HomeMy WebLinkAboutEAGLE RIVER HEIGHTS BLK 2 LT 33iver Height lock 2 Lot 33 050- 282 -04 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251049 Parcel ID 050 -282-04 Expiration Date: 2/6/2026 Legal description EAGLE RIVER HEIGHTS BLK 2 LT 33 Site address 10143 CARIBOU ST Current property owner(s) HARVEY JERROD F & MACKENZIE R X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: By: / Original Certificate Date: 2/25/2025 Thi Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject ,s stem(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Absorption Field Advisory Tank Age Advisory Other Well Flow Advisory Nitrate Advisory X Arsenic Advisory MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050-282-04 Complete legal description Eagle River Heights Block 2 Lot 33 Location (site address) 10143 Caribou St. Eagle River, AK Current property owner(s) Jerrod & Mackenzie Harvey Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ® Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Waiver Fee $ Date of Payment 2Z_IEZ2= Date of Payment COSA # 0 _S C j 0 9 Waiver # COSA Application June 2022 COSA Checklist Legal Description: Eagle River Heights Block 2 Lot 33 Parcel ID: 050-282-04 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Unk Total depth Unk ft Cased to 40+** ft 0 Sanitary seal is functioning correctly © Wires are properly protected Casing height (above ground) 20 in. Date of flow test for COSA 2/6/25 Well production at time of test 3.8 qpm Water storage tank volume None gallons Well disinfected for coliform test? ❑ Yes ❑ No x❑ Coliform bacteria is Negative Nitrate 8.53 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by Arcterra Consulting Static water level at beginning of test _ 60 ft. Date 2/6/25 Comments **See previous approved COSA from 2015 based upon surrounding well logs. B. TANK DATA C. LIFT STATION Measured operating fluid level in septic tank ❑ Required maintek Date of pumping o lift station years ❑ Required maintenance co S Lift station material C Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or fief used for more than 30 days prior to date t) Gallons introduc _gallons date Any rejuv ion treatment (past 12 months) enter date Comments/Deficiencies: COSA Checklist June 2022 Adequacy test date _ Results ❑ Pass Fluid depth prior to test Water added gal New fluid depth in Elapse i e min Inal fluid depth in in Absorption rate gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' ❑ Yes if No NA ft ./❑ Yes if No ft Neighboring Tank > 100' ✓❑ Yes if No ft Private Sewer/Septic Line > 25' © Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No NA ft Holding Tank > 100'✓❑ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50'�/❑ Yes if No ft ❑/ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑ Yes if No 50+* ft Q Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft > 100' S=Zjacent Yes if No ft Tank to Property Line > 5' ❑ Yes if No ft W Lots: Field to Property Line >�1101'❑Yes &_ if ft Private Wells > 100' ❑Yes if No ft Water Main > 10' Yes if No ft Community Wells > 200' ❑Yes if No ft ervice Line > 10' ❑ Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS *Based on AWWU as -built and property as -built, well installed prior to 1983 per MOA documentation. G. CERTIFICATION & 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 Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Arcterra Consulting Phone (907)-695-6111 Engineer's Printed Name Kenneth Duffus Date Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. COSA Checklist -June 2022 ter— ■ "F r � 1 A KENNETH M LF tiu! Ar &_ MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 1 On -Site Water and Wastewater Section wvvw.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC251049 Subdivision: Eagle River Heights, Block: 2, Lot: 33 907-343-7904 Fax: 343-7997 A water sample revealed a nitrate concentration of 8.53 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org In October 2024, this Department was notified that the ground in the area of the seepage pit had collapsed and formed a depression. In November 2024, this Department was notified that the seepage pit was decommissioned; the cribbing was removed and backfilled with dirt and topsoil and the area seeded. The area around the septic tank was investigated and determined that it had previously been decommissioned. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www,ci,anchorage.ak,us (907) 343-7904 ',GENERAL INFORMATION Comp, lete legalde§.cription : L33; 32; Location (site address or directions) 1014 3 CERTIFICATE OF HEALTH AuTHoRI..TY .APPROVAL : FOR A SINGLE FAMILY DWELLING. ' Expiration Date: I- EaEle River HeiRhts ; Caribou st.Eagle River, AK 99577 .- Current Property 0~vner(s) Larry Colegrove Mailing address Lending agency Mailing address Real Estate Agent Rae Hall /Prudential Mailing Address }_~635 _-_Cel~te:~fie.~,d Dr Day phone Day phone Day phone 6Ra-IRO~ . ~r 0Q577 Un/ess otherwise requested, HAA will be held by.DSD for pickup. NUMBER OF BEDROOMS: 4 TYPE Of WATER SUPPLY: Individual Well Individual Water Storage Community Class , Public Water System Well TYPE OF WASTEWATER DISPOSAL: ['~ Individual On-site [] r-] Individual Holding tank [] E] Community On-site . [] [-] Public Sewer [] The Municipality of Anchorage Development Services Depadment (DSD) Issues Certificates 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 beb, veen spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. 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 may be reissued for a period of up to one year with valid water samples.) 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. 4. 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 this application, shows that the on-site water supply and/or wastewater disposal system is(are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm s & s ENGINEERING .... 11034 Eagle River Loop Road No. 204 Address Eaqle River, Alask~ ?9577 Engineer's Printed Nam~ ' (~ o/~ £,,LT' C. ~ e w 6/" Phone Date DSD SIGNATURE /,,"'" Approved for L./. Disapproved.. Conditional approval for bedrooms. bedrooms, with the following stipulations:. Additional Comments Attachments: HAA Checklist SeptiC System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: Io -l-of (Rev. 17.,'00) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Legal Description: A. WELL DATA' Well type"~3.. Date completed ~- Total depth ~_..~ft. HEALTH AUTHORITY APPROVAL CHECKLIST ParcellD: If A, B, or C provide PWSID # _~'~"~'_ .. Sanitary seal (Y/N) '7/ Cased to ~)~ Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform O coloniesll00 mi. Date of sample: ~] / /~/°1 FROM WELL LOG ft. g.p.m. Well Log (Y/N) ~ Wires properly protected (WN) Casing height (above ground) AT INSPECTION Nitrate _ ~. ~,/. mg./I. Other bacteria ~ __O colonies/100 mi. .. Collected by: ~. ~ ~ t~:~ld'~/~E''~---//~f B. SEPTIC/HOLDING TANK DA~ Tank TypelMat'edal '~ '~',~~/'~/~/~- ~Ft/~~Date installed Tanl~Ee ' .... g;,.';"., Number of Com~ ...... . Cleanouts(YlN) ~ F;3undation Cleanout(y/N)' : Depr~:v~ver tank (Y/N) _ High water alarm (Y/N) Date of pumping .~/umper _ C. ABSORPTiO~i FIELD DATA / .......... , . , Data'installed ~1 rating (g.p.dJfff or ffffodrm) __ System type __ Length ~ ff./ Width ~ ft. Gravel below pipe ft. Total depth ft. /Eff. absorptionarea______~._ Mo_nit.~ringtube Depressionoverfield Date of adequacy y _ . Results (Pa;;./F. ail) ...~_.._ For bedrooms Fluid depth in a~Srption field before te~t _ ___~__ i~. . Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date De LIFT STATION Date installed ~Size in gallons "Pump on" level at/ in. 'Pump off" level at Datum / Cycles tested in, E. SEPARATION DISTANCES Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot ~/,~c / / Absorption field on lot /V/~-' '~ &"O -/-- Public sewer main On adjacent lots /V'//~-- Public sewer manhole/cleanout Sewer/se,,,~_'. service line ;;). ,~- / -F ' Holding tank SEPARATION DISTANCES FROM S~.CJt~OLDING TANK ON LOT TO: Building foundation ,,/Property line Absorption field Water main // Water service line Surface water Wells on adjacent lots SEPARATION DISTANCE FROM AB.~;R'E)N FIELD ON LOT TO: . Property line .... yding foundation _ Water main Water Service line / Surface water __ Driveway, parking/vehicle storage Curtain drain //' Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that i have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Date HAA Fee $ Date of Payment Receipt Number (Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number G&AB-HD- 1 GR"'-'TEi~ ANCHORAGE AREA BOROI.~'I D~.¢ARTMENT OF ENVIRONMENTAL QUALII.,,' 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 -279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME (~ L/~'"'~O'~'--' '"~-~~ MAILING ~/) , ADDRESS /~"zs;,,r ~;;>_~.-~..,~:::"~,~, LEGAL DESCRIPTION SEPTIC TANK: ,.. DISTANCE FROM WELL LIQUID CAPACITY GALLONS. NUMBER OF ,.~ MATERIAL ..~',,~--.,~:'-~"'-L-- COMPARTMEI',I'[S INSI'DE LENGTH ~-"~INSIDE WIDTH ~ DEPTH. SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PiTS // OUTSIDE DIAMETER /-'"'~' OR WIDTH LINING MATERIAL ~--¢/~ ~-~'~'~ '~"M~"~'~ DISTANCE FROM WELL NEAREST LOT LINE ~"/.~-/)~..~.~/~r/~_.~.~/ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) /...2 ,v-..2~, · LENGTH , DEPTH BUILDING FOUNDATION~ / ~ SQ. Ft. TILE DRAIN FIELD:/f///~ DISTANCE FROM WELL ~ , ATIO _ , NEAREST LOT LINE NUMBER OF LINES /~'~ DISTANCE BETWEEN LINES '~ TRENCH WIDTH ABSORPTIO R.~~EA SQ. FT. LENGTH OF EACH LINE L~~''''/''----- TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: TYPF~'~/"JZ--~~' DEPTH ,~'~' / DISTANCE FROM , , BUILDING FOUNDATION. '~'~' LOT LINE /~)' NEAREST SEPTIC ~ ! SEEPAGE , SEWER LINE ,,~.,'~ ~'~ , TANK , SYSTEM DIAGRAM OF SYSTEM WATER SAMPLE · CESSPOOl. , NEAREST OTHER , SOURCES/~--'~/~''~ DISTANCES: DATE ~' -'" /-~' -- ?"~-'~ APPROVED GrEa,Er ANChOraGE Area BORoUGh DEPARTMENT OF' ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. 2158 INSTALLATION LOCATION PHONE INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO SE SERVED FINANCED THROUGH COMPLETION DATE ANTICIPATED SEEPAGE PIT / DRAIN FIELD OTHER TO BE INSTALLED BY NOT~ THI~ PERMIT I~ NOT VA~ID WITHOUT ~O1~ FINAL INSPECTIONs 24 HOUR NOTICE REQUIRED. SACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION SY THE HEALTH DEPARTMENT AUTHORITY WILL SE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK ! FOUNDATION TO SEEPAGE PIT . DRAIN FIELD / SEPTIC TANK TO SEEPAGE PiT WALL SEPTIC TANK SE~BI~II[~;E PIT , . DRAIN FIELD TO NEAREST LOT LINE. / WELL TO SEPTIC TANK '~ SEEPAGE PiT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK ~ , SEEPAGE PIT DRAIN FIELD , SEEPAGE PIT / . RAIN FIELD 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 ~EEPAGE PiT FI~ED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AL~HO~ t~ OR LICENSED DESIGNER DIAGRAM OF SYSTEM Ii / / t / / I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANI DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ~AGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE .q MUNICIPALITY OF ANCHORAGE,_.. " .DEPARTME!~OF HEALTH AND ENVIRONMENT I PROTECTION -. ~--~ Street, Anchorage, Alask~ -~501~ Or~~ 279-2511, ext. 224 or 225 ~ ~. Date Received: May 18, 1977 #1: Time #2: Time #3: Time Date Date Date Insp Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: Lomas and Nettleton Mailing Address: 4449 Business Park Boulevard Phone: 274-7661 2. Property Owner: Bobbie Thurman Phone: 694-2780 Mailing Address: NHN Caribou 99577 3. Legal Description: Lot 33 Block 2 Eagle River Heights Subdivision 4: Single Family Residence: (~ Multiple Family Residence: ( ) Number of Bedrooms: 4 Number of Bedrooms: Well System: Individual Well (~ Community/Public System ( ) Permit #~ Depth of Well 78' Well Log on File ( ) Construction Bacterial Analysis See attached letter. Sewage Disposal System: On-site. System ( ) Public Utilit Permit # ~Q; ?~ Installed Installer Septic Tank Size Manufacturer AbsorPtion Area Soils Rate Material ® Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot.line Absorption Area to Nearest Lot Line Pa. ge.. ~"wo ' o Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 33 Block 2 Eagle River Heights Subdivision Comments: Disapproved: Date: Department Worksheet: Letter Attached: ( ) ~=~!I4UNICIPALITY oF ANCHORAGE t Department of Health and Environmental Protection ' ' 825 L Street, Anchorage, Alaska 9.9501 Water Facilities ~Yz'~equest for Approval of Indlvldual Sewer Property Owner: Mailing Address: e e . Name of Buyer:~..Q~AZ3~L_.~-. Mailing AddresS: '~,~~. Mailing Address: Phone: .. . Phone: Realtor/Agent: ~j~'~% ~a~_-~ Ch) ~%~ L~_~ · q¢~ ~ Mailing Address: '~"3-C). {'2o~ /i)~-- ~ ~t~;,'~//--'- P1/one:. , "~-~'~, Legal '(/ . , , . _ . . Single Family Residence: (~/Number of Bedrooms: ~ Multiple Family Residence: ( ) Number of Bedrooms Water Supply: *Individual Well (~'~Public/Community System If Individual Well, well depth If Community System, name of system Sewage Disposal System: On-site System If On-site System, date of installation: ( ) ~le~ C~: ~_ · ( ) . Public Sys.t~(~'"~ *NOTE: 3/77 A well log is required on ALL wells drilled since 6/75. idUNICIPALIT? OF ANCH. O"i, AG.': DEPT. OF 1'ISALTH & ENVI~,OFL',:'-.%] AL PROTr-Ct-iON I:'IAY .i 8 197/' RECEIVED' ,SS: .B,o~OgGt''l Administered BY: DIRECTIONS FOR COLLECTING SAMPLES OF 'WATER FOR BACTERIOLOGICAL EXAMINATION Read Carefully and Follow Instructions Exactly Bear in mind that water analysis deals with materials present in very minute quantities. The least care- lessness in collecting and handling may give rise to results which.are misleading. Samples are accepted at the regional laboratories in the early part of the week (Monday-Wednesday) unless there is an emergency or prior arrangements have been made. Arrangements'should be ma~le't°' have the water, samples reach th~ laboratory as quickly as possible and within 48 hours after collection. After 48 hours, the significance of the bacteriological analysis is impaired. In collecting samples from TAPS or PUMPS proceed as follows: (a) 'Thoroughly flush tap or pump by allowing water to run freely for five minutes . (b) Shut off water and flame the outlet with torch or burning Paper. The flame' should not be merely passed over the outlet but should be applied until fixture shows indication Of being hot. Flame should be directed against inside edge. (c) Open fixture so that a small stream flows. (d) Remove bottle from mailing tube. Hold bottle by the lower half. in one hand and with the other remove the screw cap with the fingers, leaving foil protecting '~bver in place. Fill the bottle to the shoulder. Replace cap with foil cover, screwing firmly into place but do not apply pres- sure which will split cap. (e) Pack bottle carefully in mailing tube encl:.sing this completed information-sheet. DO NOT COLLECT SAMPLES FROM FIRE HYDRANTS, YARD HYDRANTS, DRINKING FOUNTAINS OR SIMILAR OUTLETS WHICH ARE DIFFICULT TO DISINFECT PROPERLY. STERILE WATER SAMPLE BOTTLES ALE AVAILABLE UPON REQUEST FROM: Dept. of Heallh & Social Services Dept. of Health & Soci[ l Services Dept. of Health & SoclaJ Services Southeastern ReglonaJ Sanitarian SouthcentraJ Reglon~l ~Janltarlan Northern Regional ,Sanitarian Pouch J 338 Den&ii Street, Mac's:ay Bldg. 604 Barnetle Street Juneau, Alasl~a 99801 Anchorage, Alasl~a 9~'5~I Fairbanks, Alasl~a 99701 - Or D'~strlct Offices in Fairbanks, Juneau, Kelchil~an, KodiaJ~, Nome, ~almcb $oidotna an~l Yaldez. Consult local telephone directory for sanitation offices located in these communities. Anchorage area~contact Grealer Anchorage Area Borough Department of £nvlron- mental Quality. GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received 4/14/75 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR VA Selective Realty 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: Virginia Steward Eagle River AK Phone: Phone: 3. Legal Description: Lot SS, Block 2 Eagle River Heights North 4. Location: Carribou Street 5. Type of facility to be inspected 6. Well Data: A. Type Drilled Single No. of bedrooms 4 B. Depth 78' C. Construction Standard Size 1. Absorption Area Total length of lines D. Bacterial Analysis B. Installer 2. Manufacturer 2. Material 7. Sewage Disposal System: A. Installed C. Septic Tank: 1. D. Seepage Pit: E. Disposal Field: 8. Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank Satisfactor~ , Absorption area , Other contamination , Absorption area C. Absorption area to nearest lot line , Sewer Lines EQ-034 (1/74) Page 1 of two pages P.a~J' ~2eof two pages - Re~'~')t for Approval of Individu~,l ,,, ~y)r & Water Facilities Legal Description --Lot SSt Block 2r Eagl~ River t/ei~hts North Comments AFpzx~a! pend~nD £unets escrowed £or public sewer s)'_ St~! hook up_ prior to July 1, 1975. APprove~~'. ~' ~ Y~'f' Disapproved Date Approval ~Valid for one year from date signed 'Greater Anchorage Ar6a Borough, Department of Environmental ~ualtt,y 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 facilities are operating satisfactorily. SIGNED Date ' EQ-034 (1/74) Mu cip i of Anchorage POUCH 6-650 ANCHORAGE, ALASKA 99502 (907) 279-2511 'GEORGE M. SULLIVAN, MA YOR March 3, 1977 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (825 "L°' Street) Bobby J. Tiloman General Delivery Eagle River, Alaska 99577 Dear Mr. Tiloman: It has been brought to our attention that public sewer is available to Lot 33 Block 2 Eagle River Heights Subdivision. According to the Municipal Code of Ordinances "Sewage Disposal Practices, Chapter 16, Article 16.45, Section 16.45.050: "Septic tank-seepage system sewage disposal facilities shall not be installed or used on any premises where sanitary sewers are available within seventy (70) feet of the nearest lot line of said premises...". The Municipality of Anchorage Department of Public Works has checked their records and they indicate that your structure(s) is not con- nected to the sanitary sewer. Would you please check your records to verify that the structure(s) is or is not connected and notify us immediately if your records indicate, that a connection has been made. If we do not hear from you within seven (7) days, we will assume that our records are correct. We, therefore, request you connect any and all.structures located on the subject property to public sewer by the end'of the 1977'construction season. You must apply for a connection permit from the permit officer for the Municipality of Anchorage, 3500 East Tudor Road. If you have any questions regarding the above, please do not hesitate to con- tact the permit office at 279-8686, extension 259 or the Department of Health and Environmental Protection at 276-2221. Sincerely, ~.hn~e~ ~- ' ~Principal Environmental Control Officer JK/ljh Maz, eh 15, 1{{5 Filo No.: Virgtnte stewe l P.O. l{oz 1184 ~agle River, Alaska 9957~ Dea~ Ms. Steward: It. has bf~n bFoufht to 0u~ attentlGn that public s~wor is awdlable to Block 2 ~ Lot 33. Ea8:l? Rlvor He~hts Subdivision. ' Ao~ordin~ to Ore'or AnOhoral~o Area ]~h Ordtnon~e, Chapter 16, Artlole 16.45; Section 16.45.050: - '"Septio tnnk-seop~e systom sowal~e ~~l t~fles ~nU n~ be ~~ or ~ ~ ~ p~aes who~ ~t~ s~ere ~ e le :r t me lot ~e or s~d p~aea .. ~ u. ~e O~ ~eho~ A~o BoF~ ~bHe Wor~ D~~t has ~s to v~ ~at ~e st~ (o) is or ~ not ~~ ~d n~ us t~~ely ir yo~ ~rds ~o that a ~n~on ~ b~ rode. If we do not heo~ f~-om you witht~ seven (?) days, we will assume that ou~ re~ords .~e ~~. 'We, the~fore, ~ue~ ~ ~t ~ ~d ~ ~~s 1~ ,~ ~o ~Je~ p~e~ to pubic s~e~ du~f ~e 1975 ~~~ se~. You nmat apply for a eonnoation permit from tho permit offloor f~r the Greater Ano. hore~o Area Borough, 3500 l]a~t Tudor Road, 'If you hove any questions rega~dini~ the above, please do not hesitate to contaat tho permit officer at. ~70-8686, eztension 259, o~ tho Depm. tment or · Gnvirmunental quality at ~74-4561, extension 141. 'John lee . G~,gle River Diatrl~t Sanitm'ian L/lw RECEIPT FOR CERTIFIED MAIL--30~ (plus postage) SENT TO POSTMARK OR DATE STREET AND NO. P.O., STATE AND ZIP CODE OPTIONAL SERVICES FOR ADDITIONAL FEES RETURN iL 1, Shows to whom and date delivered ........... 15¢ With delivery to addressee only ............ 65¢ RECEIPT 2. Shows to whom, date and where delivered .. 35~ SERVICES With delivery to addressee only ............ 85¢ DELIVER TO ADDRESSEE ONLY ...................................................... SOd SPECIAL DELIVERY (extra fee required) .................................... PS Form Apr. 1971 3800 'NO INSURANCE COVERAGE PROVIDED-- (See ofher s;de) NOT FOR INTERNATIONAL MAIL * o~o: ]gr~ o- e60-?~3