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Home My WebLink AboutMEADOW BROOK BLK 1 LT 4 ¢7%. GREI ANCHORAGE AREA BOR ~, Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME/~N$'¢'t~/'~'~t~ ///~gz/~/)¢,g~ MAILING ADDRESS LOCATi ON ~¢~¢ l~) I'~¢ ¢ ~' ~'/~), LEGAL DESERIPTION ~ SEPTIC TANK: DISTANCE FROM W E L L ~/~W/~/~'~ ~ INSIDE LENGTH MAN U FACTU R E R ..~'~,d/.~ ,1¢/~' INSIDE WIDTH_ -, NUMBER OF MATERIAL /J',~ ;/¢'"'~' / ~* ~ COMPARTMENTS LIQUID DEPTH LIQUID CAPACITY¢~O~') GALLONS. T H_~fiN'-F-I'E+-D: 7 DISTANCE FROM WELL ~it~- FOUNDATION___ _NEAREST LOT LINE TOTAL LENGTH OF LINES '~'~ NUMBER ~)F LINES DISTANCE BETWEEN LINES __ TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA '~¢3¢' SQ. FT. LENGTH OF ~ LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE IN. ABOVE TILE IN. WELL: TYPE BUILDING NEAREST FOUNDATION__ LOT LINE __ CESSPOOL OTHER SOURCES APPROVED DISAPPROVED CONSTRUCTION NEAREST SEWER LINE__ DEPTH SEPTIC SEEPAGE TANK _.__ SYSTEM REMARKS DISTANCE FROM: DISTANCES: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS:.?~'~p./'~_ ~2~ ~r' DIAGRAM OF SYSTEM APPROVED '-"¢ '~ ' ' G.A.A.B. Form EQ-032 AREA BOr UGH GREt ANCHORAGE ' ¢' : DEPARTMENT OF ENVIRONMENTAL QUALITY ' 3330 "CI' STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4§6! SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT LEGAL DESCRIPTION ~ DRAIN FIELD ., OTHER , ¢~' - COMPLETION DATE ANTIC~TE~ FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION, WATER MAIN TO SEPTIC TANK--~/(~ SEPTIC TANK, U~2 SEEPAGE PIT MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK 9-0 t FOUNDATION TO SEEPAGE P]T i DRAIN FIELD SEPTIC TANK SEEPAGE PIT TG NEAREST LOT LINE. SEEPAGE P]T ALSO CONSIDER Area WELLS. , SEEPAGE PIT , DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE P[T FITTED WITH AIRTIGHT REMOVABLE CAPS. DIAGRAM OF SYSTEM GRAVEL BACKFILL CONFORM TO BOROUGH REGUL~TION~t~/~ARDING INSTALLATION. I CERTIFY THAT [ Am FAMILIAR WITH THEE R~RE J~IREMENTS Of GREATER ANCl DESCRII~C~ SYSTEM IS IN ACCORDA~"TTH SAID CODE, DATE ~ , PPLICANT'S SIGNATURE AREA ~OROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE: FORM NO. EQ-0[ 6 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. Cf 6'-2',~'(~ --/~,''/~ '-~'~ HAA # //77~¢ ~ ¢~),~- '¢ ? 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Descriptio~ (include lot, block, subdivision, section, township, range) Lot 4; Block I~ Meadow Brook Subdivsion Location (address or di(ections) /d 2.¢-.¢- ' ' NHN Iditarod CirCe (b) Prop. erty owner ~¢-~ Telephone: (home) (c) Lending Institution Telephone Mailing Address .Business (d) Real Estate Company and Agent REMAX OF EAGLE RIVER AJ~n: Eva Lo~en Address 16600 C¢~erfi~d Drive Suite 201 Eagle Riv~r~ AR 99577 Telephone 694-4~00 (e) Mail the HAA to the following address: (or check herex~, if hold for pick up,) List contact person and day phone number below: ENGINEERING River, Alaska 2. TYPE OF RESIDENCE Single-Family,~ Number of bedrooms 3. WATER SUPPLY Individual Well [] Community? Public/~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site ~' Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental ./ · Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 shows that the on-site water supply and/or wastewater disposal system is safe, functionaJ.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. Telephone 17034 Eagle River Lo~p Road No, 2~ ~agi~ n~w,, ...... Name of Firm Address Date 6. DHHS APPROVAL Approved for ~ Approved : bedrooms b ~~'~ Disapproved Conditional Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services(DHHS) issues HealthAuthorityApproval cerificated based only upon the representations given in paragraph S 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. Employeesof DHHSdo 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. 7/88} Back Page 2 of 2 /"~"% or. M ,UNICI PALITY OF ANCHOFiAG E (MOA) ~ [, e~'~-~¥~ ,'~s~,O~' Health Authority Approval (HAA) ~ ,~ ~ 343-4744 A, WELL DATA C~ Well Log Present (Y/N) __ Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SFPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot "7....¢~ I Jr To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments ~ ~ ) t'~'~ ~.~ i~,'a="~L~' Date Completed Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ~ I+_ ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ; Date B. SEPTIC/HOLDING TANK DATA Date Installed ~-2~[~'~ Size ) oo<::P No. of Compartments Standpipes ¢~/N) "/ Air-tight Caps CN) Depression over Tank (Y~]~ Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) r-A/P,` "/ Foundation Cleanout (Y/~ / Date Last Pumped ~ ' ~'~ t-~//~, ; for --'--- Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well To Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments ~t~-~x~ To Building Foundation To Disposal Field 72 026 (Rev 7/88) Fronl Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absortion Area Depression over Field (Y/CC)' Results of Last Adequacy Test Type of System Design Length of Field Depth of Field Gravel Bed Thickness --~ ~.>,d¢ '¢ Statndpipes P resent(~YN) Date of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foun~lation~ Lot To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments-~- ~ l+ To Property Line '~ I ! -- To Existing or Abandoned System on ; On Adjoining Lots "~ c:~ 'p I ~ To Cutback (if present) D. ,,FT STATION Dimensions Size in Galion--~s----~_ "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Manhole/Access (Y/N) "Pump Off" Level at Pumping ' Test. acy **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in inspection, s & S J~NGINEERING Signed 17034 Eagle River Loop Road No. 204 Company Eagle River, Alaska 995,77 MOA No. d~-'/~ ff>)~¢~O_.? effect on the date of this Receipt No.Y/¢¢¢~~--------~ Date of Payment Receipt No. ¢.~/Z~.~ ~' Dateof Payment Amount: /7¢ 72-026 (Rev. 7/88) Back Page 2 of 2 % Tom Fink, Mayor Nlunicip lity of At, chorale Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 22, 1989 ,/ Robert A sharer, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 4 Block 1 Meadowbrook S/D Waiver Request ~WR890042, PID ~050-191-36 HA890297 Dear Mr. Shafer: Your request for waiver of the required 100 foot separation of a septic tank to a stream to 75 feet and required 10 foot separation between the absorption field to lot line to 1 foot has been approved. This approval applies to the existing septic system to stream and lot line only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Si~g~)e ly, //~ Robert W. Robinson Civil Engineer On-site Services RWR/ljw HEALTH AUTHORITY APPROVALS SEWER &WATER MAIN EXTENSIONS SEWER & WA'rER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST S~TE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST ROBERT SHAFER, P.E. ROGER SHAFER August 18, 1989 MUNICIPALITY OF AN~I~INEERS DEPT. OF HEALT~0o~,)694-2979 ENVIRONMENTAL PROZf~-~1211 / ,lJ6 2 ! 198,q RECEIVED Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTN: Robbie Robinson 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 4; Block I; MEADOW BROOK SUBDIVISION Dear Robbie, This letter is to provide the additional information desired for your review of the waiver request for the referenced property. I. The i~et of the fiberglass septic tank has been excavated to verify a water tight seal between the i~et pipe and the septic tank. There does e~ist a water tight seal. I~tead of excavating the outlet of the tank, which wou~d destroy a small portion of the asphalt d~veway, we can assume there also exists a water tight seal on the outlet of the tank. 2. We have drilled an observation hole between the septic tank and Meadow Creek. We found no groundwater to a depth of 12 ft. Therefore, there appears to be no groundwater to act as a conduit for seepage leaking from the septic tank to the creek. 3. Attached is a profile showing the elevation differences between the septic tank, bottom of the observation hole, and Meadow Creek. If you require additional information for your review, please contact STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 995'77 SEWER & WATER MAIN EXTENSIONS SEWER & WAFER 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 ROBERT SHAFER, P.E, ROGER SHAFER August 4, 1989 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 4; Block I; Meadow Brook Subdivision Request you issue the attached Health Authority Approval (HAA) and grant a waiver for the distance between the septic tank and Meadow Creek located 75 ft. away. Also request you gra~ a waiver for the distance between the leachfield and the property line located ~ ft. away. The septic syst~, was installed in August of 1975 and i~pected by a Municipal inspector. The separation distances were approved at that time. The topography of the property is generally flat until it starts sloping toward the creek approximately 50 ft. away. It is our opinion the lesser separation distances are acceptable in this i~tance. Attached for your review is a copy of an annotated copy of an as-built survey. If you require additional information for your review, please contact Sincere: R.R.R~/gm ~ ~- ~ ~ O Enclosure 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 GREATER ANCHORAGE AREA BOROUGH Department o'F Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Jun ll, 1976 Time of Inspection Q-/-~ Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Cony. 1. Approval requested by: Mailing Address: Pouch 7012, 2. Property Owner: Eric Johnson Mailing Address: Eagle River Legal Description: Alaska Bank of Commerce 99$10 % Peg Phone: 279-5641 x 341 Phone: 694-2794 Lot 4 Block 1 Meadowbrook Subdivision NHN Iditarod Circle Location: 5. Type of facility to be inspected Single Family 6. Well Data: Public Utility A. Type C. Construction Sewage Disposal System: A. Installed .... 1~75 C. Septic Tank: 1. Size D. Seepage Pit: 1. No. of bedrooms 3 B. Depth D. Bacterial Analysis On-site system B. Installer 2. Manufacturer Absorption Area 2. MJterial E. Disposal Field: Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank Total length of lines , Absorption area , Other contamination , Absorption area C. Absorption area to nearest lot line , Sewer Lines ___ EQ-034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVI 3330 "C" Street, Anchorage, Alaska 99503 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO 2. Property Owner: Eric Johnson VA FHA CONV Mailing Address: Eagle River, Alaska 99577 3. Name of Buyer: Laz~e G. and Teresa A. Rice Mailing Address: Box 109, Z~gle BZ~rer~ Ak 995:77 4. Name of Lending Institution: Alaska B~nk of Co~erce Mailing Address: Pouch 7012~ ~chorage, Ak. 99~10 5. Name of Realtor or Agent: None Mailing Address: n/a Day Phone 694-279~ (rms wor ) Day Phone 69~-2161 Phone 279-5641 (3~Z) (~eg [.) Phone 6. Legal Description: Lot 4, Block 1, Meadowbrook Subdivision Location' NHN Iditarod Cir.~cle~ Eagle River~ Alaska Type of Facility to be inspected: SFR Water Supply Type of Supply: Public Utility Z2CZ If Individual, number of dwellings presently served Individual If Individual, depth of well Sewage Disposal System Type of System: If Individual, date of installation Public Utility 197/ Individual (on-site) No. Bdrms, 3 EQ-037 (1/74) Page 2 of two pages - Re st for Approval of Individual ~ er & Water Facilities Legal Description Lot 4 Block 1 Meadowbrook Subdivision Comments Approved sapproved / Approval~Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I 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 Date EQ-034 (1/74)