HomeMy WebLinkAboutEKLUTNA HGTS STEWART ADDN LT 11
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
hftp://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP251407
Work Type: SepticTank Upgrade
Tax Code Number: 05106328000
Site Legal Address: EKLUTNA HGTS STEWART ADDN LT 11 G:1460
Site Mailing Address: 21624 BEAR VIEW PL, Chugiak
Owner: O'SHANE HERBERT F & DENISE I
Design Engineer: Northern Lights Construction and Engineering
This permit is for the construction of:
Effective Date
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
1)chartmc���c
11 /6/2025
11 /6/2026
8400
Non -Public
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Water Well ❑ Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Coodinate with On -Site staff regarding preferred method.
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions: WR86-139 was issued for reduced separation of 80' from tank to well.
W89-0043 was issued for reduced separation of 80' from tank to well.
These permits are renewed with the issuance of this permit. The new separation distance is 86'.
('V" - I V1: f7-S
Issued To: Northern Lights Construction and Engineering
Issued By: Curtis Townsend
Date: 11 /6/2025
Date:
11 /6/2025
3
MUNICIPALITY OF ANCHORAGE
Site address 21624 BEAR VIEW PL, CHUGIAK AK 99567
Legal description EKLUTNA HGTS STEWART ADDN LT 11
Number of Bedrooms 3
Engineering Firm NORTHERN LIGHTS CONSTRUCTION AND ENGINEERING
Buildina Permit Number Not ADDlicable V
APPLICATION IS FOR:
APPLICATION IS AN:
(Z all that apply)
Disposal Field ❑
Initial
Septic Tank F.
Upgrade
Holding Tank El
Renewal
F�
Privy
Well
Water Storage D
THIS APPLICATION INCLUDES A WAIVER REQUEST
FOR:
R-C-
Gv V�r-
r-, 6 e
Distance: 6'—
I-L
Permit/Rush Fees:
Waiver Fees:
Date of Payment:
Date of Payment-.
Permit No. QS
Waiver No.
May 2025
Northern Lights Construction & Engineering
Ph: 907-854-5244
Municipality of Anchorage
Onsite Water & Wastewater Program
4700 Elmore Rd Anchorage, Ak 99507
RE: Proposed Septic System for Eklutna HGTS Stewart ADDN Lot 11
Dear Reviewer,
The above referenced property is currently served by an older septic system with a tank that has failed.
Effluent is backing up at the tank and is not flowing to the drain field. Water cannot currently be used at
the property, and the property is currently occupied by the Owner. Therefore, we are requesting
expedited review of this permit.
Our review of available documentation and field investigation show that this project will not adversely
impact any nearby Wells, Wastewater disposal systems, replacement disposal sites, or drainage flowing
onto and off of the subject property.
The tank was installed in 1978 with a lesser separation distance of 80’ from the well serving the subject
property. A waiver was issued by the MOA on November 16, 1978, for this condition. Additional waivers
for this same condition were issued again by the MOA on September 19, 1986 (WR86-139) and August
14, 1989 (WR890043). This area has a number of wells with waivers for separation distances due to
small lot sizes. It is our opinion that replacement of this tank in the same location will not adversely impact
the well.
We request that the existing waiver be applied to this tank replacement with a new waiver distance of 86-
feet.
There is a shed (labeled as a carport on the asbuilt drawing, but actually a shed with closed ends) on top
of the existing tank that will be demolished before the new tank is installed. There is a wheel chair ramp
attached to the house to the East of the proposed tank location that partially blocks access to parking at
the tank location.
As shown on the plan, the tank and field will be greater than 10’ from the house foundation.
The tank will be of MOA approved construction.
The tank shall be covered with a minimum of 2” moa approved insulation and 3’ of cover or a minimum of
4’ of cover without insulation.
Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854-
5244 or by email mpbalzarini@gmail.com with any questions or concerns.
Sincerely,
Matthew Balzarini, PE
11/4/2025
MATTHEW P. BALZARINI
CE118893REGISTEREDPROFESSION A L E N GINEER
11/4/2025
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251407, Curtis Townsend, 11/06/25
MATTHEW P. BALZARINI
CE118893REGISTEREDPROFESSION A L E N GINEER
11/4/2025
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251407, Curtis Townsend, 11/06/25
., 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
[] UPGRADE
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION NO. OF BEDROOMS
J We I Absorption area Dwelling PERMIT NO,
~ ~ < Z Manufacturer ~~ Ma~ ~ N°- of compartments
~ ~ Liq, capacity in gallons Inside length Width Liquid depth
/~ IF HOME,DE:
~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
O Z ~ Manufacturer Material Liquid capaciW in gallons
Q Well Foundation / Nearest lot line PERMIT NO.
~ ~ DISTANCE TO: /~ ~ ~ ~ /
~ ~ ~ NO. of lines Length of each line Total length of lines Trench width Distance between lines
- / ~ / ~ ~ ~ inches
~ ~ ~. Top of tile to finish grade ' Material beneath tile Total effectiv~ausorption area
n ~' ~ ~ ' ~ inches ~¢~ ~.~
Length Width Depth PERMIT NO.
~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller Distance to lot Pine PERMIT NO.
m Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
PIPE MATERIALS ~,r~.~ ~ ~//~ ~,
SOIL TEST RATING
IN~LLER I I~G'/ I~ r'~ /~.1 '
REMARKS
APPR~ ~ ~ DATE LEGAL
72-0: lev. 3/78)
DEPARTMENT HEALTH ~D EN¥IRONMZNT~ OTECTiON
=.T~E~T, ANCHORAGE, AK. 9960i
264-4?20
~ELL AN~ ON--~ITE SEWER PER~IT
PERMIT NO.
APPLICANT KURKA ALASKAN BUILD INC P.O. BOX 2i4 E. R. 99577
LOCATION
LEGAL Lil EKLUTNA HTS STEWART ADD' LOT SIZE
84~8 SQUARE FEET
TYPE OF' SOIL. ABSORBTION SYSTEM I$: TRENCH
MAXIMUM NUMBER OF BEDROOMS
SOIL RATING (SQ FT?BR)= 250
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
DEPTI""~= --' :~::L LENI3TH= ~m~. 4 EiRFIVEL DEPTPI= 8
THE LENGTH DIMENSION IS THE'LENG~ (IN FEET)'OF'THE TRENCH OR DRRINF~LD.
TIlE DEPTH OF R TRENCH OR PIT IS' THE DISTANCEBETWEEN THE SURFACE OF THE
~ROUND AND THEBOTTOM'-OF THE E~AVATION (IN FEET).
TblERE IS NO SET WIDTH FOR TR~4CHES.
THE GRAVEL DEPTH IS THE.~INIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE
AND THE BOTTOM OF THE ,~CRYRTION (IN FEET).
REQUIRED sEPTIC TR~41( SIZE= 1008 E~RLLOr~4S
PERMIT APPLIC¢INT 'HRS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURIf~ THE
I[,'STRLLm"ION INSPECTIONS OF ~N'/ WELLS ADJACENT TO THIS PROPERTY AND THE
NU~,~,E~ ~F RESIDENCES THAT THE WELL WILL SERVE
TWO ( 2 ) I ~.45PEOT I O~,45 REF r~FQU I RED
~CI(FILLING OF ~' 5'./5TEM WITHOUT FINAL INSPECTION AND APPROVAL BM THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTI~'4.
MINIMUM DISTANCE BETWEEN R WELL RND ANY ON-SITE SEWAGE DISPOSAL SS'STEM IS
100 FEET FOR R PRIVRTE WELL; OR
150 TO ~00 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
WELL LOGS 8RE REQUIRED AND MUST DE RETURNED TO THE DEPARTMENT WITIIIN
OF THE WELL COMPLETION.
OT|:ER REQUIREMENT5 MA~ ~PPLY. SPECIFICRTIONS AND CONSTRUCTION' DIRGRRMS RRE
RVRILRDL. E TO INSURE PROPER INSTRLLRTION
PEF~I~ I T E;-~P I f~FE. DFCF,"IE:F.R .3~::1..,, 1, 9?8
I CERT I F°',' THAT
:L: I AM FRMILIRR WITH THE REQUIREMENTS FOR ON'"*SITE SEWERS AND WELLS RS SET
FORTH D',' TI'tE MUNICIPALIT"*' OF RNCHORFtGE.
~: I WI-LL INST~LL TI~ 2,"5TE~J IN AOCORB~E WITH THE COPES.
¢: I UNDERSTAND TI.I~rTHE ON,-..SITE SEWE~'STEM MAY REQUIRE ENLARGEMENT IF THE
RESIDEN~X~~,~~ ~0 I~D~E~ THIqN ~ BEDROOMS.
SI8 aPP~O~NT-- I:URKa ~SKn~ILD IND ....
I_.~UED D .... DATE ....
O ,~ E GEC~ECHNICAL ~ DEVELOPMENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster
694-2774 S0IL LOG
Soils ~ Foundations
Perfomed for:
Legal Description:
Depth (feet)
0
5
6
7 IAI
9,
Earl Ellis
688.~1~0
Land Development
.ailing Add~ess:~,~ ~;4 ~~,=~ ~ ~
Sotl Characteristics
15
Ground Water Encountered: Yes ,, No__
Proposed Installation: Seepage Pit
Comments: ~ .~-~f~ ~x~
~/ If yes, what depth
Drain Field
Performed by: ~~ Date: /~/?r 177~
DRILLING LOG
Well Owner Walt Kurka UseofWe]l Dom,
Location (address of: Township, Range, Section, if known; or distance main road
Lot 11 Eklutna Heights' Subdivision ?~[v~A~q ~OC~-t~
Size of casing 6" Depth of Hole
Static water level 100 ft. ~,~)
Screen ( ); Perforated (
Describe screen or perforation N/A
Well pumping test at 1~. gallons per (I~Y~;
of drawdown from static level
Date of completion 6 / 26 / 78
204 feet Cased to 136.5 feet
(below) land surface. Finish of well (check one) open end (
).
xx );
(minute) for 1 hours with 100~
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
0 TO. 2 Casing s tickup
2 TO. 4
TO. 25
TO 40
.TO 57
.TO 75
.TO 85
.TO 95
.TO 100
.TO 128
.TO 132
TO 136
__.TO. 204
.TO.
.TO.
4
25
40
57
75
85
95
100
128
132
136
Organics
Silty loose grave]
Sandy gravel
Sandy gravel: cabhly
Gravelly hard pan
Sandy gravel
Silty cobbles
Loose gravel
Silty hard pan
Water Erave]
Hard pan
NWWA Certified Contractor
Certificate No's. 814 ~
Bedrnek: wmtmr ~oopm in sporadic fractures throughout
1 -- CUSTOMER
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
Parcel I.D. # O{;[ - 0~ ~
1. GENERAL INFORMATION
Complete legal description
' ~ · HAA #
Lot 11;
Eklutna Heights
Location (site address or directions)
21624 Bearview Place
Chuqiak, AK
P~oPerty owner ".~ Peter Dekreon
~,', Mailingraddress 6..~ate Whipple Hw~;. ~204
Lending agency i~
":Mailing a dres
A'~ent Barbara Crittenden/ Jack White Real Estate Day phone
Day phone (401) 658-4699
Cumberland, Rhode Island
Day phone
694-5500
Ad dress
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER sUpPLY:
Individual well
Community well
Public water
NOTE:
xxx
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
xxx
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front 'MOA #21
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
S & S ENGINEERING
Name of Firm 17034 ~_-~- giver Ln,,p Reed No. 204 Phone (~'
Eagle River, Alaska 99577
Address ~_v--~/~.~w~-_ / /
Engineer's signature , Date o
DHHS SIGNATURE
Approved for
Disapproved.
Conditional approval for
bedrooms,
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or Omissions in the professional engineer's work.
72-025 (Rev. 1/91) Back MOA i121
ManhOle/Access (Y/N)
High water alarm level at*
Size in gallons
~ at*Datum C
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot '~ 80 z
Absorption field on lot Ic~ / ~
Public sewer main k) !.~
"Pump off" level at*
On adjacent lots
On adjacent lots
Public sewer manhole/oleanout
Lift station
Sewer/septic service line '~ ~'
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
FOundation ~ t -~ Property line ~' ~ 4- Absorption field.
Water main/service line Io~ f' Surface water/drainage ~o ~'~ Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
Surface water
Curtain drain
/L~'~ :~_)Building/' ~ foundation (O,~ Water main/service line
4.- Driveway, parking/vehicle storage' area ,5
~ Wells on adjacent lots ~ ~ ~
ENGINEER'8 CERTIFICATION
Signature ~
Engineer's Name
Date /
HAA Fee $ ~,'~"0
Date of Payment
Reoeipt Number
72-026 (Rev, 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
MUNICIPAL
Box 196650 99519.6650
Parcel I.D.
1. ~, GENERAL INFORMATION
DWELLING
HA950110
Locabon (s~te address or directions),, · , ~
Prone~ owner r,,': Micha~ 'M~6~?'":~:~"~[~'~?' ~ Day phone
Mailing address C/O..G~d, ~V,~hl l 41.1,~O~r G~EE H~V. E~Ze,.
Lending agency" ' . ....... , , ay phone
Mailing address ,'" . . , .... ~,:F~l~;~t~;~,~..~: .::,.,?;...
Agent ~'' Joh~ ~/GEEATLAN~'EEALT~,~',~,~i~'~:?~:?~'~: Day phone
Address 11411 O£d g£enn H~/. '~.~,t,e ~. .~ i;AK
Unless otherwise
2. NUMBER OF BEDROOMS:,~.
3. TYPE OF WATER
NQ,TE:
4, TYPE OF WASTEWA
,:'~,~, ~
"~': '"~, I; ~,~,~?~-~!h
NOTE: If communi~:
attesting
,my
ipal~ty o~,
i'ordinanCes!!and ,reg,
S'ENGII~
I verify that my
)llcatlon~show$ that the on-s te water supply
amber of bedrooms
1'{he Information obtained from
the on;site water
pal and State codes,
::,.~ , · , Condltlonal'a
ROBERT C. COWAN
E-8801 :
:b~lrooms4with the following Stipulations:
Date
:::' ~:: professlonalen
~ ISSUes He~:lth Authority
5 above by an Independent
! to purchasers of homes
L~immentS, Employees of DHHS do not
of AnchOrage Is not
,~ .,' DEPARTMENT
.,.;.;~.~;~.,.?: ~ Division
.... ' ...... , ;: :~ -~.'-. P.O. Box 1~0
.; ' ': '~ '~-,-'~.?~,'~ CERTIFICATE OF H~LTH
' :' . APPROVAL FOR A SINGLE
Parcel I.D. ~O~1- ~- ~ r
:.,,: .
GENE~ INFORMATION _~-':-,"..~.~'
' ' ~ .r. :::.: -:- ' .., ~.:;- ~:';- - ..~,,-,~--
Complete legal descnpbon. ..... Lo~..4
&. :..::.~,,?:~' ~r~i-~Sl~;,m.~/-~e~i~affix~Kl.heretoand aSof the validation date shO~O'~below,, ver,~ that my
". '" ' ori A roval application showstfi~~:th'e-~n'site W~teisuP~l¢'-;
inv~ti atlon of.~.th~s Health Auth,..~.~ pp~. .........: . __, ms
and/o~teWater dispo~l sysmm is ~fe, fun~lonal ana adequate for the numar of b~roo '~
.~, ~- and ~pe of structure indi~t~ herein. I fU~he~ veri~ that'bas~ on the info~atlon obtain~ from
,.,' ~:~ th~ Mun~oi~li~ ol ~n~o~ fll~ an~'~;~'mv inv~atlon and ink.ion, t~ on-~t~ w~t~r;~
~u~ly and/or ~t~t~t.~i~po~l ~y~t~m i~ Incom~li~n~ with all Municipal and 8tat~ ~oa~,,:.
, :'~:~-'~{:~'~ ~ '"~, ~ ~ -"~* ~ ~'-? ~ ~'~'~ ~ ~k,.,.~.,~ "" ' ' Phone ' -- - '-
' ~ '~: ' ....... ~'~:~ ' 'm-~rtlflcata~: b~ ~ii y'upon thempresentatlons
"!~!~..' ~ ~,'~~i~¥~p~r~i~(~miss[$ns In the professional eng
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ~ \/ ~ ~'r'~,~- ¥-~"~ Parcel I.D.
A. Well Data
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed ~ ~ ~.L~ ~ '7~ Driller t~
Cased to ~ L. ,'5' ~a~ing height
Wires properly proteeted~l) x]
AT INSPECTION
Well type ~, ~>~.~
Log present ~) ~
Total depth ~ "-{ ~
Sanitary seal(~l) ~-~
.g.p.m.
Date of test
Static water level
Well flow \,
Pump level1
FROM WELL LOG
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot ~ ~c~ ~
Absorption field on lot \ c,~ ~
Public sewer main ~
Sewer service line
WATER SAMPLE RESULTS:
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank ~-~
Coliform ~:~ Nitrate '~-~, ~ Other bacteria
Date of sample: "'~ -~ 7~"/.--~ ~'- Collected by: <~4t~
B. SEPTIC/HOLDING TANK DATA
Date installed ..~;,.~!~ ~...-~.. Tank size ~c~cx~ ~._w,~-~ Compartments
Cleanouts~)~ "7/' Foundation cleanout(~N) ~ Depression ('~
High wate~i' alarm (y~i;~ ~ . ~,' Alarm tested (Y/N) ~/~
Date of pumping ~'~-~o --~5'~ Pumper .--~_~- . ~o ~.P,~
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
To property line
Surface water/drainage
72-026 (3/93)* Front
On adjacent lots Foundation
Absorption field Water main/service line ~,D
CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N).
High water alarm level
Meets MOA electrical codes ~
SEPARAT~J*~'~CE FROM LIFT STATION TO:
Well on lot On adjacent lots
Manufacturer
Manhole~ ~
"Pump on" level at ~ "Pump off" Level at
~ Cycles tested
Surface water
D. ABSORPTION FIELD DATA
Date installed ~o -'Te, Soil rating (GPD/FF)
Length ~ o t Width ~ * ~ Gravel thickness
Total absorption area .~c~ ~' Cleanout present(~/N)
Date of adequacy test "5 -~ - ~1~ Result~ail)
Water level in absorption field before test'~'"~
Peroxide treatment (past 12 months) (Y~[~
System type
B ~ Total depth / /
Depression over field (Y~
for ~ Bedrooms
After test ~/~J(
~z~ ~.~ ~ If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot ~.O '~
To building foundation _~'2.- /
On adjacent lots ~'~ ~+~
Surface water /~(~ ~ 'P
Curtain drain 'J ~
On adjacent lots \ ~ ~'~ Property line ~
To existing or abandoned system on lot ~-[ IA
Cutbank ~l~ Water main/service line 1 ~ ~'
Driveway, parking/vehicle storage area ~o ~ Jc
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guideline~this inspection.
Signature ....
· '~:.!~ ,...
HAA Fee $ ~L~) ' ~J~ Waiver Fee $
Date of Payment .~ ~ / ~ ~'~- Date of Payment
Receipt Number ~ 7~ (~-/,~-~/~ 1 Receipt Number
/
72-026 (3/93)* Back
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. # ~) ~l ~&, ~ ~-~' HAA # ,.'~L~,_¢-¢ C~,//
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include 10t, block, subdivision, sectionl township, range)
Location (address or directions)
N/J'
(b) Property owner k!' d, b, '~
Mailing Address (,,¢ C~'
(c) Lending Institution
Telephone: (home)
Telephone
· Business
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone
(e) Mail the HAA to the following address: (or check here~[, if hold for pick up.)
List contact person and day phone number below:
S & S ENGINEERING
17034 Ea~_le River Loep Read No. 2G4~
Eagle River, Alaska ~577
2. TYPE OF RESIDENCE
Single-Family~'v Number of bedrooms
3. WATER SUPPLY
Individual Well~ 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 J~ 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 INFORMATION ....
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 end 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 s & s ~.NGiNF. F-~,;~'4G Telephone ~ ~'~ ~-"~ ~
Address 17034 Eagle River Loop Roa~ No. 2~
Eagle ~iver, Al.,k~ 225~
Date ~/~,~ ~
Approved for _~ bedrooms
Approved Disapproved Conditional
Terms of Conditional Approval
Date'
/ -/
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 om issions
in the professional engineer's work.
72-025 (Rev. 7/88) Back Page 2 of 2
A. WELL DATA
Well ClaSsification
u~y MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
, ,CHECKLIST- FEBRUARY 1984
0;~ ^, ,:C,I ,.~ :,,.,,~r. 343-4744
~.NVTT~oNM~N~AL SE~V~CE~ DiVISl~
Legal Description: ~-~'1'" /I
Well Log Present ~.~).~ y Date Cop:~p/eted
Total Depth~o .~r' "'Cased to ! ~'~'~Depth of Grou~tJ.qg '
Static Water Level ! ! 'Z-- ' ~ Pump Set At "'- I ~
Casing Height Above Ground / ~ ff'p ,..-~"~-_~anitary Seal on Casing([~:;/N)
Electrical Wiring in Conduit~:~/N) ~
Depression Around Wellhead (Y<Z3~
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot "~ ~O ; On Adjoining Lots
To Nearest Edge of Absorption Field on.Lot / 05' ' ~ ; On Adjoining Lots
To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole
To Nearest Sewer Service Line on Lot 'Z~ ~ +
Water Sample Collected by ~,~lp ~ ~::::::~/~E:~,"/~-I~)~ ;Date 7-~
Water Sample Test Results ~,¢5"/'75~~ ---- ~/~__.~z
Comments ¥- [,,~,~31/lCr'Z~ ~--'~-~-'~ ,~l'k---~O,
. D.E.C. Approved (Y/N) ~ ,~
Yield ~ 4J:::)~ ~
!
B. SEPTIC/HOLIDI~_~ TANK DAT.~'
Date Installe~1~ /J/7~ Size.
Standpipesd~/N) '/ Air-tight Caps ~'N)
Depression over Tank (Y/<~)
No, of Compartments
Pumping/Maintenance Contact on File (Y/N) /
Holding Tank High-Water Alarm (Y/N)
SEPARATION DISTANCES FROM SE~LDING TANK:
To Water-Supply Well ~c~/// To Building Foundation'
Foundation Cleanout ~N) y
f4//~ate Last Pumped '7- ~ ~'~'
; for
Temporary Holding Tank Permit (Y/N)
T° Property Line
To Water Main/Service Line
To Stream, Pond, Lake or Major Drainage Course
Comments
To Disposal Field
72-026 (Rev, 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ~/.o /
Width of Field
{~//~//? ~-' Length of Field z:~ /
~ Depth of Field //
I Bed Thickness 'l~ /
Square Feet of Absortion Area ~,'~o '~ G,~e Statndpipes Present (~'N)
Depression over Field (Y~[~ ~-~ Date of Last Adequacy Test
Results of Last Adequacy Test '.~,~'!~_~..~ ,~'~ ~ 2--
SEPARATION DISTANCE FROM ABSORPTION~LD:
To Water-Supply Well / '~'~
To Building Foundationl ~'Z~ ~-' To Property Line ~,~
To Existing or Abandoned System on
Lot ~/'~ ~ ; On Adjoining Lots/ ~'~/'~
To Water Main/Service Line /o ~1- To Cutback (if~Present)
To Stream, Pond, Lake, or Major Drainage Course / c~ ~
To Driveway, Parking Area, or Vehicle Storage Area ~,1~ ~ ~
Comments
Date Installed
Dimensions
Size ir~.~o n s
"Pump On"~
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
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 effect
inspection.
Signed $ & $ ENGINEERING
17034 Eagle Klear
Company ~..~. m,,~r. Alaska 99577
MOA No. ~/' ~
Receipt No. C~'
Date of Payment
Amount: $
72-026 (Raw 7/88) Back
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
act (;Lr'~t~_e date of, ,tl~js
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
FEDERAL TAX iD # 92-0040440
ANALYSIS REPORT BY SAMPLE for Work Order ~ 15206
Pate Report Printed: JUL 27 89 @ 13:39
Client Sample ID:Lll EKLUTNA HGTS
PWSID :UA
Collected JUL 24 89 @ 18:30 hrs.
Received JUL 25 89 @ 16:00 hrs,
Preserved with :AS REQUIRED
Client Name : $ & S ENGR
Client Acer : SNSENGP
?.0.~ NONE
Req #
Ordered By :
Analysis Completed :JUL 26 89 Send Reports to:
Laboratory Supe~v~q~:.STEPHENC~~ EDE 1)S & S ENGR
Released By
Special
Inetruct:
Chemlab Re£ $: 6564 Lab Smpl ID: 1 Matrix: WATER
Allowable
Parameter Tested Result/Units Method Limits
NITRATE-N 2.5 ms/1 EPA 353.2
Sample ROUTINE SAMPLE
Remarks:
1 Tests Performed ' See Special Instructions Above UA~Unavallable
ND- None Detected ** See Sample ~emarks Above
NA~ Not Analyzed LT-Less Than, GT-Graatez Than
unicipality of Anchorage
Department of Health and Human SerViCes
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
August 14, 1989
Robert A Shafer, P.E.
S & S Engineering
17034 Eagle River Loop Road
Suite 204
Eagle River, Alaska 99577
Subject: Waiver Request for Lot 11 Eklutna Heights Subdivision
Waiver Request 9WR890043, ~HA89-311, PID ~051-063-28
Dear Mr. Shafer:
Your request for waiver of the required 100 foot separation of
a septic system to a private well has been approved. The
approved separation distance is 80 feet.
This waiver approval applies to the existing septic system to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this department.
Si~erely; ~
Robert W. Robinson
Civil Engineer
On-site Services
RWR/ljw ~6
MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
RECEIVED
ROBERT SHAFER, P.E.
ROGER SHAFER
August 8, 1989
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
HEALTH AUTHORITY
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
Muni~pality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519~6650
REFERENCE: Lot 11; Eklutna Heights
Request you ~sue the attached Health Authority Approval and grant
a waiver for the horizontal separation distance b~tween the private
well and septic tank located on the referenced property at a distance
of 80 ft.
The septic system was installed and inspected in October of 1978,
with the lesser separation distance noted. An approval of the water
and sewer facilities was issued on November 16, 1978 by the Municipality
of Anchorage (MOA).
The septic tank was excavated at this time and water tight couplings
installed. The topography of the area is generally flat. Area well
logs show various layers of soil with a "silty hard pan" from 100
ft. to 128 ft. on the well log for Lo~ 11.
A risk analysis has been performed and it appears that no bacterialogical
pollution is possible from this source. Attached for your review
are the following documents:
A. A plot plan showing relative distances betweeen wells and
septics.
B. Risk analysis waiver review worksheet.
C. A flow test report for the referenced well.
D. Well logs for the referenced and neighboring wells.
E. Coliform and nitrate analysis of water taken from the well
located on the referenced property.
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
Page Two
Lot 11; Eklutna H~ights
August 8, 1989
It is our opinion that the horizontal separation distance prescribed by 18AAC72.021
is not required in this case.
If you ~uire)additional information for your review, please contact us. /
,, SCALE I
SCALE
t
~ASEMENTS OF RECORD, OTHER THAN T~OSE SIIOWN ON TH]
~ECORDED PLAT ARE NOT SHOWN I{EREON.
~he!information hereon is for the use of lending
.nstitUtionS showing the relationship of existing
;trUctures and Platted easements and lot lines.
~t is~'not'.to be used for positioning additional
~truct~u~.es, or fen¢elines.
~RAWN: DMS I ~ DATE: 5-25-89
:~ALE: 1"=20' FB: 8-04 ' -- ~ NWl460
I herebyi certify that I have performed a Mortagee'e b~-!:
~pection of the lollowi~g described property:
Eklut.~a ,Heights Subd., Lotll' __:
Anchorage Recording Precinct, Alaska, and that the improve-
merits situated thereon are within the property lines and do
not overlap or encroach on the property lying adjacent there-
to, that no improvement~ on prol:~rty lying adjacent thereto
encroach on the prernkses in question and that ther~ are no
roadways, tra.nsmission lines or other visible easemeat:~ on
~aid property except -. lndicalzd hereom
Dated at Anchorage, Alaska
this 25 __._day of May __ lO 89 , _
688-4566
S['_'NA}U) & ASSOCIATES LAND SURVEYING
17034 Eagle River Loop Road
Eagle River, Alaska 99577
PROJECT
LOCATION OF WELL {Legal Description): ~'
WELL DEPTH:_ '"'~:;>~C' FT. CASING: \~
DATE DRILLING COMPLETED:_ {Y~ --'~Z"t'~O ' ~ ~
ROBERT A. SHAFER
CIVIL ENGINEER
694-2979
FT. SCREEN:
STATIC WATER LEVEL (top of Casing): ___~_ _~-~_~ FT. DATE: _ .~ ~ ~ ...~.~.~,c~
ELAPSED TIME SINCE DEPTH TO DRAWDOWNI PUMPING
CLOCK PUMPING STARTED/ WATER, FT. RECOVERY RATE, GPM REMARKS
lIME STOPPED, MIN.
, ' ,' ~::~ 0 Start
. ~. f> ~o \[2.- (sw,) o
5 ~ ~"- ~' ~,~ ~~
' 45 1
r
50
55
60 (1 hour)
----- 120 (2hou rs)
~ 150
~-- ~ 210180 (3 h°urs) / -'] ~/ _~' '~'~
-------- 240 (4 hours) ~~~
RECOVERY (/~,
15
20
25
30
35
Flow is not Guaranteed
~bsoquont Variations
Can Occur.
'~-W DRILLING, INC.
DRILLING LOG
Well Owner Walt Kurka UseofWell Do~I.
Location (address of: Township, Range, Section, if kmown; or distanc~ main road
Lot I1 Eklutna Heights Subdivision 5~£~,1~ /~Carl~
Size of casing 6" Depth of Hole
Static water level 100 ft. (g~vv~)
Screen ( ); Perforated (
Describe screen or perforation
Well pumping test at 1-~ gallons per ('F~-~: (minute) for
of drawdown from s~atic level
Date o! completion 6/26/7~
204 feet Casedto--136-5 teet
(below) land surface. Finish of well (cheek one) open end ( XX );
).
~/^
1 hour~ with
WELL tOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
0 TO 2 Casing stickup
2 .TO 4 Organics
4 .TO. 25
25 .TO. 40
40 TO. 57
__.TO. 75
__.TO 85
TO 95
__.TO 100
___TO 128
TO 192
TO 136
,TO 204
__.TO
__.TO
57
75
85
95
100
128
136
Silty loose ~ravel
S~Hdy gravel
Sandy gravel~ rnhbly
Gravelly hard pan
Sandy Kravel
Silty cobbles
Loose gravel
Silty hard p~n
Hard pan
CUSTOMER
Depth in feet frmu
2
[' £°o ,,TO
85
95
,,t2,,~
(_minute) fm'~ WJ,h
Olw det~l_~ of forndt!~m~-~ penetrated, size e~ nmterl~ ~
.~n Lc~
!
Sandy
C~avel~7 hard
Sandy ~ravel
Silty cobbles
lOl~ tlL~
3 - CONT/U~GTOR
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ¥~(,,~_:~ -- f' ~[ ~,~ /
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
GENERAL INFORMATION
(a)
Application Date September 8, 1986
LegaiDescription(includeiot, block, subdivision, section, township, range)
Lot 11 Eklutna Heixhts Stewart Edition T15N tlW Sec.~
Location(addressordirections)
Anchorage"
(b) AppticantName Chris Kilday Telephone:Home ~J37- Business 265-8767
Applicant Address 4840 E 43rd Apt' d-1 Anchorage; Alaska 99~08
(c) Applicant is (check one): Lending Institution []; O,,wner/builder []; Buyer []; Other [] (explain);
(d) Lending lnstitution 1st Interstate of Alaska Telephone 276-7200
Address Pou. ch 70~ 2 Anchorage ~ Alaska 99510
(e) Real Estate Company and Agent N/A
Address N/A
(f)
Telephone N/A
Mail the HAA to the following address:
p-i~k~? by ang-ineer
TYPE OF RESIDENCE
Single-Family [] Multi-Family []
Number of Bedrooms ~
Other
WATER SUPPLY
Individual Well [] Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite [] Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11/84)
,ENGINEERING FIRM PROVIDIN~ INSPECTIONS, TESTS, FILE SEARCH, DA,~ AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of tills He41th
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 dompliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection. * With apProval of well to septic tank separation of 80'
Name of Firm
Address
Date
FA6LE R!VER ENG!NEER!NG SERVICES
EA6LE RIVER, AK 99577
P, O, BOX 773294
694-5195
Telephone
DHEP APPROVAL
Approved for "/'¢'"'~--~- bedrooms by
Approved Disapproved Conditional
Terms of Conditional Approval
Date
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 (11/84)
WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
ANCHOI~G~HECKLISTc ' FEBRUARY 1984
NUJNICIPALITY
264-4720
DEPT. OF HEALTH &
Sm -
RE CEIV.ED
Well Classification
Legal Description:
Well Log Present (Y/N) ~'
Total Depth ~, o ~ / Cased to ,/*~;
Static Water Level [ O 7 ~
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole ,V./~-
Water Sample Collected by ~J
Water Sample Test Results ~ ~ ~' '~'~-'~'~'
Comments '~CuC// -- 7-~ ~,~ ,~..~,v'e~,,- ...~-~-J
If A, B. C. D.E.C. Approved (Y/N)
Date Completed ~/.~, ~,/7~ Yield
Depth of Grouting A,//',,c
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots ~'/O~D ~
/,~o ~ ; On Adjoining Lots ¢-/o ,~"
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
;Date ~/.~7--/,~ ~'
SEPTIC/HOLDING TANK DATA
Date Installed /'~ ~'''~ Size /,~..~ ~ L No. of Compartments
Standpipes (Y/N) ~ Air-tight Caps (Y/N) .,Y Foundation Cleanout (Y/N)
Depression over Tank (Y/N) "~ Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) ~//'~ ; for ~"~
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
Temporary Holding Tank Permit (Y/N). ,~x~
To Water-Supply Well ~'~
To Property Line /~ /
To Water Main/Service Line
Course ~'/~ /
'/-/O"
To Building Foundation / I
To Disposal Field ~ CZ ¢
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata '~-~-~ ~'~'~
Date Installed
Width of Field z./~"
Square ~-eet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test ~ f~c ~--~/~,~,
Separation Distance from Absorption Field:
To Water-Supply Well /o~ /
To Building Foundation /~ ~
Lot
To Water Main/Service Line ~'/~ /
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
Type of System Design 7-~¢,~,c
Length of Field /-~"~
Depth of Field //
Gravel Bed Thickness
Standpipes Pr~esent (Y/N)
Date of Last Adequacy Test
To Property Line ~:'
To Existing or Abandoned System on
; On Adjoining Lots ~'o ·
To Cutbank (if present)
LIFT STATION ~//~
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Dimensions __
Manhole/Access (YIN ~"~'~'/~ -
"Pump Off" Level
Vent (Y/N)
Pumping Cy(
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelir
Signed J.~~ Date ~///'"~ / ~6
Company ~'~'~ ~, _F, MOA No. '-~" ~-'""~- ~*,~
Receipt No.
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
~ DEPARTMENT OF HEAL'TH & ENVIRONMENTAL PROI~;/,~/jR · LTH ~
825 L Street-At,chorage, A,aska 99501 ONMENTAL PROTECLTi~(~-~ IJ-,,~-')~,~,
DIR[CTION8: Oomplete ail parts on page 1. Incomplete reques~ will not be processed. Please allow ton (10) days for processing.
~a~te~ ~. ~a~ka L 69~-3493
MAILING ADDRESS
~ost O~&ae ~o~ 2Z~ 99577
2, BUYER PHONE
Chris Kilday
MAll.lNG ADDRESS ......................
3. LENDING INSTITUTION ~ PHONE
Alaska Bank of Co~erce 279-5641
MAll_lNG ADDRESS
3230 C Street 99503
4. REAL3'OR/AGENT [ PHONE
=oh e=a =rea =ea=or ..............
MAILING ADDRESS
Post Office Box 249 99577
~: 'L~GAL ~ESCR,.T,ON
Lot 11 Eklutna Heights Subdivision
STREET LOCATION
6. TYP~ OF RESIDENCE NUMBER OF BEDROOMS
~ One L-~ Four Lq Other
~ SINGLE FAMILY ~ Two ~ Five
[~ MULTIPLE FAMILY $ Three ~ Six
7. WATER SUPPLY . .
~ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled
~ COMMUNITY since June 1975. For wells drilled prior to that data, give well
~ PUBLIC UTI LITY depth (a[tach log if available.)
"8. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE** ~*lf individual/on-site, give installation date_ 1~3_8
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.
72~10(3/78)
THIS SIDE FOR OFFICIAt. USEONLY
f~AI ~ HECEIVED
INSPECTION APPOINTMENTS
' ........................... * To '--; ............................. INSPECTOR
i rJ~PECI )R INoPECFOR
/1, 1YPE OF RESIDENCE NUMBER OF BEDROOMS
L ~ SINGLE FAMII.Y
~i~; MULTIPLE FAMILY
2, Nr'JAI'ER SUPPLY
INDIVIDUAL
COMMUNITY
" PUBLIC UTILITY
Co,mection Verified
3 :EWAGE DISPOSAL SYSTEM
i)INI)IVIDUAL/ON -SITE
E:] ()NE [:] THREE [23 FIVE
[Lq TWO [~] FOUR ~_1 SIX
PERMIT NUMBER
DEPTH OF WELL_
I)ATE DRILLED
LOG RECEIVED
F___.] OTI4ER
PERMIT NUMBER
DATE INSTALLED
UTILITY
(%al;J~ection Verified .................... ~'-,~ L. L E F~ ....................................
T,mk or [~]]Holding Tank
/¢O ........ If Tank is homemade SOILS RATING
ANK MANUFACTURER
ABSORPHON AREA MATERIAL
'5 L;;CWiMENTS
APPROVED FOR _.__~__~___ BEDROOMS
CONDITIONAL APPROVAL (letter must accompany certificate)
OISAPPROVED
~ d q (l~v. 3/?8)
'REALTORS'
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Type of Inspection: CMRO
2. Property Owner:
Mailing Address:
3. Name of Buyer:
VA FHA
CONV ~
o
Mailing Address: Day Phone
Name of Lending Institution: ~//"/,'~-r///? :' >,?~'/~A/ o':/
Mailing Address: C~' ,j~:- :: ,-_~; -//. Phone
Name of Realtor or Agent: (:,5,e :// :~J/:~ ., , : '
o
o
Legal Description:
Location:
Type of Facility to be inspected:
No. Bdrms. -
Water Supply
Type of Supply: Public Utility
Individual
If Individual, number of dwellings presently served /
If Individual, depth of well
9. Sewage Disposal System
.Typ6 of System: Public Utility __
If Individual, date of installation:
Individual (on-site)
· REALTOR®
AREA, INC. REALTORS
~l~ Anchorage
"C" St. Office
3300 C Street
(907) 278-2525
[] East Anchorage [] Eagle River
Eastgate Office Parkgate Office
5437 E. Northern Lights P.O. Box 249
(907) 278-2525 (907) 694-9555
unicipaHty
Anchorage
P.O. BOX 6650
ANCHORAGE, ALASKA 99502-0650
(907) 264-4111
TONY KNOWLES,
MA YOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
September 19, 1986
Lou Butera, P.E.
Eagle River Engineering Services
P.O. Box 773294
Eagle River, Alaska 99577
Subject: Lot 11Eklutna Heights, Stewart Addition
Waiver Request, WR86-139
Dear Mr. Butera:
Your request for a waiver of the 100 foot separation required between
the septic tank and well on"the subject lot has been granted. This
distance has been waived to 80 feet.
This waiver is valid for the existing three bedroom single family
dwelling only.
Sincerely,
Morris
Civil Engineer
On-site Services
SSM/Jw
EAGLE RIVER ENGINEERING SERVICES
Lou Butera P.E.
P.O. Box 773294
Eagle River, Alaska 99577
Telephone (907) 694-5195
September 12, 1986
Mr. Steve Morris
Civil Engineer, On-site Services
Municipality of Anchorage
P.O. Box 196660
Anchorage, AK 99619
REF: Lot 1! Eklutna Heights, Stewart Edition
Dear Mr. Morris:
On behalf of my client, Chris Kilday, I am submitting the
information necessary for your determination of a waiver of separation
distance, well to septic tank, to 80' for the above referenced lot.
The septic system absorbtion rate has been tested and found
adequate for a $ bedroom use. The leachfield was installed in 1978 by
Kurka Alaska Builders and was inspected by Earl Ellis and approved by
the Municipality at that time as per the inspection report enclosed.
The request for approval shows the well to septic tank distance as
,.~ 80' Our field measurements confirm the tank inlet to be at 80' from
the well. The enclosed well log shows that the well draws from a
~ bedrock confined aquifer at a depth of 136-204'. The casing is
~entinuous to 136.6' where it is seated into bedrock. The surface
· topography is level from the well location toward the septic tank with
~the house located directly between the two. The subsurface soil is a
~M type with a perc. rating of 255. A water sample for coliform
~acteria was satisfactory. This area, due to small lot size, has a
number of wells that contain waivers of separation distance. It is
expected that since the installation was inspected by an engineer, the
connections to the tank are as required in 1978.
If there are any questions or if additional information is required,
please feel free to contact me at 694-5195.
Sincerely,
Lou Butera, P.E.
Encl: HAA application
soil log inspection report