HomeMy WebLinkAboutEKLUTNA HEIGHTS #1 BLK 3 LT 5Eklutna Heights #1
Block 3
Lot 5
#051-061-27
Municipality of Anchorage
On -Site Water and Wastewater Section - (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: QSP251098 PID Number: 051-061-27
Dwelling: M Single Family (SF) El with ADU R Duplex (D) El Two Single Family Project: El New Z Upgrade
Name
MICHELLE MARIE TAGLE
ABSORPTION FIELD
E] Deep Trench Z Wide Trench FJ Bed El Mound
Site Address
21437 SETTLERS DRIVE, CHUGIAK
El Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
1 5
1.2 GPD/SF1
9 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
5 Ft.
Gravel depth beneath pipe
4 Ft.
Subdivision Block Lot
EKLUTNA HEIGHTS 3 5
Fill added above original grade
VARIES -0.09 to 0.09 Ft.
Gravel length
63 Ft.
Township Range Section
Gravel width
5 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To, Septic Absorption Holding Sewer
Total absorption area
Number of trenches
Dist. between trenches
1 Lift Station
From Tank Field Tank Line
625 Ft2
1
Ft.
Well 200+1 200'+ 25'+
TANK 2 Septic [:1 S.T.E.P. E:1 Holding [I Other
Manufacturer
GREER
Capacity
1500 Gal.
'
Surface Water 100'+ 100'+
Material
HDPE
Number of compartments
2
Lot Line 5'+ 10'+ NA
Foundation 10'+ 10'+
LIFT STATION
Manufacturer
Capacity
Gal.
Remarks Trench installed 9' total depth. Deep -burial ST.
Alarm location
Electrical installed by
PIPE MATERIAL House totank
drainfield Tank to 3.034-
Installer QRS
_3101134
Drainfield 3034 CO/MT 3034
Inspector FWC
BENCH MARK (Assumed elevation) 100 ft
Inspdates:ection 1" 5/16/2025 2 5/19/25
Location and description
3`d 5/19/25 4'^ 5/20/25
ITOP OF MH RISER
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Conditional Approval: Date
AV TH
— ----------- -------
Septic Sys
joi .... .... t.1 . .........
Curtis Huffman
p p -
A rove ve��
•. CE 128991
' Dat-
�'f'NIP,•.
06/02/25..• *� ,ew
PROFESSOW
Note: this approval does not include well permit requirement
(Rev 09/02118)
PID:051-061-27 PERMIT:OSP251098
FIRST WATER CONSULTING
EKLUTNA HEIGHTS #1 BLOCK 3, LOT 5
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: OSP251098
Work Type: SepticTank Upgrade
Tax Code Number: 05106127000
Site Legal Address: EKLUTNA HEIGHTS #1 BLK 3 LT 5 G:1461
Site Mailing Address: 21437 SETTLERS DR, Chugiak
Owner: TAGLE MICHELLE MARIE
Design Engineer: NORTH RIM ENGINEERING
This permit is for the construction of:
Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date:
411 l i1 j-
f
t}eparCnac�ttr
4/10/2025
4/10/2026
Lot Size in Sq Ft: 21780
Total Bedrooms:
5
❑ Private 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. Provide notification by calling (907) 343-7904 (24/7).
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
Received By: -� L
Issued By:
Date: L
Date: Y t� U `)12
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section
ON -SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 05106127000
Property owner(s) TAGLE
Mailing address 21437 SETTLERS DR
Site address 21437 SETTLERS DR
Legal description EKLUTNA HEIGHTS #1 BLK 3 LT 5
Number of Bedrooms 2
Engineering Firm NorthRim Eng.
Building Permit Number
Day phone 726-7637
Not Applicable *1
APPLICATION IS FOR: APPLICATION IS AN:
(Z all that apply)
Absorption Field
0 Initial El
Septic Tank
M Upgrade 0
Holding Tank
r_1 Renewal R
Privy
EJ
Well
n
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Permit/Rush Fees: -Z ?_ �;-
Date of Payment: VIt 0 /?-,j L i�-
Permit No. U0 (
s I Z,
Waiver Fees:
Date of Payment:
Waiver No.
Distance:
0 C_ I
First Water
C O N S U L T I N G
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
May 5, 2025
Municipalities of Anchorage
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC SYSTEM UPGRADE PERMIT — OSP251098
LEGAL: EKLUTNA HEIGHTS #1 BLOCK 3 LOT 5
The property owner has requested we obtain a permit to upgrade the undocumented 3-bedroom
septic system of the above referenced lot. North Rim Engineering recently obtained a permit to
upgrade the septic tank & we now propose to upgrade the absorption field also to accommodate a
5-bedroom system per the attached design. One shallow trench and a 1500-gallon tank is
proposed to serve the existing 2 residences with a total of 5 bedrooms. The design is based on
the recent test hole conducted on April 25, 2025. No groundwater was observed at test hole
excavation or monitoring.
The slopes are flat at the proposed upgrade location. The lot and area are served by public water.
The design will not impact any of the neighboring properties. Please contact us if you have any
questions.
Sincerely,
Curtis Huffman, P.E.
r
fL' 4",
_F
I
S4 A 111 WSI[R
AH411G
DESIGN CALCS:
5BR X 150 GPD = 750 GPD
750 GPD/1.2 GPD/SF = 625 SF SAS
625 SF / 0.5RF (4'ED) = 63 FT. TRENCH
USE 1 TRENCH — 63'(L) X 5'(W) X 4'(ED)
TOTAL MAX DEPTH FROM EXISTING GRADE: —10'
cc '-:
AREA HAS 0-10% GRADE & NO SLOPES >25%
WITHIN 50'OF PROPOSED FIELD. STAKE
PROPERTY LINES, WATERLINE, ESMTS,
OR OTHER SEPARATIONS... PRIOR TO CONST.
SUBJECT LOT & ALL OTHER
ADJACENT LOTS ARE SERVED
LOT 4
BY PUBLIC / COMMUNITY WATER
BLOCK 3
VERIFY ANY REQUIRED SEPARATIONS
1
PRIOR TO CONSTRUCTION.
0D
MT
DG
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S 89 '22" W 264.00'(R)
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LOT 6
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SERVED BY PUBLIC
CLASS A WATER
SERVICES:
EKLUTNA HEIGHTS #1 BLOCK 3, LOT 5 SUPPORT � Aw OF
AZ` PREPARED FOR: �� ,
MICHELLE MARIE TAGLE /�� T
21437 SETTLERS DRIVE FC * 9 TH
CHUGIAK, AK 99567
FIRST WATER CONSULTING DATE: 5/5/20251 �+ its Huffman
13030 SUES WAY DRAWN 05/5/25 FWCS , CE 05/25 A#
ANCHORAGE, AK 99516 SCALE: 1" = 50' , eAW
Aw
907-350-9566 FirstWoterAK@gmoil.com PAGE: 1 OF 2 ��`�°'�ow
I
DESIGN DETAILS:
INSTALL NEW DEEP —BURIAL
1500—GAL HDPE TANK & 631 x 5'W x 4'ED — 10' OG. MAINTAIN 10'+
FROM FOUNDATION, 200' TO
PUBLIC WELLS, 100' TO PRIVATE WELLS & 100' TO SURFACE WATER, 10'
TO PL (FIELD), 5' TO FIELD FROM TANK & DECK SUPPORTS WITH 4' OF COVER OR INSULATION
(TANK) OR 3'+ OR 2'+
COVER & INSULATION (FIELD). INSTALL PER AMC 15.65, 15.55, &
MASS... TANK BEDDING, SEPARATIONS,
MATERIALS,... VERIFY & STAKE ANY REQUIRED SEPARATIONS
PRIOR TO CONSTRUCTION
SUBJECT LOT & ALL OTHER
ADJACENT LOTS ARE SERVED
LOT 4
BY PUBLIC / COMMUNITY WATER
BLOCK 3
VERIFY ANY REQUIRED SEPARATIONS
PRIOR TO CONSTRUCTION.
FLAT
MUST STAKE
FLAT S 89 5'22" W 264.00'(R)
PL PRIOR
TO CONST.
N 89°56 9" E 263.59'(M)
WOOD FENCE
FLAT FLAT
0-5% _
FLAT CO
0
5-10%
L 0 T 5 ,/ MT MDCO,T
MT
Q APPROXIMATE WATERLINE
CO
TH25-1
STAKE PRIOR TO CONST.
a
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Ass i N.ow_��0
FCO o DECK
o-*
RAVE
G R A DEL
ABANDON EXISTING CRIB
& DECOMMISSION S.T.
, 6.
$ 1 +� DRIVE
E 68.8
INSTALL NEW 1500-GAL
DEEP-BURIAL HDPE SEPTIC
3BR HOUSE '--
CV
r7 40
TANK & ENTER NEW TRENCH
INTO THE LATERAL CENTER
CN Ur
N
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AS MUCH AS POSSIBLE.
52. 5' . - LINE
CA
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PORCH `rt 8.1
M 2BR HOUSE p
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DRIVE
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&GARAGE
o
FENCE
N
48.1'
-<
N 89°59'55" E 264. 0' C CHAIN LI
N
N 89°55'22" E 264.00' R
LOT 6
EKLUTNA HEIGHTS #1
BLOCK 3, LOT 5 SUPPORTIsERViCES:
PREPARED FOR:
MICHELLE
_r► OF A r`�
/' �� ,
21437SETTLERS DRIVE
CHUGIAK, AK 99567
~ '
i TH
��ir'ktxisj
FIRST WATER CONSULTING
DATE: 5/5/20251
SURVEY. JPO
Huffman
� , CE 128991 �`� AV
13030 SUES WAY
DRAWN: FWCS
SCALE: 1" = 30'
05/05/25 V*.Ir
ANCHORAGE, AK 99516
PAGE: 2 OF 2
'4?0FRSSjOV0 i
907-350-9566 FirstWaterAK@gmail.com
F!t'rsl Water
CONSULTING
I
3030 Sues Way - Anchorage, Alaska 99516
Tel.907-350-9566 firstwaterAKkgmail.com
SOILS LOG -PERCOLATION TEST
LEGAL: EKLUTNA HEIGHTS #1 BLOCK 3 LOT 5
DEPT
op
..
' Curtis Huffman
�� �Fc•. CE128991 .•.�`�/
o i� PROFE 64'�e
H
FEET OG SOILS PERFORMED FOR: MARIE MICHELLE TAGLE
10
11
12
13
14
15
16
17
18 _
I:•
19
'Fill
TESTHOLE # 25-1 DATE PERFORMED: 4/25/2025
GROUND WATER ENCOUNTERED: NO
IF YES, AT WHAT DEPTH: NA
DEPTH TO WATER AT MONITORING: DRY
DATE: 5/2/2025
SEE SITE PLAN FOR SLOPE & LOCATION
COMMENTS:
VERIFY GROUNDWATER MT
AT TIME OF CONSTRUCTION
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net Drop
4/25/25
10 min
6"
4 9/16"
"
6"
4 7/ 16"
"
6"
4 7/ 16"
"
6"
4 5/16"
"
6"
4 5/16"
"
6"
4 4/ 16"
PERCOLATION RATE 2.4 (MIN / INCH)
TEST RUN BEWTWEEN 4 & 5 FT
PERC HOLE DIAMETER 6"
PRE-SOAKED PRIOR TO TEST & ALL READINGS TO
THE 1/16TH.
PERFORMED BY: FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 05/05/2025
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MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Parcel ID 051 -061-27
Certificate of On -Site Systems Approval
OSC251197
Expiration Date: 5/20/2026
Legal description EKLUTNA HEIGHTS #1 BLK 3 LT 5
Site address 21437 SETTLERS DR
Current property owner(s) TAGLE MICHELLE MARIE
X The On-site system(s) is/are approved for 5 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
By:
Original Certificate Date: 6/3/2025
ThWCertificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
stem(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
Development Service Department (DSD) issues COSAs based upon representations provided by an
independent professional engineer. The Municipality of Anchorage is not responsible for errors or
omissions in the professional engineer's submittal.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
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Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 051-061-27
-Complete legal description EKLUTNA HEIGHTS #1 BLOCK 3, LOT 5
Location (site address)
21437 SETTLERS DRIVE, CHUGIAK, AK 99567
Current property owner(s) MICHELLE MARIE TAGLE Day phone
2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS
3. TYPE OF WATER SUPPLY: [] Private Well serving # dwelling units
❑ Other Non-public well as regulated by MOA 171 Water Storage
11 Community well or Public
4. TYPE OF WASTEWATER DISPOSAL: Mid Private Septic M Private Septic serving 2 dwelling units
LF
HoldingTankF-Communi-
y Septic or Public Sewer
5. SEPTIC TANK: n Steel *Plastic OConcrete nFiberglass
Age J' - See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: 171 AvVvVTS F] Bed n Deep Trench W, Wide Trench n Seepage Pit
Waiver request for: Distance:
Expedited review requested: ❑
By applying for this entitlement, this property is subiect to inspection by municipal On-site staff
IL
LO verify the accuracy of the information provided.
COSA Fee $ � Waiver Fee $
Date of Payment S 0 - �Z �- S_ Date of Payment
COSA # 05U2,15- 11 .9-1- Waiver #
10SA Application—Api,20025-doc
COSA Checklist_May2025 copy.docx
COSA Checklist
Legal Description: EKLUTNA HEIGHTS #1 BLOCK 3, LOT 5 Parcel ID: 051-061-27
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA – CLASS A OR PUBLIC WATER
Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank NA
Date of pumping NEW TANK
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. DISPOSAL FIELD DATA
Which system tested (date installed) NEW FIELD
ALL standpipes present per record drawing
Total measured depth from grade 9.1 ft (max)
Measured depth to pipe invert from grade 4.9 ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective.
If not, state depth into effective
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Adequacy test date NEW FIELD
Results Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS – NEW FIELD
Effective depth (per record drawings) 48 in
Effective depth used 0 in
Effective depth remaining 48 in
Comments/Deficiencies:
COSA Checklist_May2025 copy.docx
E. SEPARATION DISTANCES
From Well on Lot to: (Please enter distances if less than required)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Disposal Field on Lot > 100’ Yes if No ft
Neighboring Disposal Fields > 100’
Yes if No ft
Sewer Line/Main > 100’ Yes if No ft
Sewer Manhole/Cleanout > 100’
Yes if No ft
Sewer Service/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required)
Tank to Foundation > 10’ Yes if No ft
Field to Foundation > 10’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main/Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F. ENGINEER’S COMMENTS
G. CERTIFICATION & 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, based
on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Engineer’s Printed Name CURTIS HUFFMAN, PE Date 06/02/2025
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting &
06/02/25
26
.
4
'
52.8'
4.
0
'
8.1'
12
.
4
'
6.2'
10
.
0
'
54.7'
30.4'
40.0'
3.7'
8.4'
34.1'
48.4'
GARAGE W/ 2ND
STORY APARTMENT
RESIDENCE
SINGLE STORY
SHED COVERED
STORAGE
RETAINING WALL
LEGEND
EDGE OF GRAVEL DRIVEWAY
DECK
FENCE
OVERHEAD UTILITIES
POWER POLE
RECORD DATA PER PLAT #P-215A
SEPTIC PIPE
WATER VALVE
SEPTIC TANK LID
TIMBERLINE SURVEYING AND MAPPING
17035 BARONOFF AVE
EAGLE RIVER, AK 99577
907-242-5320
ryan@timberlinealaska.com
FILE NO.: 25.120
SCALE: 1" = 30 FEET
DATE: 5/30/2025
SHEET: 1 of 1
MOA GRID: NW1451
SCALE: 1" = 30 FEET(11"x17")
30'0' 60'
AS-BUILT OF:
ADDRESS: 21437 SETTLERS DR, CHUGIAK, AK
LOCATED IN: ANCHORAGE RECORDING DISTRICT
LOT 5, BLOCK 3EKLUTNA HEIGHTSADDN. NO. 1, PLAT #P-215A
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF ~r~,AI,TH AND ENVIRON~NTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
General Information
(a)
Legal Description (include lot bloc~ .subdivision,
Location (address or directions)
(b) Applicants Name_~_/~/~/'-3~3z0 ~/~ .
Applicants ~dress ~5~~ Z ~o ~ f~ 6 ~ ~
(c) Applicant is (chec~one) Lending ~ns~i~utioa
(d) Lending Institution
A,d~ss
section, township, range)
- Home B~s iness
Te___lephone
(e) Real Estate Co. & Agent
Address
(f)
Telephone
~i-1 the tiaa to the following address~
2. T_~pe of Residence
Single-Family~
Number of Bedrooms
3~ Water Supply
Individual Well~--~
Multi-Family
Community
Other (describe)
Public~
Note: If community w~ll system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
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]
E_~ineerin~ Firm Providi__n~on_~s,~ests~ File Searc~h~pata and Infomnation"
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, f~%ctional amd adequate for
the number of bedrooms and tTpe 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 wmstewater disposal
system is in compliance with all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inapection.
Name of Fiz~
Address
Da~e
DHEP A~p_~p v~a~ l_ ~
Approved for ~::~ bedrooms By
Approved.7~__ Disapproved
Terms of Conditional Approval
Conditional
Telephone
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF R~ALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH A~fHORITY APPROVA3~ CERTIFICATES BASED SOLELY UPON THE REPRESEN~I'-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA~ THE ~HEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQULRE-
MENTSo k~PLOYEES 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 ~ ~tE PROFESSIONAL ENGINEER'S WORE.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2]
7-19-84
A. ~ELL DATA
Well Classification
Well Log P~esent (Y/N)
Total Depth
Static Water Level
Casing Height Above Ground
MUNICIPALITY OF ANCHORAGE (MOA)
H~ALTH AOm~TY APPROVAL (~A~)
CHECKLIST - FEBRUARY 1984 R E f E I V E D
Legal Description:
If A, B, c~ C, D.E.C. Approved(Y/N)
Date C~leted Yield
Cased to Depth of G~outing
Pum~ Set At
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &' ,,.~
ENVIRONMENTAL PROTEGt'JOJ~ .. _*
Electzical Wiring in Conduit (Y/N)
Separation Distances f~cml Well:
To Septic/Holding Tank cn Lot ~. ~ .... ; On Adjoining Lots 2~
To Nearest Edge of Abscml~tion Field on Lot~X30 ~ ; On Adjoining Lots
Sanita=y Seal on Casing (Y/N)
Deu~ession Amound Wellhead (Y/N)
To Nea=est Public Se~r
To Nearest Sewer Service Line on LOt
Date
;
To Nearest Public Sewer Line
C leancut/Manhole
Water Sample Collected By
Water Sample Test Besults
B. SEPTIC/%~ TANK DATA
Date Installed ~( ~-f Size /69d~O No. of CQ,~a=tments
Standpipes~) Air-tight Caps~) ,, Foundation Cleanout (~i'~'~
DePression over Tank (~) Date Last Pumped ~ -
Pumping/Maintenance Contract on File (Y~/~. ; fo~
Holding Tank High-Water Alaz~n (y/N~/~- Temporaz-y Holding Tank Permit (Y~///$
Separation Distances f=cm Septic/Holding Tank:
To Water-Supply Well 2Do ~ To Building Foundation ~ ~ I
To ProDerty Line
TO Water Main/Service Line
Course
C~ents
' TO Disposal Field ~- '~-
To Stresml, Pond, Lake, c~ Majo= D=ainage
Receipt ~ ~9~(%~
Date Paid: ~,.~-~%- .
Amount: c{~. (DC>
[Page 1 of 2] 2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Abscmption Strata {~ ~ Type of System Design -g~~-~~'~
Width of Field ~ ~ ~p~ of Field ~ '
S~e ~et of ~s~tion ~ea ~ ~ Stan~i~s ~e~nt ~
~p~ation Distan~ ~ ~s=pti~ Field:
To Buildi~ F~n~tion ~ '~ To Existing ~ ~ndo~d System ~
To ~i~way, P~ki~ ~ea, ~ Vehicle St~a~ ~a ~ ~
LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes(Y/N)
Dimensions
· Mgnhol /A ss
**
** Check Permitted Bedrocm Rating Against HAA Request
I csrtify that I have checked, verified, c~ ~onfo~,=d to all MOA HAA Guidelines in effect
on the date of this inspection.
Signed
Ccm~any
KB1/d5/s
[Page 2 of 2]
2-15-84
DEPT. OF ENVIRONMENTAL CONSERVAT]ON
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA gg501
BILL SH,EFFIELD, GOVERNOR
Telephone: (907)
Address:
274-2533
To Whom it May Concern: ~.~
According to records.on file in this office the
~ Water System is in compliance-with the State Drinking
Water Regulations
Sincerely,
-. APPLIr?ANT FILLS OUT UPPER HA'-" ONLY
,~roPerty ~wner /,,~-/'~y~F',.~ ~.~.)~--~ Z ~~ Phone
~ailingAddre~ ~D~ ~',,/~7~ ~ ZipCode <~ ~'~/~--~ ~
Lending Institution ~ 4 //~ ~¢~ O/CZ Phone
Address ;"/~¢Z/~/ ~ ~,/.~ ~/.J~ D E'~ ¢~ Zip Code 4~(~_2~4.3~ ~'~2
Realty Co. & A~nt ~ ~ ~ ~l~7 S ~¢ Y~ L ~y ~'¢ ~ ~y ~2~. ~ ~1 ~ Phone
Ty~ of Resi~nce
Single Family
D Multiple Family No. of Bedroo~ ~
~ Other
Water Supply
~ Individual A~AOH WELL LOG. A w~l log is required for all wells drilled since June 1975.
~ Community For wells drilled prior to that date, give well depth (attach log if available).
~ Public Utility
Sewer Disposal
~ Individual Year Individual Installed:
~ Public Utility When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OOESSlNG CAN BE INITIATED.
Time Time Time Time
Date Date Date Date
Inspector Inspector Inspector Inspector
Field Notes: ~ C.(..,~ ~ "-~ ~.~'~'~ ~UNICIPALITYOF ANCHO.AGE
DFPT C': ~'::'1.1;! o,
( ) APPROVE *OONDITIONS OF APPROVAL
(~DISAP~OVED
Soils Rating Date ~wer Installed ~ell To Absorption Area Well Log Received
Well to Tank Septic T~k Size
72-023 (31~2)
EXCAVATION
ROBERT A. SHAFER
WORK
February 15, 1983
CIVIL ENGINEER
694-2979
Finis Realty
ATTENTION: Jerry Braman
Mile 20, Old Glenn Highway
Chugiak, Alaska 99567
Dear Jerry,
Reference: Lot 5: Block 3: Eklutna Subdivision
MUNICIPALITY OF ANCHORAGE
DF~T Cr ;'~'L'i ' ?.
ENVIR.D~ ,IL.' :t,: ,'~ .... ~) LL rIGN
RECEIMED
A sewer system adequacy test was performed on the system located
on the referenced property, as you requested. The septic tank was
pumped and verified to have a capacity of 1000 gallons. The
seepage was tested by first removing approximately 500 gallons of
water from the crib and then adding 500 gallons of fresh water
back into the crib to completely fill it. After a period of
74 hours the water level in'the crib was measured to determine
an approximate amount of water that had percolated out of the
crib. As a result of this test approximately 408 gallons of
water had percolated out over a period of 24 hours.
It can be concluded from this test that the waste water disposal
system serving the two bedroom residence located on this property
is currently functioning adequately. However, the system cannot
be guaranteed against subsequent failures.
If we may be of fur>her service, please do not hesitate to call.
~s/ss
cc: Municipality of gnchorawe
De'~artment of Health and Enviionmental protection
Safeco Title Company
AT'PE~?'TON: Pam
MUNICIPALITY OF ANCHORAGE
ENVIR'.);4L :1', A.: .<3.
RECEIVED
SRB 196X EAGLE RIVER, ALASKA
January 27, 1983
Betty and Herschel Bryant
Box
Chugiak, AK 99567
Subject: Lot 5 Block 3 Eklutna Heights Sub. Add. #1
Approval for the individual sewer and water facilities cannot
be granted until the following items have been completed:
The septic tank pumped with a receipt submitted to this
department. The total number of gallons pumped needs to be
on the receipt and verified by a registered engineer as to
the actual number of gallons pumped. This is to verify the
size of the septic tank.
A four (4) inch cleanout neods to be installed to the sep-
tic tank.
four (4) inch cleanout needs to be installed to the
leaching area.
An adequacy test needs to be performed on the existing
leaching area. This test will determine if the system is
adequate according to National Standards. A listing of
private firms performing the test is enclosed. This report
needs to be submitted to this office for our review.
Please notify this Department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerely,
RP91p/EH
Enclosure
Robert C. Pratt
Associate Environmental Specialist