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Home My WebLink AboutMEADOW BROOK BLK 3 LT 14GREA.,:R ANCHORAGE AR£A BOR,- Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 NAME ------ LOCATI ON _ INsPEcTION~E~ORT ON-SITE SEWAGE DISPOSAL SYSTEM ,-~ ~ "/-,~ ,5 ?'27.~,~.~-~c~;c P~ o SEPTIC TANK: , /~/::. DISTANCE ~,~'~' ~--~ FROM WELL_ M A N U F AC T U R E R _C..~D~/,'~'~;~ MATERIAL INSIDE LENGTH~ INSIDE WIDTH_ LIQUID DEPTH NUMBER OF ,Z.~-- COMPARTMENTS LIQUID CAPACITY /¢K<~''~GALLONS' TILE DRAIN FIELD: DISTANCE FROM WELL. NUMBER OF LINES _ ABSORPTION AREA ...... / DEPTH OF FILTER DEPTIt: TOP OFTILE TO FINISH GRADE _ MATERIAL BENEATH TILE I'c-c'/'A~ . ~,~/,~") ..... / TOTAL LENGTH / FOUNDATION - NEAREST LOT LINE ']~'S _OF LINES / DISTANCE BETWEEN LINES - _TRENCH WIDTH ~'~-IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH LINE IN. ABOVE TILE WELL: TYPE -- CONSTRUCTION BUILDING NEAREST FOUNDATION ---- LOT LINE NEAREST SEPTIC SEWER LINE TANK~ CESSPOOL OTI-IE R SOURCES APPROVED DISAPPROVED _REMARKS _DEPTH ~ SEEPAGE SYSTEM-- DISTANCE FROM: DISTANCES: .... -- INSTALLED BY: - J sEWER LINE DEPTH: PIPE MATERIAL: DIAGRAM OF SYSTEM i i"ii:: i iii",iU i H L:, :!. I"'1[(t",1:~'; :1: Otq :! :~, THI::: I..ICi"~(J I'H ':: Ipti:~: t)[~:t::;"it'1 (~11: I::i 'i'F~:EI",ICH Cl[;.: I:::']. ]' ]:~ THE D Z'.E;"I'RIqE:E ~?,E:"I"t.,.II:F:E;N THt( i_:ii~:(:]lLIi"4[) I:'ffql.)iI"II:~: 1~,.31'~O1"t ElF: 'I'H['~: [E:;.4C:F~',/FII':[CiN ' ~[., 'iHE i"l[H'[I"tUi"l I..c:l' H Ell:' .~kH,[~l.. t~[E:TNi~:E:N THE 'Jl'l::l:::tlJ~ i'::':1:i'::'~: ii'ii:. ~:m:.m,,, :'.~. l)l:~l';"i H ':: . - i"!~',il..:' i i I[:~: b',Cl'l t (':11"1 I]:1[::' 'iH[E [::;;';'J::::f:~',/FI'i :[ I'.)N ':: ]: N FbJ!:~'l' ). MI'ii.;t';:.i' :i. t .i.. I. i"4i;~i I...i[- i:':IN'¢ ?'r':~::FI ICFI [,.I :[ "lH()l.l"i' i" ]. P,IRL. ]. NSI:'b]:CT :[ Eff',l laND F:tI:.:'I:'I:,~:C¢',,'F:Ii.. E','~" iH :~ '.~:, i.)i:: i"l ih?. I'1'"ii:::i"4 I I.'.1 ]. I,L. BE :!~;l_li~',.]~li(IL: '1 i'O I;;:'t4'.OE;E(::UT :1: E~lq. i"i I. P41. iviLIFi t.:,.[~J; I[.:IP,tt.::I:~: [::t:::'l'l,.tl~:[~:l",l I::;I bJEL. L. FIN[) RN'¢ I:]it"4-":~];]:'l'l~: S[~:I.,tI::IGE I) ]: St-:'CI:~:;[::I[.. ~:;'.r'~:ii'[:~:f'1 :l:'.:'i, ::i.kli:g i'.[:.b:t I.I.)i;:: t:;:1 I::'kl]]',/l::;tT[:: 14ELl.. i;;l[~'. 2EIEI FLCET t;'t])1;;~ FI PIJ~?,L:[C 1.4EL. I.~. ::::,i:.-'i:.i..: [ t' i (];i::i'i ]1 I~Ji",l:~; FIND (];l:)[,,l:~:i I ~4:1..1[; i' ]; O1",t l::' :1: [:ll:~:l:lf"l::~; .i i",i::, i I.'iki .it I ~. LIN. ii. . i-: i.:' I .i. k' Y i PII:I I · , :~.. ] .I Iii"t i~I:LliVi'[I']i:: :ii t''1:1./ H THE t:;~lE~:;:!l'J:li[;?'l~J''l'~!i:i'''t'i':ii:; I;:''ol:i: CIt'*'I'~'*:~;Z'I~( :~i;[::l."tE'.l:i;~:::; laND I'"IEi .i.r.:~ii I:;:l'--":; r''r. I i:'ri].ii":: I il l:":"r' i t'11:: H .. 1"4 's C :t: I:'"1::t t ~1 "¢ (r)l'; t~tf"!li.~:H(])l:~:l ;,:; .i i'"Iib.L t.I'"I:::;tt:--II.L. 'iFIE :.~;'*"Sr I:'~1'1 :lin t:':IIL:CEq'~'.I)I':'INCE t.'.t):"I'H '1"14[!:: 'L'~EI::'E"!i;' :i:' 'i' r.,ll) -: Fi ': ; 'I::I",D 'll~'lt::l"r '/'Hi:ii: ~':~I'.,I-~-!;]' l~ :i.:;EI.,.IE[;?. :;:;'.r'::z:;TEI"I I"1F1'¢ tilb~:(~:!l...I[[[;::[;i; [..:?.tlJ-:;tl:;'3[:'"' i'.i ' :I_1. i.;:l:::::, :i. i:,i::;.iq(.~:[~. J. :iii, I,::[~:i'1Oi)l;:i:l..ED I'O t. I',,IC:IJ..IDE I"IE,:ii:E;: THRN ~: E EE:,I4' '~' '~ I-:: :::' :.:t .I.~'iiF-"-) I"1. t'(. IE. CEIF?.P. / // -/~"i"*", ¢ / [ 'll ,Y/., Performed f o r_ _ j ~.~_. ~<Af~L~].~_Q~4' Legal Description._.~~c~l This form reports: Soils lo Dep ~h ?eat Gl<L/\ Lii Am.~iu.~._. ~,I~..~ LiUROUGil Anchorage, Alaska 99b03 hOG - PEROI,ATION TEST Date Performed Percolation ~est '12 - 13_- 14- Was ground water encountered? If yes, at what depizh? Reading Date Percolation rate -Proposed i ns tal 1 a~-T~-n; Gross Time Net Time Depth to Water mi nute. Seepage Pit Drain Field Net Drop Depth of Inlet Depth to bottom%-f~)it or trenci, COMMENTS: 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 Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address 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: Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of sysfem. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: 72-025 (Rev. 1/91) Front MOA #21 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 alt Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. David R. Dayton P,E. Name of Firm Chu~iak, Abska 99567 Address / r Engineer's signature _ Phone Date DHHS SIGNATURE ~' Approved for Disapproved. Gonditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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 engineer's work. 72-025 (Rev. 1/91) Back MOA~21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST A. Well Data Well type ~I,I.)(,'J/,L CL.)A-~Ii~A, B, or C, attach ADEC letter. ADEC water system number FROM WELL LOG g.p.m. Log present (Y/N) Total depth Sanitary seal (Y/N) Date completed Driller Cased to Casing height Wires properly protected (Y/N). AT INSPECTION Date of test Static water level Well flow Pump level1 DISTANCES FROM WELL TO: /U]/,~ SEPARATION 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 Date of sample: Nitrate Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA [)ate installed (~/I'l/~ (,¢ Cleanouts (Y/N) '~/ High water alarm (Y/N) Date of pumping Tank size j C~-~..~.~) Compartments Foundation cleanout (Y/N) ~ Depression (Y/N) /"J./'/~ Alarm tested (Y/N) '4"// SEPARATION DISTANCES FFIOM SEPTIC/HOLDING TANK TO: Well(s) on lot To property line Surface water/drainage On adjacent lots A/.///,'.'~ Foundation ,/'~ _Absorption field ~ Water main/service line CONTINUED ON BACK PAGE 72-026 (3/93)* Front C. LIFT STATION Date installed Size in gaffons Vent (Y/N) High water alarm level / "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length % L Total absorption area Date of adequaoy test Width Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/Ft2) Gravel thickness Cleanout present (Y/N) Results (pass/fail) ]/'~ ~/'"~"/E~ System type · [.P Total depth Depression over field (Y/N) hd for Bedrooms After test -'t¢'7~ ~T~ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /'"J /,/'}- TO building foundation On adjacent lots ~(.~"}- Surface water Curtain drain On adjacent lots /u'//¢. Property line -~-~- To existing or abandoned system on lot Cutbank ,%) o ~-~-' Water main/service line Driveway, parking/vehicle storage area. E, ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect o~ _t. he~ d~te of this inspection. uaw~ R. Dayton P.E. Signature Engineer's Name Date HAA Fee $~'~ ~.~ ~ d~) ~,._~o Date of Payment / ~- ,~ ~ ~ ~ Receipt Number c:~ ~---,2~ '") ,~ ( ~ O' ~- 72-026 (3/93)* Back Waiver Fee $ '-~ Date of Payment ~ Receipt Number O. R, DAYTON, P.E., R.LS. ~:~~~ Chugiak, Alaska 99587 20210 Donalar 696-2417 October 22, 1993 ADEQUACY TEST Lot 14, Blk 3, MeadowbrooR Subdiw[sion Date of T~st: October 19, 1993 Septic Tank: 1000 gallon, 2 compartment, Sunset Plastics tank Absorption System: 31' long x 6' effective depth trench Soils Rating: 110 sg. ft. per bedroom Requirements: 3 BR - 450 gallons per day (DHHS Records) (DHHS Records) (DHHS Records) Test: Water was pumped into the trench while measuring volume and water level rise. After pumping was stoppedl the water level drop was monitored for a 24 hr. period. Results: The absorption trench accepted 462 gallons with'a 8¼" rise in the water level. After 24 hrs., the water level dropped to 1" lower than the initial level. The system is currently functioning adequately for a 3 BR home. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date July 25, 1986 GENERAL INFORMATION (a) Legal Description (include tot, block, subdivision, section, township, range) Lot 14; Blo(;k $; Meadow Brook Subdivision Location (address or directions) 2920 Sanctuary DJ~ve (b) Applicant Name ..?e~ End~le¢ Telephone: Home 694-9109 Business 694-2161 Jackie ~ MEA Applicant Address 18028 Sanctuarq Driv¢~ Ea.qle Riv~, Alaska 99577 (c) Applicant is (check one): Lending Institution []; Owner/builder i"XI; Buyer [:]; Other F:] (explain); (d) Lending Institution Alaska M~tual Bank Telephone Address .ATTENTION: Sheri Lipping/Eagle Riv~, Alaska (e) Real Estate Company and Agent none/refinan~ng Address Telephone (f) ~,~Dthe HAA to the following address: S & .S'~jcgineerZ~ _ .~RB 19~ Ea~- Rx'.~L~A_~ ka 9 9 5 7 7 TYPE OF RESIDENCE Single-Family'( Multi-Family [] Number of Bedrooms Other WATER SUPPLY Individual Well D Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite ~ 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 (11,8d) Page 1 of 2 ENGINEERING FIRM PROVIDIt..~ INSPECTIONS, TESTS, FILE SEARCH, DA,A AND IN. FORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation c)f th~.~, Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obi from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply a ~d/o, wastewater disposal system is in compliance with all Municipal and State oodes, ordinances, and regulations in ettect the date of this inspection. Name of Firm S & S ENGINEF-R~Ne Telephone (-~ ¢¢~ ~¢ ~ ? Jl I1 2 -" Date DHEP APPROVAL ^pp oved for *,'</ 2bedrooms by Approved __~/~... Disapprovad Terms of Conditional Approval Conditional CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approvat certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduot 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. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: .MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION o 8198§ WELL DATA Well Classification '/~ ¢~'¢-' / d.- If A, B, C. D.E.C. Approved ~'~,,N-~ Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot ~'~ ~ ~ 4-- To Nearest Edge of Absorption Field on Lot 'Z./_.oo t r Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments A//.C]. A~. To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date SEPTIC/HOLDING TANK DATA Date Installed Standpipes Y~!~t) Air-tight Caps ~/N')'. Depression over Tank (:~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~ Separation Distances from Septic/Holding Tank: Size /¢~::)c~ No. of Compartments Foundation Cleanout~2,N% Date Last Pumped ~ 7_-,~---~=, /"/~_4--- ; for Temporary Holding Tank Permit (Y/N) To Water-Supply Well To Property Line To Water.Nfei~/4~r-v-i-ee Line Course To Building Foundation /:~ r To Disposal Field (~ / To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(~1/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~' ~/'~" '?,'~ Width of Field ~% / Square Feet of Absorption Area -'~ Depression over Field Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well 'Z~.~,_~ ' To Building Foundation ~-~1' Lot /'"~/-¢~ To Water Main/gec'd~e Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field ~"/ Depth of Field Gravel Bed Thickness Standpipes Present f~AN'} Date of Last Adequacy Test ,/ To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pu~p Off" Level at / /./ Vent (Y/N) ,,,~//~ Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed S ~ S ENGINEERING Date JUL 2 7 SRB 196X MOA No. ,¢2t¢.~~ C°mpa~Y~G/E RIVER, AK ?~r,777 Receipt No. z~ t)~ I ,6~[ r~ Date of Payment ~ ~ ~¥¢-6' Amount: $ (0 Page 2 of 2 72-026 (11/84) 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: ,agle River GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received December 2, 1976 Time of Inspection 11:30 a.m. Date of Inspection REQUEST FOR APPROVAL OF Pratt INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. Home Federal Savings and Loan 12-3-76 Friday 535 D Street Phone: 272-1451 James E. Davis Phone: 276-7777 1670 Crescent Legal Description: Lot 14 Block 3 Meadowbrook Subdivision Location: Type of facility to be inspected Well Data: A. Type Community C. Construction Sewage Disposal System: A. Installed 1976 C. Septic Tank: D. Seepage Pit: E. Disposal Field: Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank Sanctuary Drive Single Family No. of bedrooms B. Depth D. Bacterial Analysis On-site system, B. Installer 1. Size 2. Manufacturer 1. Absorption Area 2. Material Total length of lines , Absorption area , Other contamination C. Absorption area to nearest lot line , Absorption area , Sewer Lines EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re~ st for Approval of Individual S. er & Water Facilities £.egal Description Lot 14 Block 3 Meadowbrook Subdivision Comments Approved~K~/3~...~ [ Disapproved Date 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) Please call for me t ick up... MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO 2. Property Owner: James E. Davis Mailing Address:_ 1670 Crescent VA FHA. Day Phone: CONY 276-7777 3. Name of Buyer: Mailing Address:_ 4. Name of Lending Institution: Mailing Address:. 5. Name of Realtor or Agent: Jo Davis E×ecut±ve Mailing Address: 2810 C Street 6. Legal Description: Day Phone: Home Federal Savings and Loa~ Phone:. Phone:. Lot 14 Block 3 Meadowbrook Subdivision 276-7777 --- Eagle River Location: Sanctuary Drive 7. Type of Facility 'to be Inspected: 8. Water Supply Type of Supply: SFD 1 No. Bdrms. Public Utility X × × Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility Individual (on-site) × × If Individual, date of installation 1976 72-003( 3/76}