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Home My WebLink AboutEKLUTNA EAST LT 8Eklul'n( E 1' Lo1' 8 #051-061-58 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 --'[PHONE rL~NEW PGRADE iSCRIPTION DISTANCE TO: Manufacturer / n~th of/ach n~ AbS~.~i on ~¢e~_ Dwelling NO. OFBEDROOMS No, of comjSarTnts Inside length Width Liquid depth Dwelling PERMIT NO. Foundation :~:::si:ll o t li~e / ........ , L/o', To~al leng~ of lines ] Trencl~)Nic~thc. I~-~tariaJ~beneath til~ - ~ ~ Liquid capacity in gallons e absorption area DISTANCE TO: Width Well Depth Building fo Depth ildin~ foundation Driller Sewer line DISTANCE TO: OTHER Total effective absorption area Nearest lot line PIPE MATERIALS SOIL TEST R~ING. INSTALLER REMARKS Distance to lot line-~----[PERMIT NO. Septic t~n~ _.~_JAbso~r~'~nn_ ~ea(s) 72-01 (Rev. 3/78) . :. ~ , .DA,TEl. LEGAL E:,): i"il!ii:i'-,it!:!; ]: O!'-,i ! ;~!!; 'T'HI!':: L.I:{i:NG'T:H ,:: t N FLEET ::, OP' "i"HE: "FF~:[ENCH O1::~'. DRFI Oi:::' !:::~ TRENCH OF: F:':i:'T~ Z:~:; 'T'i...i~E D:Ct~5'T'F:ihh~!:}: i~:E"FHE:E:N THE: SUF:I:::'FICE OF' THE THEE E~O"FTOi't OF' 'i3::ii~E E:XC:Ff,,,:FFi" :[ ON (:i:N FEE:T). E.,!}~:I:::'TH )::~: "i"i"i~: i',l:i:i'.,ilr'ILJH D~EP'T'i..~ OF' Gt:~'.F:I',/EEL. E:I~:THEEtEN THE: OLr'FFFIL.L. i::~;QTTOH OF "FH[:E ~E'XC:Ff,,,'FI"i~'tON (IN !F:~::i~Z:I(:::::~, ::~:5~::::::'IF::~,,3F' "[' ": .... F' ~:::::: "..,, .-:::: ~5;~ :2~::ll~3:: ........ :~ ~::Eii,~ " ...... FI.liE F:!~:SI::'()N:~; I El: ! L. t '] .... FO :1: NF:'ORH .... 1-'1 t :~]; E: I~:F'FII:~:TI',tI~:NT 13 LIFZ: I 1'-,t ]~i THE IN~SF:'~ECTIEd",H::~; OF' Fd'.,~'Y t.,.i~:L..L.:~; !:;:iE:,.J?tC~ENT 'T'O "13..-1I:~5 PI:;;:OF::'~EF:"F'.~.' I::INI)THE i','iL.IH E:, i :i::;"f'F!NCiiE ti.!:!ETt,.II~E~!i:N FI HE:LL. !:::lNi) {::H",Fr' Oi",l"'":~i; I ']"lie :!:i;~.:'~'l.,.!I:::l{::i~: E:' I ?,1:::'O:~:i;1:::11.... :.:.'!;"r".!.:,TI!!!:H i .'E'; !-::'Ii::~E'T' !:::'OJq'. i:::! F!:;i:IV!:::FFiE i41Ei....L OF'. T!'-iI'.E t"*.~q::'!i!!: OF' PL.I,r::.:,'LiC: I.'.!E!:I...i ..... MUM l:::':i: :i:i;Ti:::iMC:E:: F:'RCd'I 61 I'::'~;i~ I "/ I::!'T' t!'}: HIi!~L.L. 'FO t::~ F'F: I ',,,'I:::I"I"I:.:E :~!i;ti:.::HEF: L.:[ F,tL:i: :[ :5 ;25 I:::'E:E!:T FIND ('::Oh'IHUHI"i'"~" St:i::NEF:: LINE: O"i"HiEi:;i: i::~:iiig:~:!L.i :~: F:~Ei'iiiEHT:i~:; i'if:A~; t::'d'::'i:::'L.Y. i:::f,/Ff:[L.F~I{i!~L.t;'~: '1"0 !N:ii:;i. JF:ii!: F:F:OF'IiEF~: NAME ~ LOCATION MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONIVIENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT .., :? ,¢.!.. '~.~ " tInside length DISTANCE TO: .~,~1 //wd; ~~gallons We~ /~_~2 ~ IF HOMEMADE: DISTANCE TO: Manufocturor Top of ti)e~.~,.~ fi(qish Length Width Type of crib Total leg,~tb, of 1~5~.~ Material Width Well DISTANCE TO: Depth Material TrengJ~-~i~th~ ~%~'~ inches I~¢er~¢l Depth NO. O Fy/ROOMS P ER M IT N~_?/~ Liquid depth PERMIT NO, Liquid capacity in gallons PERMIT N 0~,~ ,,~. ~al effe~j~e absorptio~area PER---~T~-~ Crib diameter Crib depth Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundatio; Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS INSTALLER ~ / / REMARKS Applicant: Location: Legal Description: ~'~ F~ ~''/~91},'- Type of Soil Absorption System ts: Trench: ~ Drainfield: Maximum Number of Bedrooms: ~ ~UNICIPALITY OF ANCHORAGE Department Hea~th and Environmenta' rotection 825 ~ Street, Anchorage, AK. J9501 264-4720 * * * HANDWRITTEN PERMIT * * * r,de~"c"~ ON-SITE SEWER PERMIT Phone Nu er: Seepage Bed: Holding Tank: Soil Rating(sq.ft/br) /~i~ ~/~/~_ The Required Size of the Soil Absorption System Is: DEPTH ~' LENGTH''~/'ZC') GRAVEL DEPTH ,,_'~-7 WIDTH The length dimension is the length(in feet) of the trench or drainfietd. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). /~ ._ ~] * ~ REQUIRED SEPTIC(HOLDING) TANK SIZE ~~ - ,~ C~ GALLONS ~ * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion° Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I wil~statl the~stem in accordance with codes. (3) I un~.ers~a~d th~t~he on-site sewer system may ~equire enlargement if the.~es~e /~×s/remodeled to include more tha¢3~room~'./ SWP/024 (1/81) PERFORMED FOR: LEGAL DESCRIPTION: DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SLOPE XSOILS LOG [] PERCOLATION TEST SITE PLAN lO 11 12 13 14 15- 16- 17 18 19- 20- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Depth to Net Reading Date Time Water Drop Net Time PERFORMED BY: ~g~ ~:?,~ ,~> >~ ¢~ CERTIFIED 72-008 (6/79) ,~::/ih°ne Buyer Address Lending Institution /::'i *; ./ ¢ ' '/ Address Realty Co. & Agent Address Legal Description Zip Code Zip Code Zip Code Phone Phone Type of Residence [] Single Family ~MuJtiple Family No. of Bedrooms_~:--; ____ [] Other Water Supply [~ Individual ~t [:J,-~Cbm mun ity ,~ ~: ..... :' [] 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). Sewer Disposal ,~,/l~divid ual E] Public Utility ~] Holding Tank Year Individual Installed: ~ '¢' When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE! F~OCESSING CAN BE INITIAKED. Time Time Tirne Time Date Inspector Field Notes: Date Inspector Date Inspcctor Date Inspector (?;) APPROVED BEDROOMS ( ) DISAPPROVED ) CONDI'r/ION,~L APPROVAL* DATE / u//, ,/_/~,> ~ ~_ --~ /~' / - Soils Rating Date Sewer Installed 72-023 (3182) lWell To Absorption Area Well to lank Well L.og Received Septic Tank Size oGRE,,,,ER ANCHORAGE AREA BOk...JGH ~ Department of Environmental Quality 3330 C Street ,, Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ,Z/~ ~- LOCATION ~O~ ~(~ ~%. SEPTIC TANK: DISTANCE FROM INSIDE LENGTH MANUFACTURER ~ MATERIAL INSIDE WIDTH LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY /'<2~t') GALLONS. Tile DRAIN FIELD: DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE_ TOTAL LENGTH OF LINES NUMBER OF LINES .DISTANCE BETWEEN LINES TRENCH WIDTH__ IN. TOTAL EFFECTIVE ABSORPTION AREA ~.~)~-~ SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER ~ . DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE~,,.~ t~1. ABOVE TILE ('F/ IN. WELL: TYPE {'--. ~ I,~ BUILDING FOUNDATION CESSPOOL APPROVED ~ CONSTRUCTION NEAREST LOT LINE_ , OTHER SOURCES DISAPPROVED NEAREST SEWER LINE__ DEPTH SEPTIC SEEPAGE TANK__, SYSTEM REMARKS DISTANCE FROM: DISTANCES: DIAGRAM Of SYSTEM INSTALLED B Y: ~'~2'~-~ SEWER LINE DEPTH: LOT SLOPE:_ k'~ ~ REMARKS: /,__~'~ ~ ¢~ G.A.A.B. - GRE~T~ER ANCHORAGE AREA BOROUGHr..~. , DEPA' :NT OF ENVIRONMENTAL QUAL " CASE # ' 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 erformed For I'~c~¼L~¢ tLl~,~,~,,',: Date Performed Legal Descrip'~ion: Lot'~ Block_bj_S~bdivision F/~/v~,~,' This Form Reports Soils~'[-6'g Percolation Test' Depth ...... Feet Soil Characteristics Was Ground Water Encountered9 ~ ~ 1 · , ~ / If Yes, At What Depth? Reading Date Gross Time Net Time Depth to H20 Net Drop h nute Proposed Installation: Seepage Pit Drain Field Depth Of Inlet Depth To Bottom Of Pit Or Trench COMMENTS: ~ ~ ~¢ ('r /~.,,~>~:,~.~ -- N Test PerformedBy ]~¥' ~ ';~""--""'/~?'3' ' Data Certified By: Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051:061-58 GENERAL INFORMATION Complete legal description Location (site address) COSA # 0 Expiration Date: Lot 8, Eklutna East ,' 21308 Monron Drive Chugiak, AK 99567 Current Property owner(s) Gary and Jeannie Rainey Mailing address P.O. Box 672223 Chugiak, AK 99567 Day phone Lending agency Day phone Mailing address 2:' NUMBE~,OF'E~"~DRooMs: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class _.~ Well Public Water System Real Estate Agent · Mailing Address 'Unless ~therW isb~r~equested, COSA will be held by DSD for pickup. Four (4) Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding Tank [] Community On-site [] Public Sewer [] I The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a pdvate or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a pedod of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown bel0w, 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-s'~e 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Phone 522-7773 9/7/2011 Date ~ ~. t~,~ee .,~ .. ~ DSD SIGNATURE ~ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other ~)~riginal Certificate Date: C/_C~. ,_. // Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type Pubic Date completed Total depth ~ Lot 8, Eklutna East Subdivision Parcel ID: 051-061-58 IfA, B, or C provide PWSID #211431 Sanitary seal (Y/N) Cased to ft. g.p.m. Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION Nitrate mg/L Date of sample: Number of Compartments Two Depression over tank (Y/N) Pumper JRs Pumping FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform coloniesl~100 mL Arsenic: ug/I SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size ~.2so & s00 gal. Foundation cleanout (Y/N) Y Date of pumping 8/26/2011 ABSORPTION FIELD DATA Date installed 6/83 & 10/83 Length 6o & 10 ff. Total depth 9 ff. g.p.m. Other bacteria Collected by: in. Date of adequacy test 6/26/11 Results (Pass/Fail) Pass Fluid depth in absorption field before test o Elapsed Time: 1,248 min. Final fluid depth 0 Any rejuvenation treatment (past 12 mo.) (Y/N & type) Soil rating (g.p.d./ft~ or ftZlbdrm) 100 SF/BDRM Width 3 ft. Eft. absorption area 700 ft2 Monitoring tube System type Deep Trench Gravel below pipe 5 ft. Y Depression over field N For 4 bedrooms in. Water added 750 gal. New depth 12.5 in. in. Absorption rate >= 500 g.p.d. N If yes, give date Date installed 6/83 & 10/83 Cleanouts (Y/N) Y N High water alarm (Y/N) N colonies/100 mL UFT STATION Date installed. "Pump on" level at Datum. in. E. SEPARATION DISTANCES Size in gallons "Pump off" level at Cycles tested in. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer/septic service line Animal containment areas Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas in. Bedrooms. A Second 500 Gallon Septic Tank and an Additional 10' of Absorption Trench Were Added in October of 1983. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field >5' Water main >10' Water service line >10' Surface water >100' Wells on adjacent lots >200' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >10' Curtain drain None Noted Walls on adjacent lots >200' COMMENTS: Property is served by a Public Water System. Septic System was Originally Placed in June of 1983 for Four I ~ that I have dete~ln~ thmugh field ,nspections and ~w~w of Mun~ipal ~s that the above systems a~ ~ confo~an~ with MOA COSA guidelines in effe~ on this date. COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ O~[~ II\ Date of Payment Receipt Number JRs Pumping PO Box 77341.5 Eagle River, AK 99577 (907) 694-6454 ~'i'~i ~ g Info~mafion Gary Ralney 21308 Monron Chugiak, AK 99567 (907) 688-1018 [Job Site In.t Gary 21308 Monfort Stre~ Chugiak, AK 99567 (907) 854-8621 Additional Location ormatlon ;omments; Diagram: Service Agreement Number: 034188 Order Date: 24.Aug-2011 Service Date: 29.Aug-2011 Technician: Mike Job Description. 15009 P.O. Number: Terms: Net 30 Tax %: 0 Salesrep: Dawn-Dawn Job Type: Repeat Map Book: Map Grid: 23 - - Cro~s Streets: Homestead Road Job Comments: Last serv '";i'0118120o2; ........... -1~oO'~ ........................... pumped & checked tank S:~Oi~L~rams~34188.brag Gallons Planned: 1500 4 bdrm 1 and 2 sto~ house pipes in back and ~ 2 tanks 10009 4-50( Service Type Septic Serv 15K Customer agrees to the y, blue, #'s on isible. Qty Price Each 1 $0,00 Estimated Charges: Actual Charges: terms and conditions shown. THIS I$ A .... · ~ Gal. Actual: ~'ont of I ~'~' I Hose Length: ~ Double Tank; ~ --- ~ Pump .System: [] ~ I - ] Baffles Inlet: [] ,,---i. ~,.. Baffles Outlet: [] _ Tax? ExtenSion Actual NO $0.00 NonTaxable Total Taxable Total Tax Total Grand Total ~,NDiNG'AGREEMENT. For your added conveni'e.q~accept: Dicover, Visa and Master Card payments over the phone. After 30 Days account will be turned over to COLLECTIONS. $30.00 For NSF Checks Returned. I/I'd 99ALA19:0£ I~S6~£L06 ~NIdHR~ Olld3S S,~£:HOSJ I~:80 NO03~O W 125.65' 66.1' i;. i,i £xisUng66,1' Bu,lding SO°03'O0"E 125.65' 24.0' Z hO 0 Monror~ Drive GRE~TER ANCHORAGE AREA BOROUGH DEPA~ ENT OF ENVIRONMENTAL QUAL, 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 CASE # Performed For. ~I~L,., ~k-iot,,.,~., Date Performed Legal Description: Lot ~ Block .~ SubdiviSion, This Form Reports Soils-[-6'g...~ Percolation Depth Feet 6,~ ~* 8~ 10~ Soil Characteristics Was Ground Water Encountered? If Yes, At What Depth? Reading Date Gross Time Net Time Depth to H20 Net Dro~ nute Proposed Installation: Seepage Pit Drain Field Depth Of Inlet Depth To Bottom Of Pit Or Trench N TeSt Performed By_ '~i-;'.~.~'?,-~m ' Data Certified By: Date: