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Home My WebLink AboutMCGOWAN LT 3 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPIECTION REPORT LEGAL DES(: DISTANCE TO: Manufacturer Liq. DISTANCE TO: Manufacturer IF HOMEMADE: Well DISTANCE TO: No. of lines/ Length ~ e~ ~ne Top of tile to finish grade ~ Inside length Dwelling Foundatiol~,~ /- ¢ To,a, T Dwelling ..~ ~ r~ ,.)~ ~ Material<~' ~ .~ Width ~ I ~-~ Material Near~ lot line Tre nc h.~i,Ct ~(~'~/ inches NO. OFBEDROOM8 PE.P~MIT NO. No, of compartme~tts Liquid depth PERMIT NO. Liqnid capacity in gallons PERMIT NOTT~_- dCf~ (~ D's'a"ce ~77,~"nes Total effectiv~absorption area Length Width PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sawer line Septic tank Absorption area(s) OTHER PiPE MATERIALS SOIL TEST RATING INSTAELER REMARKS L.:i!: ['"IC:E!iI:~[,.II::IN :ii:,."'[::, 'I"H!!:: I.lE:Nl::!i"l'H I:::' THIi!. I'::, !i!: I:::' "f' I .I (:!fiE:CE.IN[::, FIN[::' TI. !1~:: Fi:!ii: :!: :iil THE: I:il:,Jff::l?l:i:[.. [::,EI:::'"['I"[ I::'II'-,!D THE: E:CITTCIH O 6` E GED Russell Oyster 694-2774 Soils ~ Foundations Performed for: Legal Description: D~p_~h (feet) 0 2CHNICAL 6' DEVEL~ ?MENT Box 90, Davis St., Eagle River, Aiaska 99577 694-2774 or 688-2280 SOIL LOG CO. 2 Soil Characteristlc~ ,m 10~ 11__ 12~ Earl Ellis 688-2280 Land Development Ground Water Encountered: Yes ~ Proposed Installation: Seepage Pit Comments~ ! No If yes, what depth_/._~_.. Drain Field~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 $43-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot 3 & 4; Mc Gowen Subdivision; Location (site address or directions) 20613 Scenic Drive Property owner H.U.D. #033755 Mailing address Day phone Lending agency Mailing address Day phone Agent Sandy A-SSOC!ATED BROKERS Day phone 563-3333 Address 640_(~x_~_ ~tb_ ~-¢nu_¢ q-~'t~_ P~¢ ~(,~g~, Ak. 9q~;fl.~ Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4, TYPE OF WASTEWATER DISPOSAL: NOTE: X~ Individual on-site 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. 72-025 (Rev. 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affi×ed 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/orwastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverifythat 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 ~ ¢ ~¢:;"~ .___~ ~' Name of Firm Address ,70:':4 F.~le P, iver Loop Road No. ~agie River, Alaska 99577_ Engineer's signature Approved for ~ ~) bodrooms. DHHS SIGNATURE Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: //~-'~ ~)'~ Date -rH'.qlllll[.] ~ ~-~-- _ . -- --~ 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 satisfl/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~)25 (Rev. 1/91) Back MOA ~1 Municipality of Anchorage Department of Health & Human Services ^u .o, Tv A,,,OVA, C. CK,ST t If A, B, or C, attach ADEC letter. ADEC water system number Uateco~pr~ted ~'~¢--,~¢-~ \¢11 o _ Driller Cased~toC¢J''~AI'~ ~,¥ Casing height Wires properly protected ~'~N) FROM WELL LOG A. WELL DATA Well type Log present (YI~ Totaldepth Sanitary seal (~)/N) g.p.m. Date of test Static water level Well flow Pump level PARATION DISTANCES FROM WELL TO: Septic/holding tank on lot \ O° Absorption field on lot \ Public sewer main Municipality of Anchorage DopL Health &Human Services Public sewer service line ~1,~ WATER SAMPLE RESULTS: Coliform ~ c'¢~/~o~-,./'~Nitrate Date of sample: /-¢¢ f"¢- ¢/J f.¢- SEPTIC/HOLDING TANK DATA AT INSPECTION \ . ~ g.p.m. ; On adjacent lots \ ; On adjacent lots \ Public sewer manhole/cleanout Petroleum tank \, ~ ¢'~J¢~,. Other bacteria Date installed O\Z~ Cleanouts (~N) High water alarm (Y~ Collected by: S & $ ENGINEERING 17034 Eagle River L~op Road No. 2[14 Eagle River, Alaska 99577 Date Of pumping Tank size \~7.~ ~c:) Foundation cleanout ~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot To property line Surface water/drainage On adjacent lots Absorption field IC)O ~ ~- Foundation Water main/service line 72-026 (Rev. 3/91) Front MOA 21 CONTINU ED ON BACK PAGE C. LIFT STATION Date installed Size in gallons .Vent (Y/N) "Pump on" level at Manufacturer Manhole/Access (Y/N) ~m12-~ff" level at High water alarm level Meets MOA electS_ SEP~TANCE FROM LIFT STATION TO: W~II on lot On adjacent lots Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed ~ ~ Length "~'~ Width Total absorption area Depression over field (Y/(~ R es u Its, d~-~fa i I) Peroxide treatment (past 12 months) Soil rating ~/~¢-~ System type -~¢.~/&~rl. Gravel thickness ~f ! Total depth -~ ' Cleanouts present ON) ¥ Date of adequacy test ~ - 2_~-- -'~ I for ' ~'"¢¢¢-¢~ k~'~ bedrooms If yes, give date. ~/~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: To building foundation On adjacent lots Surface water \ Curt{ain drain E. ENGINEER'S CERTIFICATION On adjacent lots \ c~(;;~ ~ ~ Property line To existing or abandoned system on lot Cutbank ~ 1~*,- Water main/service line Driveway, parking/veh cie storage area I certify that I have checked, verified, or conformed to all MOA ar~..H~A ouidelines in effect on the date of this ins ection .~.~.~,~ ~,~. P . ' . HAA Fee $ / Waiver Fee: $ ~ o ~ Date of Payment .~-/~' / Receipt Number ,~.~-c~ ?¢d ~' 72-026 (Rev. 3/91) Back MOA 21 Date of Payment Receipt Number June 28, 1991 ROBERT SHAFER, P.E. ROGER SHAFER CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 3 & 4; Mc Gowen Subdivision; Request you issue a waiver for the separation distance from the absorption find to the south property line. This separation distance is m~asured at 9.5 ft. The property line ~ adjacent to Weeping Birch, therefore this absorption field will not cffe~t n~ighboring septic systems. If we may be of further service, pl~as~ co~act us. ~..S/g//.~gBE~mT A. SHAFER, P.E. REC E IV E D 'JUL 1 1991 Municipality of Anchorage Dep[, Health & Hun~an Services 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS REPORT E¥ SAMPLE for WORKoxder~ 35270 Date Report Printed: JUN 17 91 @ 14:56 FAX: (907) 561-5301 Client Sample ID:LOTS 3 & 4 MCGO~EN S/D Client Name :S ~ S ENGINEERING PWSID :UA Client Acct :SNSENGP Collected JUN 13 91 @ 17:35 h~s. BPO { PO # NONE RECEIVED Received JUN 14 91 @ 13:50 h~s. Req t Preserved with :AS REQUIRED Ordered By :R. SHAPER Analysis Completed :JUN 14 91 Send Repo~ts to: Laboratory Supe[v.ls~ :S_~CEPNEN C. EDE 1)S & S ENGINEERING Released By :~~ ~ 2) Chemlab Ref #: 912744 Lab Smpl ID: 9 Matzix: WATER Allowable Parameter ~ested Result Units Method Ll~ts NITRATE-N 1.8 r~/1 EPA 353.2 10 Sample ROUYINE SAMPLE COLLECTED BY: RAY. Remarks: Tests Performed ' See Special Instructions Above UA-Unavailable None Detected "See Sample Remarks Above Not Analyzed LT-Less Than, GT~G~eeter Than Member of the SGS Group (Soci(~t~ S~n~rale de Surveillance) DECLARATION OF EASEMENT FOR SEPTIC SYSTEM WHEREAS, the U.S. Department of Housing and Urban Development (hereinafter HUD) is the Owner in fee of Lots Three (3) and Four (4), MCGOWEN SUBDIVISION, according to the official plat thereof, filed under Plat Number 67-45, Records of the Anchorage Recording District, Third Judicial District, State of Alaska -- Co~nonly Known As: 20621 Scenic Drive and 20613 Scenic Drive, Chugiak, Alaska 99567; and WHEREAS, there exists on said Lot 4 a septic system and related apparatus owned by HUD, which presently serves Lot 3 (only); and WHEREAS, HUD desires to assure the continuity of septic service to Lot 4. NOW, THEREFORE, HUD declares and covenants as follows: 1. There is hereby established and reserved, for the benefit of Lot 3, McGowen Subdivision, according to Plat 67-45, Records of the Anchorage Recording District, State of Alaska, an easement for the use and maintenance of the presently existing septic system which is located on Lot 4 and which connects to and serves the property on Lot 3. 2. Said Lot 4 septic system is located as depicted on the As-Built Survey dated 6-17-91, which is attache(] hereto as Exhibit A. The within established easement is intended to provide reasonable access in, to, and around the presently existing system, as well as any future oonfiguration of a necessary replacement septic system, or any portion thereof, which is located on Lot 4 and is connected to and serving Lot 3. The purpose of said easement is for the use and maintenance of any said septic system. 3. The said easement shall run with the land and shall be binding upon the owners of Lot 4, for so long as the Lot 4 septic system, or any necessary replacement thereof, is needed for the habitation of Lot 3. I~ WITNESS WHEREOF, the undersigned has set his hand and seal th~s /?~/~ day of ¢~.~/~ .~5~ , 1991. Secretary of the U.S. Department of Housing and Urban Development ~llam Marks-~ Ao~ing Chie~ Property Disposition Branch Anchorage Office B,K02202 P 2"/5 STATE OF ALASKA ) )SS, THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on the /~L day of 19~/, before merthe undersigned Notary Public in and f~r the State of Alas~a~,and commissioned and sworn as such, personally appeared ~,/~¥C/~_~ ~, ~ ~4~ , known to me to be the person(s) described in and who executed the foregoing document, and he acknowledged to me the execution thereof as his free and voluntary act and deed for the uses and purposes therein set forth. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal the day and year in this certificate first above written. Notary Signature AFTER RECORDING PLEASE RETURN TO: U.S.DEPT. OF HOUSING & URBAN DEVELOPMENT 222 WEST 8TH AVE., #64 ANCHORAGE, AK 99513-7537 FOL.LOWING DESCRIBED PROPERTY' McGowen Subd. ,Lots 3 & 4 AND THAT NO ENQ~MENTS EXIST EXCEPT AS / 6-17-91 INDICATED. IT IS THE RESPOfl$1SlLITY OF .THE ~ . F.~sa~r. NTS, COVrmANTS. OR ~_s_-rf__.?u_.~.. I ' N~ [357 WN.m ~O ,or ~.,m ._o, ~_._[..~. VISION Pt. AT. UNDE~ NO [;Ir.~,u~.'i~=~ I ~ DATA ~_..Z~_, ~ US~ ~OR CONS'muc'rioN OF FF~ I. INES~ OR FOR ESTABLISHING i~O- [-~WN---'~~- ARY LINES. DMS ASBUILT-NO COtrCNERS SET THIS DATE. SEWARD.& ASSOCIATE~'LAND"SURVEYII~ 688-/~5J ~.... ,. -~.',,~T.~ '910CT 15 Piti 2 55 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS RESULTS £or INVOICE # 40700 Chemlab Ref.~ 91.6409 Sample ~ 1 Matrix: WATER FAX: (907) 561-5301 Client Sample ID : DRINKING WATER LOTS $ & 4 MCGOWEN PWSID : UA Collected : DEC 3 91 ~ 07:00 hrs. Received : DEC 3 91 ~ 13:30 h~s. Preserved with : AS REQUIRED Analysis Completed : DEC 4 91 Laboratory Superyleo;~ '.,_]~IEP}IEN_C. EDE Released By : ~~_~ Client Name :3 & S ENGINEERING Client Acct :SNSENOP BPO{ : Reqt : Ordered Ey ~R. S~EER Send Reports to: i)S & S ENGINEERING PO~ :NONE RECEIVED Parameter Results Units Method Allowable Limits NITRATE-N 0.14 n~/1 EPA 353.2 lO Sample ROUTINE SABLE COLLECTED BY: R.3.S. Remarks: I Tests Performed ' See Special Instructions Above UA-Unavailable ND- None Detected '* See Sample Remarks Above NA- Not Analyzed LT=Less Than, GT-Greater Than Member of the SGS Group (Soc{OtO GOn~rale de Surveirrance) I. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: 3. Legal Description: 4. Location: uREATER ANCHORAGE AREA BOROUGr~ Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received 2/].9/75 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR VA Smiley's Realty Eagle River Ai( Phone: ~ir. No~m Phone: ~agle River Al< Lot 3, ?*[cCowm~ S~)division 5. Type of facility to be inspected 6. Well Data: A. Type D~illed o Single C. Construction Sewage Disposal System: A. Installed No. of bedrooms B. Depth 65' C. Septic Tank: 1. D. Seepage Pit: 1. E. Disposal Field: Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank D. Bacterial Analysis Sat..2/20/75 _ B. Installer Self 2. Manufacturer Self 2. Material Size 4xSxlO' Absorption Area Total length of lines , Sewer Lines , Absorption area , Other contamination , Absorption area C. Absorption area to nearest lot line EQ-034 (!/74) Page 1 of two ,3::gs:s Legal Description ~o'~ 3~ ~icGowc~'. S,~i~c:J.v~.sJ_o~ C O~l~F~le~ tS Approval Va~id for one year from d~.',~e a'reater Anchorage Area Borough~ Oepa'rtir, en-~ of EF, v';ronmei-,'c~'i DIAGRAM OF SYSTEM i certify that the information contained in th~s request for approva'i to bca '::'.'~:e ~;'c~ accurate representation of the subject sewer afoot water 'Facilities ai-~d thes~ i"c~.:-i'i~'i:-ic,u are operating satisfactorily. SIGNED Date Eq-o3q. J · · ........... , .~ . - ' ' ( ~Y , ~ L~, d. Distance f~om w~ll tO closest exlstin~ Or p,~o:~sed: 2. Septic tank ~,r houses, ba~n, d~ainage ditch, etc. .......... ~~~,, ~' ~[U 7.Sewage disposal system. a,' Age of system' . · i ~/ / : '-[~-~-~, --~) 1. ]:f "home made" show dlaF~am on ~everse side of this fo~m. . d.' 1. Distance to p~ope~y, line /~ to house fo~datlon a, Perco~tlc~ Te~t ~results f, Percolation Test performed by se the re.verse .side of this form to show diagram. Diagra~ should include ~.~he followzn~ ~nfo~ation: ~operty lines; .well location, house location, ~tic tank location~ disposal araa location, loca'tion of percolation test, aD~ direetlon of ground slope. 9. The ~tlon on this form is true and correct to the best of my knowledge. TO BE FILLED OUT BY HEALTH DEPAP. TqENT PERSONNEL ~]b°ve descrlbed sanltary facflitles are hereby approved~ subject to ~he .... on~l'tons ~[ C nditi The above described sanitary 'acll~ties are dis~;pproved for the following f ' · reasons: - ~'-Approval is valid for one year following the date of approval. CPJ:cw