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Home My WebLink AboutBROADWATER HEIGHTS TR H LT 1Broadwater Heights Tract H Lot 1 #050-081-45 Only the 4 bedroom field shall be tested for any future COSA's Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 121333 PID Number: 050-081-45 ❑ New ❑✓ Upgrade Name: Erin and James Smith -Cohen ABSORPTION FIELD ❑ Deep Trench ❑✓ Shallow Trench ❑ Bed ❑ Mound Address 12027 Sweetwater Circle Drive Eagle River, AK 99577 ❑ Other Phone Number of Bedrooms Soil Rating - Total depth from original grade 244-0783 4 1.2 GPD/SF 4 Ft. LEGAL DESCRIPTION Depth to pipe invert from original gradeGravel 1 Ft, depth beneath pipe 3Ft. Subdivision Block Lot Broadwater Heights Tr H 1 Fill added above original grade 1-2 Ft. Gravel length 58 Ft. Township Range Section Gravel width 6Ft Beds: Number of Lines Distance between lines I Ft SEPARATION DISTANCES To Septic Absorptionolding Lift Station H Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 500 R2 2 >10 Ft. Well >100' >100' >100' N/A >25' TANK [-]Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Existing Capacity Gal. Surface Water >100' >100' >100' N/A Material - Number of compartments Lot Line >5' >10' >5' N/A Steel Two NA Foundation >5' >10' >5' N/A LIFT STATION Manufacturer y Curtain Drain None Noted Anchorage Tank/Orenco500Gal. Remarks Lift station and absortion trenches placed Pump on level at 26 in. Pump HatHigh water alarm at 32 in. under this permit. Existing septic tank remains in service. Only the four bedroom absorption system may Pump make and model OSI P2005-11 Electrical Inspections performed by Access Electric be tested for a Certificate of On Site System Approval. Installer PIPEMATERIAL Housetotank D3034 Tankto drainfield D3034 G & R Excavating Drainfield HDPE CO/MT D3034 Inspector MEA BENCHMARK (Assumed elevation) 100.Oft Inspection „ dates: 7/24/13 2-2/25/13 Location and description p 3'd 4'"- Garage Slab. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date �l7; 00 ..... i • ................. ?, -MICHAEL E ANORtSON 1, Jf.•• CE-4381VI ;\2_ Approved Date / �'/ �t��pIt 4111%FES t0�p♦•• % .,r..,.. - rte _ - -P.,Gc p' > n Z O EL QO m -0 `Opn o Cxx o pc ci o« o o c (n oQ zg�F U4� o f W SO � ..Z o I W O YS�� Y J v) E V La a I—N \ LLJ Q o+ a� ® x W � Q �\ O c est Ep5 ��\ m / �tdtty \� o \ o H ono ami E x_2 mzo GwM C Cy C \ 2 Q` J -0\ w O) Q N C7 m O Q UW xG �� cc W 0 QU 0 Y 4i o LLJ w N C.0 �- N .�IZL W c mQ (� om 3�c LCL UQ .Q M 4 `vu "a 0] \� O O o to /�v Z T w CL O O0.o c wo �'+ 0pN0 11 E '� 4 Z o ° L_L LU o e m NJ O r0 Z`L J ¢ U CO �O c ; d .**r'aa as f ll 33y7'�ff"f w EczjN •O•s} • ONNl2O w • Tw" p� 0 � U r JII W Ln • �11 TL F �pcy �� am :a w ti% U) E -OU 00 S. U Wo .w ~�I ,111 Q oar m °., �� '•" Z:'�J� ° Ifs ..., L' c o �S� •• 1ff0\q�w �• > a n /.� .�1 / I Q Emu N 0 avmax�uvr xuvmr _ Q Q( Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP121333 PID No. 050-081-45 90.8 Page 3 of 3 W Finished Grade Existinq Ground 1,250 Septic e. 12 93.8 y UU 1 Drainfield Rock 1 1 No Groundwater Bedrock @ 76.5 �� 77.5 9-26-12 29' (Trench Length) �n WEST TRENCH II 91.7 Grade Ground 87.1-rDrainfield Rock No Groundwater Bedrock @ 76.5 9-26-12 29' (Trench Length) EAST TRENCH DInnI—TI F- n <7� T -)I I T I T No Scale 84.1 85.8 87.1 �1 ACCESS ELECTRIC AND GENERAL TRADES tic PO BOX 670856 CHUGIAK AK 99567 The septic System supplied by others at at Lot 1, Tract H, Broadwater Heights on Sweetwater Circle, Was wired in accordance with the latest electrical code. Certification number. X�YC� DANIEL DELANEY OWNER / ADNINISTRATOR State of AK Specialty contractor # 39228, Owner ADMINISTRATOR DANIEL DELANEY ngineer: .egal Description 3ermit: 2eport Type: Municipality of Anchorage P.O Box 196550 4700 Elmore Road Anchorage, Alaska 99519-6650 (907) 343-7904 Fax (907) 343-7997 hftp://www.muni.org/onsite Planning and Development Services Department On -Site Water and Wastewater Program On -Site SewerMell Submittal Comment Sheet ANDERSON ENGINEERING BROADWATER HEIGHTS Tr H Lt 1 OSP121333 Septic As Built Review Completed By: -he attached paperwork has been reviewed and is being returned for the following reasons: 1. Need electrical report on letter head with licence number. 2. Trenches were re -figured from permit. 7/10/2014 J.Poet 3. Note on permit requires staement on Inspection Report saying only new 4 bedroom field can be tested for future COSA's. 1. The electrical report is attached. 2. The trenches were placed parallel with the contours of the lot. The area was cleared prior to placement and the ground surface leveled over the entire absorption trench area. The trenches were placed in conformance with the Municipal Ordinance. 3. The note has been added to the inspection report requiring only the 4 bedroom field to be tested. On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP121333 Tax Code Number: 05008145000 Work Type: Septic Upgrade Permit Effective Dates: October 12, 2012 to October 12, 2013 Design Engineer: ANDERSON ENGINEERING Subdivision: BROADWATER HEIGHTS Site Legal Address: BROADWATER HEIGHTS TR H LT 1 G:0253 Owner/Address: SMITH-COHEN ERIN & COHEN JAMES M 12027 SWEETWATER CIRCLE EAGLE RIVER AK 995777913 Site Mailing Address: 12027 SWEETWATER CIR, Eagle River Lot Size in Sq Ft: 23906 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N Water Storage 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: If the existing 3 bedroom field is not decommissioned but a diverter valve is used, a note must be made on the Inspection Report stating that only the field designed for 4 bedrooms shall be tested for any future COSAs. 71113 C0 *-1 cha YC5 desyn �-om (I)5s' Received By: *"""'� `-'lr � c"z"�`—^ Issued By: * CZ) z4' /�71-4> / 0-1z —17-- Date: 2— Date: MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 050-081-45 Property owner(s) Erin Smith -Coen and James Cohen Day phone 2y u{ - 0793 Mailing address 12027 Sweetwater Circle Eagle River, AK 99577 Site address Same Legal description (Sub'd., Block & Lot) Broadwater Heights, Tract H, Lot 1 Legal description (Township, Range & Section) Lot Size 23,906 Sq. Ft. Number of Bedrooms Three -F3) (q) APPLICATION IS FOR: (® all that apply) Upgrade phi -'hmomwwj``ft .; €; Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: Initial ❑ Upgrade ' Renewal ❑ TYPE OF DWELLING: Waiver Fees: Single Family (SF) s (w/wo ADU) Receipt Number: Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. property owner or authorized agent) Permit/Rush Fees: S 3 �� Waiver Fees: Date of Payment: Date of Payment: Receipt Number: Q3O5�cl Receipt Number: Permit No. 01519121;73 3 Waiver No. Permit App_9-1-12.doc ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766.FAX September 27, 2012 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Subject: Lot 1, Tract H, Broadwater Heights Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: A new septic tank was recently placed on the subject lot and tied into the existing absorption crib which has now failed. A new absorption system must therefore be constructed on the lot. We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the four-bedroom home on the lot. The attached Site Plan and backup documentation identify the location and configuration of the existing and proposed septic system. The existing Septic Tank will remain in place. It has been verified to have a volume of 1,250 gallons. A new 500 gallon lift station will be installed along with a new absorption trench. The existing absorption pit will be left intact and tied to the new system with a flow diverter valve. Also identified on the plans are the locations of the existing well on this and adjacent lots and adjacent septic systems. No conflicts exist between the proposed septic system and the wells on this or adjacent lots. Protective radii are shown to the adjacent wells. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test hole placed on the lot indicated Silty Gravel with Sand (GM) underlain by bedrock at 10.5'. The percolation rate was determined to be less than 5 minutes per inch. We have designed the new trench with an appfcati rate of 1.2 gallons er date per square foot. We are proposing to place af58 ng trench by 5' wide with a 3' Z rtiq effective depth to remain a minimum of 6' above the bedrock layer. The total depth of the system will be 4' with the distribution line at 1' below the existing surface. The ground surface on the lot slopes slightly to the northwest in the area of the absorption trench. The trench will be placed parallel to the contours of the ground as Lot 1, Tract H, Broadwater Heights September 27, 2012 Page Two much as possible and in conformance with design criteria. A minimum of 100' will be maintained between all components of the septic system and the existing well and from any surface water in the area. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments .°• 49th W °* MICHAEL E. ANDERSON S1 5A 4A 7 \ �� 49th 6 V MICHAEL E. ANDERSON No. CE -4381 1 \ \ \ I oxnm •.0 `�� \\ 2 Y. mmiq wi N 8 6 3 WEST SKYLINE DRIVE AREA MAP SCALE 1° = 100' / / I / I / / 1 11 W 0 I V D z am as 03 0 C 2 , O W 3N 0a O 0 .; i D x \ m Ivo n r D �0(/) H x m o =X X A Z r SN� < O O • 3 �Na GO m m w C ox N0oa 0 QD maoo� � �7 O D G V N O C O t.0 N N U 0 0 � so m C Z= 3 NT V N Q ,0� �:E D o 0 m o a 00 NV1D nD D Lo m Ivo n r �0(/) ,\G SX^o O m o =X X A Z SN� < O CIA I �Na GO m m a C N0oa 0 0 maoo� � �7 D G V N O C C/) t.0 N N U 0 0 � D m C Z= 3 NT V N Q ,0� �:E D m 0 n ° 0 N N W T 1 >x N \ p WN anti ;o 0 , \ NIX a z WO / O Lo n mart0Oo �0(/) ,\G SX^o O r �' SN� < O CIA I C/) % a C N0oa 0 0)0 � �7 o O o G V N O C C/) t.0 N N U 0 >x N \ p WN anti ;o 0 , \ NIX a z WO / Lol Lo n mart0Oo Fz��E O ,\G SX^o O SN� < O --CC rri mS\ Om ,02l a N0oa 0 � �7 o O o o o N O C N N U S O N m O O O O 0 x 0 3 N V N Q O C ° 0 Lol LOT 1, TRACT H, BROADWATER HEIGHTS SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS Four Bedroom Home 5' Wide Trench System Perc. Rate: 2.2 Min./Inch Existing 1.250 Gallon Septic Tank Application Rate: 1.2 GPD/SF 500 Gallon Add On Lift Station 3' Drainfield Rock 4 Bedrooms * 150 GPD/Bedroom = 600 SF Absorption Area 600 SF/1.2 GPD/SF/5 SF (Width) *.58 (Red. Factor)= 58 LF Trench Length THEREFORE: Construct 2-29' Long x 5' Wide x 3' Effective Depth Absorption Trenches Flow Line Elevation in Trenches to be 1' Below Original Ground Surface. Total Depth to be 4' Below Existing Ground. Provide 3' Cover Over Absorption Trenches and 4' Cover Over Septic Tank. Place Flow Diverter Valve and Tie in Existing Absorption Pit. 2'6" (i 6'. I 1 O 3' Geotextile Fabric 1" Perforated PVC (Holes Down) 30-7/16" Holes @ 1.5' O.C. Drainfield Rock TYPICAL 5' WIDE TRENCH SECTION OF (NO SCALE) ��P�E ... NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock.. ................ Minimum 4' Separation From Groundwater. cfu Minimum 100' Separation From Private Wells in the Area. �A: MICHAEL E.AN0ER ON Minimum 100' Separation From Surface Water or Streams: �j`�j%;_ No. CE.�a, MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (feet) 1 - 2- 3- 4- 5 - 6- 7 - 8- 9 - 10- 11- 12- 16 17 18 19 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT I, TRACT H, BROADWATER HEIGHTS PERFORMED FOR: ERIN DATE: 8/2/2012 PROJECTNo.: PARCEL ID#: TECHNICIAN: JKB TEST HOLE 1 61 /0 L. SLOPE Silty Gravel w/Sand GM Bedrock @ 10.5' WAS GROUND WATER ENCOUNTERED' No IF YES Q WH DEPTH OF WATER AFTER MOM DATE OF MO N 0 F 49th MICHAEL E. ANDERSIIN AT DEPTH? TORING: None MON 9/26/12 P E 2% DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH ro WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 7/18 1 2:24/2:34 10 4.00°/9.00° 5.00" 2 2:35/2:45 10 4.00^/8.50" 4.50" 3 2:46/2:56 10 3.75"/7.75" 4.50" 4 2:57/3:07 10 3.88"/7.88" 4.50" 5 3:08/3:18 10 3.75°/7.75^ 4.50" 6 3:19/3:29 10 4.00^/8.50" 4.50" PERCOLATION RATE: 2.2 (MIN/INCH) PERC. HOLE DIA. 8 (INCHES) TEST RUN BETWEEN: 4 FT. and 5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 9/26/12 Municipality of Anchorage OCT Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Pagel of 3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: OSP111067 PID Number: 018-173.31 name: Wastewater System: ❑ New ® Upgrade Atltlress: 12 27 Sweetwater le ABSORPTION FIELD Phone: Number of Bedrooms: ❑ Deep Trench p Shallow Trench 0 Bed O Mound i] Other: LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: GPD/Ft'Ft. Block Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 1 Broadwater Heights, Tract H Fl. Ft. Township: Range: Section: Fill added above original grade: Gravel Length: Ft. Ft. Well: New Upgrade ❑ ❑ Gravel moth: Number of lines: Distance between lines: Ft. Ft. Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: ExistingPrivate Ft. Ft. F 3034 PVC Driller. Data Drilled: Static Water Level: Installer: Date Installed: Ft. Flintstone Enterprises 5/18/2011 Yield l Pump Set at: Casing Heigh( Above Ground: TANK GPM FL Ft SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding ublic/Pnvate Manufactures Capacity: From Tank Field Station Tank sewer Line Anchorage Tank 1250 Gal. Well 130.2 25+ Material: Steel Number of Compartments: 2 Surface Water 100+ LIFT STATION Lot Line 10+ ize: an acture.. Gal. Foundation 13.2 'Pump on' level at: -Pump ofr level at: High water alarm at: In. in. in. Curtain Drain PII NIA Pump Make &Model Electrical Inspections performed by Remarks: Tank replace only. f —z-z> soft dw-r- BENCH MARK Location and Description: P� S It Gs 0. =A Al House FF Assumed Elevation: 100.0 Ft. Engineer's Stamp Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1' 5/18/2011 OF Development Services Department Approval A V4C Conditional Approval Date: ° T" ►............ ..a..... 0 r }}}yyy j. �Steven..R. Pannone; y�/—No. Reviewed and approved by: a Date: /0 - %' / Z CE 8149 •' F ... .•• �: da.o�oa> 44 it WELL (E) 4A A B T7 14.2 33. 1 1 T2 1 22.1 1 40.1 \ ` DCO 24.4 41. C1 37.6 49.55 C2 54.1 63.9 10 W`N LG 3 m EXISTING N h SEPTIC AREA N EXISTING CRIB 0 NEW 1250g SEPTIC TANK W/ DCO �^ C21 � 4° R.I. M M C1 \ D� F 0 J AREA\ 9.9 T1 A SFJ 'i�ypLs� 1s� 0 0 1, H 0 t 4' 96.7 96.4 NOTES: 'ORD DRAWING PLAN Syy�, 3.0 Og 96.2NK CONNECTED TO EXISTING DRAIN FIELD SECTION 3 PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 BROADWATER HEIGHTS, TRACT H, LOT 1 JAMES COHEN 12027 SWEETWATER CIRCLE EAGLE RIVER, AK 99577 130.2/ / \WELL (E) I � a .. Iwo—WSW w bi I I OF A �� Date i `qst' 10/3/12 �-49��) Scale *. � ••*tI/ P.I.D NO • 7 050-081-45 Steven 'R1 annone 0 PERMIT N0. I'�P�•. CE 81 ..� OSP111067 1 OF 1 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP111067 Tax Code Number: 05008145000 Work Type: Septic Upgrade Permit Effective Dates: May 18, 2011 to May 17, 2012 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: BROADWATER HEIGHTS Site Legal Address: BROADWATER HEIGHTS TR H LT 1 G:0253 Owner/Address: SMITH-COHEN ERIN & COHEN JAMES M 12027 SWEETWATER CIRCLE EAGLE RIVER AK 995777913 Site Mailing Address: 12027 SWEETWATER CIR, Eagle River Lot Size in Sq Ft: 23906 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: KI f Date: '� Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-081-45 Property owner(s) James Cohan Day phone 552-9424 Mailing address12027 Sweetwater Drive Zip Code 99577 Site address 12027 Sweetwater Drive Zip Code 99577 Legal description (Sub'd., Block & Lot) Broadwater Heights, Tract H, Lot 1 Legal description (Township, Range & Section) Lot Size 23,906 Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms a AD 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. Pannone Engineering Services, (Signature of property owner or authorized agent) -7- � ,_ Permit/Rush Fees: . _ Waiver Fees: Date of Payment: Date of Payment: Receipt Number: Receipt Number: (Rev. 11/05) Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: Steve@_panengak.com May 18, 2011 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street Anchorage, Alaska 99519 Subject: Broadwater Hts S/D, Tract H, Lot 1 Emergency Septic Tank Replacement Permit Request Ladies and Gentlemen: I am writing to request that a permit to install a new 1000 gallon Septic tank be issued for this lot. The proposed systems will serve an existing three-bedroom house. Currently the lot is developed. The existing septic system was designed and installed for a three-bedroom house and is operating adequately for three bedrooms. The existing concrete tank was damaged during the construction of a new garage for this property. Additionally, the existing tank is located under the new foundation. The damaged top is exposing the raw sewage to the environment. The existing tank will be filled with clean gravel or concrete and abandoned per code. The surrounding lots are served by private water systems and there are no wells within 200 feet of the proposed septic tank. This lot is served by private well. PES will verify all required separation distances at time of installation. 1. Upgrade Tank Design. a. See Sheet 1 of 1 of the plan set 2. Surface Water: There is no surface water within 100 feet of the proposed system. The proposed systems will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: Lot 1 B is approximately flat. The proposed installation will be located in the north -central portion of the lot next to the existing septic tank and absorption system. �..Axe, . i. G, P, �. 2 e 6 se l 'g 7 ._ `. Page 2 of 2 The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: A i 27 2 �Ax: (r,'07" 2 F 2_ v To o IR nn 0 v To 49TH* STEVEN R. PANNONE CE -8149 !'aurone �g�neering Servk� WC P.O. BOX 100217 AracHN9,AKS9510-0217 (907)272-8218 ziA:- �is GREAT► ANCHORAGE AREA BOROI'^H Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME _ /1H VAS RAI6ER MAILING ADDRESS PHONE LOCATION 5/1 4kKt LEGAL DESCRIPTION 10t riiacf # eyewulak'a r�"/-S 21 SEPTIC TANK: DISTANCE F`/ NUMBER OF FROM WELL 1-37 MANUFACTURER t6"_aC� MATERIAL �iC<2eTz-7 COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY 16we GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER �7 y' OR WIDTH f&- f LENGTH—,3SDEPTH LINING MATERIAL C (�'F� CRIB SIZE: DIAMETER DEPTH DISTANCE FROM: WELL /JQ / TOTAL EFFECTIVE /1//� BUILDING FOUNDATION � , NEAREST LOT LINE _?9 ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: was r reSS �� tie" .7 el'p 1"Iew TYPE IA/ 401 CONSTRUCTION BUILDING NEAREST NEAREST FOUNDATION LOT LINE SEWER LINE , CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DISTANCES: INSTALLED BY: l PIPE MATERIAL: LOT SLOPE: rin" F4- a k """'.'� REMARKS: Form No. EQ -031 REMARKS DEPTH SEPTIC TANK_ DIAGRAM OF SYSTEM DISTANCE FROM: SEEPAGE SYSTEM Municipality, of Anchorage - • Development,Services`Department Building Safety Division e: On -Site Water and Wastewater Program' ' e 1 ,.J.74700 South Brag"'Si. ` s. ... P.O. Boz 196650 Mchorage,'AK' 99519-6650 , www.ci.anchorage:ak.us (907)343-7904' ; CERTIFICATE OF HEALTH ALlTHORITY_APPROVAL FOR ASINGLE FANLY,DWELLING, Parcel l.D.-050-081-45 HAA# oStPO d 1;l r Expiration Date: 1 GENERAL INFORMATION Tiegai Complete legal description 'Lot 1 Broadwater Heights S/D Location(sdeaddressbrdirecbons) `12027 -Sweetwater Circle • Dave Hardy 694-9932,,.; Current Property owner(s) Day phone 7, - Ma�lirigaddress P'MB#118;,_ 12110.,Business Blvd. -.Ste ,;6,,.,E R:,,tAK"99577 Lending agency .,, Day phone __...__. Mailing address " Real Estate Agent Day phone - Mailing Address - Unless otherwise requested, NAA will be held by DSD for pickup. -c-Ar-4 / 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Wdividual On-site El Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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, based on procedures outlined In the Health Authority.Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect atstllesjgW@UpjM�8on_ Name of Firm 17034 Eaflt• River Loop Road No. 204 Phone 6°t `1—a cl ? `J Address Engineer's Printed Name Robert C. Cowan, P.E. Date 5. DSD SIGNATURE Approved for_ 3: bedrooms. Disapproved.. V�Qw. .Lys O • ON-SITE WATER AND : WASTEWATER : PROGRAM Conditional approval for bedrooms, with the following stipulations: A itionall om ents Note: ie we I or t is pr per y —n---F— Note s existing State and Alunicipal Codes. There are nitrates present It is suggested that periodic testing be performed to incnre_the wplic enntln„ed s,1ltaht)(k_ Current nitrate concentration is 544 mg/i. EPA maximum concentration is 10.0 mg/l. Vlore information Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: Original Certificate Date: (Rw. 12W) Municipality of Anchorage • Development Services Department Building Safety Division On -She Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6850 www.cianchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: �T --fir /►� !!(%hle Parcel ID: A WELL DATA Well typeV4—v r rR- If A, B, or C provide PWSID # = Date completed JQ-3 Sanitary seal (YIN) Total depth ?ft. Cased to eft. Date of test Static water level Well production WATER SAMPLE FROM WELL LOG ft. g.p.m. kU Well Log (YIN) ^/ J Wires properly protected (YIN) V(e$_ Casing height (above ground) /19 min. AT INSPECTION G 01 i n. Z6 /00 g.p.m. Coliform colonies/100 ml. Nitrate rly mg.A. Other bacteria O colontes/100 ml. 3D ©) 5 & 5 ENGINEERING Date of sample: Collected by: 17AM Facie River Leen Road No 2nd Eagle River, Alaska 99S77 B. SEPTICIHOLDING TANK DATA Tank Type/Material z `G� Date installed G Tank size &W gal. Number of Compartments Cleanouts (YIN) T Foundation cleanout (YIN) Depression over tank (YI6 Ndv High water alarm (YIN) N /� Date of pumping / O v Pumper R • C. ABSORPTION FIELD DATA Date installed &I Soil rating (g.p.d./WL rr 1�7 System type iY/tfs� Length "3 95- ft. Width 3g• S� ft. Gravel below pipe Total depth 6- ft. Elf. absorption area Monitoring tubeDepression over field A/ 0 Date of adequacy test / / Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test WG in. Water added gal. New depth - Elapsed Time:& min. Final fluid depth Z15r in. / Absorption rate >= 4� g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) �dN�4VZ41AI If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) `Pump on" level at NPr"Pump ofr level at —_ in. High water alar level at in. Datum Cycles tested Meets alarm 8 circuit requirements? E. SEPARATI N DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanklIMAtatl6n on lot /00 �t Absorption field on lot / 00 �a Public sewer main r Sewer /septic service line Z�5- On adjacent Ws /00 150 - On adjacent lots /60 �+ Public sewer manhole/cleanout N 1,4, Holding tank / ,- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: r Building foundation ! t Property line _!E:1*' Absorption field 5 r Water main N Water service line Surface water _ /GU Wells on adjacent lots 00 1 J - SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ! 0 r • - Building foundation to rt Water main _/A Water Service line 1Q r t` Surface water /00 fl- Driveway, parking/vehide storage /0 f Curtain drain WONE 4;�&AI Wells on adjacent lots Ax 14-- F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA gguidednes in effect on this date. Engineer's Printed Name /_t OdEAT C. COwA,,J Date `/ -r/ aj HAA Fee $ 3 00. `2 Date of Payment a I V1 e / Receipt Number 0 o S- G o S' (Rev. 17100) Waiver Fee $ Date of Payment Receipt Number Z ROt$MVAPowAH f ti CE -8801 r+? tj JUN -07-01 08:40 FROM- LLr CUE Environmental Services Inc. CM RetN 1013012001 Cllent Name S k S Engineering Project Name/N N/A Client Somple ID L1;1311; DroadwaterHts S/D Marta Drinking Water Ordered By MID 0 T-475 P.02/05 F-106 Client POM Printed Daterrlme Collected Date/rime Received Date/Time Technical Director Released By A_ 06/062001 17:25 05/302001 15:30 05/312001 12:10 Stephen C. Ede Parameter Mule VOL Uuln Method Allowable Rep Analysis Limits Due Dale Init Nitrate -N Y V. 5.94 0.500 mg/j. EPA 300.0 (<10) 05/31101 SCL IOBw/Cali, No Fecal col/100mL SM189222B (<I) 05/31/01 ICRP 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 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) / o T / Ti?v+ct_1 h4 11A- Location (address or directions) (b) Applicant Name Telephone: Home / 1'7 - 7132- Business (o Applicant Address S2. 3 oz- rl (c) Applicant is (check one): Lending Institution ❑ ; Owner/builde?V; Buyer ❑ ; Other (explain); -- (d) Lending Institution Telephone Address (e) Real Estate Company and Agent — Address 9 — Telephone (f) W4 the HAA to the following address: tigineermg SIRS 196x Engle River, Alaska "377 2. TYPE OF RESIDENCE Single -Family Multi -Family O Other Number of Bedrooms 12 3. WATER SUPPLY Individual Well( Community ❑ Public 0 Note: If communyty well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public O Community 0 Holding Tank 0 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 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 regulations in effect on the date of this inspection. Name of Firm 5 & 5 Nineering Telephone • • 14bx Address r• <,.ao Qs..4 .. Date 9 ,�-c OF ALA %% 6 9 v• � DHEP APPROVALO) Approved for Q- bedrooms by Approved_Disapproved Conditional Terms of onditional 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 (11/64) ;MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE (MOA) DEpT, OF HEALTH & HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTECTION CHECKLIST- FEBRUARY 1984 '1 AA 264-4720 APR MOND- • 68 •...:, .rITE i -A Q A. WELL DATA Well Classification If A, B, C, D.E.C. Approved (Y/N) Well Log Present PMI:� Date Completed t CA l 3 Yield t U Total Depth CIO' Cased to `� b t Depth of Grouting Static Water Level I-V Pump Set At LA Casing Height Above Ground 17- `� Sanitary Seal on Casing am Electrical Wiring in Conduit (!iIw Depression Around Wellhead (� Separation Distances from Well; To Septic/Holding Tank on Lot �� b I ~ ;On Adjoining Lots L t ~ To Nearest Edge of Absorption Field on hot �0 a } ; On Adjoining Lots ba To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole. -- To Nearest Sewer Service Line on Lot 3a Water Sample Collected by S �� L ; Date 3 1-04, Water Sample Test Results 5A -f Ci b FAd:r04-�/ Comments B. SEPTIC/HOLDING TANK DATA Date Installed L�`Z�`�3 Sizey Cie No. of Compartments 1 Standpipes dyw Air -tight Capsto/m, Foundation Cleanout Depression over Tank) Date Last Pumped - 3-2-77-.-8 L Pumping/Maintenance Contract on File (Y/N) J`r ; for Holding Tank High -Water Alarm (Y/N) 1 +� Temporary Holding Tank Permit (Y/N) r Separation Distances from Septic/Holding Tank: To Water -Supply Well ,yot To Building Foundation st To Property Line la t ♦ To Disposal Field To Waters a4e AService Line 3a` To Stream, Pond, Lake, or Major Drainage Course k - Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata3�' Type of System Design Date Installed Le '- Z —'_7 3 Length of Field ! Width of Field -5 5 Depth of Field S Gravel Bed Thickness Square Feet of Absorption Area Li�� Standpipes Present clbxy Depression over Field Pea Date of Last Adequacy Test 3"31-8b Results of Last Adequacy Test r--> �-J Separation Distance from Absorption Field: To Water -Supply Well kbo t �- To Building Foundation Lot To Water Mai ,Service Line ©i. �t acs t +- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments — D. LIFT STATION Date Installed . To Property Line I C) To Existing or Abandoned System on On Adjoining Lots 3 b t til To Cutbank (if present) , Dimensions 3 C�( 4- Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all M9A an HAA guidelines in effect on the date of this inspection.:,_ w Signed S & S Engineering Date G SRO 196x A* At, Company layle River, Alaska 9957Y MOA No. a,► �� .••• ••'�•,�• � ��. % Receipt No. x-79 3 "7 -7 l sus •,rem•+• so Date of Payment � ••'"' e sereew Amount: $ . ,P A. !alar e ;ur• • °• tip, 1 r� d'•• fi Page 2 of 2 72-026 (11/84) } 5. LEGAL DESCRIPTION DA rE RECEIVED INSPECTION APPOINTMENTS TIME NUMBER OF,BEDROOMS TIME TIM DATE Three ❑ Six DATE D3E�:v 0 INDIVIDUAL* INSPECTOR COMMUNITY INSPECTOR INSPECT �00 depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM M�4ilANCHORAGE YEAR ON-SITE SYSTEM WAS INSTALLED. Vtff. OF H :ALTH & MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION • i L 2 1980 825 L Street - Anchorage, Alaska 99601 JUL ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 R E 1 E `V REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWN !!7�� bbit C� G_ S PHONE MAILING ADDRESS p p PROPERT REFSI ENT (If ifferent rom above) PHONE 2. BUY aJ L ` PHONE MAILING ADDRESS �Z 2 3. LENDING INS U ION PHONE .. d %�r o?7 9? MAI LIN6 ACUAE78s 4. REA OR/AGE T PHONES 7LO MAILING ADDRESS �� 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY ❑ One 1:1 Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY 0 INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM X INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) 72-010 ( Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY - 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ TWO ❑ FOUR ❑ FIVE ❑ OTHER ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: 1000 If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER o TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Se r Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS PROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE -1y a BY 72-010 ( Rev. 6/79) Bobbie Chargois Target. Inc. Realtors 1021 W. 25th Ave. Anchorage, Alaska 99503 Subjects Lot 1, Tract H, Broadwater Freights Subdivision Approval for your individual sewer and water facilities can not be granted until the following Items have been completed; �( 4 The septic tank pumped with a reciegt submitted, to this ,_��!� 'office. (2) An adequacy test be performed on the existing Leaching area. Mis test will determine if the system is adequate 4�p�&-Oftavdddggt6o National Standards. A listing of pr&vate firms performing the test is enclosed. This report needs to be submitted to this department for our review. (3) The wateraanalysis report be delivered to this office from the Chem Lab, 5633 B Street, for our review. If there are any further questions, please contact this oftiee at 264-4720. Sincer&lit, Roiarert C. Pratt, R.S. Associate Specialist :RCPjkas cc: Alaska stational Bank 4f the Pleoth mortgage Loan Division Pouch 7-010 99503 Target Realty ATTENTION: Dick Brown 1021 West 25th Avenue Anchorage, Alaska 99503 Dear Mr. Brown, DAVID A. SLENKAMP MECHANICAL ENGINEER 694-9055 July 8, 1980 ROBERT A. SHAFER CIVIL ENGINEER 694-2979 Reference: Lot 1; Tract H; Broadwater Heights Subdivision A sewer system adequacy test was performed on the system located on the referenced property. The septic tank was pumped and in accordance with Municipality records has a capacity of 1000 gallons. The seepage pits were charged with 1000 gallons of water and after a period of 24 hours all the water which had been added to the pits had percolated from the system. It can be concluded from this test that the sewage system is currently functioning adequately for the three bedroom residence located on this property. If we may be of further assistance, please do not hesitate to call. Sincerely, f ERT A. SHAF 'R, P.E. !� S/ss c: Municipality of Anchorage Department of Health and Enviornmental Protection SRB 196X EAGLE RIVER, ALASKA GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received January 5, 1976 �d 4 Time of Inspection rt(�� Date of Inspectiony t REQUEST FOR APPROVAL OF 4�2 �. INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval requested by: National Bank of Alaska % Earl Carson Mailing Address: Post Office Box 3-3859, 99509 Phone: 279-2506 x 16 2. Property Owner: Travis L. & Barbara S. Barber Phone: 694-9408 or Mailing Address: Post Office Box 66, Eagle River 752-4041 (Barbara) 3. Legal Description: Lot 1 Tract H Broadwater Heights Subdivision 4. Location: NHN Sweetwater Circle, Eagle River 5. Type of facility to be inspected Single Family No. of bedrooms 3 6. Well Data: Individual A. Type gxgjil-f0 B. Depth 96' C. Construction S r N �i¢�Q , D. Bacterial Analysis S9r Sf/l�� 7. Sewage Disposal System: On—site system. A. Installed 6/72 B. Installer Klondike Excavating C. Septic Tank: 1. Size &oe 2. Manufacturer D. Seepage Pit: 1. Absorption Area �� % _ 2. Material (,"py ege rc - E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank ` Z 7 Absorption area -1!5rO Sewer Lines , Nearest lot line ,5r 7 Other contamination B. Foundation to septic tank , Absorption area G C. Absorption area to nearest lot line 0 9 EQ -034 (1/74) Page 1 of two pages D��'i`^`iI h !"il1�i fi��f:;�.ti� J(jRi;UUMUNICIPALITY OF ANCHORAGE %. it V 1 r0lli!iil DEP; .TMENT OF HEALTH & 333Q Ic" -taI 4Liu S FI n C h 0 r a J 0, A] a s k a 9 J 5,D `� i`i NMENTAL PROTECTION 274-.4S6l FOR APPROVAL OF JAN �:) �9�C 1 NDIVI DUAL SEIWIER & 11ti T EI; rACIL; � = I� C-sRECEIVED I Type 0- n s p e c *ion: Ci10 iailin g 4- Address: 6t1vA & -7,15,2 's ;Y{ 3 Uy �r<� IG�� u `:`r t i 0 X10 3. y ,�a 4 G1` Buyer: M 'S' ' D "ailing Address.Phone �o�r a e o " Lend , / .'� i nig I,,s i i cLlt oil MAL f.i-AZA' Irfa i I i rig Address. abr.'- a ��rclk�,�!//z= L M„��,�% Na.^e 0-1 Realtor „ or A JC e t..Jr�j�RA Nailing Address: i my`O/14� ✓y 3s 6. Legal Description. L 0 c a C 7 n. 6 7. .Type QI Facility to be �. Inspected: _ L;.- f1:0 Zm Wer Sj.rpply Type o; Supply: PL;biJ { I is .- �Cf 1 0 C{i r I r° ; vi dL�al , rG,,,��er � /n�11 7 I1 J .. 1fS li��jL/ i ItgS preSLid.nL►y .Jer I0ci g. Sewage t7-isposa7- Sys-.�941-7. e,,, Typeo I` Sys Lnm.7 _. rJ1I�l is UL{ I, Ly ry lntlt kori-site) I; ind;'vidLral> ddtE: 0 k— inctallation y Page 2 of two pages - Re st for Approval of Individual er & Water Facilities Legal Description Lot 1 Trach H Broadwater Heights Comments Approved Y� Disapproved Date Approval,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM i certity 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 satisfac ri1y. SIGNED Date a EQ -034 (1/74)