HomeMy WebLinkAboutEKLUND LT A1 OF TR AEklund
Tract A
Lot
Al
#050-531-01
Municipality of Anchorage
Development Services Department
i Building Safety Division .•,,,,
On-Site Water and Wastewater Program, 4700 S. Bragaw SL
P.O. Box 196650 Anchorage, AK 995196650 Page1 Gf3
www.d.anchorage.ak.us (907) 343-7904 /
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: 4-5, Wn30 qq PID Number: (350-531 -Q/
Name:U 1 mei p. a u er
Wastewater System: ❑New ,Upgrade
Address:
5V ABSORPTION FIELD
Pfwne: 8� U 5DD Nurtba a eedroarhs;
(l
k°eep Tmrh cl snaaaYr Trench O Batt O mmrd C1 Other:
LEGAL DESCRIPTION
Sod Rating:
I,a
De
Tow Depth tam er final grade: 1
GPOTI=
Ft.
/l11 c
TJX:: L I hat: A I suediNsim: / I14 n al
� to me bottom tram ad grade:
FL
GnvA dept Donation pipe: � � Fl.
Township: Range: section:
Fa added above oipnal grade:Gravel
�"
Length:
FL
2S Ft.
Well: Upgrade
El rade
Or" 101114;
NU be
Distance between tines:
FL
Ft.
Classtanoon(Pnvate.0. . C} Taal Depth: Cased b:
+; �a FL
Torah atxaryecn area:
S FP
q MatwF
r g/ o
DNIK ed: staucwater Level:,
Gate
FL
If
Yreld:
Pump set al' /largnl Above (iraand:
TANK
GPM
F,, FL
SEPARATION DISTANCES
t4S-p5c O Hokting O S.T.EP. ❑ Other.
To
From
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
ubrirJPdvate
Sewer Line
ad ,
, J411 t! �lp 't(LS
Q Gel.
wall
Material:Material:Horsier
bo
�aCmCanmerns:
surface water
I ,
LIFT STATION
Lot Line
6Lt ,
e:
11 Gal.
Foundation
I T-D%
/ �\
'RnD on'levet at: 'Rmp ar I" as
f4ph watn aurin at:.
J�
l/�%
Curtan Drain
O nal
610 wn
��-
Pum Make i Model hfpetacns pert "need br.
Remhka:
E,r<s: r,.c S /F
BENCH MARK
Ut4Plbaom
td Coevsl/•�.r
and OesrnDam: � ON? `�
o j
i46.�,,, vv,v E -
// evauon:
Cottle l�lpu '100 Fl.
Engineer's Stamp
LOF .,
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N
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17034 Eagle River Loop Road, Na- st
Inspections performed by:ep, �ba(es: 1 �- - 3
ytt,
2 fid
Development Services Department Approval
y -ri s ROBERT C. COWAN fr^a
Reviewed and approved by: _,83 Date: / � -/ 0
l#+c�l� CE-8801 r
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PERMIT NO. SWO30492
PACE 2 OF
Municipalit of Anchora e
DEPARTMENT OF HEATH AND HUN'IAN 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 LOT A-1, TRACT A, EKLUND S/D P.I.D. NO. 050-531-01
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PERMIT NO. SWO30492
PAGE 3 OF 3
DEPARTMENT
pHEA�TH ANDhHUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 •Anchorage, Alaska 99519-6650 • TeWL hone: 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT A-1, TRACT A, EKLUND S/D P.I.D. No. 050-531-01
ST1 ST2 ,,-82.0'
FINAL GRADE
NEW
77.7'1000 GALLON
POLYETHYLENE
SEPTIC TANK
FINAL GRA
2" INSULATION
77.4'
C01=79.6'
=80.6'
M l 1- U U. V
NO WATER FOUND
62.6' B.O.H.
2" INSULATION
D1=76.3'
D2=76.3'
N. T. S.
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW030492
Legal Descriptions. EKLUND LT ; Al OF.TR'A ...if
Design Engineer: 0003 S & S Engineering
Owner Name: James Brauer
Owner Address: 29965 EAGLE RIVER ROAD
EAGLE RIVER, AK 99577-9754
Date Issued: Nov 25, 2003
Expiration Date: Nov 24, 2004
Parcel 1D: 050-531-01
Site Address: 029965 EAGLE RIVER RD
Lot Size: 107158 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
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 DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By.
Issued By:
,-2e& � - Z,,,,
Date: // /a G /0 3
Date:ZI
2S 03
Municipality, of Anchorage
• Development Services Department 0044�
Building Safety Division
On -Site Water and Wastewater Program s T y
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ok.us
(907) 343-7904
ON-SITE SEWERIWELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. O SO - 5 3L - 0 1 Permit Number SW 304
Property owner(s) S A M ES S? -NA- Day phoneLf`11° - 15 $ ::V
Mailing address (1
Mailing address (2 1 C1*1 �Pk Zip Code 9 9'Si q
Legal description (Lot, Block & Sub'd.)
Legal descri tion (Se ion, Township & Range)
Lot Size ->'tcrEs q.F . Number of Bedrooms
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
certify that the above Information Is correct. I I`drther certify that this application is being made for a
Single Family Dwelling and is In accordance with applicable Municipal Codes.
/f � / 1 & S ENGINEERING
�(�/71/ G/fz�r 17034 Eagle River Loop Road No. 204
w._ _i_ wf____-Al_ _ ww�-.i_
(Signature of property owner or authorized agent)
Permit Fees: r 'Yoe ." Waivert=ees:
Date of Payment: it io 41 3 Date of payment:
Receipt Number: 6 q `l f: o o Receipt Number:
(Rev. 12/00)
S&
-- �►1GIn�GlZIng ROBERT C. COWAN, P.E.
CMLENGINEERS
(907) 694-2979
FAX (907) 694-1211
November 19, 2003
HEALTH AUTHOR N
APPROVALS
MUNICIPALITY OF ANCHORAGE
Services Department
SEWER&WATEDevelopment
MNNEXTENSIO
AWNE7CTENSpNS
P.O. Box 196650
Anchorage, AK. 99519 '
REFERENCE: Lot 1A, Tract A, Eklund Subdivision
SEWER6 WATER
MPECTION
It is requested that you issue a permit to upgrade a septic system to serve the existing
three bedroom dwelling on the referenced property.
ENGINEERING STUDIES
ANDREPORTS
One test hole was excavated and a percolation test was performed on 11/13/03. The
approximate location of the test hole is located on the attached site plan. Ground water was
WELLNISPECTION
monitored and after seven days the hole was dry as shown on the attached soils logs.
aFLOWTEST
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
areas or drainage patterns by the installation of the proposed septic system. The
SITE PIANS
construction of this system will not prevent any future development on any of the adjacent
properties.
If you require additional information, please contact us.
Roan DESIGN
Sincerely,
SOILTEST
7Z'� �- .
Robert C. Cowan, P.E.
PE„OOLATION
RCC/jhm
TEST
Enclosure
STRUCTURAL&
MECHANICAL
MdSPECTIONS
CNSITE
WASTEWATER
DISPOSALSVSTEIA
DESIGN
17034 NORTH EAGLE RIVER L06P - SURE 2134 i EAGLE RNER. ALASKA 99577
SITE PLAN DESIGN 1" = 60'
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Soils Log - Percolation Test
Performed For: 12A—(iiL Date Performed: 1 1
Legal Description: LDT I h ; T2iE GT h E6�r_t J N� S 7
Slane Site Plan
Depth
1- 0.
2-
3- 0
4-
5- 0
6-
7.
o
10- • 0
11- •
12-
13- ' 0
14-
15-
16-
17-
18-
19-
COA.1 .LENTS
VIAS cPOut WATER
N D
'OFA `ta c
S
IF YES. ATYP'ATDEPTH?
'• LD
Depth to Water After
4lonilodng?
Municipality of Anchorage
Dau:
'F j ; (ENGIN EA- fir,
Development Services Department
;+W.Alt?Buldng
Safety DivisionOn-Site
Water and Wastewater Program
1,.a
i4700
South Bragaw SL
V ROBERT C. COWAN
P.O. Box 196650 Anchorage. AK 99519-6650
�^�.: cc . 8801
www l] anchcrane.ak.us
.0, %, e
f', �...
(c07) 343-7904
_ " ....•
CDr, .•� .
%y r,r
Soils Log - Percolation Test
Performed For: 12A—(iiL Date Performed: 1 1
Legal Description: LDT I h ; T2iE GT h E6�r_t J N� S 7
Slane Site Plan
Depth
1- 0.
2-
3- 0
4-
5- 0
6-
7.
o
10- • 0
11- •
12-
13- ' 0
14-
15-
16-
17-
18-
19-
COA.1 .LENTS
VIAS cPOut WATER
N D
ENCOUnE'•ED7
S
IF YES. ATYP'ATDEPTH?
'• LD
Depth to Water After
4lonilodng?
P
_ky E
Dau:
Il- 26-03
Reading Date Gross Time Net Time Depth to Water Net Drop
-P/A zl . n I r I /_ rr I --
O'4 j' '14 "
IX��
orr rl
0 I17" Orr
'Olt 4_ IfJ �orr/rm- tePERC HCLE DIAE%I=TER e'Pc „Ol4TICH PATE t
TEST RW E TNEE.I FT PAID FT
PERFOPMED BY: CERTIFY THAT THIS Tc5 WAS
PERFORMED IN ACCO DANCE WITH ALL STATE P?ID l.IUA:ICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 1� / � /t73
S&
EfiginCLK1nG ROBERT C. COWAN, P.E.
w1
CML ENGINEERS
AOMA
(907) 694-2979
!W-XTHALff
FAX(907)694-1211
ON-SITE WASTEWATER DISPOSAL SYSTEM
OVANo�TM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
SEWER & WATER
MAINEXTENSIONS
REFERENCE: Lot 1 A, Tract A, Eklund Subdivision
November 19, 2003
SEWER&WATER
INSPECTION
,
GENERAL:
1. The scope of this project includes the installation of a 1000 gallon Premier
polyethylene septic tank and a new trench to serve the proposed three
ENGINEERINGSTUDIES
ANDREPORTS
bedroom residence located on the referenced property.
2. Construction shall be in accordance with the approved site plan and 'design
WELL INSPECTION
drawings, Municipal permit with any special provisions or conditions,'and all
&FLOWTEST
applicable State and Municipal Wastewater Disposal Regulations.
3. The contractor shall be responsible for obtaining any necessary underground
SITE PLANS
utility locates.
4. Unless specifically agreed otherwise, the property owner shall be responsible
for final grading areas subsequently depressed from soil settling.
ROAD DESIGN
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Health Department for system installations. Owners installing
SOILTEST
their own systems must also receive prior approval from the Municipal Health
Department.
PERCCUTION
SEPTIC TANK INSTALLATION:
TEST
1. A septic tank is to be constructed by a certified septic tank manufacturer.
STMXTURAL&
Construction shall include two 4" cleanouts for pumping access.
MECHANICAL
INSPECTIONS
2. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
ONSITE
WASTEWATER
DISPOSALSYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP 4 SURE 204 i EAGLE RfVER, ALASKA 99577
• Page 2
Lot 1A, Tract A, Eklund SID
November 19, 2003
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 (ruffed -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.
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.
Page 3
Lot 1A, Tract A, Eklund 31D
November 1g, 2003
MINIMUM MATERIAL SPECIFICATIONS:
1. Any septic tank proposed for installation must be constructed by a Municipal approved
septic tank manufacturer.
2. The following pipe materials are approved for use in septic system installations in the
Municipality of Anchorage:
Type of Pike 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, Femco, 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, which ever requirement applies.
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:
Page 4
Lot 1A, Tract A, Eklund S/D
November 19, 2003
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.
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
Tom Fink,
Mayor
Municipality Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
January 8, 1991
Knud Korsgaard
PO Box 71
South Berwick ME
03908
Subject: Lot A-1 Block A Eklund Subdivision
Permit #900217, PID #050-531-01
The subject permit, issued by this office for a single family'
well and/or on-site wastewater system has expired as of December
31~ 1990o
A new permit must be obtained from this office for a well and/or
on-site wastewater system not installed by the expiration date°
If you have drilled the well, a well log needs to be sent to
this office for documentation of the installation and to close
the permit.
If a private engineer inspected the installation of the on-site
wastewater system, the original as-built inspection report
(three-part form) must be sent to this office for review,
approval and documentation° All inspection reports must be
submitted within 30 days of construction completion°
When applying for a new permit, the fees are: $90.0~ for an
on-site wastewater permit; $50.00 for a well permit; $140o00 for
a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744°
On-site Services
JW/ljm:200
enc: Copy of Permit
"Kids Are Our Future
Nlunicipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG ~ PERCOLATION TEST
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15-
16
17
18
19
20
DATE PERFORMED:
PERFORMED BY: ............
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEd
72-008 (Rev. 4/85)
Township, Range, Section~:SI_OPE Ti ~sI E~PLANL'~-i
-/
WAS GROUND WATER
ENCOUNTERED? ~O
S
IF YES, AT WHAT L
DEPTH? . pO
E
Depth to Water Alte~/
Monitoring? (_Iii'L4 Date: -:~- ~c~O
Gross Net Depth to Net
Reading Date
Time Time Water Drop
PERCOLATION RATE __
(minutes/inch) PERC HOLE DIAMETER __
TEST RUN ~
BETWEEN FT AND FT
COMMENTS __ _
S & ~ ENG~NF~F''~dNG .
FECT ON THiS DATE.
CERTIFY THAT/~HIS TEST WAS PERFORMED IN
DATE: ~//~ ~///~¢¢
oGRF ....... ANCHORAGE AREA BO"'"
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~-~¢-tt,~]~) G(~¢I~'~, MAILING ADDRESS PHONE
SEPTIC TANK: ~ LC' i~-I/~
DISTANCE <~jl/~.~ ~:l,t,
F.OMWELL !1~~ MANUEACTURER
INSIDE LENGTH
INSIDE WIDTH
~ ¢if NUMBER OF
~'~ MATERIAL ~ ~-"~' L.~ COMPARTMENTS
LIQUID DEPTH LIQUID CAPACITY ~ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS __
LINING MATERIAL
I
DIAMETER ~l~~
~¢~4C1¢¢ ~ CRIB SIZE;
BUILDING FOUNDATION__
OR WIDTH /~i LENGTH/ .~.i DEPTH
DIAMETER DEPTH_ DISTANCE FROM: WELL
TOTAL EFFECTIVE
NEAREST LOT LINE ABSORPTION AREA (WALL AREA) ~-~' SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE"~AILL~o~ CONSTRUCTION
BUILDING NEAREST
FOUNDATION_ , LOT LINE__
CESSPOOL , OTHER SOURCES
APPROVED DISAPPROVED
~q¢ ~¢}I)AmD DEPTH ~' DISTANCE FROM:
NEAREST SEPTIC SEEPAGE
SEWER LINE TANK I~?~I SYSTEM /t¢¢'
REMARKS
DISTANCES:
INSTALLED BY:_
PIPE MATERIA£ ·
LOT SLOPE:
Form No.
DIAGRAM OF SYSTEM
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 27/~-4561
PERMIT NO.
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
'"1 ~ ~ ' / I
INSTALLATION LOCATION [ ~
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST rESULTS--~X~i'~.
COMPLETION DATE: ANTICIPATED
TO BE INSTALLED BY
NOTE: TBIS 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.
MINIMUM DISTANCES, BEQUiR~EMENT$
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE Pit
SEPtiC TANK tO SEEPAGE Pit WALl
SEPTIC TANK "-} .. SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO sePtiC TANK
DRAIN FIELD
WATER MAIN TO SEPTIC TANK __
DRAIN FIELD
SEPTIC TANK, ~; i~ _, SEEPAGE PIT
TO RIVER, LAKE, STREAM.
SEEPAGE AREA SIZE
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 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS R~G~RDING
INSTALLATION,
TYPE
DIAGBAM OF SYSTE~
[ CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH/~RD~!NANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE, ~ ', ~ ..... ~ / i ~ ? ~
by
A & L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 ® TELEPHONE 694-2588
OWNER OF LAND
ADDRESS
LEGAL DESCRIPTION
DATE - Started
Ended
PERMIT NUMBER
DEPTH OF WELL
STATIC LEVEL OF WATER FT.
DRAW DOWN FT.
GALS. PER HR
KIND OF CASING
KIND OF FORMATION:
From Fi. to Ft.
From Ft. to Fl
From Ft. to Ft.
From Ft. to ~ Ft._
From Ft. to Ft.
From Fi. to_ Ft,
From Ft. to Ft,
Front Fi. to Fi,
From Ft. to Ft,
From Ft. to Ft.
From _Ft. to _Ft.
From _' Ft. to Ft.
From Ft. to Ft.
From FLto Ft.
From Ft. to_ Ft.
From Ft. to Fi.
From Ft. to___.Ft.
From__Ft. to Ft.
From Ft. to Ft
From Ft. to Ft
From Ft. to_ _Ft
From Ft. to Ft
From Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft.
From Ft. to _Fi
From Ft. to_ Ft
From Ft. to Ft.
From _Ft. to Ft
From_ Ft. to Ft._
From Ft. tQ Ft
From Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft.
MISCL. INFORMATION:
DRILLER'S NAME
-� unicipalit), of Anchorage ,..0,
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw Sl.
P.O. Box 196650 Anchorage.
6650
•�=
www.ci.anchorage.ak.us
(►� (907) 343-7904 �®
CERTIFICATE OF HEALT H AU i'HORiTY APPROVAL
FOR A SINGLE FAMILY DWELLING
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon regdest to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B wells br a public water system. The
fA.inicipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
t -")O 13
Parcell.D. 050-531-01
HAA#
Expiration Date: 3 — D -- O jy'
1. GENERAL INFORMATION
Complete legal description Lot A -ice TrartA
F.k1,nr� ��n
Location (site address ordirections) 2995 Eagle
River Rd. Eagle River, AK 99577
Current Property owner(s) James Brauf
Day phone696-1547
Mailing address same
......... ...
Lending agency
Day phone
Mailing address
Real Estate Agent Claudia mmit- nary
Day phone 688-9500
Mailing Address, PO Box 671923 Chuoi nk, AK 99567
HAA be held by DSD for pickup. 02.47--. "' I r r to 3
Unless otherwise requested, will
2. NUMBER OF. BEDROOMS: _3-
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well ®
Individual On-site}
Individual Water Storage ❑
Individual Holding tank ❑
Community Class Well ❑
Community On-site ❑
Public Water System ❑
Public Sewer ❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon regdest to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B wells br a public water system. The
fA.inicipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION 13Y 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 Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm S & S Engineering PaW e 694-9979
Address 17034 N. Eagle River LP RD, EaPle River.,. -AK 99577
Engineer's Printed Name Robert C. Cowan Date _/ 711/ola 3•
- .......... _
5. DSD SIGNATURE Jt R06ERi C COWAN 4
I/• Approved for bedrooms.
�•,, f,:�rtSS
Disapproved._
Conditional approval for bedrooms, with the following stipulations:
Attachments:
NAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By:Original Certificate Date: ! — / — 0 3
(Rev Ov07)
Municipality of Anchorage }•�
Development Services Department
Building Safety Division -
On -Site Water & Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.enchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: (iOT X ^ %/.4iGT Z : 6<1-U�15 5/0 Parcel ID: d SD -S3 / -O/
A. WELL DATA
Well type,L If A, B, or C provide PWSID # = Well Log (YIN) y'
Date completed ,��6 Sanitary seal (Y/N) Wires properly protected (Y/N)_i1�
Total depthi-ft. Cased to 4o "'ft. Casing height (above ground) n.
FROM WELL LOG
Date of test q 7-�r,
Static water level ft•
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform D colonies/100 ml. Nitrate 0.1P mg./l.
Arsenic: '" mg.A. Date of sample: *03
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material 6t p nu 1 t4'D P r
Tank size loco gal. , Number of Compartments Z
Foundation cleanout (Y/N) Depression over tank (Y/N) N
Date of pumping A/ EYJ Pumper
C. ABSORPTION FIELD DATA
Date installed If 3-0 03
Length �_ ft.
AT INSPECTION
_j Z I f S I 10;�
X150 ft.
4.0 g.p.m.
Soil rating (g.pAA2 or felbdrm) ° Z
Width
Other bacteria colonies/100 ml.
Collected by. EiV G)J-J<F L/nlc�
Date installed f 2 b 3
Cleanouts (YM)
High water alarm (YM) Ari
System type
Gravel below pipe
Total depth 10 ft. Eff. absorption area.. Monitoring tube Depression over field Ai
Date of adequacy test Results (Pass/Fad) As For 3 bedrooms
Fluid depth in absorption field before testin. Water added_ gal. ew depth_ in.
Elapsed Time: _ min. Final flu' depth _ in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) Al If yes, give date
D. LIFT STATION
Date installed A11A
"Pump on" level at in.
Datum
E. SEPARATION DISTANCES
Size in gallons
"Pump ofr level at _ in.
Cycles tested
Manhole/Access (YIN)
High water alarm level at in.
Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/IA-s tion on lot 100 14- On adjacent lots
1 AD it -
Absorption
Absorption field on lot / DO 1+ On adjacent lots / OCA �+
Public sewer main N Z A Public sewer manhole/cleanout n! / A
,Sewer /septic service line ZS tw Holding tank A)
SEPARATION DISTANCES FROM SEPTIC/HOtDttQG TANK ON LOT TO:
i
Building foundation �J� f Property line 5- 'i- Absorption field )}
r tT.
Water main ti 1A Water service line Surface water loo
Wells on adjacent lots 100 t -r
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 1 D �r Building foundation f O �f— Water main
' �-
Water Service line i t+- Surface water Driveway, parking/vehicle storage
Curtain drain Nclur K^j0-w Wells on adjacent lots X 00
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name Rota ier C. C'aw,4r
Date 1--)//0/0-
HAA Fee $ 3 7 S, u" f' / r� �. R"f �> Waiver Fee $
Date of Payment /,I- /f o 0 3 Date of Payment
Receipt Number C7 4 S Y S \ Receipt Number
(Rev. 12101)
l';
:^,1 ROBERT C. COWAN Iti
CE -8801
tai cV�,:..........
..,,�\. yw
12- 9-03:13:39 :CT and E
5 a S Engineering :5615301 2/ 2
CT&E Environmental Services Inc.
200 W. Potter Drive
Anchorage, AK99518-1605
Telephone: (907) 562-2343
Facsimile: (907) 561-5301
200 W. Potter Drive
Drinking Water Analysis Report for Total Coliform Bacteria r lc(so7i e, 999518-t sos
43
uFAn.rNCTRur-noNSONARYERS,USia,E$F+FORECOLLECTINtiSAMPLE Fax: 19071561 -sant
MUST BE COMPLETED BY WATER SUPPLIER
oPUBLIC WATER SYSTEM I.D. W TI
I1/PRIVATE WATER SYSTEM
Send Rfn O Send Invoice
mbee
omnumtwr as u
Wvia
SAMPLE DATE: '
Afontlt • . Day
`SAMPLE TYPE: ' 1
/l� RoEtlne .
q lfepeat Sample (for rogfitte saitiple
wltlt lab rFf +.o,
p Speclal Purpose
SAMPLE,LQCATIOiY
e -SID
�• .
Kam
Year
O Treated Water
p' Vntrbated•Water
Time • CoIlected
t:ollectei! .By.
• rkN•hint
M
Analysis shows this Water SAMPLE to be:
1�5` Satisfactory
O Unsatisfactory'
• Sample.over30hours old, tesultsmay
be unreliable .
O• Sadh'Ple too l'd)ig iri.tM'nsit, sample should
notbopvoal ours old'ateitamtnation
to indicate relic le results: Please send
.nety sample via special delivetymail.
Date Receive d
Time Received to f3
Analysts Began
Analytical Method: X Membrane Filter '
o MMCF -MUG
1037794Result'
"x"
Analyst
`7EJ
.6 Fbks Jun ❑
Faxe,d
Date: _ Time:
Client potlfled of tinaatisfaetory resuI'.s:
❑ ❑
Phoned Spokewtth Faxed
Date, Time:
BACTERIOLOGICAL WATER ANALYSIS I,2ECORD
blAO-MUG Result: Total Coliform E. Coli
hlembrane Fl ter. Direct Count --r� Colonies(100 ml
Verification: LTB BGB • COLIFIRM TMC- roe Nummus re Coma
.,
Fecal Coliform Conrirmation 03-orn.rl!"A';a
FinalMembraneF ter Results _l Coliform/100ml
Reported By Date Time %,!/ hrs
Comments:
(®) -CIL-
.
CIL nun
t2-10-03: t2:26PMt ;907 5615301 a 2/ 2
E 1 1441
E.
SGS Rel.11
1037794001
Client Name
S & S Engineering
Project Name/p
L 4-t Tract A, Eklund SID
Client Sample ID
1,A-( Tract A, Eklund S/D
Alatrix
Drinking Water
Sample Remarks:
All D2tes/1'imcs are Alaska Standard Time
Printed D21e/rlme 12/10/2003 11:22
Collected DateM= 12/08/2003 10:00
Received Date/rime 12/08/2003 10:34
Technical Director Steph C. Ede
Released Ij 4
Allowable Prep Analysts
r
Parameter Results PQL Units Method Container ID Limfts Date ate Init
4iaters Department
Nitrate -N 0.100 U 0.100 mg/L EPA 300.0 D (<=10) 12/06/03 JIB
..;__1~ DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
&U~ ~JF~LITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE ~NVI:
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
ENVI RON~ENTAL SANITATION DIVISION
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Comptete all parts on page 1, Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER PHONE
MAILING ADD~ E~
PROPERTY RESIDENT(If different from above) ~~ PHONE
2. BUYER
~AILING ADDRESS
MAILING ADDRESS
4. REALTOR/AGENT
MAI LiNG ADDRESS
5. LEGAL DESCRIPTION
STREET LOCATION
5. TYPE OF RESIDENCE
[~SING LE FAMILY
MULTIPLE FAMILY
NUMBER OF~BEDROOMS
[] One E~ Four
[] Two [] Five
[~Three E~ Six
[] Other
7. WATER SUP/~t-Y
~ INDIVIDUAL*
[] COMMUNITY
PUBLIC UTI LITY
* 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
[~IN DIVI DUAL/ON-SITE~
[] PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
E~ SINGLE FAMILY [] ONE E~} THREE [] FIVE ~ OTHER
[] MULTIPLE FAMILY [] TWO E~] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
b~_] 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 '~'7' '-~
Connection Verified
INSTALLER
[]Septic Tank or ~ Holding Tank
Size: /.~ ~!~ ~' ~ If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line
I
WELL TO: __
Absorption Area to nearest Lot Line
5. COMNIENTS
~ APPROVED FOR /~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY
72 010 (Rev. 6/79)
EXCAVATION
ROBERT A. SHAFER
WORK
JUly 5,
1982
CIVIL ENGINEER
694-2979
MUNICIPALITY OF ANCHORAGE
DFr~T C?': I-'~'~T't ".
Dynamic Realty, Inc.
A~T~TION: Petie Strang
501 W. Northern Lights Boulevard
Anchorage, Alaska 99503
RECEIVED
Reference: Lot [LA~ ¢~.L~trz~ £ubd~v±s±o~
A sewer system adequacy test was performed on the system
located on the referenced property at the request of
Robert Ballay. The septic tank was pumped and verified to
have a capacity of 1250 gallons. The seepage pit was
tested by charging the system with approximately 1000
gallons of fresh water and after ~ period of 24 hours
the water level indicated all the water that had been added
had percolated out of the crib.
It can be concluded from this test that the waste water
disposal system serving the three bedroom residence
located on this property is currently functioning adequately.
However, the system cannot be guaranteed against subsequent
failures.
If we may be of further assistance, ~lease do not hesitate-~
to call.
Sinc y.
,~/~T A. SHA~R,~P.E.
cc: Municipaltiy of Anchorage
Department of Health and Environmental Protection
SR8 196X EAGLE RIVER, ALASKA
MUN C PA_ TY OF ANCHORAGE
DEPARTMENT OF HEALTH 8, ENVIRONMENTAL PROT~CTi'O~
825 L Stree~ - Anchorage, Alaska 99501
ENVIRONMENTAL
ENGINEERING
DIVISK) N
Telephone 264-4720i~%~'~1 ~l~, ~? ~ L ~ ~,i ~'! i' :i ~
REQUEST FOR APPROVAL OF INDiViDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER Adt~f~Y~i-~
Edward B. & Judith L. Coleman work [ 274-1534 x 26
MAILING ADDRESS
P.O. Box 746 Eagle River, Alaska 99577
PROPERTY RESIOENT(Ifdifferentfromabove) PHONE
-same- -same-
2. BUYER PHONE
Robert E. & Annette P. Ballay ---
MAILING ADDRESS
P.O. Box 360 Anchorage, Alaska 99510
JPHONE
274-8683
3. LENDINGINST]TUTION
Fred Meyer Savings & Loan
MAI LING ADDRESS
1000 E. Northern Lights Blvd. Anchorage Alaska 99503
4. REALTOR/AGENT
D~namic Realty, Inc./Ron Huffman
PHONE
279-7611
MAI LING ADDRESS
501W. Northern Lights Blvd. Anchorage, Alaska 99503
5. LEGAL DESCRIPTION
Eklund Tract A-1 (050-531-01)
S-FR EET LOCATION
Mile 10.5 Eagle River Road
6. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
home is located on the north side of the road
d~civew~z is marked with sawhorse with"Private
~7~ ~-~UR o--d-~
[] One [] Four E~] Other
L~ Two [] Five
[] Three [~] Six
7, WATER SUPPLY
[] INDIVIDUAL<' ~'ATTACH WELL LOG. A well log is required for all wells drilled
[] ' COIVIMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
~] INDIVIDUAL/ON-SITE"* ~*[f individual/on-site, give installation date_ 1 !~ !~-
If system is over two (2) years old an adequacy test is required
[] PUBLIC UTILITY by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
Drive!!
sign
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
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
E~] PUBLIC UTILITY '-~
Connection Verified
INSTALLER
E~]Septic Tank or [] Holding Tank ~,
Size: /~..~--C) If Tank is homemade SOILS RATING
give d)mensions:
TYPE OF TANK __ MANUFACTURER
4. DISTANCES Septic/Holding Tank IAbsorption Area Sewer Line I Nearest Lot Line
I
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
· ' APPROVED FOR BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY (Title)
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
Oc hobc. r }.8~
.~ ........ ~: c,~c]~ma Sub(Sivi,sion
ClX/l! f!!Y( !NI ER
(~94 2979
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
OCT 2 3 1979
RECEIVED
· ..... 'd '-o Oc'I;oL, er 13 .nd ]Z'~ 1t.979 and -~nc]um;d 'bhe
tank axd
.... n( .e ~., s; ',' '! ...'. ~::] I ] o
SRB 193X EAOLI: RIVER, ALASKA