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MCKINLEY VIEW ESTATES BLK 2 LT 8
NAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Abska 99501 Telephone 264~4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION "EPOR'f' ~EW [] UPGRADE MAI LING ADDRESS LEGAL DESCRIPTION LOCATION I D STANCETO ]'Wel-~ , / Absorption area ~ Z I Manufacturer ~ [Liq. capaciW in gallons~ ~ Inside length ,,,~.~ ] IF HOMEMADE: Manufacturer ~ ~ No of lines ILl.th ofea~hline Totailengthoflines ~ ~tof,nls~grade~- ~- ~ Sa~na=~beneatht,I' 'e Length Width ~ Type of crib :rib diameter Crib depth DISTANCE TO: ~less Depth Driller Building foundation Sewer line Building foundation [Width Material / Trench ~idth inches inches NO, OF BEDROOMS PERMIT NO. No, of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. Distance between lines Total effective absorption area ITota~l effective abs~orption area Nearest lot line OTHER PIPE MATERIALS !i~ ,; ,~. ,:;~ { SOIL TEST RATING 'i',i ':' / INSTALLER REMARKS APPROVED DATE LEGAL / 72-013 (Rev. 3/78) C:~ li'-,,t~ .... .".;~; .][ T' PERMIT NO. ( 82:::1.~.0:.t ) F4. F'P[.. I CRNT [.OCR:,' I ON LEGRL DEPRRTMENT L,r" HEI:ILTN FIND ENVIRONMENTR[ .... r,;!OTECTIGN 825 '"L." STREET., f:fNCHORFI(::'iE., 264-4720 klFIYNE KLIBFrI' PO BOX 21-Z~6 E.R. 2a:~57'? 6ff-44-]:6±Z.': L8B2 I"ICKINLEV ¥IEI.,.I ESTRTES LOT SiZE :~;?PffJS.~9 SC-.!UFIRE FEET ],'YPE OF SOIL RE:SORPTION SYSTEM IS: TRENCH I"IFt',dI?'tUM NUMBER OF BE[:'ROOMS = 2: SOIL RFI'¥ING (Sk.-:-! Ff'/SR)= :,'HE REG~U:[RED SIZE OF THE SOIL HBSORPTION L:;'¢STEM IS: :1.42 THE LENGTH DIMENSION IS THE LENGTH (tN FEET.'." OF THE TF-:ENCH OR DRRINFIEL[:'. THE DEPTH Of:' R TRENCN OR PI:'' IS 'I"HE DISTRN(.'.:E BETHEEN THE SURFFIE:E OF THE GROUND lIND THE 80TTOM OF THE EXCRVWrION ,.'.'IN FEE]''). THERE IS NO SET klIDTH FOR TRENCNES. THE GRf:IVEL DEF'TH IS :,'HE MINIf'IUM DEPTH OF GRFI',,,'EL E:ETI.4EE:N "tHE OUTF'f:~ILL F:'IF:'E RND THE E:OTTOM OF' TPIE EXCR',,,'RTION (IN FEET::,. PERMIT FIF'PL. ICRNT I--IFIS THE RESPONSIBIL. tT¥ TO INFORM THIS DEPRR],'MENT DURING THE INSTFILLRTION INSPECTIONS OF FtN'.¢ HELLS R[:,..TRCENT TO THIS PROPERT'¢ FIND THE; NtJi',IBER OF RESIDENCES THf:-IT THE [,.IELt_ HILL SERVE. BFtCKFIL. LING OF RN¥ S'.?STEM I.,.IITHOUT FINFIL IN'..SPECTION RND 8PPROVf:IL. 8¥ TF-IIS DEPFIRT¢tENT 1.4ILL BE SUBJECT TO PROSECUTION. I',IlNIHUM DISTRNCE BETWEEN R HELL RND RNV ON-SITE SEt.4RGE DISPOSBL S'gSTEI"t :;L00 FEET FOR Ft PR IVFt~rE NELL OF.: ±50 TO 200 FEET FROM R PUBLIC klELL DEPENDING UPGN THE T'-r'F'E OF PUBLIC MINII'¢tUFI [:,ISTRNCE FROM R PF.:tVRTE t.4ELL TO R PRIVFITE ~:SEP.IER LINE IS 25 FEE:]" FIND TO R COFli'ILINIT¥ riE;,EktER LINE IS 75 FEET. OTHER REL.';!UIREt"IENTS 1',1W¢ RPPL.'9. SPECIFtCFtTIONS RND CONSTRUCTION DIRGRRPIS RRE RVRILRBLE TO INSURE PROPER INSTf)LLR],'IOhl. I CERTtFV THRT ±: I FIM FRMILIf:IR HI'TH THE REOUIREMENTS FOR ON-SITE SEt.,IEF.:S FIND klELLS FIS SET f:'ORTH B"r' THE F1UNICIPFILI TV OF FtNCHORRGE. ':2: I I,-IiLL INS],'RLL THE Sh.'STEI"I IN f:ICCORDRNCE klI]"H THE CODES. >~:: I UNDERSTFIN[:, THf:I],' THE ON-SITE SEklER S"r'STEM MR'9 REOUIF.:E ENLFfRGEi"IENT If:' THE RESIDENCE IS REI'"IO[:'ELE[:' TO INCLUDE t'IORE THflN 2:: BE[:'ROOi'"IS. I'S S. EP E:¥. ........ £:,I.T'FE ~ 82' sL~ ;,Lresetl. ;n~hora;e~ ~,~s;~_ 9A9;;10 N 2~;-;7¢0 ,~J~' SOILS LOG PERCOLATION TEST LEGAL DESCRIPTION: iv~,L~ t~;~\~4L~ '~',~::*%/ i~.'(~(-r'~ ~)'L ~-* SLOPE SITE PLAN 10 11 12 ~_~.,13 14 15 16 17 18 19 2O WAS GROUND WATER S O P E IF YES, AT WHAT DEPTH? Gross Net . Depth to Net Reading Date Time Time/j'~; ~ ~ Water Drop PERCOLATION RATE J ~ (minutes/inch) TEST RUN BETWEEN ~'~ "/~ FT AND FT i,,,~',~,,~.. 2." ..~,~;~. 6.~', I:~;,' ~- .~,~,,~ Russell Oyster 694-2774 E ENGINEERING & D:VELOPMENT CO. Box 90, Davis St., Eagle RiveAlaska 99577 694-2774 or 688-;80 SOIL LOi Performed for: Name: /-//'~/~- -~ ~ ~% ~ /~ ~/~/~' Mailing Address: />~"~ d). /.~ X ..~ 2 ~, Legal Description: 688-2280 Depth fleet) 0 Soil Characteristics 10-- 11____ 12__-- 13 14~_ 16-- Ground Water Encounbred: Yes.__ Proposed Instal%ation: Seepage Pit. Comments: No ~ If yes what depth__ _ Drain Field ..... PLOT PLAN Ik/~ PERC, TEST : _/, : 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. # O ~/ - -7 ¢1 ~- -; 1. GENERAL INFORMATION Complete legal description Lot Loca't'[c;n"'isite address or directions) 22493 Center, ion Drive Chugiak, AK ' Ernest L~wis P.O. Box 670204 Day phone 688-8954 [hl Chugiak, AK 99567 269-1168 (w) ' prope~.y owner Mailing address Lending agency %',Mai'ling add~eSs-. Agent "'~L~nn Swanson/' JACK WHITE CO. Ea.qle River Address 11823 01d Glenn Hwy. Eagle River, AK Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 ~, Day phone Day phone. 99577 694-5500 3. TYPE OF WATER SUPPLY: Individual well Comm unity well XXX 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 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. .Phone ~' ~/~- ~- ff 7~ S & S ENGINEERING Name of Firm. 17G~4 F.=~;. Aiver L--'~ Read Ne. 204 Eagle River, AI.aska 9~_577 Address ~/ ~ ~ Engineers signature - , -- DHHS SIGNATURE /~ Approved for ~ _ bedrooms. Disapproved. Conditional approval for · Date bedrooms, With the following stipulations: Additional Comments ,,~:~~~.,;,/(~.~_ ~~ Date-~-- 2 .~-- ?_ ~'_ i..Tihe ~.~i~[~ality o,f"~orage Department of Health .a. nd Human Serv,ces (DHHS)issues Health Author,fy 'Approval Certifica]t~' based only upon the representations given in paragraph 5 above by an independent ' ~, .' · ered in the State of A aska. TheDHHSdoesthisasac°urtesyt°purchasers°fh°mes 'fessionalehgineerreg'st ............ ~ .....*o ~,~1 veesofDHHSdonot Pa~ thei'r I~nding inStitutions in order to satisfy certa, n ,eaeral ano s[a[e r~qu,J~, ............ . o, 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 & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist A. WELL DATA - Well t~e ~'/ If A, B, or C, attach ADEC letter~-~C water ~stem number Log pr~m ~ Da~o~pleted Total depth ~ ~ ~ C~t~ Casing height (above ground) Sanitaw se~Y~~ W~-~op~v protected._. _ (Y~) Date of td~t- Static water level _~ - Well production .......... ~ ~ ~ glp7m~_ g.p.m. WATER S~LE ~S~TS: Coliform ~ Nitrate Other bacteria Date of sample: ~- B. SE~IC~OLD~G TANK DATA Date installed /'~" '-~ ~>'' Ta~ size ~ c,~vyg~¢ Number of Compa~ments iL Cleanouts (Y~) Foundation cleanouL(~ ~' Depression (Y~) /dj ~gh water alarm (Y~) Date of PUmping z / Pumper ~ '" /(~*'*/~' ABSORPTION FIELD DATA Date installed /'r~ -- ~' Length ~(" ~ / Width Effective absorption area Date of adequacy test o '-/ Soil rating (g.p.d./ft~ or ft2podrm) _/'72~/~ System type. ~'y' ¢ Total depth Gravel thickness below pipe Monitoring Tube present(Y/N) Results (Pass/Fail) Fluid depth in absorption field before test (in.); Fluid depth '/-!'~ Minutes later: ~7 Depression over field (Y/N) A-/ For ~ bedrooms Immediately afterV/: '/,gal. water added (in.): (in.) Absorption rate = ;<-~" g.p.d. // If yes, give date Co Peroxide treatment (past 12 months) (Y/N) too :% LIFF STATION Dale installed '- Manhole/Access (Y/N) High water ahuun level lit* Size in gallons ~'-Pnm_~ on". tcv6I at* *Datum "Pump oW' level lit* Cycles tested SEPARATION DISTANCES SEPARATION D~D1STTMNC~S FROM WELL, ON LOT TO: Septic/holding tmtk on lot -- - - - ---- _: Qn adjacent Absorption field on lot Public sewer main ....... ~li6~&rvice line - k Oh adjacent lots Public sewer manholc/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation Property line /.i; //- Absorption field Water ~nain/scrvice line jr; '-4- Surface water/drainage ~ ,9 A * '~ . Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation ,,/~9 "~" Water ~nain/servicc line ! Surface water Driveway, parking/vehicle storage area Citrtam drain_ ___/-?//(:' Wells oil adjacent lots ENGINEER'S CERTIFICATION m confor,nance with 3dOM ..................................................................................................... HAAFee $ ~)D Date of Payment ._~ ~' ~>~q' ' Date of Payment ReceiPt Number /,;~D .... ' Receipt Nmnber Rev. 8/95 OSS: haa.wk.doc 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. # £%~i-~-~Q.*)-~ ~ 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA# i'~'~ IA', Lot 8; ~-~ 2: ~c~y ~.r~~v~ Location (site address or directions) 22¢_93 centu~~ .:;,~: ; ' ,' :: Property owner Mailing address Lending agency Mailing address. Ed and Opal Lambert C/O Mm~d Day phone 205-957-2601 p_o. Rnx 48_q, Tr~J3~g.hon, AlabAma 365~4 Day phone 694-9035 Agent Cindy Wilson/DON MCKENZIE REAL ESTATE Day phone Address 13135 Old Glenn Highway, Eagle River, Alaska 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOi~IS: ~ 3. TYPE OF WATER SUPPLY: Individual well Community well XXX Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site ××x Holding tank Community on-site Public sewer 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 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/orwastewaterdisposalsystem is safe, functional and adequate for the number of bedrooms and typeofstructureindJcated 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. ~ ~ ;:¢'~N~.',-:,X~NG Phone Name of Firm Address Engineer's signature DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. 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 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 & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~ ~:~ ~-~-¢-~ ~¢'t'-t~-'~t'~~ Parcel I.D. A. WELL DATA Well type /~, If A, B, or C, attach ADEC letter. Log present(Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow~ Pumpl~el ADEC water system number Date completed Driller Cased to Casing height Wires properly protect~-{~7~ FROM WEL~INSPECTION g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~Z~ 6) ~'~ ; On adjacent lots Absorption field on lot ~¢L-oo ; On adjacent lots Public sewer main Public sewer m~ Sewer service line Petr. ol.eu~Ttank WATER SAMPLE. Coliform . Nitrate Other bacteria Da~ Collected by: Date installed Cleanouts ~,~N) High water alarm (Y~) Date of pumping B. SEPTIC/HOLDING TANK DATA Tank size \ oc~4;> Compartments Foundation cleanout~/N) q Depres~on (Y/~ ¢ Alarm tested (Y/N) I/~. ~ ~ ~ r~~ ~ ~ Pumper --~-.~,- ~c~%~-~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TA~K TO: Well(s) on lot On adjacent lots *-~' To property line ~,o ~ ~ Absorption field ~ ~ ~ Surface water/drainage \ ~c~ ~ k~ Foundation Water main/service line_ tF)~4' 72-026 (Rev. 7/9t) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) _ Manufacturer "Pump on" level at Manhole/Access (Y/N) __ . j__j~g~m~5-O~f" level at Cycles tested High water alarm level -~-J- Meets MOA electrical (;()des (Y/N~)~--- SFPARATIO__~DtSC~NCE FROM LIFT STATION TO: ~/~/~1 on lot On adjacent lots Surface water 13. AI~SORPTION FIELD DATA Date installed _ ~¢.p Length_ ~'L¢' _ _Width Total absorption area Depression over fiel~ Result~fail) ~ Soil rating _. ~'-Z-+/D_¢:--,) System type. '¢~-~-~-5 ~/¢-t _ Gravel thickness /_al ' . Total depth Cleanouts p resent (~_Y)'N) ',1/ _ _ Date of adequacy test _ ~ ~ ~'-~"- °1% . _ for ~rk¢-¢-'6-~ ~'%-~ . __ bedrooms .~Per~xide~treatment (past 12 months)(Y~)) r-~¢-?~ /.---~.~ ,.& ~ ~EPARATION DISTANGE FROM ABSORPTION FIELD TO: Well on lot ~ ~'%~t~' ___On adjacent lots ¢~ If yes, give date Property line To building foundation .... ~ To existing or abandoned system on lot. __ On adjacent lots Surface water Curtain drain E. ENGINEER'S CERTIFICATION I c,~,rtify that I have checked, verified, or conformed to all MOA and HAA guidelines in eff¢~ ~,¢ of this inspection. :,-~ :; ;; ;: ?' ?;.} Engineer's Name Date Date ot Payment ~) ~P ' 2.~'~ Receipt Number ___ ~,~ ~: / j Waiver Fee: $ Date of Payment Receipt Number DEPT. OF ENVIRONMENTAL CONSERVATION WALTER J. HICKEL, GOVERNOR ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 (907) 349-7755 Januaw 28,1993 Mr. Ray Sha~r S & S Engineering SUBJECT: McKinley View Subdivision Class "A" Public Water System, PWSlD 2'10697 Dear Mr. Sharer: I have completed a review of this office's files concerning the monitoring status of the above-referenced Class "A" Public Water System and found the following: The last satisfactory Total Coliform Bacteria Sample results was submitted to this Department on January 4, 1993. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. The last inorganic Chemical Contaminants Sample results were submitted to this Department on February 4, 1991. 'rhis does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. The last Radioactive Contaminants Sample results were submitted to the Department on October 30, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. The last Organic Chemical Contaminants/Volatile Organic Chemical (VOC) were submitted to this Department on June 23, 1992. Based on analysis of the previous VOC samples results have been satisfactory. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. Issuance of this letter does not imply that the above-referenced Class "A" Public Water System is in compliance with other provisions of the State Drinking Regulations. If you have any questions on the above information, please do not hesitate to contact this office at 349-7755. Sincerely, Environmental Eng. Asst. APPLK NT F LLS OUT UPPER HA[ ONLY / ,~ Phone Property Owner ,/~-' /~ ~/ ~! ¢ ./~ ~ ? /2 Address Zip Code Street Locati~ Type of Resi~nce ~ Multiple Family No. of Bedrooms ~ Other Water Supply ~ Individual ATTACH WELL LOG. A w~l log is required for all wells drilled since June 1975. ~. Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Insp~tor Insp~tor Field Notes: (~ ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* By:DATE / ~ a~,~ -- Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received 72-023 (3182) D~bkbg Wa~er A~aly~b Report ~or ToM Coii~om~ L~acteria TO BE COMPLETED BYWATER SUPPLIEP, I.D. NO. Public W~ter System Name ~, '~'~",/L '~L-~~' Mdling Adciress City State Zip Code Mo. Day '(ear SAi~PLE TYPE: E] Routine Lq Check Sample (for routine sample with lab reft no ) ' El Treated Water F:::C'Special R~,rpose ,~FO~ Untreated Water AMPLE NO. 1 2 3 4 5 Time Collected LOCATION Collected By TO Dr~ COMPLETED BY LABOFIATORY LABORATORY: NAME ADDRESS CITY Time Received ~ '(~ ("~ A, alytlca Method: ¢:;' Fermentdion Tube [] Membrane Filter Lab Ref. No. Resulr' Analyst ................... .................. J F!iI , . j CONSTRUCT ON AND OPERATION CERTIFICATE ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT ' ..... Plans for [he construction of_ K;~'~__j~b:,%'~. .public w~ter system located i~__~;:A'~'r: v,_., .. ,.~~, A~,k,. ,,~mitted i, ~cco~,n,e with ~S AAC S0.~00 by ...... f][..~_._~!~ have been reviewed and are approved. /i.,z'© conditionally approvq~d (see attached conditions). ', ~ , ': .... ¢ :i: ,-. ' By TITLE f) ' DATE If construction has no[ started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. APPROVED CHANGE ORDERS Change (contract o~d~ ,o. Approved by Date or descriptive reference) /lC The "APPROVAL TO OPERATE" section must be completed before any water is made available to the public. APPROVAL TO OPERATE ¢,'~ ,0' .'~ ,'~ ~-; ~. public '-' ~ '" ' 7" ~< (date). The system is hereby water system was completed on ~' granted interim approval to operate for 90 days following the cpmp etlon date. BY TITLE DATE As.-buiit plans submffted during the interim appr~)val period, or an inspection by 'the Department has confirmed the system was constructed according to the approved plans. The system is hereby granted f ~,a,~approval to ..o, perate.. /'~