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Home My WebLink AboutPETERS CREEK BLK 3 LT 9 GRF"-'R ANCHORAGE AREA BO '""GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATI ON~'~r-, CK~,~K ~ ' 0-~F_.6L"bR; U e MAILING ADDRESS LEGAL DESCR IPTIO'N PHONE SEPTIC TANK: DISTANCE FROM WELL ~'e/ INSIDE LENGTH Ct 0'z~- INSIDE WIDTH NUMBER OF ~'/-~ MATERIAL S/~-~-~ COMPARTMENTS ~ .LIQUID DEPTH __.LIQUID CAPACITY. /~0 GALLONS. SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL DIAMETER z/~r CRIB SIZE: OR WIDTH /~', LENGTH /'7'/, DEPTH ~-~/ DIAMETER ~'DEPTH ~, DISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~ BUILDING FOUNDATION ~//~r NEAREST LOT LINE SQ. FT. ADDITIONAL ABSORPTION WELL: BUILDING FOUNDATION __ CONSTRUCTION NEAREST LOT LINE CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED B' r-b/~ Ob~D DEPTH ~P t DISTANCE FROM: NEAREST SEPTIC SEEPAGE ~ ~ SEWER LINE , TANK '~?___~ SYSTEM REMARKS DISTANCES: INSTALLED BY: PIPE MATERIAL: LOT SLOPE: REMARKS: Form No, EQ-031 DIAGRAM OF SYSTEM APPROVED/~ //~2./~.~...._~.. ~/G.A.A.B. 0 8' E E/vulNEERING 8' DEVELO/.'MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 333-5240 Russell Oyster £~r/ Ellis 694-2774 333-5240 Civil Engineering Surveying Soils ~ Foundations Land Development SOIL LOG Performed for: Name: ~ ~"~x~x~J--xe' ~o~qh~ Tel. No. Mailing Address: ~ ~ ~.~x~ , ~~ Legal Description: ~ ~ ~~ ~ ~z~ ~'~ Depth (feet) 0 Soil Characteristics 3 4 5 6 7 8 Ground Water Encountered: Yes ~" :No__ If yes, what depth -Proposed Installation: Seepage Pit. ~/ Drain Field Comments: ~,-~ ~ ~l~ ~.~' ~ ~ ~' ~ ~ ~ ~ Performed by: 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. GENERAL INFORMATION Complete legal description Lot 8 & 9; NICIPALITY OF ANCHORAGE ONMENTAL SERVICES DiVISiON OCT 2 1 1997 RECEIVED Block 3; Peters Creek Subd~vi~nn Location (site address or directions) .,:~: PrOperty '...,., owner,'." '"Lorena Jordan -7 'Mailing address ~ 'P~.O. Box 671914 ~'" ~":..Lending agency' ~,,'~ ~ailin'g-addresS: Agent Address 21043 Four Chuq iak, AK C~uqiak, AK Dr i vP Day phone 99567 Day phone Day phone 688-5188 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- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer XXX 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 MOA #21 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. Name of Firm S & S ENGINEERING 17034 Eagle River Loop Eoad No. 204 Address Eaale Rlvem Ale.b= 99577 Engineer's signature Phone G q "/- > 7 ~ Date St DHHS SIGNATURE Approved for ~ Disapproved. Conditional approval for bedrooms. .bedrooms, with the following stipulations: Additional Comments Date //-/-Y-'7,7 The Municipality of A. Lnchbrage 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' ifistitutions 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-O25(Rev. 1/91) Back MOA i Y2.1 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION Municipality of Anchorage OCT 2 1 1997 DEPARTMENT OF HEALTH & HUMAN SERVICES_ Environmental Services Division R E C LE J V ~ ~ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Description: A. WELL DATA ~j~pe ~/JE)/~ Log pre~ Total depth '".,,, Sanitary seal (Y/N) Date of test static water level Well production WATER SAMPLE RESULTS: Coliform Date of sample: i , B. SEPTIC/HOLDiNG TANK DATA Health Authority Approval Checklist Lo-'r'~ ~, t~/_o~v,.~,; t~.re.p_.~ cE~_.~ SJ~ Parcel I.D.: If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to Casing height (above ground) ~ Wires properly protected (Y/N) FROM WELL INSPECTION g,p,m. ~ Nitrate Other bacteria g,p.m, Collected by: Date installed Foundation c!ean0ut. (Y/~ Date of pumPifig IC- c. ABSORPTION FIELD DATA Date installed Tank size Depression (YA~ Pumper ~uGJ.~',~ .Number of Corn partments ~..~ Cleanouts I~)~ High water alarm (Y/N) Soil rating (g.p.d./fF or fF/bdrm) ~.5'"/'~',~,,System type Length ' I z, Width Effective absorption area Date of adequacy test I o~! ~, Gravel thickness below pipe present (~) ?~-5 Monitoring Tube Results {~Fail) ~'~<-, Fluid depth in absorption field before test (in,); _"~ 1' Immediately after.5'Zcj Fluid depth ~)// (ins) Minutes later: ~'.b Absorption rate = Peroxide treatment (past 12 months)(Y/N) I~.._u.~._ J~ / Total depth c~ / ... Depression over field (Y~) ~0 For 'l'ft ~ bedrooms gal, water added (in,): ~)~ .+~O~' g.p.d, If yes, give date ~ 72-026 (Rev. 3/96)* LIFT STAT..~kiln Date installed ~'~ Size in gallons Manhole/Access (Y/N) -'"""-~ "Pump on" level at* High water alarm level at* ~ *Datum Cycles tested ~..~ RATION DISTANCES 'ION DISTANCES FROM WELL ON LOT TO: "Pump off" level at* Septic/holding tank on On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public ~hole/cleanout Sewer/septic service line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation I o ' ~' Property line IO' ~' Absorption field ! 0' Water main/service line lo~ Surface water/drainage Ioo~f Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line · ~ Building foundation Water main/service line Surface water ~bo' + Driveway, parking/vehicle storage area Curtain drain I~,~[ I(.flo~,,J Wells on adjacent lots ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal recor~l~.~.~.ll~.,abo' '~'~tf~ns are Sig ature ~ ~. ~/~ : .-:~:.'~, ~ ~ ~ HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received December 29, 1975 Time of Inspection I:~/{ Date of Inspection, ~;, } ~. /~0/~. REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR VA 1. Approval requested by: Coast Mortgage Company Mailing Address: Post Office Box 1200, 99510 Phone: 274-9504 2. Property Owner: Robert Loughory Phone: 688-2905 Mailing Address: Star Route Box 3030, Chugiak, Alaska 99567 3. Legal Description: Lots 8 and 9 Block 3 Peters Creek Subdivision 4. Location: 4-Wheel Drive Road, Chugiak 5. Type of facility to be inspected 6. Well Data: Individual A. Type C. Construction 7. Sewage Disposal System: A. Installed 1973 C. Septic Tank: 1. Size D. Seepage Pit: E. Disposal Field: 8. Distances: A. Well to: Septic tank Nearest lot line Single Family No. of bedrooms 2 B. Depth 38' D. Bacterial Analysis On-site system. B. Installer /~0~ 2. Manufacturer 1. Absorption Area ~ ~zT~ 2. Material Total length of lines Absorption area , Other contamination , Sewer Lines B. Foundation to septic tank ~2'~", Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re t for Approval of Individual r & Water Facilities Legal Description Lots 8 and 9 Block 3 Peters Creek Subdivision Comments Approved .~'~~~ Disapproved Date /- Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED ~-~[ J~"~ ~/ Date EQ,034 (1/74) MUNICIPALITY GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF HEALTH & OF ANCHORAG~ Department of Environmental qual .... ity ENVIRONMENTAL PROTECTION 3330 "C" St., Anchorage, Alaska 99503 - 274-456 1EC291975_ REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES. RECEIVED Type of Inspection: CMRO VA ~ FHA CONV Property Owner: Robert T.o~hozcr Mai'ling ,Address: Star Route Bo× 3030, Oh~±ak Day Phone Name of Buyer: John Jordan Mailing Address: 4?20 Baxter, Space 16, Day Phone 333 1503 Anchorage, AE' 9'950~ Name of Lending Institution: Coast Mortgage Co. Mailing Address:P.O. Box 1200, Anchor~e, AK Phone 27~ 950~ Name of Realtor or Agent: John Wallace, Dynamic Realty Mailing Address: 3380 "c" st., A~chor~e, AK Phone 279 7611 688 ~90~ Legal Description: Lots 8 & 9, Block 3, Peters Creek Subdivision Locatio.n: 4-Wheel Drive Ro~d, Ch~giak, Alaska Type of Facility to be inspected: Water Supply Single family No. Bdrms. 2 Type 'of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System 1 Type of System: Public Utility If Individual, date of installation Individual (on-site) 1973 EQ-037 (~/74) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 9950'7 279-8686 Date Received July 24, ]973 Time of Insoection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR A:g _H_A ...... Anproval Requested By: Great I mnd Address . BOX. 279 Chugiak AK gq~67 Phone: 688-2125 2. Prooertv Owner: Phillin (ang~) Th~mg:+=m Phone, ....... 3. Legal Description: LOtS 8 & 9, Block 3. Peters £r~ ~nhH~!sion ..... ~. Location: Four Wheel Drive 5. Type of Facflity to be Inspected:_____.~]e Family ~e!!in~ , Number of !Jedrooms: . Two~,(2) 6. Well Data: A. Type Drilled c. Construction Standard oewa~e Dts~osal Svstem~ B. Depth 38' D. Bacteria] Analysis A. Installed C. Septic Tank: 1. D. Seepage Pit= 1. E. Disposal Field: Size 1000 2. Size 2. Installer ~anufacturer .,. ~St_a:ck_Steel Material Total Length of Lines 8. Distances: A. ~!~].! To: Septic Tank__75' , Absorption Area___].O~, Sewer Lines , Nearest Lot Line 0 , Other Contamination B. Foundation to Septic Tank Absorption Area C. Absorption Area to Nearest Lot Line . Re~.~st for Approval Page Two 9. Comments: DIAGN^M OF SYSTF,~.. certtf,i that the information contained in this request for appreval to be a true accurate representat~.on of the subject sewer and w~ter facilities located ~t: Signed Dmte