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Home My WebLink AboutVALLEY VIEW TERRACE BLK 2 LT 11 Municipality of Anchorage Page / of~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343:4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~-~ "~]'~.4:::~)/'~, PID Number: ~~/~ N~ ~' ~ / ~ 'Wastewater System: D New ~pgrade ~ ~ /~ ~ ABSORPTION FIELD Phone~+. ~/~ INo. of B~ms: ~DeepTrench~hallowTrench ~Bed ~Mound ~Other LEGALDESCRIPTION so,, Rating: I-~GPD/Sq. Ft. Total Depth fromorigi~,~/ Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe Lot:l/ a,ock:~ V~ Vl~J ~ ~ Ft. . ~ Ft. Township: Range: Section: Fill added above original grade: Gravel length: WELL: D New ~ Upgrade Grave~~ ~J Ft. Number of lines:~ [D~stancebehveenlines:~ ' Ft. ~n ~: Total'Depth: Cased To: Total absorption area: Pipe material~,~ ~ Driller: DateDriged: StaticWaterLevel:Ft. ~ ~~ Date installed: Yield: GPM ~ PumpSet at: Ft. [Casing HeightAboveGround:Ft. ~ ~/~4~ TANK SEPARATION DISTANCES ~eptic ~ Holding ~ S.T.E.P. To Septic Absorption Lift Ho,ding ~ublic/Private ~~~ Capacity in gal,ons: From Tank Fie~d Station Tank Sewer Lines . ] ~ S~W~,r t~ [~ ~ ~ ~ LIFT STATION Remarks: BENCH MARK Assumed Elevation: I ~ ENG,[~L Inspections performed by: ~N~:lst~ ,2nd~~ ~~~,~ ~*o:.,~.~,.~.,,.~,: Department of Health and Human Services approval ~',.~ Reviewed and approved by: ~ ~~ Date: 72-013 (1/91) MOA 25 P~rmit No. '~--[~ '~"<:~:>~:~)l '~ Page ~-- of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description~ -'~i ~ [[ PlO No.: 72-013 A (2/91) MOA 25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920012 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:MILLER DALE L & OWNER ADDRESS:HC BOX 1593 EAGLE RIVER, AK 99577 DATE ISSUED: 2/05/92 EXPIRATION DATE: 2/05/93 PARCEL ID:05035216 LEGAL DESCRIPTION: VALLEY VIEW TERRACE BLK 11 2 LT LOT SIZE: 44867 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ~3~WELL TO BE INSTALLED PRIOR TO CONSTRUCTION OF NEW gTRENCH. MONITOR GROUND WATER THROUGH 5/15/92. IF GROUNDWATER LEVEL RISES RESUBMIT DESIGN FOR APPROVAL. 3) THIS PERMIT WILL BE AMENDED TO INCLUDE THE LEACH FIELD UPON VERIFICATION OF pROPER GROUNDWATER SEPARATION. RECEIVED BY: ~ ~/~" ~ DATE: DATE: z ;%0£ ~ Z , 3o~gdfl N~q¢ 3&IS PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920012 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:MILLER DALE L & OWNER ADDRESS:HC BOX 1593 EAGLE RIVER, AK 99577 DATE ISSUED: 2/05/92 EXPIRATION DATE: 2/05/93 PARCEL ID:05035216 LEGAL DESCRIPTION: VALLEY VIEW TERRACE BL 2 LT 11 LOT SIZE: 44867 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1o 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: UPON VERIFICATION OF P,~OPER GROUNDWATER 1) WELL TO BE INSTALLED PRIOR TO CONSTRUCTION OF NEW TRENCH. 2) MONITOR GROUND WATER THROUGH 5/15/92. IF GROUNDWATER LEVEL RISES RESUBMIT DESIGN FOR APPROVAL. 3) THIS PERMIT WILL BE AMENDED TO INCLUDE THE LEACH FIELD SEPARATION. DATE HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ROBERTSHAFER, P.E. ROGERSHAFER, P.E. January 23, 1992 CIVIL ENGINEERS (907) 694-2979 Muni~p~ity of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. ~ox 196650 Anchorage, Alaska 99519~6650 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION RECEIVED REFERENCE: Lot 11; ~loek 2; Valley View Terrace RequeSt you issue a permit to drill a w~ll (application subm~ed January 17, 1992) and upgrade the septic leaehfi~d s~rving the referenced property. From the ~tached site plan you will observe the proposed leachfi~ld w~ be installed less than 50 ft. from ~wo separate cutbanks. The first cutban~ is created by the d~veway and we fe~l it is minimal enough to be disregarded. Th~ second ~utbank ~r~ated by Lower T~rrace Drive is substanti~. However, the proposed separation distance is 45 ft. which should be sufficient to prevent surfacing of effluent through the bank. We ~o fe~l the septic effluent would tend to follow the assumed water tabl~ gradient. Th~ gradient mu~t follow the contour of the land or the groundwater encounte~at 12 ft. within our test hole wou~d day~b~e through the bank. The compacted soils under the driveway may ~o aid in d~touring the horizontal migration of effluent toward the cutbank. We do not anti~ipat~ a negative impact on n~ighbo~ng properties by the inst~la~ion of th~ proposed w~ll and s~ptic system. Sincerely, ROGER J. SHAFER, P.E. RJS/gm ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 SCALE SITE PLAN UPGRADE SLOPE VARIES 10%-50% ~ 30%~ z E ./ PROFILE UPGRADE N.T.S. SCALE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED LEDA' DESCR,PT,ON: 2 3 5 7 8 9 10 ~2 13 18 19 2O WAS GROUND WATER ENCOUNTERED? DEPT"?'FVES'ATW"A* E Depth to Waler After [~. Date: I' Monit0rinD? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE '~,'~ (minutes/inch) PERC HOLE DIAMETER ~(~ TEST RUN BETWEEN ~' FTAND ~ FT COMMENTS PERFORMED BY: 17034 Eagle River Loop Road No, 2,~4"~__. (/'~ ~-CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev, 4/85} FOLD ~ & ~ ~,g~eer~g ~ 7~ EA~LE R~¥ER LOOP R~ADi ~U~TE EAGLE RIVER, ALASKA 99577 MESSAGE ROBERT A. SHAFER, P.E. 694-2979 FAX: 694-1211 HEALTH AUTHORITY APPROVALS EXCAVATING I CIVIL ENGINEERING WORK ARRANGEO I ADEQUACY TESTS ! SOIL TESTS WATER & SEWER LINES & MAIN EXT. ON SITE INSPECTIONS DATE OF MESSAGE ~ ROUTING SYMSOL I REPLY From: DATEOFREPLY SIGNATURE OF REPLIER IROUTING SYMBOL TITLE OF REPLIER RETAINED BY ADDRESSEE Munii;ipality of Anchorage Page I of~'~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: 'c::~'~..~::'c:::'~:>':~ PID Number: Na~~ ~ ~~ Wastewater System: D New ~Upgr~de ~ ~ ~ ~ ABSORPTION FIELD / Phone: ~ _~,~ INo. of~ooms: ~ Deep Trench ~ Shallow Trench ~Bed ~Mou~Other LEGAL DESCRIPTION Soil Rating: Total Depth fr~nal grade: GPD/Sq. Ft. Lot: [[ Block> Subdivision: Depth to pipe hot,om from original grade: Gra~beneath pipe To~ ~ ~ I~. ~~ Fill added above original grade: ~ ~avel length: Ft. WELL: D New ~ Upgrade Graveldepth: ~ Number of lines: ~D,stancebetweenlines: Ft. Ft. ation(Private. A,B,C): Total Depth: Cased To: Tot~area: Pipe material: Driller: Date Dril,ed: taticWaterLevel:Ft.~;~=~ ~ Date instal,ed: Yield: GPM IPump Set at: Ft. ICasing Height AbOVe Gr0und:Ft. TANK SEPARATION DISTANCES ~septic ~ Holding ~ S.T.E.P. TO Septic Absorption Lift Holding ~ublic/Pr[vate Manufscturer: Capacity in gallons: From ,/Tank Field Station Tank Sewer Lines ~~ ~ ~ Well ~ ~l [~l ~ ~ ~t+ Ma~~ Number of C~rtments: Sudace m~ w.t~ t~'+ i~'~ ~ ~ ~ LIFT S iz"ino""on : I Line ~ ~ Fo O ,,on ,t' Cu~ainDrain ~ ~)~ ~~ ~ =ump Ma~ & Model ~ Electrical Inspections peHormed by: Remarks: BENCH MARK Location and Description: Inspections performed by:~ ~ ~ ~,, ~ates: 1st J~ 1~ Department of Hea~>~~vlce, approval Reviewed and approved by: ~/~4_ Date: ~ 72-013 (1/91) MOA 25 Permit NO. '~'~:='C>~:::~3f~ Page '~' of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: ~_ v~'~.-~--- ~'-~.-- ! I.--'~:~ t / PID No ' l'S S 72-013 A (2/91) MOA 25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT NUMBER:SW920004 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:MILLER DALE L & OWNER ADDRESS:HC BOX 1593 EAGLE RIVER, AK 99577 PAGE PERMIT DATE ISSUED: 1/17/92 EXPIRATION DATE: PARCEL ID:05035216 LEGAL DESCRIPTION: VALLEY VIEW TERRACE BK 2 LT 11 SEC 15, T14N, R1W, SM LOT SIZE: 44867 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. 1 OF 1/17/93 1 SPECIAL PROVISIONS: EMERGENCY PERMIT TANK REPLACEMENT ONLY. WELL ENCROACHMENT MUST BE ADDRESSED NO LATER THAN JUNE 1, 1992. BY THAT DATE A SITE-PLAN WILL BE MADE AVAILABLE TO THIS OFFICE COMPLETE WITH NEW WELL LOCATION, SOILS TESTS, WATER MONITORING AND NEW SEPTIC DESIGN, PER AMC 15.65. ISSUED BY: _ DATE: DATE: HEALTH AUTHORITY APPROVALS SEWER &WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ROBERTSHAFER, P.E. ROGERSHAFER, P.E. January 17, 1992 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 MUNJCIPAUTY OF ANCHORAGE ENVIRONMENTAl- SERVICES DIViSiON Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVI D REFERENCE: Lot 11; Block 2; Valley View Terrace Subdivision; Request you issue a permit to replace the septic tank and d~ a new wall to serve the referenced property. In 0c~ober of 1991 we performed an adequacy test on the existing septic system and a flow test on the existing w~ll. We found the absorption capaclty of the septic lcachfiald to be inadequate for obtaining a Health Authority Approval. The wall production was mi~al at 19 g~ons per hour (GPH). On January 6, 1992 in an attempt to rejuvenate the existing septic system the leachfiald was treated with 110 gallons of 50% hydrogen peroxide. On January 11, 1992 a new septic adequacy test was performed and unfortunataly we found the absorption capa~y still inadequate for a H~alth Authority Approval. Due to the lack of room on the property to upgrade the septic system without installing an expensive lift station and terraced dr~nfields uphill from the house to the north, and due to the low production of the existing well, the property owners have de~ided to dr~ a new wall and install a new septic system on the property. However, during the recent peroxide trea~ent of the septic system we found signs of f~ilure of the existing septictank. Excavation of the tank on January 16, 1992 found the tank to have collapsed. Unfortunataly, the optimium location to replace the septic tank is in its current location which is too close to the existing well. However, since the septic tank is in need of immediate replacement we are requesting a permit to replace the septic tank under the cond~on the w~l is retocated more than 100 ft. from the n~w septic tank next summer, 1992. We are also requesting a p~rmit to drill a new w~. During the installation of the n~w septic tank, test holes will be excavated in front of the hoase to design a new seepage trench. This proposed trench area is designated on the attached site plan. Once a design is performed, we will request a permit to install the new seepage trench. ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Page Two Lot 11; Block 2; Valley View Terrace Subdivision; January 17, 1992 Since there currently exist~ an exposed, co~apsed septic tank on the property, your dmmediate attention to this p~rmit application is requested. If you require additiono~ information for review, please contact us. Sincerely, ROGER J. SHAFER, P.E. RJS/gm SCALE UPGRADE F ~GRE~~' '2 ANCHORAGE AREA BOE. ~H. ~j~ Department of Environmental Quality ~ 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~'~ l/.../..,- LOCATION SEPTIC TANK: LEGAL DESCRIPTION /~¢~'¢ /]2 PHONE /<2 I)~ [/~ U, ~ DISTANCE NUMBER OF FROM WELL ~;~t MANUFACTURER ~-2~ ~/~¢6~ MATERIAL 5/g~/-~ COMPARTMENTS INSIDE WIDTH INSIDE LENGTH LIQUID DEPTH LIQUID CAPACITY /'~-'~"-(~) GALLONS. SEEPAGE PiT: NUMBER OF PITS / DIAMETER ~' OR WIDTH /~/ LENGTH~'//, DEPTH ~¢' /' LINING MATERIAL ~'~ [dX~' CRIB SIZE, DIAMETER__DEPTH DISTANCE FROM: . .~A~ ~o~.~ 2~' A~O.,~,O. ~A ~WA..A~A~ WELL /~' SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE CONBTBUCT,ON BUILDING NEAREST NEAREST FOUNDATION__ LOT LINE SEWER LINE CESSPOOL OTHER SOURCES APPROVED ~/~ DISAPPROVED REMARKS DEPTH DISTANCE FROM: SEPTIC ~ SEEPAGE TANK , SYSTEM DISTANCES: INSTALLED BY: PIPE MATERIAL: REMARKS: Form NO, EQ-031 DIAGRAM Of SYSTEM DATE GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street ANCHORAGE, ALASKA 99503 Performed For ~,Y/ /~.~rd/ Legal Description: Lot Block This Form Reports Soils Log - Soil Test Must Be Logged To 4' Depth Feet Soil Characteristics 4-- 5-- 6m ll-- 12-- 13-- 14-- Was Ground Water Encountered? If Yes, At What Depth? Case # Dated Performed ~,/~/> ~ Subdivision Percolation Test Below Proposed Seepage System - I I Reading Date Gross Time Net Time Depth to H20 Net Drop I .Percolation Rate Minute Proposed Installation: Seepage Pit Depth of Inlet Depth to Bottom of Drain Field Pit or Trench Test Performed BY_/~L. sl ~9~-~07/ Date Certified BY: Date: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site serVices Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# 050-352-16" 1. GENERAL INFORMATION Complete legal description Va~.ey V±ew Lot 11, Block 2 Location (site address or directions) NHN Lower Terrace, Eagle River Property owner Mailing address Lending agency Mailing address Agent Address Kjell & Judy Risunq Day phone H~ Rt ~ 1~qt: ~gl~ P~v~r. AK 99577 Alaska Home Mortgage/John Anderson Day phone P.O. Box 196850, Anchoraqe, AK N/A 99519 Day phone 696-4378 563-3033 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ' 3 '~ TYPE OF WATER SUPPLY: Individual well Community well/ Public water X NOTE: If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer X NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91 ) Front MOA ¢Y21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulationsin effectonthe date ofthisinspection, Phone 995?? Name of Firm Eagle River Engineering Services Address P.O. Box 773294, Eagle River, AK Engineer's signature ~ 694-5195 Date DHHS ,SIGNATURE / Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: Date 6 J The Municipality o,f<Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certifi~:at~ based only upon the representations g van n paragraph 5 above by an ndependent professior~al 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 certific~,te is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72~'Z5 (Rev. 1/91) B~ck MOA ;t21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. Well Data Well ~pe ~/V~ If A, B, or C, attach ADEC letter. ADEC water system number Log present (WN) Total depth /~ / Cased to Sanitaw seal (Y/N) FROM WELL LOG AT INSPECTION Date of test / Static water level Well flow Pump SEPARATION DISTANCES FROM WELL TO: Septic/~g tank on lot Absorption field on lot Public sewer main ~/A Public sewer manhole/cleanout Sewer service line ~ ~O / Petroleum tank ~ ONE WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: ~ ~,/~//9 ~ / /4//~/'Z----- Other bacteria Collected by: z~,~ ~; ~' B. SEPTIC/HC,~,~}NG TANK DATA Date installed ~)///'?/~ ~' Tank size /~'¢¢ Compartments Cleanouts (Y/N) yr~'~ Foundation cleanout (Y/N) !/~-~ Depression (Y/N) High water alarm (Y/N) ~///~ Alarm tested (Y/N) /V/~ Date of pumping /~'~/$//5)¢ Pumper ~-~-,~- SEPARATION DISTANCES FROM SEPTIC/i"I~E~NG TANK TO: Well(s) on lot '-//0~ ~ On adjacent lots Foundation J ~ ~ To property line ¢--__~0 / / Absorption field Lf (_p I Water rc~t4cr/service line 7'/'~ Surface water/drainage -f/00 72-026 (3/93)' Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Manufacturer Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at ".BufrC"~Level at High water alarm level _~O~ycles tested Meets MOA electrical codes (Y/N) _~ ~n lot On adjacent lots Surface water Date installed Length /¢,~ / Total absorption area Date of adequacy test Water level in absorption field before test /.2, Peroxide treatment (past 12 months) (Y/N) ~-/./.-':[ D. ABSORPTION FIELD DATA 0~',/¢'.~/¢'~-- Soil rating (GPD/Ft2) /.~- (~P~,/¢ Systemtype ~/'~£/~/~--// Width -~ / / Gravel thickness .~ '~ / , Total depth ,~ '~ 5 ¢ Cleanout present (Y/N) /~-~ Depression over field (Y/N) ~5/~//95 Results (pass/fail) P,/,¢ ,~-~ for ~/~/~ Bedrooms After test /'~-' ~'" If yes, give date /,//~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ~1(.)0' To building foundation On adjacent lots /c- Surface water Curtain drain _ /V//~ On adjacent lots '~/OO ! Property line /~ / To existing or abandoned system on lot Cutbank ~..~ / Water ~i~'service line Driveway, parking/vehicle storage area /, ~ E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name Date ,¢'- HAAFee$ r~. ¢ Date of Payment Receipt Number _~ Waiver Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back CT&E Environmental Servic;s Inc. Labora~m'~ Division ~'~ ~='~ "*~"-~ Laboratory Analysis Report 100 W. Potter DHva, AnChorage, AK 99518-1605 -- T~.I; (907) 562-2343 Fax: [907) 561-5301 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # L_~._~C'~ - ~/--,.-.'~\~,.~ 1. GENERAL INFORMATION Complete legal description Lot 11; Block 2~ Valtey View Terrace Location (site address or directions) Lower Terrace DRive Property owner Mailing address Dale L. Miller Day phone California Lending agency Mailing address Day phone Agent Virginia Kohfi~d RE MAX OF EAGLE RIVER 16600 Centerfi~d Drive Address S~te 201 Day phone 694-4200 Eagle RZver, AZaska 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: 3 Individual well XX Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Fronl MOA #21 ')pOM s,Jeeu!Sue leuo!ssejo~d eql u! suo!ssi~uo ~o sJoJ~e ~o~ elq!suodse~ lou s! abeJOqOuv JO X~!l~d!o!un~ @ql 'pans9! 9! e~o!J!P@o e eJojeq ~ep aZ/,leUe Jo suo!~oadsu! ~onpuoo ~ou op SHHC] ¢o seeXolduJ~ 's~uemeJ!nbeJ e~e~s pue leJapeJ u!e]Jao ~s!1es o~ Jap Jo u! suo!ln~!~su! bu!puel J!etp, puc seuJoq ~o sJeseqaJnd o~ Xse]Jnoo e se s!ql saop SHHQ eq/'e~Sel¥ jo ele~9 OLI~ U! pOJelS!§@J Jaau!bua leUO!SSejoJd ~uepuedapu! ue Xq e^oqe g qdeJbeJed u! ue^!6 suo!ie~ueseJdeJ aq~ uodn ,quo peseq seleo!Jl]JeO le^oJddv ,qpoq~n¥ qHeeH senss! (SHHQ) seo!Mes ueumH pue q~leeH lo ~ueuJpedeQ eSeJoqouv jo X~Hed!o!un~ eq± s~uewwoo leUO!i!PPV :suo!~elnd!is 8U]MOIIOI eq~ q]!M 'sLuooJpeq JoJ le^oJdde I~UO!~!puoo 'pe^oJddes!Q ~"1 'suJooJp@q >~ JoJ peAoJddv %/~ alJn±VNgl$ sNNa --~ ~_ ~ ~ ~ e]ea e~n]eu6!s s,]aeu!6u:l Z,'~66 ~t¥ '~a~ja ~l~ sseJppv euoqd ONI~NION~ S ~ S wJ!~ jo eWeN 'uo!~oadsu! s!ql ~o e~ep eql uo ~oe~Je u! suojlelnSeJ pue 'seoueuipJo 'sepoo elelS pue ledio!un~ lie ~M eoueild~oo ul s! ~els~s lesodsip JS~MSj9eM JO/pU~ ~lddns JS~BM 8J~9-UO 8q~ 'uoBoedsu! pue UOlJeSlJS8AU] ~B ~oJJ pUB Sel!~ eSeJoqouv ~oJJ peu~e~qo uo!jeBJo~u~ 8q~ uo pegeq Jeql ~JpeA JeqMnJ I 'u!eJeq po~eo!pul eJn~onJ19 jo edX~ pub 9~ooJpeq jo Jeqmnu eq~ JOj e~enbepe pue leUOlloun] 'eje9 9~ ~olsX9 leBods!p JOleMe~SeM Jo/pue ~lddns Jeje~ elis-uo eq~ ~eq~ SMOqS uo!leoildde leAoJddv ~lpoqlnv qlleeN ~ je~j ~peA ] 'MOl8q UMOq9 elep UO!~ep!leA eq~ ~o se pue oleJeq B~NIDN3 AB NOI~O3d~NI JO ~N~3~Y~ "9 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L,~-I- t l '~::>L-~.. ~- Parcel I.D. A. WELL DATA Well type~"~/'~xl"¢-'' If A, B, or C, attach ADEC letter. ADEC water system number Log present~i~ZN) Total depth [ Sanitary sealdC~TN) ~ Date completed (,~- t,"/.-- q"~ Driller ~'~'~ I~'L tr-~l Casedto ~:~ ~ 'F-~l~singheight Wires properly protected~[:~'N) FROM WELL LOG AT INSPECTION Date of test (.~- ~-" ~1'~ ~ ' Static water level ~ ~ / Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~ ~ ~+ ; On adjacent lots Absorption field on lot ~ ~ ~ ; On adjacent lots Public sewer main ~ /~ ~UbliC SeWe~ ma~hole/claa.out Sawer semice line ~ ~ ~etroleum tank WATER SAMPLE RESULTS: Coliform ~ Date of sample: q ~' I-~'~ Nitrate ~..[ 1 lj~, Other bacteria '~' Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~ ~: [-'~ ~'Z.- Tank size \'~-~ Compartments Cleanouts~N) "-// Foundation cleanout4~zN) ~ Depression.(Y,~ High water alarm (Y/N) Alarm tested (Y/N) Date of pumping ' ~'-~'-V~ Pumper --" SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~ Oc:~ To property line t,c:>~ Surface water/drainage On adjacent lots Absorption field \ ~ I. jo_ Foundation \ '~ ~t.~ water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Vent (Y/N) High water alarm level . "Pump on" level at Manhole/Access (Y/N) . "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Soil rating \ '~' ~'~ ~-'~'"~"/ System type Date installed Length '¢¢ '~' Width ~--¢ ~ Total absorption area '"'~"-~ ~ ''/-' Depression over field (Y~ r-~ Results (pass/fail) ["'J~-~'-~ '~~ Peroxide treatment (past 12 months) (Y~_ ~ Gravel thickness '~"' '~ Total depth Cleanouts present~;ZN) \/ ~ /.~. Date of adequacy test for ~ If yes, give date -- bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot / ~ t 4- To building foundation On adjacent lots Surface water _ Curtain drain ~.~D On adjacent lots ~ c~o I-~ Property line ~, c::~ To existing or abandoned system on lot Cutbank ~ ~ Water main/service line Driveway, parking/vehicle storage area E, ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in $ & $ ENGINEERING 17034 Eagle River Loop Road No. 204[ Signature ~:.,.,I. l~lu¢.- AIn~lrn gq~?7 Engineer's Name _ Date ~ - ~-fl'2~- HAA Fee $ I-'lC~ ,L~~ Date of Payment ~ ~,~ ~ Receipt Number o~M~O&~/ '?'~-~ 72-026 (Rev. 3/91) B~ck MOA 21 Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS RZSULTS for INVOICE t 57227 Chemlab Ref.~ 92.4289 Sample ~ 1 Matxix: WATER FAX: (907) 561-5301 Client Sample ID : Lll E2 VALLEY VIEW PWSID : UA Collected : AUG 18 92 @ 08:40 Reeeived : AUG 18 92 @ 15:30 Preserved with : AS REQUINED Client Name ;S & S ENOINEERING Client Acct :SNBENGP BPO~ : Reqt : Ozdered By :R. SHAEER POt :NONE RECEIVED Analysis Completed : AUG 20 92 Laboratory Supe~)[ls_~ :~PNEN C. EDE Send Reports to: 1)S ~ S ENGINEERING 2) Parameter Results Units Method Allowable Limits NITRATE-N ND(O.IO) mE/1 EPA 353.2 Sample ROUTINE SAMPLE COLLECTED BY; Remarks: 1 Tests Performed See Special Instructions Above UA=Unavailable ND= None Detected *' See Sample Remarks Above NA- Not Analyzed LT-Less Than, GT-G~eate~ Than ~SGS Member O! ,he SGS Group (So¢i0'0 G~n~rale de Surveillance) F-"NICIPALITY OF ANCHORAGE ~ ~ Department of Health and Environmental Protection :825 L Street, ~lc]oraqe, Alaska 99501 ' ' 279-2511, ext. ~24, 225 '"-'~quest for Approval of Individual Sewer and Water Facilities Property Owner: Mailing Address: Name of Buyer: Mailing Address: Realtor/Agent: Mailing Address: ~.~,~..,X.~-ZS;. Lending Institution: ~.'L~? ~' 2~' ~ , ~ ~,~ ~) G Phone: Mailing Address: ~L), 4~ /~a,¢ ~:~;~¢: ~,'u'~ ~/~ Phone: Legal Description: ~, Street Location: /3~ Single Family Residence: Phone Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: *Individual Well (~ If Individual Well, well depth ~..TO If Community System, name of system Public/Community System Sewage Disposal System: On-site System If On-site System, date of installation: ~x~' Public System ( ) *NOTE: A we.ll log .[s required on ALI, wells drilled since 6/75. 3/77 DAVlD A. SLENKAMP ROBERT A. SHAFER MECHANICAL ENGINEER 694-9055 September .25, 1979 CIVIL ENGINEER 694-2979 Mr. Bill Lyford c/o Sun Realty P.O. Box 1201 Eagle River, Alaska 99577 Dear Mr. Lyford, Reference: Lot 11; Block 2; Valley View Terrace Subdivision A' sewer system adequacy test was performed on the system located on the referenced property on September 19 and 20~ 1979 at the request of SUn Realty. The septic tank was pumped and in accordance ~th ~nicipality records, has a capacity of 1250 gallons. The seepage pits were charged ~th 1000 gallons of water and at the end of a 24 hour period had percolated a~y approximately 500 gallons or 167 gallons per bedroom. As a result of the above test, it can be concluded that the system is adequate for a 3 bedroom home. Department of Health and Enviornmental Protection Sun Realty SRB 196X EAGLE RIVER, ALASKA ~ t{~ Thur~: ~.m. ~. (~-%~ Meet :~-~Sun Realty 9-13-79 · Pratt - ~IUI~IcIJ~/~Lll 'r Ul- ANCHORAGE · ' ~UNICIPALITY OF ANCHORAGE D~PT. OF ~;5.:'Li'H ~ DEPARTMENT OF HEALTH & ENV RONMENTAL PROTECT ~N/I ,O~v,~HTAL P,O EET ON 825 L Street - Anchorage, Alaska 99501 SEP 1 2 1979 ENVIRONMENTAL ENGINEERING BlVlSlON RECEIVED DIRECTIONS: Complete aH parts on page 1~ Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER Bill/Gail LYford PHONE 694-9784 MAILING ADDRESS Post Office Box 195 99577 PROPERTY RESIDENT {If different from above) PHONE 2. BUYER PHONE Bruce L. Duncan 694-2859 MAILING ADDRESS Post Office Box 575 Fort Richardson, Alaska 99505 3. LENDING INSTITUTION Coast Mortgage Companyt % Rose MAI LING ADDR ESS 4797 Business Park Boulevard 99503 PHONE 279-0665 4. REALTOR/AGENT Pete Ostdiek, % Sun Realty MAI LING ADDRESS Post Office Box 1201 99577 JPHONE 694-2509 5. LEGAL DESCRIPTION Lot 11 Block 2 Valley View Terrace Subdivision STREET LOCATION Lower Terrace Drive 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four [~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six [] Other 7. WATER SUPPLY [~ INDIVIDUAL~ * ATTACH WELL LOG. A well Icg is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach Icg ]f available.) 8. SEWAGE DISPOSAL SYSTEM []~X: INDIVIDUAL/ON-SITE** **lfindividual/on-site, give installation date 7/74 . If system is over two (2} years old an adequacy test is required [] PUBLIC uTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCE$SINi2 CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY ' ' DATE RECEIVED INSPECTION APPOINTMENTS · TIME TiME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS; 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [~ THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SlX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED [~]PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER 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 [~i--~APPROVED FOR --"~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED ~(~.~. DATE BY (Tit~ LEGAL DESCRIPTION '~-¢ - 72-010 (Rev. 3/78)