HomeMy WebLinkAboutBROADWATER HEIGHTS TR D BLK 2 LT 2Broadwater
Heights
Tr 0 Blk 2
Lot 2
#050-131-35
On -Site Water and/or Wastewater 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: OSP151380
Tax Code Number: 05013135000
Work Type: SepticTank Upgrade
Permit Effective Dates: November 25, 2015 to November 24, 2016
Design Engineer: GARNESS ENGINEERING GROUP LTD
Subdivision: BROADWATER HEIGHTS
Site Legal Address: BROADWATER HEIGHTS TR D BLK 2 LT 2 G:0253
Owner/Address: GROHOL JOHN V & STACEY L
28906 BONNEYVIEW RD TOLLHOUSE CA 936679744
Site Mailing Address: 11610 BIRCH HILLS DR, Eagle River Lot Size in Sq Ft: 29030
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.
Receive
Issued E
-,
MUNICIPALITY OF ANCHORAdt'
Community Development Department Ta
RUSH!e: 907-343-7904
Development Services : 907- 343-7997
On -Site Water & Wastewater ProgramOV 2 4 2015Mayor Dan Sul!111% ah 3
On -Site Sewer/Well Permit lication
For A Single Family Dw fi H 9
Parcel I.D. 0456— 35
Property owner(s) JOHN
Mailing address 11610
& STACEY GROHOL Day phone 307-251-2979
BIRCH HILLS DRIVE *EAGLE RIVER, AK 99577
Site address 11610 BIRCH
HILLS DRIVE *EAGLE
RIVER, AK 99577
Legal description (Sub'd,
Block & Lot) BROADWATER
HEIGHTS; TRACT D,
BLOCK 2, LOT 2
Legal description (Township,
Section & Range)
Lot Size
Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DEWELLING:
(Rall that apply)
Initial
❑
Single Family (SF)
Absorption Field
❑
(w/wo ADU)
Septic Tank
Upgrade
®
Duplex (D)
❑
Renewal
❑
Holding Tank
❑
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
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.
GARNESS ENGINEERING GROUP, Ltd.
(Signature of property owner or authorized agent)
Permit/Rush Fees:
Date of Payment:
Receipt Number: eV't6` oor�
Permit No. —0,5{
- -35FV Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
(Rev. 01/11)
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
November 23, 2015
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Rd.
P.O. Box 196650,
Anchorage, AK 99519-6650
(907)343-7904
Ref: Proposed Septic Tank Upgrade for Broadwater Heights; Tract D, Block 2, Lot 2
To whom it may concern:
The existing three (3) bedroom house on the referenced property is served by AWWU water
and a private septic system. The existing steel septic tank is 33 years old and needs to be
upgraded. We are proposing to decommission the existing tank and replace it with a new
1000 gallon septic tank. The water line has been located by One Stop Services.
We are unaware of any adverse impacts this installation may have on adjacent wells or
septic systems. If you have any questions, please contact us at 337-6179. Thank you for
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com
t�
CC E
SEPTIC
�I
I
_\Gz
6j
.� Op
/BROADWATER
HEIGHTS; TRACT
BLOCK 1, LOT
r
1
1
1
ve
�REA
BROADWATER
1 HEIGHTS; TRACT D.
BLOCK 1, LOT 18
1 PUBLIC WATER
L
IT BROADWATER
HEIGHTS; TRACT D,
II511Esni BLOCK 1, LOT 17
CSERETAC
II PUBLIC WATER
— —10' Utll Esni
/— _ _ — — — — — — —
PUBLIC WATER
BIRCH HILLS
TERRACE #1;
rf-�I)�- BLOCK 2, LOT 4
,( I LRTL FACES OF
PRESCHOOL
BSEP AC
tiI
l
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3"1 E. MMR R . 5110E 101 r M NORAGE, ,N{ 99W7 • PHONE 907) 337-9179 • FM (907) 339-3218 • N4LLSft: n g mmwoo mg.c9m
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
JOHN & STACEY GROHOL 307-251-2979 1 OF 2
LEGAL DESCRIPTION: DRAWN BY:
BROADWATER HEIGHTS; TRACT D, BLOCK 2, LOT 2 PNB
2J
n
L L—
E OF WORK: DATE: ���;,;;;5;*:*J; �
SITE PLAN 11/10/15
TANK DESIGN ONLY
64
AWWU WATER SERVICE
LINE WAS PROFESSIONALLY
LOCATED BY ONE STOP
SERVICES
PROPOSED
1000 GALLON
SEPTIC TANK-
- EXISTING DRAINFIELD
INSTALL MONITORING TUBE
AT EITHER END OF TRENCH
,AND A CLEANOUT AT EACH
/
/ AG RAGE
e.:
H
/
W
/
/
dl
/
EXISTING
�I
-
EXISTINGTO
/
HOME
BE
DECOMMISSIONED
/
o
BY SULUVAN
EI
I
/
HED
N
133' ELM SECTION
LI REISERVATION
w
10' UTIL ESMT
W LL
of
64
AWWU WATER SERVICE
LINE WAS PROFESSIONALLY
LOCATED BY ONE STOP
SERVICES
PROPOSED
1000 GALLON
SEPTIC TANK-
- EXISTING DRAINFIELD
INSTALL MONITORING TUBE
AT EITHER END OF TRENCH
,AND A CLEANOUT AT EACH
INSTALL 1
DOUBLE 1
C/O'ST
EXISTING 1000
3ALLON SEPTIC
PER UPC
` 10' Util Esnt I
\ BIRCH HILLS TERRACE #1; BLOCK 1, LOT 2
\ AWWU WATER
\ IMPORTANT: THERE IS MINIMAL ROOM
ON THIS PROPERTY FOR A FUTURE /
DRAINFIELD; THEREFORE, THE NEW
\ \ TANK SHALL BE PLACED AS CLOSE
AS POSSIBLE TO THE DRIVEWAY SO /
\ \ \ AS TO PRESERVE THE AREA BETWEEN /
\ THE TANK AND DRAINFIELD FOR A /
FUTURE DRAINFIELD. /
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3)01 E W" R . MM 101 • PNONO9ROE, M 99607 • PHONE (90)7 JJ) -61)9 • FM (90T 3JB-3968 • K Sn- w. �...w..ui..a
PREPARED FOR: I PHONE NUMBER: PAGE NUMBER:
JOHN & STACEY GROHOL 307-251-2979 2 OF 2
LEGAL DESCRIPTION: DRAWN BY:
BROADWATER HEIGHTS; TRACT D, BLOCK 2, LOT 2 PNB
TYPE OF WORK: DATE:
�_ SEPTIC TANK DESIGN UPGRADE 11/20/
/
/ AG RAGE
e.:
H
W
/
dl
/
EXISTING
�I
-
EXISTINGTO
/
HOME
BE
DECOMMISSIONED
/
o
BY SULUVAN
WATER WELLS /
I
HED
133' ELM SECTION
LI REISERVATION
10' UTIL ESMT
W LL
INSTALL 1
DOUBLE 1
C/O'ST
EXISTING 1000
3ALLON SEPTIC
PER UPC
` 10' Util Esnt I
\ BIRCH HILLS TERRACE #1; BLOCK 1, LOT 2
\ AWWU WATER
\ IMPORTANT: THERE IS MINIMAL ROOM
ON THIS PROPERTY FOR A FUTURE /
DRAINFIELD; THEREFORE, THE NEW
\ \ TANK SHALL BE PLACED AS CLOSE
AS POSSIBLE TO THE DRIVEWAY SO /
\ \ \ AS TO PRESERVE THE AREA BETWEEN /
\ THE TANK AND DRAINFIELD FOR A /
FUTURE DRAINFIELD. /
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3)01 E W" R . MM 101 • PNONO9ROE, M 99607 • PHONE (90)7 JJ) -61)9 • FM (90T 3JB-3968 • K Sn- w. �...w..ui..a
PREPARED FOR: I PHONE NUMBER: PAGE NUMBER:
JOHN & STACEY GROHOL 307-251-2979 2 OF 2
LEGAL DESCRIPTION: DRAWN BY:
BROADWATER HEIGHTS; TRACT D, BLOCK 2, LOT 2 PNB
TYPE OF WORK: DATE:
�_ SEPTIC TANK DESIGN UPGRADE 11/20/
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL- PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
NEW
s�
1
DE
MAILING ADDRESS
pp
LEGAL DESCRIPTION
L J < Z P !? .,9 7, fe.
LOCATION
NO. OF BEDROOMS
UY
DISTANCE TO:
Well
()� ��
Absorption area!�l
L
Dwelling
M
PE . T O .
d 17
a QManufacturer
!
Material.
Noof tompaftn4ents
Cn
Lic. capacity in gallons
Inside length
Width
Liquid depth
IF HOMEMADE:
G Y
DISTANCE TO:
Well
Dwelling
PERMIT NO.
Jaz
= Z
Manufacturer
Material
Liquid capacity in gallons
DISTANCE TO:
Well p
Foundation %v/a
Nearest lot line
PE ITN
=
W V
w
No. of lines J
Length of each line./
+
Total length of inV
Trench vv
Distance bet een lin s
/cc
�'D—
inches
�%
Top of tile to finish grade
Material beneath tile
�C�
Total effective a4bso n area
'4
inches
Length
Width
Depth
PERMIT NO.
W
C7
aF-
Type of crib
Crib diameter
b e th
Total effective absorption area
Wa
WWell
w
B Iding foundation
Nearest lot line
DISTANCE TO:
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
Building fo at'
r lin
Septic tank
Absorption area(s)
DISTANCE TO:
OTHER
PIPE MATERIALS
Pvc
SOIL TEST RATING
l �o e0000za
INSTALLER
REMARKS
�3
.► f Q
i 5 1
•••e•+nG0
•
!r
Rohert A. .' b
/�'••• No. 145 .*
So
.. +•
%%, PRQF£SSIly" '
t
E
r
I I
APP OV D DATE] LEGAL' P.MINr�
2C "M IVEO"I, ALASKA 5I1
012-03 (Rev. 3/78)
I
���x (0 x !F"> FA L.- 1 _T- "-v' 114 F`�" F:� C',A-11 IC -'N Ci.`i�
DEPARTMENT HEALTH AND ENVIRONMENTAL -7OTECTION
825' STREET, ANCHORAGE, HK 9- 31
264-4720
CML.L. F"I P4 [It K-) 01_Es :E -F E" K EE L4 �r-1 1
PERMIT NO. ( 811009
APPLICANT EDWARD MHYER 917 COR[OVH c\��l�\ 27-54]0
LOCATION BIRCH HILLS DR.
�
LEGAL LT. 2 BLK. 2 BROADWATER HTS TR.0�~�:�'
LOT SIZE 30000 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR)= 116
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
cO ���=
�������all, �������_�
~^
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD.
THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION(IN FEET).
THERE IS NO SET WIDTH FOR TRENCHE?
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
HND THE BOTTOM OF THE EXCAVATION (IN FEET).
�F-i r -A F,--- �X - FEE-. LEA CA ED C3 Fi L_ L_ CA rA 15
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
714 CA �22! -7--if T F"F--. C.-,-7 I lr_A.t--4"a-.' F1 Ff E" FT E= G-! kJ I����
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL
MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND
TO H COMMUNITY SEWER LINE 15 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS
AVAILABLE TO INSURE PROPER INSTALLATION.
lF" 104 FT! 1-11 0- F` I FT EO co E> EO C? E� tl ED En FQ �T lL�
I CERTIFY THAT
1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOM& .
SIGNED 4 �. .. _______________
\ MUNICIPALITY OF ANCHORAGE
•\ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
❑ SOILS LOG
t
❑ PERCOLATION
TEST
PERFORMED FOR: ""aww G, e- DATE PERFORMED: !o
LEGAL DESCRIPTION: 1-2 eO / aL/l (.0) / �✓aqk
DEPTFY SLOPE I SITE PLAN
1
2
3
4
5
6
7
8
•--•9
10
11
12
13
,4
r'
15
16
17
18
19
20
'#/C -5/L 7-3*Vd
��Aelr nv)
Jgti tle- /
74
/0o X oe
• .rs
sem'
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
I F
f-
Y'-/
■■■■■■■■■■
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
00
S
PERCOLATION RATE Pi
(minutes/inch)
TEST RUN BETWEEN FT AND
FT
COMMENTS
PERFORMED BY: S a�gir1��+ x1I CERTIFIED B A
72-008 (6/79)
DATE:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4744
Application Date February 19, 1988
1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 2; Block 2; Broadwater Heights; Tract D
PA
Location (address or directions)
Birch Hills Drive
(b) Property Owner Ed Mayer Telephone: Home
Mailing Address
694-5536 Business
(c) Lending Institution Vola uocue rcainier Telephone
Mailing Address
(d) Real Estate Company and Agent RE/MAX OF EAGLE RIVER — Virginia Kohfield
Address 16600 Centerfield Drive, Suite 201, Eagle River, Alaska 99577
Telephone 694-4200
(e) Mail the HAA to the followina address: or: Check here IN, if hold for pick up.
List contact person and day phone number below.
S & S ENGINEERING/694-2979
17034 Eagle River Loop Road, Suite 204
Eagle River, Alaska 99577
TYPE OF RESIDENCE
Single -Family E]
Number of Bedrooms
2
3. WATER SUPPLY
Individual Well ❑ Community ❑ Public IN
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 Ea 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 (Rev MM Front
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
Telephone
Address S & S ENGINEERING
17 034 Eagle River Loop Road
Date Eagle River, Alaska 99577
6. DHHS APPROVAL
H
Approved for bedrooms by
Approved Disapproved Conditional _
Terms of Conditional Approval
CAUTION
Date
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
certificates based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in
order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data
before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional
engineer's work.
Page 2 of 2 72-025 lRev 8/86) Back
PSG\>,O! S\O�
MUNICIPAL .'F NICIPALITY OF ANCHORAGE (MOA)
DEQ ALTH AUTHORITY APPROVAL (HAA)
EAL PROT CHECKLIST - FEBRUARY 1984
FE81�b f. t 264-4744
N\Alk!� Legal Description: ��
A. WELL DATA REC" �A—��
Well Classification n If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N) Date Completed
Total Depth
Static Water Level
Cased to Depth of Grouting —
Pump Set At
Casing Height Above Ground Sanitary Seal on Casing (Y/N) —
Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N)
Yield
Separation Distances from Well:
To Septic/Holding Tank on Lot -Zc� "4` ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot 2� !4- ; On Adjoining Lots —
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
; Date
Water Sample Test Results
Comments H . 0. 4'!!:
B. SEPTIC/HGL9IN TANK DATA
Date Installed -7 `Z4E3 `t32 Size I c2C24-2 No. of Compartments
2
Standpipesd% N) Air -tight Caps (DN) Foundation Cleanout (Y/Kp N
Depression over Tank (Y/& Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) ; for
Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/HeW449Tank:
l!
To Water -Supply Well �L'» ')' To Building Foundation -' ±
To Property Line 0 4` To Disposal Field
I
To Water Main/Service Line ` c:) 4- To Stream, Pond, Lake, or Major Drainage
Course l 4:�D
Comments
Page 1 of 2
72-026 (Rev 8/86) Front
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata (1 '� Type of System Design' ��-
Date Installed 1 Za — 82— Length of Field S,
II 1
Width of Field �� Depth of Field �•�
Gravel Bed Thickness
Square Feet of Absorption Area � Standpipes Present(JX%)
Depression over Field (Y/6?r-, Date of Last Adequacy Test
Results of Last Adequacy Test�--
Separation Distance from Absorption Field:
I
To Water -Supply Well Z,e;:�c::, 4 To Property Line
I,
To Building Foundation
r�
Lot
To Water Main/Service Line
To Exis in or Abandoned System on
On Adjoining Lots
To Cutbank (if present)
To Stream/Pond/Lake/or Major Drainage Course 1 eco
To Driveway, Parking Area, or Vehicle Storage Area
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
** Check Permitted Bedroom Rating Against HAA Request **
Vent(Y/N)
Cycles during Adequacy Test. Meets MOA
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed S & S ENGINEERING Date
17034 Eagle River Loop Road
677 -ce,,3
Eagle
River, Aas a ter„ i Ik
Receipt No. ZU w''`f.,
Date of Payment
Amount: $ / ��y gJ,n` r'` eal
v.
Page 2 of 2
72-026 (Rev 8/86) Back
n
m �f
HEALTH AUTHORITY
APPROVALS
ROBERT A. SHAFER
CIVIL ENGINEER
February 19, 1988 694-2979
Mr. Dan Bolles
Municipality of Anchorage
Department of Health and Human Services
SEWER & WATER
825 L Street
MAIN EXTENSIONS
Anchorage, Alaska 99501
REFERENCE: Lot 2; Block 2; Broadwater Heights; Tract D
SEWER & WATER
Dear Dan,
INSPECTION
This letter pertains to the conditional Health Authority Approval given
for the referenced property. We have been informed that the private
well located on the referenced property has been retained for limited
ENGINEERING STUDIES
use. A site inspection revealed that one faucet within the lower level
AND REPORTS
of the residence is still served by the well. The owner, Ed Mayer,
claims this is because he prefers to drink well water.
Bacteriological and nitrate water samples were taken and found to be
WELL INSPECTION
satisfactory. ( results attached) An inspection of the well revealed
&FLOW TEST
a casing more than 12 inches above ground. A sanitary seal is present
and the ground slopes away from the well. Electrical wires at the
well head were placed in conduit at this time. The well is located
more than 100 feet away from any on-site septic systems.
SITE PLANS
Request you issue a final Health Authority Approval for the referenced
property.
ROAD DESIGN
If you require additional information, please contact Roger/694-2979.
Sincerely,
SOIL TEST�`�
ROBERT A. SHAFER, P.E.
RAS/ss
PERCOLATION
MUNICIPALITY OF AWHORAW
TEST
DEPT. Of HEALTH &
ENVIRONMENTAL PROTECnON
FEB 191988
STRUCTURAL&
MECHANICAL
INSPECTIONS
RECEIVED
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
AL
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
TELEPHONE (907) 562-2343 5633 B Street
Anchorage, Alaska 99518
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY
❑ PUBLIC WATER SYSTEM I.D.# Analysis shows this Water SAMPLE to be:
PRIVATE WATER SYSTEM
WSatisfactory
El Unsatisfactory
Name Phone No.
1�C----_� ❑ Sample too long in transit; sample should
b _ 1) S -t '�Y C�"I not be over 30 hours old at examination
Mailing Address to indicate reliable results. Please send
new sample via special delivery mail.
SAMPLE DATE:
Mo. Day Year
SAMPLE TYPE:
,Routine
❑ Check Sample (for routine sample
with lab ref. no. ) ❑ Treated Water
❑ Special Purpose ❑ Untreated Water
SAMPLE
NO. LOCATION
Ler PSL Z�
2
3 I ��
4 I
5I !
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Time
Collected
Collected
By
Date Received 2 r /'L~ 2-9:
Time Received 1-1/00
Analytical Method: Membrane Filter
* No. of colonies/100 ml.
Lab Ref. No. Result* Analyst
14�15-0- I M0
m
-_._..+UNICja1OF ANCHORAGE
F HEAUR -&--
Nviiz f pifIIim PROTECTION
II FE IIB 191988
BACTERIOLOGICAL WATER ANALYSIS RELIC D I V E D
2
'Membrane Filter: Direct Count Coilform/100ml
Verification: LTB BGB
Final Membrane ilt r ults Coilform/100ml
1. r U
Reported By Date //gzff
Time: / a.m.
p.m.
TNTC = Too Numberous To; Count
OB = Other Bacteria
PART I OF 2 REMAINDER TO FOLLOW
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343
FEDERAL TAX ID # 92-0040440
LABORATORIES
ANALYSIS REPORT BY SAMPLE fox Work Order # 5267
Date Report Printed: FEB 19 88 @ 11:13
Client Sample ID:L2, B2 BROADWATER HTS.
PWSID :UA
Collected FEB 18 88 @ 10:30 hrs.
Received FEB 18 88 @ 14:00 hrs.
Preserved with :NONE
Analysis Completed :FEB 18 88
Laboratory Supervisor :STEPHEN C. EDE
Released By : C- 44-/
.......................................................................
Special
Instruct:
Chemlab Ref #: 9150
Parameter Tested
----------------------------
NITRATE-N
Sample ROUTINE SAMPLE
Remarks:
Lab Smpl ID: 1 Matrix: Water
Result/Units
----------------------------------
ND(0.10) mg/1
Client Name S & S ENGINEERING
Client Acct SNSENGP
P.O.# NONE REC'D
Req #
Ordered By
Send Reports to:
i)S & S ENGINEERING
2)
Allowable
Method Limits
-----------------------------------------
EPA 353.2 10
MUNICIPALITY OF AN04OR"
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
FEB 191988
RECEIVED
..............................................................................................................
1 Tests Performed IN See Special Instructions Above UA -Unavailable
ND- None Detected " See Sample Remarks Above
NA- Not Analyzed LT -Less Than, GT -Greater Than
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4744
Application Date February 9, 1988
1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, b subdivision, section, township, range)
Lot 2; Block 2; Br adwa r Heights T D
Location (address or directiorjs)
(b) Property Owner ria 1'qaVeW
Mailing Address
(c) Lending Institution Gold D
Mailing Address
(d) Real Estate Company art Agent
Address 16600 Ce terf
Telephone 6941
(e) Mail the HAA to the followina
List contact person and day p
S & S E EERING/
17034 E le 'ver
Eagle Ri r, Ala
2. TYPE OF RESIDENCE
Single -Family IN
Number of Bedrooms _
Raini
ss: or:
numb,
+2979
Loop R d,
.a 99577
Telephone: Home 694-5536 Business
Telephone
OF EAGLE RIVER — Virginia Kohfield
e, Suite 201, Eaqle River, Alaska
here), if hold for pick up.
to 204
3. WATER SUPPLY \j
Individual Well ❑ Commun' ❑ ublicg
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 ER 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 (Rev 8/W Front
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 Telephone
Address 170Facie Riyer i ms Road U.. nA
Date
Eagle River; Alaska 99577
6. DHHS APPROVAL
Approved for Ma_bedrooms by _
t
A,prpruve
Terms of Conditional Approval
2-112_.)-
° ine S
Date zZWItional
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Hexh Authority Approval
certificates based only upon the representations given in paragraph 5 above by an independent I
ofessional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their, le ding institutions in
order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspection or analyze data
before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in he professional
engineer's work.
Page 2 of 2 72-025 (Rev 8/e6) Back
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