HomeMy WebLinkAboutROLLING HILLS VIEW ESTATES BLK 2 LT 8
www.sullivanwaterwells.com
Pump Installation Log
Well Drilling Permit Number: SW Date of Issue
Parcel Identification Number:
Legal Description Property Owner Name & Address
Rolling Hills View Estates Block 2 Lot 8 Matt Moore
18811 Upper Skyline Drive Eagle River, AK 99577
Pump Installation Date:
7-31-20
Pump Intake Depth Below Top of Well Casing:
280 feet
Pump manufacturer’s Name:
F&W
Pump Model:
4F07G10305
Pump Size:
1 hp
Pitless Adapter Burial Depth:
10 feet
Pitless Adapter Installer:
Unknown
Disinfected Upon Completion?
yes no
Method of Disinfection:
Chlorine 50 PPM
Comments:
Pitless Manufacturer: Unknown
******NOTE: The well is inside with drop pipe coming through top of casing.
Pump Installers Name:
Sullivan Water Wells
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Municipality of AnchOrage Page / of .~
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: ~ PID Number: ~
~ Wastewater System: [] New J~Upgrade
Name:
Address: ABSORPTION FIELD
~No. of~rooms: ~DeepTrench ~ShallowTrench ~Bed ~Mound ~Other
Phone~ ~ - ~ ~ ~ Total Depth from original grade:
Soil Rating:
LEGAL DESCRIPTION ~: ~ ~. ~,~ ~,o~sq.F,. ~,~ ~ ~'
Block: Subdivision: [~ Depth to p pe bottom from o~igtnal grade: Gravel depth beneath pipe
Township: IRange: ISect`°": FIll added above original grade: , Gravel ,englh: //~ Ft.
WELL: D New ~ Upgrade Gravel~ ~/~ Number of llnes: 10ista.ce~tweenti~s:
~ ~ ~/~ ~ ~ Pipe material:
Classification (Private, A,B,C): ~ Cased ~o: Tolal absorption area:
Date instal[ed:-
Driller: ~ Date Drilled: StaticWster Level: Installer:
~,eld: ~ IPumoSet ",: [ Casing Height Above Ground: TANK
~ ~// GPM Ft. Ft.
SEPARATION DISTANCES ~ Septic ~ Holding ~~:~.E.P.
To Septic Absorption Lilt Holding ~Prlvate Manufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines
Material: ~ Number of Compartments:
Surface
i Size in gallons: I Manulacturer:
Line
by:
Drain
BENCH MARK
Location and Description:
Department of He d HU rvices approval -~ ~-,~
72-013 (1/91)MOA 25
Permit No. SW94003 Page 2 of 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: Rollinq Hills View Estates Lot 8, Blk 2 PID No.: 050-322-08
SCALE 1" -6O'
MONITOR TUBE
o SEWER CLEANOUT
- WELL
I - LEACHFIELD
EASEMENT
SWING I'IES
A - C = 357
B - C = 35.5
A - D = 14.7
B - D = 47.4
A - E = 48.3
B - E = 18.0
A - F = 49.9
B - F = 34,8
70,49
S 89'57'50'
COMMON CORNER RC8AR
ASSUMED ELEV = 88,18'
ELEVATIBNS
(NOT TO SCALE)
8' 35PSI INSULATION
GROUND
.~J~bS' ADDED FILL FEEL LEVEL AT
fRENCH D 90.4'
TRENCH 8~ 86,8'
oon 8. ~RENCH 8: 89,1' BOTH ENDS
SHED
/ /
EXISTING TANK
TEST HOLE
NO GWT
· TH4, 5 TD
/ TH5~ 4.5' TD
ABANDONED TO CODE
72-013A (Rev 991) MOA 25
NORTHSTAR
ELECTRIC
COMPANY
:/:tu. [ (.Ippe~C ,S, kvZ'lne Ro;id
I ! r' ',,
P,O, Ii~ 77~1A1~(!
SAND & GRAVEL
P,O. Box 1456
Pahner. AK 99645
Pit'. (907) 373-5~211
1-800-478-5213 ~..
Evenings: (907) 746-0235
LOC~)TION MILE 37% PAIl. KS I1WY. .¢.,
PHONE
/'_ / _../._ ...~.~-
LABOR
PAY THIS AMOUNI' ~.
MARK HANSEN P,E.
Consulting Engineers l'~stl~g Laboratory
1tC0'2 BOX 738'/, pALMER, AK 99545 /90't) 74r · ~
June 25, 1993
QUALITY SAND AND GRAVEL
P.O.Box 1456
Palmer, AK 99645
Fax: 373-7979
Project: Sieve analysis
The fo}lowing is the sieve analysis of the filter sand sampled on 6/:"' ' ~3
Sieve Percent Passing Percent required for DEC sel' filter s~nds
Group A Groul
#10 86 85-100 85-10.
#20 72 60-90 '-
#40 32 25-50 -'
#60 20 0-~
~100 3 ""
#200 1.3 0-5 "
Coefficient. of Uniformity (Ce) 3,4
Coefficient, of Curvature (Cc) 1.2
SincerelF,' ,/
PAGE 1 OF 2
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW940003
DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES
OWNER NAME:WRIGHT CATHERINE IRENE
OWNER ADDRESS:P.O. BOX 770184
EAGLE RIVER, AK 99577
DATE ISSUED: 1/07/94
EXPIRATION DATE: 1/07/95
PARCEL ID:05032208
LEGAL DESCRIPTION: ROLLING HILLS VIEW ESTATES BLK
2 LT 8
LOT SIZE: 62290 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
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 (iSAAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
DURING CONSTRUCTION OF THE THREE PROPOSED DRAINFIELDS, ALL
ORGANICS MUST BE REMOVED (TO A DEPTH OF 1.5 TO 2.5 FEET).
THE REQUIRED 6 FEET OF VERTICAL SEPARATION BETWEEN THE
BOTTOM OF THE TRENCHS AND BEDROCK. (AT APPROXIMATELY 4.0
PAGE 2 OF 2
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
FEET) MUST BE ACHIEVED BY INSTALLING A CLEAN SAND FILL
APPROVED BE DHHS. THE AMOUNT OF SAND FILL SHALL NOT BE LESS
THAN 4 FEET. DURING CONTRUCTION, ADDITIONAL PERC TESTS MUST
BE TAKEN IF THE ACCEPTING SOILS VARY FROM THOSE ON WHICH THE
DESIGN WAS BASED.
RECEIVED BY: ~ ~x~ ~ DATE:
Louis Butera, P.E.
Registered Civil Engineer
January 6, 1994
Robbie Robinson
Manager, On-Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Rolling Hills Lot 8, Blk 2
Dear Mr. Robinson:
Please find attached soils logs for the above referenced property. After discussion with the
performing technician, the logs were revised. If during construction, soils deviate from expected
conditions, a perc test will be conducted on the open excavation.
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
\1994\93-038A.LTR
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
(ENGINEER'S SEAL)
PERFORMED FOR: ~--~T~'T' yJ~.,,ll~.~-~/[~AU~-.. ~'T DATE PERFORMED:.
LEGAL DESCR*PTtON:I~'II*N& H*LI,5 Ulf~W E 51'; I,Po4 ~. Township, Range, Section:
SLOPE
SITE PLAN
2
4
5
6
7
8
9
10
11
12
WATER
ENCOUNTERED~
IF YES, AT WHA'
DEPTH?
Depth Io Waler Aller C:
Monitoring?
Reading
. PERCOLATION
13 ~ ~ Date:
Gross Net Depth to ,, Net
Reading Date Time Time Water Drop
$o^ ~.
14
15
16-
17-
18-
19
20 ~"
:lATE ~ °.~.~ Iminu~es/inchJ PERC HOLE DIAMETER
TEST RUN BETWEEN . ,~t~ FTAND Z,,'~" FT "
PERFORMED BY: ~..~/E ~-5 I ~"~"'~-- CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE: //~¢/~7~
Municlpalily of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
(ENGINEER'S SEAL)
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
g
10
11
12
13
14
15
16
17
18
19
20-
COMMENTS
DATEPERFORMED: ~'~'~
CF..(736
Section:
SLOPE
IIIi
IIII
IIII
t111
SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT I~/AIP~ O
DEPTH? p
E
Depth lo Water Alter r.,G, ~
Monilorlng? ~ Date'. ~.~'
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE __
(minules/inch) PERC HOLE DIAMETER __
TEST RUN BETWEEN __
IkI I' L.L. Mo n'o '1'o
FT AND __ FT
PERFORMED BY: , ~ - CERIlFY THAT THIS TEST WAS PERFORMED IN
S;ATE
ACCORDANCE WITH ALL AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: //"~/~/~,~
/
72~008 IRev 4i851
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
(ENGINEER'S SEAL)
4/'z-I ~ 5:p/~'/~15
PERFORMED FOR: ~-~TI'tT ~d~.~/[~)AU~. ~,-~."~ DATE PERFORMED:
L~AC ~ESC.,~,O.:~II~HC H~5 UIE~ E ~C ~ ~ ~ownship, Range, Section:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15-
16.-
17
18
19
20
COMMENTS
//
CE-~Y3~
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT
DEPT.? u/^ .
E
Water Alter [;~p_..~ Oale: __
Gross Net Depth to Net
Reading Date Time Time Water Drop
SOAK..
PERCOLATION RATE ~) ° '~ Iminutes/inch) PERC HOLE DIAMETER --
TEST RUN BETWEEN ~Z,*.,~ FT AND -~ FT ....
PERFORMED BY: ~I~.H/~. [~'-~ CERIlFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE. DATE:
Louis Butera, P.E.
Registered Civil Engineer
November 30, 1993
John Smith, P.E.
Manager, On-Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re:
Rolling Hills Lot 8, Blk 2
Narrative
Dear Mr. Smith:
The proposed
1.
septic upgrade will have limited impact on adjacent properties:
The area has large lots allowing sufficient room for septic sites. Considering
careful well placement of the neighbor's existing wells.
Immediate neighboring septic systems are all +30' distance.
Drainage will not be adversely affected. The system is mounded and constructed
to direct overland run-off away.
A variance for slope requirement of < 25 % will be required for this permit. The
slope at the proposed location varies from 25-30%.
The septic system for this lot is designed to be installed on a 30% (17°) slope. We require a
variance from the 25 % maximum as there are no areas on this lot that are below 25 %. The
30% area is the best possible area for septic field installation based on our on-site investigation.
The soil type shows an adequate percolation rate and the slope ground surface below the site is
naturally vegetated. It has been our experience that 5' wide systems on similar slopes operate
satisfactorily on existing systems in Eagle River. The proposed upgrade will improve the
situation where the existing systems is allowed to leach to bedrock. Based on this, we would
support your approval of the system as designed.
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
\1993\93-038A.NAR
LEGAL:
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LOT 8 BLOCK 2 ROLLING HILLS VIEW ESTATES
Ao
Co
GENERAL
1. The well and septic plan are for a single family residence only.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Health and State
Department of Environmental Conservation requirements.
4. All soil tests are advisory to the design and are to be verified or modified in the field by the
engineer.
5. All excavations and depths are advisory and are to be verified in the field by the contractor to
meet Municipality of Anchorage, Department of Environmental Conservation requirements.
6. It is the responsibility of the owner to obtain all necessary pernfits or easements and to locate any
adjacent multi-family wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer
approval.
8. It is always recommended that a surveyor locate the nearest lot line position and the location of
any easements.
SEPTIC TANK
1. Tank is to be 1,250 gallons minimum with Orenco Systems lift station and 20 OSI 05-HHF pump
wired to code by a licensed electrician, receipt to be provided to engineer.
DRAINFIELD
1. The drainfield is to follow the natural land contour to maintain uniform total depth of the
drainfield bottom approximate contour shape is shown on site plan.
2. The total depth of the drainfield excavation is to be as shallow as possible, removing only the
topsoil layer to soil surface shown as acceptable soil on attached soil logs, depth varies.
3. The 6' separation to bedrock is to be achieved by an imported clean sand fill placed without
mechanical compaction and leveled to 4-0.1'. Sand source is to be approved by engineer prior
to constrnction. Estimated depth of imported sand is 3.5'.
4. The drainfield gravel to a depth of 1' is placed on sand layer and is to be covered with typar
fabric material.
5. Pressure effluent pipe is to be buried at + 3' to and between drainfields and covered with 2" burial
foam. 1-1/4" PVC effluent leachpipe is to be installed 2" below top of 1' gravel layer and is to
contain 1/8" holes spaced at 1.7' (21") facing up with orifice shields installed. Pipe ends are to
,contain threaded cleanouts buried 6" below ground level with rebar markers (see detail).
6. A combination of soil and extruded board insulation with a minimum soil depth of 2' is to be
placed over the leachfield and sloped 3:1 beyond leachfield at edges (see//7 below).
7. The area over and between the drainfields is to be filled and finish graded to prevent pending of
surface water runoffbetween leachfields. The entire leachfield mound and area over the tank shall
have 4" topsoil and be seeded with "Sunny One" Alaskan lawn seed mix and fertilized with a 8-
32-16 mix. Owner may provide an alternate seed mix.
8. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to
any Class "C" well, or 200 feet to any community well.
RECOMMENDED LEACHFIELD DIMENSIONS:
GRAVEL ELEVATION = 1-2' above grade (mounded)
DRAINFIELD LENGTH = 112'
SOIL RATING = 0.8 GPD/ft~
SEPTIC TANK = 1,250 minimum including lift
GRAVEL DEPTH = 1'
DRAINFIELD WIDTH = 5'
BEDROOM CAPACITY = 3
Twenty-four (24) hours notice required for all inspections.
\1993\93-038A.SPC
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
EAGLE RIVER AK 99577
(907) 694.5195
SHEETNO. OF
CALCULATED BY DATE.
CHECKED BY DATE
SCALE
Single Family Three Bedroom Residence
3BR = 450gpd
Soil absorption rate --. 0.8 gpd/ft2
Trench absorption area = 450 +
0.8 ~" 563 square feet i
Drainfield dimensions:
Width = 5'
Gravel depth =
Length = 563. + 5 ;.=i 112'
Pressure lateral holes:
1/8" orifice hole @ 5' residual head
25 gpm flow rate + 0.43 gpm/hole = 58 holes
112 LF + 58 '~ 1:9' = !23~' h01~ spacing on center for ii total 0f58 holes
Tank size:
= 1,000 + (3 - 3) (250) = 1,000 gallons minimum for 3 bedroom + 'lift station
= 1,250 gallons
\1993\93-038A.CAL
~ i----~____--a- PVC I ~ELL
~._ MAN[FOLD
~ ~ ~ 1.25' PVC
LUT 1, BLK 1 --~V~<i I/
L'sT ~ ~ ~ .2 ............ J EXISTIN~
/
~ . ~¢~ ~ - TEST HOLE
X ~'~'~ · - MONITOR TUBE
o SEWER CLEANOUT
NO SURFACE WATER COURSES +100' ~ - WELL
PROPOSED LEACHFIELD
NO KNOWN CURTAIN DRAINS EASEMENT
SEPTIC SITE PLAN
LEGAL: LOT 8 BLOCK 2 ROLLING HILLS VIEW EST.
OWNER: LEET/WRIGHT
CONTRACTOR: N/A ff~'" . .'~', ,*,~
~o~ ~ ~-o~ ~: ~/~o/~ ~c~ ~,,: ~o, ~~~ ....
~A~ mv~ ~z~m~ s~vzc~s '~,~.~A~i~"~ "~
EAGLE RIVER, AK. 99577
(907) 694-5195 FAX: (907) 694.3297
EAGLE RIVER
ENGINEERING SERVICES
P,O, Box 773294
EAGLE RIVER, AK 99577
(907) 694-5195
SHEETNO. OF
CALCULATED BY~'~'1~ DATE
CHECKED BY. DATE
SCALE
INfJ~lN HiM,
Munlclpallly of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTIoN:,~--~IIN~. I'{,~$ ~1~ ~1~, ['~)/~3~,, Township, Range, Section:
El-- ~
3 \
5
6
7
8
g
10
11
12
13
14
15
16
17
18,
19-
20
COMMENTS
SLOPE
WAS GROUND WATER
ENCOUNTERED?
S
IF YES, ATWHAT /A L
DEPTH? ~'~__ ~
E
Deplh lo Waler Alter ~,.l:,
Monilering? l,~r~ I Dale:
SITE PLAN
Heading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE . (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND ~.FT
l
PERFORMED BY: _~-~l~'J//¢~ ' ~'~'"'--~ CEH'IFYTHATTHISTESTWASPERFORMEDIN
ACCORDANCE WiTH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: /2-.-. /- ~ ~
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
¸4,
PERFORMED FOR: ~/~'l~.l~r~ ~I~-t~;~/DA~-- ~T DATE PERFORMED:
LEGAL DESCRIPTION:~IIIH~ ~I~SUI~ E 5~ ~ ~'Township, Range, Section:
1
5
6
7
8
9
l0
11
12
13
16
17
18
19-
20-
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT
DE.T.? U/^
E
Oeplh Io Water Alter ~ ~ Dale'
MonilorinD? .
Gross Net Depth to Net
Reading Date Time . , Time Water Drop
So^ ~
I I~/?/q~ I1.,: ICl: O0 I~ HIH. ~ ~,t'(~' ' ?.. ~.,~&"
PERCOLATION RATE I~ o~ (rninutes/~nch) PERC HOLE DIAMETER ~ fi
TEST RUN BETWEEN__~ ''~ FT AND Z.,~' FT
PERFORMED BY: ~_..I~H/[[I[~.~'~ , ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN E?FECT ON THIS DATE. DATE: //"~"//./~ ~'
Municipality o! Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG-- PERCOLATION TEST
PERFORMED FOR: ~r~T~r ~J~I~.~/DA~')J~ [.~E'r DATE PERFORMED:
LEGAL DESCRIPTION:j~-°IIIH~' JJlJ~5 k)lJ~J ~ ~ [-~O//~ ~-Township, Range, Section:
1
2 T~A c,~.~ O r&(~ ANIC
4
5
6-
7
8
9
10
11
12
13
14
15
16
17
18
19
20-
SLOPE
11111
I IIII
~,~ [/?/~ WAS GROUND WATER
ENCOUNTERED?
S
IF YES, AT WHAT
DEPTH? J~J/A, pO
E
SITE PLAN
Deplhlo Wale, After PlZ. y Dale' ~'/
Mofliloril,o? ---- · i-~__~
Gross Net Depth to Net
Readiog Date Time Time Water Drop
SOAK
PERCOLATION RATE__~ ' '~ (mlnutea/u)ch) PERCHOLE DIAMETER --
1EST nUN BELWEEN '~ FT AND
COMMENTS _J~r/~_~__J~I' j~c ~IT~ TO~,~I
WITH At I ~TATE AND MUNICIPAL GUIDELINES IN EFFECT ON 1HIS DATE. DATE:
GAAB-HD- 1
G~6.?ER ANCHORAGE AREA BOROU.~H
HEALTH DEPARTMENT ~"
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
~ INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
~DDRESS~ /~~ ~/~-, PHONE
SEPTIC TANK: ~~
DISTANCE FROM WELL_ ~'"'~ ! ,~.~ NUMBER OF
MATERIAL
, COMPARTMENTS ~ '
t'~.; (~,~'.,~.,j LIQUID
LIQUID CAPACITY /,) ~ GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH__
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT LINE
SEEPAGE PIT:
/
OUTSIDE DIAMETER OR WIDTH
DISTANCE FROM WELL //~ ~
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
, LENGTH DEPTH ~, '-~ j
BUILDING FOUNDATION. ~d) /
SQ. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCEFROMWELL /~.. , NEARESTLOTLINF .OF LINES
ABSORPT O N'"'A-R~A SQ. FT. LEN~~'~ [ ~ ~' ~
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
p~""~ DISTANCE FROM WATER
WELL: TY . ~ . DEPTE . BUILDING FOUNDATION _SAMPLE , NEAREST
NEARESI' SEPTIC SEEPAGE OTHER
LOT LINE SEWER LINE . TANK . SYSTEM . CESSPOOL , SOURCES.__
DISTANCES:
DATE
DIAGRAM OF SYSTEM
HEALTH AIjTHORITY
GA A B-H D-2
GREATEI-'tNCHORAGE AREA" ROUGH
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
Case N o..~ ~_?
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
RESIDENCE ADDRESS
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH
~,,~/_,~,, MAILING ADDRESS ~ Zo~ PHONENO.
L0CAT, ON OE ,NSTALLAT, ON
~ .,SEEPAGE PIT. ,DRAIN FIELD , OTHER
TO BE INSTALLED BY ~"~ ~' .~,~4;,
PERCOLATION TEST RESULTS ANTICIPATED DATEOF COMPLETION ~ /.~
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS (; ..... 7/ .... / ....
AS BESCRIBED BELOW.
SEPTIC TANK SIZE/~"~' qq/
''
BISTANCES:
Health Authority
, PERMIT TO INSTALL A
SIZE OF UNIT TO BE SERVED /
TYPE ,~': / ./SEEPAGE AREA 4 0"~' .'/~ x ? .TYPE .~¥4-fi'.~'/:,/ DIAGRAM OF SYSTEM
I certify that I a~h familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code. t~/ c.
DAVID A. SLENKAMP
ROBERT A. SHAFER
MECHANICAL ENGINEER
694-9055
November 26, 1979
CIVIL ENGINEER
694-2979
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
Ak'ea, Inc. Realtors
Parkgate Professional Building
P.Oo Box 249
Esgle River., Alask8 99577
ATTENTION: Joyee Porte
Reference: Charles }~il.ler ~oper~y:i'Lot 8; Block 2:
D~a.r Joyce ~
DEC $1979
RECEIVED
Rolling Hills View Estates'
A s(u.,er sw:;:mm adequacy test was performed at 'the referenced property on
November 20 and 21, 1979, per your request.
'i~e septic tank was pumped and verified to have s cspqcity of 1000 gallons.
'I~e seep~tge pit w~s charged with 1000 gallons of water and after a 24 hour
period had elap'sed me.'qsurements indicate that approxi~tely 9~8 gallons
had percolated from the pit, or appro?imately 316 ga].!cm,~ par ben, room.
It can be concluded from the above test that the sewage system (septic
tank and seepage pit) are sdequate for e three bedroom residence.
If we may be of further service, please do not hesitate to call.
Lawyers Title . ;" .:,
SRB 196X EAGLE RIVER, ALASKA
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. #
0
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A S INGLE FAMILY DWELLING
1. GENERAL INFORMATION ~:
Complete legal description Lot 8, Block 2'~~ ~ol*l~nq Hills View' Estates
Property owner
Mailing address
Lending agency
Mailing address
Location (site address or directions) 18811 upper Skyline Drive
745-4459
C.-~-h,=r"i ma W~ 9ht Day phone 694-9450
[8811 ~p~r Skyline DrSve~ ~qle RSver
Day phone
(work)
m
Agent Audrey Mason Day phone 694-4200
Address EEtvL~x of Eagle River
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
XXX
NOTE:
72-025 (Rev. 1/91) Front MOA ~1
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 xx×
- Holding tank
Community on-site
Public sewer
If community waSteWater sYstem, provide written confirmation from State ADEC
attesting to the legality and status of system.
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.
Name of Firm S & s ENGINEERING Phone ~ ~ ~ - ~ ~ 7 ~ r '
17034 Eagle R~yer Loop Road No. 204
Address =_~:,~ ,,~.... ~'_.u,. °~.'7 / ~ _
/,
/
Engineer's signature v - - Date /
DHHS SIGNATURE
Approved for ~
Disapproved.
Conditional approval for
bedrooms.
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 engineers work.
72-0~(Rev. 1/91) Bacl~ MOAffi~I
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
A. Well Data
Well type
Log present~l) ~
Total depth ~ '~
Sanitary seal ~/N)
FROM WELL LOG
05-o
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed .~,~ / ~ ?co Driller
Cased to '~ '~ ~" [~-- Casing height
Wires properly protected ~N)
AT INSPECTION
Date of test
Static water level ~
Well flow J g.p.m.
Pump level1 J
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
\
Absorption field on lot \~:~
Public sewer main
Sewer service line
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform ~ Nitrate
Date
of
sample:
!
B. SEPTIC/HOLDING TANK D~TA
Date installed [~- ['/- ~ Tank size
Cleanouts ~N) '~
High water alarm (Y/N)
Date of pumping
O, t o Other bacteria
Collected by: ~, c.> ~ c.--, ~ ~ ¢,-¢,..-~J
V'z~c~ Compartments '7..--
~ iF:undation cleanout (~1) ~ Depressio~ (Y/~
Alarm tested (Y/N)
r~'l,~-- ~ '~,~ Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot \ o ~
To property line "~-~?-~
Surface water/drainage
On adjacent lots / ~c:, Foundation
Absorption field I ~> ~ Water main/service line
72-026 (3/93)* Front
CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (~N) y
High water alarm level
"Pump on" level at
Meets MOA electrical codes~N) /
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot /os ~ On adjacent lots
Manufacturer ~ ~-J ~ u///~J~-/
Manhole/Access J;~N)
"Pump off" Level at L/O
Cycles tested
/~o ' / Surface water /~o ' ~
D. ABSORPTION FIELD DATA
Date installed (-~ - t -7 -~ 5[
Length J I S-
Total absorption area
Date of adequacy test
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y.~
Soil rating (GPD/Ft2) ~, ~ System type
Width -~- Gravel thickness / ' Total depth
5-7~-- / Cleanout present ~N) / Depression over field (Y/~
"J/.4 - /,/~-v-/ Results (pass/fail) ~ for -- Bedrooms
After test
,"'J If yes, give date "-(~
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot / E) Lc / On adjacent lots / O0 / 4 Property line
To building foundation ~:) ~) / To existing or abandoned system on tot
On adjacent lots .¢o ' -k Cutbank "///~ Water main/service line
Surface water /,~ ~ + Driveway, parking/vehicle storage area
Curtain drain /'J'~_
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the. elate of this inspection.
Signature "
H~ Fee $ ~. ~ Waiver Fee $
Date of ~ayment .~ ~ Dato of ~aymont
01/03/95 10:21 COMMERCIAL TESTING ~ 90769d1211 Ne. J99 ~02
Client ~ample ID
Matrix
Commercial Testing & Engineering Co. i;'
Environmental Laboratory Services w~,~,~r~,~r~,~,f~'~'~~'~r~r~'~~
~4, ~29~-1 LABORATORY ANALYSIS REPORT
LOT 8, ~K 2 ~OLL~NG ¥~w ~ILL$ V~W EST
WATSR
Cli=aC N&n~e S & E E~GINSSRING NOOK Order 11625
Ordered By R. SHARER Printed Date 01/03/95
Projec~ Name Colle=~ed Date 1~/27/S4 ~ 1~;80 hrs.
~ro~eoc# ~aceived Date 12/28/94
~W~ID UA
Technical Director STEPHEN C. EDE
~ample Remarks: SAMPLE COLLSCTED BY= RAY.
OC Allowable Ext. Anal
Parameter Results Oual Units Method Li~lt¢ Date Date Inlt
~£t~ate-~ 0.10 U m~/L ~PA 3S3.3 10. 12/30/94 CH~
~ * See Special Inetruotione Above UA - Unavailable
· * See Sample Remarks Abo~e NA= No~ ~alyz~d
~U R~p~rb~d pra~ioal ~antlfication limit. LT - ~sm T~n
Under ected,
~D = 8~oond~ry d~lution. OT - ~a~t'
5633 B Street, Anchorage, AK 99518-1600 -- Teh (~7) 562-2343 Fax: (907) 561-5301
ENVIRONMENTAL FACILITIES IN A~$~. COLORADO, FLORIDA, ILLINOIS. MARY~ND. NEW JERSEY, OHIO. ~AH. ~ST VIRGINIA