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Home My WebLink AboutUPPER EAGLE RIVER ESTATES BLK 2 LT 4A MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT .am~ DISTANCES ~'~'-'~ '/~:' &~ WJg,P ~ SEPTIC ABSORPTION ^ddre~ ~ WELL p, O ~O~L ~/ ~ ~ ~ ~ TANK FIELD Ph~n~{s) -- Pem~it NO. ~ Ino. of Bedrooms WELL ~-Z~ ~ ~00~ ~ LOT LiNE LEGAL DESCRIPTION Township, Range, Iq~j IWj' ~(c Z T driveway.AS-'UJLTwaterDJAGRA"bodies, etc)(Sh°w location of ~e,I. septic system, p,ope,ylines. ,ounOation. ~ SEPTIC ~ HOLDING ~ ~ Manulact re~ Capacity in gallons TYPE OF SYSTE~~) ~ " 2 ~TRENCH ~ BED ~ W. DRAIN ~OTHER ~'~ UE~ ~C,~ 5~ / &jj~t/__ Depth to pipe bottom from ~otal depth from original grade Gravellength~ ~ / GravelwiOth / FT ~, ~ FT Total abs°rpti°n area / D~stance between lines Number ol ii.es ~ Pipe material ~PRIVATE ~ OTHER (Identify) ~ ~ Clarification (A,B,C) Total Depth Cased to FT Inspections Pedor ' 59" iTo~4~&gle ~[ver L~p No. zue 72-013 (3/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: L~ I~ ~ 3~?~¢r_~ Township` Range, Section: -'"'~ ~_~./.,~ ~ I,~'~ 1 2 3- 4- 5- 6- 7 8 9 10 11 12 13 14 15 16 WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT ~) DEPTH? p E Deplh 10 Water ~ ,' M0nit0rinD? 1,~ Y~'"7 Dale: Gross Net Depth to Net Reading Date Time Time Water Drop (minutes/inch) PERC HOLE DIAMETER ~ C~ FT COMMENTS PERFORM~I~4 EagJe River Loop~Road No. 204 Eagle Rlver~ Alaska Y~*',' CERTIFY THA.,.T- THIS TEST WAS PERFORMED ACOORDANCE-WITHALLSTATEANDMUNICIPALGUIDEL,,~E~EE~ONTHISDATE' DATE: IN J...i::rL ! xa(:la ] ~ S!..tb d :i v J. !i[, i .'.:;)ri [ !!};~c t'. :~. on: :!.7 L.o'~' !3:iz~:~ 4-6'500 (~C:l. ~k,~, i::)! CEi]:?T ]: F:Y ') J.J(:~ T :: for'!:.h by 'k.l'i~? l"h.~.n:ic:ipa].:i.t.y of Anc:l"lc)r'ag~s? (I"IOP~) and 'Ll"l~_~) [~'La'L~* of Alaska. and in c:cimp].ia, nc:ea ~/.~J. Ch ~:,.lae~ d(s?,ign cPi'L¢~,r'ia oF t. hi~ p6:}r.m:L'L. ]: ~,,xJ. 1]. adl'x:~r'c~ t..c:l all 1'l(3(.~ and SCALE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG m PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Depth to Waler ~ ,. monitoring? Y y---"/ Dele: Gross Net Depth to Net Reading Date Time Time Water Drop "~', ~,~ ~o '" zA~/~::~~' PERCOLATION RATE "~ (minutes/inch) PERC HOLE DIAMETER Es Ru. ETwEE. FT 13- 14- 15, 16- 17- 15- 19- 20- COMMENTS ACCORDANCE WiTH A~L STATE AN D~UNiCiPAL 'G/~7~II~ECT ON THiS GATE. DATE: 72-008 (Rev. 4/85) MUNiCiPALS'fY OF ANCHORAGE ~ DEPAR'rMENT OF HEALTH & ENV~RONM£NTAL PROTECTION ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAILING ADDRESS LEGAL DESCRIPTION LOCATION --~: I DISTANCE TO: I ~ ~ Absor~tio are ~ Manufacturer I DISTANCE TO: Iw.,, D Well ~z ~No. ofhnes / ~ ~ Top of~i~to fini~ grad~ ~ ~ Type of crib Crib d' ete ~ ~ DISTANCE TO: Well ~ lClass Depth ~ DISTANCE TO: Building foundation Inside length Dwelling Crib depth Driller Sewer line NO, OF BEDROOM.~.~ PERMIT NO. No. of compartments Liquid depth Material Neares~lJine r ~ Trench 'dth /, ~0 inches OTHER PIPE MATERIALS REMARKS PERMIT NO. Liquid capacity in gallons ptJon area PERMIT NO, Total effective absorption area Building foundation Nearest lot line Septic tank Absorption area(s) Distance to lot line PERMIT NO. LEGAL PERMIT DEPRRTMENT ~E. HEALTH FIND ENVIRONMENTAL .Fz~.uTEuTIuN 825 "1 ~STF'.EET., ANCHORAGE., Ak:. 9'~ ]. ( °E:OO47~L ', FF LI _.ANT LOCRT I ON LEGAL GEORGE NRDE FOz, r OFFICE BO;,< 541 99._,, ,. 694-90t0 WREN '= _,TREET LOT 4-R BLOCK 2 U. EAGLE RIYER ~_%~t~j:3. LO1''=_,I~E~ ..... ~¢4ARt.] _,641JHRE'= - ' FEET TYF'E OF=,'-OI'L HE_ORPTIoN- ' '= ' ' '=_,~_,TEfl' '-- ' ' I=,.'- ' TRENCH MA>:ilMLIM NLIMBER 0F E, EDROOM~ = =< =,l_liL RRTIN~ (SQ FTrE, R..,- 24'--] ]"HE REI~.P_IIRED cTM c; c-.,, - ,- =,I~E OF TFIE _OIL RB_,tJRFTIuN SYSTEM I=,: E:' E P T ~---~ = :i.E-': LEI"-IG TH= 6 "::': "~ R F'i %-' E L E:"EPTH= ~.~.-;, THE LENGTH DIMENSION IS THE LENGTH <IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFRCE OF THE GROUND AND THE BOTTOM OF THE E~CRYRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). F'ERMIT RF'F'LICRNT HAS THE RESF'ONSIBILIT~' TO INFORM THIS DEPARTMENT DLIRING THE · ':, ' I" -I '- ffl ~E'T,- INSTALLATION IN_FE..TIEhI= OF RN~' WELLS RDJRCENT TO THIS PR_F ...... AND THE NLIMBER OF RE-,I[:,ENE. E=, THAT TFIE NELL WILL SERVE. .............. TIL..,~C, ,:: ~ ..., l: t'--~E;PECT T Cil'-.IS RF-:E F;: E,....'3. LB I E, HI_.}..FILLINu OF AN"r' -,'¥-,TEM WITHOUT FINAL IN~,FEbTIuN AND FIPPROYAL B'¢ THIS DEPARTMENT WILL EE =,UB-J'EuT TO PROSECLITION. MINIMUM DISTANCE BETWEEN R WELL RND ANY ON-SITE SEWAGE DISPOSRL SYSTEM IS ±00 FEET FOR R PRIVRTE WELL OR &50 TO 200 FEET FROM R PUBLIC NELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM R PRIYRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET RND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY RPPLb'. SPECIFICATIONS AND CONSTRUCTION DIAGRRMS ARE RVRILABLE TO INSURE PROPER INSTRLLRTION. F'E 'F--:~-I Z T E~,:P Z RE'Z:; [)EC:-E~E:EF~ ]~-1 .. it' ..... ':~ -':-" ~.:~: I CERTIFY TFIRT &: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY ]'HE MUNICIPALITY OF ANCHORAGE. 2: I WILt. INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. -, I bNED. ........................................ FIPPLICANT GEOP. GE WR[:,E r-lgf1,-.I Z r--: Z PRE. I -T"-r' . t~fF' r:,EF'RRTMEt~'"°~OF HEALTH AND' EN ~ Z F L I',,H"IENT¢'~ PROTECT ! ON 825, L" STREET., ANCHORAGE, AK. _. . ,.r~_..~ 264 -472E~ I-IELL R1,-.IE:, F-j I'.4--'_=~ I TE "..~]E I--4 E F~: F'ERP1 I T PERMIt HA ~,( ~ LOCATION (.,C) ~ ~/O ~F, TYRE OF SOIL F4B~ORPTION _,~:,TEM MAXIMUM f.gJME;ER OF BEDROOMS = ~ SOIL RATING THE REQUIRED SIZE OF THE SOIL ~E,:,ORPTIRN _,~:,TEM I:,. - [:,E F' T H =' /~ LEb''3T"= g~. '3 F, R%-'E L THE LEHGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE D~z'~TRNCE BETWEEN THE SLIRFRCE OF THE GROUND RND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET NIDTH FOR TRENCHES THE ~RR/EL DEPTH IS THE MINIMLIM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE Bt-iD THE BOTTOM OF THE EXCAVATION (IN FEET). RE,DEl I RED SEF'T I C TRr4K S I ZE--' PERMIT APPLICANT HAS THE RE~PONSIBILITY T_ INFORM THIS DEPARTMENT DURING INSTALLATION INSPECTIONS OF ANY 14ELL:, ADJACENT TO THIS PELFERT~ RNC, I'HE NUMBER OF RESIDENCES THFIT THE HELL WILL _ERVE. THE TI-,.I Cl ( 2 ) I 1'-,I__'SPE C T I 01'45 ARE BH~kFILLING OF ANY SYSTEM WITHOUT FINAL IN_PEETION AND [:,EPRRTMENT NILL BE SUBJECT TO PROSECUTIOH. F-:E 6)LI I E:E[) APPROVAL BY THIS MINIMUM DISTRHCE BETWEEN R WELL AND RNY ON-SITE SEHRGE DISPOSAL SYSTEM IS 10~] FEET FOR B PRIVATE WELL OR 15L~ TO 2~0 FEET FROH B PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC NELL MINIMUM DISTANCE FROM B PRIVATE HELL TO B PRIVATE 5EHER LINE IS 25 FEET TO R COMMUHITY SEWER LINE IS 75 FEET. PlELL LOGS ARE REQUIRED RHD MUST BE RETURNED TO THE DEPARTMENT WITHIN 2:8 DRYS OF THE HELL C:OMPLETION. OTHER RE6R.IIREMEHTS MAY BPPLY. SPECIFICATIONS RHD C:ON%TRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER IHSTRLLBTION. PERI"11 T' E,':--::F' I F:ES [":-,EFI3EPIE:ER 3:it_.. t'9:3~Z~ C:ERT I F'-F' THAT I RM FAMILIAR WITH THE REQLIIREMEHT$ FOR ON-SITE SEWERS AND WELLS RS SEt I 1: FORTH BY THE MUNICIPFtLITY OF RNCHORF~GE. 2: I HILL INSTALL. THE SYSTEM IH ACCORDANCE WITH THE CODES. Z: I UfI[',ERSTRND THAT THE OH-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE I S_ REMODELED TO INCLUDE MORE THAN g BEDROOMS ~F'pL I C:~NT MUNICIPALITY OF ANCHORAGE [] SOILS LOG DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST SOILS LOG -- PERCOLATION TEST / · ' 1 2 3 5 6 7 '7-' 8 9 10 11 14- 17~ 18- 19 20 Robert A. COMMENTS PERFORMED BY: PERCOLATION RATE__ ~ ~7 (minutes/inch) Gross Net Depth to Net Reading Date Time Time Water Drop 0 0 0 0 0 0 0 0 0 0 0 0 0 LA. LA. 0 0 0 0 0 0 O~ 0 PERMIT N0, ( DEPRRTMENT~-or HERLTH RND ENVZRONMENTR~ ~-ROTECTZON 825 264-4728 ~,~ELL PE~:~ Z T 800682 ) APPLICANT LOCATION LEGAL DON MYERS E.R. LT 4-R BLK 2 UPPER E. R. SRA BX 624~ PALMER EST LOT SIZE ~76-'~0~1 ±5000 SQURRE FEET MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS %00 FEET FOR A PRIVATE WELL OR ~50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE PROM A PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTRLLATION. F'E~:~.~ ~ T E::-IF~ I F-:E'?; L]:,EC;E~--1E:EF~; 7__~:1.. ::L'-=3:3 ~-TM I CERTIFY THAT i: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SE]' FORTH BY THE MUNICIPALITY OF ANCHORAGE. R: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. V4. 0 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH'AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D.# 050-781-16 HAA# HA89-0020 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 4A Block 2 Upper Eagle River Estates Subdivision Location (address or directions) Corner of Raven and Wren (b) Property owner Mailing Address (c) Lending Institution Mailing Address George Wade Telephone:(home) Business PO Box 541 Eagle River, Alaska 99577 Northland Mortgage TeJeph0ne 694-7872 11431 Business Boulevard Suite l-B, Eagle River 99577 (d) Real Estate Company and Agent Carolyn Mc Phee, Re/Max Address 16600 Centerfield Drive, ~201, Eagle River Telephone 694-4200 99577 (e) Mail the HAA to the following address: (or check here [] , if hold for pick up.) List contact person and day phone number below: S & S Enqineerinq 17034 Eagle River Loop Road, Suite 204 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Number of bedrooms three (3) Single-Family~Q:x 3. WATER SUPPLY Individual Well ~ Community lq Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site ~kx 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. 72-025 (Rev. 7/88) 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 th is 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. NameofFirm S & S Engineering Telephone 694-2979 Address 17034 Eagle River Loop Road, Suite 204, Eagle River 99577 Date Engineer's Seal 6. DHHS APPROVAL Approvedforthree(~droomsby ~~/~Date July 7, 1989 Approve~XXXX Disapproved Conditional Terms of Conditional Approval As per the Conditional Approval of January 25, 1989, this property has been upgraded and now meets with MOA Code of Ordinances. This property is now fully approved. The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72~)25 (Rev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING ['~_~,("~) -'-~ ~ ~ - ICC. HAA# ¥~¢,°1 - ~(~)¢-~'~:~ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Lot 4A: Block 2; Upper Eaqle River Estates Location (address or directions) Corner of Raven. and Wren (b) Property'owner Georqe Wade Telephone: (home) Mailing Address P.O. Box 54~ .Eaq~e River, Alaska 995?7 (c) Lending institution Northland Mortgage Telephone Mailing Address 11431 Business Blvd. Suite l-B, Eagle River, Ak. (d) Real Estate Company and Agent Re/max-- Carolyn McPhee Address 16600 Cent~rf~e]d Dr. ~20l, Eagle Ri.v~r, Ak. 99577 Telephone 694-4200 (e) Mail the HAA to the following address: (or check heretiC, if hold for pick up.) List contact person and day phone number below: .Business 694-7872 99577 S & S ENGINEERING .. ". 17034 Eagle I~iYer lioop Road'No. ~04 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single-Family [~ Number of bedrooms 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 th legality and status· 4. SEWAGE'DISPOSAL On-site C~ 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. 72-025 (Rev. 7/88) Page 1 of 2 ')pOM S,JOeU!BUe leUO!SSOJoJd eql u! suoms~wo Jo ~JoJJ@ JoJ elq[suodseJ lou s! e6eJoqouv jo,q[led!o!unl~ eqJ. 'penss! s! oleoWPeo e eJoJeq elsP ez,qeu~ ~o sUOilO~dSU! lonpuoo lOU op SHHQ jo see/~oldw3 'slueweJ!nbaJ elels pu~ leJopej, u!~3~eo/~j,s!les ol JepJo u! sUO!lnl!lOu! 5u!puel J!eql pue sewoq j,o sJeo~qo~nd ol ,~smJnoo ~ se s!q~, seop SHHQ eqJ. 'mtselV j,o elelS eql u! pe~els¢~eJ Jeeud~uo leuo!ssej,oJd ~,uepuedepu! ue,~q e^oqe S qdeJ§eJed u! ue^!B suo!le~uesoJdeJ eql uodn/[lUO pessq pelBoWJeo }e^oJddv,~lpoq~,nv qltseH senss! (SHHQ) seo!^Jes uewnH pu~ qll~eH jo lUOWlJedeQ e§~Joqouv j,o Al!led!o!unl~ eq.L ..~HJ ,4~ ..~a~fi/~d~ -..~-L.~7~1-"/O,) ~ ~O.:J /(~7/'y(JJ~/ c~O~)~ IOAOJddVleuO!I!puOOj'OswJe/ /~ leUO!l!puoo peAo.ldd~B!C], , peAoJddv / Aq owooJpeq JoJ poAo,lddv 'lVAOIdddV SHHi3 '9 ouoqdele± sseJppv wJ!-I j,o OWeN ~e¢"MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 A. WELL DATA Well Classification Well Log Present.N) ~ Total Depth ~ Cased to Static Water Level Casing Height Above Ground Electrica Wiring in Conduit ~}N) Date Completed ~5-'-~\ -- ,i~c~' ~ Depth of Grouting (¢¢~ Pump Set At Lega~l Description: ~:~m' If A, B, C, D.E.C. Approved (Y/N) ~/,~ Yield ,~,~ ~.~'1"~ --~ SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot Sanitary Seal on Casingd[~N) '¢' Depression Around Wellhead (Y,~P_ ; On Adjoining Lots To Nearest Edge of Absorption Field c~ Lot \ ~ '~ ; On Adjoining Lots To Nearest Public Sewer Line t'5/J~ To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot '~ Water Sam31e Collected by ~'~ '~f"~ [~ ; Date \~' \'~'- ~')°l Wate r Sam pie T~est Resu its ~, .~.~i%.~ ~..~- '~..~C ~'"'~/A¢.. L?/!~, ~z. ~%:) Comments ~ ~ ~ \~\~_o~ - No. of Compartments ~/ Foundation Cleanout Date Last Pumped t~ ~¥~t, -~ ; for ~ ~-, Temporary Holding Tank Permit (Y/N) r~/ B. SEPTIC/HOLDING TANK DATA Date Installed ~ ~._:~O Size ~ ~ Standpipes4[i~/N) ~ Air-tight Caps (~N) Depression over Tank (Y.~ ~ Pumping/Maintenance Contact on File~l) ' V / Holding Tank High-Water Alarm (Y/N) rs/~~. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: ~ ~:~ IdJ'~ To Building Foundation ~*=> ~A'~ To Disposal Field To Water-Supply Well To Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course \ ~ Comments %~"~ ~c:~t...- '~',} t'"~i f"'~,, I 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA ~-~ Soils R~ng in Absorption Strata Date Inst~. _ Width of Field'% Type of System Design Length of Field Depth of Field Gravel Bed Thickness Statndpipes Present (Y/N) Date of Last Adequacy Test Square Feet of Absortion Depression over Field (Y/N) ~ Results of Last Adequacy Test ~ _ SEPARATION DISTANCE FROM ABSORPTION FIELD: ~ To Water-Supply Well To Property Line~-~. To Building Foundation To Exis~stem on Lot ; On Adjoining Lots To Water Main/Service Line To Cutback (if present) ~ Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) acy Test. To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Co m m on ts "'~¢r¢-~ ~-~ L ~-~t~-~(~ D. LIFT STATION bS//~ Da%nstalled Size "Pump On"Level ~ ~ High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelin,~s in effect on the date of this inspection. " g, & S ENGINEERING Signed --1703zlFEagt,, ~.-;:;cr Loop Road Nc. 294 Company l=nale River, Alaska 99577 Date MOA NO. Date of Payment Amount: $ 72-O26 (Rev. 7/88) Back Receipt No, Waiver Fee: $ Date of Payment Page 2 of 2 ROBERTA. SHAFER July 4, 1989 CIVIL ENGINEER 694-2979 HEALTH AUTHORITY APPROVALS SEWER &WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN Mr. Dan Roth Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99501 REFERENCE: Lot 4A~ Block 2; Upper Eagle River Estates Subdivision You issued a condit~onal H~Cth Authority Approval (HAA) on January 25, 1989 for the residence located on the referenced property. A condition of this HAA required the absorption area to be upgraded to meet the full requirement of a three bedroom residence. Municipal permit #890005 was issued on January 19, 1989 for the system upgrade. On July 2, 1989 work ms completed in accordance with the terms and conditions of the permit and ~ modified in coordination with you in the field at the start of the project. Attached is a copy of the on-site sewage disposal system inspection report and a copy of the original so~ test showing the test hole was extended to a depth of 18~ feet. A 2 inch PVC monitoring tube was installed in this test hole prior to backfdlting. At the t~me the test hole was excavated and several days afterward~ the hole was dry. now issue a final HAA for the referenced property. SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS A. SHAFER, Ss MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 5 't989 RECEIVED ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Contractual Agreement J.R.'s Cesspool Pumping hereby agrees to service the septic tank located at Lot 4A Block 2 Upper Eagle River Estates. J.R.'s will remove the septic waste every 30 days or less if so required by occupant Rich Moran. The fee for this service will be the dicounted "Frequent Service" rate of $63.00 per pumping. The starting date of service will be 2/19/89 until the system is up- graded to municipal code. J.R.'s Cesspool Pumping Barbara J. Gibbs - Manager Rich Moran ~0~ * Last date of service by J.R.'s -1/19/89 , CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SAt~LE Eot Work Order ~ 11346 Date Report Printed: JAN 20 S9 @ 10:59 Client Sample ID:L4A, B2, UPPER EAGLE R. EST. PWSID :UA Collected JAN 18 89 @ 12:30 hrs. Received JAN 18 89 @ 13:45 hrs. Presezved with :4 DEG. C Client Name : S & S ENGR Client Acct: SNSENGP P.O.# NONE REC'D Req ~ Ordered By : RJS Analysis Completed :JAN 19 89 Send Reports to: Laboratory Supervi;~EN C. EDE 1)S & S ENGR Released By: ==============================~ ~============== ~ ==================================================================================== Special Instruct: Chemlab Ref $: 4009 Lab Smpl ID: 1 Matrix: WATER Allowable Parameter Tested Result/Units Method Limits NITRATE-N 2.4 ms/1 EPA 353,2 10 Sample ROUTINE SA}~PLE. Remarks: SAMPLE COLLECTED BY RJS. ======================= 1 Tests Performed ' See Special Instructions Above UA=Unavailable ND= None Detected "See Sample Remazks Above NA= Not Analyzed LT=Less Than, GT=Greater Than INSPECTION APPOINTMENTS ' TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR MUNICIPALITY OF ANCHO~AGE~oTECTI ~MVIRONMLNtALP O~' ' ,..A:CTION DEPARTMENT OF HEALTH & ENVIRONMENTAL 825 L Street-A,chorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 ~EOUEST FO~ APPROVAL OF INDIVIDUAL WATE~ AND 8EWE~ FACILITIES PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 4. REALTOR/AGENT PHONE 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four [] Other J~J SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six 7. WATER S PLY ~/t~ iNDIViDUAL~ [] COMMUNITY [] PUBLIC UTI LITY 8. SEWAGE D POSAL SYSTEM ~f~l~ll N D i VI DUAL/ON_SiTE~ [] PUBLIC UTI LITY * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) YEAR ON-SITE SYSTEM WAS INSTAl_LED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS E~SINGLE FAMILY [] ONE ~HREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [~INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER N[~']"~DI VI DUAL/ON -SITE DATE INSTALLED Coo nec.~tion Verified INSTALLER [~-tic Tack or [] Holding Tank Size: [r--~C~--~ If Tank is homemade SOILS RATING give dir'nensions: TYPE OF ~ MANUFACTURE~ TOTAL ABSORPTION AREA MATERIAL , 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS PPROVEDFDR ._% BEDROOMS [] CONDITIONAL APPROVAL {letter must accompany certificate} [] DISAPPROVED 72-010 (Rev, 6/79)