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HomeMy WebLinkAboutRIVER VIEW ESTATES BLK 2 LT 7Onsite File River View Estates Block 2 Lot 7 #050-721-16 kr-,uv V.7/UL/ 10) Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211129 PID Number: 050-721-16 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name JOE & FAITH BATES ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 6961 WATERFALL DRIVE, EAGLE RIVER ❑ 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 RIVER VIEW ESTATES 2 7 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line FtZ Ft. Well 100'+ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1500 Gal. Surface water 100'+ -- Material HDPE Number of compartments 2 Lot Line 101+ -- NA Foundation 10'+ __ LIFT STATION Manufacturer Capacity Gal. Remarks Alarm location Electrical installed by Installer ARM SERVICES PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspdection V1 7/13/2021 7/13/21 Location and description 2nd 3`d 10/24/21 4th TOP OF MANHOLE ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Date 1V .•' •.k � �AwAw •• TH Septic System Curtis Huffman. : Approved - 4 R` •• CE 128991 Date��C��'TF�•.,1/12/202,?.•��C�, FESStO�A pROFESS0W_1" Note: this approval does not include well permit requirements. �.�� kr-,uv V.7/UL/ 10) M U N IC IPALITY OF ANCHORAGE On -Site Watar & Wastowafar Program PO Box ,WHO 4700 flmnre Road Ae0~1 A146k.5 fie! (91171 9.7904 F*x; [$p7};t4 •x9 f hUp-1hww.muni.oVursi6e On -Site Wastewater Disposal System Permit Permit Number. OSP 11129 Work Type. SepticTank Upgrade Tax Godo Nurn hor, 05072110000 Site Legal Addr-6-5s= RIVER VIEW ESTATES BLK 2 LT 7 G;03;57 ;site M a i I ing Ad d res s. 8981 WATERFALL DR, Eagle Rlver Owner; BATES JOSEPH SAMUEL & FAITH L)o51gn Engineer; F1R T WATER CONSULTING This permit is for the constructron of: Effective Date: Expiration Date, Lot Sia$ in 5q Ft: Total Bedrooms, SM CY2021 X11 N2022 41219 ❑ Disposal Field EO Septic Tank D Holding Tank ❑ Priory ❑ Private Well 0 Water $gage All construction shall be in accordance vrith: 1_ The attached approved design_ 2. All tequirerrien is speoifi&d in Ar oharnge Municipal code Chapters 15.55 and 15.65 and the State of Alaska Waslowaler Disposal Regulatlons {18AAC72} and Drinking Water Reguia5ons (1$AAO80 ) _ Thri w;mul waler ride raq ui rv!j In �,pucle0ns d uring the installation. The englneeT small notify tna Development Services Department per AMC 15.6E. Priwide natlficagon by calling (907) 343-7004 (24)7), 4_ From Gcbober 15 to April 15, s subsurface soil absorp[ on system un -der nstructlon during Freezing weather Shall be eitfMer; a. Opened and Closed on the same day. or b. Covered, sailed, and heated Lo prevent freezing X11012021 Received BY' -Dale; Issued By. 6Z Date: l o ' t. + Development Services Department On -Site Water & Wastewater Section ON-SITE SEPTICM/ELL PERMIT APPLICATION Parcel I.D. 050-721-16 Property owner(s) JOSEPH & FAITH BATES Day phone _ Mailing address 6961 WATERFALL DRIVE, EAGLE RIVER, AK 99577 Site address 6961 WATERFALL DRIVE, EAGLE RIVER, AK 99577 Legal description (Sub'd., Block & Lot) RIVER VIEW ESTATES B2, L7 Legal description (Township, Range & Section) Lot Size 41,219 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN (® all that apply) ___Absorption_Field_ ❑_ - Initial__ Septic Tank 0 Upgrade Holding Tank ❑ Renewal Privy ❑ Private Well ❑ Water Storage ❑ Phone: 907-343-7904 Fax: 907-343-7997 TYPE OF DWELLING: ❑ Single Family (SF) El (w/wo ADO) El Duplex (D) ElEl Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Ignature or property owner or autnorized agent) Permit/Rush Fees: t .2 25 Waiver Fees: Date of Payment: S ; D- V Date of Payment: Receipt Number: a0 (0 002 Receipt Number: Permit No. OSP 2 111 d'9 Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com May 5, 2021 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: RIVER VIEW ESTATES BLOCK 2, LOT 7 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1000-gallon HDPE tank per the attached design to serve the existing 3-bedroom residence. The lot and area are served by private wells. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211129, Rebecca Carroll, 05/10/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211129, Rebecca Carroll, 05/10/21 MUNICIPALITY OF ANCHORAGE i DEPARTMENT OF NEALTH & ENVIRONMENTAl- PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL. INSPECTION REPOFI'¥ _-~ I PJqOUE ~NEW MAI LING ADDRESS ~ ~ DISTANCE TO: ~ ~ ~ ~ Inside length Width Liquid depth Liq ~ ~F HOMEMADE: ~ .... ~ DISTANCE TO: ~ o¢~ Distance b.tw~li,~ - No. of lines / Length~0~¢ ~,~ Total length/~of urns+¢ TrenclLwidtb,~ ~ inches P ~ ~ Top of tile~ini* 9rade~ / ~aterigne:,s~ tile -- ¢~ ~otal. p~.RMiTef NO.i s Length ' W~dth Dep ~p Typeofcrib Crib diameter C~'b ep ~ Total effective absorptionerea ~ ~ ~ Buii~ ~ ~ Well 9 founeation Nearest ~ot ~ine ~ DISTANCE TO: ~ O~ass Depth " D~riller Di'~ance to lot line PERMIT NO, ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: PIPE MATERIALS . NSTALLER REMARKS d . % . , ,' ~t, ' ~'%PPROV D '~ DATE LEGAL FI F' F' L :1: C I:::li",l "i" L1.JE:F:IT I ON LOT THE [;i:F..:(;:!I...I]:F'::[]:I) [~;:1,;.~[]: f;)F THE '.:..:;OIL. I-I[:,::, I~1 I]:01"4 :: .::,][:.tl ]::5 Tt. 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',,,' [:L ....................... -E" ~.,_§ Cu ,::] ;?. ::,, ::1!: lh.,.ll ."E!!; F" [~] C:: ~!1.'" :.~E ,::) ~'-Jl :ii/:,; It::~1 I~::~" IE!i: If:L" ~L::: u:.:.:~ IU :1[: IF;-::: I~ii]:: II]::: .......................... [:~I::IE:I<.'F ILL. :[ t'.,IG OF' t:li",l"r' ::5"r':"STEH H :I: THO[r[' 1,:: :1: f..ll:~l.. :1, NSF'I:~:C:T ]: CIl'.,I Fli'.~[:) F]F'F'[;;t1.rJ",,'I:::II... 13'-/ TI.I :[ '.E; [':,[]:F'F:IF~t"Ir'H[Ef,I'I' H .'1: L.I.... E:E SLI[3..TECT r['o t':'ROfi;ECI-.IT ~ ON. H 11"41 I"IlJH [::, :l.00 FEET F(31,~'. :l..'.~:~i(.!l 't"1.:) 2. O(i.~ FEET FF.:OH 1.::I F'IJ[i:L. IC H[:.'I..I.~ [:,P:F'EN[::,ING IJF'OIq ]"H[~: ']"k'F'E OF [:4Jl~i:l~]:C I.,ff]:l....L.. OTHEF;: F..'. E (;]1..I 1,::l'v'F:l I I...I:"I[i:L.E TO ~ i'4:[.};I. JF.:[]: F'I~'.(::IP[:..:F.'. ~ N:EiTflLL. Ff]" :[ ON. f.:" E;C IF;ii: It'"lt I 1.::EI;i:T I F"~.' "t'H1,T1.' :L: ]: FIH F'FIHIL. IFIF'. HI ITt THE F;?.EQUtF..'.E:r,'I[.ZNT% FOF:: O1',!"~ S1' "1"1!]: :SEI.,IEF;?.~:i; FIND I.,.IEL.I_:E; 1::I$ :~;ETi:' [:'O1,:::TH E?'r' ']"FIE: I'ql...li',! I C I F'F4L. 2: I I.,.III.A.. IN~..!;"1,'1,:-II..I.. THE :?.,.'~-:;TEH II',l FflZ:COIT;:E:,f':II",I1..':E I,.tITH :?i:: :[ tJN[::,E[;?.~TFII"~[::, THFIT TH[i: ON"~':-:!;IT'~E ~i;E!.,.IEF.:: :[!;'¥".'C, TErq I','IFI'.? R,.I:D]:!I..I]:Fi:E ENLFiF?.1.'JE:HE]I",IT Z F THEi: F~.:E~:; I E:,I:.".NCE Z $~; F:'.I~MO[::,I?.'LED 'ro I NC.1,J..I[::,E HOF::E THFIN :~: E',E[::,F;:OC$1~.:,. 55 21, GNEE:, · ........ ~..'.5'~!....2 .................................................... J'OHN I... 1.:~i1:,:.:O%:5 SOILS LOG PERFORMED FOR: LEGAL DESCRIPTION: ~'~0'~''~ 1 2 3 4 5 6 7 8 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-2221' SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST SLOPE SITE PLAN lO 11 12 14 15 16- 17- 18 19 20 OO.'v'ENTS WAS GROUND WATER IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND __ FT DATE: 72 O08 (7/76) ( erlifieh rilling by OOC Co. dba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688.2759 OWNER OF LAND :' , ..... (: · ADDRESS ; '.i . / : ,7:. ,' ' ~ ': ' i' ":' LEGAL DESCRIPTION DATE - Started PERMIT NUMBER DEl'TI4 OF WELL ~ ST4TIC LEVEL OF' W&TER FF. Ended ~ / ~ / GALS. PER HR KIND OF CASING KIND OF FORMATION: From ) Ft. to From Ft. to From : Ft. to : From / Ft. to From Ft. to From ~; Ft. to From Ft. to : ) Ft /, . ~ From.__ Ft. to Ft.. From__Ft. to___Ft From__ Ft. to Fit. Frmn__ Ft. to Ft.~ From Ft. to__ Ft, From Ft. to Ft. F~om Ft. to~_ Ft. From [:t. to Ft. Frmn ~_Ft. to Ft. From~Ft. to Ft. From Ft. to Ft, From Ft. to.__ Ft. From__Ft. to.__Ft, From__Ft. to Ft. From Ft. to Ft From Ft. to Ft From Ft. to Ft From Ft. to Ft. From Ft. to Ft From Ft. to Ft. MISCL. INFORMATION: From _ _Ft. to Ft From__Ft. to... Ft From__ Ft. to __Ft From_ Ft. to__ F t rro,n____Ft, to__Ft. From Ft. to__Ft DRILLER'S NAME :: ' 1"=50' SCALE SITE PLAN PAGE 1 OF 1 IvIgNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUlV~AN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASICA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940118 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:DUNCAN BRUCE L & JOYCE I OWNER ADDRESS:P.O. BOX 9351 EAGLE RIVER, AK 99577-9351 PARCEL ID:05072116 LEGAL DESCRIPTION: RIVER VIEW ESTATES BLK 7 DATE ISSUED: 5/09/94 EXPIRATION DATE: 5/09/95 2 LT LOT SIZE: 41219 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL 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 (iSAACS0) . 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: RECEIVED BY: ISSUED BY: /~.~'{~~/. HEALTN AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERINGSTUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN ROBERT SHAFER, P.E. ROGER SHAFER, P.E. April 30, 1994 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 'L' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: River View Estates Subdivision; Lot 7; Block 2 Request you issue a permit to drill a well to serve the three bedroom house on the referenced property. The existing well is located in the right-of-way along Rushing River Circle. We propose to abandon the existing well once the new well is drilled. There are no points of contamination within the proposed well radius which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring properties by the drilling of this well. If you ha/y~hany questions, or require additional information for your ///~/rt A. Sharer, P.E. /RAS/LSU/jk 17034 NORTH EAGLE RIVER LOOP · SUITE 204 . EAGLE RIVER, ALASKA99§77 /(3 N¥]d 311S I:':1F'I:::'L ]' C':l:::lt"l L 0 (3 Fi T ); 0 I",! l..[7!J (]il:::IL. April 2~ 197~! ~ ?227 John Gross ]]o× ]..1.61 ~aglo !liver~ Alaska 99577 Subject~ Permit A }~ornit issu~d by '~ ' - ~nzs d~partment for w~/:~].l and/or on-site sawer ~nstaf.la-;ion on Lot 7 Blook 2 R:lvc-~r V' Subd.ivis~ on n~is e~l,){'ec,('; since the lnsne d~t,.e, exceeds oile (1) ~n '{;h(] event you ~,.~.~ ~ ~ }plan to insgall the wc~].l ama/or on,.-a~e sewer .~y:-,~e~ a new per~J..t is requirod. 9?he original soil test l~'uty be use~', to obtain a current permit~ ~f the well has be~m drilled, a well loq should be sent ~:o this depar.h%~ent to document the installation date, 32g you have any qt]est:[ons refiardin~ the above iaa'tter~ please con'tact 'this offic(~ ' · , . ~ - llmc~edza'gely at 2 64- 4 7 2 0 ~ Sincerely~ 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 1. GENERAL INFORMATION Complete legal description Lot 7; Block 2; Riverview Estates Subdivision Location (site address or directions) NHN Waterfall Drive Eagle River Property owner Mailing address Lending agency Mailing address Agent Address Bruce Duncan P.O. Box 9351, Day phone 694-2859 Eagle River, Alaska 99577 Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: Three (3.) XXX Public water If community well system, provide written confirmation from State AD£C attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: xxx Public sewer If community wastewater system, provide written' confirmation from State ADEC attesting to the legality and status of system. 5. STATEMENT OF INSPECTION BY ENGINEER Name of Firm Address Engineer's signature DHHS SIGNATURE ~'~ Approved for 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. Phone ~-/7 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 ,n 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. 72-025 (Rev. 1/91) Back MOA Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~-¢< '~ (~7.~ ¢-~,/¢.,p4~-¢ ~--~'r.%l'~' Parcel I.D. A. Well Data Well type '~(-- d ~.¢¢., Log present ~4) Total depth U'~ Sanitary seal ~-,)N) Cased to If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~'~_,~ z~ Driller ~,3L¢-. ~ ,./ ¢-/ '~ '~ Casing height Wires properly protected ~N) }/ AT INSPECTION Date of test Static water level Well flow Pump level1 FROM WELL LOG 7,0 g.p.m. uK 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 DATA Date installed \ 0 - Cleanouts (~/N) High water alarm (Y,~). Date of pumping Collected by: Other bacteria 5 & $ ENGINEERING Eagle River, Alask~ 99577 Tank size [ o,=, o Compartments ~ Foundation cleanout ('¥~N) y Depression (Y/~') ~ Alarm tested (Y/N) '~(¢~ ~t z~ Pumper %/,,_~k ,,~--.¢,-.¢~ ~2,j~r~$ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot L ~ ,=, ~- On adjacent lots To property line ~o ~'~ Absorption field Surface water/drainage / o o Foundation Water main/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pump ~ High water alarm level Cy~ Meets MOA electrical codes (Y/N) ~ SEPARATION DISTAIN TO: Wel on Iott"d~~ On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed / Length I ~'~ Width Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y~ Soil rating (GPD/FF) ~ 5'~¢/~:~¢~. System type .~ ~ Gravel thickness ~ ' Total depth Cleanout present ,-~/N) ',/ Depression over field (Y~:,~ Results~ail) (~/,¢~% for '~ Bedrooms ~" After test ~" ,-/~ .--(E.- t/~/d,, J~/,J If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /~ f~ To building foundation On adjacent lots '~ o Surface water Curtain drain '~//~ On adjacent lots /~o Property line / ~ / '~' To existing or abandoned system on lot / Cutbank "///,~ Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION or conformed and HAA I certify that I have checked, verified, ./~¢~v_~J,~ Signature -~///~ ~er, Alaska 9~577//~ Engineer's r~ame Date guidefines in effeb~ bn HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back Waiver Fee $ Date of Payment Receipt Number ~5/03/94 14:38 CTSE ENUIROHHENTAL LAB SERUICE'.¢ ~,~u. ~,lu w~,¢ Commercial Testing & Engineering Co, Environmental Laboratory Services ~',e'J,~'J,~'-~'J~'-~r~'~''e~,e',~jA~jjf~~ LABORATORY ANALYSIS REPORT CT&E Rcf./t 94,~61 } - ] Clipit Sample rD L7 BI,K2 RWER VI.EW EST. Maid× WATF, R ClientNarr~e S & S ENGiNEI~.RING WORK Ordm' ?8964 Ordered By P,. SHAFEK Printed Daic 0I:,/0'3/94 ,¥.? 1 .~:4 { ttr~. CMlected Fide 05/30/94 ~.! 16:45 lu's. pn~ject Name tkeceiv ad l-id c 05/31/94 ,~, 14:00 hrs. Project# PWS]D I.IA '['echrdcal Director S'i'EF~N C. QC Allowablc Purazlieter Rcsult.~ Qua) LTni~s .McLl-:od l.in;i(s ........................................... ~,¢ .................. ;,~t;,~_' ........ [~i;~5-/7('~'., 2 ,:.'6 ,o :~1 Nitratc-N Ext. Anal Date Date hilt 05/31/94 CIvlX * See Sp ¢ch~l. l.ustmclionu Above UA.= thlavail_abl¢ ** 8~ Sample Remarks Above NA ~ Nol ~al)'Ted ., U = lJn&tccte(k Repo~ted val~ is lhe practical ~ntilica~ion limit' 15= l.c~s ~tan {~.~1) ~ Secon~ry ~ lution. (H'= ~cu~er'lhan ~,,. 5633 a Street, Anchorage, AK 99818-1 600 -- Toh (9071 562-2343 Fax: (907) 561.., -', ...... ~,~*~TM ~Ze{~ I?~ IN ~I~KA ~OLORADQ. FLOR[DA, ILUNOI~, MARY~ND, NeW JERSEY, OHIO. uTAH, W58T vIRGINIA MUNICIPALITY OF ANCHORAGE , o  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEd!~¥~©~'''MLi'd/\L F;,O'fECTION ENVIRONMENTAL ENGINEERING DIVISION REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIREOTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. 1. PROPERTVpWNER ~ PHONE MAILING ADDRESS PROPERTY RESIDENT {If different from above) PHONE ' ' PHONE 2. ~UYE} MAILING ADD~ ESS 4, R~ALTOR/AGENT ~ PHONE MAILING ADDRESS LEGAL DESCRIPTION Xo :- STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [~ One [~ Four [~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six [] Other 7. WATER SUPPLY tgi' INDIVIDUAL' ~] COMMUNITY [] PUBLIC UTILITY ATTACH WELL LOG. A well log is required for all wells drilled since June 1975, For wells drilled prior to ti~at date, give well depth (attach log if available.) SEWAGE DISPOSAL SYSTEM [~ INDIVIDUAL/ON'SITE** PUBLIC UTILITY *~lf individual/on-site, give installation date . · If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQuEsT BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE "1 NSP ECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2, WATER SUPPLY PERMIT NUMBER [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY / 0 ~" ~ ~' Connection Verified - INSTALLER ,(.) , [~]Septic Tank or [] Holding Tanko~. Size: [(¢~(~) (~) If Tank is homemade SOILS RATING give dimensions: c:~ _~.~ TYPE OF TANK MANUFACTURER,...-' ~z.-.t._~z~ '~ ~, TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank .IAbsorpti(~n Area Sewer Line I Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS ~/"APPROV ED FOR 3 BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Titla) LEGAL DESCRIPTION (Rev, 3/78) October 30: 1979 John {h:os s Post Offic(~-~ Bo~.x 1161 99577 Lot 7 lO. et. it: 2 River View Es~aates Subdivision Ap}~z-ov~! for year J.n¢[tvic[ual sewer and water facilities can not be ,jr~.m'ke~! m~til th~-~ following' i[:o~ns have becm co}apl (} t~C[ ~ (1) A wall !o~3 [ntl.r.',~itt~::d to this depa:ct~aent~  from (]he~ ,haD~ 5633 B S%r~el;~ :~or our r~viow. office at 264-47~0. A~sociate Specialist RCP/!jw i,lortsfage Loan Department ]?ouch 7--025 99510