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Home My WebLink AboutBROADVIEW BLK 2 LT 1A Municipality of Anchorage Page ~ of z DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: '~wg~O/~'~' PID Number: Name~ck--._ f ~OA.)O~ ---~r"(~-~/t,J -~1~. Wastewater System: ~ New D Upgrade Address: ABSORPTION FIELD LEGAL DESCRIPTION soi,,.,~: ~. ~,~s,. ~. ~o~.l ~,,~ ~ro~ o~i~i~.l ~r.~: O ' Lot: Block: Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe Township: ~ Range: Section: Fill added above original grade: Gravel length: ......] Z Ft. ~7 Ft. Gravel width: Number of lines: I Distance between lines: WELL: New Upgrade ~O Ft. ~] ~ Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: ~/O IVR ~ Ft. Ft. /1~1~ SQ. Ft. ~T~ ~O~ ~V.~. Driller: Date Drilled: Static Water Level: Installer: Date installed: Yield: .''GP' J Pump Sot at:u~. Ft. Icasing Height Ab°ye Gr°und:~ Ft. TANK SEPARATION DISTANCES ~ s~pti~ ~ Ho~Uing ~.T.E.,. TO Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank ' Sewer Lines ~~ ~ Material: Number of Compa~ments: Sudace Water /O~'+~ ~o', /m ~ ~ ~ LIFT STATION Lot Size in gallons: ~ Manufacturer: ~ "Pump on" lev~at: I "Pump off" level at: High water alarm Cu~ain ~0~ ~0 ~ Pump Make & Model J Electrical Inspections pedormed by: Drain ~1 ~HW ~~ ~ ~o~Pr~o~ BENCH MARK Location and Description: I Assumed Elevation: ENGINEER'S SEAL Department of Heal~ and Human Se~ices approval ~ Reviewed and approved by: Date: ~-/~-~ ~ ' ~ ......... ~' '*' ~ 72-013 (Rev. 9/91) MOA 25 Permit No.SW940158 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O, Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description?°ADVIEW SUBDIVISION, BLOCK 2, LOT lA PID No.: 05032114 CO1 :: C02 ~ C04 I~T1 MT2 CO ~ i . i 6' /- FINAL GRADE I~ :: II ~-FINAL GRAD~. ' / IJ ~90 3 Il MH ..d z' ~ ., / ~ ~ ~ ': 99 5' :.¥ ."'~.;'?':::'"'.'".:.'.'.:';~' ,'"'~"~;'.'~'~"~";' ~':~ ' 85.5~' ,~o C~L 1%85.3! ~ ~, ~ ,~ ~lOO r ..................................... s ~ ~ ~ ............ r ...................................................................................... =. .. ~ .... 5.0.~ ...................... ~...;~ ..................................................................... /-- 10;8.6' ~TION · 93i5' BEDROCK FOUND WELL DRILLED 1D-12-93 A B C D FC0 - - 16.5 4.5 CO1 78.0 50.5 - - C02 84.5 58.0 - - M.H, 87.0 60.0 - - C03 59.5 56.0 - - C04 97.0 81.0 - - · MTn''"58;5 -4'4'~0 .......... ' ................. ~' MT2 95,5 86.0 - - FCO, N DRAINFIELD INSTALLED PERMIT#SW930123 ...5-.~8--93. 1500 GAL. ~940158 SCALE 1" 72-013 A (1/93) * ENGINEER'S SEAL Halmar Electric PO Box 1864 Palmer AK 99645 Ph. 745-8883, 696-8883 To: Ronda & Jack Stoebner 18640 Jamie Dr Eagle River AK 99577 Date: 06-28-94 Ref: Lt. 1A,Blk. 2 Broadview Eagle River AK This is to certify that on site sewer lift station at above mentioned property has been wired in accordance with the National Electrical Code and manufactures specification. Systems were checked and performed as specified in the systems manual. PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940158 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:STOEBNER JACK & RONDA P OWNER ADDRESS:18640 JAMIE DRIVE EAGLE RIVER, AK 99577-7916 DATE ISSUED: 6/01/94 EXPIRATION DATE: 6/01/95 PARCEL ID:05032114 LEGAL DESCRIPTION: BROADVIEW BLK 2 LT iA LOT SIZE: 32287 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: THIS PERMIT IS FOR THE CONTRUCTION OF: SEPTIC TANK 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 (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 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: f_~ 03. ~E~LT~ A~T~OR~T~ ^PPROYALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN ROBERT SHAFER, P.E. ROGER SHAFER, P.E. May 30, 1994 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 Municipality of Anchorage DEPARTMENT OF HEAL TH AND HUMAN SERVICES 825 'L' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Broadview Subdivision, Block 2, Lot lA Request you re-issue permit #SW930123 to install a septic tank effluent pumping (S.T.E.P.) system to serve the proposed four bedroom house on the referenced property. On May 25, 1993, permit #SW930123 was issued to drill a well and instafl a septic system to serve a proposed four bedroom house. On May26, 1993, and May 28, 1993, inspections were performed on the installation of the absorption bed. Prior to the expiration of the permit a well was drilled, however, the well was drilled in North-east comer of the referenced property. There are no points of contamination within 100 feet of the new well. Attached is a revised site plan showing the new well location, new absorption bed location, and the proposed 1500 gallon S.T.E.P. location. Due to high bedrock elevations in the area of the proposed 1250 gallon septic tank under permit #SW930123, we request the proposed septic tank be relocated to an area with lower bedrock elevations. However, due to the topography of the property a 1500 gallon S.T.E.P. system will be required. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed S.T.E.P. If you have any questions, or require additional information for your review, please contact us. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 o \ \ \ o~ 0 oo NY-Id qllS n :,, ~: ~,~ LC', '.~ ~: ~ .~ c: . · --: eq! eq: O~ c"4: : ~: '¢i .¢: ~.. ~n! : ~ ' : : : : 0 0 O. 0 0 0 0 0 O. 0 0 0 :~,. ~ '7~ ' . : .--,.~: ~.-41 ~ ~,~; : : : 0 0 0 0 0 0 0 0 0 0 0 0 · '. ". '; ,1~ 1',. "( · - ' : ~ ' ,' ,:i ,' "'~..~'. ' ' . ,~4 . , ': ' ;', ,~' ' ' -..: ... .... ,.., ,,... : ....: .... :,.: :'.: ':?...'~:'~ ~ : ; : ' ~ .';,;:,,?,,.~:5: ~, :14 ,~: ~ :i~'.': !.': ~n~i: ,:! '~' ~!h,,~: ",i~'.~. ".:, j' .0~, ..:'.,: .: ~ ~.,i' ".:,- : ' : ~: : r,~ ¢~ ~ c: : : ~: : n: : ,: 'o: . !; ~: ~: ~ I~: O: H~ ~ ¢~ ~: ' ~ :,~. : : : : | : : .: : o o ~ o o-o o o o od o oo ] unicipality of Anchorage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 May 25, 1994 Jack & Ronda P Stoebner 18640 Jamie Drive Eagle River, Alaska 99577 7916 Subject: Lot IA Block 2 Broadview Sudivision Permit #SW930123, PID #050-321-14 The subject permit, issued May 25, 1993 by this office for a single ~family well and/or on-site wastewater system, has expired as of May 25, 1994. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. ' Robert W. Rob~ Acting Program Manager On-site Services Copy of Permit cc: S & S Engineering PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW930123 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:STOEBNER JACK & RONDA P OWNER ADDRESS:18640 JAMIE DRIVE EAGLE RIVER, AK 99577 DATE ISSUED: 5/25/93 EXPIRATION DATE: 5/25/94 PARCEL ID: 05032114 LEGAL DESCRIPTION: BROADVIEW BLK 2 LT iA LOT SIZE: 32287 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / 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 (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 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: THE SIX INCHES OF PEAT MUST BE REMOVED AND A TWO FOOT SAND BED (MINIMUM~NSTA~ ROBERT SHAFER, P.E. ROGER SHAFER, P.E. May 25, 1993 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 Anchorage, AK 99519-6650 REFERENCE: Hamann Subdivision, Lot 6A We request you issue a permit to drill a well and install a septic system to serve the proposed 4 bedroom house on the referenced property. Four test holes were excavated and perculation test performed on the referenced property. The approximate location of the test holes are located on the attached site plan. The monitoring tube within the hole has been checked and found to be dry. This property has enough area for future septic upgrades, which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your review, please contact us. rt A. Shafer, P.E. RAS/LSU/lsu 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 n~ W~-~w NV-la ':Ills ,0~ = ,, ~ 3-11.JO}Id '~'±'N Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR:J~'~r S~'~).~,t~/t./~'~~' 1 2 3 4 5 6 7 8 9 10 11 12 13- 14- 15- 16- 17 18 19 20 COMMENTS DATE PERF Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E SITE PLAN Depth to Water Alter /'~///~ /,/~..2 Monitoring? Date: ~ Reading Date Gross Net Depth to Net Time Time Water Drop TEST RUN BETWEEN__-~ FT AND FT 17034 Eagle River L~n PERFORMED BY: , ,C, ,,~ I///~ ' Eagle River, Ala,k. ACCORDANCE WITH ALL STATE AND M~I~PAL GUIDE~ ~FFECT ON THIS DATE. 72-~8 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: SEAL) Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 ,L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERF~ Township, Range, Section: 1 2 3 4 5 6 7 8 9 lO 11 12 13 14 15 16 17 18 19 20 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Monitoring? SLOPE E SITE PLAN PERCOLATION RATE ~°7 (minutes/,nch, PERC HOLE DiAMETER ~ '¢/ / TEST RUN BETWEEN ,-'"'~¢T,,AND FT COMMENTS 17034 Eagle ~ L.p Road No. 2~ ~[gl ..... ,, ~,... ,,~11 // ~ ~ THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIN~tN EFFECT ON THIS DATE. DATE: 72-008 (Rev, 4/~) Reading Date Gross Net Depth to Net Time Time Water Drop Municipality of Anchorage ~' DEPARTMENT OF HEALTH & HUMAN SERVICES ~ 825 "L" Street, Anchorage, Alaska 99502-0650 ~ SOILS LOG -- PERCOLATION TEST ~ PERFORMED FOR: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 ~rownship, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E SITE PLAN Depth t° Water Alter~)~L~/Monitoring? Date:/~///2 ~/~'~ Reading Date Gross Net Depth to Net Time Time Water Drop / ,,q/4!/q:~ ~ p ~,t ~ ~ ,, .----- 2_ ! ~ 3 .~ ,~ / ~ 1~, , i" to. I PERCOLATION RATE TEST RUN BETWEEN I COMMENTS E~r& $ ENGINEERING PERFORMED : I i 7034 Eagle River Loop Road No. 204 ACCORDANCE~bl~I ~TAI'~ri~IL~I3~IJI~F~IPAL GUIDELI 72-008 (Rev. 4/85) [minutes/inch) PERC HOLE DIAMETER :T AND ~ FT CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: BROADVIEW SUBDIVISION, BLOCK 2, LOT iA GENERAL: 1. The scope of this project includes the installation of a 1250 gallon septic tank to serve the four bedroom residence located on the referenced property. Construction shall be in accordance with the approved site plan and design drawings; Municipal permit with any special provisions or conditions; and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Page Two Broadview Subdivision, Block 2, Lot iA May 25, 1993 Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. LEACHFIELD BED INSTALLATION: me Excavate the proposed Bed Area to the depth shown on the design. The bottom of the excavation shall be within 2 inches of level. If the bottom of the excavation becomes smeared, it must be raked or scratched (ruffed-up) before gravel or sand placement. If a sand layer is required, place sand over entire excavation to the required depth shown on the design. The top of the sand layer must be within 2 inches of level. Sewer rock shall be placed uniformly throughout the entire bed. Perforated distribution pipe must be installed level with perforations down. Gravel depth below the perforated pipe shall be a minimum of six (6) inches. Gravel depth above the perforated pipe shall be a minimum of two (2) inches. The total gravel depth throughout the entire bed shall be a minimum of twelve (12) inches. Page Three Broadview Subdivision, Block 2, Lot IA May 25, 1993 Se The perforated distribution pipes must be no more than six feet apart. The distance between the outermost perforated distribution pipes and the sidewall of the absorption bed must be no more than three feet. Silt barrier material must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter and installed at the locations shown on the design. The portion of the monitor tube extending through the gravel depth shall be perforated six (6) inches below the bottom of the horizontal distribution lines. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finished grade over the bed must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS= Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Page Four Broadview Subdivision, Block 2, Lot iA May 25, 1993 e Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, it's gradation specifications must conform to AMC 15.65.060D. INSPECTIONS= Typically there will be a minimum of three (3) inspections required during the installation of the wast·water disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre- construction meeting will take place on-site. P.O. Box 874747 PHONE 688-3199 or 376-31 - / 7.z 7 MATERIALS 'AMOUNT MATERIALS AMOUNT "All charges shall be paid in full Within ten days un/ess other arrangements are made prior to work, The customer shall pay interest at the rate of two (2) percent per month on any amount not paid within ten days, Failure to pay may result in a lien against the property, THIS I$ A RIGHT TO LIEN SAID PROPERTY DESCRIBED ABOVE WORKMAN. DATE OUT HOpRS,, I RATE ~,~.~.~;~ . ~.'~$ ~,~ <,:,,~. ', MATERIALS (FROM ABOVE) OTHERCHARGES PAY THIS AMOUN'~( ?.~, 7o GREA,FR ANCHORAGE AREA BORudGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE ~.~)1 FROM WELL /3 INSIDE LENGTH MANUFACTURER ~.~~''- MATERIAL,~~ NUMBER OF COMPARTMENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPAClTY/g./~,'~./ GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL /,-~("') j I ~ TOTAL LENGTH FOUNDATION '-~'~') NEAREST LOT LINE ~.~/--~ OF LINES NUMBER OF LINES t DISTANCE BETWEEN LINES ~/~ TRENCH W lDTH~IN. TOTAL EFFECTIVE ABSORPTION AREA ~O SQ. FT. LENGTH OF EACH LINE ~3 / DEPTH: TOP OF T~L~ TO F~N~SH~RAg~ ~ / OEPTH OF F~LTER ~ i MATERIAL BENEATH TILE ~ ABOVE TILE IN. WELL: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION__ LOT LINE__ SEWER LINE__, TANK__ SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCE FROM: DISTANCES: INSTALLEDBY: .'~-'~_ SEWER LINE DEPTH: ~ / PIPE MATERIAL ./J.~-.- ,. LOT SLOPE: REMARKS: horm EQ-~2 G.A.A.B. D I:::,E:F::'I:::IF::'T'HI!EN'T' OF' I...IE:t::il..."FH FtI'.,t[::, E:l'.,l'v' :[ F~:OI'.,!I"IE;NTF:tl .... F::'F: ::: 'T'E: ;:; 'T' :i' F~N ,2./~ '7/ C:H INI ......... Ei!!;; :.11:: ""fi'"' IE-~L' E::.i.:;,; E.E R..dl E~. F;i~: F" Ei::':: tF;;i~:: ~',,'~ ::1[: "~J ,;: '~::'E;E;OE; ) 'FHE: I..IEN(ii'T'H I:::, .1: I'"IE:N:i~.; ,1'. ON :1: I..E' 'T'HE: L.E:NGTH ,:: :1: N F'I.'.:.:E'i" ::, OF' THE "I"RE:t'.,tCF~..-f3~;i? 1;::,1:;i:1:::1.1: NF:: .1: E:L.i:::,. 'i"HE I ::, E: F::" I" H Oi::: I:::1 'T'F~:tE:NCH OF;i: I:::':1:'1" :[E; THE: E:,:[:~i;'I"FINI.:::E Ii~',L:.i:'T'HEE:N 'T'HE: :!!::L.IF;E:F:'I:::I(:::E!: I:::11:::' 'T'HEi: EiiF;i!OLiN[) I:::fNI:::, THFE: E~r.::Ft"TOH OF::' "FHE E::.::C:FI'v'FI'T']:OI'-,I ,::]:N F'EE:'T'::,. "!'t...iii!i:!;i:li~: ]::ii!; I'.,IO ti~;liii:"l" I.,.I:I:E:,TH I:::'OF;~: THE: GF;i:f::!'v'E:I .... E:,E:F::'TH ]:.':5 'T'HE.E H :[ i'.,t :I: HUH t:::,E:F'TH OF GF:FI'v'E!:i..~ EE!:THEE!:N 'T'HE: OUTF::'FIL. I .... F::' ]: F::' ti!i: FIND 'H-..il~ii: E',O'T-T'OH OF' 'T'HE: E: ::.',: I:::: FI 'v' i:::I T :[ ON ,:.' ]: N Fli!:EE:T ::,. DeparLn'lent of LnvironmerILal Qualicy 3330 "C" Street Anchorage, Al aska 99503 SOII,S I,OG - PEIIOI,ATION TEST This form reports: ~oi/s /og~J...~' Percolation test Feet 5- 6- 7- 10- 11- 12- 13- 14- Was ground water encountered? if yes, at wi,at depth? Reading Date Gross Time Net Time Depth to Watmz Net Urop Percol ali on r-a-~'e- ............. mi nute-. ,Proposed installa~-i-~n: Seepa'ge ~ "~-__.][~_.~I:_~___~_.~1_ __ Drain Field ......... DupLh of Inle~ . Depth to~o~tom of pit or~cenci~ _ ;~K.. mY ............. DATI ............... JOI NO ....................................... GHKD. BY ............. DATI[ ............... /0 IZ: o~' / o .7. f, .C" ,)Z: o/,, o lC( /Z: Zi / 0 /0 o ~ £t/e~,, //ole # ~. mY .......................... DATE ~HKD, mmy ............. DATE ............... ........... :~./~...Z .............. .~. ............... aHEET NO ..... Z.. .......OIm'. ..... ../..... .JOB NO ....................................... GREATER ANCHORAGE AREA BOROUGH ~NmATED B DATE OF MEMO: DATE ANSWER RECEIVER: 7 R~CTION SCHEDULE FOR IMMEDIATE ACTION '~:i~:~ CALL ME BEFORE YOU ANSWER FOR YOUR CONSIDERAIION '~: NEED YOUR RECOMMENDAIION OTHER SIGNATURE 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 C).~) - ~,~1- I~-~ HAA# /l ~"~°~'L[ ~2~.'-~'"~ 1. GENERAL INFORMATION Complete legal description Lot IAi Block 2; Broadview Subdivision Location (site address or directions) Mountain Ash Drive (off Skyline Dr. ), Ea~l~ River, aK Property owner Mailing address Lending agency Jack and Ronda Sto~bn~r ! 8"//3 Day phone. Eaale River~ Al: Day phone 694-5151 Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: XXX Individual well Community well Public water 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 NOTE: XXX 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 5. 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 ' n.the Name of Firm ~Phone ,"~ .~'~-~" 5 & S ENGINEERING Address '* Alaska 99 Engineer's signatur~agle River, Alaska~ DHHS SIGNATURE ~' Approved for Disapproved. bedrooms. Conditional approval for 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, I/91) Back MOA#21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Parcel I.D. Legal Description: A, Well Data Well typ~")/'~l V/~A'3--~: If A, B, or C, attach ADEC letter, ADEC water system number Log prese~)x~ Date completed /~-/~ Driller ~ Total depth ~ / / Cased to FROM WELL LOG / Sanitary sea~_) / Wires properly protected~N) AT INSPECTION Casing height Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/h~;l~g tank on lot [ ~--~! Absorption field on lot i,~ I Public sewer main I---/ ~ ~-~' Sewer service line ~--~"~ ~ ~ RECEIVED g.p.m, jUL 6 1994 Municipality o~ Anchorage Oept. Health & Human Services ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: ~1 Io/~'1./-~ . ~.~. I 0 Vt~J I_~ Other bacteria ~ Collected by: ~ ~[ ~ ~--~t-~ t ~ ~l',~ ~___~. B. SEPTICIH~L:i~NG TANK DATA Date installed Cleanouts~l) High water alar (~( Date of pumping Tank size Foundation cleanou~(~N)"7/ Depression (Y~__~ pA:~~etreSte (~~~~~ % /:::>/---Compartments SEPARATION DISTANCES FROM SEPTIC/~ TANK TO: Well(s) on lot l ~'-d_2 1 On adjacent lots To property line ~ 1 Absorption field Surface water/drainage I O~ -~ Foundation z.~ / Water main/service line ::~ ~r' ~:. CONTINUED ON BACK PAGE 72-026 (3/93)* Front ~ C. LIFT STATION Date installed Manufacturer ~l~Jc~.~/~ ---~"t:~ ~ I~--- \ ~~ ~ ~------ Manhole/AccessiON) "Pump on" level at ~'~'~'-'~l' "Pump off" Le/velat Cycles tested Size in gallons Von~N) a"~m/m High water al level Meets MOA electrical c°de~-~N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot / ~'-~ I On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length .~.~t Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) Width If yes, give date Soil rating (GPD/Ft2) ~- ~' System type '~"~ ~- ~'-~. "~-'~! Gravel thickness E...O.~-~ / I Total depth ~, z~ Cleanout present~) V Depression over field (Y/~) ~ Results (pass/fail) ~ ~d_~ ~--~'~'~r ~- Bedrooms ¢:~ After test F~/¢~' SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water Curtain drain ~-~ On adjacent lots Property line To existing or abandoned system on lot Cutbank ~.-~/~ · Water main/service line Driveway, parking/vehicle storage area E, ENGINEER'S CERTIFICATION Name17034 Eagle Riy~.,Kj:m'~13 ~'oad Engineer's Eagle River, AI~;~ Date Waiver Fee $ __ Date of Payment Receipt Number HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back Commercial Testing & Engineering Co. Environmental Laboratory Services LABORATORY ANALYSIS REPORT CT&E Ref.# 94.2863-1 Client Sample ID L1A BLK2 BROADVIEW S/D Matrix WATER ClientName S & S ENGINEERING WORK Order 79306 Ordered By R.J.S. Printed Date 06/14/94 ~ 11:38 hrs. Project Name CollectedDate 06/10/94 ~ 10:00 hrs. Project# Receiv ed Date 06/10/94 ~ 11:52 hrs. PWSID UA Technical Director STEPHEN C. EDE Released By: Sample Remarks: ROUTINE SAMPLE COLLECTED BY: RAY. QC Parameter Results Qual Units Method Allowable Ext. Anal Limits Date Date Init Nitrate-N 0.10 U mg/L EPA 353.2/300.0 10 06/13/94 DJS * See Special Instructions Above ** See Sample Remarks Above U = Undetected, Reported value is the practical quantification limit. D = Secondary dilution. UA = Unavailable NA = Not Analyzed LT = Less Than GT = Greater Than 5633 B Street, Anchorage, AK 99518-1600 -- Tel: (907) 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA Eagle River GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received November 3, 1976 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF . INDIVIDUAL SEWER & WATER FACILITIES FOR Cony. 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: First National Bank of Anchorage Post Office Box 720 Phone: Everett L. Honegger~ Phone: General Delivery, Eagle River 99577 276-6300 x572 272-1474 Legal Description: Lot 1 and 2 Block 2 Broadview Subdivision Location: NHN Skyline Drive 5. Type of facility to be inspected 6. Well Data: Individual A. Type e Be Single Family No. of bedrooms 3 C. Construction Sewage Disposal System: A. Installed (~ ~-/(¢- C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines B. Depth D. Bacterial Analysis On-site system B. Installer 2. Manufacturer 2. Material Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank , 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 ENVIRONMENTAL QUALITY 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: HONEGGER, Everett L. VA FHA CONY X Mailing Address: Name of Buyer: Same General Delivery Eagle River Day Phone 272-1474 Mailing Address: 4. Name of Lending Institution: Mailing Address: P.O. 5. Name of Realtor or Agent: Mailing Address: Same Day Phone First National Bank of Anchorage Box 720 Anchorage, Ak. None Phone 276-6300 x572 Phone Legal Description: Location: Lots 1 & 2 Block 2 Broadview S/D NHN Skyline Dr. Eagle,River~ Ak. 7. Type of Facility to be inspected: SFR 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation No. Bdrms. ;) Individual X Individual (on-site) X EQ-037 (1/74) Mary Ann Dodge, R.E. 11/1/76 Page 2 of two pages - Rec ~t for Approval of Individual ~ ~r & Water Facilities legal Description Lot 1 and 2 Block 2 Broadview Subdivision Comments 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)