HomeMy WebLinkAboutNORTH WOODS BLK 5 LT 1North Wood
Block 5
Lot I
#051 -731 - 1
Municipality of Anchorage:..,~
Development Services Department "'
Building Safety Division
On-Site Water and Wastewater Program, 4700 S. Bcagaw SL
P.O, Box196650 Anchorage. AK 99519-6650 Page ~ of 7..
www.ci.anchorage.ak, us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. ,~)'~/,/O Iol--I to PID Number.
"~' "'~.lO~.v'0~ ~,(,~0 WastewaterSystem: [] New '~Upflrade
"~"":~/~/l'~ ~0,-~o~ ~oov""~" ABSORPTION FIELD
LEGAL DESCRIPTION ~.~,~:
9P9~
~"": ~~ TANK
SEPARATION DISTANCES ~ Septic D Holding D S.T,E.P. D ~he~
Septic ~so~tion ~ff HoMing Publi~at~ ~ C~
Tank Field S~tion Tank I s~, &HtHoaA&~- T~tL I~.
R~,: BENCH MARK
.
Inspections pedormed by: Dates: 1" I ......... '
Developm~Se~ices Depa~ment Approval
Reviewed and approved by: Date: ' ' - ' · ....... .'. · '-
LOT ~
I
LOT 8
~$IWI~ET£ENCNESEXIST.
!
INSTALLE
1 I~5~ GAL SEPTIC TANK
1~TUSE A~DITION
DR TON
1250 GAL. SEPTIC TANK
SCALD 1' = 58 FE
MUNICIPALITY OF ANCHORAGE
Development Sen/ices Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(gO7) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Jun 07, 2001
Expiration Date: Jun 07, 2002
Permit Number: SW010176
Legal Description: NORTH WOODS BLK 5 LT 1
Design Engineer: 0007 Tobben Spurkland, PE
Owner Name: Richard Judd
Owner Address: 22415 NORTON COURT
CHUGIAK, AK 99567-5441
Parcel ID: 051-731-01
Site Address: 022415 NORTON CT
Lot Size: 32894 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well
[] Water Storage
Ail 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 DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A, Open and closed on the same day,
B. Covered, sealed, and heated to prevent freezing.
Date:
Date:
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.cLanchorage.ak.us
(907) 343-7904
ON-SITE SEWER/VVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. O~ J ' "'/'51 - O I
Permit Number SWO I O I 76
Property owner(s)
Mailing address (1)
~;,-~j address (2)
Day phone
Zip Code
Legal description (Lot, Block & Sub'd.) L~ ~- I ~ ~ ~ ~10
Legal description (Section, Township & Range)
Lot Size ,'~ ~'~ ~ Acres/Sq.Ft. Number of Bedrooms
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
Well Only
Water Storage
Jacuzzi
Water Softening Unit
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Munipal Codes.
(Signature of property owner or authorized agent) ~ '
Permit Fees: ~1
Date of Payment: ~/7/~
Receipt Number:
(Rev. 1~00)
Waiver Fees:
Date of Payment:
Receipt Number:
LO~ ~
I
LOT 2
5IWIDE TRENCHES EXIST.
INSTALL 125~ GAL SEPTIC TANK
REMOVE I
,, 1000 GAL ~ND $00 GAL SEPTIC TANKS
· n~ P~DPOSED HOUSE ADDITION
7
I
I
150
TOSBEN SPURKLAND
205 W ISTN. AVENUE
ANCH. Al(. 9950!
(~07)
PERMIT # SWOIOOXXX
LOT I BLOCK 5 NORTHVOOB$
RICHARD UUDD
22415 NORTON COURT
PlO # 051-731-01
SEPTIC SYSTEW DESIGN
DATE: JUNE 6, 2001
SNEEr: 2/2 GRID: NV 1459
NOVOSOI2.DVG
' Municipality of Anchorage Page
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: ~-1 ~ ~.4~ '~-~ PID Number:
Nh I~~ ~. ~~ Wastewater System: D New ~Upgrade
A~ ~ ~ ~1,~~ ABSORPTION FIELD
NO. of B~O~ ~ ~ ~hallow Trench ~ Bed ~ Mound ~ Other
Ph~ ~ ~ ~ ~ ~ Deep Trench
Total Depth from original g~ade:
LEGAL DESCRIPTION S°ilRating: ~. ~ GPD/Sq. Ft.
Lot: ~ Block: ~~Subdivisi°n:~~ Depth to pipe bottom from original~lgrade: Ft. Gravel depth beneath pipe~/ Ft.
Township: Range: Section: Fill added above original grade: ~ Gravel length:
~ Ft. t t~'~ Ft.
WELL: ~ New ~ Upgrade Gravel~:~ f Numberof nes: Distance between lines:
Classification (Private, ~B,C): Total Depth: Cased To: Total absorption area: Pipe material: ~
-~ Ft. Ft. ~ SQ. Ft. ~ ~~
Driller: Date Drilled: Static Water Level: Installer: · Bate installed:
Yield: GPM Pump Set at: Ft. Casing Height Above Ground:Ft. TANK
SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P.
To Septic Absorption Lift Holding 3ublic/Private ~anufacturer: Capacity in gallons:
From Tank Field Station Tank SewerLines ~~~ ~
Well ~'~ ~ -- -- ~'~ M~ Number°fC°mpartments:
Surface -- LIFT STATION
~ Si~ ~yurer:
L~:: ~1 *~' -- -- ~ "Pump on' level a~, I High water alarm at:
Foundation ~/ ~1 ~
CurtainDrain ~ ~ / ~ ~'~ -- Pump Make & Model I Electrical Inspections perf~by:
Remarks: BENCH MARK
Location and Description:
EN~IN~'~ SEAL
Inspections performed by: ~ ~{, t~: lst~' ~
No. 82!5
Department of Healt~Huma~ervices approval,
Reviewed and approved - ~ Date ~~,
72-013 (1/91) MOA 25
Permit No. ~<~ ~ '7~~ Page
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 Description: {,...1~:~ [z,.J_(:}~-~;::~-~~ ~L.~ ~ RID No'
72-013 A (2/91) MOA 25
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
PAGE 1 OF 1
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW920023
DESIGN ENGINEER:S & S ENGINEERS
OWNER NAME:JUDD RICHARD W &
OWNER ADDRESS:HC 80 BOX 7701
CHUGIAK, AK 99567
DATE ISSUED: 3/02/92
EXPIRATION DATE: 3/02/93
PARCEL ID:05173101
LEGAL DESCRIPTION: NORTH WOODS BLK 5 LT 1
LOT SIZE: 32894 (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 FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
ECEIVE , j ,."_.--:X ..,
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
ANDREPORTS
WELLINSPECTION
& FLOW TEST
S~TE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
F~bzuaz-y 25,
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
Anchorage, Alaska 99501
REFERENCE: North Woods Subdivision, Block 5, Lot 1
Request you issue a permit to upgrade the septic system
serving the referenced property.
An adequacy test was performed on the existing system and the
absorption capacity of the system was found to be inadequate.
A test hole was excavated and a percolation tests was
performed in the area of the proposed upgrade. Attached is
the proposed upgrade design.
This property is served by a Community water system. There
are no protective well radii which encroach upon the property.
As can be seen from the site plan this lot is large enough for
another future upgrade. We do not anticipate any adverse
effects on neighboring properties by the installation of the
proposed septic upgrade.
If you have any questions or require additional information
for your review, please contact us.
Sincerely,
ROGER J. SNAFER, P.E.
RJS/lsu
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
SCALE
UPGRADE
OB£RG ROAD
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
DATE
Township, Range, Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
L
IF YES, AT WHAT O
DEPTH? p
E
Depth to Water Alter ~ r
Monitoring7 [ ~ Dale: ~
SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
q,/4!'
,~ G ,, '~-'~ %"
PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER
$ ~-; E E,~''' .........
PERFORMED
ACCORDANCE WITH ALL STATE AND MUNICI~L GUIDELINES IN EFFECT ON'HIS DATE. DATE:
72-008 (Rev. 4/85)
, MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
PHONE
NAME ~ X '~ 5 ~w'-~/ [] VPGRADE
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION NO, OF BEDROOMS
DISTA~Cfi TO:
~ ~ Manufacturer (~1 ' Material ~o. of compartmonts~
Lie ~]n gallons IF HOMEMADE: Inside length Width Liquid depth
~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
O ~ ~ Manufacturer Material Liquid capacity in gallons
~ Well Foundation Nearest lot line PERMIT NO.
Length of each line ¢ Total length of lines Trench width Distance between Hnes
~ Tooo, tile to fin,sh ~rade~ O, MatarialbeneathtHo~, ........ ...... Total effe~t~pt,on area
Length ~idth De~th P[~MIT ~0.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ WeiJ Building foundation Nearest lot line
~ ' DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO,
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area{s)
OTHER
PIPE MATERIALS
SOl L TEST RATING
INSTAELER
REMARKS
~ I~ ~, .... ~:~,
72-013 (Rev. 3/78)
PERMIT NO.
HF F L I _.HNt
LOC:AT I ON
LE.~HL
NORTOI"~ CT.
LOT t DLK 5 NORTHWOOD SLID
[:,EPARTMENT ' HEALTH AND EN',,,'IRONMENTAL :OTECT I ON ]~q~,~/-~-~
' E'25 '"L." STREET., BNCHORBBE., BK. '3:~501 ~,[~,~/~
LOT _,I~,,E .~.~ ....... . _,gLARE FEET
TYPE OF SOIL RB.:,LF. FTI.N --,~'-FEI1 Iz,. TREN_.H
.... I1, I ' ' SOIL R. ATING ':'q':] FT/E:R):
MH,:'=,IM_M NLME, ER OF BEDROOMS = --< ....
"FHE REQUIRED _,B_E OF THE SOIL HB_-,uEPTI_N _-,.~-_.,7Erl IS:
2B0
[l, E: F" 1- F! == ~_q _ 5 L, E ~'-.~ ,Ll 'Y iq = t 1. 2 ,3 R R %." E L [:., E F T H --. ,~1-. P-~
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIEL. D.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCRVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
FEF, MIT HFPLI_.HN7 HRS THE F..E._,FON..,IE, ILIT'r TO INFORM THIS [:,EPRRTMENT DURING THE
INSTRLLRTION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
,., .... ,~ ,~ ,~,,~ .
NUMBER OF F..E_-,IDENCE_, THFIT THE WELL WILL ..EF,,E.
T ff..,..ff ~3 .:].::.'-' .":, I ,'"-, ~_?. r:, :- ,-- -r.,, _... ~ ._. _..- I -_,"3 l-.~ q_.. __ ARE F" E ~C~-! LJ I RE-TD
E,~L. KFILLING OF ANY _~r_-,TEM WITHOLIT FINAL INSPECTION AND flFFR-,At... DY THI.:,
[.,EPBRTMEN1 WILL BE '-qlIDJECT TO FF..L_~E_.L FION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYS'T'EM IS
t00 FEE7' FOR R PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM R PRIVATE RELL TO A PRIVATE SEWER LINE IS 25 FEE'T AND
TO R COMMUNITY SEWER L. INE IS 75 FEET.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
I CERTIFY THRT
i: I RM FRMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH DY 'THE MUNICIPRLITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN RCCORDRNCE WITH THE CODES.
~: I LINDERSTRND THAT THE-ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF' THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS.
V4. 0
PERFORMED FOR:
PJ&S
· MUNICIPALITY OF ANCHOI~AOE
MUNICIPALITY OF ANCHORAGEDEpT OF HEALTH &
DEPARTMENT OF HEALTH AND ENVIRONMEN~EI:~LI'~T~CT~I
SOILS LOG
PERCOLATION
TEST
825 L. Street, Anehorage, Alaska 99601 264-4720
SOILS LOG - PERCOLATION TESTAPj~ 2 2 ~gal
.RECEIVED April 10, 1981
DATE PERFORMED:
LEGAl. DEscRIPTION: Lot 1, Block 5, Northwood Subdivision
1
2
3
4
5
6
7
8
9
10
11
12
13-
14-
15-
16-
17
18
19
2O
COMMENTS
Organics and organic silt, dark
-- brown, to frozen.
Gravelly-sandy-silt, tan to
light brown, moist, stiff,
contains organics.
SLOPE SITE PLAN
Silty-gravelly-sand, gray, dense,
moist, rounded particels to
boulder size.
(GM-SM)
WAS GROUND WATER Yes s~
ENCOUNTERED?
O
P
E
IF YES, AT WHAT 105
DEPTH?
[]~S0 ',LFE$:
~E ~C 'ESF
J R0,D
Gross Net Depth to Net
Reading Date Time Time Water Drop
2 4-10-81 3:39 PMi 20 MJn. 9 1/2 3/4
3 4-10-81 3:49 PM 30 HJn. 9 5/8 1/8
4
4-10-81 3:59 PH 40 Min. 9 3/4 1/8
5 4-10-81 4:09 PM 50 Min. 10 1/2
6 4-10-81 4:19 PM 60 Min. lO 1/2 1/4
PER~O ~J~TION RATE 40 (minutes/inch)
TEST RUN BETWEEN ~'~ , FT AND 7 ET
Howard Grey & Assoc., Inc.
PERFORMED BY:
CERTIFIED BY:
DATE: April 11, 1981
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 1;
Block 5;
North Woods Subdivision
Location (site address or directions)
"(NE' corner of Oberq Road and Norton Court)
Property Owner
Mailing addCeS~ HC 80' Box 7701, Chugiak, Alaska
22415 Norton Court, Chugiak, Alaska
Day phone 269-5702
688-9375
99567.
wk
Lending agency
Mailing address
Day phone
Agent
Day phone
Ad dress
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: _x34x 4
TYPE OF WATER SUPPLY:
Individual well
Community well
Public wate,rr
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
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm
Address
Engineer's signature
DHHS SIGNATURE
i~- Approved for
Disapproved.
Conditional approval for
S & S ENGINEERING.
17034 Eagle River Loop Road
E~g!e R!¥er, A!~__,,k~_ 99577
Phone
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
Date
"f4'JiLfli
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.
72-025 (Rev, 1/91) Back MOA (Y21
Legal Description:
A. WELL DATA
Well type
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
I
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
~1~ Parcel I.D.
If A, B, or C, attach ADEC letter.
Date completed
Cased to
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer service line
WATER SAMPLE RESULTS:
Coliform Nitrate
Date of sample:
B. SEPTIC/HOLDING TANK DATA
MuNiCIPALITY OF ANCHORAGE
FNvIRONMENTAL SI:RVIC~'S DiViSiON
dElVED
ADEC water system number ''~ [ "~O~ I
Driller
Casing height
Wires properly protected (Y/N)
AT INSPECTION
g.p,m.
g.p.m.
On adjacent lots
; On adjacent lots
Pubiic sewer man hole/cleanout
Petroleum tank
Collected by:
Other bacteria
Date installed ::;~J I (-~ (dj ~ Tank size Compartments
Cleanout~l) ~' Foundation cleanou~N)~ Depression (~
High water alarm (Y/N) l.--J/,t~'- Alarm tested (Y/N) I'-,!
Date of pumping . .I..J.~_t/~ -"[~'..~,_K~ ,~/ Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot
To property line
Surface water/drainage
On adjacent lots
AbSorption field
Foundation
Water main/service line
72-026 (Rev. 7/91) Front "~ ; ' ? ' C'ONTINUED ON BAOK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Meets MOA electrical)
SEPARATION DI~,S,T/ANCE FROM LIFT STATION TO:
Well on lot On adjacent lots
j.~lanhole/Access (Y/N)
"Pump on" le~ "Pump off" level at
J Cycles tested
Surface water
D. ABSORPTION FIELD DATA
Date installed :~. ~.
Length I[,~ ~ Width
Total absorption area
Depression over field (~
Results (pass/fail)
Peroxide treatment (past 12 months)
Soil rating
Gravel thickness ~ /
Cleanouts preser~N)
Date of adequacy test
for ~
~' ~' ~::~r'~yystem type ~AJ~
Total depth
bedrooms
If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot I~/,.~. On adjacent lots "~::~:~ ' -J"' Property line ::~ '~1' I
To building foundation ~.~0-'~ ! To existing or abandoned system on lot J ~) ~'-~"
On adjacent lots .~O' ~ Cutbank t,,-.{.Ok.J~_~ Water main/service line I ~:> ~ Jr-
Surface water 1 ~)(~ ~ ~ Driveway, parking/vehicle storage area ~:~/~/
Curtain drain ~'.,[~ ~[J~- ~ r~ 01~1 ~ .
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
S & S ENGINEERING
Signature ~7034 Eagle River L~p RoadNo.
~le River, Alaska 99577 '
Engineers Name ~
Date '~- ~'-~
HAA Fee $ [~ Waiver Fee: $
Date of Payment ~ ~(~ - Date of Payment
/, /~
.ece,pt.umb r . ce,p, Num er
72-026 (Rev, 3/91) Back MOA 21
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE DISTRICT OFFICE
800 E. DIMOND BLVD., SUITE 3-470
ANCHORAGE, ALASKA 99503
WALTER J. HICKEL, GOVERNOR
(907) 349-7755
February 19, 1992
FOR: S & S Engineering
PWSID # 213001
My review of the records on file in this office reveals that the Northwood Subdivision Class
"A" Public Water System, is in compliance with the routine coliform bacteria sampling
requirements listed in Table C, and with the inorganic sampling requirements listed in
Table B of 18 AAC 80.200.
Sincerely,
Byron Roys
Environmental Engineer
BR/cf
"--'[ APPE ~.NT FILLS OUT UPPER HI~?ONLY
Property Owner
, & JOYCE DUFF ·
MamngAddra~ /SR2, BOX 7701 Norton CourL Ch~/giak zip Code 99567 688-3073
Suyer Richard >Judd
Address Zip Code ',
Lending lnstitutlon ~irst National Bank, Muldoon Branch Phone
Address Zip Code
Realty Co. &Agent Totem Realty, Inc. = Eagle River - Barbara Wagnitz Phone
P.O. Box 911 694-9494
Address EaGle River 99577 · zip Code
Legal Descript~3n K LOtl, Block 5, (Norton Court) Northwoods Sub
Street Location ~O~tOn ~('31]'r"t .
Type of Residence
Single Family
M~Jl~iple Family No. of Bedrooms 2,
[] Other
Water Suppi~
[] IndividUal; ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975.
{~ Commubity~ For wells drilled prior~_o that date, give well depth (attach Icg if available).
[] Public Utili~ -
Sewer Disposal
Individual Year Individual 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 Time Time
Date Date Date Dat~//~
Inspector Inspector Inspector Inspector
Field Notes:
~ ¢ ~/ i MAY 1 6 1983
"Muntdpalily of 4~ch~rage,"
( ~.)-'~"PROVED BEDROOMS ~ *CONDmONS OF APPRoVaLr°nmenml
( ) DISAPPROVED
( ) CO N DITIO N AL~APP ~IOVA L~
DATE,
Soils Rating Date Sewer Installed Welt To Absorption Area Well Log Received
72-023 (3182)