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HomeMy WebLinkAboutSUN VALLEY NORTH BLK 4 LT 2Sun Valley North Block 4 Lot 2 #050-652-17 .qubii�.. Inspection Report 9-1-11doc C/ Municipality of Anchorage !' I tt On -Site Water and Wastewater Program • (907) 343-7904 Q62P 0� ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141168 PID Number: 050-652-17 Dwelling: W Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New W Upgrade Name: JOHN OLOFSSON ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 4315 ELKHORN DR EAGLE RIVER AK 99577 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft.Gravel depth beneath pipe Ft. Subdivision Block Lot SUN VALLEY NORTH 4 2 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines I Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption aa re Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ftp I Ft. well >100' >25' TANK N Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1000 Gal. Surface water >100' Material STEEL Number of compartments 2 Lot Line >5' NA Foundation >5' LIFT STATION Manufacturer Capacity Curtain Drain >50' Gal. Remarks EXISTING SEPTIC TANK ABANDONED Pump on level at in. Pump off level at in. High water alarm at in. PER UPC REQUIREMENTS Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 drainfield Tank to 3034 Installer DEAN CONST. Drainfield CO/MT3034 Inspector ANSON MOXNESS BENCH MARK (Assumed elevation)100 ft Inspection 1' 6/19/14 Location and description dates:2 ,m 3b 0 TOP OF DECK FOUNDATION COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Ew"'"'e X\ OF Conditional Approval: Date CO." ....i. . . ........... SPURKLAN y t 500 ,i,N,\\ Approved /N• / r'e�,' Date% zq _0L ES' ES`` Inspection Report 9-1-11doc C/ -- —� --+-- — �WINGrI A © .C.O. C 15' I .T. C.O. D 30' i T. C.O. E 36' BL. C.O. F 39' 3 BDR LOT SFR EXN 10 EI.KN RN DRIVE SEPTIC�AN£X PERISrMIOOA CODE REQUIREMENTS lY I INSTALLED NEW 1000 GAL STEEL SEPTIC TANK CONNECTED TO DRAINFI£LD OPE 4' CpNr LIM 25 0 25 50 75 Loo 125 150 1 SCALE, 1' = 50 FT. SUN VALLEY NORTH S/D BLOCK 4 NOTE. THIS IS NOT A SURVEYED PLAT WELL & SEPTIC LOCATIONS TAKEN FROM ON -517E WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. 2 FEET COVER DOUBLE 2' INSULATION CLEANDUTS =seal FDUNBATIDN CLEANOUT CONNECT TD EXISTING WAINFIELB IODO GALLON SEPTIC TANK BENCH MARK TOP DECK FOUNDATION ASSUMED ELEVATION 100 FEET SPURKLAND ENGINEERING SUN VALLEY NORTH BLK 4 LT,? SEPTIC SYSTEM ASBUILT 203 V 15TH. AVENUE ANCH. AK. 99501 JOHN BUTSSI N DATE..' JUNE 19 2014 (907) 279-3916 4315 £LKHDRN OR EAGLE RIVER AK 99577 SHEET+ 1/1 GRID; SVO758 PERMIT # DSP 141168 PID # 050-652-17 VVEIBILPO—ASB.DVG On -Site Water and/or Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141168 Tax Code Number: 05065217000 Work Type: SepticTank Upgrade Permit Effective Dates: June 17, 2014 to June 17, 2015 Design Engineer: SPURKLAND ENGINEERING Subdivision: SUN VALLEY NORTH Site Legal Address: SUN VALLEY NORTH BLK 4 LT 2 G:0758 Owner/Address: OLOFSSON JOHN A 4315 ELKHORN DRIVE EAGLE RIVER AK 995770000 Site Mailing Address: 4315 ELKHORN DR, Eagle River Lot Size in Sq Ft: 104111 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcell.D. 050-652-17 Property owner(s) John Olofsson Day phone 854-3196 Mailing address 4315 Elkhorn Cir., Eagle River, AK 99577 Site address SAME Legal description (Sub'd., Block & Lot) Sun valley North B4 L2 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank Ej Upgrade El Duplex (D) ElHolding Tank ElRenewal ❑ Multiple Dwellings F-1Privy ❑ U 13 n � I TTA 1 (SF and/or D) g Private Well El�V� L Water Storage ❑ JUN 0 3 2014 THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. property owner or authorized agent) Permit/Rush Fees: 217 � Waiver Fees: Date of Payment: Receipt Number: Permit No. Permit App_9-1-12.doc Date of Payment: iC)rA U Receipt Number: Waiver No. Sp Maimd Enaonsenong Environmental Consulting and Design May 29, 2014 Municipality of Anchorage Development Services Department Building Services Division On-site Water and Wastewater Program 4700 Elmore Rd. Anchorage, AK 99519-6650 Subject: SEPTIC TANK PERMIT APPLICATION Sun Valley North Block 4 Lot 2 Ladies and Gentlemen: We are submitting an application to upgrade the septic tank for this lot. The submittal consists of one (1) drawing showing the present improvements on the lot and the proposed improvements of the lot, of which only the septic tank is subject to this permit application. The installation of this septic tank will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank location. The proposed septic tank will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or are in need of additional information please contact me at 279-3916. Sincerer . Lars urkland, P.E. 203 West 15th Avenue Suite 202, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurldandEng@gci.net 10 EI.KN�RN ORNE N -7 I. ABANDON EXISTING SEPTIC TANK PER MOA CODE REOUIREMENTS 38 SFR LOT -� -- - l 4. 25 0 25 50 75 100 125 150 SCALE; 1' = 50 Fr, SUN VALLEY NORTH S/D BLOCK 4 NOTE., THIS IS NOT A SURVEYED PLAT. WELL & SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. 2 FEET COVER DO(/BLE 2' INSULATION CLEANOUTS FOI/NDATION CLEANOUT CONNECT TO EXISTING GRAINFIELD 1000 GALLON SEPTIC TANK 0 No. CE -11500 N Jl'UKKLANU LNUINLLKING I SUN VALLEY NORTH BLK 4 LT 2 SEYIIG JYSItM UtWUN 203 V 15TH. AVENUE ANCH. AK. 99501 JOHN OLOFSSON BATE, MAY 29 2014 (907) 279-3916 4315 ELKH17RN BR EAGLE RIVER AK 99577 SHEET, 1/1 6RIB: SVO758 PERMIT N OSP 141XXX PID H 050-652-17 VV£IBIL20.BV6 MUNICIPALITY OF ANCHORAGE DE 4TMENT OF HEALTH AND HUMAN SER ES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL. INSPECTION REPORT Name C? If [on.r Ji"re, a/Inry DISTANCES --'"— FROM SEPTIC TANK ABSORPTION FIELD WELL Address -- S,C' li o x `7 ,j S .,i !�, %( lh i J✓ (�/�r vW/t .Flr 5' ss 7 7 e�— WELL /04, / Phone(s) d5el-9/17 Penml No. 38/ No. of Bedroom:: 3_ LOT LINE s i- i7 r LEGAL DESCRIPTION TO —I Block Subd vlslon L- , , 1 //c ur y/ Township. Range. Section �3 FOUNDATION -- - AS -BUILT DIAGRAM (Show location of well, septic system, property tines, foundation, driveway, water bodies, etc.) TANKS - — -- - SEPTIC ❑ HOLDING Manutachaer Capacity in gallons r) C9 P Material S t-ee, If No. of Compartments a TYPE OF SYSTEM — — ❑ TRENCH ❑ BED W. DRAIN ❑ OTHER Depth to pipe bollom bear original grade -j- (9 FT Total depth from original grade ()L9-1/�a FT .� � 3 Rp(y v' ` — n n — � ( s h M1 4 — sg o — Fit added above oiiglnal grade �a FT Gravel depth beneath pipe - /7SA✓n r G / FT Gravel length �/� FT Gr:rvel vn0lh— S FT Total absorption area Lf SQ FT Distance between tines �! FT Number oI hnes Sod rating ///G SQ FT _ Pipe material AS7nN ?-3y Installer Dale Installed WELLS �4 PRIVATE ❑ OTHER (Identify) Clzssdicalon CA , 13 C) ----- Total Depth Gasetl to FT FT - -- Installer Date Installed: — REMARKS: y SCLC' G/'✓rJ/r,C r"—ice //�Sr/",. �U- 7�1e SC J/� S rr — � / _ �nr�, /, /ems vu�rT�.2 .? /'du/ /1.y Scale: Inspections Pmtormed by, ENGINEFR'$,SEAI. C� f, •t E r<h ;, Icr u2r-i r•r 9 ` �C eN=°° G W 6 Dale. I certify That this Inspection was performed according to all 7� Municipal and Slate guidelines in effect on this hale: _� "�-�' Health Department Approval —.Dale: 1 72-013 (3/85) 1J Pell U.._U U%. .0 B r:.::;U .—^ I'"t IE._. JF -"q" Nir IF—.11 F' A P'.q Q-. U -q C3 F a:=:; F, DE'PART'MENT OF I-IEAL_i-H AND ENVIRONMENTAL PRCITE.13 FI ON I._ E{1 RE:E:T ., ANC::HC{RAGiE: , Al'.: 99' O :E 264--4720 ':U q',,g..._• :_:i; W:..._q.. 6 :.: : i F.H: qe,,q E�: FR r_"•"..: P -S F. q_._ Il_... F' 1E F= ..1-11 J.:...1_. PE:R111:4 NO - DA F 1H 0.DA"r'Id I':iSUE:U;, APPIL ICAN] CONTACT PHONES. 1._01 SIZE''. 8111150'OMI EhIW:CNEE:R i:D DEFlIriIV q'7 /o2 /Ei{(:°i r:>E[AIV G;f..II�IS`E'Eil.1C:-r l:(:)1�I SR rHC{X 'i'<U32 WILD MC)LINrAIN EAGLE: RIVE -'R,, Al"' e 9tJ7'7 f�e7�4-•'71. 17 Sl.ltla:)7:VT':JIOIV. SUN VALLEY NORTH LOT: .3 l+a..Cla l<::. 4 E3E:C'f:r.C'IIV. 1'C:IWNSHIP. :1�41\I RANGE'. 1.W `7A (E3G.FT. OR ACRES) 1. c.-, e r t- i. f y t- h at.. 1.,. .1 am fiamili.ar` wit..h thc--+ roquiromC'nts for on-si.te ovjpr'.a and Wf?l1.f3 c1 scA, forth by the Municipality of Anchorages (110A) i -mid the'.I.-a•Ie of, Alaska. "? I wi.1.1 i.nsta.l'1. the systxml in 6accorrianc.E? with a l l 110A c:ode!,r and rradulrrl:.:i.ons, and i.n compliance with tho de sign e.r.i.i:.-r>ria of th:Le.:, permit.,, :3. T. wi.l.l. adherf± U) all. MI::IA and St.atea of Al<isk,a rf=llui.romumtsr for the set. ci:l.stancos from any existdng well„ wastewater disposal.!�y£itefrl Ur` pUbl.if. !ae?UJ E?r i:l l:f e3 system on this or any adjacent or nearby Iot. IF A L II="1" STATION IS INSIAI_L.E.D IN AN AREA CCIVE.RED BY hCIA BUIE.DINCi Com—s„ "rlIE=1I (1.) Oki ELF..'C:TRICAL. PERMIT AND:lNSF'Ei:f-;'1:ECIN mus'r BE UBTAINEDg (2) AS -1 -A.111 -TS WIE_L.. NOT BE AE'PRLIVCD WITH01..I1' AN E'L.E'iCIRI.CA_ INSPE:CTICN RI:i:PC{R'1'; AND (:3) v-iE: WORE: 110.31' BF: DONE BY A L.ICIcN'.31A) Ecl_E'CIRICIAN. 'i ICiNEY) c — _............ _......_........„........ .._ _..........._............ APPLICANT. DEAN/G{�NSTRUCTION J DATE:. DATE. C Ls T V -_--� t� SOILS LOG --= MUNICIPALITY OF ANCHORAGE /` DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION �i' 825 L. Street, Anchorage, Alaska 99501 264-4720 �' — SOILS LOG — PERCOLATION TEST O J O � PERFORMED FOR: LEGAL DESCRIPTION: DEPTH (FEET) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Z( tih �v„S �Y, c. 'Cy %Z -6r Top so ; $-tin „C/ G. -•.w( CG A¢ G -Mi wcfe,. ruble 8em� of //a/e C"1 SLOPE �o a _ DATE PERFORMED:/ �S'�5_ /oma Ir G/ / /S v /c 33 SITF PI AN u A �I+ 7i Gross Net vc° a eov vuvaovvvavu'ee e WAS GROUND WATER ENCOUNTERED? Yj S- YES - Time Time Water _ 11� aveo oe o°eaeave en eoa o° J ................ I.cuis A. Belem W �>� CE G9 IF YES, AT WHAT e -6736 ,? �a DEPTH? _ DATE PERFORMED:/ �S'�5_ /oma Ir G/ / /S v /c 33 SITF PI AN S L J'a O E a o 0 Reading Date Gross Net Depth to Net Time Time Water Drop SOAK W C I C V178r l60 — ? re r $ D E., s 1% aa/4 S L J'a O E a o 0 Reading Date Gross Net Depth to Net Time Time Water Drop SOAK oZ 4 3 ,i ,2. e '7116 D E., s 1% aa/4 20 "JJ- —7 — PERCOLATIONRATE / (minutes/inch) TEST RUN BETWEEN _ FT AND FT COMMENTS_ .See A 7-7 fJ C/-iGYJ /,€j/-.fr— /v PERFORMED BY:_ir��° G'�S/e ��� /%/ti0°T_ CERTIFIEDBY: /_�i. 7�—c DATE: 72-008 (6/79) JJ 611 ;s !A//t� L/YL�'•-r {ieI'll I Lv/ I p / ' Ile Y �%O lA hr�eLf GfC'�'J •-2 .f•. �,�' / /c>.v G'r �orrs 7`r„o frf-�` 7/a Be vim. e.,c•c 4ke•, /va%ovt'y ✓ 7 % sGA e I OKrbrrvnc ELJi' o�rr _ 1 Level /r a o`. <Llrf,',r{.���-'�.� ..—.� Se,-e-ene�F S:�j Y.c G-. �, os/ G�” v � �•�e,/v//� W U� c Grmnc M!", r nQ 0 i Louis ,4, C.uierq o i, j ( erlifie rilling by SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 * TELEPHONE 688.2759 OWNER OE LAND /~ ~ 6 ,~)~ ,'J '- ' DEl'TH OF WELL ADDRESS ~ ~a~ ~3C,~ ~ I~ ST.ATIC LEVEL OF WATER F'r. LEGALDES'CRI~ION Z &,fl&/~ ~ .FJ~, ~n~F~ '~O~'r~AW DOWN FT. PERMIT NUMBER '" KIND oF CASING KIND OF FORMATION: From ~) Ft. to '.~ Ft. 00~="~ ~'OA~''O Frmn Ft. to From .~t Ft. to"/"~' Ft. ~C~ ,t ~,~,ad~. From Fl. lo_ . From__ Ft. to ' ' Ft. ~...d~ 7~ From__ Ft. to From/4'q Ft. to From .... Ft. to Fromm_5' I. Ft. to From , Ft. From :, Ft. to- From-- Ft. to From__ Ft. to Fr6m ~.. FI. to Fr6m__ ,F,t. to Ft. Ft. Ft. From____ From____Ft. to Ft.. From Ft. tO _Fl.. From Ft. to_ Ft. From Ft. to Ft From ' Ft. to Ft.__ From Ft. to Ft. __ From Ft. to_ . Ft_ Ft. , _Fl, _ Ft. Ft. to_ _Ft~ Ft. to Ft .Fl, to · Ft._ NL~O~d 1YIN~NO~/~N~' .Ft..to_ _Ft. ,w aU MISCL. JNFORMATION: DRILLER'S NAME i ~ ;.>ii. '~'h ~:;~,< '~ >:'<)[~\l~a3'.'~l :i ,.DEPARTMENT. OF HEALTE & ,H.U. MANSEI~V, !.CE$..~,~ i ........ ~,- \~.-~l~'~J .. , D v s on of Env ronmenta Serv ces ' "~" ~" ' "~';'" ~"i. ~'~-~',, ' ': "On-Sit& services Section - '~: : '":.; ' -"'~ "" - ,; '~i' P,,o. B6X !96650 ~A~C~0!age, Ai~ka"99519-6650 ^PP.OV^L ^ F^U..¥ DWSLU Parcel ,D..# 050-652-17 . 1..,.~ GENERAL INFO ' Complete]~gal description . Sun Valley North Lot 2, Blk 4 Location (site adaress or directions) .... ' ; ~ Elkhorn Drive, Eagle River ;'<':.?rope~¥ owner Wenda Hunter & Paul Meyer Day phone 694-6841'. .;~ilin~-ad~ires~<~9~37 Hil~d Road, ~gle River, ~ 99577~i~· ~..Lending ag~poy, N~/Pat ~gev~e Day phone -.-~.~ ,,> P,O, ~x 6127, ~chorage, MaiI[n~ addr~ ~nt '~ ~e/~ o~ Ea~l~ ~ver/l~a ~ken 16600 Centerfzeld er;:,A~ -' 7 TYPE OF WATER SUPP[Y ......... ' '"'''' 'r ~-,.-~ .... .-..--~: ndvdua we ~.', ............. r:..'.;.,;~.:':~ ~::'~.:'.:,~.~:!:Co~unity well ~'- ~.:>-~:~<'.~. · ".' ' ~ ~, .:, .. ,~-.,. ,. . : ~. .,. :. Pub cwater:. ,. . - .. ... 4' TYPE OFWASTEWATER DISPOSAL: ~ -.~,.~ -~ .,, ,:~ ? ,.....,,~,. ¢,:lndlvldual on-site...? .~,; ,... -¥, .,~,..~ :~.-..~:~ ;?~.,-:~,,;<, ;-;¢.~;..~;'~,~,~ .~..~ ,.. ., ~, ~' .~ ' Holding tank~ ' ~ub 'c sewer NOTE: If communi~ wastewatcr sy~tem~ P(~(de Wri~en confirmation from state ADEC attesting to the legali~ and status of system. 5. STATEMENT, OF INSPECTION BY ENGIN~ER,, · .... · As ~er~ifled by~y seal affixed t~ereto and as ot:th~"va'lidat'icJn date show~ ~elow, I veri~ that investigation of this Health Authori~ Approval application shows that the on-site water supply. and/or wastewater disposal system is ~fe, functional and adequate for the number of b~rooms and ~pe of structure indicateC herein, I fu~her veri~ t~at based on the information obtained from the Munimpali~ of Anchorage files and from my inves~ation and inspection, t~e on-site water supply and/or wastewater disposal system is in compliance with all Munic~ pal and State codes, ordinances, and regulations in eff~t on the date of this inspection. Name of Firm ~qle River Engineering ~R~i~ Phone ~q&-~q~ Engineer's signature 99577 Date ..~; .~. h,T. he Munic pa ty of Anchorage Department of Health and Human Services (DHHS) issues Health Authority A~)proval Certificates based only upon the representations giyen in. paragraph 5 above by an indeoenoem 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 emissions in the profe~ion~l engineer's work. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A, Well Data Well type //~,2/-¢,'¢F,C- Leg present (Y/N) Total depth Sanitary seal (Y/N) Parcel I.D. if A, B, or C, attach ADEC letter. ADEC water system number ~"E: % Date completed ¢~'//~'~ Driller /~/ / Cased to /~/ / Casing height )/~--~ Wires properly protected (Y/N) /v lA Date of test Static water level Well flow Pump level1 FROM WELL LOG AT INSPECTION , /¢P g,p.m. ¢'/-/' ~' SEPARATION DISTANCES FROM WELL TO: Septic/he, ding tank on lot Y-leO ' Absorption field on lot /-/0¢ ' Public sewer main Sewer service line 7 RECEIVED .g.p.m JUL 1 4 1995 Municipality ct Anchora¢~8 Dept. Nealth & Human Sorwces ; On adjacer)t lots .; On adjacent lots Public sewer manhole/cleanout Petroleum tank A/OD WATER SAMPLE RESULTS: Coliform '¢~ Date of sample: Nitrate _ O, ~'Z' Oollected by; Other bacteria B. SEPTIC/I~;~bDING TANK DATA Date installed (? c///S/Z~ Cleanouts (Y/N) }/~¢ High water alarm (Y/N) Date of pumping Tank size / 00~ Compartments Foundation cleanout (Y/N) ~'~ Depression (Y/N) /'///} Alarm tested (Y/N) /k/J/c/ {~'?/?,'/¢ ~ Pumper SEPARATION DISTANCES FROM SEPTIC/HQEDfNG TANK TO: Well(s) on lot Y/O0 To property line ,¢' /~ ' Absorption field Surface water/drainage Foundation Water mairr/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Manufacturer ~ Manh~ Vent (Y/N) "Pump on" level at ~ "Pump off" Level at High water alarm level ~- Cycles tested Meets MOA electrical codes (Y/~ .~ SEP~S'TA~E FROM LIFT STATION TO: ..NWll on lot Surface water On adjacent lots D. ABSORPTION FIELD DATA Date installed /*~//~,/~' Soil rating (GPD/Ft2) //¢~ /~/]~/<' System type Length c~ (.,~ / / Width ~ Gravel thickness ~' ~ Total depth Total absorption area ~/~ ~ Cleanout present (WN) ~ Depression over field (WN) Date of adequacy test ¢ ?//~/~ ¢ Results (pass/fail) /~¢ 5~ for " * ...... ,/ Water level in absorption field before test /7 ~¢~ 7~¢~ r,~¢~¢,, After test /~ Peroxide treatment (past 12 months) (Y/N) ~/¢ If yes, give date O'-~ 0,5' Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water Curtain drain On adjacent lots ?- /0~ Property line ¢ ~¢ To existing or abandoned system on lot /'¢/-~ Cutbank ,/k//~ Water ~mai__sn/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 guidellnes,~ te of thi¢ inspection. Signature ~ Engineer's Name /~2L//£ ,/.~ ~,~,,/2~ / Date '~ ~/z - 2 ~'- ?£ HAA Fee $ ~' ~ Dateof Payment Receipt Number //¢2 ,~',~ Waiver Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back 07/i4/95 88:~6 COHHERCIgL TESTING -,' 997 ~94 3297 NQ.878 gOE, zTF. CT&I! E,vironrr,ental Services Inc. Laboratory Dive,ion ~mmm~me~m~~~~~ ...~.s~-~ Laboratory Analysis Report WATER 200 W, P01;ier [}rive, Anchorage, AK 99518-180~ -- Tel: (907) 502-2343 Fox; {907) 561-5301 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPAR%/4ENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. Genera]. Information Application Date 9/].9/85 (a) Legal Description (include lot, block, subdivision, section, township, range) ___Lot 2_~B~l~oc.k 4 SUN VALLEY NORTH SUBQIVISION__~7-/W~,~zw f~.c ~ Location (address or directions) NHN Elkhorn Circle Eagle River, AK 99577 (b) Applicants Name DEAN CONST, & DEVEL. Telephone -- Home694 9]'lB~usine, s~s Same Applicants Address S R BOX 9352 Eagle River~ AK 99577 (c) Applicant is (check one) Lending ~nstitution Buyer [~----~ ; Other ~ (explain!, (d) Lending Institution Alaska Mutual Bank Address P. O. Box 771028 (e) Real Estate Co. &~Agent NONE Owner/builder ~] ; Telephone 694 9571 Eagle River~ AK 99577 Address Telephone (f) Mail the NAA to the following address: Please call for pic___~k..~p~ 694 9117 Dean Const. & Dev. 2~ Type. o~_Re_cstdence Single-Family ~ Number of Bedrooms 3. w___ater Individual Well~ Multi-Family~--~ 3 Other (describe) Community~ Public~__~ Note: If community wei1 system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. se__w 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] Engineering Firm Providing Inepections~ Tests, File Sea_rc~, Dat.a a____nd I___~nformation 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-sits 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 en 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 ~Ith all Municipal. and State codes, ordinances, and regula- tions~ in effect on the date of this inspection. Name of Firm Telephone Address DHEP A_pj~r oval Approved for f~/-~bedrooms Approved 7~~ Disapproved 3 Terms of Conditional Approval EAGLE RIVER, AK 99577 CAUTION THE WJNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DREP) IS$1~S HEALTH AUTHORITY APPROVAL CERTIFICATES BASED ~OLELY UPON THE REPRESENT-i ATIONS 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 REQUIRE- MENTS. 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. (DHEP SEAL) RR4/eJ/D18 [Page 2 of 2] 7-19-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORI'f~/APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264,.4720 MUNICIPALITY OF ANCHORAG~ DEPT OF HEALF,~ & ENVIRONMENTAL PRO [ECTION Legal Descripuon: WELL DATA Well Log Present (Y/N) Total Depth ,/~/ t __ Cased to Static Water Level //? / Casing Height Above Ground Electrigal Wirin~ in Conduit (Y/N) . Separation. Distances'fi;om ~'~ell: ,To Septic/Hotding 'Tank cD,Lot ~/~ Td Nearest Edge o~.Absorption Field on Lot T~ Nearest ~ubl.ic Sewer I'ine If A. B, C. D.E.C. Approved (Y/N) ~ Date Completed oc;/0c 5-'" Yield /~'4-'/ / D'8pth of Grouting Pump Set At ~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead [Y/N) : On Adjoining LOtS : On Aaioining Lots To Nearest Public Sewer Cleanout/M.m~hoie /7//.4- Water Sample COllected by Water Sample Test Results Comments To Nearest Sewer Service Line on LOt ~-~,~? ~ ,3- , ; Date B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) Depression over Tank (Y/N) Size Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/lflolding Tank: To Water-Supply Well /'¢~ / To Property Line ,/¢' c- To Water Main/Service Line Course ../~ z~ No. of Corr aartments Air-tight CaDs (Y/N) ~ Foundation Cleanout (Y/N) Date Last Pumpea '/'¢/~ ; for ~.~' Temporary Holding Tank Permit IY/N) To Building Foundation To Disposal Field . ~' 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 7//~--~//~- ,~' Width of Field ~ / Square Feet of Absorption Area Type of System Design Length of Field ~'~"" Depth of Field ~/',A / Gravel Bed Thickness ~ // Standpipes Present (Y/N) Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well //~,¢ "- To Building Foundation 7¢¢' Lot To Water Main/Service Line /~' ~' To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parkin9 Area, or Vehicle Storage Area Comments Date of Last Adequacy Test To Proper~y Line ~.}o / To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) /¢~- 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. SignedJ~ Date Company ,~,,~'~-~-~ MOA No. Receipt No. ,.~'~, 4://¢ Date of Payment _ Amount: $ ~,~-¢ C:~ Engineer's Seal Page 2 of 2 ; · AS-BUILT I hereby c~rtify that I have Surveyed the followiCg' 5lesc¢ribed Anchorage Recording Precinct, ~aska, and that the Impure- meats situated the~on are within the prope~y lines and ~o not overlap or encroach on the property lying ad acent thereto, that no improvements on prope~y lying adjacent thereto encroach on the premises in question and that them a~ no roadways, ~ansm~sion lines or other visible easements on said pmpeRy except as indicated hereon. Dated at Eagle ~ver, Alaska · ROBERT C. JOHNSON ~.x ". SCALE: ~ Registe~d ~nd Su~ey~r No.~fS~LS 1" '~ ~ ~ ~x ~, Eagle ~er, Alaska 99577