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Home My WebLink AboutMCKINLEY HEIGHTS #1 BLK 3 LT 6McKinley Heights #1 Lot 6 Block 3 ~VqdOd 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. # 1. GENERAL INFORMATION Complete legal description Lot 6; BloCk $; McKinleq H~i~hts #I Location (site address or directions) Property owner Mailing address 18682 Amonson Dan S chul~ 18682 Amonson Chuglak, AK AK Day phone 99567 688-1376 Lending agency Mailing address Agent D~_n~, NLcol~ys~n/REMAX OF EAGLE RIVER Address 16600 C~nt~rfi~ld D~iv~ Eaql~ River, Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROO MS: ~ Day phone Day phone AK 99577 694-4200 3. TYPE OF WATER SUPPLY: g 72-025 (Rev, 1/91) Front MOA#21 Individual well xxx Community well Pub lic water NOTE: ing to the legality and status of system. .~,,~\ ~,~ TYPE OF WASTEWATER DISPOSAL: .. -'- Public sewer .? -- NOTE: If community wastewater system, provide written confirmation from state ADEC attesting to the legality and status of system. If community well system, provide written confirmation from State ADEC attest- Individual on-site Holding tank community on-site 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. Name of Firm Address Engineer's signature ~ '..~- ~ Phone Date DHHS SIGNATURE for ~ Approved Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: By: Additional Comments Note: The well for this property meets existing State and Municipal Codes. There are nitrates present. It is suqaested that a periodic testing be performed to insure the wells continue/~ suitabilj~Ty. Nitrate concentration is 5.65 mg/1. EPA 't';1,'llP|l The Mu~<iCipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Appro~v'/I' 'Certificates based only upon the representations given in paragraph 5 above by an independent :~ professional engineer registered n the State of A aska. The DHHS does th s as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections o~ analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1;91) BaCk MOAt421 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~-~=,~ ~, ~-"~ ~ r~ [Z-,~ ~/{r~lParcel I.D. A. Well Data Well type ~'P~ ~.l~-~ If A, B, or C, attach ADEC letter. ADEC water system number Log present {.Y~ h/' Date completed Total depth L~V---- Cased to .~ Sanitary seal ~N) ~/ FROM WELL LOG O V---- · Driller ./--it c>~+' Casing height Wires properly protected ~N) AT INSPECTION Z'/' · g.p.m. ; On adjacent lots .; On adjacent lots Date of test Static water level Well flow Pun]p level1 SEPARATION DISTANCES FROM WELL TO: Septic/~.~ tank on lot J ~ ~ ~ Absorption field on lot Public sewer main Sewer service line Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: J/~ 1 o ~ ~ / Collected by: Other bacteria B. SEPTICIN:~IEI~,,%'C TANK DATA Date installed Cleanouts ~) High water alarm Date of pumping Tank size .-~ ~, ~c>c~ Compartments Foundation cleanout (Y~ ~ D~epression,(Y/~j~ ./~/ Alarm t'~sted (Y/N) ' ' :i--~/'~/b¢ ~'~_ )/~ ,~.z/ Pumper ..~'~/,/~ ~.~'~ ,~ o L. SEPARATION DISTANCES FROM SEPTIC/~TANK TO: Well(s) on lot /~o On adjacent lots To property line /~' / ~ Absorption field Sudace water/drainage /,.1/ Foundation 2~/ Water main/service line 72-026 (3~3). Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level ~les tested Meets MOA electrical codes (Y/N) SEPARATION D~ROM LIFT STATION TO: W'~'on lot On adjacent lots Manufacturer Manhole/Access (Y/N) ~ ".~l~ff" Level at Surface water Date installed Length '-'" 35' ! Total absorption area Date of adequacy test D. ABSORPTION FIELD DATA Width 1/- 15-~ ~/ Water level in absorption field before test Peroxide treatment (past 12 months) (~ Soil rating (GPD/Ft2) ~ 5' ~z- System type 7'-~,~J~ --,-'b ' Gravel thickness 3,5'~- ~/'.a ' Total depth -'-- 7 ' Cleanout present ~N) / Depression over field (Y/~ ,,J' Results ~ail) /~,4~'.~ for -~ Bedrooms ~" After test ~" ~,J~- /~-~Jo ~J 'J If yes, give date "J~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot / o To building foundation On adjacent lots Surface water Curtain drain On adjacent lots ! ~ ~ ~' Property line To existing or abandoned system on lot Cutbank ~J~/,~ Water main/service line Driveway, parking/vehicle storage area /o E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA of this inspect'on. Signature Engineer's Name Date CE-8801 HM Fee $ ~0, Date of Payment Receipt Number 72-026 (~)' ~ck Waiver Fee $ Date of Payment Receipt Number 11/15x94 10:49 CT&E ENVIRONMENTAL LAB SERVICES ~ 9076941211 N0.390 ~t~l~ Environmental Laboratory Services ......... LABORATORY ANALYSIS REPORT CT&~ Ref,~ 94. cliea% Sample ~D L6 ~LK3 MCKINLEY ~TS ~1 WATER Commercial Testing & Engineering Co, WORK order cliez3t Name $ & 8 ENGINEERZNQ Prior,ed Date Proj QC AllowablE Ext. Reeulte Oual units Me uhocl Limit ~ Date Date Init l~itrate-N 5.65 m~/L EPA 353.2/300.0 10 11/1~/g4 See Spe~.ial InstZ'u¢:r. ione Above NA - Not ~zalyzed Undetected, Reported valile is the p~actical ~anti~icatio~ limit. LT - bees Th~n ~T" Grea~cr Than Secondary dilution. 5633 B Street, Anchorage. AK 99518-1600 -- Teh (907) 562-2343 Fax; (907) 561-5301 ENVIRONMENTAl FACILITIES IN A~SKA, COLoR~Do, FLORIDA. ILLINOIS, MARYLAND. NEW JERSEY. OHIO, UTAH. WEST vIRGINIA MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES: DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORI~ APPROVAL. OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date February 29~ 1988 GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 6; Block 3; McKinley H~ights~1 ~ Location (address or directions) Amonson (b) Property Owner A. Ho F.C. Telephone: Home Mailing Address (c) Lending Institution Eir~an's.. Fund Telephone Mailing Address (d) Real Estate Companyand~gen~t'., Jack W/~te Co./ Ca&ol~ Mc?bee Address,', 1.0928 Ea~l~ :~v~r Road- Eagl~ ~v~rr Alaska 99577 T elepho~':~ .;' ~ ~ ~,.~5~ 0 ~' ' Business (e) Mail the HAA to the followina address: or: Check here'S, if hold for pick up. List contact person and day phone number below, S & $ ENGiNF. EEiNG 17034 Eagle Rivet Loop. Road l~e~ ~__r~. Eagle River, Alaska 99527 2. TYPE OF RESIDENCE Single-FamilyYl~ Number of Bedrooms Three WATER SUPPLY Individual 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. SEWAGE DISPOSAL OnsiteJ~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of. Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (Rev 8/86~ Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with ail Ml~nicipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm _~ & $ i~NGINEERING Telephone 17034 Eagle River Loop Road No. 204 AddresSDate Eagle KJVer, ~--~.~-.~?,."7. DHHS APPROVAL Approved for ~'~'~z'(J~/bedrooms by Approved ~ff~ Disapproved Terms of Conditional Approval Conditional Date CAUTION 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. MUNICIPALITY OF ANCHORAGE (MOA) · J:.~EALTH AUTHORITY APPROVAL (HAA) t4,C,~AL¥~.O~t~CC~O~V~S~o~CHECKLIST-FEBRUARY 1984 NN~ ','T,,N~ S'.-" ' 264-4744 ~w~O~~ t 7 [955 Legal ,~ri~tion:-- Well Olassification ~ ~ ~ Well Log Present (Y/~ ~ Date Completed Total Depth ~, Cased to ~' Depth of Grouting If A, B, C, D.E.C. Approved (Y/N) Static Water Level Casing Height Above Ground Electrical Wiring in Conduit(~N) Separation Distances fi'om Well: To Septic/Rot~ Tank on Lot Yield Pump Set At ~-----~'Z-- ~ Sanitary Seal on CasingS) "/' Depression Around Wellhead (Y~) ; On Adjoining Lots To Nearest Edge of Absorption Field on ~_ot / '~ ~ ; On Adjoining Lots To Nearest Public Sewer Line I'~ ~t~'/~, To Nearest Public Sewer Cleanout/Manhole //~' To Nearest Sewer Service Line on Lot Water Sample ColleCted by ~'~-2'~--~ ~r'-k'¢'~2'~ ~ ; Date --o-.2 ~ \~_~ Water Sample Test Results ~'"~"~"~ f ~~ "~ i"-~l~"~'~----''S Comments ~ ~ -~ ~ ~ ~ "t ,O,Z~-~ .~:~=;,//_~¢j¢~ B. SEPTIC/~ TANK DATA Date Installed ~' Size,~'¢¢~., le~ex~ No. of Compartments Standpipes~N) ~ Air-~,~ht Caps ~N) y Foundation Cleanout (Y/~ Depression over Tank (Y~ Date Last Pumped Pu mping/Maintenance Contract on File (Y/N)?,] P~/I~ ;for ¢/^ Holding Tank High-Water Alarm (Y/N) r-/,g~, Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Hold~l Tank: To Water-Supply Weft ~ C::Pt::~ To Building Foundation To Property Line \ c~ I.j¢ To Disposal Field TO Water Main/Service Line I-E::~ To Stream, P;nd, Lake, or Major: Drainage Course \ ~ I Comments "~r~"P ~'~"~::::~"'" ~t'~t"'~e~ Page I of 2 72-026 IRev 8/86~ Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata //~'~/2X, ~:~'~/~'Jg-'"Type of System Design "~~ Date Installed ~,.,~ ~-~, Length of Field .,t~,{~, Width of Field ~Z~:~, "~ / Depth of Field J~(~:Z..~, "~ Gravel Bed Thickness ~ ,~ ~ '~' ~ ! Square Feet of Absorption Area ~>~¢,c:Y~ ~,.~,.~t:>'''/c=' Standpipes Presentd~N) y Depression over Field (Y/~ ~ Date of Last Adequacy Test Results of Last Adequacy Test ~--~'~'~--~="~-~r';>~'Tz ~ ~ ~ Separation Distance from Absorption Field: To Water-Supply Well \ ~1 To Property Line I To Building Foundation ¢ '~7 ~' % To Existing or Abandoned System on Lot r~'~/~' ;On Adjoining Lots To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Cutbank (if present) LIFT STATION ~ /. 7Z'3,.5 ~Zc/5 ~,)f~',,~ _.~.~u Size in Gallons ~ Manhole/Access (Y/N) "Pump On" Level at ~ "Pump Off" Level at High Water Alarm Level at ~_ Vent (Y/N) Tested for ~yctes during Adequacy Test. Meets MOA Electrical Codes (Y/N) ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to ali MOA and HAA guidelines in effect on the date of this inspection. Sag I~e~ S ........ Corfll/01~ Eagle River Loop R~d No. ~OA No. Receipt No. Date of Payment ~ ~¢ Amount: $ //~ ~L Page 2 of 2 72-026 (Rev 8/86/ Back LAB INSTRUCTIONS £or Work Order ~ 5633 Date Report Printed: ~AR 16 85 @ 13:56 Client Sample ID:L6, B3 MCKINLEY HTS Wi PWSID :UA Collected MAR i5 88 @ 11:20 hfs Received MAR 16 88 @ 11:00 hfs Preserved with :NONE Client Name : S & S ENGINEERING Client Acct : SNSENGP P.O.$ NONE REC'D Req $ Ordered By : R. SHAFER ChemLab Ref. ~ :9389 Analysis Completed : Laboratozy Supervisor :STEPHEN C Released By : EDE Send Reports to: I)S & S ENGINEERING Special Instruct: Chemlab Client Parameter Sample ~ Sample Dascription Matrix To Test Method Units Result 1 L6, B3 MCKINLEY HTS #1 1 20153-NITRATE-N EPA 353.2 mg/1 ' - APPLI?~NT FILLS'OUT UPPER HA''-'~ ONLY ' ~,.-% Phone l~lailing Address ~i~ {) Buyer Address Zip Code Lending Institution to~,lt~j C/.~::(~) ~,~[ cJt(_, r..~-:~ ~ /3(~..~t~_.~ ~f~ Phone Phone Realty Co. & Agent Address Zip Code Street Locatio~ Typ~ Residence h~' Single Family [] Other Wat~.Supply ~ Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975, [] Community For wells drilled prior to that date, give well depth (attach log if available). [] Public Utility ,~ Indi¥idual Year Indi¥idual Installed: ' [] Public Utility When Connected to Public Utility: [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, / Time Time Tlme~ , ~- · Time Date Date Dat~,~. X /~ .. Date Inspector Inspirer insp~'X Insp~to / -7--Z ~.~ " ~ ~ · ~ u AUG ~ . ~ ~=~ .~ "Dept. (~PPROVED BEDROOMS p~ *CONDITIONS OF APPROVAL ( ) DISAPPROVED ~ ~ ( ) CONDITIONAL APPROVAL* ....... ~ .......... D,TE ~--~O--~ ~ Soils Rating ~ Date ~wer Installed Well To Absorption Area Well Log Received Well to Tank Septic T~k Size 72.023 (3182) "& DAli= RECEIVED ~' '' INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY\,~,~[~/OWNER~,~.~? ' I PHONE PROPERTY RESIDENT (If different from~ above) / ~ - ~ 2. BUYER PHONE MAILING A R ~ ' ~ 3. LENDING INSTITUTION '.. · MAILING ADDRESS MAI LI NC/~}D~ ESS ..¢/J ' 5. LEGAL ,~ESqRIPTIO~)~ STREET LOC/~TI/O N / 6. TYPE OF RESIDENCE [~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four , _C-~__. Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY I~--I NDIVI DUAL* [] COMMUNITY [] PUBLIC UTI LITY *ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~-~ INDIVI DUAL/ON-SITE [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) T/:'t,,,. ~ 'T',-~ ,,/-~' / ~ - --- ~ ( ~ / THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] I NDIVl DUAL/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 DISTANCESwELE TO: Septic/Holding Tank Absorption AreaIlSewer Line Nearest Lot; Line 4, Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOB BEDROOMS [] CONDITIONAL APPROVAL {letter must accompany certificate) [] DISAPPROVED DATE B ~ 72-010 (Rev. 6/79) July 21, 1982 Ted Smith P oO. Box 310, Amonson Rd. Chugiak, AK 99567 Subject~ Lot 6 Block 3 McKinley Hts. Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: ~ ~e water analysis report needs %o be submitted to this office from the Chem Lab, 5633 B Street, for our review. Expose the well for our inspection to determine proper construction, also to insure minimum distance ~re~aire~e~_ are met between the well and sewer syste~. ~ ,~-J)-~ / T.he septic tank mu~ped with a receipt submit'ted to thl~--- department. An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to ~ational Standards. A listing of private firms performing the test is enclosed. ?his report needs to be submitted to this office for our review. Please notify ~is Department for a reinsp~ction when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. RP171/~/EH Enclosure EXCAVATION ROBERTA, SHAFER WORK CIVILENGINEER 694-2979 August 16, 1982 Ted smith P.O. Box 310 Chugiak, Alaska Dear Mr. smith, Reference: MUNICIPALITY OF ANCHOI~AGE DFP'r Cc ijF,,i.Z,4 2, 99567 RECEIVED Block 3: McKinley Heights Subdivision A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The absorption trench was tested by a continuous flow of 593 gallons of water over a period of 24 hours without any adverse effect on the system. It can be concluded from this test that the waste water disposal system serving the two bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subseqment failure. If we may be of further service, please do not hesitate to call. Since' 1y, cc: Totem Realty ATTENTION: Audrey Mason Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA ~ ,~ "- D,~,¥E RECEIVED INSPECTION APPOINTMENTS TIME TIME DATE Ii DATE DATE INSPECTOR INSPECTOR INSPECT~I~NI~IPALITY OF ANCHO~E ~~ DEPT. OF H~ALTH & MUNICIPALITY OF ANCHORAGE DEPARTMENT o~ .~H · E.W.O.~.~ P.O~EC~O. DEC 2 0 1979 825 L Street - Anchorage, Alaska 99501 RECEI Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be proce~ed. Please allow ten (10) days for processing. 1. PROPER~OWNER ~ ~ . / i P~O~_ MAILING'ADDRESS -. / R :Si ( iffa nt o~above) ~ ~ONE 2. BUYER /J ~ ~ ~HONE 3.' LENDING INS~ION ~ "' ~ ~ , , J r h'u 7 - lln MAILING ADDRESS . ~ ~ ~ / 4 REALTOR/AGENT "/~ -- ~ ~ ' PHONE - b 6. TYPE OF RESIDENCE FI~-~Sl NG LE FAMILY --I MULTIPLE FAMILY NUMBER OF~BEDROOMS [~Twne F- Four o [] Five [] Three r- Six [] Other 7. WATER SUPPLY ~ INDIVIDUAL* ~] COMMUNITY PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth ('attach log if available,) S. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. C'~-" 72-O10 {Rev. 6,79].,.T.,.~ ~ .~ ~ ~ ~ ~ ~,~ ~.~,t' ~.,,~.. ~ ~ ~ ~ ~ THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTI LITY 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. DISTANCESwELL TO: Septic/H°ldin9 Tank IAbs°rpti°n Area 1Sewer Line INearest L°t Line Absorption Area to nearest Lot Line 5. COMMENTS ~/ [~ APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must acc~np~any certificate) /? ~ DISAPPROVED 72-010 (Rev. 6/79) DAVID A, SLENKAMP ROBERT A. SHAFER MECHANICAL ENGINEER 694-9055 CIVIL ENGINEER 694-2979 January 9, 1980 MUNICIPALITY OF ANCHORAGE DEPT. OF I!:~ALTH & ENVIRONMENT;t,L ?20TECTION Totem Realty ATTENTION: Audrey Mason Artillery Road Eagle River, Alaska 99577 JAN i ':: 1980 RECEIVED Demr Mrs. Mason, Reference: Lot 6; Block 3; McKinley Heights Subdivision; Van Ordte Property At your reauest, a septic system adequacy test was performed on the ref- erenced property on January 6 thru ,Tanuary 7~ 1980. In accordance with the builder there exists a home-made, concrete septic tank, wi. th two compartments with a capacity of approximately 1000 Fallons and two trenches for a combined length of approximately 70 LF. The trench ~ms tested by c ntJ. nuous flow of water through a meter for a period of 2~ hours. Approximately 604 gallons flowed through the system with no back uo or adverse effect on the operation of the system. 17~e septic tank clean out pipes were replaced and the septic tsnk pumped. It can be concluded from this test that the system is functioning ade~uate].y for the three bedroom residence. If we can be of further service, please do not hesitate to call. Sinc~y, ~ '-, /"/ ..., /'/ // ,-"--.."'- II / 7.,- cc: Municipsli~ of Anchor~e Department of Heslth and Enviornment~l Protection Alaska Pacific Bank SRB 196X EAGLE RIVER, ALASKA