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Home My WebLink AboutEARL RAY BLK 2 LT 13 ' " 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 MAI LING ADDRESS LEGAL DESCRIPTION LOCATION I D STANCE TO' Well i~/ O,_~/ _o~ ' I !-~¢ -- I- 2 I Manufacturer c~ Liq. capacity in gallons ~,~--~ ~) ,r ~ .......... : ~0__~ Manufacturer ~ I IWell ,,J, -rI DISTANCE TO: I .~ u- 2 I No. of lines Length of each line "- ~ ~ Top of tile to finish grade uJ I L. ength Width Well ~ [Class Depth .~ I Building foundation DISTANCE TO: IAbsorption area Dwelling Material W dth PHONE [ [~NEW NO. OF BEDROOMS PERMIT NO. No. of compartments I Inside length Liquid depth Dwelling PERMIT NO. Liquid capacity in gallons Foundation PERMIT NO, Material Nearest]otline Trench width Total length of lines Material beneath tile Distance between lines '~ (~ inches Depth PERMIT NO. Crib depth Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line PERMIT NO. Sewer line Septic tank Absorpt on area(s) Total effective absorption area OTHER PIPE MATERIALS SOl L TEST RATING U NSTALLER REMARKS APPROVED 72-013 (~e¥. 3/78) DATE LEGAL PERMIT NO· DEF'RRTMENT ~ HEALTH AND ENVIRONMENTRL ;;.'OTECTIF~N ('"~,~s, ~-ILt-~(~) APPL I CRNT LOCAT I 0N LEGAL o.-,~- .. '= ' 9".~..oEli ,.,--'.., L"' _,TREET., ANCHORAGE., Al-::.'. ' ~=' -~¢,.4 .4 '~'-~A SEI4ER PEAr'1 ][ T EVERETTE C. L. RLKIN_ F ETER=, CREEK Li-~. EARL RAY PO BOX 68'. E. R. 694-3:2:)98 LOT SIZE .-- -' ~ ,.._ :,WUARE FEET TYPE OF SOIL RBSORF'TION _,~-_,TEM IS: DRRINFIELD MR~<IMLIM NLIMBER OF BEDF.'ODMS = 4 SOIL RATING (SQ FT,.BR..- THE F.'EQLIRED SIZE OF THE _,OIL RB_~ORFTILN =,~_,TEM I~,. [:,EPTH= (:% LEI".iGTH =e.__-- - '"~' GRR'-.." E ! I~., F F" T H =. ..~- > THE LENGTH DIMENSION IS THE LENGTH (IN FEET> OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND AND THE BOTTOM OF THE EXCAVRTION (IN FEET)· THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET), PERMIT APPLICANT HAS THE RE~PON_IE, ILIT~ TO INFORM THIS DEPARTMENT [:,LIRING THE IN_,TI4LLPITIUN INSPECTIONS OF AN'¢ WELLS ADJACENT TO THIS PROPERTY AN[) THE II ' ' '- :, F: '":, N_MBER OF RE:,IrEN_.E: THAT THE HELL WILL '?'"'~"- TL-.gI3 ,:: 2 ::, I i%I'_----.PEC:T I I} ~'-.~ '_:. ]::IF;~.E R EL---!-.IJ I RE[:, BACKFILLING OF RN'¢ S'¢STEM WITHOLIT FINAL IN=FEr:TIUN AND APPRO',/RL B'¢ THIS DEPARTMENT WILL BE _,JBJEE. T TO PROSECUTION. MINIMUM DI--,TRNCE BETWEEN Ft WELL AND RN'¢ ON-SITE SEWAGE DISPOSAL SYSTEM IS i00 FEET FOR R PRIVATE WELL OR t50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UFUN THE T'¢PE OF FLBLIL. WELL. MINIMUM DISTANCE FROM A PF,'.IVRTE WELL TO R PRIVATE SEHER LINE IS¢-'"~',~, FEET AND TO R COMMUNIT"r' :,EWER LINE IS -'= FEET, OTHER ~.EL~UIREMENT_, MFW APPL'¢. _~PEE. IFIc. ATILN_, AND C, ON:,TRUc. TION DIHbRHM-~ ARE AVAILABLE TO INSURE PROPER INSTALLATION. PEP.J"'I I T E::<:P I ~."ES DECEr. IBER ----':. 2L .. :l-.--q- 80 I CERTIF'¢ THAT l: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH B'¢ THE MUNICIPALIT'¢ OF ANCHORAGE. 2: I WILL INSTALL THE S'¢STEM IN RCCOR[:,ANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SMSTEM MRM REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO ZNC:LUDE MORE TFIRN 4 BEDROOMS. O & E EN~,NEERING & DEVELOr'MENT CO. Box 90, Davis St,, Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 Performed for: Name: Mailing Legal Description: Depth (feet) 0 /V/L 2 3__ m 11~ 12__ 131 Earl Ellis 688-2280 SOIL LOG PLOT PLAN PERC. TEST 14w 15__ 161 Ground Water Encountered: Yes 40 Proposed Installation: Seepage Pit Comments: If yes, what depth Drain Field__ Performed by: ANCHORA6E AREA Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM PHONE SEPTIC TANK: FROM WELL INSIDE LENGTH ~r~ L ~ MATERIAL MANUFACTURER '~/c~ INSIDE WIDTH LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY GALLONS. SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL DIAMETER ~"' ' OR WIDTH /~'~/O/../(' ~ CRIB SIZE: DIAMETER BUILDING FOUNDATION.__ NEAREST LOT LINE ADDITIONAL ABSORPTION LENGTH /~-,i DEPTH ~]// DEPTH__ DISTANCE FROM: WELL //~1 TOTAL EFFECTIVE .?:~ ~) ABSORPTION AREA (WALL AREA) ~ SQ. FT. WELL: BUILDING FOUNDATION __ CESSPOOL APPROV ED4)/I/]' NEAREST NEAREST LOT LINE SEWER LINE OTHER SOURCES DISAPPROVED REMARKS DEPTH '~ £ DISTANCE FROM: SEPTIC ,~;i SEEPAGE TANK SYSTEM DISTANCES: INSTALLED BY: PIPE MATERIAL: LOT SLOPE: REMARKS: Form No, EQ~031 DIAGRAM OF SYSTEM GreATEr ANCHOrAgE AreA Borough DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C"STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456 ! PERMit NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME OF APPLICANT INSTALLATION LOCATION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SEEPAGE PIT-- /"*/~' f DRAIN F~ELD ~ OTHER TO BE INSTALLED BY ~ ~ NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOT~CE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK ~ FOUNDATION TO SEEPAGE P~T ~ SEPTIC TANK TO SEEPAGE Pit WALL , SEEPAGE PIT SEPTIC TANK TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD TO rIVER, LAKE STREAM. _, DRAIN FIELD , DRAIN FIELD . SEEPAGE Pit. ALSO CONSIDER AREA WELLS. , SEEPAGE PIT , DRAIN FIELD, CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO crIB CROSSING GAP OF EXCAVATION ~ FEET INTO UNDISTURBED SOl iL,; 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AMD SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. DIAGRAM OF SYSTEM GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAge AREA BOROUGH ORDINANCE NO. 2B-68 aND THAT THE ABOVE MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) LOT 13; BLOCK 2~ EARL RAY SUBDIVISION Location(address ordirections) 23644 Homestead Road (b) Property owner H6tlett, ,~-%O Oh ~o Lf~,~hv~hone: (home) ~88-¢(M?; Business Mailing Address Larry's Woodworking 23644 Homestead Road (c) Lending Institution Seattle Mortgage Telephone Mailing Address (d) Real Estate Company and Agent RE/MAX OF EAGLE RIVER ATTN: A1 Romaszeus~,~ ,~ddress 16600 C~.¢~/rfx'~'d D~x'.~; -q-/t~_ ~¢01 Fag~e R~,.,e~. A6~.~ 99577 Telephone 694-4¢00 (e) Mail the HAA to the following address: (or check her~, if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING 1707. =__-~,!e ~'-'¥o? L'"',~ Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single-Family ~X Number of bedrooms 4" 3. WATER SUPPLY Individual Well Ei~XX Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental .. Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site ~ 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. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATIO~I 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 Address S & S ENGINEEKING 17034 Eagle River Loop Road No. 204 Eagle River, Alaska .~577 Date Telephone 6. DHHS' APPROVAL ~/'~ Approved Disapproved Conditional Terms of Conditional Approval '/:',"iii'ii The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. 72-025 (Rev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANC HORACE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: L( A. WELL DATA Well Classification ~,ru~/C ~--~,~r~]f~ ~..~L /~ - If A, B, C, D.E.C. Approved (Y/N) __ Well Log Present (Y/N) ~ Date Completed Yield ~ ~ o - ~- ~ Total Depth ~ ~ ~ased to ~0'¢ Depth of Grouting Static Water Level ~ O Casing Height Above Ground /~ u ~ Electrical Wiring in Conduit (Y/N) ¥ SEPARATION DISTANCES FRO.~vv ELL:"'" ~ ~' To Septic/Holding Tank on Lot __ ~ ? To Nearest Edge of Absorption Field on Lot Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) i~Dn Adjoining Lots /OO''k ; On Adjoining Lots / oO ~ ,/ To Nearest Public Sewer Line /0/(~ To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot ~ ~ ~- Water Sample Collected by Water Sample Test Results COmments-/~ /,,~, ", To PropertY Liriel ']' '~: !i / r? / -.,TO Water :Maih/Ser~ic¢'Line Te Stream, ,Pond, Lake or Major Drainage Course B. SEPTIC/HOLDIN~TANK DATA Date nstalled-7~,~ ~ Size"~l~ ,¢'c;c~ '~No. of Compartments Standpipes (Y/N) ~ Air-tight Caps (Y/N) u~ Depression Over Tank (Y/N) /0 Pumping/~aint~nance Contact on File (Y/N) Hb,d ng T~ink Higtl-tWater Alarm (Y/N) A) .: SE~IS',~,RAT'ION DiStANCES FROM SEPTIC/HOLDING TANK: To Building Foundation Foundation Cleanout (Y/N) Date Last Pumped ~ - [ O - h,)/~ ;for /~//~ Temporary Holding Tank Permit (Y/N) To Disposal Field 72-026 (Rev. 7~88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~ --/~- - ~)C~ Width of Field ~r_ {~ ~ Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test f,,/.:~ '~- ~¢~'/~' Type of System Design Length of Field Depth of Field Gravel Bed Thickness ~J~ z~ Statndpipes Present (Y/N) fO Date of Last Adequa/cy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well / To Building Foundation /o I Lot To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area ~'" To Property Line / O '¢- ¢- ""- To Existing or Abandoned System on ; On Adjoining Lots ,/0 0 ¢-' · '~' To Cutback (if present) rd~c ¢0rc~¢~- ~ /0o"1- ~' Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effe~ inspection. Signed Company Date MOA No. S & S ENGINEERING 17034 Eagle Ri~er Loop Road Na. 204 ~.agie ~,iver~ ~.ia~k~/ Receipt No. _/'~/q2/ / ;~// Date of Payment Amount: $ /~', 72-026 (Rev. 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. ~~ 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562.2343 ~,~'L~,8'o~,~',;~% FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT gY SAMPLE for Work Order ~ 17456 Date Report Printed: OCI 16 89 @ 09:23 Client Sample ID:LT lC, BLK 2 PWSID :UA Collected OCT 11 89 @ 12:10 hrs. Received OCT 11 89 @ 15:00 hrs. Preserved with :AS REQUIRED Client Name : S Q S ENGR Client Acct ; SNSENGP P.O.$ NONE RECEIVED Req $ Ordered By Analysis Completed :OCT 13 89 Send Reports to: Laboratory Supe~]i~.~/~EPHEN C. EDE 1)S ~ S ENGR Released By : ~* -' ~ ~.~/. 2] Special HOLD FOR PICKUP. Instruct: Chemlab Re£ ~: 7999 Lab Smpl ID: 3 ~atrix: WATER Allowable Parameter Tested Result/Units Method Limits NITRATE-N 1.4 mu/1 EPa 353,2 10 Sample ROUTINE SAMPLES. SAMPLES COLLECTED BY Remarks: 1 Tests Performed See Special Instructions Above UA=Unavailable ND= None Detected ** See Sample Remarks Above NA= Not Analyzed LT=Less Than, GT=Greater Than GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Date Received 12/17/73 !F Time of Inspection 3:00 pm Date of Inspection 12/18/73 RHQUEST FOR APPROVAL OF INDIVIDUAL SEtNER & WATER FACILITIES FOR , VA 1. Agprovel Requested By: Robert Poole Address: Box 364 Eaqle River AK 99577 2. Prooerty O~ner: S~me 3. Legal Description: _ lot 13~. 8lock 2; Earl Ray Subdivisinn 4. Location: Hnmestead Road 5. Type of Facility to be Inspected: ,, Single Family Number of Bedrooms:m One 6. Well Data: Phone: Phone: A. Type Drilled C. Construction , Standard Sewage Dts~osal System: A. Installed '1972 C. Septic Tank: 1, D. Seepage Pit: 1. ~.= Disposal Field: B. Depth 89' D. Bacterial Analysis' Satisfnctnry Size 1000 aal2. Size 2. Installer Robert Poole Manufacturer Steel Fab Material Concrete Rings Total. Length of Lines Distances: A. Well To: Septic Tank__.86, , Absorption Area , Nearest Lot Line , Other Contamination Foundation to Septic Tank "~ Absorption Area Absorption Area to Nearest Lot Line Sewer Lines R~q~e£~t for Approval of I/ ~vldual Sewer & Water Facilitie' Page Two Comments: A,~.~r or--Dis 8 ppr oved DIAGRAM OF SYSTEM I c~rtify that the information cont~oined in this request for approval to be a true snd accurate representat~on of the subject serA, er and ~ater facilities located at: Signed Date ,.,