HomeMy WebLinkAboutEAGLE VISTA BLK 2 LT 2( C.-�, ciz a
Cjfo-111-12�
Municipality of Anchorage Page I of a
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SWq`�03a(o PID Number: 050-71112
Name: i�yc,t_ IS C}tQTEi2
Wastewater System: ❑ New Z Upgrade
Address:
PD.Bcit< T?3at2 c-A(z;L-E Ri jelZ Ak. 996 7
FIELD
ABSORPTION
Phone:
6�`{ _ i � I �
No. of Bedrooms:
?j
❑Deep Trench :K Shallow Trench ❑Bed ❑Mound ❑Other
LEGAL DESCRIPTION
Soil Rating:
O 8
Total Depth from original grade:
GPD/Sq. Ft.
Lot: Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
'
1202 EA&L>= VISTA
j' FL
Ft.
Township:
Range:
Section:
Fill added above original grade:
t
Gravel length:
�—
�—
- 3 Ft.
o' -raTAL 80 Ft.
WELL:�r-1 New 13 Upgrade
Gravel width:_ 5f
Number of lines:
Distance between lines:
' EXISTI►J(i
Ft.
oL
5' Ft.
Classification (Private, A,B,C): Total Depth: Cased
Total absorption area:
Pipe material: A�Sr'M
fIZ IVATIE Ft.
5-71 SO. Ft.
F 610 1 x41, r{O Qv/G
Driller: a e Drilled: Static Water Level:
Installer:
lSoTt=u- lDr�$T.
Date installed: �1
10 - lot- OPS
Ft.
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION
DISTANCES
❑ Septic ❑ Holding jaS.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer:
Capacity in gallons:
`,QS -0
From
Tank
Field
Station
Tank
Sewer Lines
t.tG}IoQA isE (At31�
Well-
11131Ilrol
I ISI
—
I
o?S t
Material:
STEL
Number of Compartments:
a-
Surfac
too `+
_
_
LIFT STATION
Water
IcXo'+
loo'+
Lotf
30
I
Il
t
-50
_
Size in gallons:
Manufacturer: �.
Ar.Ic++O,eA�a IAt4l,
Line
loso
Foundation
t
I L1
I
13
I
1'{
—
—
.'Pump on" level at:
ya"
"Pump off' level at:
32"
High water alarm at:
,fy"
Curtain
NO
KN
��
Pump Make & Model
Electrical Inspections performed by:
1 S H0f!Nb+c4Cl.f, 1.. B jldlley
Drain
ost 05NM
BENCH MARK
Remarks:
ation and Description:
To OF vAANHot_tf CAVa-12
Post -It b and fax transmittal memo 7671 # of pages ►
To From J \,2rj0 GAL5..1 .� •� SYSTtSv�n
Co. Co. Assumed Elevation:
100.0
Dept. Phone #
ENG(Ft
EAL
Fax # 3K 3-Ca5_°l 5 Fax F A�
........
S 8 S ENGINEERING °;.r J�
Inspections perfor lv p7 34 Eagle River Loop Road, No. 204 Dates: 1 st ► o ...'..�-...,
rr��YRi
, �r�.-....
F
2nd to - 1°t _ q5 :_,
f�Q
ROBERT C. COWAN
�f c .� CE - 8801 a`"'
Department of Heal t and Human Services approvalaU'',� .;.�r
Reviewed and approved by: Date:
72-013 (Rev. 9/91) MOA 25
Permit No. SW950326
Page 2 of
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: LOT 2, BLOCK 2, EAGLE VISTA S/D PID No.:
05071112
ST1
11 ST2
100.0'
MH
07.8'
FINAL GRADE
MT 2
EW
1010,
MITI
95.0'250
GAL
3.T.E.P.
94.8'
SYSTEM
R
10
.5'
97.2
SR
102.5'
FCO
3'
6'
N NEW
TRENCHES
C01
6'
12'
95.z
ST 1
7'
14'
ST2
2'
20'
♦ 90.5' NO
WATER FOUND
10-
8-95
��
MH
4'
22'
MT1
7'
28'
MT7
53'
T1
HE CM
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5 1
FC
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coil
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•••- •�^^^••��
ROBERT S.. COWAN
A,
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BE USED IN THE FUTUR
ONNECTED AND CAPPE
WELL
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1. = 40'
t
72-013 A (flay. 9/91\M CIA 25
�I �.-1 l•-•ir ���. �.Ip.r iil ,.LI U_ :_._.Ilul_. .... vn
OCT 24 '95 1366 MORTGOGE SERVICING
Name of Wyagu
Alaska USA Lan No. _
►ropeny Address ►roprn Occupied by
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Nomes.Addruses and Talephone Numbers of prokers.
fly
OCT 24 '95 14:13 9675633867 POGE.662
e Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: 1HI� L.15 `— DATE PERFC
/
LEGAL DESCRIPTION: L -V L �uLZ J✓PV'L'U- IIiSYATownshipI Range, Section:
D � '.� I, �Q.i� SLOPE SITE PLAN
1 /
2
3 U Q
4-
5-
6-
7-
8-
9-
10
5 68 910 130A
11
12-
13-
14-
15-
16-
17-
181
2131415161718
19
20
COMMENTS
WAS GROUND WATER,
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth to Water After
Monitoring? Date:
PERCOLATION RATE (mmutee/imh) PERC HOLE DIAMETER L
TEST RUN BETWEEN 2"'� FT AND 317 FT
PERFORMED BY: SACS '�hI�S%'%4"'15 I �'�`��'i6 CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
October 24, 1995
To Whom It May Concern:
This is to verify that the 1250 gallon lift station located at lot
2 block 2 Eagle Vista has been correctly wired per the NEC code.
Since ly��
evin S. Hornbuckle
Residential Electrician License Number 119104
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE (�
DEPARTMENT OF HEALTH AND HUMAN SERVICES q_
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW950326 DATE ISSUED:10/06/95
DESIGN ENGINEER:S & S ENGINEERING EXPIRATION DATE:10/06/96
OWNER NAME:CARTER PHYLLIS
OWNER ADDRESS:P.O. BOX 773212
EAGLE RIVER, AK 99577
PARCEL ID:05071112
LEGAL DESCRIPTION:
EAGLE VISTA BLK 2 LT 2
LOT SIZE: 124426 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
THE EXISTING CABIN MUST BE CONVERTED TO A HEATED SHOP AS
STATED ON THE APPRAISERS SPECS. PRIOR TO CONSTRUCTION OF THE
DRAINFIELD, A SECOND TEST HOLE MUST BE EXCAVATED TO VERIFY
BEDROCK DEPTH AND PERC RATE.
RECEIVED BY:
ISSUED BY:
DATE•
DATE •it-) C G
HEALTHAUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER& WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTEWATER
DISPOSALSYSTEM
DESIGN
S & S1 ROBERTC.COWAN, RE.
jineenrnG ROBERTA. SHAFER, P.E.
/October , CIVIL ENGINEERS
D
(907) 694-2979
FAX(907)694-1211
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES RECEIVED
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650 OCT 51995
til unictpdit t
DeptNeaith.&"umanhora9e
REFERENCE: Lot 2 Block 2 Eagle Vista Subdivisioq Services
Dear Robbie,
After several lengthy conversations with all parties involved
we have come to the decision to aerwert the existing cabin
located on the referenced property into a heated shop.
Attached is a letter, from an appraiser, specifying the
kitchenette including appliances, sink, and cabinets will
need to be removed.
Also, not mentioned in letter, but discussed with the
appraiser, the closet located in the bedroom will need to be
removed and converted to a storage area.
The proposed 80 ft. long trench has been changed to two 40
ft. long trenches. A second test hole will be excavated at
time of construction (see attached site plan).
Please make a note on the permit under special provisions
"The cabin will need to be converted to a heated shop as per
appraiser's specifications. A second test hole needs to be
excavated to verify bedrock and percolation rate."
If we may be of further service please contact us.
Sincerely,
Robert C. Cowan, P.E.
v
ItOBERT C. COWAN !�?
J%) o 1 i�� ���
CE -8801 �',
4hC,0FcSS�����}.
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
key
$ 9075631360 RPPRRISRL CO RK
E cAlug a
304
October 3, 1995
Attention: Kathy SteW)&n"
Vista M01104ge
4121 '6' Street, Suite 0304
Anchorage, Alaska 89603
Dear Ms. Steinborn:
RE, Lot 2, Block 2, Eagle Vista
NHN Eagle Vista Drive, Eagle River
buyer: Hastings
VA: 297 939
01
Tdaphora (9071
562.7424
This letter concerns the above referenced property and the utility of the second
structure on site. 11)o utility of the second structure would be reduced to that of a
bedroom or heated shop area with the removal of the kitchenette including appliances,
sink, and cabinetry. Without the amenity of the kitchenette, the second structure would
have no possibility of being used as a mother in law apartment, studio apartment, or
t 11,11 nit
second separa a "Um .
if you have any further question, please contact us at your convenience.
Very Truly Yours,
Richard W. Sheasley SRA, AA 0116
Appraiser and Con Itant
Poat4i" brand tax transmittal memo 787110 °lam'
TP r. A(A �smn 07
2
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OCT 3 '95 11:49 9075631368 TE.001
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HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER& WATER
INSPECTION
ENGINEERING STUDIES
ANDREPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
September 12, 1995
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Lot 2, Block 2, Eagle Vista S/D
ROBERT C. COWAN, P.E.
ROBERTA. SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX(907)694-1211
Request you issue a permit to upgrade the septic system
serving the three bedroom house on the referenced property.
A test hole was excavated and a percolation test performed
in the area of the proposed upgrade. The approximate
location of the test hole is located on the attached site
plan.
At the time of excavation no water was encountered in the
test hole and after seven day ground water monitoring, the
monitoring tube was found to be dry.
Attached is the proposed upgrade design.
We do not anticipate any adverse effects on neighboring
wells, septic systems or drainage patterns by the
installation of the proposed septic system.
If you require additional information, please contact us. J
/
Sincerely, k v� e 7C1 -S11 74
Robert C. Cowan, P.E. �a�6 � ��nd �/
,
RCC/gk
Lias V/
Enclosure &OIL4.,
/'/o u u h1,s 3
Ci lo, y s`.n�c 71G o1Bti„neC� re)
�F�� �'.ye T s, t >�o �D�e i e (�
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR:'EI_Q DATE P
LEGAL DESCRIPTION: L-, % �.1L-L �OQ.IF U,,�9Wnship, Range, Section:
I
SLOPE SITE PLAN
FEEH l.' — t' O9-- 1 1 1 1 1
s
v
7 ,P
8 o
fm
�1�v4r�T S,L-s-
5.0. A
10
WAS GROUND WATER 1 ENCOUNTERED? v
IF YES, AT WHAT L
O
12 -DEPTH? p
E
Depth to Water Aft��-eT-ry�
13 Monitoring? TDate:
14
is-
16-
17 -
18
5161718
19
20
COMMENTS
®®®®m
off M-1
PERCOLATION RATE +� (minutes/inch) PERC HOLE DIAMETER L_
TEST RUN BETWEEN 2'� FT AND �'� FT
PERFORMED BY: S & S ENGINEERING "') P CERTIFY THAT THIS TEST WAS PERFORMED IN
17034 Eagle River twp R=d .+0
ACCORDANCE WITH AEai§1b6M& ydWAiNIC9WMUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
ROBERT C. COWAN, P.E.
ROBERTA. SHAFER, P.E.
ON-SITE WASTEWATER DISPOSAL SYSTEM CIVIL ENGINEERS
(sol) 694-2979
CONSTRUCTION PRACTICES FAX(907)694-1211
and
MATERIAL SPECIFICATIONS
HEALTHAUTHORITY
APPROVALS
Lot 2, Block 2, Eagle Vista S/D
September 12, 1995
SEWER& WATER
MAIN EXTENSIONS
1. The scope of this project includes the installation of
a 500 gallon S.T.E.P. system and a five foot wide
SEWER&WATER
drainfield to serve the existing three bedroom
INSPECTION
residence on the referenced property. The existing
septic tank is to be excavated to verify integrity.
If of poor integrity, the tank is to be pumped,
crushed and abandoned and a 1250 gallon S.T.E.P. tank
ENGINEERING STUDIES
installed in place the ro d 500 gallon S.T.E.P.
proposed
ace o ose
AND REPORTS
tank. The existing leachfield is to be abandoned such
that it may be used in the future.
2 • Construction shall be in accordance with the approved
WELL INSPECTION
&FLOW TEST
site plan and design drawings, Municipal permit with
any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal
Regulations.
SITE PLANS
3. The contractor shall be responsible for obtaining any
necessary underground utility locates.
ROAD DESIGN
4. Unless specifically agreed otherwise, the property
owner shall be responsible for final grading areas
subsequently depressed from soil settling. On all
leachfield mound systems, the property owner shall be
SOIL TEST
responsible for ensuring a satisfactory vegetation
growth over the mounded area.
5. Contractors installing wastewater disposal systems
must be certified by the Municipal Health Department
PERCOLATION
TEST
for system installations. Owners installing their own
systems must also receive prior approval from the
Municipal Health Department.
STRUCTURAL&
MECHANICAL
INSPECTIONS
SEPTIC TANK INSTALLATION:
1. A septic tank is to be constructed by a certified
septic tank manufacturer. Construction shall include
ONSITE
two 4" cleanouts for pumping access.
WASTEWATER
DISPOSALSYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
Page Two
Lot 2, Block 2, Eagle Vista S/D
September 12, 1995
2. The septic tank shall be sufficiently bedded to prevent
settling or shifting of the tank.
3. All standpipes on the septic tank shall extend a minimum of
12 inches above final grade.
4. Septic tanks installed with less than 4 ft. of cover shall
be insulated.
5. A foundation cleanout shall be installed one to four feet
from the building foundation. In the line between the tank
and the leachfield there shall be two adjacent cleanouts
(unless an effluent pumping system exists within the septic
tank). These cleanouts shall be located on undisturbed
soil not more than 10 ft. from the tank. The first
cleanout, in line, shall be to clean toward the leachfield.
The second cleanout shall be to clean toward the septic
tank.
6. Final grading over the septic tank shall be such that a
positive slope exists away from the septic tank.
ABSORPTION TRENCH/DRAINFIELD INSTALLATION:
1. Excavate the proposed trench to the dimensions shown on the
design. The bottom of the excavation shall be within 2
inches of level. If the sidewalls of the excavation become
smeared, they must be raked or scratched (roughed -up)
before gravel (sewer rock) placement.
2. once the gravel is installed, the distribution pipe is to
be installed level with the perforations faced downward.
Gravel is then to be placed over the distribution pipe to
provide a minimum of 2 inches of cover over the pipe.
3. A silt barrier must be installed between the final gravel
layer and the native soil backfill. Ensure the silt
barrier covers the entire gravel surface before placing
backfill.
4. Monitor tubes shall be of four (4) inch diameter,
installed approximately in the locations shown on the
design, and extend a minimum of 12 inches above final
grade. The portion of the monitoring tube extending
through the gravel shall be perforated from the bottom of
the trench to the invert of the distribution pipe. This is
equivalent to the effective depth of the gravel as noted on
the design.
Page Three
Lot 2, Block 2, Eagle Vista S/D
September 12, 1995
5. Backfill over the final gravel layer must not be less than
twenty-four (24) inches. Insulation must be installed when
the backfill depth is less than thirty-six (36) inches.
The finish grade over the trench must be mounded to prevent
the formation of a depression after settling.
MINIMUM MATERIAL SPECIFICATIONS:
1. Any septic tank proposed for installation must be
constructed by a Municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic
system installations in the Municipality of Anchorage:
Tvne of Pine Perforated Solid
Cast
Iron
Yes
Yes
ASTM
D3034
(PVC)
Yes
Yes
ASTM
F810
(HDPE)
Yes
No
ASTM
D2662
(ABS)
Yes
Yes
Use of a type of pipe other than listed above must be
approved by the inspecting engineer.
3. Insulation shall be at least 2" thick extruded direct
burial polystyrene (Dow Chemical Company Styrofoam HI or
equal).
4. Septic tank inlets and outlets shall be fitted with
watertight couplings (Caulder, Fernco, or equal).
5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N,
or equal) must be installed between the final leachfield
gravel layer and the native soil backfill.
6. All leachfield gravel (sewer rock) shall be 0.5"-2.5"
screened gravel with less than 3% passing the #200 sieve.
7. When sand is being used as a filter material, its gradation
specifications must conform to current M.O.A. or D.E.C.
requirements.
Page Four
Lot 2, Block 2, Eagle Vista S/D
September 12, 1995
INSPECTIONS:
Typically there will be a minimum of three (3) inspections
required during the installation of the wastewater disposal
system. These inspections will occur as follows:
1. The first inspection must be conducted after the
excavation of ditches, pits, trenches, or beds and
before the installation of any gravel. A septic tank
may be set in place, but may not be backfilled before
this inspection.
2. The second inspection must be conducted after the
placement of the silt barrier, gravel, distribution
lines, standpipes, cleanouts, and insulation, but
before the placement of any other backfill.
3. The final inspection is to occur upon final grading of
the property.
Often there will be more than these 3 inspections required.
Especially with the installation of multiple trenches, sand
filters, pressurized distribution systems, etc. Thus, the
inspecting engineer is to be contacted at least 24 hours prior
to the start of construction. If necessary, a pre -construction
meeting will take place on-site. The inspecting engineer will
not coordinate, direct or control in any way the contractors
activities.
The owner shall contract with the contractor to perform the work
outlined in these specifications and plans and in accordance
with the attached M.O.A. permit. There will be no contractual
arrangement existing between the contractor and S & S
Engineering. S & S Engineering shall be the owner's
representative and will inspect the work as stated above to
document the contractors activities. Final acceptance of the
contractors work rests with the owner and the M.O.A.
Page Five
Lot 2, Block 2, Eagle Vista S/D
September 12, 1995
S & S Engineering shall have no liability to the owner or to
others for acts or omissions of the contractor or any other
persons performing work on this project or the failure of the
contractor to carry out the work in accordance with these
construction documents. S & S Engineering's inspecting engineer
will not be responsible for the construction means, methods,
techniques, sequence, procedures or the safety precautions
incident to this project.
CONTRACTOR/INSTALLER
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
PHONE
NEW
y�
1,A e- 5 �r
563 — 79 �,3
0 UPGRADE
MAILING ADDRESS
b(S L_ N aIOOa P R_
LEGAL DESCRIPTION
I..0T ` gu2 Gr G.L_L V15T h
LOCATION
NO.OFBEDROOMS
12u0(40i5:— C3 AE 2DAp
'5
Well
Absorption area
Dwelling
PERMIT NO.
Uy
DISTANCE TO:
100
I ;>a
/O
831001
PZ 2
Manufacturer
U 12.�I= YL
Material
Si k �L_
No. of compartme is
Tivf t?
UJ
Liq. capacity in allons
I EJ &
I F HOMEMADE:
Inside length
Width
Liquid depth
C Y
DISTANCE TO:
Well
Dwelling
PERMIT NO.
J0z
_ F
Manufacturer
Material
Liquid capacity in gallons
O
Well .Jj-
Foundation
Nearest lot IV
PERMIT NO.
LU
DISTANCE TO:
il�
15a
3o
J LL Z
No. of lines I
Length of each line
Total length of lines
Trench width
Distance between lines
BZW
%-5
5
/Of'f
Qcc H
Top to finish
Material beneath tile
Total
of tile grade _
effective absorption area
inches
Length
Width
Depth
PE RMIT NO.
Lu
Q f
Type of crib
Crib diameter
Crib depth
Total effective absorption area
wa
Lu
Well
Building foundation
Nearest lot line
DISTANCE TO:
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
3
Building foundation
Sewer line
Septic tank
Absorption areals)
DISTANCE TO:
OTHER
PIPE MATERIALS
44TO D 303
SOIL TEST RATING
INSTALLER
SM�2i
REMARKS
OF'4IAw
vs
®ow
C` -n. •••o•2225-F-
uNE 25, is/>.
ti
+ K
APPROVED DATE LEGAL
ko I a, �;� 4 L t"IlS
72-013 (Rev. 3/78)
^ ^ I F`rII CHF--
' . DEPHRTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
~ �25 'L' STREET, ANCHORAGE, HK 99501
264-4720 : ANCHORAGE 694~21]1 EAGLE RIVER
C) t"i T _T EE i.-A EF F_" �E��. I I F=, E.--- F_ Irl I -1F
PERMIT NO. 871001
APPLICANT: LARRY SMART PHONE: 56]-78]]
ADDRESS: 615 LHKEWOOD DR.
HNC, HK 99502
LEGHL DESCRIPTION - SUBDIVISION: EAGLE VISTA BLOCK: 2 LOT: 2
LOT SIZE 122700 SQ.FT. TOWNSHIP� 1]N RANGE: IE SECTION: 4
MHXIH0M NUMBER OF BEDROOMS = ] SOIL RATING = I.E.
165 165 (SQ�FT�/BR)
LISTED BELOW ARE THE OPTIONS HVHILHBLE TO YOU IN DESIGNING YOUR SEPTIC
SYSTEM. CHOOSE THE OPTION THAT BEST FITS YOUR SITE.
- - - - - - - - - - - - - - -- - -- - - - - - - - - - - - -- -- - - - - - - - - -
-F i:;:.EF t4 C� E�- ET I '_���
WIDTH = 2.5 FT.
LENGTH 8I0 FT. ! NOTE ! - }75 FT. REQUIRES TWO TRENCHES
TOTAL DEPTH 60 FT. ! NOTE REQUIRES INSULATION
GRAVEL DEPTH 0 FT. ! NOTE ! -'MAY REQUIRE LIFT STATION
GRHVEL VOLUME = 26.8 CU_IT' DS.
THNK SIZE = 1,000.0 GALLONS (TWO COMPARTMENT TANK)
E� 1EE Cm Cit-4 .� l � � '
�'�r/��/ ��/��
WIDTH � 20.0 FT. �� ' ' /
�°~ _ . ' /
LENGTH = 40 0 FT /
� ���/� ��_�� »*/
TOTHL DEPTH � 5 0 FT / ''�
� � c� /
6RHVEL DEPTH = 0 5 F'[ ��' /,��
� 7 v~ ��/7
_' __-_ /
GRHVEL VOLUME � 29. 6 CU. YDS. /
TANK SIZE 1,000.0 GALLONS, (TWO COMPARTMENT TAN[;....
1-41 CvE=_ F--F-:F=f 1 14 F=- I���
WIDTH = 5.0 FT.
LENGTH = 70.0 FT.
'TOTAL DEPTH FT.
GRAVEL DEPTH 2.0 FT.
GRAVEL VOLUME = ]2.4 CU.YDS. `
TANK SIZE 1,000�0 GALLONS TWO COMPARTMENT THNK)
- - - - -- -- -- - - - - - - - - - - - - - - - - - - - - - - - - - - - -
I CERTIFY THAT:
i. I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS HS SET
FORTH BY THE MUNICIPALITY' OF ANCHORAGE AND THE STATE OF ALAS[--:'.A.
2I WILL INSTALL THE SYSTEM IN HCCORDHNCE WITH THE CODES AND HAVE RECEIVED
H COPY OF THE CODE SUMMARY AND DIAGRAM ATTACHMENTS WHICH IS PART OF THIS
PERMIT.
I I UNDERSTAND THAT THE ON—SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS.
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM PERSONNEL DURING
THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND
THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
IF A LIFT STATION IS !NSTAU_EDAN E ECTRICHL PERMIT AND INSPECTION MUST
�E OBT ELECTRICAL INSPECTION
REPORT. T LICENSED ELECTRICIAN.
SI6NE��
------------------
F-I.PPLICHNT: LARRY SM T
DATE:
ISSUED BY:
' `
- x SOILS LOG
MUNICIPALITY OF ANCHORAGE �JR PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST
\ 825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: JJGL CARTEZ DATE PERFORMED: OC•e-y
LEGAL DESCRIPTION: LOT r BLOC-� I 0. EAGLa VIST^ SGgf 113N/"n
ik
SLOPE SITE PLAN
F PT ORGAN IGS I I I I I
1
2
.r
3
•0 4r
a '• r
5
6
7
.r
8 •
9 •
10
11
12
13
14
1 �P'•
r
49 fi
SQA%/ %ANpy slur
pCHSCE:
occ-A. sou1,.b-v4C-1
sM
Eel
27 T
Q JUNE 25, 1971 4(;"r4'0
19-
20 186' 6..•M1• •. ���.�,:
19 20
COMMENTS_ e. CO W7 LN'
La +� C� 3
PERFORMED BY:ro,
72-008 (6/79)
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
!D•/O•�
O
L
2 O
L
3v
U
so
0
3�i
1
PERCOLATION RATE (mi utes/inch)
TEST LIN BETWEN FT AfVD t FT
.!/0"
CERTIFIED BY: 17 S DATE: iy .04 e.1
CHUGIAK, ALASKA
68831991'�'�• KID DIAK, ALASKA _
t 'q 486826;
tl ;, .CO.:.
WE.SERVE ALL ALASKA •• -
_ POST OFFICE BOX 42,-CHUGIAK, ALASKA 99567 •: ,: ,:,,, ,
!OWNER OF LAND ...AZis1and..PbylLiz ... Cartes=....:..:........:..'• t DEPTHOF.WELL......:...160ft.L :.^\. .:` ..::.:.:.::.
.:ADDRESS .:. f}..,84. ......1` I..;:� I2 t..a�!`. 149$77:.:.':: ` �•.',\�< `r'.:STATIC LEVEL OF WATCR`ho s'
WELL - SITE ...... L..2... n... 2...Ea g.Le..:Vista...Suh'.....::..:..:...::..: ' :.:
FT...
,DRA ......... 00%eSt
..............................
:'DATE-STARTED.............. 9'2,Qr..8.3::.:.......:.....:........:. .
DRAW . .
VN FTZ'
•1
40 gpli 'est.
r GALS. PER FIR::....::.................
DATE -ENDED ..............: 9-23' 8 3 :'
OF
.........................................:..........::........`::::::,' ... -.
60f :.of '6• Sch4...
:'KIND CASING'.::.1.........t'.:....................
......... .
.. -. it
KIND OF FORM1tAT10N: �%: � - '
FROM ........ �.:...... verburde
fT. TO .....:12 ::..:.... FT....................................
111'
FRO. ...................... FT: TO
:. FROM ........12.......: FT. TO ......2II..:....... :. FT
r - - -,.._ .. _ ..
...
-30' Boulder ."_.. _ ..
av FROM
FROM .....:.. d.......: FF. TO ..................:... FG ..................
. ,.
FROM :..
..... ......
....: FT. T0:' .
FT
FROM ........ 30........ FT: TO ......60......::. FT. Ssnd.:A...Sz7CaY..e FROM ...:....:.'....:::....: FT. TO .:..........:........:.: FT..........:...:.:..... .
FROM .......:60..:..:. ; -
Boulder - _ ""'
FT. To :..... 63.::....... FT.B r, - .
:FROM; .- � ,-
3....:... FT. TO....... IQQ....... FT.5S1110...�L..�ax.A.Y. �
-.s.FROM ......... :.. ...... FT. TO ......................... FT.
-FROM_......104 Boulders, .
FROM ........104 .. I I' assorted_„poulders
FROM ,...*.. FT .TO�.:....::..::�,. FT
FT. TO :....:121....... Fr................... r.....
121- ... :.... '
..........
FROM ...................... FT. TO ......124....... FI'.Boulder
.......
124
:F
150. Dirt &.boulders
ROM1I
,FROM ........ ..
FROM -
.. . FT
FT. TO ............ ..:..:FT
;..: FROM ::.:..............
.TO. FF.. :1
:..�
FROM1I,.......15n.....FT.TO......j6
Boulders ......
.�....... .....
1)0
.....
.9 ......
,nra
titer. :: "
vel;
,m:
�F
FROM
. OM
........... .
.... FT: TO
FROM . FT: TO ...:.....::......... FI..:.............:....
FT. TO .::....:...:::.. FT...
.1-..' ...:. ..';,.'FRO ...:.: ..:.....:...FT,TO• �'" ..
..,-: MISCL:.INFORMATION: Hans um y• ..-
M:
3 pump off bottom.;'f:o Warranty.or no.warrahizes ,zmplzec].
_ _ -..... :DRILLERS NAME..::'�orcrt..S:'.ilc?rt'
.. -. _ , - • ,..••...••...nnn............•.....................nnn• r .� y
Parcel I.D. #
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
Cs0-7((-1Z \,
1. GENERAL INFORMATION
HAA#
Complete legal description Lot 2; Btock 2; Eagte Visa. Subdivision
Location (site address or directions) Ea9ke Vii to Dn2ve
Eagte Rivet, AK
Property owner PhyfLia Cantoll Day phone 694-1313
Mailing address P.U. Box 773212 Eagte. Riven, AK 99577
Lending agency
Day phone
Mailing address
Agent Kick Moae.sl VISTA REAL ESTATE Day phone 273-7250
Address 4241 "B° Street Anchorage AK 99503
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well XXX
Community well
Public water
NOTE: if community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site XXX
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rw. 1191) Front MOA *21
S. 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 furtherverify 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 5 & S ENGINEERING Phone % c1 y �� '7
age River Loop Road No. 204
Address Eagle River Alaska 99577
Engineer's signature Date
6. DHHS SIGNATURE
X Approved for
Disapproved.
By:
;o ROBERT C. (]COWAN
��1.,'•� CE • 8801
Y f -• " h
L47T, ffe=
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
111TIC
Date lU — 3U — qs
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 orderto 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 (AN. 1/91) BWk MOA Q1
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division
825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744
Health Authority Approval Checklist
Legal Description: LOT $cocky EAGLW VISTA Si0 Parcel I. D.: 0507111 a p Z
g' P �
tn
70 D j v
A. WELL DATA
o
Well type ilei VATEE If A, B. or C. attach ADEC letter. ADEC water system number
� f <
n �
Log present (7)N) \%ES Date completed0'3 D p
Total depth (6C) Cased to 1 t' b Casing height (above ground) 1 1 +
t Z
Sanitary (Y seal ) \TES Wires properly protected t4)
FROM WELL LOG AT INSPECTION
Date of test 9"x3'83 7-1$-45
i
Static water level '`/O
Well production 1 g.p.m. 3 • a g.p.m.
WATER SAMPLE RESULTS:
Coliform Nitrate Other bacteria
Date of sample: I d- a 3" C S Collected by: k 0.V S h Crre r
SE OLDING TANK DATA
Date installed 10-19 -q S Tank size kaSO4" Number of Compartments Cleanouts Y N) ViES
Foundation cleanoutON) "/4'S Depression (Yo QO High water alarmQf�y'q) �(�S
Date of Pumping NIA N; Pumper
C. ABSORPTION FIELD DATA
'�Qsss�rz�z�
Date installed -10 -19 -9 Soil ratin (g.p.d./ft ft'-/bdrm) `� System type SHA1-LaW T12&-�-1,'-4
a��4a 1
Length -rm*e� 815' Width S Gravel thickness below pipe Total depth (o ,
Effective absorption area 5710 Monitoring Tube presenoYY N) ES Depression over field (YQ t4o
. ww
Date of adequacy test /V A s sTdMA Results (Pass/Fail) For bedrooms
Fluid depth in absorption field before test (in.); Immediately after gal. water added (in.):
Fluid depth (ins.) Minutes later: Absorption rate = g.p.d.
Peroxide treatment (past 12 months) (Y/N) If yes, give date
D. LIFT STATION
Date installed (0 - 19 —cV5
Manhole/Access Y�I) 7 E'S
High water alarm level at*
Cycles tested
E. SEPARATION DISTANCES
Size in gallons l -a!5- 0 GA c
"Pump on" level at* "Pump off' level at* 3�
*Datum
SEPARATION DISTANCES FROM WELL ON LOT TO:
I
e
z-n—tic'ldioldini, tank on lot 11$
Absorption field on lot _
1jbr
On adjacent lots 100 �t
On adjacent lots
100
Public sewer main -75 ( t Public sewer manhole/cleanout
Sewer /septic service line
'a +
Lift station 1 t S
�on'r
SEPARATION DISTANCES FRO SEPTIC LDING TANK ON LOT TO:
1 1
Building foundation `i Property line 30 Absorption field 1 a
Water main/service line I D + Surface water/drainage 100 + Wells on adjacent lots 100 +
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation t 3/ Water main/service line
I
Surface water loo +
Curtain drain xvoNr- KN'wh/
F. ENGINEER'S CERTIFICATION
I
10+
t
Driveway, parking/vehicle storage area 496
Wells on adjacent lots loo d- Property line
I certify that I have determined thru field inspections and review of Municipal records that �tt�taz sctems are
in conformance with AfGA ILA 4 ideli s in effect on this date. ,�-.� � C < < i + `• ;
Signature _ /BwAnJ
/�a/'d�
Engineer's Name /1� ` �Jt 'dY, "'•�`/
Date ROBERT C. COWAN ^- p
QFC
CE -8801
l
HAA Fee $ 6(l)
q
Date of Payment /C)
Receipt Number Z-3 / (J Z ff /
Rev. 8/95 OSS: haa.wk.doc
Waiver Fee $
Date of Payment
Receipt Number
t l'N'al l .1:� -1A,w ('iAA\Y_ 4-r)vE'ro' Lt`l bE +i)Ev 42- r7
- -
Time
APPLIC AT FILLS
OUT UPPER HAI ONLY
Pro�+ay Owner
).. 7t (i !�. (�
f, hone
Mailing Address—
f I
Zip CodeCk-
Buyer
Date
Date ( /
Address
Inspector
Zip Code
Lending Institution
F \J r C ,:- .t
i. !- -
Phone
Address`C.-4-�
Field Not -�¢T S9•vr�.�
���- � �l ,Y -.i ;' Zip Code
/�_Ip,,,,.�n
Realty Co. & Agent
OK
,�cc
Phone
Address
( ) APPROVED BEDROOMS �--"
Zip Code
P
Legal Description
(( I
Street Location
DATE 2 ��
Type of Residence
mgle Family
Soils Rating
❑ Multiple Family
No. of Bedrooms
Well Log Received
❑ Other
Water pply
Individual
ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
❑ Community
For wells drilled prior to that date, give well depth (attach log if available).
❑ Public Utility
Sewer D' osal
ndividual
Year Individual Installed:
❑ Public Utility
When Connected to Public Utility:
Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
t l'N'al l .1:� -1A,w ('iAA\Y_ 4-r)vE'ro' Lt`l bE +i)Ev 42- r7
- -
Time
�_ , .
Time
Time
Time
.-�
Date
Date
Date
Date ( /
Inspector
Inspector
Inspector
Inspector
l� Lis
15 .
Field Not -�¢T S9•vr�.�
/�_Ip,,,,.�n
OK
,�cc
OIL C'0
( ) APPROVED BEDROOMS �--"
'CONDITIONS OF APPROVAL
P
- ( ) CONDITIONAL APPROV L'
DATE 2 ��
BY:
Soils Rating
Date Sewer Installed
Well To Absorption Area
Well Log Received
Septic Tank Size
Well to Tank
January 6. 1984
Otis D and Phyllis A. Carter
P. u. box 770410
f.ayle diver, AK 99577
subject: Lot 21 Block 2, Eagle Vista Subdivision
Approval for the indivictual sewer and water taciiities cannot
be granted until the following items have been completed:
W well lo:j submitted to this office for our tiles and
review.
° The top of the well casing should be sealed so that it is
water tight.
° Exposed electrical wires to the well head are in violation
of the Municipality of Anchorage codes and mist be encased
in conduit.
°r
'1 e pe r.Frit for the installation of the on-site sewer system
ill expire Oecember :31, 1983. lie have not received the
� as-builts of the installation in this office. If a private
L engineer inspected the system, please send us the report
for our files and review.
Please notify this Depart�2ent for a reinspection when the
noted discrepancies have been corrected. It there are.any
further questions, please call this office at 264-4710.
sincerely,
Cory Willis, R.S.
/acting Sewer & ,dater
Program Mana:3er