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HomeMy WebLinkAboutT15N R2W SEC 25 LT 128BTISN R2W Section 25 Lot 128B #051-312-39 Municipality of Anchorage Page of 2-- 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: S W 9 l 0179 PID Number: OS/3/239 Name: Wastewater System: ❑ New Upgrade J ,%1 Es ¶ TO A AJ r r A yO U N G- Address: ABSORPTION FIELD JS-L132- 1-�v5�-y ST. ,P erne. No.of Bedrooms: FAC-6 F .IVER. / Ak 99577 LI XDeep Trench ❑Shallow Trench ❑ Bed E Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: 1 O.&GPD/Sq.Ft. 1 Lot: {)lock: Subdivision:- Depth to pipe bottom from original grade: Gravel depth beneath pipe 12 S Ft. 7 Ft. Township: I Range: 1 Section: Fill added above original grade: Gravel length: TiSN (22_W 2.5 ( Ft. 72-Ft. Gravel width: Number of lines: Distance between lines: WELL: ❑ New ❑ Upgrade 2.SFt. i /-)bei Ft. Classification(Private,A,B,C): EXIST. Total Depth: Cased To: Total absorption area: Pipe material: F 8/O Y6RF> ? i VA 1 tr Ft. Ft. //00? SQ.Ft. l457 Al E)3034-1 P v.c > Driller: Date Drilled: Static Water Level: Installer: Date installed: Ft. /WEED EEcAvA /A.1G (o —Z3 -44.1 Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES yi Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines g7N crf OI G E /is AJ, 1253 Material: Number of Compartments: Well' /02-1 117 ' 2S 1 + STEEL Z. Surface / STATION Water /00 '-i- /00 LotSite i allow ns: Manufacturer: Line z4l S I "Pump on"level at: off"level at: High water alarm at: Foundation q ' 28' Curtain 0MKNO 11/N Pump Make&Model Electrical Inspections performe Drain ` Remarks: A4 apo pEp-Ty GINE kJ Ri vo 72 BENCH MARK J E; - 'é3/4,•/ Location and Description: To? OF Co,uC. SLAM AT' 6/4R.,43&G' Assumed Elevation: /00.0 Ft ENGINEER'S SEAL --f. .0ys si7 . 5 R 5 RNGINRRRINO 17034 Eagle River Loop Road,No.204 d ••i ....., •.a.�•••••• Inspections performed by: Eagle River.Alaska 99577 Dates: 1st (o -2Z-9 y , L ti,' 2nd (2 -z3-9y •. ,• . ••ed A.�sbofe : E i No. 1437- ;to ;i, . Department of Health and uman Services approval 4 •-.96;;,..........<4' - '� Reviewed and approved by: / J���`7 Date: T /`� "y4- •11��,�`� ;..,0 72-013(Rev.9191)MOA 25 Permit No.SW940179 Page 2 of 2 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 Description15N, R2W, SEC.25, LOT 128B PID No.: 05131239 CO1 CO2 98.1' /98.6' - FINAL GRADE MT CO3 II lI INSULATION _ 95 1250 GAL \95 0 ii S.T. 11 ., 93.1' • I 86.1' ♦ 80.1' NO WATER FOUND wM. , w w LST 1'��.��_�...�.V..M.�.w A i B C FCO 14.0 — 12.0 CO1 11.0 36.0 28.5 CO2 17.5 40.0 — EXIST. TRENCH D.V. 27.0 47.0 — ABANDONED SUCH THAT IT CO3 57.0 79.0 — w£.�. _ Y....BE..USE JA1..THE..FUTURE 00.4...36:5....30:0. — _................... MT 47.0 67.5 — N 5' P/L WAIVE' NSUTATION GRANTED CO3 / a 0 MT•` 1 Ii II i f tx1 HED I I D.V r CO2 c. II co ' EXIST. zi r FCo .4 BDRM................--.............. . NEW TRENC I I A C HOUSE d EN BT ÷te, URE • i, 4 IE coo % r NEW 1?r50 GAL. CONC. ;•• ' •c, °•" `•b '1 SEPTIC"TANK:,.. r.......... ..,,__ ..��.:.,_ �.,..,..,,,,..,......._. WELL,o ..._............_ ; ..., e.. F �JI00. {� SCALE 1" = 40' osrt A. Shefn ,...a, • r. e1, • ` *.? "„N No. 1.437.4 /'� ' 44.;''',' • , ,, i* Q ' 72-013 A(1/93)' c1"1‘a "4/ LLS66 YNSV1Y '1d3AI1:1 310V3 • POZ 311f1S • d0011:13A11:1 3 V3 H1HON b£OLl NOIS30 1.131SAS 1YSOdS10 M31VM 31SVM 31ISNO vy brn SN01103dSNl 1VOINYH03W 9 lVtlnLOnkus 1531 NOI1Y1001:13d s3Nnsol '3 217SVN 1; 1S31lIOS '3'd `N3dVHS 'V .?1 : ��' N'JIS30 OYOH ', ,u'aau'rs •911 prr u0a a?V 7d 'a7yn109 ual w9 go aq Mow am g1 SNVId 311S -pay 5 o Van7-nm aura nriadOW V an997 non x9anhaj dol 140 rUawd07anap aun7-ng fiu'V 140 rJaggV a9u'anpV lIt) anrnI 77rm V'an'rnm 1S31MOldV 71477 fi -adoud 1 •$gz i XO7 go aauap ' n ata fig pais -n 9'' ygz i NOI103dSNIT13M X07 140 p4naoJ uunq pun pay9 alp' nfl 4a7arn3 •uaumo aun-ng V fig aur' o� atp, go 7nnouru 'mg o uany6 aq finw uomwap'c'uoa pun padonnapun nnuauuna 9?' MI i 707 •yg31 X07 VOW 0c7t) gni X07 go uaumo ay1 S11:1Od3ll ONY • aag 5 97 pauornhau aau1497p uo-mwnda9 S3wf11SONI1133N1ON3 714140ZYI1011 a2yl •ygZ 1 X07 pub gm '07 uaamrag auf nryadowd a ye pun 0.317 uo urninv 7v?od 9-rp ua4rnma 9mn n1: -u0 ani: uaanxk-aq aauv rrp uo"r. 'nunda9 7nuoz 'itoy aip 0 'ram-nm V arm? non 9anhaN NOI103dSNI 1131VM V 1:13M3S 411'oN •VW VVWI MUNICIPALITY OF ANCF{O1tAGE m 1 N `N511 •`5Z 'aas '$$Z 1 P0l s 3ON3N3d3N ENVIRONMENTAL SERVICES DIVISION SNOISN31X3 NIVW 61566 >Iy 'a5vioyauy 1131YMV El3M3S :UL 1 2 1994 059961 X0$ '0'd igON una :um RECEIVED 9aDI:A S UVWVH pun lynraH go uaw'Vbdaa 3JVNOHDNY 10 Alllyd13INfYV S1VAOklddV ALHOH1flY H11Y3H os.,ov d 3/tit/3>pd3 llZl-P69 XVd V V 6L6Z-t'69(L06) b661 '31 firlt y Sa33NION31IA10 NIP r '3'd'II3dVHS E1390U �,; ' • '3'd'Ej3dVHS 1E I39OEI •,lam es' > ety PAGE MUNICIPALITY OP ANCHOP~AGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940179 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:YOUNG JAMES & JUANITA OWNER ADDRESS:15432 HUSKY ST EAGLE RIVER, ALASKA 99577 DATE ISSUED: 6/16/94 EXPIRATION DATE: PARCEL ID:05131239 LEGAL DESCRIPTION: T15N R2W SEC 25 LT 128B 1 OF 6/16/95 LOT SIZE: 40287 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE 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 UNDER 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 RECEIVED BY: ISSUED BY: ~-~ ROBERT SHAFER, P.E. ROGER SHAFER, P.E. June 06, 1994 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERINGSTUDIES ANDREPORTS WELl. INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 'L' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 128B, SE¼, Section 25, T15N, R2W Request you issue a permit to upgrade the septic system serving the four bedroom house on the referenced property. An adequacy test performed on the existing system for Health Authority Approval purposes found the absorption capacity of the existing system to be inadequate. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The approximate location of the test hole is located on the attached site plan. The monitoring tube within the test hole has been checked and found to be dry. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your r~t. us. A. Shafer, P.E. %S/LSU/jk ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP · SUITE 204 ° EAGLE RIVER, ALASKA 99577 o 0.~ SAN BOWFEL AVE. 100' WEALL RADIUS z W 0 NVgd 311S ,OS = ,,~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION:~ ~J~.~ [-~ [ ~ ~"~/T }~L::~''j ~ Township, Range, Section: SLOPE 1 2 4 8~ 9 10 11 12 13 34 - w,/'/--2e.~7~' 15- 37- 38- 19- 20- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? pO E Depth to Water After Moniloring? /~' Oale: d SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop 1( :05 io., ~,/v,, :1~ to" ~%" ~s" :~& ~o -' ~ %*' '/~" COMMENTS -- S & S ENGINEEEIN~ PERFO M '1. vi~ ~e~ll~ r~lvur Loop KO~II~ ACCORDANCE V~I~!~LqI~VT~JA~PPAL GUIDELI DATE: 72-008 (Rev. 4/85) PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN __ __ CERTIFY THAT THIS TEST WAS PERFORMED IN GRE/ .,:R ANCHORAGE AREA BOR ,JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION SEPTICTANK: C~-) FROM WELL INSIDE LENGTH MANUFACTURER ~ INSIDE WIDTH  NUMBER OF MATERIAL COMPARTMENTS LIQUID DEPTH LIQUID CAPACITY //~'~¢~GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA II / TOTAL LENGTH FOUNDATION I~ h~' NEAREST LOT LINE /~/~¢- OF LINES DISTANCE BETWEEN LINES DEPTH: TOP OF TILE TO FINISH GRADE TRENCH WlDTH2~-cc:~N. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH LINE ~ / DEPTH OF FILTER MATERIAL BENEATH TILE_ (.) ~ ABOVE TILE /~/ IN. WELL: TYPE __ BUILDING FOUNDATION CESSPOOL _ APPROVED -- CONSTRUCTION NEAREST NEAREST _, LOT LINE__, SEWER LINE- , OTHER SOURCES DISAPPROVED REMARKS DEPTH SEPTIC SEEPAGE , TANK__ SYSTEM DISTANCE FROM: DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL' LOT SLOPE: REMARKS: Form EQ-032 DIAGRAM OF SYSTEM · G.A.A.B(~.~_ [:,EPFIF.'.'THENT oF HERLTH RIqD ENV:!:II;'.OI"a"iEi",I"FFIL. PII~'.cFrEcTZEIN :E'.5:L6 E. 7'UDOt~: RE:,.., FINC:HORFIGE., FIK. :~)'_-aSii;~K~' CD ~-Jt -- :~: ~ "T ,.E-}Z '_':E: E+X ~---~ .F_'E tF,'~: Ii:=" E:: II~E'.' ll"-'it :E 'T' < 'TE;E:90 ) I-FLI ..Hiq L. OC:FIT I ON L..EC:iRL E,L.,.., 594 E.R. L. CFI' =, ]. ~:..E ::] E '-" -;:2 ~: 54.4.5;:3 ,~rjJ FIF~:E: FEE'T' 'T'HE RE:::¢It~'E[':, S]:ZE ['F' 'THE '20:fL FIIE:SORF"I"]:EH",I :,T_TEll Ii:E:, E: IF:" 'T IF41 :-'= :]_. L.73 L. E: ~"-a C~ 'T fP--~ ---=-" "~-"-" :::ii- ,:.~i F:-': IF:Il %." E: ~ ..... IE::, E: Ii:::-~" 'qF' ii-.-fi ...... ~.--.£'.: THE LENI]~TH B'I HENS ]:ON I S THE L. EIqGTH ':: :I:N F'EE:T) OF 'FHE 'T'RENC:H Ell:;?. DRF:III",IF ]:II:;LD. TI'"I[C DEPTH OF FI TRF£NC:H OR F'IT IE; ]"FIE [::' ]: ~;TFINCE BE-FHE:EN THE SURFFICE OF: THE: EiI:;.'OUI",ID II:IND THE 130TTOM OF :['HE EII':',C::FIVF:FI"IOt",I (IN FEE:T). 'FHERE ZL::; NO E;E.'T 14IDTH FOR TRENC:HE:E;. THIE GRFI'v'EL L"EPTH :['Z': THE I"I:[N:[HIJH DEF'TH OF GRFI","EL BETHEEI",I THIE OLI'FFFILI_. F']:F:'E FIND TIDE: BOTTOH OF THE E::':',CFI","FI"I"~C~N (]:i",l FEET). . . I..Jl t _, J. ] E ::_;EZHF:I(aE E:' :!: :SF'0E;F:IL :, r ._,l LII i ._. i"I]:N]:HLIH [,:[S'FFII'.IF:E' E:EI"I.,.IEEI',I FI HEL..L FtNII> FH',!U -'-"": ......... '":' ':: .... ":' ::1. Oii3 FEE-F F:(]F.: FI PR]:',/F-i'TE I.,.iELL _-F:' 2PH:;I FEE]" F"R' FI F'UBLZC HELl _ . _ J. hL, l..I ',..I... I:::'l:,l:E~F'iiii:ii~: 5F:'E :: ][ F :[ ': FFII"[ :: FIc, FINC, C-N':TF.' "T't:"N C.LH:.K-II'L RI::::[:: M,hlLHF.',LL 'TE~ .': '""::' ].1,] :, I NI_L .t I I ]: CERTIF'./ THR'I" :].: ]: Flii"l FI::tP'III._.]:FIR I.,.lI FH THE: I:~'.E(;!I.JIREFIIENTS FOR ON-SITE E;EI.,.IE:RS IqN[::, I.,.IEL..L.E; FI:E; FORTH [3'¢ THE PiL.INICIF'RI._.I T'¢ OF IIaNCHORFIGE. 2: ]: W:[L.L INSI-FflL. L Ti'dE E;"r'STEH IN RCCOR[xaNC:E H:[-FH THE 3:: I IJNDERSTFflND 'T'HRT THE ON-'SITE SE:HER E;'T'E;TEI'fl I'flRY REQU]:RE ENL..FIRGEHENT 'IF' THE RES Z[:,ENCE IS REHCIDELE[:, "1-(] :[NCI...UDE I',IORE THRN 5 E~EDR:OOH:E;. FIF FL :[ CRI.,I'F O~IN) E, OI.,ILE5 Russell Oyster 694-2774 SoUs 8' Foundations GEO. cCHNICAL DEVEL _,PMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Earl E/#s SOIL LOG 688-2280 Performed for: Name: Mr. Orin Bowles Tel. No. Mailing Address: Box 594 Eagle River, Alaska 99577 688-2645 Legal Description: Lot 128, Section 25, T15N,, R2W, S.M. East Depth (feet) Soll Characteristics 0 1 2 ML - Silt topsoil with roots and organics 275 sq. fto/Bro 5 GM - Silty Sar~y Gravel with cobbles to 6 inches. 235 Sqo ft./ir° m Percolation Data Percolation Rate = 2°38 inches / 60 minutes = 25 minutes / inch = 235 sq. ft. / Br. 12 Bottom of pit. Ground Water Encountered: Yes No YJ~ If yes, what depth Proposed Installation: Seepage Pit Drain Field ~ Comments: Pit measured appro×imately 3' x 15 ' in plan area. All sides of the pit logged the same. Performed by: Date: 5 Oct. 1976 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 TI5N; R2W~ Se6 25; Lot 128B Location (site address or directions) Property owner ' Mailing address Jim Young 15432 Hu~k~ Street Eagle River, AK Day phone Box 804 Norwood, Colorado 81423 Lending agency Mailing address Day phone Agent Address Dick Brown/ TARGET REALTY Day phone 694-2388 17034 N. Eagle RiU~r Loop Road Eagle River, AK 99577 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: XXX 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 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 o, irm . . . E.O,..-E.,.O I .. J Address17~74 E~c!e ~Ye~ ' dc=~ ~, =~ EngineeCs s~gnature ~~- DHHS SIGNATURE /~ Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: / 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 DH HS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DH HS 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 Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~0~' I~-?E;) ~'ec.Z.5]T~/q) P-,IH Parcel I.D. If A. B, or C, attach ADEC letter. ADEC water system number ,~,/,~ Date completed ~- Driller Cased to ~ Casing height Wires properly protected I~N) A. Well Data Well type g.p.m. Log present (YJ~) NO Total depth Sanitary seal FROM WELL LOG Date of test \ z Static water level ~v~ Well flow Pump level1 / ~ SEPARATION DISTANCES FROM WELL TO: Septic/l~ tank on lo{' Absorption field on lot //7' Public sewer main Sewer service line /v /Pr AT INSPECTION & -~-~ -,~ 7E ~ ..~/.,, ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform /a/~. Date of sample: ~ - Nitrate ,/o Collected by: Other bacteria B. SEPTIC/~TANK DATA Date installed Cleanouts (~N) Y~-3' High water alarm (Y(~ Date of pumping ~ - Z$- ~/W Tank size /Z,~o ~-,,a~-. Compartments Foundation cleanout (~N) y~s' Depression (Y,(~ ~/,,~ Alarm tested (Y~) ~'//~- AP/~ Pumper SEPARATION DISTANCES FROM SEPTIC/~ TANK TO: Well(s) on lot To property line Surface water/drainage On adjacent lots Absorption field /~© /--~- /?' Foundation ~ Water main/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM~O: Well on lot ~ On adjacent lots D. ABSORPTION FIELD DATA Vent(Y/N) "Pum~pp i~evel at ~at High water alarm level ~ Cycl~4~ed Meets MOA electrical codes (Y/N) ~ ~ Surface water Date installed Length Total absorption area Date of adequacy te~t Water level in absorption field before test Peroxide treatment (past 12 months) (Y~) ~-3 * '~ ~/ Soil rating (GPD/Ft2) ~¢. c, System type ,p¢~-~ Width 2_ .~- ' Gravel thickness '7' Total depth i/co? ¢-¢~ Cleanoutpresent(~) ¥='~ Depression over field (Y~ ,do /tJ/~ Results (pass/fail) /J,/~ for ,~/,4L Bedrooms ,0/~- After test /J ¢ If yes, give date /,~,/,~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water On adjacent lots ?oo ' ,,- Property line To existing or abandoned system on lot Cutbank ~-~ ' ~ Water main/service line Driveway, parking/vehicle storage area 2 ? Curtain drain Noz4~- ~'/vo w~/ E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guide/ines in effect oq.(h, edCe of.this inspection. Signature . -/~'- _..~____ ~-'~' - ¢ Engineer's Nam~//u~gle R. Ner Loo~ Eoaa No. ~ HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back Waiver Fee $ Date of Payment Receipt Number ROBERT SHAFER. P E / ~ ×~/ · ' ] WELL RECOVERY TEST DATA (9o71694.2979 APPROVALS SEWER & WATER MAiN EXTENSIONS SEWER & WATER INSPECTION £NGfNEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOiL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS WELL DEPTH: CASING DEPTH: TEST PROCEDURE: l) Draw water down to pump. 2) Shut pump off 15-60 min. -record time -record meter reading 3) Turn pump on. Drawdown. 4) Shut pump off. -record time -record meter reading 5) Calculate gal./min, recovery. TEST DATA: START TIME: WELL DRILLER: DATE DRILLED: MISC. DATA: [L~ Casing Height: Sanitary Seal?: Wires in Conduit?: Grading O.K.?: Pump Depth: ~ Samples Taken?: Date: ~-~ ~ STATIC WATER LEVEL: TRIAL PUMP TIME METER GAL./~t OFF ~); o ~D "~,~'~, ~ OFF ~1 ', ~ ~ ~ .~ OFF 0~o O ~,Q 2 ON ~ ~ ~ ~f~ OFF $%'. o ~ ~ ~ . % OFF ~ ', % ~ ~ %% ,'~ OFF O~ O ~ %~%,~ OFF ~'.~fl %~. ~ OFF $¢O~ ~ 4~¢ ~ ~tDO 5 ON OFF RESULTS: WELL CURRENTLY PRODUCES: ~C~ ~ FLOW R~TE NOT GUARaNTEED--SUBSEQUENT VARIATIONS CAN OCCUR! ON SITE WASTEWATER OiSPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP. SUITE 204 EAGLE RIVER ALASKA QQR77 un pality of AnchOrage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 July 14, 1994 Robert Shafer, P.~E. S & S Engineering 17034 Eagle River Loop Road Eagle River, Alaska 99577 Subject: Waiver Request for T15N ~ Section 25 Lot 128B Waiver Request #WR940040, PID #051-312-39, SW940179 Dear Mr. Shafer: Your request for waiver of the required 10 foot separation between a septic system and a lot line has been approved. The waived distance is 5 feet from property line between Lot 128A and Lot 128B. This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services ljw#7 MUNICIPALITY OF ANCHORAG~ Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR~ WR940040 PID# 051-312-39 HA# Permit ~ SW940179 Date Received: July 12, 1994 Legal Description: T15N ~ Section 25 Lot 12~B Engineer: robert Shafer, P.E., S & S Engineering 17034 Eagle River Loop Road, Suite 204, Eagle River, 99577 Applicant: James & Juanita Young Waiver Requested: Lot 128B & 128A Lot line waiver of 5 feet from property line between Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: X Waiver is NOT Granted: List Conditions or Reasons for above: Date: 7--/~ -¢~ By: ~M/ ~D~/ Name of Reviewer Rec ~: 00094/5573 Amount: $ 115.00 Date Paid: July 12-1994 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received January 7r 1977 Time of Inspection 10:30 a.m. Date of Inspection 1-10-77 Monday l. Approval REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & NATER FACILITIESii FOR requested by: ~'~ Pratt ,~i~77 A. Type C. Construction Sewage Disposal System: Mailing Address: 2. Property Owner~: Orin Bowels Mailin'~ Address: Box 222 Ea~le.R'~,~er"99577 3. Legal Descrlotlon: T15N R2W S~,~%i/on -25 l~oi~ 128B 4. Location: See map~ onfback 5. Type of facility to be inspect:ed Single Family 6. Well Data: Individua~ 7. Cn~.slte~ ' system, A. Installed Aug.1967 perc B. Installer Phone: Phone:688-2645 No. of bedrooms 5 B. Depth 302' D.,,Bacterial Analys~s for new trench area C, Septic Tank: 1. Size ~, ,..~2. Manufacturer D. Seepage Pit: 1. Absorption Area ~,~ 2. M~teri~l E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines , Nearest lot line , Other contamination Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES /- 7-7 '7 1. Type of Inspection: CM RO VA FHA 2. Property Owner: ~ / ~ , ~-'-2~o ¢~,/ ~ Mailing Address:,~ ~, ~-~_' ~- ~,4~.~/~ X~//,~,~ Day Phone: CONV 3. Name of Buyer: Mailing Address: Day Phone: 4. Name of Lending Institution: Location: Mailing Address: Phone: 5. Name of Realtor or Agent:' //~/I,~ '~-~//7'y _~_'/'~/~ Mailing Address: Phone: 6. Legal Description: ~ ~ ~ ~, ~'~ ~ , Type of Facility to be Inspected: Water Supply Type of Supply: Public Utility ,Individual If Individual, number of dwellings presently served If Individual, depth of well ~4% ~ Z 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site) 72-003(3/76) .Page ~ o.f t'w~ pages - Re~L~st for Approval of Individual '.~-~er & Water Facilities Le§a~ Description T15N R2W Section 25 Lot 125B Comments Approved Disapproved . Date · Appro~val/,Valid for one year from date signed Greater Anchorag~rough, Department of Environmental Quality DIAGRAM OF. SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these faci.lities are operating satisfactorily. SIGNED Date EQ-034 (1/74) EAGLE RIVER AREA F-~ MUNICIPALITY OF ANCHORAG?<~ DEPARTME..., OF HEALTH AND ENVIRONMEN~ ~- PROTECTION 825 L Street, Anchorage, Alaska 99501 279-2511, ext. 224 or 225 Date Received: August 31, 1977 #1: Time IO'.~x ~2: Time #3: Time Date ~-%~_~ ~. Date Date Insp [~3~J~. Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Lomas and Nettleton Mailing Address: 4449 Business Park Boulevard Phone: 274-7661 688-2068 Property Owner: Gerald L./Alix A. Mailing Address: Post Office Box wilkerson Phone: 99577 Legal Description: Lot 128~ection 25 T15N R2W Single Family Residence: (x) Number of Bedrooms: Five Multiple Family Residence: ( ) Number of Bedrooms: Well System: Permit # Construction Individual well (x) Co~nnunity/Public System ( ) Depth of Well 200' Well Log on File (~ ~O ~ ~-~ ~ Bacterial Analysis Sewage Disposal Permit # ~~ Installed Septic Tank Size ~O ~ Absorption Area [ / 3~ Soils System: On-site System (x) Public Utility 1976 Installer Manufacturer Rate 7~k~ Material Distances: Well to Septic Tank [~ to Sewer Line [ ~ ~ Nearest Lot line to Nearest Lot Line I Q [~ to Absorption Area ~ 0 ~ O + Absorption Area MUNICIPALITY OF ANCHORAG[ / //~Ckh Department of Health and Environmental Protec~t{Oh 71'~ 825 L Street, Anchorage, Alaska ~~ ext. 224, 225 99501 279-2511, ~quest for Approval of Individual Sewer and Water Facilities 1. Property Owner: _ C~/$LA ~ , ~ ~ ~ ~ ~-~[ Mailing Address: ___ Phone: _~__..~ o Mailing Address' _~-/~ 7 ~'/g//~-Z ~"///~ ~--~-~-- Phone: Lending Institution: ~ ~ ~?~.~./~ ~7~) Mailing Address: Realtor/Agent: Mailing Address: Phone: o Street Location: Single Family Residence: (~ Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: * Individual Well (~ Public/Community System If Individual Well, well depth _~ -~_ b~/{/$ /~--~'~ /~ If Comraunity System, name of system ( ) Sewage Disposal System: On-site System (~ Public System if On-site System, date of installation: /~F~ ( ) ~NOTE: A well log is required on ALL wells drilled since 6/75. 3/77 P~qe ~wo Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Comments: Lot 128 ~.ection 25 T15N R2W Affadavit Attached: ( ) Letter Attached: ( ) Disapproved: Date: Date: Department Worksheet