HomeMy WebLinkAboutGLEN EAGLE BLK 1 LT 3B GREA~ER ANCHORAGF AREA BORudGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAl. SYSTEM NAME /;) /~ ' MAILING ADDRESS ,S?'-'~f' t~"Yl ?¢ Z:'~i/~ '¢'"~'~"PHONE SEPTIC TANK: DISTANCE . /~ ~ FROMWELL /J/'O MANUFACTURER '~SbY-'/l'?'~r;'F MATERIAL.~:~//]~"[~'g., COMPARTMENTsNUMBER OF / INSIDE LENGTH INSIDE WIDTH LIQUID DEP'FH LIQUID CAPACITY/?~¢'~° ~ GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER~ OR WIDTH /,g~,t LENGTH/~.~/'DEPTH LINING MATERIAL ~'¢t~I¢"P/;~/~'~ CRIB SIZE: DIAMETER___.DEPTH .. DISTANCE FROM: /i~/ TOTAL EFFECTIVE BUILDING FOUNDATION_;~''' , NEAREST LOT LINE .ZL,¢ *" ABSORPTION AREA (WALL AREA) WELL ~ /~d]' ~' ~> '~' ¢¢ SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE BU,LD,N~ FOUNDATION CESSPOOL CONSTRUCTION NEAREST ~//g¢, ~' LOT LINE OTHER SOURCES APPROVED DISAPPROVED_ NEAREST DEPTH~~('''¢'- w,/ DISTANCE FROM: SEPTIC ///'¢ '~' SEEPAGE /~m ' TANK ____ SYSTEM REMARKS DISTANCES: INSTALLED BY: PIPE MATERIAL:_/// LOT SLOPE: DIAGRAM OF SYSTEM DATE j/ZZ/7-'~ APPROVED INSTALLATION LOCATION EGALDESCR,PT,DN (,.;RE:, ;R ANCHORAGE ARe:A BO; DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456 I JGH PERMIT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AN[) PERMIT SEEPAGE PIT-- __, DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION bY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY Will BE SUBJECT TO PROSECUTION, FOUNDATION TO SEEPAGE Pit ~"~ ~"') / , DRAIN FIELD SEPTIC TANK TO SEEPAGE PIt WALL. ///~'~ / DRA~N FIELD /~) , ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK DRAIN FIELD , SEEPAGE PIT DR A,N P,EL D TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ~ eertif3r this sewer will set,re no more that], a two (2) bedroom house a~d the o~e (1) b~tthroorn i~ the g'~r~g'e. DATE APPLICANT'S SIGNATURE FORM NO. EQ-016 Performed for Bra~d__D.i~c. ke~ff. Legal Description: This form reports: Depth Feet GREATER ANCilORAGE AREA BORO" Department of Environmental ~ 3330 "C" Street Anchorage, Alaska 99503 SOILS LOG - PEI~.OLATION TEST ¸ ty Date Perforined Lot 3. Block t, Glenn Eagle Soils log_ Yes Percolation ~.est 1 ~ Reddish -S~'~-'~"Or~anic~ 2 ~ Slightly Damp Silty Sand (S.M.) 3~ aSo S.F./B.R. 6 - 7- 8- Damp Sandy Gravel 15o Bottom of Test Hole 13' Was ground water encountered? Yes If yes, at what depth? 12' Reading Date Gross l'ime Net Time ?e_I)_Hj_!;? w~n_tmL. Net Drop Proposed installation: oeepa[Io Pit ..... ~8 ...... Drain Field :mpth of Inlet . Oepth to bottom o'F pit or D~ench ........................ COll[IENTS: drou~-'-~-~--~.~-shown above - Do b~_<~o.ck_~c.~cer~d ............... Perfor,,~ed by._N_~g_Z_.~_ag>%am ............ Cern. i fi ed bY.Coa~atmuot~on..~.est_~e.._6/21¢74 040 (6/74) o © MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGP~ADE) PF. RMIT PERMIT NUMBER:SW940361 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:WOOD WILFRIED E OWNER ADDRESS:P.O. BOX 3123 SITKA, ALASKA 99835 PARCEL ID:05060129 LEGAL DESCRIPTION: GLEN EAGLE BLK 1 LT 3B PAGE 1 OF 1 DATE ISSUED: 9/22/94 EXPIKATION DATE: 9/22/95 LOT SIZE: 49393 (SQ. FT.) NUMBER OF BEDROOMS: 2 THIS PERMIT: 2 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM [~DER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: EXISTING WELL SHALL BE ABANDONED PROPERLY AND PROOF OF THE ABANDONMENT MUST BE PROVIDED TO THIS OFFICE. RECEIVED BY: DATE: DATE: k~scri~d prope~, L~~ ~l~k %r'~;~r~ ~ordin~ p~ecm~t, Alaska, and ~at the :,-,,~r~v~e~s ~itua{~d ~h~r~on ~re w~lhin the p~pe~ ,:~y ?~'ing adjacent themt~ ~nm~ecn on tha prem~e~ I ~ ~' IVl..W DRILLING, inc. 'J? P.O. Box 4-1224 · 1310C International Airport Road (907) 274-461] ANCI4ORAGE, ALASKA 99509 DRILLING LOG Well Use of Well~2~za__ Location (address of: Township, Range, Section, if known; or distance main road 6" ;" 86 Size of casing. Depth of Hole_'~'60___~eet Cased to .___feet Static water level__l? 0 ft. (abQve) (beiow) land surface. Finish of well (cheek one) open end ( :<::< ); Screen ( ); Perforated ( ). Describe screen or perforation 71/-A Well pumping test at_~q gallons per ~ (minute) for_._Z%___hours with ..... 1~0~-~.(. ~: of drawdown from static level. Date of completion 1.'.I_/20/79 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size o£ material, color and hardness _~2 .... 4 .TO 50 50 TO 78 78 TO 36 86 TO 't60 TO TO_ TO .TO. TO .TO_ Certificdte No~. 814 & ~ci3 3--CONTRACTOR MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES_ Division of Environmental Services On-Site Servic~ Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # © 5' 0 ¢ o I ~ °1 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Lot3B Block 1..' Gl~.n Eagle. Location (site address or directions) NHN Sun Loft Ea~al~ Riv¢~; AK Property owner Mailing address Lending agency Chrystal Wood~ C/0 Target Realty Day phone Fag~e Day phone 99577 Mailing address_ Agent P~te Ostdiek/ Tar,q~t R~alty . Day phone 694-2388, Address 170,~4 N. Eagle_ Riu¢.r t_nn? Rnad Fag£a ~?/uo~; A~ 'qq~77 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ins to tl~e legality and status of system. .,., ,,.~ ~ ~.)1,, , ,, 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX ~_:~," ' . ,~ :.,! ,.-..~ . .... . ,, ::: . ' Holding tank ...... ' ' : ,-* ;' .-l, 72:~'.' ,' , :" , ~ .~ ~.. , _,.? Community on:site , ' :':-' :.. ':::: , :.- , ; Public sewer, ., -., 'W,/": i~'~,";k~; · . :--:'.'::,; . · .. ;:;~)~p~'~d)'~t.t'~':'~.... ·., ' 'NOTEi' iJ~Ommunity WasteWater system, provide written confirmation from State ADEC , attesting to the legality and status of system. ;--..~ /2-025(Rev, l/g1) Front MOA#21 .,-',. ',, ,,,-2,-_~ ,- ,,,:.?,l-~?_'-f~';~ ,'.,'"!' ,', ,,, . . - . .... 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 ~hat 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 S & S ENGINEERING iTO~d F. agJe Aiver Loop Aoad Eagle River, Aleska 99577 Phone. Date ////~"/ff ~/ DHHS SIGNATURE Approved for ~- Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date ..'~.'.. -The, Mumc~pahty,_ .,°f'Anch°rage,.,-. Department of Hea th and Human Services (DHHS) ssues Hea th Authority :,'..Appr°val,~. ,. ";Certificates,.".~'. based, on y upon the representat ons given in paragraph 5 above by an independent pr,o, mss!O,n.a~ engin.eer registered m the State of Alaska. The DH HS does this as a courtesy to purchasers of homes ' ar~l'thei~'-I~ndin~'i'nstitutions 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. -, ~" :.. : 72-025(Rev. 1/91) Back MOA#21 . ~ ; ~,-' Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST A. Well Data Well type Log present (~'4) -1/ Total depth ¢2~o ' Sanitary seal (~) '--/ If A, B, or C, attach ADEC letter. ADEC water system number Date completed 9 ,-'Z-~ ~o~ Driller Cased to ~'~ Casing height FROM WELL LOG Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Public sewer main '~ A-- ,~%ewe r ~ ~ ~ service line WATER SAMPLE RESULTS: Wires properly protected (~_N) ,,~ AT INSPECTION Septic/holding tank on lot Absorption field on lot Coliform ~--~ Nitrate / Date of sample: / 11¢1-~¢ / El. SEPTIC/HOLDING TANK DATA g.p.m. Date installed o~ .. q ~-~ Cleanouts ~N) High water alarm (Y/~-. Date of pumping ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank o, ~,4::~ Other bacteria Collected by: Tank size / c,(::> o Compartments _Foundation cleanout ~ _ / Depression ~ Alarm tested (Y/N) ¢,2~ -~/ Pumper --~r ~-~'.J ~OD/- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot / ~ ® On adjacent lots To property line /~ / "h Absorption field Surface water/drainage /,~ ¢ Foundation Water main/service line /o 72-026 (3J93)' 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)_..~--/ SEPARATI~FROM LIFT STATION TO: V~I on lot On adjacent lots Manufacturer Manhole/Acoess (Y/N) ~ted Surface water D. ABSORPTION FIELD DATA Date installed ~ .. ~j ~ Length \ ~- Width Total absorption area Date of adequacy test Soil rating (GPD/Ft2) ~- I Gravel thickness Cleanout present ~q) ,.f/ R e s u it s dTC-a~-~ail) 3°~$ Water level in absorption field before test Peroxide treatment (past 12 months) (Y/~:) ~,~, ~ ¢.-,..~o ~,,Y SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation ~.~ On adjacent lots '~ Surface water Curtain drain System type Total depth Depression over field (Y~ for -2.L~ Bedrooms After test '¢ "~ ~ If yes, give date On adjacent lots ~ t:) ¢ Property line ; o To existing or abandoned system on lot ~. Cutbank ~'/~ Water main/service line \o~ Driveway, parking/vehicle storage area .~- ,5-o~,, ~,J~/z_ c~,~, ¢~ E. ENGINEER'S CERTIFICATION I cenJfy 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 HAA Fee $ ~ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number il/Dd/~4 ll:DZ CT&E ENUIRONMEN[~L LRB SERUICES ~ 90?6941211 N0,247 ~g CT&g Re[,~ client 8at~p~e ID Matrix Commercial Testing & Engineering Co, Environmental Lebor~tory LABORATORY ANALYSIS REPORT 94.5591-3 L3B BLK1 gLEN gAGL~ Proj~¢~ Name CQllec~ed Frojeot~ Reu~lved Date 1~/01/94 @ 3.5:~0 hr~, pWSID UA Technical D)rector ~TEPHEN C. EDS Camplo R~m{rks: ROUTINE g3~PLE COLLECTED BY: R.A.I~. QC Dllowabl¢ Ext. &~lal parameter ~e~ul%~ gual Unit~ Method Limit~: Date Nit~Ce-N 0.10 U mg/L ~p~ 35~.2/30~.0 10 Zl/02/9~ c.:~ See s~mple Remark8 Above ~A - ~o~ Analyzed Und~.ec%'~d, Ruported value is the l)z~act,J, cal q~l~jfica~iDt% l~.m~t. LT = L~f:c: Than 5833 B Street, Anchorage. AK 99518-1600 -- Tek (907) 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACILITIES IN A~SKA, COLORADO. FLORIOA. ILLINOIS, MARY~ND, NEW JERSEY. OHIO, UTAH, WEST VIRGINIA '.MUNICIPALITY OF ANCHOP3~GE D~VISION 07 ~NViRONMENTAL Dk~,~{TMEb~ OF ~AL~ ~ND E~IR(~MSNT~L ~Rt2~ECTION APPLICATIOn] ~0R H~:AU~I AU%%~ORITY ~PROV~% CERTIFICATE a) h~wal ~scuiption (inClude lot~ block~ subd~vision~ctie~ t~ship~ Locution (ad~es~ or directions) Applicants Adduess c) Aoplicant is (check or~) [ending Institution d) ~ haling Institution ....................................................... ?~e $~h_o__~? Address e) Real Estate Co. & A~ent <. ~ ~ t.~//-~d'~ ~t 5{Z~ Address ._~. le phon_ water Ol:her ( c~sc'.': ['b~. ) Not:e: If cr~muni[:.y ~ell system, must have wn'itten [~Uat~t~nt of E~vJ. rcn~mntal Conservahion ' ' '- ~ am.es [?age I of 2] 5. __n_g~l]zmz_~En ine.~ering .... Firm ~P[.?.~v~i_d.i._r?~g_j[_n~p~ctions, Tests, Data and Informati©n ( ENGINEER SEAL) Address Signed by Date 6. DHEP A~proval Approved for._~.~_!. 'j ...... bedrooms Approved ~'~[' D.i. sappro~d ff~ Co~d J. ti©nal _[~. _~[ Tern~ of Conditional App~zoval 'i~e Municipality of Anchorage Depar'~Jrent of Health and Environmental Protection does not guarantee the continued satisfactory [~.~rformancm of tlm~ water .~3uppJ.y arid/or the wasbewater dislx~sal system. 'ibis approval indicates that, as of t}~v; validat].cn shcwn a~yove, L~sed o~'! tl~ ct~ta and infor]m~t~ion furp. ished I~ at-, e?.?ji~%eer registered the State of Alaska~ the water.~ supply and wastewater disposal system is sa,[[~ and tional for the numbe~, of.' beck-oo~ amd t~.~.~ of structure indicat~,tJ~ ( ~}']P SEAL ) 7. Mail the HAA t:o the follcMing add~..ess: KB2/d5/s [Page. 2 of 2] MUNICIPALITY OF ANCHORAGE (MOA) HEAL%/4 AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 WELL DATA Well Classificati9~ Well .Log P~esent (~/~ Total Depth Static Water ~1 Casing ~ight Elee~ical Wiring in ~nduit ~p~ation Distance ~ ~11: To ~ptic~4 /2~/ '"~ ~ Yield~ Date Completed .//r ,~., ~ ~ Depth of Grouting /, Sanit~y ~al on casing (Y/N)~%~ /~O ~ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot /'~ / To Nearest Public Sewer Line /%/ /~ ' To Ne, a~est Public seWer C leancut/Manhole /%/ /, ~, To Ne~lrest Sewer Service Line on Lot Water Sample ColleCted By .~"~ ~-f~ ~/~?///~//~; Date "3z--//.~/,/~// . Water Sample Test Results ~v/~ K//.~w~ ~zc?/~ Cements ; On Adjoining Lots SEPTIC/HQL.~.~.~'~ TANK DATA Date Instal~ ~.2 2/-7~ Size /~ ~) No. of Ccmpa~tr~ents / Standpi~s/(Y~) ' ' ~i~-tight CapP~) Foundation ~].eanout -. , , '~' . · . -- ~ P~lng/~lntenan~ ~n~a~ ~ File (Y~/~ , fo~ ~/~' Holding Ta~ High-Wate~ Ala~ (Y~)'',/~ ~rary Holdi~ Tauk Petit ~paration Distance ~ ~ptic~olding Tank: To Water-Supply ~11 _ /~ To ~ilding Foundation TO ~o~rty Li~ --_ , ~P '/ TO Dis~sal Field ~ To ~ter ~Sgrvi~ Li~ ~ Z · To S~e~, Pond, ~e, ~ ~jor ~aina~ Co~nts [Page 1 of 2] 2~15~84 Ce MUNIcIP/" "W OF ANCHORAQI] DE~ DF HEALTH & ENVIRONMENTAL PROTECTION ABSORPTION FIELD DATA MAY 2 'i lpnZt Soils Rating in Abso,ption Strata /~J-<? ~E ~ ~e~ Design Date Installed ¢/7~L /~ ~ngth of Field'' u~/ Width of Field /_~"- / ' ~p~ of Field /¢ / ~ ~ Grail ~d Thick.ss z~ / Squ~e Feet of ~so~ption~ea .~Q~30 Stan~i~s ~esen~(Y~ ~p~ession ove~ Field (~/ ~te of ~st A~a~ ~s~~ , ~ · Results of ~st a~a~st .~/~ ~/~C- ~ ~ ~ Separation Distan~ fr~ ~sorption Field: · o ~t~-su~¢~ ~zz /~ ~o ~om~t~ ~t~ ~ TO Building Foundation ~ / To Existing or ~ndo~d System Lot ~7'/~ ~; ~ ~joining ~ts ~ ~ ~G~ TO Wate~ ~/~rvi~ Line ~.~0 ~ TO ~t~(if pre~nt} ~ ~- To St=e~ond~ke/~ Majo= ~aina~ C~ ~ / ~ To ~iveway, Pa=ki~ ~ea, ~ Vehicle St~a~ ~ea /~ / Cor~nents D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Dim3nsions Manhole/Access (Y/N) /"~Off" Level at ///~ Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify tha~I ~.e checked, verified, or conformed to all MOA HAA Guidelines in effect on the d~,of t~/~//~{~ction. ---~ Company/ /, MOA No. ,~"~, : - '....v.. , .. ' ' ~. ~ ' D.~TE RECEIVED \\ INSPECTION APPOINTMENTS ~-IME TIME TIME "SAT E DATE DATE TNSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE MUNICIPALI'rY OF ANCHORAGE  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DFPT. 825 L Street - Anchorage, Alaska 99501 ENVIRO; ~Mdi'~IAL :-',,O ~ ~:crlON ENVIRONMENTAL SANITATION DIVISION ' (,t., 1 1,982 Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. ~. PROPERTY OWNER I PHONE Brad and Paula DickeyI 694-9239 ~-AI LIN G ADDRESS St. Rt. 1613, EaAle River, 99577 PROPERTY RESIDENT (If different from above} PHONE NHN Sun Loft Dr.~ EaRle River~ Alaska 99577 694-9239 2, BUYER PHONE James Roddick 344-8689 MAILING ADDRESS P.O. Box 10-1288~ Anchorage~ Alaska 99511 iA_"LENDING INSTITUTION PHONE Alaska State Bank (Attn; Kathrin) 277-5661 ILING ADDRESS - 310 E. Northern Lights Blvd., Anchorage~ Alaska 99503 4, REALTOR/AGENT I PHONE Jack White Co. (Attn; Larry Maulden)I 277-1553 MAI LING ADDRESS ~201 C. St.~ Anc~orage~Alaska 99503 5, LEGAL DESCRIPTION Lot 3, Blk 1, Glen Eagle Sub. ( Mile 5, Eagle River Rd.) STREET LOCATION NHN Sun Loft Dr., Eagle River, Alaska 99577 6, TYPE OF RESIDENCE NUMBER OF~BEDROOMS ~ SINGLE FAMILY [] One E- Four [] ~ Two E] Five [] MULTIPLE FAMILY ~-I Three I-~ 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 odor to that date, give wel depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY 1976 YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] 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 E~]PUBLICE~]INDIVIDUAL/ONuTILITy'SITE DATE INSTALLED Connection Verified INSTALLER []Septi, c T~ank~or [] Holding Tank Size: i(¢') ~(? If Tank is homemade SOILS RATING live dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL : , .... 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line I WELL TO: Absorption Ares to nearest Lot Line 5. COMMENTS [~]~APPROV ED FOR :~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY EXCAVATION ROB[iRTA. SHAFER WORK CIVIL. ENGINEER 694-2979 October 26, 1982 Jack White Realty Company ATTN: Larry Mauldln 3201C Street Anchorage, Alaska 99503 Dear Mr. Mauldin, Reference: Lot 3; Block 1; Glenn Eagle Subdivision MIJNICIPALI]Y OF /,' F- fOR~',GE EI'qVIF, ,,', :,.'. _ ]]L?.C.~F4 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 approximately 1~000 ga]ions, 'Uhe absorption trench was tested by continuous flow of water over a period of 24 hour.s, without any adverse effects on the system, It cau be concluded from this test that the waste xqater d{sposal system serving the ........ ~ijT/residence located on th~s proper.ty is currently functioning adequately; however, the system cannot be gunranteed against subsequent failure. If we may be of further service, please do not hesitate to contact us. cc: Municipality of Anchorage Department of ]lealth and Environmenl:al Prot:ection Alaska State Bank ATTN: Catherine SRB /96X EAGLE RIVER, ALASKA J;]?ad an.,1 Paule. Dickey Eagle River, ?\K 99577 Subject~ Y,ot:. 3 Block 1 Glen l~agle Sub. Approw~.l for t.he J_ndividual r~ewer and water f~c:J..].i!'.ieo eanno4 R×po~{ed electric:al wires 'to t'he well l~ead arc: :i.t~ vJ. olatiou ()-~ ~:hr~ ?4unicipality of Ant:borage /::odes and mu.~t he encased J.n (2onduit. tPhe water analysis repor'k need..% ko be :~ubmJ_tteJ. 'to this office from the Chore Lab, 5633 13 Strce. t, for our review. '.Phc septic tank purg, pod with a recei, pi: su¥~mit'hed t:o this depari:'n~ent, An adequacy teat needs to he performed o~ t. he exisi:ing ].em. chi. rig area. This test v/ill_ rl{~term:[ne :i.f 'l':l~e sysiJeh! J.S adequate accor'dinq 'Lc Natiorlal Silandards. A liatirlg of private f:trms performing the tost is enclosed. This repor't nee(]~ 'ko be at]bruit-ted i-o thif~ office for ()~lr review. Please no'LJ.:[y this ])e,nartment for a rc;inspecri:ion when i;he noted discrel~)aDcj, es }lave !)eeB covrc~ct~od, l:f: there are any Sincerely, RoberL C. Pratt Assoc J.;vhe Nnvi r onmeN,'ka].