3/96)*
System type ~',~¢,--',~
:5 ~ Total depth //~
· Depression over field (Y/N) __
For ~"
Immediately after ?/.r gal. water added (in.):
Absorption rate = -~- ~( c~ .g.p.d.
If yes, give date ~
bedrooms
D. LIFT STATION /~ j
Date installed
Manhole/~/N)
High w~alarm level at*
Cyc~s tested
Size in gallons
"Pump on" level at*
*Datum
"Pump off" level at*
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot ~-/~ ~
On adjacent lots 'f/~,, '
Absorption field on lot -~/~ i
On adjacent lots
Public sewer main
Public sewer manhole/cleanout f/¢ o"
Sewer/septic service line
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation z.// ' Property line /-/o ' Absorption field
Water main/service line. v-/¢ ~ Surface wateddrainage "/'"'~" Wells on adjacent lots ,'/,,,"
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line /~ Building foundation '/~ /~ Water main/service line
Surface water -~ ,~ '
Driveway, parking/vehicle storage area
Curtain drain
Wells on adjacent lots ~',',~ ~ '
ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review
in conformance with MOA HAA guidelines in effect on this date.
Signature ~'
Engineer's Name
Date ?- ~ ~,-
HAA Fee $ ~ ~
Date of Payment 7./~////~ ~-
Receipt Number .-~/~"~//
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
CT&E Environmental Services Inc.
CT&E Ref.#
Client Name
Project Name///
Client Sample ID
Matrix
Ordered By
PWSID
973938001
Eagle River Engineering
Eagle River Hts L5 B8
Eagle River H~s L5 B8
Drinking Water
0
Sample Remarks:
Client PO//
Printed Date/Time 07/21/97 16:18
Collected Date/Time 07/18/97 09:30
Received Date/Time 07/18/97 13:55
Technical Director: Stephen C. Ede
Parameter
NJtrate-N
Total Cotifo~m
Resutts
3.71
4 OB W/O COLI
PQL
0.500
Units
Attowabte Prep Anatysis
Nethod Limits Date Date Init
mg/L
SM18 4500-NO3F 10 max
SM18 92ZZB
07/19/97 JRJ
07/18/97
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~ _.,~
GENERAL INFORMATION
(a)
(b)
Lega~l Description~(include lot, block, subdivision, section~[ownship, range)
Location~z/~/, ~'~(address or_direc~
Applicant Name./"~f-'~', ~)~-~-~' Telephone: Home ~' ?~"-?'~- ~-~- Business
Applicant Address
(c) Applicant is (check one): Lending Institution []; Owner/I;u.d~er ~r; Buyer []; Other r-I (explain);
(d) Lending Institution Telephone
(e)
Telephone
(f) ,Z~-'~e HAA to the following address:
Address
Real Estate Company and Agent
Address ,~ ~' /
TYPE OF RESIDENCE
Single-Family'~' Multi-Family
Number of Bedrooms
Other
WATER SUPPLY
Well~' Community [] Public []
Individual
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 {11/~4)
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seat 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 ~ & .~ c~T,~,~ ........ Telephone
Address '~. ,'..~LE ~IIVFD p~e ...... /
Date
..... / /
Approved for /-' ~-~.-bedrooms
Approved ~ Disapprove~
Terms of Conditional Approval
CAUTION
The Muncipalit¥ 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 {1 ,/84)
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description:
MUNI'ClPALfTy. OF' ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAl. PROTECTIo/~
JUN 2 4
WELL DATA
Well Classification
Well Log Present (Y~)
Total Depth ~/', J~, Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit
Separation Distances from Well:
To Septic/I ',o',d:,r.G Tank on Lot
To Nearest Edge of Absorption Field on Lot
If A, B, C, D.E.C. Approved (Y/N)
Date Completed ~¢.4off-.- I '~1 ~'~ Yield
'~ ~'~ Depth of Grouting --
Pump Set At
Sanitary Seal on Casing (~N)
Depression Around Wellhead (Y/,,~)
; On Adjoining Lots t ~.~12> ~-~
; On Adjoining Lots
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments ~ ~¢J¢-~--
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot ~ dc'
B. SEPTIC/H~L"B~I~ TANK DATA
Date Installed ~ - I,~
Standpipes~N) Air-tight CapsO/N)
Depression over Tank (Y&I~~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/I,,i~d+¢~ Tank:
To Water-Supply Well
To Property Line
To Water M&:,~/Service Line
Course
Size /~',.~'~) No. of Compartments
Foundation Cleanout (Y/,~i)_
Date Last Pumped ~,-~.Z.-~,~'
¢'~/~ ; for
Temporary Holding Tank Permit (Y/N)
I~:=~'t.5,~ 't' To Building Foundation
~ 1 Jo' To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(1~/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
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 ~ l,~,z.
To Building Foundation ,O~:~
Lot ~~1~'~''~ f'~ '
To Water Mcafn/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway~,Parking Area, or Vehicle Storage Area
Comments~ [~) ~. 'c'~-j'''X~--~ z---~-~
Type of System
Length of Field
Depth of Field I \ ~
Gravel Bed Thickness (12./~"
Standpipes Present ~[~1)
Date of Last Adequacy Test
/
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To C_~tbank (if present) I,,~/~.
D. LIFT STATION
Date Installed
Dimensions
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Manhole/Access (Y/N)
/"Pump Off" Level at
puVmep~'tn:(~'cl:s 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 gu delines
Signed ¢~ ~, . E,'~GI~F..ERi[~ Date
- ,' -SRB
Receipt No.
Date of Payment
Amount: $
Page 2 of 2
in effect on the date of this inspection.
72-026 (11/84)
t DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
~ 825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL ENGINEERING DIVISION J~UNIClPALITY OF ANCHORAGE
Telephone 264-4720 ~ ~ut. t-{t ~ ~ DEPT. OF HEALTH &
ENVIRONMENTAL P~:OTECTION
E 'rE
DIRECTIONS: Complete all parts on page 1. Incomplete requests will riot be processed. Please allow ten
1. PROPERTY OWNER
MAILING ADDRESS
PROPERTY RESIDENT (If different from above) PHONE
2. BUYER PHONE
MAI LING ADDRESS
13. LENDING INSTITUTION I PHONE
'MAI LING ADDRESS
4. REALTOR/AGENT [ PHONE
LEGAL DESCRIPTION
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] Four
~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY ~ Three [] Six
[] Other
7. WATER SUPPLY
INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
**If individual/on-site, give installation date
If system is over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78) ~-~
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
I NSP ECTOR INSPECTOR I NSP ECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[]Septic Tank or [] Holding Tank
Size: I '~.,~-O If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/HoldingTank ]A~orl~tionArea SewerLine [ Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
~PROVED FOR --_~ BEDROOMS
~ CONDITIONAL APPROVAL (letter must acco~p~y certificate)
~ DISAPPROVED
DATE B
~EGA~ DESCRIPTION
72-010 (Rev. 3/78)
MUNICIPALITY OF ANCHORAGE ~ ' '
' ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PRO~E~IO~ (
Telephone 264-472~H, ~X~: '' ' ~ ~
DIRECTIONS: Complete all parts on page 1. Incomplete reques~ will not be proceed. Please allow ten (10) days for processing.
1. PROPE~OWNER PHONE
MAILING ADDRESS
PROPERTY R~SlDENT (If different from above) ' PHONE
2. BUYER PHONE
MAILING ADDRESS
3, LENDING INSTITUTION [ PHONE
I
MAILING ADDRESS
4, REALTOR/AGENT ] PHONE
I
MAILIN6
5. LEGAL DESCRIPTION
STREET LOCATION
6. TYPE OF RESIDENCE [~ SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF BEDROOMS
[] One [] Four
[] Two [] Five
~' Three [] Six
[] Other
7. WATER SUPPLY
/~ INDIVIDUAL*
COMMUNITY
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
**If individual/on-site, give installation date ,/~"~'
If system is over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72~310(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR I NSP ECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SlX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTI LITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY _5 '
Connection Verified INSTALLER
[]Septic Ta, a,a~ or [~]Holding Tank ~
Size: /,-~' If Tank is homemade SOILS RATING
give dimensions: 1 ~ --~ r
TYPE OF TANK MANUFACTURER { /~ _¢_.~_~
TOTAL ABSORPTION AREA MATERIAL
Absorption Area to nearest Lot Line
5. COMMENTS
[~ APPROVED FOR ~-~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
ALASKA 99501
September 14, 1979
Dayton E. Prince
Box 44 Lee Road
Eagle River, Alaska
99577
Subject: S½ Lot 5 Block 8 Eagle River Heights Subdivision
Approval for your individual sewer system and semi-public
water supply located on the lot directly north of you,
can not be approved until the following items have been
completed:
1) The septic tank pumped a receipt ~
with
submitted
to this office.
A percolation test be performed on the existing leaching
area. This test will determine if the system is
adequate according to National Standards. A listing
private firms performing the test is enclosed. If the
adequacy test fails, an upgrade will be necessary.
(3)
The semi-public well is in a pit. The well head will
need to be raised above ground level and the pit filled
with impervious type soil to ground level. ~
M~. Prince
September 14, 1979
Page Two
(4)
The sewer system on the adjacent lot needs to be
relocated so that it is eighty(80) feet from the
tank and 120 feet from the leaching area.
You can choose to drill a new private well to serve your
residence. A permit will need to be issued prior to the
well being drilled.
Please notify this department for a re-inspection when
the noted descrepancies have been corrected. If there
are any further questions, please contact this office
ht 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
DAVID A. SLENKAMP
ROBERT A. SHAFER
MECHANICAL ENGINEER
694-9055
September 25, 1979
I,/,Utq Cr?/,,L~;:' ~ ,,~,c !O~AGE
:L .,]: CT;ON
CIVIL ENGINEER
694-2979
Doyton Prince
Leo Street
5~le ~ver, Alaska
Deqr ~1rs. Prince,
RECEIVED
Re£e~ence: So. ~; Lot 5; Block 8; F~le River Heights 9ubdivtsion
~t your request we preformed a sewer system adequecy test on the system
located on the referenced property.
The seotic tank ~,~s pumped snd in accordance with municipality records
hn~ ~ cspncity of 1250 ~s~lons,
~e seeosce pit ~s also full of w~ter and hod to be pumped. The pii
~s then recharged with 1000 gallons of w~ter.. At the end of a 2& hour
oeriod, oercol~tion from the pit resulted in the removel of approximately
272.7 ~al!ons or 90.9 ~allons per bedroom.
It cnn be~concluded, ss e result of this test, thet the septic tank is
~dem~te, however the seepspe pit is only adequate st approx-Zm~tely 1.8
bedrooms.
I re,et to inform you that the ~y~tem will h~ve to be upgraded for
~nprozi~ntely 1.2 bedrooms.~ You z~y obt~in ~ permit for this upgrading
from tho }~micio~lity, Dept. of Health ~nd F~nviornment~l Protection,
g?5 L Street, Ancbors~e.
If we c~n be of £urthnr ~ervice to you, ple~e do not hesitate to call
~.~unzczpazzty of Anchorage
Department of Heelth and Enviornmentel Protection
SRB 196X EAGLE RIVER, ALASKA