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Home My WebLink AboutFIRE LAKE LT 2 TR H MUNICIPALITY OF ANCHORAGE DEPART,VtENT 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 NAME PHONE [] NEW AILING LEGAL DESCRIPTION DISTANCE TO: ]Well Absorption~ /~ ~¢~ ~ ~ / ~O /~ Dwelling PERMIT NO, ~ Z Manufacturer Material No. of compartments Liq.~n gallons IF HOMEMADE: Inside leith Width Liquid depth ~ M DI,STANCE TO: Well ~// Dwelling PERMIT NO. O Z ~ Manufacturer'-~ I Material Liquid capacitv in gallons Well Foundation ¢ Nearest lot line (~ P~MIT NO. i = DISTANCE TO: / ~ /, /¢ c~ i ~ No. of lines Length of ea el Total length e~ Trench ~-- ~ .. / ~ ~n Distance between lines ~: ~ inches Length Width Depth PERMIT NO. ~ Tg~o of crib Crib diameter Crib depth Total offecti~e absorption m Well Building foundation Nearest Icl line ~ DISTANCE TO: Class~' ''V¢ ~. , j~ l~t~ ~ Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) PIPE MATERIALS OTHER INSTALLER ' &[:,~ t41¢J6 ~ ~O ~C, ~'~' ' REMARKS 3 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE Department f Health and Environmenta' ~rotection 825 .~ Street,264-4720 Anchor age, AK. ~9501 ~/'~~' * * * HANDWRITTEN PERMIT * * * Permit ~ . WELL AND/OR ON-SITE SEWER PERMIT~ Applicant: /~ ~(~lt~' Mailing Addressy- ~' '.:':64J.' Location: Phone Number: ~ q~ - 'L~-? Legal Description: ~C,~ ~ :i~ L'I~ ':/~ LOt Size: Type of Soi~sorption System Is: Trench: X Drainfield: Seepage Bed: Holding Tank: Maxim~ Num~f Bedrooms~~ Soil Rating (sq. ft/br) ~ The Required Size of the Soil ~sorption System Is: DEPYH LENGTH GRAVEL DEPTH ~ WIDTH The length dimension is the length(in feet) of the trenoh or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of grgv~l between the outfall Pipe and the bottom of the excavation(in feet). ~ * * REQUIRED SEPTIC(HOLDING) TANK S~E= ~ GALLONS Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * Baokfilling of any system without final inspection and approval by this dep~rtmen~ will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee~ for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31~ 1 9 8 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. / (3) I und~s/%~nd that~e on-site sewer system may require enla~ment if t~'~s~nce/is/~emodeled to include more that/3 bedrooms// /% Signe~:/f//(~X/~'//~ ~.--- Issued by: ~~f~-~ ~~ ~piic'~t ::' ~--~ Date: ~7~/~ ~ [] SOILS L.OG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PEF~CO LATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS Tf~ ~c~m 14 /..-/ L../¢'r cz_MY [~' lq l C ,E SLOPE SITE PLAN No. PERFORMED 72-008 (6/79) ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop I o--7-,e~ 7; zor, ' / I - PERCOLATION RATE ~'~'7 (minutes/inch) TEST RUN BETWEEN 4~-' FTAND ~ FT 0 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. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING -~,.?~ '~ - ~,~ NAA # 1. GENERAL INFORMATION Complete legal description Lot 2; Fire Lake Subdivision; Location (site address or directions) 14532 Fire Lake Road Property owner Mailing address Lending agency Mailing address Agent Address Dani~ W. Claugu~ P.O.Box 771971 Eagle River, 694-4540 Day P hy~'d~th- wk~--~- 2b 5- 2 $ i 0 Alaska 99577 Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 5 "~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: 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 Public sewer NOTE: XX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. t/91) Fron~ MOA ~21 5. STATEMENT OF INSPECTION BY ENGINEER o 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. Name of Firm Address Engineer's signature S & S ENGINEERING 17034 Eagle River Loop Road _No~. 2_~ Eaqle River, Alaska 99577 Phone Date (,~,_ DHHS SIGNATURE /~ Approved for ,-- ~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date ~//~--~ / / , 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. 72~0.75 (Rev, 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L'c-'T t-~, ~-"~? L.--~ ~ Parcel I.D. A. WE LL_~TA Well type ~-\V//"~c-- If A, B, or C, attach ADEC letter. ADEC water system number -/ Date completed '('~-~' /~'-~z[~- Driller Cased to ~'~-'~-~: Y---- Casing height Wires properly protected<~"~N) Log present (Y~)~ Total depth ~'"~' Sanitary seal~TN) FROM WELL LOG Date of test / / Static water level / Well flow / Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot t ~.~ Absorption field on lot AT INSPECTION ; On adjacent lots ~ ~ .'t"' ; On adjacent lots Coliform _e__of. sample: B. SEPTIC/HOLDING TANK DATA [ c.-~.. ~, ~, ~.~_ Date installed -'-~-~. ~-'~i-~'~ Public sewer main Public sewer manhole/cleanout Sewer service line ~ I Jr Petroleum tank Nitrate Other bacteria Collected by: Tank size /~, ~z:~P/'-~ Compartments Foundation cleanout (Y~ ~ Depression (YLqq~ Alarm tested (Y/N) ~ ~ '~"'~'~" ~'~-~ Pumper Cleanouts ~;~/N) '-(' High water alarm (Y/N) Date of pumping Foundation Water main/service line SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: On adjacent lots Absorption field Well(s) on lot To property line Surface water/drainage 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed,'?~-~-:~{J ~ Length ~'¢-' ~ ~t' Width Total absorption area ~ I ~ Depression over field (W~-~b Resulted/fail) Peroxide treatment (past 12 months) · Soil rating '~-~' ~-~ ~//~¢-~ System type Gravel thickness -~¢~ Cleanouts present~) Date of adequacy test for /z--q'~[::~'~ If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon lot ~,~~1'4 To building foundation On adjacent lots Surface water Curtain drain On adjacent lots ~ ~' ~ Property line ~ To ex~isting or abandoned system on lot / Cutbank ~N- Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on t~e, date of this inspection. .~.~, '.: ~.. - ~...~, Signature 17034 Ea~le River Loop Roa~ NO. 2~ ~ ~j/~ *.. ~.[ ~" ~ 1~ Eagle River, Alaska 99577 ~;~,.~~ ~'" 'TM":' "~ ,~' ~ ~ ~' ~:~ Engineer's Name ~ ~ / ~ / ~l ~, ~ ~;~'Op.- ........ 2.~t~~'~Z'' HAA Fee $ [ 7D '~ Date of Payment ~/Z-/q~ Waiver Fee:, .... Date of Payment Receipt Number ~-~ ~ / ~ ~ Receipt Number 72-026 (Rev, 3/91) Back MOA 21 ATER .WE n ADViSORy During a recent Health Authority Approval on-site inspection and, the p 7~ Block~ /~ test of otable water supply well on Lot of /~-t~- ~/J Subdivision, the well's productivity was determined to be ~.'7/~ gallons per minute. The minimum well productivity required by ~his department (AMC 15.55) for a ~'- bedroom residence is ~9-~/ gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of noncritical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all'copies of the subject Health Authority Approval. I & $ ~NGINEERING !~0~14 Eagle River Loop Road No. 21)4 llmgle RiVer; Alaska 99577 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS REHULTS for INVOICE ! 54042 Chemlab Ref.{ 92.2307 Sample t 3 Matrix: WATER FAX: (907) 561-5301 Client Sample ID PWSID Collected Received Preserved with LOT N OF LOT 2 FIRE LAKE $/D Client Name :S & S ENGINEERING UA Client Acct :SNSENGP ~AY 26 92 { 12:35 hrs. BPO! : }{AY 26 92 e 14:45 hrs. Reql : AS REQUIRED Ordered By :R. SHAFER POt :NONE RECEIVED Analysis Completed : }dAY 27 92 Laboratory Super~¥~gor )~STEPHEN C. EDE Released By : Send Reports to: i)S & S ENGINEERING Parameter Results Units Method Allowable Liners NITRATE-N 3.5 mg/1 EPA 353.2 lO Sample ROUTINE SAMPLE COLLECTED BY: R.J.S. Re~rks: 1 Tests Pez£ormed ' See Special Instructions Above UA-Unavailable ND- None Detected "See Sample Re~arks Above NA- Not Analyzed LT-Less Than, GT-Greater Than ~-~ Member of the SGS Group (Soci~t~ G~n~rale de Surveillance) APPLI(' . IT FILLS, OUT UPPER HA! ONLY Mailing Addre~ ~ - ~.- / , - /" ..' ~ / /,'/~ ~ ~ ~L ~ ) ,.~ Buyer , ..:~ ~ /t (.~ C~. .... T : ~ ~ ('~ ~t:'~ ~ Address , ' . .... I ~j .... ;' , .... ~. UU' ' ~f ~ Single Family ~Multlple Family No. of Bedrooms ~ Other Water Supp[y ~ Individual A~ACH WELL LOG. A w~l Icg Is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach Icg If available). ~ Public Utility ~ Individuali , "~ Year IndivMual Installed: ~ / ~ Public Utility {i~ : ' ~ When Connected to Public Utility: ~ Holding Tank ~? NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Inspector Inspector Inspector Inspector "',,t ¢[ ~ *. & r' ( ) CONDITIONAL APPROVAL" Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received Well to Tank Septic T~k Size APPL C IT FILLS OUT UPPER HAL DNLY Property OwNer ~/~,'l/'(?)' ~,~ /~_.~~~ --- Phone Mallin~ ~ddre~ ~*~ _ Zip Code ~ ~'~- ~/ Address ~ ~ ~ ~~~/ ~ ~. Zip Code ~ ~~ Address ~ ~, ~ ;~. ~ ~ ~/% Zip Code ~ Phone Type of Resi~nce t " .~ ~ ~ Single Family ~ ~?e Family No. of Bedroo~ Water Supply ldual A~ACH WELL LOG. A w~r log is required for all wells drilled since June 1975. munlty For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility _ 1 Year Indlv~ual Installed: tlllty When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Cate Date Date Date Insp~tor Insp~tor Insp~tor Insp~tor ANcHORAG~ Field Notes: ~ ~;~"~ ~ ' ~ ~UNtCIPALt~ OF ENVIR')ilh' :t,,A .... 0 2LT ON ( ) ~..~ow~ aE~.OOMS ~.--'- ~'~ ~ON~O.S O~ ~..ROWC / ~ -- ~ ( ) CONDITIONAL APPROVAL' Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received Well to Tank Septic T~k Size 72.023 (3/82) RECEIVi-D November 20, 1982 Mr. Dee Walker SRA 290-W Eagle River, AK 99577 Re: Septic System Adequacy Test; Lake Subdivision Track H, Upper Fire Dear Mr. Walker, Today I performed an adequacy test on the septic tank and absorption system at the above listed property. The system serves a five-bedroom house and 800 gallons of water were used for the test. The water was drained into the system at 10 gpm and there was no evidence of a system back-up. There should be no immediate problem with using the system. The system appears to be somewhat unconventional and system componentB should be exposed and evaluated before approving for long term use. The depth of liquid in the tank was only 2'9". Following the test the tank was pumped and only 200 to 300 gallons could be removed. There were no standpipes other than the one at the septic tank and no indication of the type of absorption system in place. However, the system did absorb well in that the water level came up only 4 inches during the test. There was a heavy sludge deposit in the tank and the tank should probably be pumped again after 6 months. Please call if you have any questions. ~er~o~ Lo Roel~ 13LEDOUXLANE · EAGLE RIVER,ALASKA 99577 · TELEPHONE (907)694-3574 November 8, 1982 Devon Walker c/o Charlene [)avis Realty North 1577 C Street, Anchorage, AK 99501 Sul)ject: Lot 2 Tract, Fire I.ake Sub. The sewer syste~;] and water su,,,~t)ly servinfl the subject prope]?ty not been approved by this department. Therefore, before an vel may be issued the follo~.linq items %;ill,~n...et~ to be com~)lete(]: The water analysis report needs to be .~;ubmitte,'l to this l~//~office from the (;I,e,'~] Lab, 5633 ~, Street, for our revie\v. ExDo;~¢; the well ~or our inspection to detera~ine pro~er coustruction, al.so %o insure minimum distance requirement~ are n%et bet~een the %;ell ant~ sewer svstem. The seDtic tank [)umped ,,litha receipt submitted to thio de})artment. The total number of gallons l)um,~e~] needs to be on the receipt and vel'ified by a registered enqineer as to the actual number of gallons pumiced. This i~] to verify tile size of the septic tank. o A four (4) inch cleanout need,q to be installe(3 to the sep- tic tank. four (4) inch cleanout needs to be installed to the leachinq area. An arlequacy test needs to be performed on the existing leachinq are~. Th~s test will deter~aine ii: the adequ,?~te according to National Standards. A listing of private firms !~erforminq the test is enclosed. This report needs to be sub~nitted to this office for our review. Prior to the adequacv te,~t you shoul(1 determine ho~; [/ar a%lay your sewer system is a%laV from your ~lell. If the septic tank is less than 8()' and your leaching area less than 120', you will need to relocate your gev;er systern. Devon Walker November B, 1982 Page Two If you need to relocate your system, a soil test will need to be p(3rformed and submitted ~o their office so that a permit may be issued. Please notify this Department for a reinspection when thc noted discrepancies have been corrected. If there are any further questions, please call this of£ice at 264-4720. Sincerely, Enclosure RP219/p/EH Robert C. Pratt Associate Environmental Specialist December 8, 1982 }lob Rogers 3520 Hazen Circle Anchorage, AK 99502 ~3ubject: Lot 2 Tract ti Fire Lake Sub. Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: The 3 %zells have conduit placed around the exposed wiring. The 2 wells on the outside have seals placed on them, so they are water tight. Expose the leaching area to evaluate it and also determine the distance between it and the 3 wells. (See enclosed copy of engineer report). ~£he septic tank is not large enough to meet the needs for a 5 bedroom home. Tile sea)tic tank must bo exposed to deter- mine its condition. According to the engineer report the tank may be under 500 gal. capacity. This then would mean another tank of 1250 gals. or more would need to be installed. A four (4) inch cleanout needs to be installed to the leaching area. Conditional approval ]nay be granted if monies are placed into escrow to cover the cost of tile mentioned item. It should be noted that if the leaching area is too close to the 3 wells it will need to be relocated. 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, ~ Robert C. Pratt Associate Environmental Specialist RP245/p/E~ ,~.' ( .- ~ 1'~.~.. ..... ~/>/_ '. ',.,:.,'. :: '"' . ..~. .~r~., ,. ;, -..,. . ..~ ~... · r ,-',~*~'~' ~ ' . . . . ~.-~, ~r, fr .'.',, .... ,.. . ~ ~). a.'.' .'~ .. ~ ~ ,. - I hereby certily Ihut I have .~vey~ U~e tulluw~i ~ ' ~c~,aal,I l.L'cor~nl Pr,~cin~, Alllkl, Ind thll tho"i~,L meals lituit.~ ~erenn itl within tl,e proPe~y 11.e5 nol overllp ,~r encroach .~ ~ ~ro~Z lying to, that ~ i ~prove~lnL; On ~to~y ly~g ~jaeen~ m~croach o. the premiss In ~liQa I~ tll~l said pro.rtl' except M 1~ d~eale~ ~( gistered L ami ~rveyur