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Home My WebLink AboutT15N R1W SEC 19 LT 38 ~ ' ' - : ' -- ' ~ . - GE DISPOSAL SYSTE - ,~ ~ -- ~'INSPECTION REPORT ON SITE SEWA ,/~,. ~, ~.~-~f// ~AILNGADDRESS ..... ~-~,~-~ ~ - - . ........ AMB -~.-~/ / ..... ' ....... ~ ~;'~ ~. ~ ' ' ......... - :" ,; "/' ./'" ~ ' :' ' LEGAL DESCRIPT ON ~.' LOCATION /3 · '~"'/ ~ ' ' ': . . ~.. . SEPTICTANK~ : ' ..... .: .... ' · ~ ' : ''/ , ? ::~:j~:~'-~'~?~ ~:NUMBER OF ::. ~:~':.'. : · FROM WELL-~-~'~' - MANUFACTURER ' ':' "m~'=~'~ ~ ....... ' ...... . :':. · '~,?~ ';::.,:~..~:,..~i,.~:~::::~ , ~. . INSIDE LENGTH INSIDE WIDTH. '-' ~LI~UID DE~H~I~UID. ~ACITY~) ~ ~A~LONS. SEEPAGE PIT~ . ' ''''~:¥ '~ :~ ~.. I ~ .-/:i,:,,,....~.f ,~.ll?.-',,g'~ · D~A~Tea--; ' 0. WI~TH~, .'L~NaTH ~ DAP*H_ NUMBER OF PITS / ,. ~ . BUILDING FOUNDATION .~-.~, ADDITIONAL ABSORPTION ..... ~.. ,.;."ET'ER .~/DEPT. 3~'O ~A,'i~.~'?OM, '.WELLW'~6,".." · ; ' / TOTAL EFFECTIVE ?~:': :" " -- ' NEAREST LOT LINE~ · ABSORPTION AREA {WAL~ AREA) ~'/~/ .SO, ~. WELL.' TYPE BUILDING FOUNDATION CESSPOOL APPROVED-- " __ CONSTRUCTION NEAREST LOT LINE ." , OTHER SOURCES_ DISAPPROVED -- NEAREST SEWER LINE-- ' REMARKS- · ' ' :'~. ' _DISTANCE FRO~: DEPTH SEPT,C , ;; ~ ! ' S~EPAGE _, TANK~, SYSTEM ~'.k~t.~, t-. INSTALLED BY: PIPE MATERIAL= LOT SLOPEr REMARKS; - Form PW-026 DIAGRAM OF SYSTEM GREATER ANChORAgE ArEa Borough DEPARTMENT OF WfllVIROflMEHTAm QUALITY SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT -. VALID WITHOUT ilNIMUM DIITAN¢~'B, REQUIREMENTS OUNDATION TO S~EPAGg pIT. ~/~ ~ ,, ORA~N FIt~D , fATES MAIN TO SEPTIC TANK DRAIN ,rlAVIcL BACKFILL 'HEALTH AUTHORITY Drilled by ~es Ne~t~n--~,~-~ I0' 9 ~" Gruvol & Rook ~t0 ~' .- tO' " ~ard ~an tO 2~~ 6' I ~" ~and & 811t to 58' I1}" Dr~ H~d ~nd &~n~lt'f~om ~" Sand & G~vel at 68'. Some eater· ~ 7" ~ity ,sad from 68' 6" to 78'.j lO~ 6" Olay ,~ sand to ~ Reek at ~7~ to:leo seep hot'eon 88~7" to ~1o~ .. About ~ gal, ~er min. Qui~a.$ of ouatome~'''~ ~sll eased to 88~ 7", rest o~en hoXeo MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services S~ction P.O. Box 196650 Anchorage, Alaska 99519~6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Oy/- 241 -2 7 1. GENERAL INFORMATION Complete'legal description Location (site address or directions) Property owner Mailing address Lending agency Mailin. g address Day phone Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: '~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank 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-O25 (Rev. 1/91) Front MOA/121 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 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. · $ & $ ENGINEERING 'Phone ' ~ ~ ''/- ~- c~ 7 ~ Name of Firm ii6.~,~ I=agle River Loop Road No. 204 Address Eagle River, Alaska 99577 Engineer's signature '~'/~'~ ~' ~-'4~"'-"-~ Date )~/'1 /"/f' DHHS SIGNATURE Approved for ~-- Disapproved. ' ' Conditional approval for bedrooms. bedrooms, with th-e following stipulations: The subject seepage pit type absorption field currently meets minimum requirements of Chapter 16.65 of the Anchorage Municipal Code with the exception of a building foundation construct~dTover the top of the s~epage pit. The engineer submitting this H.A.A. has certified to this office that this Addition~ Comments uu~,diLio,~w~z .... ~uL uump~umi~= Lhu ~L~uctu£ai i~Lugricy of uhe $eepage pit or the hu~ldlnE. 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 orderto 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. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · Health Authority Approval Checklist Legal Description: ~:~' ~ ~ ~-.,. I~ ~t¢/O ~ ~I~ Parcel I.D.: A. WELL DATA Well type ~'~¢t'J Log present ~N) Total depth \ \ Sar~itary seal (~N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to FROM WELL LOG ~c~ ~-~ Casing height (above ground) Wires properly protected (~)N) AT INSPECTION Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: ~ ~ ~'~ ~' B. SEPTIC/HoLDING TANK DATA Date installed "c1'~')7~' Tanksize ~, ~ o J Other bacteria 'Collected by: -~/~ ~'~)GZ. Foundation c ead~at:(~N) "~ Depression (Y~ OateofP~ih~ :'~"'t~.'~lou :' Pumper ~~ . ABSORptION FIELD DATA. Date in~alled ~ ~ Length ; Width Effective absorption area ~/~ ~ Date ~f adequacy test ~ ~ Y'~ Number of Compartments ~ Cleanouts ~i~/N) ,7/ High water alarm (Y/N) 'J IA Soil rating (g.p.d./fF or fF/bdrm) ,/2. ' Gravel thickness below pipe Monitoring Tube present ~N) ~ Results (l~/Fail) ~'5' )/,,~. System type (-, ' Total depth /,~ Depression over field (Y/~ ,O For ~ '/ /~' ~' ~ bedrooms Fluid depth in absorption field before test (in.); /~ Immediately after~d° gal. water added (in.): Fluid depth / '~ (ins) Minutes later: /~'- Absorption rate = ~'//,~"~ ~ .g.p.d. Peroxide treatment (past 12 months) (Y~/J~/J Z- [zW~,/J If yes, give date 72-026 (Rev. 3/96)* LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at* ,_._.-~-----"Pump off" level at* High water alarm level at* / *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ~ cO x ~ Absorption field on lot ~ ?~ Public sewer main Sewer/septic service line -'~' ~ Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation lC, t -V- Property line I ~> ~'~ Absorption field On adjacent lots On adjacent lots / Po Public sewer manhole/cleanout Water main/service line Surface water/drainage , .~,, ~ ~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line !~ ~ ~- Building foundation Sudace water Curtain drain //,~ ENGINEER'S CERTIFICATION Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots I~ I certify that I have determined thru field inspections and review of Municipal r Signa~urein conformance ~/~/~with MOA ~guideli.~es.~/~.Z,r~..,_.~in effect on this date. Engineer's Name /~/~'?~"- ~-- ~ ~ Date ~0 /~ ~ HAAFee $ ~' Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number ~ 72-026 (Rev. 3/96)* ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. SEWER &WAIER MAJN EXTENSION8 ROAD DESIGN WELL RECOVERY TEST DATA CUENT: ~ WELL LOCATION (legal): TEST DATE: ~ ~ ~'--"~ TESTED BY: WELL DEPTH: I t 0 ' WELL DRILLER: CASING DEPTH: CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 DATE DRILLED: TEST PROCEDURE: 1) Draw water down to pump. 2) Shut pump oft 15-60 min. -record time -record meter reading 3) Turn pump on. Drawdown. 4) Shut pump off. -record time -record meter reading $) Calculate gal./min, recovery. MISC DATA: Casing Height: Sanitary Seal? Wires In Conduit? Grading O,14.? Pump Depth: Samples Taken? Date: TEST DATA: START TIME: I t, "~ ~/~'~,, STATIC WATER LEVE.L: '7~ ' TRIAL II PU~P II TIUE II METER II GAL.~.g~ OFF 0~, o~ ~c~j I~, 't I ON OFF OFF OFF 4 ON OFF OFF 5 ON OFF RESULTS: WELL CURRENTLY PRODUCES: FLOW RATE NOT GUARANTEED--SUBSEQUENT VARIATIONS CAN OCCUR, 17034 NORTH EAGLE RIVER LOOP · SUITE 204 * EAGLE RIVER. ALASKA 99577 0CT-02-98 16:19 FROM-CTE ENVIRON~NTAL ~ CT&E Environmental Service~ Inc. CT&It ReL# Client Name Plmject Name/~ Client Sample ID Matrix Ordered By PWSID Sample Remark:s: 985651001 S & S Eagmeeriag L38. T15N, R1W, Sec 19 L38, T15N, R1W, $~c 19 Drinking Wa~er 0 Client PO~ Printed Date/Time 10/02/98 14; 10 Collecxed DaTe/Time 09/28/98 13:05 Received Date/Time 09129/95 13:30 Technical Director: Stephen C. Ede pOL 09/29/98 KAp lOm~x 09z~9/98 o9/~9/95 GCP