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Home My WebLink AboutBROADVIEW BLK 2 LT 3Broadview Block 2 Lot 3 050-321-12 PER ENGINEER OF RECORD — NO SYSTEM WAS EVER INSTALLED Municipality of Anchorage Development Services Department Building Safety Division i On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Spurkland Engineering Legal description: Broadview, 132 L3 ®Permit ❑C.O.S.A. ❑Inspection Report The attached paperwork has been reviewed and is being returned for the following reasons: Ground water monitoring done the month before or after high seasonal water dates must subtract 1 foot from the reading or wait to monitor at high seasonal dates. Therefore, the system as designed will be within 4' of groundwater. Also, there is not enough native unsaturated soil. 2. The bed is not parallel to contours. 3. The site plan shall have a description of the topography, areas of excessive slope, and extent of slopes and surface drainage patterns within 100 feet of any part of the system or portion of the lot intended for use for on-site wastewater disposal. AMC 15.65.030 D. Please provide this information on the site plan. Name of reviewer: Deb Date: 819107 L Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK Parcel I. ProDertv Al cia ity of Anchorage D3velopment Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907) 343-7904 ON-SITE SEPTICMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING D. 050- 391- 1;;k owner(s) e, lk%l ks%) _Dayphone 30q'1511 Mailing address 1 a :50L, MCI)n4(i t'n PrJh —Df'• -_Zip Code —" Site address Zip Code Legal description (Sub'd, Block & Lot)�/SSf Legal description (Township, Section & Range) Lot Size �5 '19tv Sq. Ft. THIS APPLICATION IS FOR (®all that apply) Absorption Field Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms q THIS APPLICATION IS AN: Initial ❑ Upgrade ❑ Renewal certify that the above information is correct. I further certify that this application is being made for a Single Famyy Dwelling ankis in accordance with applicable Municipal Codes. (Signature of prope`r(y owner or authorized agent) Permit/Rush Fees: 11 Waiver Fees: Date of Payment: g� i) Date of Payment: Receipt Number. Si Receipt Number: (Rev. 11/05) MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SWO60258 Legal Description: BROADVIEW BLK 2 LT 3 Design Engineer: 0007 SPURKLAND ENGINEERING Owner Name: RAE WALSH Owner Address: 12326 MOUNTAIN ASH ROAD EAGLE RIVER. AK 99577-7917 Date Issued: Aug 11, 2006 Expiration Date: Aug 11, 2007 Parcel ID: 050-321-12 Site Address: Lot Size: Total Bedrooms: This permit is for the construction of: ❑✓ Disposal Field E Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: The attached approved design. 012326 MOUNTAIN ASH DR 65986 SQ. FT. 1 4 Permit Bedrooms: 4 ❑ Private Well ❑ Water Storage 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 DSD at least 2 hours prior to each Inspection. Provide notification by calling'; (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). i 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. THE UPPER SIX INCHES OF THE MOUND SYSTEM MUST CONSIST OF TOP SOIL AND THE MOUND MUST BE VEGETATED SUFFICIENTLY TO PREVENT EROSION. i -A MAINTENANCE AGREEMENT NEEDS TO BE SIGNED AND SUBMITTED WITH THE AS -BUILT.' Received By. Issued By. Date: IRAD 6 Date: Municipality of Anchorage -� Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEPTIC/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. Property owner(s)• RAE t*l&ksi, Dayphone 349-1511 Mailing address Au, _Zip Code 9x518' Site address Jm(o mountain AStr Zip Code Legal description (Sub'd, Block & Lot) 1013 INK Z arca-AyIet.J Legal description (Township, Section & Range) Lot Size, q$% Sq. Ft. THIS APPLICATION IS FOR (®all that apply): Absorption Field Septic Tank �[ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms THIS APPLICATION IS AN: Initial Upgrade Renewal I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. vv'nx (Signature of property owner or authorized agent) Permit/Rush Fees: $NHo Waiver Fees: Date of Payment: g 26 CI mG✓ Date of Payment: Receipt Number: �� Receipt Number: (Rev. 11/05) Spurkland Engineering Environmental Consulting and Design SEPTIC SYSTEM DESIGN LOT 3 BLOCK 2 BROADVIEW S/D Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 November29,2005 We are submitting an application for the upgrade of the septic system for this lot The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed The septic system design is based on the following: Groundwater at 3.8 FL Use Mounded Bed with BioCycle Soil Rating. From Testhole 05/16/05. 12 min/in — 3 gal per sq.ft/day No. of Bedrooms 4 Required Area per Bedroom: 15013 -50 sq.fL Total area required: 50 x 4 m 200 sgft Use 12:18 feet Bottom Rock At + 1 feet Top Rock At + 1.5 feet Rock Depth 0.5 feet SYSTEM CONFIGURATION BIOCYCLE W/ STANDARD MOUND TOTALLENGTH 18 FT TOTAL WIDTH 12 FT TOTAL DEPTH -1.0 FT FILTER SAND 2 FT ROCK DEPTI I 0.5 FT INSULATION 2IN. COVER 2 FT (MIN) The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the arca. Ponding and/or concentration of surface runoff will not result from this installation. 203 West 15'6 Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 ! Fax: (907) 276-6013, SpurldandEngogcLnet i COSTATE PARK CHUGA —�-- — 1 well I \ 1 2 �I 1 ,llhll 1 \ 3 �I I 3 BL 0CK 1 el 34 ' L — Well S� vrtt r�r. kc We11 A\ a l�\ 2 IIZ'Ilo(, pan C{ c' \ \ --t PA �'� 49th�� •�•�� ..0 00 • roe srumaa+n := � a f'•,t No. tS-2223 ,41Ar V 1p 50 0 50 1w-150 C -M ew Sao ��till �..•• SCALE! 1• - 100 FT. N N TOWN SPURKLAND P.E. LOT 3 BLOCK 2 BROADVIEW SID SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE RAE WALSH DATE. • NOVEMBER 30,1005 ANCH. AK. 99501 11316 MT. ASH ROAD SUM. 1/3 'GRID. NW254 907 279-3916 PERMIT #SV060XXX PID / XXX -XXX -XX BDV03021.DVG CHUGACN STATE T(P ft rFASI7ZNT — — — — — — 1 I 1 I I I I I S<25% M 1 I t I ASUMAN D EM7Mc I DAMN MO t MW' TAW 3 �- S<2M DW I MTAU 4 -MIR" SEPTIC SMnM 1 I LEAGTN Olz / STAMARD ND 1 I MM 12 FEET DIM 1 MT SM® 2 /FET ROCK 0.5 mor I I ti5O1AnM 2 AV. COM 2 FEET (MW) Z\ t I 1 = 1 I ♦ r, •< 2A 25 I 0 25 50 75 100 125 150 SCALER Y = 50 FT. Septic r- Area I Well Abp. ,r, `Pet 2Mr 15.55 _ -A KCL ESNT.. -712110 6 icy Aa+ kma?4 i 203 W isles VENUE L' I I LOT 3 BLOCK 2 BROADVIEW SID I I SEPTlC SYST£AI DESIGN ANCH. AK. 99501 RAE WALSH DAM -NOVEMBER 302005 /om► q7a-tatoz 12126 AIT. ASH ROAD SHM 21.2 CRID:MY254 I PERMIT # SV060XXX PID # XXX -XXX -XX BDV03022.DVG I 4' MNITDP ASTM 3034 GRAX TO ADAM BACK FILL 18 ------------ HOUNDED BED NTs 6 RL TD' SDR, VE6E7A7£ W PREVENT ERl7SIDN X P=ATMV ?4' MU i FDNDBATMV CLEAN D? 17R]W 4L GRIR'ND SLLP£ FDNISIED 9VADE AVAT �, FRDI TD' M ALL 'DIRECT1W .vc,v 4 r I' PVC MUCK m PPRRLARY CINNBER m ACRATOV CHWBER 0CLARIFI£R .,� ®DISCFARGE CIWB£R TIDY Lr .TAMC BLLCBTNRD RMLATMV INSTALLATION " " \4' SANB LEVCLG I EXCAVAI£ A ff x ff x ff DEEP HZ£ PDP DRCYLY£ SYSIEN CLWACI 0- PLACE A NMIMM Or 4' SAND DP GRAVEL FM LEVE M CLLRSE IN TIE BDTTDM D• TIE EXCAVATER CLWACT AS K OWREB 3 PLACE 4 STETS D• P x &'x 2' DIRECT BCR/K RIGID BMLATDY DV TD' 9r CBWACT£D L£VCLpc CDAPS£ TD PRDTECT BDTTL:I D' F!BEMASS TANK TAKE EXTRA CAR£ W ASSLR£ TINT DKSLLATIDV CDIRRS£ IS LEVEL M ALL PIRECTOM 4. BACKFILL ARD.ND TAM' LP TD INVERT D• 4' MILCNT AND I-1/4' EFTLLCNT LRES VITH FRE£-TLDVMG NST MATERIAL FREE DrLARGE'STDES DR BLELLDCRS /OVI JURE SAND/GRAVEL BACATRL zo r 'I 'J`•'• (•� 7 49th s'}•i COMA TOBBE SPURKLAND No. CE -2223 Fi VOVITLR TUBE ��"c`,Zy;•,• 1L.l-Oi,.••''• OBBEN SPURKLAND P.E. LT3 BLKZ BROADVIffSID SEPFIC SYSTEM SCHEMATIC 103 W 157H. AVENUE RAE WALSH DATE. -NOVEMBER 30, 2005 ANCH. AX 99501 12326 MOUNTAIN ASH DRIVE SHEET- 3/3 I GRID: NW254 907 279-3916 PERMIT # SV030XX PID 6 XX BDVo WIM OK:mww�o 'I 'J`•'• (•� 7 49th s'}•i COMA TOBBE SPURKLAND No. CE -2223 Fi VOVITLR TUBE ��"c`,Zy;•,• 1L.l-Oi,.••''• OBBEN SPURKLAND P.E. LT3 BLKZ BROADVIffSID SEPFIC SYSTEM SCHEMATIC 103 W 157H. AVENUE RAE WALSH DATE. -NOVEMBER 30, 2005 ANCH. AX 99501 12326 MOUNTAIN ASH DRIVE SHEET- 3/3 I GRID: NW254 907 279-3916 PERMIT # SV030XX PID 6 XX BDVo WIM Municipality of Anchorage ey+' '.IENGINEERS SEAL Development Services Department Building Safety Division , �- a,� On -Site Water and Wastewater Program'.:.....waarrr 4700 South Bragaw St. ,.... P.O. Box 196850 Anchorage, AK 995198850 www.munl.org/onsite -["� t� x�jj'�j (907) 940-7904 �"rJ Soils Log - Percolation Test Performed For. VAF WAI_SH Date Performed: I(1 •� I$—OS Legal Description: LOT -5 ,�j�. 13tLoh r> V I Fa4ownship, Range, Section: i Slope Site Plan Depth 1• "; �7oasntl 2- -3 Net Drop hlLL- 3- 4- 'r- SNI L1 to s 0 - 11:1117 5- � i p3 Ci ` z- p f rt 7. 7• 8` z R_ 0 p[.DQoc,1� 1 1 1 1 15- 16- 17- 18- 19 - WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT DEPTH? r _ L Depth so O to Water After nr P Monitoring? 3.g E Date: 111,40 0 Reading Date Gross Time Net Time Depth to Water Net Drop hlLL- Imo/ SoA\L to s 0 - 11:1117 p3 Ci ` z- 1 i% 1 b -bo th, 8` z 4 0 1:10 30 b "CZ%z ! PERCOLATION RATE U�(mn ~) PERC HOLE DIAMETER b ' TEST RUN BETWEEN f1 Y L FT AND 15 FT PERFORMED BY; I . S DV r V I .! N I I S ✓ /lam IAN CERTIFY THAT THIS TEST YVAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELII ES IN EFFECT ON THIS DATE. DATE: Vab .� GRE/ ER ANCHORAGE AREA BOR '1GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION) REPORT ON-SITE SEWAGE DISPOSAL SYSTEM / NAME L i �yt!��C�f��{:��d MAILING ADDRESS�P`=�L'�/�'�+C�yy� fv PHONE LOCATION =C�C V LEGAL DESCRIPTION 2) SEPTIC TANK: DISTANCE) NUMBER OF FROM WELL MANUFACTURER MATERIAL �' �� C' COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER OR WIDTH` LENGTH, DEPTH f r r LINING MATERIAL �� CRIB SIZE: DIAMETER DE TH 4L DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION �'6'), NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL TYPE CONSTRUCTION BUILDING f NEAREST FOUNDATION LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DISTANCES: INSTALLED BY: k-1 PIPE MATERIAL: OA5-T LOT SLOPE: REMARKS:' Form No. EQ -031 NEAREST SEWER LINE REMARKS j% � DEPTH `7` 0 DISTANCE FROM: SEPTIC/4 f SEEPAGE TANK " SYSTEM DIAGRAM OF SYSTEM DATE _G5/�!' APPROVED G.A.A.B. /G -G -Z r� --7 i! e� . GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3 330 "C" STREET ANCHORAGE, ALASKA 99503 III TELEPHONE 274-4561 �th4tD 111N.6 MJ SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT �Y C' Jt../ �4/��MAILING ADDRESS Q _ v�J' F.K-C G `/. PHONE4,�9 INSTALLATION LOCATION 11 nn ` / LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK SEEPAGE PIT , DRAIN FIELD , OTHER TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENV-IRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE .�j(7 C.! TYPE ��1 �O M SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK _S -j 0 0 FOUNDATION TO SEEPAGE PIT _ cam( DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL _d.) SEPTIC TANK - �^% SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE. f WELL TO SEPTIC TANK /� ,SEEPAGE PIT /�a DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD ALSO CONSIDER AREA WELLS. SEEPAGE PIT SEPTIC TANK, / / , SEEPAGE PIT S DRAIN FIELD TO RIVER, LAKE, STREAM. 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 PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. 44 -ea L— G.A.A.B. OR LICENSED DESIGNER DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. / �� DATE 7 APPLICANT'S SIGNATURE .. /(62 FORM NO. EQ -01 6 III_ — i ISI iil� liilla�l I I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. / �� DATE 7 APPLICANT'S SIGNATURE .. /(62 FORM NO. EQ -01 6 All 0 & E Eli dI NEERI NG & DEVELOPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 333-5240 Russell Oyster Ear/ Ellis 694-2774 333-5240 Civil Engineering Surveying Soils Ft Foundations Land Development SOIL LOG Performed for: Name: �� V�j�,°� a Tel . No. V11A Mailing Address: :ko �)2►a�r Legal Description:--cY;�.4c Depth (feet) C 2 3 4 5 6 7 8 Soil Characteristics gas n., A, j� -~ 10 fA 12� Ground Water Encountered: Yes No ✓ If yes, what depth Proposed Installation: Seepage Pit V-' Drain Field Comments: C 'N ► .1 Performed by: Date:—S 79 7.1 'el(j 44 hOe"... -:, r /vxr //v psi - r7 iA . �' -, �. ', r l ' �� _ ;; r7 iA . �' -, �. �.' r - - } 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 June 5, 1986 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 3: Btock 2: Broadview Subdivi6ion Location (address or directions) (b) Applicant Name Bob Mown Telephone: Home 694-2629 Business Applicant Address P.O. Box 274, Eajgft Riven, Ataska 99577 (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder 6 ; Buyer ❑ ; Other ❑ (explain); ME (e) Lending Institution Ata4ka State Barite Telephone Address Aneh.onage, Ata.6ka Real Estate Company and Agent none Address Telephone (f) XWhe HAA to the following address: S & S Bngineenting Eagt'_e Riven, Ata6ka 99577 2. TYPE OF RESIDENCE Single-FamilyA Multi -Family ❑ Other Number of Bedrooms 4 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 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. / Page 1 of 2 72-025 (11/84) 5. ENGINEERING FIRM PROVIDIi`W_ INSPECTIONS, TESTS, FILE SEARCH, DA . A 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, 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 ngpection. w 6 ENG1NEERINc ��ZZ? Address 9 Name of Firm Telephone 196X p Date 71r. V r, . JU�J I 0 J��n C •+ jor 01r . • r' SAI* *'u . •fis•r • Dare « ••• wRob A. shafer �� r•u Na. 14,57•9 6. DHEP APPROVAL / Approved for F'�'��` bedrooms bye'`"""—�z'� Date =Approve7 �. Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval 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 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. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 v U N 1 C 264-4720 � D Legal Description: 3�� '�1tZnao�/ 1Gc�.J � fl A. WELL DATA Well Classification �'�• If A, B, C, D.E C. Approved (Y/N) Well Log Present ON) Pate Completed_ Yield ©•s L"�p� "�' Total Depth �D3 r Cased to Depth of Grouting '"'-- Static Water Level Isi Pump Set At L) K"• H Casing Height Above Ground Sanitary Seal on Casing (.!'N) Electrical Wiring in Conduit&9N) Separation Distances from Well: 1 Depression Around Wellhead (Yo To Septic/He+dhTg Tank on Lot �3 ; On Adjoining Lots lea t� To Nearest Edge of Absorption Field -on Lot 1© t f ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole N A To Nearest Sewer Service Line on Lot 30l� Water Sample Collected by ` �t �-lr36, ; Date X66 Water Sample Test Results •SiFlc'DIL�..I Comments -0 G,0,S� !'r,are � � ��k � .Eisra� ��.s�u u.�r. fir• � B. SEPTIC/W0k0TN Z,`' TANK DATA Date Installed 10 Size ) 25-D No. of Compartments 1 Standpipes &N) Air -tight Cap"s',(`.1�/N) Foundation Cleanout (Yo j)�I Depression over Tank (Y/6 Date Last Pumped Pumping/Maintenance Contract on File (Y/N) A ; for Holding Tank High -Water Alarm (Y/N) A Temporary Holding Tank Permit (Y/N) A)Id Separation Distances from Septio+fokhrrg Tank: � S , To Water -Supply Well `� 3 To Building Foundation To Property Line To Disposal Field To Water Main/Service Line ty 4— To Stream, Pond, Lake, or Major Drainage Course Comments r/- F� Page 1 of 2 � n 72-026(11/84) C. ABSORPTION FIELD DATA err - Soils Rating in Absorption Strata C GJ " da P Type of System Design Date Installed 1D/7$" Length of Field &":;)! Width of Field / D r X Depth of Field log �.l;rI Gravel Bed Thickness to r 3 Square Feet of Absorption Area Standpipes Present (91N) OF % ..//� Depression over Field (Y,O Date of Last Adequacy Test �� I / 6r Results of Last Adequacy Test%�Tl�-��-;� Separation Distance from Absorption Field 4' To Water -Supply Well _ < o J To Property Line � � t i To Building Foundation 3S To Existing or Abandoned System on 1 Lot 0, ; On Adjoining Lots 130 To Water Main/Service Line To Cut7.-f k (if present) h To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area S b 4- Comments D. LIFT STATION Date Installed Dimensions Size in Gallons qPumping ccess (Y/N) "Pump On" Level at Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify thJ I&q3fNGER1'N$ or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed SR RoAx Date JUN 1 0 `her CompanyEAGLE RIVIFR DK 00577 MOA No. ZT—CC�3 Receipt No.AV to l'i Date of Payment t. b Ilk Amount: $ Page 2 of 2 72-026 (11/84) /wosaw too, J R*6W1 A. 3h.rf r r 7.4 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Descri tion (in ude 1 , block, su �/ision, section, township, range) _3 e" C. -J, 91/ y Location (address or directions) . P1 216(b) Applicants Name OR df'b6J AJ Telephone - Home Business 01 S & V, E."101WEPERltvr Applicants Address S�RB 196X . 1'+�tii1+w. 71p1 YLL1++s!'cn!! qAv n' l! fff (c) Applicant is (check one) Lending-- nst tion ; Owner/builder UZ; Buyer E::l ; Other F-1 (explain); (d) Lending Institution tiU Y'j C Telephone Address (e) Real Estate Co. & Agent Ou0'Nt'0 Address Telephone L (f) 1 the HAA to the following address: 5RB '196X 1j 1 rru, ALA YJlw 2. Type of Residence Single -Family M Multi -Family Other (describe) Number of Bedrooms 4 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 the legality and status. 4. Sewage Disposal Onsite �< Public =1 Community E�7 Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [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, 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 regula- tions in effect on the date of this inspection. Name of Firm $ & 4 E�iC3If�tEEHINr Address ! PH. +ALAbAA pg 94 -'QST A • Date • >. 6. DHEP Approval Approved for ou bedrooms Approved X 'k `A- Telephone p la L1CifDG�j�.r't.2''i " .p�. 1457-C % ROH / By �A� w� U �,rlR Lt' Date / 2 / 25 ls> Disapproved Conditional Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS 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 REQUIRE- MENTS. EMPLOYEES OF DHEP 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 A. WELL DATA MUNICIPAUTY 07 " i1•CH0°AG1_ DEPT. DEG 10 1984 rNVED Well Classificatiop, If A, B, cr C, D.E.C. Approv,.gd,(Y/N) Well Log Present (Y Date Completed f Yield Total Depth Cased to /S /6 rc /Cc' Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing6(y)lw) Electrical Wiring in Conduit _( /8�) Depression Around Wellhead Separation Distances from Well: To Septis/H Tank o1 LotAdjoining! On Lots � D To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected By4 .S"r&fAKeyLt:Z ;Date�/% /B y Water Sample Test Results -S!9 7/ .T",-C�A e ;;-.Ole, V Comments 0 4- 0 6✓ IFL-C IVD -7- /Ai e �e ��oc �C' ��9. N2c.J G✓c® G ( /e 60" r2 ✓ ,q f � � B. SEPTIC/I TANK DATA Date Install d /d 1 75 Size ��r� _ No. of Ccmpartxments Standpipes ( Air -tight Caps (Y Found tion Cleanout NW ) Depression over Tank (+d Date Last Pumped // Pumping/Maintenance Contract on File (Y P ; for P_ Holding Tank High -Water Alarm (Y Temporary Holding Tank Permit (Y Separation Distances from Septic/Eiolding Tank: To Water -Supply t\bll- /� J t To Building Foundation To Property Line P°© _f To Disposal Field 2 r To Water Main/Service Line 3o � To Stream, Pond, Lake, ar Major Drainage Course A-) do Nir Comments tick n.t1E [Page 1 of 21 ��j�0 2-15-84 C. ABSORPTION FIELD DATA sw 4? l/ Soils Rating in Absorption Strata �r�t/ -�- /� Type of System Design "L4 e Date Installed /Z) /'%�.- Length of Field 60 r Width of Field /0 -X 1 Depth of Field 46 ( f 0/1 A/ N Ft O -L 9 3 ` w � �✓ i� /t�Gra 1 Bed Thickness G i �✓ �c `j Square Feet of Absorption Area �y Standpipes Present(Y ) Depression over Field ( ) Date of Last Adequacy Zest // t7 4, Results of Last Adequacy Test -5,4 -77 SP,4c -o �T_ Separation Distance from Absorption Field: To Water -Supply Well /0/ To Property Line AD To Building Foundation _73— To Existing or Abandoned System cn Lot /A --)C> ; On Adjoining Lots 64 -V 015 -�-/ To Water fiftitLService Line .:7V To Cutbank(if present) A o To Stream/Pond/Lake/cr Major Drainage Course /ten ^/ To Driveway, Parking Area, cr Vehicle Storage Area s0 "Ye - Coati, nts Ye- Comments /v C) ^f leff D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (YM) "Pump On" Level at Off" Level at High Water Alarm Level at WVent (YM) Tested for Pumping cies during Adequacy 'lest. Meets MDA Electrical Codes(YM) Comments Check Permitted Bedroan Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guiq1A in effect «a on the date of this inspection. 0 c"e6•`. •..,�� Signed 8 & 19wQINUAINQ Date 042 r*. , 31. 111 Ej J4LASKh 'EO57i MOA No. � •'. � .�.» Company ' _. _ s M oo of • .. •.n �� KBl /d5/s A. Sha%r u ". No. 1457-6 $� -n 54 [ Page 2 of 2 2-15-84 September 14, 1973 A. Robert E. Brown P. 0. Box 6043 North Konai Road Kenai, AK 9011 3JbJEGT: Lot 3, Block 2, %roauviuw Subdivision. Dear 1r. Brown: This department has received a complaint of an abandoned trailer on the subject lot, and upon investigation found the trailer unsecured. Vandalism appeared wini►nal at this time, but the situation appears inviting to vandals that might ,pass through the area. If this residence is to be occupied, anApproved sewer system should be instal- led, and the permit for the installation obtained from the GAAB-Dept of Enviro- mental Quality. Sincerely, Jahn R. Lee, R. S. Eagle River Uistrict Sanitarian sr 1 j A BILL SHEFFIELD, GOVERNOR ..7 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 December 6, 1984 Mr. Robert Shafer S & S Engineering SR Box 196X Eagle River, Alaska 99577 Telephone: (907) Address: 274-2533 SUBJECT: Waiver Horizontal Separation between Well and Septic Tank, Lot 3, Block 2, Broadview S/D - Eagle River, Alaska (8521 -WA -079) Dear Mr. Shafer: After receiving new information by Robert Brown on December 5, 1984 it appears that the well casing is grouted into the bedrock as required. The Department hereby waives the horizontal separation between the well and septic tank to 73 feet on the subject property for a 4 bedroom single family residence only. Sincerely, e2C Al ruc��Erickson District Engineer BEE/dd 0 T