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Home My WebLink AboutGROLL #1 BLK 1 LT 3A 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: ¢/o;z o,~' RID Number: -~ %~: ~,~ ~ ~ Wastewater System: u New ~Upgrade ~: ABSORPTION FIELD -Phone: ~ ~ ~ 7 No. °~Bedrooms:~~ Deep 'French ~Shallow Trench ~ Bed ~ Mound ~ Other Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION ~,~ ~/s~.~t, ~ot: Block: Subdivision: Depth to pipe boltom from original grade: Gravel depth beneath pipe ~0wnship: Range: Section: Fill added above original grade: Gravel length: /,~- 3 Ft. ~o/ Ft. . Gravel ~h: Number of lines: Distance ~tween lines: WELL: ~¢'~ U New ~ Upgrade ~'"~ ¢ Fl. ~ /0 ' Ft. ~assiflc~tion (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft, Driller; Date Drilled: ~latic Water Level: Installer: Date installed: ~,~,~: m Pump se, at: casing Height Above Ground: TAN K GPM) Ft. Ft. SEPARATION DISTANCES ~s.puo ~ Holding ~ S.T.E.P. To Septic Absorption Lift Holding =ublic/Pdvate Manufacturer: Capacity in gallons: From Tank Field Stat~on Tank Sewer Lines M~teriah Number of Compartments: Surface ...... LIFT STATION ~/~ Water /¢/~ ~ ~ ~' ~ / Size In gallons: ~ Manufacturer: Lot Line ~ / /~ / - "Pump on" level at: ~ "Pump off" level at: High water alarm at: Foundation ~ / ~ ~ / Puap M~e & Model ~ Electrical Inspeclions performed by: Curtain Drain 2~ / ¢ o ~ ~ Remarks: ~/M ~ z~C¢¢ ~5~/~,/¢/ Loc~tion and Description: Assumed Elevation: ~," ,_. ~ ,, ..,~. . Inspections performed by: ~, ~,~ %, Dates: 1st 2/¢¢ ~;.,~~~, Reviewed and approved by: ~,~ ~,Z~ Date: ~/b-'~[ '~'~'" ' ..... ?' 72-013 (1/91) MOA25 Permit No. -%/'J c)10~'O/-¢ Page 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: _~£0/.-/... ¢// SCALE~ 1~=50' THII5 .[] DIVERTER VA SYSTEH / FIELD II4- TH fl4 NO SURFACE WATER :VACAN-F SWING LUT 10~ UTILITY WELL WALL EAST 290,00' TIES _ HT PT 'A' ; P-r ']~' lA 61,8' : 1~0,8' lB 70,9' 60,8' 8 75,2' 83,9' 3 87,6' ' 98,6' 4 139.8' 186.6' 1500 GAL SEPTIC TANK FIELD IIIB DRAIN FIELD fl3 SYSTEH 'B' (INSTALLED THIS CDNTRACT) 291' 'FRENCH - FENCE / INTD GROUND TEST HOLE MONITOR TUBE SEWER CLEANOUT WELL LEACHFIELD EASEMENT CURTAIN DRAIN 72-013 A (2/91) MOA 25 Permll No. 5pr ¢)/~ P-¢~'-/' Page ~ of -~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SEFIVICES 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: .iL,~-P 5.4 .:¢.-'./¢ / ~-~-,// ~/ PlO No.: ~)~L;b - ~"Zj,,,.~ -El/ ELEVATIE]NS (NOT TO SCALE) 1,4' ADDED FILL ~- 88.4' ~// , ,m/' ~- ORIGINAL t,"' IF'",,/ GROUND ' %0T/-- 80,i, NSULA.ON FIELD 2,2' ADDED FILL ~ 80,5' .J . ~F~ /- ORIGINAL t~,' I I~ ~,,/ GROUND, ~ ,INSULATIUN 77.3' ~ 77,3 FIELD ~2 TOP OF BACK DECK ASSUMED ELEV = 100.00' --I Fq fJO --I ZE o F' 71,5' 3,8' ADDED FILL ~ 79,4' ~ II ~ ~ ORIGINAL t'~ IF ,~ GROUND ~ 3.9'' II ~ LEVEL e 76,2' NO GROUND ~~-- 8' 35 PSI , II WATER %758'INSULATION : II FOUND '~ 75,8' ' ~ 668' FIELD It3 ; 1' ADDED FILL ~-- 67,5' , ~ .~' ORIGINAL t p I~./ ~ROUND "~_ '~: ,INSULATION II F~ELU fl4 72-013 A (2191) 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 99519-665O ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW910204 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:RODDICK JAMES & EVA M OWNER ADDRESS:HC 83 BOX 1672 EAGLE RIVER, AK 99577 PARCEL ID:05052201 LEGAL DESCRIPTION: GROLL #1 BLK 1 LT 3A LOT SIZE: 56450 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 DATE ISSUED: 7/17/91 EXPIRATION DATE: 7/17/92 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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: THE TOTAL LENGTH OF THE DRAINFIELD MUST NOT BE LESS THAN 290 FEET. RECEIVED BY: ISSUED BY: To EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-5195 LETTER Date Subject RECEIVED dlJL 2 6 1991 IVlunicipalit¥ of ^nchorage Dept. Health & Fluman 8orvi~es Please reply [] No reply necessary SIGNED RECEIVED JUL. ~ 6 1991 Municipality of Anc ~90.00' Services VACAI,II- LU 1- HO SURFACE WA1ER .S E I° T I C S I-I- E I~ LA lq LEGAL: LOT 3A, BLOCK I, GROLL SUBDIVISION ~ - 1EST ItOLE · - MOIIIIOR TUBE o - SEWER CLEANOU! -(~)- - WELL Hl,~ml~ - LEACtlFIELD .... EASEMENT OWNER: RODDICI( COHIRACTOR: FI/A JOB # 91-07'l_J L)AI'E: 07/17/9i[ SCALE l" = 60 P.O. Bo:c 773294 ~AGLB I~IV~R, AIl. 9957/ (907) 694.-5195 FAX: (907) 694-3297 PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 SOILS LOG MUNICIPALITY OF ANCHORAGE DFPARTIVlENT OF FlEA/TH ANB ENVIRONMENTAL ,ROTi~:~i..~ E i~ PERCOLATION 825 L, Street, Anchorage, Alaska 99501 264.4720 SOILS LOG - PERCOLATION TEST JUL 2 6 1991 DDAelc~MUnicipaliIY of Anch~)r/~ SLOPE SITE PLAN WAS GROUND WATER S L ENCOUNTERED? .~,/'/~'-~..,C O P E IF YES, AT WHAT DEPTH? ~' ~ ~ Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE -~ (minutes/inch) TEST RUN BETWEEN .~' J~- FT AND .'z_ FT COMMENTS Eagle River EnCneerlng Services ~'~ DATE: PERFORMED BY: P, 0, Box 773294 CERTIFIED BY: Eagle River, AK 99577 694,-5195 EAGLE RIVER ENGINEERING SERVICES P. O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-5:/95 JOB SHEET NO. OF CALCULATED BY CHECKED BY DATE_. SCALE ,,~"~'£ Munibip~ility i~f A:nchbrago Do~t. H~alth & Human agO,O0' VACANT LBT [] - TES~ HOLE · - klONITOR TUBE o SEWER CLEANOUT -(~ WELL IIIIIIH+I~ - LEACHFIELD NO SURFACE WATER .... EASEMENT LEGAL: LOT SA, BLOCK I, GROLL SUBDIVISION ',,"~i'~''' -,,'": .... OWNER: RODDICK ' ::'" CONTRACTOR: N/A JOB # 91-074 DATE: 07/17/91 SCALE 1" ,.., -, EAGLE RIVER ENGINEERING SERWCES EAGLE RIVER, AK. 99577 ,. (90?) S94-5~gS ~'AX: (907) Groll #1, Lot 3 JO8 EAGLE RIVER ENGINEERING SERVICES P. O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-519,5 SHEET NO. CALCULATED BY CHECKED BY SCALE OF DATe 07/17/91 DATE Wastewater ~Design 5 bedroom system = 750 GPD ' i Using 5 w de drainfield Soil Perc Rates~ TH/fl = 27 rain/inch = 0.6 OPD/ft2 TH//2 = 53 min/inch = 0.45 GPD/ft2 TH #3 = 3.9 min/inch = 1.2 GPD/ft2 TH//4 = 3.8 min/inch = 1.2 GPD/ft2 Using TH #1 for 1/2 of Nortll portion and TH //2 for remaining i/2 of system Soil average = 40 min/inch Required absorption area = 750 = 1,666 ft2 0.45 5' wide drainfield with 1' gravel at 2' total depth 1,666 X 0.87 (reduction factor for 1' gravel) = 290 L.F. of trench 5 Utilize existing tank with a diversion valve Revised 07/17/91 Louis Butera, P,E. Registered Civil Engineer July 16, 1991 John Smith, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Lot 3A, Groll #1 Narrative Dear Mr. Smith, The proposed septic upgrade will have very limited impact on ad~jayent properties for the following reasons: 1. The area has large lots allowing sufficient room for septic sites. 2. Immediate neighboring lots have septic systems or wells in place. The neighbor lot to South is a large, unsubdivided tract. 3. Reserve space is adequate. This is the first upgrade of the septic system and will utilize a diversion valve to allow alternating of the leachfields. 4. Drainage will not be effected by septic system installation. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. P.O. Box 773294 · Eagle River, Alaska 99577 · Telephorte (907) 69,14195 . k'ax (907) 694-3297 VACANT LOT ~ - TEST HOLE o - SEWER CL~NOUT -~ - WEt. L ~ - LEACHFIELD NO SURFACE WATER .... EASEMENT SEFTIC SITE PLAN Ca, LEGAL: LOT SA, BLOCK 1, GROLL SUBDIVISION - O~NER: RODDICK {~.~.,,,- ~:~.,'::.~ .,,.v ~,~ 30B ~ 91 0741 DATE: 07/15/911 SCALE 1": 60' m EAGLE RIVER ENGIN~ERIN SERVICES A P.O. Box 773294 EAGLE RIVER, AK. 99577 EAGLE RIVER ENGINEERING SERVICES P. O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-5195 JOB SHEET NO. CALCULATED BY__ OF / DATE__ CHECKED BY DATE SCALE. Wastewater Design 5 bedroom system = 750 GPD Using 5' wide drain#eld Soil Perc Rates: TH #1 = 27 min/inch = 0.6 OPD/ft2 TH fl2 = 53 min/inch = 0.45 GPD/ft2 TH #3 = 3.9 rain/inch = 1.2 GPD/ft2 TH fl4 = 3.8 rain/inch :- 1.2 GPD/ft2 Using TH fil for 1/2 of North portion and TH #2 for remaining 1/2 of system Soil average = 0.525 GPD/ft2 Required absorption area = 750 = 1,429 fL2 0.525 5' wide drain#eld with 1' gravel at 2' total depth 1,429_ X 0.87 (reduction factor for 1' gravel) = 5 249 L.F. of trench Utilize existing tank with a divemon valve MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 82!5 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: L~::~'T %/~ SLOPE SITE PLAN 10 11 12 13 14 1§- 16 17 18 19 2O COMMENTS WAS GROUND WATER - S ENCOUNTERED? y~ L o p IF YES, AT WHAT 7, / E Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~,"~:~- '~ (minutes/inch) TEST RUN BETWEEN [ ' fi FT AND ~-".-----' ~ FT DATE: 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: ~'~"~ 0--ji. ~1,5 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 DATE PERFORMED: \~'-~:;~ SLOPE SITE PLAN 17 18 19 20- COMMENTS WASGROUND WATER S ENCOUNTERED? ~ L O P E IF YES, ATWHAT '?,! ~ ~fN- DEPTH? 7 ~ff~ Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ,~ ,~ (minutes/inch) TEST RUN,ETWEEN ,~' ~ FTA,D .3.,~l · PT PERFORMED BY: ~-'~. ~?-"- ~----*. ,~- CERTIFIEDBY:~ 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST ~' SOILS LOG PERCOLATION TEST LEGAL DESCRIPTION: L~)'~' '"~r~) ~.~-OL-L--,:''~'~ 7/-/3 1 DATE PERFORMED: f SLOPE SITE PLAN lO 11 12 13 14 15 16 17 18 19 2O WAS GROUND WATER S ENCOUNTERED? ~',1~ OL P E IF YES, AT WHAT M/'/R DEPTH? , Gross Net Depth to Net Reading Date Time Time Water Drop (I lo/ PERCOLATION RATE "~, e1 (minutes/inch) TEST RUN BETWEEN '~, / . FT AND A' FT COMMENTS T' ~"~' ~ '~ 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Stroat, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: ~4~2~'-~ ~'~ ~--~"- LEGAL DESCRIPTION: ~-~ ~f~t ~I 1 DATE PERFORMED: '~'~ ,.~.~,.,~ C~ I SLOPE SITE PLAN 10 11 12 13 14 15 16 17 18 19 2O COMMENTS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop ¢~o r~Y~ 2-1 II PERCOLATION RATE '~' ~ (minutes/inch) TEST RUN BETWEEN ~,4 FT AND 3, '~ , FT PERFORMED BY: '~, ~'" · ~- ~' CERTIFIED BY~ DATE: 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DE ~TMENT OF HEALTH AND HUMAN SER~ -~S Environmental Health Division 825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Add(ess Phone{s) LEGAL DESCRIPTION /¢~z' **-J TANKS ~-, SEPTIC ~] HOLDING Ma,e..,~g~-A'.-e. / I~'°'~~;~' TYPE OF SYSTEM []TRENCH [~ BED N~' W. DRAIN [] OTHER orJg,nal grade / F1 ~ FT ;~ FT / FT /',7,..~ FT ~- FT I DISTANCES ~Ro~TO SEPTIC ABSORPTION ___ % TANK FIELD WELL WELL /o0 / LOT LINE FOUNDATION AS-BUILT DIAGRAM lShow Iocanon of wen, sephc systom, ploperly hnes, Ioundanon, Installer WELLS ~' PF{IVATE [] OTHER {Identify) Classfflcahon (A,B,C) }oral J3epth JCased to .7'~A~/Fy1 'rib' FT REMARKS: Scale; Inspections PeH,ormed by. ,, I--.~'~ ~"~'~?~--"~ cedily that Ihis insp0oli0u was podormod according to all Municipal and Stale guidelines in ellecl on Ihi$ date: _ ~/-~..~/dc~'% _ A.)L I ', L,.~ El:=,:; ":, ::; :L } HAN;O WR ;[ T]'EI'-I 06 / ], 7 JAMES RODDICK :~S2 SF'R]:NGBR[]OI< DRIVE EAGLE RIVER, AK 995T7 2'.~5-8129 SUBDIV]:,S:I:Olxl: GROLL 451 SECT I lIN: 25 'TOWNSH Il'-:': 14N :1.. 25A (SQ. F::"I". OR A£]RES) I~"REELISS DRIVE I..[)"1': ~' ..:,A RANGE: IW BLOCK: :1, :1: cert,:i, fyt, hat: :1.,, I am t'amil:i, ar w:i.'Lh the requir'ements f'(::m on.....site sew::,,r's and we:l. ls as se'L forth by 'Lhe Hurl:i.c:ipali'Ly of Ar'ichor'age (MOA) arid the State o~' Alaska. 2. I wi:l.:l, install the system in ac:copdance with all MOA codes arid r'egu:l, at:i. ons, and in coml::~liarice wJ.'Lh 'Lhe design criteria oF th:Ls per'mit, 3,, I w:Ll:l, adher,(:~ to all HI]A arid State of Alaska r'equiremc~nts for' 't'..l'l<::.: set back distarlces Fr'om any existing well, was'Lewa'Ler, disposal sys'J:.em of pLtb:l, ic s(:.)t46~Pag(~ Jsys't. em 01] th:i,l:!: C)l* any acJj~::t::;rgr'lt op r'm)arby :l. crL,, ~F A LZF;']" S'TA'f'ZOIq IS INSTALL,ED IN AN AREA, COVERED BY HOA BULI:L. DZIqG CODES, THI..:Ixl (1) AN E:.I...~,[Yl I::( :I: CAI.... F. EFU.I:I:T AND IIqSF'EC'I~:I:I.)Iq MUST BI:::. (.JB'IA.I. NED, (2) AS.-BJ ~ZLI... N[)'I BE AF'F'ROVED NI"I'HSUT' AN EL.EC]"R]:CJ~)... J;NSF'IECI"ZBN REF'OR'F, "AND C3) PERFORMED FOR: LEGAL DESCRIPTION: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL. PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST ,/~ SOILS LOG PERCOLATION TEST ~2 3 4 5 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS SLOPE PERFORMED BY: WAS GROUND WATER S ENCOUNTERED? YEs L 'O P IF YES, AT WHAT / 7 D,~ ~, E DEPTH? SITE PLAN Reading Date Gross Net Depth to Net Tithe -rime Water Drop PERCOLATION RATE TEST RUN BETWEEN CERTIFIED BY: FT AND FT 72-008 (6/79) 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. # ~O - .~,--.~ - ~)~, HAA # . . Complete legal description Location (site address or directions) ~'1~'1~ ~ ~__¢~ ,1~.¥¢..,.~ ~ Property owner ::~?~ ~ Maiming address _1'~,~5 ¢t~- Lending agency phone Mailing address '¢21~ Agent ,,r.~¢,4~¥ ~ J~ Day phone Address ~\ C~,Z'~V', Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: Day phone TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1191) Front MOA ~21 o 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 furtherverifythatbasedontheinformationobtainedfrom 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 Phone Engineer's signature ~~ ~ D~; ~"*_.~'~"~ DHHS SIGNATURE ,/~ Approved for J bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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. 72~)25 (Rev. 1/91) Back MOA ~21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~r '~¢¢ ~g~lb t ~..V'~[! '~:~/'l~"l;~i4s Parcel I.D. A. WELL DATA Well type ~~ Log present CN) Total depth It~¢ Sanitary seal ~N) IfA, B, orC, attach ADEC letter. ADEC water system number Date completed ~';'~_ '~ ~" Driller ,S¢-, Cased to /,~ f~t,~ Casing height !'~ Wires properly protected (~N) Date of test Static water level Well flow Pump level FROM WELl. LOG AT INSPECTION .f4¢ I.z 0" g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main _ ~/ Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed ~' °~' ~"' Cleanouts ~/N) Collected by: Tank size 1 ?j"'~14~ Compartments Foundation cleanout (~N) Depression (Y/,_._~ Alarm tested (Y,~ Pumper High water alarm (Y/~j~! Date of pumping ,./'~¢~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Welt(s) on lot [0~)* On adjacent lots To property line ~ _Absorption field Surface water/drainage _ _ I¢ Ot'~'' __Foundation Water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ~ '~,~,' Length ,~)11' Width Total absorption area !1~, '~.¢ Depression over field (Y/¢ Results ~),)f8 il) Peroxide treatment (past 12 months) (Y/~) Soil rating -J~-~-~]-~ System type ~ Ir~ Gravel thickness ~ .~(' (~'¢'~lTotal depth . Cleanouts present Date of adequacy test for ~ bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot [~-,~ ! To building foundation On adjacent lots Surface water Curtain drain On adjacent lots ~ ~)l)l~'''' Property line To existing or abandoned system on lot Cutbank ~J/~ 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 e¢ect q.r~t~e., date of this inspection. HAA Fee $ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number June 4, 1993 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 To whom it may concern: This letter is to confirm that I Douglas T. Kenley performed an on-site septic system and water well evaluation of Lot 3, Block 1, Groll Subdivision. In conjunction with my inspection of the property I am able to verify that the residence at the site is a single family dwelling and, at the time of my inspection, was used as such. If there should be any questions concerning this matter please contact me at 746-1073 Sincerely, -- ,~ ~_ ~.. ~Y, State of Alaska Registration(817~ \J J,_li'l Ell '9:_:; !2~5'q FI,:)F.'THEF'.H TE'._:TII'iL:;, AI'.ICHOE'AGE F',2."2 NORTHERN TESTING LABORATORIES, INC, ;t330 INDUSTRIAL AVENUE I~AIRE~ANK$, ALASKA 99~01 907456-3116 2506 FAIRBANKS ST, ANCHORAGE, ALASKA 99502 7920 ~¢ney~uokle D~ive Ancho~agm ;~k 99502 Water System I.D.# Date Received: Date Analyzed~ Date Re.fred: Next sample Due~ 05/21/93 Time Re¢~i~l~ 13:45 05/21/93 Time A~alyR~ 05/24/93 Time R~r~z ~;ll~cted by: DTK Sample Routine Untreated : ~e~lbrane ~iltration U POS ND HeM sA ~ Old ~ NT - Satisfactory Unsatis£actory Positive Test Result Too Numerous To Count (>~00 ~k~l~ni~) confluent Gro~d:h Heavy Sediment Wasking, ~u~s May No~ Be Reliable Sa:uple Age >30 Hours ~U~ R~sults May Not Be Sample Age >48 Hours, To~ O1~ For Analy~i~ Res~ple Required No Test ' ~ Colonies/100 mi sample Sample Total~ Fecal~ Other~ HPC** Loe~tion Date Time Lab~ Coliform Coliform Bacteria ~e$uit ~nts I L3 Blk i Levell Sub 05/21/93 13:00 AB1327 0 NT 0 NT ~ NORTHERN TESTING LABORATORIES, INC. 3,~0 ~NDUSTRIAL AVENUE FAIRBANKS, ALASY~, 99701 I907) 4~$1 2595 FAIRBANKS STREET AN(;HORAGE, ALASKA 99~0~ DoUglas T. Kenley '7720 Roneyeuckle Drive Report Da~e: Date Arrived: 0~/21/$3 Date Sampled: 05~21/$3 Time Sampled: 13~0 Collected ~y: D~ Ou~ Lab #t A123585 Lo~ation/ProJ~ct= - Your sample ID: L3, S~ple Matri~ Water La~ Definitions * - Below Regulatory ; Above Regulatory = ~stimated value Matri~ Interf~re~e ~oat to Dilution MDL ~ ~ethod D~tectiOn Li~it Date Date Numbe~ Method Parameter Un£t~ Result * MDL ~rSpa~m4 Analyzed A~235185 EPA 353.3 Nitrit. mg/1 <MDL 0,1 05/21/93 A;~235B5 Nitrate~N mg/1 <MDL 0.1 05/~5/93 Microbiology Supervisor 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.# ~[[D~~-~ HAA#_ '~O~.\[~..~L.~,_'~ GENERAL INFORMATION Complete legal description Groll #1, Lot 3A T14N R1W Sec 23 Location (site address or directions) Prauas_BLv~d. ~ Eagle River Property owner Mailing address James & Eva Roddick Day phone 694-8697 HC 83, Box 1672, Eagle River, AK 9957'7 Lending agency Key Bank Day phone Mailing address I01 W. Benson Blvd., Anchoraqe, AK 99503 Agent Verna Danielson/Heritage Real EstateDay phone Address 18550 Eagle R.i~e~.Road, Eagle River, ~< 99577 564-0257 694-9125 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 5 TYPE OF WATER SUPPLY: Individual well X Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: X 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 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/orwastewater 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 ~ag;L.~ R~ngi~.ering Services Phone ~6~4-5195 Address P.O. Box 773294, Eagle River, AK 99577 Eng neers s'gnature DHHS SIGNATURE Y Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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. 72~)25 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ,~¢ 7' _~,,4 ,,¢~/~'f ¢:"~// '¢t Parcel I.D. (~2 ~'-(2 .-- ~ .~- )- - O I A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal If A, B, or C, attach ADEC letter. Date completed Cased to_ ,9'¢ ' ADEC water system number "~'/~ ~' -//_ ¢c,¢- Driller _..~,/,,r'~,,/~./ Casing height Wires properly protected (Y/N) ~" FROM WELL LOG Date of test _ Static water level _ ~'~ Well flow _ /, Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot _ Absorption field on lot ?--~'~" Public sewer main g.p.m. Pe~,q¢-sewer service line ,,.r-'¢ / AT INSPECTION ; On adjacent lots ; On adjacent lots "~-/¢~/ Public sewer manhole/cleanout. Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate "% '*~'~//'-- Other bacteria Collected by: B, SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) /.v High water alarm (Y/N) Date of pumping Tank size /..~ ~ '/ _~ Compartments Foundation cleanout (Y/N) --Y Depression (Y/N) Alarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK 1'O: Well(s) on lot //¢ / On adjacent lots ¢'/'~'~ ~ To property line ¢'/~" ~ ' ~ Surface water/drainage Absorption field Foundation /rJ Water main/service line 72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA "~/ Width Date installed Length ~ ¢/¢ 5- / Total absorption area /7'"~¢ ¢z¢ Depression over field (Y/N) ~ Results (pass/fail) /'¢ JcP Peroxide treatment (past 12 months) (Y/N) Soil rating '~'¢~' ~'~,,"¢~'- System type 5' Gravel thickness /'" Total depth --~ Cleanouts present (Y/N) Date of adequacy test ,'¢¢--.~¢' for bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot J.2.¢ To building foundation On adjacent lots Surface water Curtain drain '~,~ Property line /~'~" 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 effect on the date of this inspection. Signature Engineer's Name Date ¢~'/7/ HAA Fee $ /' Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number A Eagle River Engineering Services 11940 Business Blvd, Suite #205 P,O. Box 775294 99577 Eagle I~iver, Ak. Legal: Owner: 694-5195 Fax 694-5297 Meter Well GPM Time Reading Level Meter Well GPM Time Reading _evel 1{;~/ ~¢~ ~ ~,~ //~ ~ ~¢ ~ ~ ~,~ //,.~ ~/~/ ~ /, 2 Date: AUG 07 ~91 12:31 HTL-AHCHORAGE 90? 2?4-9645 P,1/2 NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE FAIR~ANK,S, ALASKA 9~)701 (907) 4S0.$116 * FAX 456-~12~ 2505 FAIRBANKS ~TF[EET ANCHORAGE ALASKA 99503 (907) 27'7.83'78 ,,' FAX 274,~645 Eagle River Engineering P.O. Box 773294 ~agle River A/{ 99577 Attn~ Louis Butera Our Lab 9: Location/Project; Your Sample ID= Sample Matrix= Oommente~ A1~269~ Grol #1 Lot 3 Water Report Dater 08/07/91 Date Arrived~ 08/01/91 Date Sampled~ 08/01/91 Time S~n~led: 1000 Colleete~ By~ LB Flag Definitions Below De[eotion Limit DL Stated in Result Below Regulatory Min. Above Regulatory Max, Below Deteotion Limit Eetimat~d Value Date Method Parameter Unite Result Flag Analyzed S~ 418 O Nitrata--N mg/1 0,2 08/0~/91 Reported By: William Anchorage Operations Manager AUG 07 '91 12:32 HTL-ANCWORAGE 907 274-9645 P, NOflTHEflN TESTING .LABORATORIES, INC, 2,~05 FAIRBANKS STREET ANCHORAGE. ,'~A~KA' 99~03 (007) 277-8378. FAX ~74-9645 3330 INDUSTRIAL WAY FAIRBANKS, ALASKA 99701 (907) 456-3118 o FAX 4~8~ 1~ Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY CLIENT TO BE COMPLETED BY LABORATORY Purchase Order [] PUBUC WATER SYSTEM I,D. /~RIVATE WATER SYSTEM NAME Mall]ag Addre~ City SAMPLE DATE: ~ 0/ 2/ Mo, D~y Year [] Treated Water v~Untreated Water SAMPLE TYPE: .~outine [] Special Purpose Check Sample (for original contaminated ,,~sample with lab reference no, ) LG~aflOn C~lh~ K3olh~tfld by 2 10 Signature of Representative ...... LabGfatary Ref. NO. Received at: ¢ Anch. F'I Fbks. FOR LABORATORY USE ONLY Next Sample Due COMMENTS: SATISFACTORY (~ U N SATI~ FACTORY U RESAMPLE R OTHER BACTERIA OB TOO NUMEROUS TNTC TO COUNT Dh',~ ve~fflc~t~n nnil Coua~: L~S SCaB Fl~ult~ Louis Butera, P.E. Registered Civil Engineer August 16, 1991 Susan Oswaldt Municipality of Anchorage On-Site Services 825 L Street Anchorage, AK 99504 Re: Groll gl, Lot 3A Block 1 Dear Ms. Oswaldt, RECEIVED 1 1991 Municipality of Anc r')°Pt, Health & Hu- borage man Services Addressing your concerns with the above referenced septic system upgrade: The diversion valve will allow alternation of system, thereby resting the old system for future use. This is importmlt as area for a third system is limited. 2. The diversion valve is a NDS #575 made by Hancor, sold by Western Utilities. We will post a notice in the utility room regarding operation of diversion valve. A copy of notice is attached. Tile septic tank was installed in 1985 and is six years old, with an expected life of fifteen years. Integrity was not a concern. The tank was pumped July 1991 and gallonage verified. Tile system was designed based on 0.45 GPD/ft2 soil rating which is the highest possible for a shallow trench system. This was done to be conservative even though other perc tests showed a faster soil perc rate. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. P.O. Box 773294 . Eagle River, ~\laska 99577 · Telephone (907) 69+5195 · Fax (907) 694-3297 NOTICE THIS SEPTIC SYSTEM IS EQUIPPED WITH A DIVERSION VALVE. THIS ALLOWS FOR ALTERNATING LEACHFIELD OPERATION. THE VALVE SHOULD BE SWITCHED EVERY TWO YEARS WHEN THE TANK IS PUMPED. FOR INSTRUCTIONS ON HOW TO OPERATE VALVE CALL EITHER: BOB HAMANN CONSTRUCTION 694-2776 OR EAGLE RIVER ENGINEERING SERVICES 694-5195 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF 14EALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACI/.I-rY 264-4720 Application Date 12/2/85 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) ~o'~___~_A, Oroll AddiLion ttl ~P].ZlN RlW Sec.23 Location (address or directions) Pl~uess Blvd. (b) Applicant Name J'ira Roddick Telephone: Home 69/'I-8697 Business N/A Applicant Address . ~R-_]_~ Ea~le River Road, E~ag2e R:i_ve'~ Al(. 99577 (c) Applicant is (check one): Lending Institution [] ; Owner/builder~; Buyer ~ ; Other [] (explain); (d) Lending Institution Alaska ~u'bua:;L Telephone _ 6~94-.~9~.1 Address E~7-~O R:i_ver, At(. (e) Real Estate Company and Agent .... N/A Address (f) "relephone Mail the HAA to the following address: ..... p Lc ~u.p b~y_ a~p p 1 :i. c an t TYPE OF RESIDENCE Single-Family [~ Multi-Family Number of Bedrooms ___~ Other WATER SUPPLY Individual Well ~1 Community [] Public [] 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 SEWAGE DISPOSAL Onsite [] Public L~ Community [] Holding Tank [] Note: If community well system, must have written confirmatien from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (~ 1 i8,1) ENGINEERING FIRM PROVIDIN~.~ INSPECTIONS, TESTS, FILE SEARCH, DA'I ,'*, AND INFORMATION ' As certified by my seal affJxed hereto and as of the validation date shown below, I verily that my investigation of this Health Authority Approval shows that the on-site water supply and/or waslewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein, ] 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 J~E~N~I~ffiH~ ~,~ Telephone Address F~.~R, AK 99577 Date ~-- P, 0, BOX 773294 6~ Seal Approved for~l, O Approved 'Ferms of Conditional Approval Disapproved ! __ "'/ bedrooms byN,.._~ ~...~,?.__~.~,. ,,, / :__ Conditional 'h CAUTION The Muncipality of Anchorage Department of Flealth 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 DFIEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) WELL DATA MUNICIPALITY OF ANCHORAGE (MO~I HEALTH AUTHORITY APPROVAL (HAA) ,MUNICIPALITY OF ANCHORAGE CHECKLIST - FEBRUARY 1984 DEPT. OF HEALTH & 264-4720 ~NVIRONMENTA~ Pt~OTI~CTION Legal Description: ~o¢' ~ ~ ~VwFIr¢ .d~' ~ / RECEIVED Well Classification /¢g¢"~ / ~.'/A 2'-/~' If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) ,,)/ Date Completed ,~'.////~ -~'- Yield Total Depth ~ 7..~ , Cased to ~/¢,, v'" · Depth of Grouting /~-"/.d Static Water Level ~0' /='.~.. z 'LS ~¢ Pump Set At ~ '~ ''~" Casing Height Above Ground ~ / Sanitary Seal on Casing (Y/N) El'ectrical Wiring in Conduit (Y/N) _ .)/ Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot ~/~/5~¢ "~ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot '*/¢~ ' ; On Adjoining Lots To Nearest Public Sewer Line /P"¢~¢-- To Nearest Public Sewer Cleanout/Manhole /t,,¢-¢-~ To Nearest Sewer Service Line on Lot Water Sample Test Results _¢~-,-2',.~ ~ ¢ Comments B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) )/ Air~tight Caps (Y/N) Depression over Tank (Y/N) 42 Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well /~¢/' To Property Line ¢-/~' / To Water Main/Service Line ~2" ' ~')¢ Course No. of Compartments ,,Y Foundation Cleanout (Y/N) Date Last Pumped ,4/¢~., ,~ ; for Temporary Holding Tank Permit (Y/N) To Building Foundation ~--¢' / To Disposal Field --~,~¢--¢ 3',J2" To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026{11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /~'~ 5'~ J~'~ Width of Field ~'- / Square Feet of Absorption Area Depression over Field (Y/N) /lc/ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation 7~¢ / Lot ~o Type of System Design Length of Field Depth of Field // Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Water Main/Service Line /'M~..~_ ,.,.,¢~,, /o To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Existing or Abandoned System on ; On Adjoining Lots '~o ' To Cutbank (if present) Comments LIFT STATION ~.~.~ Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** t certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~-/~~ Date Company ~/~-7,,~, z¢, ~. MOA No. Receipt No. ~ ~ Z l I~t ~ Date of Payment ~ ~-- ~ -~ ~ ~%,,, ~¢' ~ ~'¢~ Engineer's Seal ~-~,,,, . 72-026 (~ u84}