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RIVER VIEW ESTATES BLK 3 LT 7
Riverview Estates Lot 7 Block 3 #050-721-25 Municipality of Anchorage Page 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~O/-/- ~ PID Number: O~ ~ i-- mmv: ~p~m,¢. ~r I~"E Z' Wastewater System: D New ~ Upgrade ~r~ '~I~ E%q~ ~;~r ~f7~ .~[~ A~SORPTION FIELD ~DeepZrench ~ShallowTrench GBed BMound BOther Total Depth from original grade: LEGAL DESCRIPTION soi,,~,m: Lot: ~ Block: ~~ ~[~¢~Subdiv~ion:% -. ~¢~ 3epth to pipe bosom from original grade:~ Ft. Gravel depth beneath pipe ,~ Ft. Township: is.,,o.: Fill .dded above original grade~[Ft' ~e ~e~g~; WELL: D New ~ Upgrade ;rave~ width: ~' Ft. Number of lines: I Distaa~ be~een lin.: Pipe materiak Cl~ss,fication (Private, A.B,C):~..~lt~ ~; V~ TotalDepth:j O~ Ft. CasedTo: Ft. T°talabs°rpti°narea;7~'~SQ. Ft. ~'~ 9~0~ Driller: Date Drilled: StaticWaterLevel: Installer: . ~ Dateinstalled: Casing Height Above Ground: m,~: Z -I""~"s~: TANK SEPARATION DISTANCES ~s.,tic ~ Ho~n~ ~ S.T.~.P. TO Septic Absorption Lift Holding 'ublic/Private MAn u fact ~rer: /~ ~~ . Capacity in gallons: i ~ OO From Tank Field Station Tank ~ewer Lines r~(~ -- ~ ¢~1 Number of Compadments: ~ Fou.dat'on [~' qe' "Pump onll level at:~le~water alarm at: C~;~n ~6' ~'' ~ IElectrical `nspecti°n, "ed°lined by: Remarks: ~ ~r ~( ~,,¢.~ ~e~,~r'¢~. BENCH MARK ~omo. m mcrmo.: ~ O ~ Inspections pedormed by:~!= n:v=r, A~=E~ 9~5~ Dates: 1st 2nd ~' I~-~ [7~ ROBER'"-~'1~ C. ~WAN '"~:~ ~ ~., CE- 8801 Department of Health and Human Se~ices approval : · ~,~'.. ' Reviewed and approved by: ~- ~/ ~. ~Date: ~/z.o ~ '- 72-O13 (Rev. 9/91) MOA 25 PERMIT NO SW990425 P^Cg 2 OF .3 Municip. aU~c_ _y__oF Anchoro. ee DEPARTHENT OF HEALTHAND HUH"AN SERVICES ENVIRONHENTAL SERVICES DIVISION P,B, Box 196650 ©Anchorage, A[askc 99519 6650®Tdephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 7, BLOCK 3, RIVER VIEW ESTATES P.U). NO. 050--721--25 CURTAIN ORAIN p~ SOLIO PIPE AREA DBLI LOT 8 ABANOONEO -- I000 GALLON SEPTIC TANK ALTERNATE SITE: LOT 3 LOT 2 SCALE: 1" = 60' C. COWAN CE-8801 PERMIT NO. SW990425 PACE 3 OF 3 Municip, cdi~; o£ AnchoPaee BEPARTHENT OF HEALTH AND HUP AN SERVICES ENVIRONi ENTAL SERVICES DIVISION P,I], Box ~96650 OAnchopcge, Alcskc 99519-6650~Telephone: 343~4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 7, BLOCK 5, RIVER VIEW ESTATES P.LD. NO. 050--721--25 MT1 = 92.3 FINAL GRAD~O0.O'~ ~~,.,,z. ,;~,..~ IN SULA TI O N NEW 1300 GAL. POLY, TANK CO1 99.2' MTq C04 MT4 Ir'a,~ _ a~ n' C02 99.0 °N H H-~)~ =- ~;~' CO1 = 95 4', . , C02 = 95'.4' . ~C03 = 94.8 ~MT2 = 92~ ~MT4 = 91.7' MT3 = 91~~ A B :CO 29.0' 9.0' ST1 45.0' 23.0' ST2 46,0' 26.0' DBL1 47.5' 29.0' DBL2 48.0' 30.0' FS 130.0' 134.5' C01 100.0' 106.0' C02 146,5' 151,5' CO3 108.0' 117,5' C04 148,5' 156,0' C05 116.5' 119,5' MT1 102.0' 108.0' MT2 145,5' 150,5' MT3 112.5' 121,5' MT4 148.0' 155.5' CO1 MT1 C02 97.0' A WATER FOUND 88'.iZ' B.O.H. C03 Municipality of Anchorage. DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ~' '~" ~.~ (/~ ,'~,~ .'~* ~ -~t ~ O 0 '~) (~ ~ -7-..- DATE PERFORMER , ~ LEGAL DESCRIPTION: ~'OT- ''~ 8L~ '~ /~iV~.VI&~,~/ Township, Range, Section: 4- 5- 6- 7- 8- 9- 11 13- 14- 15- 16- 17- 18- 19- 20- ~.O.H. Ho~ WAS GROUND WATER ~)//./~. ~- ENCOUNTERED? ~P YES, AT~,R^T ~, t ~ DEPTH? pO E Oeplh to Water Alter Monitoring? . SLOPE SITE PLAN I N Gross Net Depth to Net Reading Date Time Time Water Drop ~//~ AD o -- ¥%" - Rt~ t, ~ Ye" ~0 ~'/~" ~ '/~" a44,.~ t. ~ 'f~" ~ 0 ~ '/~" 9 %. ,~0 ~" 4 '/~" PERCOLATION RATE O~. ~'~ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN E~ETWEEN ~ '/~)" FT AND 3 '/~. FT COMMENTS PERFORMED BY:11U;S~ Eagle River Loop I~oad ACCORDANCE WE~IeLP, J~e~,T.~I,a~J~PAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: ~/'~' ? /O0 June 28,2000 ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 SEWER&WATER tNSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOWTEST SITE PLANS ROAD DESIGN SOILIEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONG MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 7, Block 3, Riverview Estates Request you grant a waiver on the referenced prope~ly for the horizontal separation distance between the leachfield and the west property line at 3 feet. We do not anticipate any adverse effect on the adjacent prope~V. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/gk MUNICiPALITy OF ANCHORAGE :'!P'~IMENTA[ SERVICES DIV ~r.. 17034 NORTH EAGLE RIVER LOOP SUITE 204 · EAGLE RIVER, ALASKA 99577 S & S Engineering ATTN: Robert Cowan, PE 17034 Eagle River Loop Rd, #204 Eagle River, AK 99577- July 12, 2000 Subject: Waiver Request forRIVER VIEW ESTATES BLK 3 LT 7 Waiver # WR000045 Lot Line Request for Parcel ID 050-721-25 Dear Engineer: Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater disposal system to the lot line has been approved. The approved separation distance is 3 feet. This waiver approval applies to the current on-site wastewater disposal system and lot line separation only. Any future upgrade to the on-site wastewater disposal system and lot line will require all separation distances to be met or another waiver approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. Jeff Poet Engineering Technician III On-Site Water Quality Program MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On-Site Services Waiver Review Worksheet WR#: WR000045 PID#: 050-721-25 HA#: Date Received: June 29, 2000 Legal Description: Riverview Estates, Lot 7, Block 3 Engineer: S & S Engineerin[I 17034 North Ea~le River Loop Rd., Suite 204, Eagle River, AK 99577 Applicant: .......... Waiver Requested: 3 foot lot-line waiver Permit~: SW990425 Criteria: 1. Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation 2. Special Conditions: 3. Other: Total: Waiver is Granted: List Conditions or Reasons for above: Waiver is not Granted: Date: '~-/2-~'0 o Rec#: 06664 Amount: $115.00 ~/' NE'r~ of'R"eviewer Date Paid: 6~29~00 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Dote Issued: Dec 02, 1999 Expiration Date: Dec 01,2000 Permit Number: SW990425 Legal Description: RIVER VIEW ESTATES BLK 3 LT Design Engineer: 0003 S & S Engineering Owner Name: Stephaoie Rodriguez Owner Address: PO BOX771268 EAGLE RIVER , AK 99577-1268 Parcel ID: 050-721-25 Site Address: Lot Size: 50116 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: Dote:/2- ROBERT C. COWAN, P.E. ENGINEERING STUDIES ANDREPORTS WELL INSPECTION & FLOW TEST SOILIEST STRUCTURAL& MECHANICAL INSPECTIONS June 6, 2000 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 7, Block 3, Riverview Estates S/D septic sys~e~ ~o ae~e ~he existing ~hree bedroom dwelling on the referenced A test hole was excavated and a percolation test was performed on 11/4/99. The approxireate location of the test hole is located on the attached site plan. At the time of excavation no water was found. However, at breakup the test hole filled up with water. A drainage trench was installed on 5/27/00. The test hole was re-excavated to a depth of 12.5' to monitor ground water. Diverting the water has lowered the ground water level to 10' deep. After monitoring for seven days, the water level was found to be constant at 10' on 6/5/00. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/bjj Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 ROBERT C, COWAN, P.E. SEWER&WATER INSPECTION SOIL TEST PERCOLATION TEST November 22, 1999 CIVIL ENGtNEEP~ (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Deparanent of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 7, Block 3, Riverview Estates S/D It is requested that you issue a permit to upgrade the septic system to serve the existing three bedroom dwelling on the referenced property. A test hole was excavated and a percolation test was performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation, 11-4-99, no water was found. After seven days of ground water monitoring, no water was found. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/bjj Enclosure NOV £,!7 1999 7034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Municipalily of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: ~ ~ '~ ~ ~¢, Township, RaRge, Section: 1 2 3- 4 5 6 7 8 9 10 11 13- 14 15 16 17 18 19 20- COMMENIS SLOPE SITE PLAN WAS GROUND WATER J(~ ENCOUNTERED? DEPTH? pO E Deplh 10 Waler f/~Ll~)?~/ /!"~ JG'"<i'cJ Moni)oring? ~ Oale: ~,L }O"~fl Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE TESTRUNBETWEEN tminules/inch) PERC HOLE DIAMETER FT AND FT $&S;. ,NGINEERING~iver I.oop Reaa No PERFORMED BY; 1~'~4 ~ag:e .Zrd~-'l -. CERTIFY THAT THIS TES] WAS PERFORMED IN ACCORDANCE WI~I~J~JI~/~tJ~.~J"aS~L~.~'~L GUIDELINES IN EFFECT ON THIS DATE. DATE: J./ /~- F / ~ ~'__ 72-008 (Rev. 4/85) ROBERT C. COWAN, P.E. ENGINEERING SIUDIES AND REPOFIT$ CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 7, Block 3, Riverview Estates S/D November 22, 1999 GENERAL: The scope of' this project includes the installation of a 1000 gallon polyethylene Premier septic tank and leachfield trench for the existing three bedroom house located on the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval fi:om the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 7034 NORTH EAGLE RIVER LOOP * SUITE 204 · EAGLE RIVER. ALASKA 99577 Page 2 Lot 7~ Block 3, Riverview Estates November 22, t999 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the diraensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt banfer must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of thc distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot 7, Block 3, Riverview Estates November 22, 1999 MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: T.vpe of Pipe Perforated Solid Cast Iron Yes ASTM D3034 (PVC) Yes ASTM F810 (HDPE) Yes ASTM D2662 (ABS) Yes Yes Yes No Yes Use ora type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the fmal leachfield gravel layer and the native soil backfill. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current MOA or ADEC requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: Page 4 Lot 7, Block 3, Riverview Estates S/D November 22, 1999 The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The £mal inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre- construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached MOA permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 LStreet-Anchorage, Alaska 99501 Telephone264-4720 ON-SITE SEWAGE DISPOSAl. SYSTEM AND/OR WEI,.L INSPECTION REPORT IMAIE-'fNG ADIP,,RESS., INO. OFBEDROOMS Well Absorption area - Dwelling ._DISTANCE TO! I /¢--0t .__ -:-t ,.c,-: ..: Manufacturer ~ } . I Mat~ia~ / [Liq. cap~ity ~ ......... ~ / Width Well I Dwelling Well ~~ ~~ I Nearest lot line [ No. o~ u,,.~ I u~a,h of .Cob ~;~..' To,.~ ~onath of U,,~, . ITrench width / ~ I ~') '~--- ~ / ~ inches ~op of tile to finish gr;de ' ' Material beneath tile ./ ~- uJ I Length ~ , } ' DISTANCE T:: PIPE MATERIALS SOIL TEST RATING INSTALLER - R EMAR KS Width C r i b.~m~t~eh Del]th Buildi0a fou~dation OTHER APPROVED Building foundation Driller Sewer line DATE LEGAL PERMIT NO. o~'/ ( No, of compartments Liquid d_e~p t_h PERMIT NO. PERMIT NO, Distance between lines Total effectfve absorl~tion area PERMIT NO. NeareSt ~t ~/ Distance to lot line PERMIT NO. ? Absorption area(s) Septic tank /0 ~ I~ / E) ~ I-t I L.I:::IN[:, L. OT ?' 13LI< ::ii: RI',,,'EI;~: VIEI,.! ESTFI'I"ES 'T"?P!Z OF:' 'i: "'~ ]'1 RI:: ': - I;'F::'T '[ -ff.I ::, '¢ .::, I E.I 1 ]: L']; -f'I:;i:E:NE:H i'"IF::I'X I I',!L.ff'! NI...IMSEF: (:)F BEE:,F:(.qOMS := 2 LO'f' :i! ]'2]!:" ~:jL,:JI:31EnE~ !:; 6! U l::l Fi: [f:: I::EI:E'r' THE F;:E(~:!I...IiF;;'.F!;[:, S!;?.'I{E OF' THE THE L. ENGTF1 [::,ZMEI'.,IS ! O1',f 1:5 THE L. ENGTH ,:: iN FEET::, OF:' THE: TRENCH OR DF;~I:::III'.,II:::'IEL.[:,. 'I"~tE DEPTH OF I:::! "f'F;:ENCH O1:;?. F':['I~ ZS 1"HE [::,I'.STF~I'.,!CE BETHEEH THE :51...It:;?.F:'t:::IC:[~: CiF THE GI::;:O!...!!,,i[:, FIN[::, Tile [i~Cq'TOM OF THE E::.:iCFIVFITiON ,:: IN F:'EET). T'Id!ZI';;:E I S HO SET I,.I I [:,"1"1..1 r::'OF?. 'i"P.E.:I'.,K::HE5. TIlE OI';;:FI',,,'EL_ DEF'TH !S THE: MINIMUM DEPTH OF: GF:FIVEL BETHEEN THE OLrT'f:::'F:iM_ PiPE FII',I!?, THE E',OTTOM OF' THE E::.::C:F'IVF:ITIOI'.4 ,::!H FIEE;T'). I::'!!EF'.M I "1" F:.F:'PL T ] FII'.IT I-II::IS THE I,.E..:,I.-. I,I.:, ] ~, t t I. I TO I I'-,I!::OF;i:M "!"1"11:5 I.::'Ii~:I:::'F:!F:°I".I"t!ii"-'I",I"!'' [:,U~;i: I I",l[~ "r'HEi: ! I'.,!STI:::ILJJ:::IT :I: O!'.,! ! i'.IE F' .E Z T I "'fi.J? CiF:' r':lN'.r' HE!....L..S Fi[:,.:rF:iCENT TO 'T'H :t: :ii; I::'Fb]d:::'EF?.T"r' I::ll".J.l:::, THE NUI"I!F?,Et:;;: 0t::' Fi:ES I !)IENCE::i!; I"HFFF THE M ]: I",11 MLII'"! D I S'i'I::!I'.,IC:E BE::TI,.IEEi:N F:I !,.I!¥.L!_ I:::!i'.,1[) i::ll"~"r' Cii",I-'L~; ! 'TE SEI'.II:::IGE [:' I SPO%I::!L. %'~.'ST![{r,1 I ::1..81;~! F:'EE:T I:::'OR FI F:'P.!VF!"I"E:: HEL. L. CII::i: i..Sl~! TO :'-i'.(;)tZl FE:ET F'P. OM F:! PUBLIC I.,.IEELL. I..IF:'OI'.,I THE 'T"~.'F:'IE OF: F'I..I!BL. I C: !,lEI_! MII'.,i!MLI!','! [:,IST'FIN(?.E F'I::iiCff'! FI PF:I',,,'FITE I,!I~:L.L. TO I:::! PI:;:I'v'F:!"I"F~': SE:HE/F: L. II',!E I'_::i; ;.;.'5 F'E:E:T Fii'.,![:, 'T'O I:::f C:Cd"!MI...INIT'.,-' L:.~;E[I.,.IE:P. L..II'.,IE ~il; ?'5 IZ!"i"!..lli~:!:;;: I:;i:i?~QI...I i I:;;:E]','IE:I'.J.T'.5 MFI"r' I':IF'PL'~.'. Si::'EC: !' F I CF!T IONS (::IN[) CONSTF;?.LIC:T I ON [:, I F:IC'iF:F:IHS F!F:E F!VI:':fI!...I:::IB!...E: TO I!'.,!SUI:,¥Z F'I:,iX)F'[EF: II'.,!L:!;TFIIJ_.I:::ITI(?H. ]: C:EF'.]" I I:::'",' !']'"IF:II" ;t.: i FIM t:::F:IMiL]:F:II:~: I,.II'T'H ]"HE !:;:E:(;!!...IIFi:EME~N'f'S Fl]fi;il OI",I-'E;!'I'E SE:HEP. L::; F:iI",![:, I,.!ELL.'J:i; I:::lEi; .'.{:;ET F::'Ot:;i:TIt E:"d THE hll...lt',! I E: I PF!I.... ;2: :1: 14II._L Ii",!'."~;TFIM_ THE: S"r'STEM ::..":: :1: LINB, EP. ST'F::II",![::, THFIT THE ON-'S~TTIE SEt.,.IER S"/L:;TEM MFI"r' REQLIIF:E EI",IL.F::II'RGEHEHT iF: THE RE:S ]: [::'IiEHC:!i!:_' I '.!:; Fi:EI"I(:)[:'Iii:L.E:D TO I I",!CLUD:F_': MORE THF:!I"-I ]: BIEDI:;bDCff'IS. 825 "L" STREE-F ANCHORAGE, ALASKA 99501 (907) 2654111 GEOfiGE M. SULLIVAN, MA YO/~ DEPARTMENT OF ttEALTH AND ENVIRONMENTALPROYECI'ION December 31, 1980 John Gross Box 1162 Eagle River, Alaska 99577 Permit # 800036 Subject: Lot 7 Block 3 River View Estates Subdivison A permit issued by this department for well and/or sewer system has expired as of this date. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. If there are any further questions, please call this office at 264-4720. Sincerely, // //,~ LNB/ljw enc: Copy of Permit suP/057 PERMIT NO. l~llIJI'ql ]: C ~ ~-:'"t::IL I T"r~ IDF DEP~RTMENT OF HE~L. TH ~ND ENVIRONMENTFIL PROTECTION 825 "L'" STREET, RNCt4ORRGE., AK. ~SCJ~L 264-,472e OF~--S I 'TFZ SEI-..IEF~ PE~:fd I ( 8000S~6 ) RF'F'LICRNT JOHN GROSS LO¢:R"r I ON E.R. LEGRL LTS :? BLK.7, RIVERVIEH LOT SIZE T'¢F'E OF SOIL. FIBSORF"FION S'rr'S'I"EM IS: TRENCH MFth',IMI..IM NUME, Ek OF BEDROOMS = ...'. 6.'::~4. '_4. ± = .... 50000 SQIJFtRE FEET SOIL RRTING =,1_1 "' ,,z, 3 THE REQUIRED SIZE ElF THE '-" IL HB_,LRFTION SYSTEM IS: [:~,E~:F"I'-~' ~= :3 i E~-~I]'TFI= 2;:2 t3RF-I"-w"EL [:"EF'-I-I-~== El THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OF.'. DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTFtNCE BETNEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF' THE EP.:CR',/RTION (IN FEET:). TFtE'RE IS NO SET NIDTH FOR TRENCHES. THE GRRVEL. DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETHEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCFI',,,'RTION (IN FEET). c'~,r ~" Ti] INFORM "['HIS DEPRRTMENT DLIRING THE PERMIT RPPLICRNT HFIS THE RE..,FdN_,IBILITY INSTFiLLFITION IN.=,FECTION--, OF FINY HELLS RDJFIC:ENT TO THIS F'ROF'ERTY FINE:, THE NUMBER OF RE..-I[:,ENCES 'THFIT THE NELL HILL. '"'~'~'~¢~' -Fl..lO ,:-': 2 :--, I I"-.ISPEC:T' I 131'-,IS FIRE F.: E(41_I I F,::E[:, E:KtCK. FILLING OF' FINer' S¥~:TEM NITHOUT F:[NRL INSPECTION RND FIPPF.'.O".'~RL E;'¢ THIS DEPRF.':TMENT 1.4ILL BE =,UBJECT TEl F'F.'f'~SEC_TION. MINIMUM DISTFINCE BETHEEN A HELL RND FINY ON-SITE SEHRGE DISPOSFIL. S'¢STEM IS 100 FEET FOR R PRIVRTE HELL OR 150 TO 200 FEET FROM FI PUBLIC HELL DEPENDING UPON THE TYPE OF PUBLIC NELL. OTHER REQUIREMENTS MRY RPPLY. SPEC:IFICRTiONS RND CONSTRUCTION DIRGP. RMS RRE RVR'~LRBL. E TO INSURE PROPER 1NSTRLL. RTION. I CERTIFY 'rtJR'r :L: ~ FtM FRMILIFtR NITH THE F:'Eg!LIRF_MENTS FOR ON-:,ITE =,ELDER_, FIND NEL. LS tis ..,El FORTH B"r' THE MLINZC?F'FILIT"? OF RNCHCRHGE. 2: I HILL tF,ISTRLL THE SYSTEM IN RCCORDRNCE HITH THE '¢: ~ ~ '~ER"",THND THflT 'f'HE r ¢.' " .NE 'S -' ' JN-..,ITE SENER SYSTEM MFIY ~Ei.J. JIRE ENLRRGEMENT IF THE RESIDENCE IS p..EMODELED TO INCLUDE MORE THRN Z, BEDROOMS. -. ) s, ¢.. .JZ =, I 6NEE . _¢.¢x_c ......... ~__= ................................ ~F'PLICFtNT JOHN GROSS SSUED B, }.979 John Gross ]Post Office Box ]_161 Eagle River, Alaska Permit {~ 1~0654 99577 Z2: an engineer has inspected the i.:.tstali, atio~,~ o~ the on-site sewer system, please have them send us the as-.buil, ts for our ~iles. If there are any .~urther c'uestions, please contact office at 264-47~0. Sincerely, / ~-. Les N. Buchhol_z, R.S. ~21 ...... Senior Env/ronmenta! Speci~}s[st LNB/ljw enc: Copy of Permit [ i[.D I_C.~ PERMIT NO. DEPFIRTI,dEI.IT 'nF HEFIL'FH ¢tNt'> ENV [ PC, i-!i,'lEi'-lT!31 n'[;:OTEC:T I ON 825 STREEC, RNCHOR'.i~GE.. RK. 9~ ( ) PPL I CFIHT OCRT ION . , EGI-]L "~' i '¢PE (iF SOIL [.o-r c..,iXE FEET 8x][i,,iur,1 NLIHE',ER OF E:F. DF'O3r,I:T, -: HE R'EOI ........ IREC' S I ZE OF THE ':-CFtIi._ FIEI'-~-iRr::'T ICff.,~ z,¥_,lEi`l~-"c" , I:5' :o E--L' F' T I,-t .... ,. I.__ IF_- P.I I2-i T' t-t :=: , ~_:~ Iq-'. P-,' -., E L._ THE LENGTH DIMENS:ION IS THE LEHGTH (.(H FEE'I,) OF THE TRENCH OR DRFIIHFI:ELD. THE: DEP.TH OF 61 TREHCH OR' F'iT [_'5.- THE D]S]-P~NCE E:E'['[,IE[£'I,.I 'THE SLIRFFICE OF THE GROLli'.~C, FIND THE P.,OTTOM OF THE E::<CF:I'v'RT:[OI,.~ (Iht FEET) THERE ~S i'qO SET H:[C, TFI FOR TRENCHE~. THE GRff,/EL DEPTH ~9 THE Mlt.,f~HUr,1 DEPTH OF GRff,,,'EI. E',ETHEE. N THE OLITFFILL P][PE BI.ID THE BO'TTOH OF 'rile EXCF¢¢FIT I OH ( I H FEET ). ER:HIT RFFI. IC:hhNT 14RS TI4E F.E._,[ Ui'i_,IB.[t. IT"r' '10 ii`~FORM ]'HIS C'EPFtF:TMENT DLIRIHCi THE NSI'FILLRTIOII INSF'ECTIEtH::C OF I~i,.Itr' P~ELL_Ci FfC, 3FtCEI,4T 'TO Tt4I'q PFtOPERT'-? thND 7'HE-: JM[:,ER. Cfi: RESIDE/.a]:ES THFtT THE HELl. 14ILL. _,ER.,,E. ...... -F I.,-1Cr ,:: '2 ;) ]i I'-,1 :E-: F' E::( C': -'1'" ].~ F'_-I 1'-4 S.'; Ft [,,?. E:~ F-': E f~--~ El :[ I:,:4 E-£ [:, ':';C:KF' l LL ! l-,h] QF Fd",~b' c, ,c - ,~- .... -r_,]EM !4ITHOUT FINFIt_. II,qSPEC:TIE~hf FIND FIF'PROVFfl.. E:h-' THI::,. EPRR-I-MEHT HILL BE' SLfBJECT FO [NIMLli,'I [:,ISTFtHC:E DETHEEH £~ [,.IELL Fife[:, Fff.l'¢ ON--SITE '_::;EI,IRGE DISPOSRL_ SYSTEM 3G FEET FOR fl F'RIVRTE HELL; '58 TO 269 FEET FR. OM R F'UE:LIC NELL C, EF'ENDIHG UF'OU THE TYF'E OF PUBLIC HELL ELL L. OGS RF<E REGLIIRED I:tt.l[) MUST BE RETLIRNED TO THE DEF'RR]-MEHT NITHIH SC~ : THE F~EL.L. COMPLETION. FHER RE6~U~REMEHTS /'lRb' RPPLV. SF'ECIF'IC:RTIONS, FiND CONfSTRUC:T~OH D~RGRRM'5 RRE /h I LRBLE TO Z NSL~RE PRGPER [ NSTRLLRT I C E R 1' I F '.r' T H R T · I RiM FRMILIRR HITH THE REQUIREr'lENT% FOR ON-SII-E SEHERS RN[:, HELLS RS SET )R'rH E',~' THE MLIH ~ C ~ F'RL I TV OF ¢~NCHORFIGE. I l,lIL, k INS'FI~LL THE Sb'STEM IH t]CCCIRDFIHCE I,IZTI-.I THE CODES. i IJNDERSTRHD '[HF~T THE ON-SITE '.SEI,IER S'¢:~;TEI'I HRh-' RECd_.IIRE EHLRRGEMEN'r IF THE CSIDENCE IS REMOC, ELED -FO IHCLL~C,E MORE -fHR~l 3 t3EC, F:OOMS F~PPI. I O& Russell Oyster 694-2774 Performed for: Name: Legal Description: Depth (feet) 0__ 1 3__ 4__ 5__ 7__ 8__ 9__ 10__ 11__ 12__ 13__ 14__ 15__ E ENL,NEERING & DEVEL©, Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG Mailing Address~ M ENT CO, Earl EIIk~ 688-2280 Tel. No, ~'~'q ?/7~ Soil Characteristics ¢.. I1~/ PLOT PLAN PERC. TEST Ground Water Encountered: Yes //..~'N o.__ If yes, what depth Proposed Installation: Seepage Pit__ Drain Field Comments: Performed b . .~4~_ c~'~ _~)c! '~7-~'~-- / MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-222~ PERFORMED FOR: LEGAL DESCRIPTION: ) '~ SOILS LOG- PERCOLATION TEST ,~ SOILS LOG [] PERCOLATION TEST 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE /:/~ (minutes/inch) TEST RUN BETWEEN FT AND -- FT 72-008 (7/76) , .I J:.l,.J Iii{ij!Z~'j' Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.' ~-'--~) Expiration Date: GENERAL INFORMATION Complete legal d~scription ~ ~/' ~ ~/~ ~>~ ~/~ addres~ Location (site or directions) ~ /~/A¢~ Current Prope~y owner(s) ~ ~/~/g~"~ Lending agency Day phone Day phone Mailing address Real Estate Agent Mailing Address Day phone Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: ~_~_~_7 NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding Tank [] Community On-site [] Public Sewer The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Cedificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72 025 ~Rev 01 009 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval application show 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 site water supply and/or wastewater disposal system is in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. S & $ ENGINEERING Name of Firm '~ 7e:~a~Eagl..~iverJ.~ep Address Eagle River, Alaska Engineer's Printed Name DHHS SIGNATURE ~ Approved for ~-- Disapproved. Conditional approval for bedrooms. Date bedrooms, with the following stipulations. Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Expiration Date: / ,//- "~ -~ ~ Original Certificate Date: Reissue Date: , CEIVI:U Municipality of Anchorage AU6 0 1 2000/~.~_~ DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division ,-¢u[~.~^LU~ OF AN~HO 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343:~,~t~E~vrcF's p Legal Description: A. WELL DATA Well type Log presentt~/N Total depth Sanitary seal,IN) Date of test Static water level Well production Health Authority Approval Checklist ¢.~'.~ /~//'~-~//'/E-'z-/~¢-~ Parcel I.D.: ~)~'~ If A, B, or C, attach ADEC letter. ADEC water system number Date completed ////'/~' ~ / / Cased to '~ ~ Casing height (above ground) Wires properly protecteC~N) ~/~"~ /;- FROM WELL LOG g.p.m. AT INSPECTION g.p.m. WATER SAMPLE RESULTS: Coliform O Date of sample: "/~/~-~/~ B. SEPTIC/HOLDING TANK DATA Nitrate :~ ' H ~ Other bacteria Collected by: Date installed ~'/¢/' Tanksize L/-7'/)7.) Number of Compartments ~ Cleanouts~) Foundation cl~nputc/t~N) y/¢~_ Depression (¢ /'~/('~ High water alarm (Y/N) Date of PLUmping ,/V'c/''¢7// Pumper '--'-'- C, ABSORPTION FIELD DATA Dat~ installed ~' //~'~/,/~ Soil rating~or fF/bdrm) ~,~ ~;' System type ~'" :' ' ,,~/a L.-,!. I ~.- / ~ ~ / .-~ Leng[h ,{¢~ ')//~- Width ~.~ Gravel thickness below pipe. 2.~ Total depth ,/ Effective a~sorption, ar'aa ~ Monitor ng Tube presen~'N)~ Depression over field (Y~) Date of adequacy test /-Jf?~ Results (Pass/Fail) For _~¢../,4~.- bedrooms Fluid depth in absorption field before test (in.); ~~er gal. water added (in.): Fluid depth (ins) Minutes later: / Absorption rate = g.p.d. Peroxide treatment (past 12 months~Y/N~ If yes, give date 72-026 (Rev. 3/96)* LIFT STATION Date installed /'~/A" / Manhole/Access (Y/N) High water alarm level at* Size in gallons "Pump on" level at* *Datum "Pump off" level at* Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line ~ ~' /OO/¢- On adjacent lots On adjacent lots Public sewer manhole/cleanout /V//~- Lift station /V//~.____ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation ¢ /'¢- Property line ~ ~ Absorption field Water main/service line / ~ ¢'P Surface water/drainage /¢ fO" Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain ENGINEER'S CERTIFICATION .~ / (7~"~"~Building foundation / O/¢'- Water main/service line /O '/¢ / 0 ~ !/.- Driveway, parking/vehicle storage area _~0 I ,.~ Wells on adjacent lots in conformance with MOA HAA guideliees in effect on this date. Signature ~~_ ~ Engineer s Name ~O~ ¢-~ ~¢ ~O~ HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72~026 (Rev. 3/96)* ,~1~. CT&IS E~lVironmental Services Inc. Client Name CHeat S~ple tD ~7; Ordered ~Y ~WS~ 0 ~pl~ R~ FQL Urals McL~ c'4 h~ 0~: Date Nztra~N ~.48 0,~00 n~L EPA 300.0 I 0 max 07/25/00 SCL To~ Col~orm 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (site address or directions) ~'ropert, y owner ~ailing address.. L~oding agency Mail]~'g.~'dd ress Agent ~/~ Address ~ Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: '-~ 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. 1/91) Front MOA #21 5. 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 regulations in effect on the date of this inspection. Nameof Firm ALA~-..A Va~q'6.,¢--. ~~ ~,Jd£. Phone Address c~-/I ~/¢p4c_,~,~oC__..,cc&~_. ~ ,Z~. Engineer's signature~ Date ~/2. ~,/c] 2-- DHHS SIGNATURE / Approved for~) bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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. 72K)25 (Rev. 1/91 ) Back MOA Iff21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L. oT' -'lj ~,~-, ~ ¢-W'¢'¢'- A. WELL DATA Well type ~¢--} VA-']'~' If A, B, or C, attach ADEC letter. Parcel I.D. ADEC water system number Log present (Y/N) Total depth Sanitary seal Date completed ~./I I/'7 7 Driller Cased to \O.~ PT', Casing height Wires properly protected (Y/N) Date of test Static water level Well flow Pump level FROM WELL LOG AT INSPECTION -70 ~-c, '7 -~ ~' ~ g.p.m. 6o ,RECEIVED SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot ~OO Public sewer main ~/A- Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank %>- tOO WATER SAMPLE RESULTS: Coliform ¢ Nitrate Date of sample: '2.../2-'7/~ '7_. Collected by: __ Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed.'" "' ~'/~.J Tanksize \d)OO ~J, © Cleanouts (Y/N) ~---, Foundation cleanout (Y/N) HighWate¢ alarm (Y/N), ;~' ~ Alarm tested (Y/N) *um e, SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~ ~ On adjacent lots >~ IOO ~, Foundation Compartments Depression (Y/N) It C. LIFT STATION Da~ Manufacturer Size in gallons % Manhole/Access (Y/N~ Vent(Y/N) ~vel at ~mp off" level at High water alarm level ~ Cycles tested _ Meets MOA ele~ ISTANCE FROM LIFT STATION TO: On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ~/~ I ,db Length ~ 2. Width Total absorption area Soil rating 1%~- System type Gravel thickness Z~ F=~ (~ ' Total depth Cleanouts present (Y/N) ~ ¢~ -Depression over field (Y/N) Results (pass/fail) Date of adequacy test 2./2_~/~ ~. for ~ ~'~' Peroxide treatment (past 12 months) (Y/N) If yes, give date ~/~z~ bedrooms Curtain drain /~ //Ir E. ENGINEER'S CERTIFICATION SEPARATION. . DISTANCE F.R(~M ABSORPTION FIELD TO: Well on lot ~OO PE~-'f- Ona~centlots ~"~ [Od) ~, Propertyline + To building foundation ~'~ ~. To existing or abandoned system on lot On adjacent lots ~ Cutbank ~/~ Water main/service line Surface water ~o~ o~s~ Driveway, parking/vehicle storage area ~ I certify that I have checked, verifi~m~ to all MOA and HAA guidelines in effect on the date of this inspection, Signature % / ~ ~ Engineer's N~~~ ~. Date HAA Fee $ \-"l C~,.(~ Waiver Fee: $ Date of Payment ~ ~ ~ -~c~ Date of Payment Receipt Number ~ ~¢ CO Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Alaska Water gz Wastewater Services "Preserving the Last Frontier" RECEIVED JquriJ.¢:JpaJ_J_t;y ol Ah(shoi-.-:~g,~, i)(4D~-~f-hfn~Sl]t: of I]oo./Lh .at~d Human Box 196650 MAR 6 1992 D Municipali[y of Anchorage ept. Health & Human Services RcF: Hea!i;h At~Lhor-JtV ,Applovo. l (-AA) Appli(;Agioi~ for' Lot '1o t,dXy)h'~ ii', rrla. y (;OfllJ£~|'l-i." 1_ WKIt. ,'qO~r4U;iCY ft~,';]"~ AtL4~ch;~d i-; hhe lhqA app]J¢.ai:ior] tr~r o [: t,JeJ ] (;a:~4 tlg. I J'~ r i:y fn~LI]U t[~% ~l;eP, tlio we:l. ] hsd 12~ GKP'f:£C :';Y,d;:/LPi ADF. L~tJ,r',C:Y iE{<I: '1 he ~.epi::i(:; r:.ystem a. dequac:y /OV~] 51l I.I,~ tioJich i'o%~ a I:oi;o,] of 9. ~b ilqcl'lot~ (97.3 Ff LIN.)A'I i'ON F:I.EAN-[JUI~: file il~i. :ja.i Telephone - Fax 338-3246 · 8471 Brookridge Drive · Anchorage, Alaska 99504 (IDJ~CEi~I"I L('J'J'S: (as cam he se6;n f rem t:he ~;.I,t. ached (qJi^al,'Jillg, /;i: yr)u have, any quesb~o~s recardi, n9 tl-i.~s tho hOfftT~(JltJl)Ot'., Th;mI< you, I hereby certify that AS-BUILT have surveyed the following described prgperty: L.,,o'P' '7~ F-/et.k Anchorage Recording Precinct, Alaska, and that the improve- ments situated thereon are within the property lines and do not overlap or encroach on the property lying ad/~cent thereto, that no improvements on property lying ad acent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said prope}ty except as indicated hereon. Dated at Eagle River, Alaska ' ROBERT C. JOHNSON SCALE: , Registered Land Su~eyor No/880-LS 1" = o,-~ Box 77-0458, Eagle River, Alaska 99577 '/ '" Phone (907) 694-2543 RASMUSSON ENTERPRISES Box 770-766 £AGLE RIVER, AK 99577 (907) 6~8-9110 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX:(907) 561-5301 ANALYSIS RESULTS for INVOICE ~ 51465 Chemlab Ref.$ 92.0756 Sample $ 1 Matrix: WATER Client Sample ID : FOREMAN'S PWSID : UA Collected : FEB 27 92 @ 10:00 hrs. Received : FEB 27 92 @ 12:05 hrs. P~eserved with : AS REQUIRED Client Name :AK WATER ~ WASTEWATER SERVICES Client Acct :AKWTRWS BPO$ : POW :NONE RECEIVED Roq~ : Ordered By : Analysie Completed : FEB 28 92 Laboratory SuperyJk~o~TEPNgN C. EDE Releaeoa By: ~~-~ ~ Send Reports to: 1)AK WATER & WASTEWATER SERVICES 2) Parameter Results Urdt8 Method Allowable Limits NITRATE-N 1,3 n~/1 EPA 353.2 Sample ROUTINE SAMPLE COLLECTED BY: LISA. Remarks: 1 Tests Performed ' See Special Instructions Above UA-Unavailable ND- None Detected "See Sample Remarks Above NA- Not Analyzed nT-Less Than, GT-Greator Than Member of the SGS Group (Soci~.t~ GCn~rale de Surveillance) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ~.-~-~(.~ -' OF ON-SITE SEWER AND WATER FACILITY 264-4720 GENERAL INFORMATION (a) (b) (c) Apptication Date_S_e.~tember 9, ] 986 Legal Description (include lot, block, subdivision, section, township, range) f,nt 7 ~lnak 3-- River View Estates TlqN R1W Sec.20 Location (address or directions) _J~ighELamd Rnacl R~gle Rive. r Applicant Name Lynn Sohr¢;i. ber Telephone: Home N/A Applicant Address Pouch 7-505 Anchorage,~Alaska 99510 Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [] (explain); Business 276-~01 i (d) Lending Institution Fedalaska Credit Union Telephone Address Pouch ?-%05 Anchorage, Alaska 99510 (e) Real Estate Company and Agent N'/A Address N Telephone 276-1011 (f) Mail the HAA to the following address: D4aku!~ by end, near TYPE OF RESIDENCE Single-Family[] Multi-Family[] Number of Bedrooms Other WATER SUPPLY Indivi;dual Well [] Community [] Public [] 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 ~ 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 I of 2 72-025 (1~/84) ENGINEERING FIRM PROVIDh,,G 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 Healt'h 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 flies 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 EAGLE RIVER ENGINEERING SERVICES Date ¢/:P~-//~'~ EAGLE RIVER, AK 99577 P, O. BOX 773294 694-5195 Approved for :/,~_,¢ (,,...4 .,/ bedrooms by Approved /~' ' ' Disapproved Terms of Conditional Approval Conditional Date CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority ,~pproval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Lega~l Description: /~r¢~ 2--/¢,¢ Well Classification /'¢"~'~ ~' Well Log Present (Y/N) ~/' Total Depth /o z¢ / Cased to Static Water Level '~/8¢/'~"~' ,'~/¢ °f= Casing Height Above Ground 2'z,3- "' Electrical Wiring in Conduit (Y/N} Separation Distances from Well: To Septic/Holding Tank on Lot ¥'/~.,o / To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole If A, B, C, D.E.C. Approved (Y/N) Date Completed / -/¢ ~ ? 2 Yield Depth of Grouting /P/J~ ~'"~-~,~'£ Pump Set At ,,¢? / Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Water Sample Collected by Water Sample Test Results ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot '¢",;¢-5" / ~¢/"¢~ ; Date Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~/~/ Standpipes (Y/N) Depression over Tank (Y/N) 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 ¢/o ' Course +/~o / Size /~ _~/ No. of Compartments -'-~- Air-tight Caps (Y/N) .,/I/ Foundation Cleanout (Y/N) /1/' Date Last Pumped ~/'~ ,,,v/,~ ; f o r Temporary Holding Tank Permit (Y/N) To Building Foundation /! To Disposal Field ~5- / 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 Width of Field ~ '" Square Feet of Absorption Area Depression over Field (Y/N) /U Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation 7 ' Lot To Water Main/Service Line ¢'-t~' -/'-~-,,..-,, ~-e.,,~,..~, To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course t-/d,-, ,/ To Driveway, Parking Area, or Vehicle Storage Area /~ ' Comments ¢¢f""J'/'~' 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 Existing or Abandoned System on 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 ** I certify that I have checked, verified, or conformed to all MOA and I-fAA guidelines in effect on the date of this inspection. Signed Company ,/~='~---'¢-' MOA No. Receipt No. '~(_..)O / 0 0 ~) ~ Date of Payment ¢~22 ~'~ Amount: $ ~" '¢"-" ~ Page 2 of 2 72-026 (11/84)