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Home My WebLink AboutEKLUTNA HEIGHTS #1 BLK 3 LT 12 GRE,'-'-'!R ANCHORAGE AREA BOI 'qGH Department of Environment Quality 3500 Tudor Road(\~'~ Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE ,~-~(,~Vl'~ FROM WELLL~ ~/T~ MANUFACTURER .~Cf' ~ATER*AL INSIDE LENGTH __ INSIDE WIDTH LIQUrD DEPTH COMPARTMENTS LIQUID CAPACITY/~i~D~') GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL FOUNDATION NUMBER OF LINES [~ ABSORPTION AREA (_~ 0(~ ~, SQ. FT. DEPTH: TOP OF TILE TO FINISH GRADE t/'~'tf DISTANCE BETWEEN LINES I TOTAL LENGT~,,~( NEAREST LOT LINE ~ OF LINES ~ ... // TRENCH WIDTH''~/'~ IN. TOTAL EFFECTIVE LENGTH OF EACH LINE / <~'~' DEPTH OF FILTER __MATERIAL BENEATH TILE (g~ IN. ABOVE TILE WELL: TYPE O0 tO 7 / CONSTRUCT,ON NEAREST SEWER LINE__ DEPTH _ SEPTIC SEEPAGE TANK__ SYSTEM _ DISTANCE FROM: PIPE MATERIAL: LOT SLOPE: REMARKS: /U~ ~)'~DIAGRAM OF SYSTEM Form PW,027 ~ ~ gte, :r ANChOrage Area Bo" J(gh ;~ DEPARTMENT OF ENVIRONMENTAL QUALITY INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK SEEPAGE PIT PINANCEDTHROUGH/75/O~/9--/~SOIL TESt RESULTS . 7~"~ NOT~'-"' TBIS 'ERM'' I' NOT 'VALID WITHOUT 'Ol~ 'TES' COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE ( 000 TYPE MINIMUM DISTANCES, REQUIREMENTS DRAIN FIELD FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAge PIT WALl SEPTIC TANK .,SEEPAGE PIT TO NEAREST LOT LINE, // , DRAIN FIELD . WELL TO SEPTIC TANK I i SEEPAGE PIT DRAIN ~IELD ~l~ ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD SEPTIC TANK .... SEEPAGE PIT , DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION S FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR ~I~ENSEO OBS~GNER DIAGRAM OF SYSTEM I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED~jg~ 75~SYSTEM ISIN ACCORDANCE WITH SAID CODE, ~-~ C DATE APPLICANT'S SIGNATURE -- FORM NO. E{~-016 O ~ E GEO'~ ~CHNICAL E~ DEVEL~, Box 90, Davia St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 SOil. LOG Soils ~- Foundations "MENT CO. Perfomed for: Name: Matllng Address: Legal Description: Z.~7'-I'~,. Earl Ellis 688-2280 Land Development Depth (feet) Sol] ;h~ractertstlcs 0 G~ound Water Encountered: Yes No P~oposed Installation: Seepage Pit Comments: ~-/~ ~ ~-~ ~: ~"~P ~ If yes, what depth Drain Fie~d Parcel MUNICIPALITY OF ANCHORAGE Division of Environmental Services On-Site Services Section 'P.O. Box 196650 Anchorage, Alaska 99519-6650 CERTIFICATE OF HEALTH AUTHORITY GENERAL INFORMATION Complete legal description Location (site address or directions) · · Propertyowner Z~/~/'~3~ ~-~.Z)?~/~'~77~ Day phone Mailing address ' '" Lending agency C/;~ J~Df'JOO&:2/~ Day phone ~ ' Mailing address. "121 '~ ~ ~u~¢d Zo~, ,~c. -.i ' ; ;i Agent~ phone ~;~:,....:.,...- . ::' :, ~,,~ reqUeSted, HAA will be held for pickup..:"'"'". 2.' 'NUMBER'~FBEDROOMS:~ ' ~ '~ water Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev. 1/91) Front MOAi21 5. 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 andi~ype of structure indicated herein. I further verify that based on the information obtained from .t..he Municipality of Anchorage files and from my investigation and inspection, the on-site water Fsu~pply and/or wastewater disposal system is in compliance with all Municipal and State codes, brdinances, and regulations in effect on the date of this inspection.. J. Date 6. DHHS .SIGNATURE - " ~:"'* Conditional approval for 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-O3~(Rev. 1/91) ~ MOA#21 Legal Description: A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES d~'f~ ~..> ~'~1~ Environmental Services Division ' ~'~..,~,. ~, 825 L Street, Room 502- Anchorage, Alaska 99501. (907)343-~4 ~A Health Authority Approval Checklist LOT/2 BLOC~ 3 ~'L/-~IT,~/~ ParcelI.D.: If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to FROM WELL LOG ,,VR Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate /~/~ Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed Foundation cleanout (Y/N) Date of Pumping C. ABSORPTION FIELD DATA '" Date installed Tank size /~)00 Number of Compartments ~'/ Cleanouts (Y/N) . I /~V/ Depression (Y/N) /~ High water alarm (Y/NI Soil rating (g.p.d./~ or fF/bdrm) /7,~ Length E)z:~' ¢.~O' Width / Effective absorption area Gravel thickness below pipe Monitoring Tube present (Y/N) ~ Results (Pass/Fail) ,/z:)~2,55 Date of adequacy test Fluid depth in absorption field before test (in.); ,..~/ Fluid depth. 3~,~ (ins) Minutes later: ~O ,,~m Peroxide treatment (past 12 months) (Y/N) ~/ 72-026 (Rev. 3/96)* System type ~ / Total depth '7,~ · Depression over field (Y/N) For ,3 bedrooms Immediately after,~'¢~ gal. water added (in.): Absorption rate =- ~ '¢,0'~:) g.p.d. If yes, give date ' /~'//~ · (~ 80 TI-I LEAI~ 771,5 OIq F/~.E W1117-1 t~OR , Date install'ed ,, ~ Size in gallons Manhole/Acces~ (Y/N) "Pump on" level at* ~* High water alarm level at* *Datum Cycles tested R SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main ,A,/~ Sewer/septic service line On adjacent lots /'V;,~) On adjacent lots /V'/~ Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ¢~Z..5 Property line ./~' Absorption field Water main/service line ,",.5/ .Surface water/drainage /'V~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ,.,=~' ' Surface water Curtain drain ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review in conformance with MOA HAA guidelines in effect on this date. Building foundation 7...~/ Water main/service line ,,'/(.2'~ ' /v'~3A/'~ I~',//~/O~, / Driveway, parking/vehicle storage area (~O ' /V/~/U~' la//~' /~1~' Wells on adjacent lots /~,~1 above systems are HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number SKLH Consultants 1700 Vashon Circle Anchorage, AK 99515 25 June 1996 Mr. Keevin Klewano AK Dept. of Environmental Conservation 555 Cordova Ave. Anchorage, AK 99501 Re: Coliform Bacteria Test Results Eklutna Heights Subdivision Add. #1, Lot 12, Block 3 Dear Mr. Klewano: Attached are the coliform bacteria test results on a water sample collected from the existing public water system (PWSlD 211431) serving the above referenced property. The sample was collected from an outside hose bib of the house on this lot. Since the water system is currently not in compliance with state drinking water regulations at this time, I am requesting that, on the basis of this water test, a site specific approval letter be issued for this property so that a health authoritY approval can be obtained from the MUnicipality of Anchorage. If you have any questions or need additional information, please call me at Sincerely, /~'t~en~C. Henslee, P.E. CE 7604 CT&E Environmental Services Drinking Water ~alysis ~epo~ for TOtal Coliform s~cter/a ~D IN~iON$ O~ ~F~E ~ID~ ~EFO~ COLL~IN~ ~MPLE Te~: (907] 562-2343 ~$r B~ COMPL~D BY WA~ S~PLIEI SAMPL~ DATE; ~, O Repeat Sample(for routlaasample with ~ab ~f. ne. ) LOCATION Day ~ Unlreated Water Time Collected Unsatlstnczory 0 Sample over .~C: hours o;d. resu!ts may be unreliable Sample too long in not be over 45 hours o:d It examination (o indicate reliable result, Please s~nd new sample via special dci;ve~ ma~L Date Rec./v.d Tim~ R,ceived _ Analysis 8egan Anatytical Metho¢: ..4;;~.~Membranc Filter ~ MMO.MUG Number ofcoJoe;es/iO~ mi. Lab Reft ~o, lq4 ' BACTI:RZOLOGICA.L WATER ANALYSIS RE, CORD Sent la A'D.F-.C. ~ rb~ Jun Client notified of unsatisfacto~, results. Pha.~ Spoke warn Colonies/tOO mi ~axed DEPT. OF ENVIRONMENTAL CONSERVATION TONY KNOWLES, GOVERNOR ANCHORAGE/WESTERN PUBLIC SERVICE OFFICE 555 CORDOVA STREET ANCHORAGE, ALASKA 99501 (907) 269-7505 July 22, 1996 Mr. Steve Henslee, P.E. SKLH Consultants 1700 Vashon Circle Anchorage, AK 99515 SUBJECT: Lot 12, Block 3 Eklutna Heights Subdivision Addt'n #1; Class "A" Public Water System ID no. 211431, ADEC Project No. 9621-DW-177-165. Dear Mr. Henslee: This letter is in response to the information received in this office on June 25, 1996, requesting a letter of compliance for a residential dwelling served by the above referenced Class "A" Public Water System. The Dawn Water System (PWSID no. 211431) is currently not in compliance with all of the provisions outlined under State Drinking Water Regulations (18 AAC 80.300). As a result, verification that the water has been recently tested for total coliform bacteria will be required to confirm that it meets minimum acceptable standards for drinking water. The Department has completed its review of the submitted information, which included recent water sample analyses for total coliform bacteria which were satisfactory. Attached is an "Approval of On-Site Residential Water and Sewer Systems" certificate verifying that this source meets the minimum acceptable standards for an approved water system. Thank you for your cooperation with this Department, if there are any questions regarding the above, please do not hesitate to call. Sincerely, Michael Lu, E.I.T. Environmental Engineer ML/cf Attachments MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ~/~- 9/~ 6 GENERAL INFORMATION (a) LegalDescription(includelot, block, subdivision, section, township, range) Lot 12~ Block 3~ Eklutna Heights T15N R1W Location(addressordirections) Pioneer Street Sec. 3 (b) ApplicantNameHenr,Y Epperson Telephone: Home 688-924/-I Busines~88-9244 Applicant Address Pioneer Street, Chugiak AK. 99567 (c) Applicant is (check one): Lending Institution []; Owner/builder~; Buyer []; Other [] (explain); (d) Lending Institution N/A Telephone Address (e) Real Estate Company and Agent Address N/A ;= .- Telephone (f) Mail the HAA to the following address: pickup by applicant TYPE OF RESIDENCE Single-FamilyF:'] Multi-Family [] Number of Bedrooms 3 Other WATER SUPPLY Individual Well [] Community [] Public [] Note: If community welt 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 I of 2 72-025 (11/84) . 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 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 w~t'bT-~'Pl~~ 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 Telephone Address EAGLE RIVER ENGINEERING SERVICES EAGLE RIVER, AK 99577 P, O. BOX 7732~4 694-5195 Approved for ~--"-~--"~ bedrooms Date Approved ,.,~ Disapproved Conditional Terms of Conditional Approval 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) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /~ ~ ..T' Width of Field ~- / Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well -r-~t.~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 '9~',~/~, ,P. Type of System Design Length of Field Depth of Field Gravel Bed Thickness 6'Oz~ 4~ ~;,-o-,,. ,~..'/¢ Standpipes Present (Y/N) Date of Last Adequacy Test Comments To Property Line --'-/o / To Existing or Abandoned System on ; On Adjoining Lots '* ~"~ ? To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~ Company ~/'~..,'~, Receipt No. Date of Payment Amount: $ Date ~ //,/ ~/'~'"~ MOA NO. Page 2 of 2 72-026 (11/84) WELL DATA MUNICIPALITY OF ANCHORAGE (MO~i MUNICIPALITY OF AI~:HORA(~ HEALTH AUTHORITY APPROVAL (HAA) DEFt'. Of: HEALTH & ENVIRONMENTAL PROTECTION CHECKLIST- FEBRUARY 1984 264-4720 MAR 2[ i ~_ Legal Description: '~ ~ ~2~ / ..~ - 1_ ~'.,,?_~- 7' ,~5",'t,~ I~k~kl · Well Classification ~ Well Log Present (Y/N) ~,,~ Total Depth Cased to Static Water Level 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 Water Sample Collected by Water Sample Test Results Comments if A, B, C. D.E.C. Approved (Y/N) Y Date Completed Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B. SEPTIC/HOLDING TANK DATA Date Installed /~ 2 Standpipes (Y/N) Y' Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) /'~,/'¢ Separation Distances from Septic/Holding Tank: To Water-Supply Well %.2~,o / To Property Line "/'~" To Water Mein/Service Line ~'/o · Course ,/!//'/~, Size J~ No. of Compartments v/ ,Y' Foundation Cleanout (Y/N) Date Last Pumped "~,J"~'/-'~ /'¢~'~" ;for Temporary Holding Tank Permit (Y/N) To Building Foundation '*-~" To Disposal Field ~'" To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(11/84)