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HomeMy WebLinkAboutEKLUTNA HEIGHTS BLK 2 LT 7B · Municipality of Anchorage Page I of ~-- DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: :~'('~ c~~ O ~'"''/(~ PID Number: ~i -~1 Name: LO~Ai~ [~ ~m~oc~ Wastewater System: ~ New ~'Upgrade Address: ~o ~L~ ~ k~,, k~ ~ ABSORPTION FIELD Phone: ~S--~ ,o. of~drooms:~ ~ Deep Trench ~ShallowTre~ch ~Bed ~Mound DOther LEGAL DESCRIPTION so~ Rating: O. ~ GPD/Sq. Ft. Total Depth fro~o~iginal grade: Lot: ~ ~ Block: ~ ~Subdivbi°n: ~ ~l~ Depth to pipe bo~om~, ~fr°m~ odginal grade: Ft. Gravel depth ~,beneath~ l pipe Ft. Township: Range:~ I Section: Fill added abovel, ~l°rigin~l_ ~grade: Ft. G r~ve]~ ~length:~l~ ,~ ~1 Ft. Number of lines: Distance ~n lines: WELL: EKI~New ~ Upgr~' Gra~e, width: Z.~I Ft. ~ {~' Ft. Classification~ ~(Private'~u~i~A'B'C): ~ ~Ft. Cased To: Ft. Total absorption~oarea: SQ. Ft. Pipe~material: O Driller:~ Date Drilled; Static Water Level: Installer: Date installed: ~ GPM Pump Set at: Ft. Casing Height Above Ground:Ft. TANK SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P. To Septic Absorption Lift Holding )ublic/Pdvate Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~ ~ C ~ ~GE ~ I 00  Number of Compa~ments: Wel~ ~t~ i~ ~ __ Z~l~ Material:~e~ Sudace Water IOOl.+ iool+ ~ -- _ LIFT STATION Lot ~t Sizein gallons: Manufacturer: Line ~ + I0 I~ Cu~ainDrain ~ ' ~" ~ ~ ~ ~ P~lectrical Inspections pedormed by: Remarks: BENCH MARK ,Location and Description: E N~~AL .... ~,.~,~:~,N~ Dates: 1st Iz-zo-'lG ~ ,~~._~:._ Inspections pedormed by: ~ ~ '; '%' ' ' ~""~'~'"~'/'"~ E~e [~tver, AlaSka 99577 *i,~ CE-8~01 Depa~ment of He approval ',," ..." .... Reviewed and approved by: ~~ ~' / ~ ~ Date: /-2~-~ ~<~,~'-".-~"~-~,<~<.~.~ 72-913 (Rev. 9/91) MOA 25 SW960579 2 2 Permit No. Page of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT 7B, BLOCK 2, EKLUTNA HEIGHTS S/D PIDNo.: 051-061-69 I k B ~ INSTALLED rL W .T~ ST1 1 .0' 15.5' ~/p)' ~ DIVIDER COZ ~_ DDmO~ ST2 2: .0' 1 9.0' ER(;. TEST o.s' s~. 001 2( .0' 30.0' ~%NEW I000 GAL C02 5~ .0' 57.0'  SEPtiC TANK MT1 5; .0' 40.0' ~W~ ' ~- . C03 21 .0' 54.0' % . ATH I % ~' .g' ~.g'  3 BDRM ~w~ GtRAOE H ~USE ~w~  WAT R LINE~ (APPE)X, LOC,) 8G~ 1" = 40' ST1 ~INS[ ~TION 6~~ N~W ' 1000 GAL ~4'TAN~SEP~[C ' ~ = ~ ~ ~ = ~' 96 MT2 C03 ~, CO1 "' I1~~-- ~ co~ = 5.a' cos = a~.l' ~T1 = 8!)4' MT2 = 89.2L NC WATER FOUND 83.2' B.O.H. 72-O13 A (Rev. 9/91) MOA 25 PERFORMED FOR: LEGAL DESCRIPTION'. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST c, ,~,,.,.- 1 2 3 7 8 9- 10- 11 12 13- 14- 15- 16 17, 18- 19- 20- ~jS~'"C'zttv~OCJ~.~'- DATE PERFORMED: I -~m"O ,..~'~ o ~/.~/~,'[~wnship, Range, Section: - ~.-~ , SLOPE SITE PLAN WAS GROUND WATER ~ l~) ENCOUNTERED? DEPTH? ~. pO E Depth to Water Alter Monitoring? --'"'-- Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN "~ COMMENTS ~0 .~13) TlO~ ,,CZ.. P~,'~¢~, ~L,4 7/~' 7'~ $' 7- (minutes/inch) PERC HOLE DIAMETER __ FT AND (.~ FT / 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX.196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW960379 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:HAMMOCK LORAINE J OWNER ADDRESS:21635 SETTLERS DR CHUGIAK, ALASKA 99567 PAGE 1 OF 1 PARCEL ID:05106169 DATE ISSUED:12/18/96 EXPIRATION DATE:12/18/97 LEGAL DESCRIPTION: EKLUTNA HEIGHTS BLK 2 LT 7B LOT SIZE: 71748 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ISSUED BY: ~'~/ DATE: /~-// ~ /~/~ DAT .: / :Z -- ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. CIVIL ENGINEERS December 2, 1996 (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOWTEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 7B, Block 2, Eklutna Heights Subdivision Request you issue of a permit to upgrade the septic system serving the three bedroom house on the referenced property. Due to high nitrate levels, the existing well is to be permanently abandoned according to water well ordinance AO N0.96-98(S) (amended and approved S-13-96) and the existing house will be connected to a Community Water System. A test hole was excavated and percolation test performed in the area of the proposed upgrade. The approximate location of the test hole is located on the attached site plan. At the time of excavation no water was encountered and after seven day ground water monitoring, the monitoring tube was found to be dry. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, Cowan, RCC/gk PoEo Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 LOT 9A PIONEER STREET ~ ~ ~ ~ ~ 0 ~ ~ ~ ~T~~ ' AS PER OCCUPANT az Z ~ / ~ ~ / / PERFORMED FOR: LEGAL DESCRIPTION: Uq 1 2 3 4 5 6 7 8 9 10 11 12 13- 14- 15- 16 17 18 19 20 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ~ '~ ~ [~T..ownship, Range, Section: SLOPE WAS GROUND WATER . [~ ENCOUNTERED? L DEPTH?IF YES, AT WHAT ,A' pO E SITE PLAN Deplh tO Water,~.r), I MonitorinD? ~ Dale: Gross Net Depth to Net Reading Date Time Time Water Drop ~1 " ~ '1'~ 1," PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER ~ TEST RUN BETWEEN ~'~ FT AND ~ '~ FT COMMENTS PERFORMED BY: .~A.~.~ ~..I.m.' .... ] .._..~ D...I kl. et~l I/----- CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE W~I~L~ff~I~PAL GUIDELiNES IN EFFECT ON THIS DATE, DATE: / ~ /~ q ~ 72-008 (Rev. 4/85) G£;-'~TER ANCHORAGE AREA BOROI)~H D~.,RRTMEBIT OF ENVIRONMENTAL QUAL / 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ADDRESS //~'~ LOCATION ,/~//':~/~ ~U/~ ~'~=: ~'-'~Z~z~' ~=~LEGAL DESCRIPTION ~'~ '7// SEPTIC TANK: DISTANCE FROM WELl LIQUID CAPACITY MATERIAl ,,,~'''/~= Z:-z/~ NUMBER OF ~ COMPARTMENTS ~2Z~(.l//(~'~-j'~=~ /~ ~('~/ //' //'¢'{{']/J'/'/~J~'- LIQUID GALLONS. INSIDE LENOTH INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: , DEPTH ' NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH , LENGTH NEAREST LOT LINT TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) TILE DRAIN FIELD: ~ , F- NDATION NEAREST LOT LINE DISTANCE FROM WELL O~ , NUMBER OF LINES // DISTANCE BETWEEN~ TRENCH WIDTH DEPTH: TOP OF TILE TO FINISH GRADE DEPIH OF RIAL-B,EI~EATH-IIEE~ TOTAL LENGTH , OF LINES / I~TOIAL EFFECIIVE IN. ABOVE TILE -- DISTANCE FROM / WATER j~.,/~/~/~:- , NEAREST WELL: [ypEz~.~/J/ DEPTH , BUILDING FOUNDATION._ ,~2~)'- SAMPLE NEARES1 ~ SEPTIC / SEEPAGE . ,' OTHER LOT LINE (~>-~'//.. -' ~'~ ~'~ SEWER LINE TANK ))~'-~ . SYSTEM ./'~6 . CESSPOOl -~ . SOURCES DISTANCES: _~<,,' ~ -/~/ B AGRAM OF SYSTEM APPROVED ' G~.A.B. GREATER ANCHORAGE AREA BONOUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCh 6-650 ANCHORAGE. ALASKA 99502 TELEPHONE 279~8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION Of: SEPTIC TANK ~ SEEPAGE P1T.~ ., DRAIN ~IELD OTHER FINAL INSPEC:TION= 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJEC:T TO pI~OSECUTION. DIAGRAM OF SYSTEM MINIMUM DISTANCES, REQUIREMENTS 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 SEEPAGE PIT TO RIVER, LAKE, STREAM. DRAIN FIELD DRAIN FIELD · SEEPAGE PIT , ALSO CONSIDER AREA WELLS. , SEEPAGE PIT DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING (~AP 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. .//v - ~ HE.~,L/Th aUthOhITY ~/ I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE APPLICA"T'SS'G"AT"RE .(~ ' 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 Parcel I.D. # 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ]'.ot 7]3; Block 2; Eklutna Be'iqht~ LocatiOn (site address or directions) 21635 Settlers Drive Chuqiak, AK Property owner Mailing address LOrraine Hammock 8660 Williwa Avenue Anchorage, Day phone AK 338-1811 Lending agency Mailing address Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well Community well NOTE: Public water if community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. ~. . TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: 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 m 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 in. dicated 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 wastawater 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 ENGINEERING 17034 Eagle River I. oop Road NO. 2~ Address Ea~lle River, ~Ala,ska 99577 Engineer's signature ~,~Z_ Phone Date / /~; / ~ 7 DHHS SIGNATURE 'X Approved for ~,D Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Note: The well for this property meets existing State and Municipal Co'des. There are nitrates present. It is ~,,~d f'hnt ,,:J .nartnd~c testin~ be performed to insure the Wells continued suitability. Nitrate concentration is 5.1 mg/1. EPA · ~;.~--..~ ........ -~^. ~ Inn ~g/] --. : . ? ' .~ :: '. Th~ Uunici~ll~ of ~nchomge Dep~ment of Health ~nd Human Se~ice~ (DHHS) I~ues Health Authori~ ApproVal. ~... C~ifi~t~"b~S~,,,. only upon the mpre~en~tions g ven n p~mgmph 5 ~bove by ~n nde~ndent prof~mnal engin~r reglster~ In the State of Alaska. The DHHS does this ~ ~ cou~esyto purch~m of hom~ ~nd their lending In~titutlon~ in order to ~tls~ ceftin f~eml ~nd ~Mte r~ulmmen~. Employ~ of DHHS do not conduct tn~pe~ion~ or ~n~l~e d~t~ before a oe~ifi~te i~ i~uM. The Uunicipali~ of Anchorage is not r~ponsible for errom or Omi~ion8 in the pr°fe~ional engin~ wo~. 72-(~6(Rev, 1/91) Back MOAiY21 D. LIFT STATION Date installed Size in gallons ~ Manhole/Access (Y/N) "Pump~'Pump off" level at* High water alarm level at*..._~'~'/*Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main S~ Lift station SEPARATION DISTANCES FRO~OLDING TANK ON LOT TO: I FoUndation ~ Property line . ~ol..,+ Absorption field Water main/service line I o I.f..Surface water/drainage ! co14' Wells on adjacent lots On adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line - I O Building foundation I o I-I' Water main/service line Surface water . I o ~ ! -f-~ Driveway. parking/vehicle storage area Curtain drain I~ /~ ,, Wells on adjacent lots I 6'o R ENGINEER'S CERTIFICATION *..~ I certify that I have determined thru field inspections and review of Municipal records ,n conformance w~O~_ HAA g~el~ ln_ effect on thls date. Signature Engineer's Name ~z~,e~ ' ~". Date Waiver Fee $ Date of Payn~ent Receipt Number HAA Fee $ t7~z~' ~) Date of Payment C)//C)'7/~'~ Receipt Number '~ ~-4 7 72-026 (Rev. 3/96)* 16:1G CT&E ESI ANCHORAGE ~ 907G941211 N0.8~4, Drir~king Water Analysis Report for Total Coliform Barter-ia ~oo w, ~o,,,~ : Am;horag*. AK 99518.1605 READilNSTRUCTION$ 0.~I ~VE~E SIDE BEFO~ COLLECTING 5AMPLE ~rel: (9071 562.2343 , ~F~x: {go7} 5~1-530~ PUBLIC WATER SY$TEM I.D.~ [ l' J I [ I Analysis shows~i$ WaterS~PLg to k ~*~'~ul~ 0 $~ In.ice UnsatiSfacto~ to indicate reliabl~ resal~. ...... new samp~ via special d¢liv~ mail. Analytical M.thod: ~ Membran. Filter ~,? s~, z,~c~i · j · Number ofc~lonie//100 m), I Month Day Year s.~ wm 96. 7085. J O { ~epeat Sample (for routine $ample O Untreated Water [ with lab ref, no. ) Date: .... Time: i Time Collected Client notified of unsatlsfac~o~' results: S~LE LOCATION ColJected By ~ ~. BACTE~OLOGIC~ WATER ~ALYSIS ~CO~ MM0-MUG Rc$ok: To~l Coliform E, Coil Membrane ~her: Direct Count . ~ Coloni~lO0 mi ' Vcrification: LTB _._ BGB COLIFIRM r.~Tc'- r,., Fecal Colirorm Con firmafio~ o~ Finml Membrane Filter Result~ __ , ' Co,form/lO0 mi Comma .... FART ONE OF D07 CT&E Environmental Services Inc. Laboratory Division -~,~-~,~.t~-~,~,~,j.a.~e~.~,~..~,,a.~.~,,~~~t/mjjj/t~ 01×0~/97 16:15 CT&E ESI ANCHORAGE ~ 90769~1211 NO. 82~ ,~ CT&E Environmental Services Inc. CT&E ReL# 967085003 Client Name S & S Bngilt¢~fing Project Name/# Client Sample ~ L7B B2 Eklut~ Hts Matrix D~.i~ Water Ordered B~ Sianpl~ Remarlcs: Sanple collected by: Ray. 2'13750 Client PO# Printed Date/Time 0l/02/97 16:05 Collect~At DatdTimc 12/30/96 12:15 Received Dat~/Tlme 12/30/96 / 4:25 Technical Director: Stephen C. F. de Nitrote-N Total Cot iform Results 5.10 0 POL Units Atlowable Prep Analysis Method Limits Date Date Inlt 0.500 mg/L 0 col/lOOmL SM18 ~500-NO3F 10 max $M18 92ggB 12/31/96 WBP lg/30/96 TRY EXCAVATION ROBERT A. SHAFER WORK CIVIL ENGINEER 694-2979 March 26, 1983 James Christian 4101Wispen Circle ~A Anchorage, Alaska 99503 Dear Mr. christian, MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMFNTAL PROTECTION APR lg83 RECEIVED Reference: Lot 7B: Block 2: Eklutna Heights Subdivision A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank had been v~ to have a capacity of 1.~LS~ gallons during a previous adequacy test performed by this office. At the time of this test the septic tank was empty and did not require pumping. The seepage pit was tested by charging the system with approximately~_SQQ gallons of water and after a period of 24 hours all the water which had been added to the crib had percolated out. It can be concluded from this test that the waste water disposal system serving the four bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failures. The standpipe in the seepage pit needs to h~ ~w~nd~ until it extends above the surrounding soil. It should also be noted that a water sample was taken from the hose bib on the back of the house and an analysis performed by Chemical and Geological Laboratories of Alaska. The results of this test indicated that the water sample was satisfactory. If we may be of further service, please do not hesitate to contact US. Si (....-ff'/RO~E, RT A. SHAFJZR, P.E. sZss 'cc: Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA CHEMICAL & G,.~LOGICAL LABORATORIE~'~)F ALASKA, INC.~., (907)-279-4014 ANCHORAGE INDUSTRIAL CENTER ~d_,/'/~s/~l~i TELEPHONE 274-3364 5633 B Street Drinking Water An§lysis Repol~t for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: I II I I Ii ,....o. c~ ///) " sm~ zip Code SAMPLE DATE: ~ ~ ~ ~/ Mo. Day Year SAMPLE TYPE: I-1 Routine [3 Check Sample (for routine sample I 13 Treated Water ~ /with lab ref. no, ~/EPSpeclel Purpose ,~ntreated Water SAMPLE NO./~)CATION , I,h~,:,~ ,~1~- ~ ,,J ~I ,l ~I I Collected TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: [~Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample. Date Received Time Received Analytical Method: I-I Fermentation Tube ~(,Membrane Filter Lab Ref. No. Result* Analyst F-I-I FT-I r-r-I READ INSTRUCTIONS BEFORE COLLECTING SAMPLE O6-1220 (~)) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD ~te CG41ictld Source EMB Broth 24 hourlf BrMh 48 houll; Multiple Tube Rlportf 1Omi Tubes polltlv~/Tot~l 1Omi podlMtl Membr&M FHter~ Direct Count Collform/10Ontl Verification: LTB BGB Flnel Membrane Filter' Results ~,~ .~/1~.~rrn/lOOnll ...,,.., --"~'....~/~-.2-_~ ..-~_o.,. ?-2.~ ' O~ ~.. ~ RECEIVED ' ' ,NSPECTIONAPPOINTMENTS' T~ TiMi=' TIME DATE DATE DATE INSPECTOR MUNICIPALITY OF ANCHORAGE ,MUNICIPALITY OF ANCHORAGE  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALTH & 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTEC:TtOI'~ t~I [~i~) ENVIRONMENTAL SANITATION DIVISION FEll P, 4 1981 .~ Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER . -~o~c~(c~ .;c/~t~/cL(/ P.O.E P.~IP.".qT'. n.o~u=~ I ~1~ olrterent trom abovel PHONE 2. ~'-u'~ ~.;~ ~ PHONE MAILING ADDR ES/~ M/~LI NG ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS LLEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE ~UMBER OF~EDROOMS ' ~ One ~ Four ~ Other ~ SINGLE FAMILY ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six 7. WATER SUPPLY ~ INDIVIDUAL* [] COMMUNITY ~1 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 INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ,..v. ,,, ~ .. THIS SIDE FOR. OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX · : PERMIT NUMBER 2. WATER SUPPLY [--I ~INDIVIDUAL : .~ . . .- DEPTH OF WELL [] COMI~UNITY ' ..: DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. sEwAG~E DI~OSAL 8Y6T, EM PERMIT NUMBER [] iNDIVIDUAL/ON -SITE DATE INSTALLED [] PUBLIC UTI LITY 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 Absorption Area to, nearest Lot Line 5. C(~MMENTS I~APPRoVED FOR ~EDROOM$ ' [] CONDITIONAL APPROVAL (letter mu~"~cco~npan2rE6~ificate) 72-010 (Rev. 6/79) Fobruat:y 27, "~ Rona]d Sc:hu].dt: 3301 Gl. cnn Don Anchor:aqe~ A]a~:dca 99501 Subject: Lo{: 7B B](cx 2 Eklutna NeighLs Subdivi ~ion Approval for your J. ndividual sewor and wat:e.]: fac~l]_Ll-. cannot be granted until the [ollowing :items have been 2' completed: ~~(]) The war. er analysis report: needs {:o be del [,./ered [:o "~.',~' this office from l:he Chem Lab, 5633 B .~...~.ec.L, / O~lr review. (2) LocaLe and expose f-he well for our inspection lhz, is Lo det:ormine proper cons[:.r~lo[:J, oI1, al. so W(.. min:imum distance roqllJ.r(llR(lrlils are llletl bel. tw(~en Locat:e an~ expose t:hc st:andpipes t.o l:]lc ~(:w..]. for our j. nspecl:.:ion. Please nok.ify t:his del)arLmenh :flor a reinsp(:ction when the noted descrepancies have been correct/.ed~ ~f there are any further questions pt=a .... call this office at 264-4720 Sincerely, ReP / ]. j w c e: A].aska PacJ fic Narlk Mort:gage Ix>an Deparl:menb Post Office Box 420 995].() DAVID A. SLENKAMP ROBERT A, SHAFER MECHANICAL ENGINEER 694-9055 February 1, 1981 CIVIL ENGINEER 694-2979 MUNICiPADTY Of: ,.~,NCHORAGE. DEPT. (ct: i: ~ ~ c~ ENVIRONiv'~ ,i: , ,:CT/ON James Christian SRB 70 Pioneer Street Chugiak, Alaska 9956? Dear Mr. Christian, Reference:' Lot 7B; Block 2; ~lutna }{eights Subdivision RECEIVED A sewer system adequacy test was performed on the system located on the referenced property as you requested. The seotic tank was pumped and verified to have s capacity of approxilm~tely 1250 gallons. The seepage pit was charged with 1000 gallons of fresh water and after a period oD 2~ hours all the ~mter added to the crib had percolated out. It can be concluded from this test that the sewage system located on the referenced property is currently functioning adequately for the four bedroom residence. If we may be of further assistance, please do not hesitate to call. Sincerely, ,// ? / / ,¥ t 4~ '~' ~- ~_C.~' ' / ~ Z - ~RDBERT A. ~FER, ~,,~S/s s ,, cc: ~nioipali%y of Anoho~a~e Depar%men~ of Heal%h and Envio~nmen%al Pro%cc}ion &lasks Pacific B~nk ATTENTION: Betty High Ronald Schuldt SRB 196X EAGLE RIVER, ALASKA · . CHEMICAL & G~.~LoGICAL LABORATORIES ~.? ALASKA, INC. (~~ /~~ 274-3364 B633SSt re et ~/~~ Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: I.D. NO. Water System Name Phone No. Mailing Address City State ~ Zip Code MO. Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose [] Treated Water [] Untreated Water SAMPLE NO. LOCATION 2[ I 4I I Time Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: [] Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample. Date Received Time Received Analytical Method: [] Fermentation Tube [] Membrane Filter Lab Ref. No. Result* Analyst r I *NO ot colonles/lOOml, or NO of Positive Dortlons READ INSTRUCTIONS BEFORE COLLECTING SAM PLE 06-1220 (b) Rev. 1978 BACTER I0 LOG ICAL WATER ANALYSIS RECORD Date Collectecl Source. a.m. NO, Presumptive 1Omi 10mi 10mi 10mi 1Omi 1,0mi 0.1mi 24 Hours 48 HOURS Confirmatory 24 Hours 48 Hours EMS. Broth 24 hours: Multiple Tube Rebort: Membrane Filter: Direct Count ratification: LTl] Final Membrane Filter Results ReDor t~l By Broth 48 houri: 1Omi Tubes Positive/Total 1Omi Portions Collform/100ml BGB _ Date Collform/10oml Time: a.m, EAGLE RIVER AREA GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality "C" Street, Anchorage, Alaska 99503 274-456i Date Received March 7, 1977 Time of Inspection Date of Inspection 3-9 ~ / REQUEST FOR APPROVAL OF ~-Ke~n INDIVIDUAL SEWER & WATER FACILITIES ' - ' FOR ):t0 a.m. 7 Wednesday 4. 5. 6. 1. Approval requested by: First National Bank of Anchorage Mailing Address: Post office Box 720 Phone: 276-6300 2. Property Owner: Ronald J, Schuldt Phone: 688-2569 Mailing Address: DQ~ .20 Pioneer Street, Chugiak 99567 Legal Description: Lot 7B Block 2 Eklutna Heights e Location: See map Type of facility to be inspected Sinqle Family Well Data: A. Type Individual C. Construction Sewage Disposal System: On-site system A. Installed B. Installer C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank C. Absorption area to nearest lot line e No. of bedrooms 3 B. Depth 80' D. Bacterial Analysis 2. Manufacturer , Absorption area , Other contamination 2. Material , Sewer Lines ..., , Absorption area EQ-034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES I~NVFC, ONMr~H h \L L4AR 7 - 1. Type of Inspection: CMRO VA FHA CONV 2. Property Ow.er: Mailing Address:-~0 3. Name of Buyer: Mailing Address: Day Phone: Name of Lending Institution: F~'7- /'-/~'-)' [ 0 ~ ~ ~' ~r ~l< Mailing Address: ~/~r-! ~J (~/~/c~¢ ~ Phone:_ 5. Name of Realtor or Agent: Mailing Address: 6. Legal Description: ~- O 1- Location: Phone: .r 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Public Utility No. Bdrms. 3' ,Individual If Individual, number of dwellings presently served If Individual, depth of well ~-0 ~ Sewage Disposal System Type of System: Public Utility Individual (on-site) If Individual, date of installation 72-003(3/76) Pag~ 2-of two pages - R .~st for Approval of Individual ~egal Description Lot 7B Block 2 Eklutna Heiqhts er & Water Facilities Comments Approved~. ~A~o~ Disapproved Date ~--~ I ~,77 Approvals}al id for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a l~rue and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74)