HomeMy WebLinkAboutELMORE #2 BLK 10 LT 8MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP251089
Work Type: Septic Upgrade
Tax Code Number: 01817314000
Site Legal Address: ELMORE #2 BLK 10 LT 8 G:3036
Site Mailing Address: 4861 E 147TH AVE, Anchorage
Owner: SMITH ANDREW G & ALICE J
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
�j11�nr
r,
Ur par till enI
4/10/2025
4/10/2026
40280
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
3
Special Provisions: Confirm well location on ELMORE #2 BLK 10 LT 9 (to the west of subject property) prior to
installing new system.
Received By: 5s `�=' TO Date:
Issued By: Date: to 20 L
ON -SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 018-173-14
Property owner(s) Andrew Smith
Day phone
Mailing address 4861 East 147th Avenue, Anchorage, AK 99516
Site address 4861 East 147th Avenue, Anchorage, AK 99516
Legal description
Elmore #2 Block 10 Lot 8
Number of Bedrooms 3
Engineering Firm Forge Engineering
Building Permit Number
Not Applicable RN
APPLICATION IS FOR: APPLICATION IS AN:
(Z all that apply)
Absorption Field
0 Initial ❑
Septic Tank
EJ Upgrade
Holding Tank
El Renewal ❑
Privy
❑
Well
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
— C"
Permit/Rush Fees: � -j
Date of Payment: Z 17 zo z
Permit No. C25p&q 0�-q'
Waiver Fees:
Date of Payment:
Waiver No.
Distance:
April 4, 2025
MOA Development Services, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Elmore #2 Block 10 Lot 8 - 4861 E 147th Ave
Septic system design
Dear On-Site Services Engineer:
The owner of the home on this lot has decided to replace his aging septic system, so we are
submitting this permit application for the construction of a new one. The attached site plan
identifies the location of the home as well as the proposed septic locatio n. No conflicts exist
between this proposed system and any other well or septic system, whether on this lot or adjacent
lots.
The ground surface on the lot slopes gently toward the west side of the lot, and the new septic
system is located in the center of the lot, constrained by the presence of existing wells . There are
no slopes greater than 25% within 50 feet downslope of either the primary or alternate site.
Contours are shown on the site plan showing the grade and direction of flow. Stormwater drainage
will not impact this septic system. The new trench will be constructed parallel to the slope as much
as possible.
Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all
wells and surface water, and more than 5’ away from the septic tank. Please refer to the attached
test hole logs, plan and profile pages for the septic design. If this design is followed, there will be
no adverse impacts to adjacent properties.
Sincerely,
Benjamin Schiller, PE
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251089, Curtis Townsend, 04/10/25
Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
1"=30'
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
2CO
ELMORE #2, BLOCK 10 LOT 8
FEET
0 30 60
EAST 147th AVE
3-BDRM HOME
420
SEPTIC PLAN
4/4/25
10' UTILITY EASEMENT
10
'
U
T
I
L
I
T
Y
E
A
S
E
M
E
N
T
424
428
432
DECOMMISSION
SEPTIC TANK PER
UPC
DECOMMISSION
EXISTING
SEEPAGE PIT
CO
NEW 1250-GAL
SEPTIC TANK
CO
CO
CO
CO
MTMT
MT MT
FS
TH#1
FCO
(2) 45' LONG x 5' WIDE, 0.5'
EFFECTIVE DEPTH
ABSORPTION TRENCHES
EXISTING WELL
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251089, Curtis Townsend, 04/10/25
ELMORE #2, BLOCK 10 LOT 8
TYPICAL TRENCH SECTION
(NO SCALE)
NOTES:
1. GRADE AREA OVER TRENCH TO DRAIN AWAY
2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2'
WITH 2" OF INSULATION
3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER
THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY
Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
4" PERFORATED PVC (HOLES DOWN)
DRAINFIELD ROCK
2'-6"
2'
DESIGN FACTORS:SYSTEM REQUIREMENTS:
450 GPD PEAK FLOW
PERK RATE: <1 MIN/IN
APPLICATION RATE: 1 GPD/SF
5' WIDE TRENCH SYSTEM
1250-GAL SEPTIC TANK
BOTTOM OF TRENCH: 3' BELOW GRADE
FLOW LINE ELEVATION: 2.5' BELOW GRADE
450 GPD / 1 GPD/SF / 5' WIDE * 1 RED FACTOR [0.5 DEEP] = 90 LF TRENCH REQUIRED (90 LF SPECIFIED)
GEOTEXTILE FABRIC
6"
4/4/25
PROVIDE ADDITIONAL FILL TO
ACCOUNT FOR SETTLEMENT
5'
MOA APPROVED SAND
2" INSULATION
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251089, Curtis Townsend, 04/10/25
DEPTH
(feet)
1-
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19-
SOILS LOG AND PERCOLATION TEST
i0'.q
LEGAL DESCRIPTION: ELMORE #2 BLOCK 10 LOT 8
PERFORMED FOR: ACE
DATE: 3 / 14 / 2 02 5 PARCEL ID#: 018-17 3 —14
TEST HOLE 1
ORGANICS
16' DEPTH TO WATER AFTER MONITORING
3/21/25 DATE OF MONITORING
DATE
READING
NET TIME
(MINUTES)
WATER
(INCHES)
NET DROP
(INCHES)
3/14/25
1
1
15911651
16
6"
2
1
159 i8
165 a
6N
3
1
159Ile
165 s
IE
6"
4
1
159 1e
65 is
6"
5
1
159 -9165
�6
6"
6
1
159 1e
165 qa
6"
PERCOLATION RATE: <1 (MIN/INCH)
COMMENTS: USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED
SITE PLAN
TECHNICIAN: JARED E
14
i
Lot__J
I
iz
I i i
— Lo, 5
N 89'56' Y7"E 212.00'
10' UTILITY EASEMENTS
8.0' x 8.9' SHED WITH LEAN-TO
811' x 10.9' DECK
134.9'
Iv
v WELL
P 10.9,
17.5'w (A C
w
0 L
A
SEPTIC
14.4' x 24.3' CARPORT ° 6.1 N PIPE
\ 12.0'
22.5' � 27'7
Lot \ 6.3' x 6.7' DECK
40,280 S.f. ASPHALT
SEPTIC PIPES
\ PAVEMENT
S 89'56'17"W 212.00'
E. 147th AVENUE
Lot 6
i
NOTES: GROUND LEVEL
IMPROVEMENTS SHOWN ARE APPROXIMATE. DATE OF SURVEY: 25 FEBRUARY 2025
PLOT PLAN -__ AS
BUILT _X- SCALE _ 1_ = 40'
GRID SW 3037 Project
No J25-043161
Lang & Associates, inc•
A005
P.O. Anchorage,Alaska 99521-0005
Professional
Land Surveyors
surve g y.
sure y@ a64surve com
,off 0
o � F A
oP '•S 00
I hereby certify that I have surveyed the following described property:
LOT 8, BLOCK 10, SECOND ADDITION TO ELMORE SUBDIVISION (Plat No. 69-96) 0° 49#.
Anchorage Recording District, Alaska, and that the improvements situated thereon are "" .. " • • •
within the property lines and do not encroach onto the property adjacent thereto, that Q
no improvements on the property lying adjacent thereto encroach on the surveyed �. • • • • • • • • • . • • • •
premises and that there are no roadways, transmission lines or other visible JONATHAN NG : Qa
easements on said `property except as indicated hereon. s�
Dated this the - lx -- Da of AQ-� f-) �d2 40440 .LS 944.••' c`
Y _------ at Anchorage, Alaska oRo' •' • • • •' .`
�4 'TSS10NA
It is the responsibility of the owner to determine the existence of any easements, �Opppoo�
covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963
QGREf' ER ANCHORAGE AREA BOF UGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ,'~"~f'-"~' ~"~-~'-'"~ MAILING ADDRESS~'~::~',~°,~:~''(''- ~,~ --/~ PHONE
LOCATION '~-~-'~"~"' /K~7~/''r/* LEGAL DESCRIPTION ~ ~ ~-/'~ /_~
SEPTIC TANK'.
OlSTANC(E/~'/ ~/~.,4'..,,~.""~,.J NUMBER OF
FROM WELt~~''''~' MANUFACTURER~ MATERIAL .-.f','~'-'"~"'~--' COMPARTMENT"-. ~"'"~'"'~--
INSIDE LENGTH INSIDE WIDTH ,LIQUID DEPTH IIQUID CAPACITY/~ GALLONS.
SEEPAGE PiT: ~.~/~/~ .~'~
NUMBER Of PITS z~-/"/~. DIAMETER// / OR WIDTH~, LENGTH ' DEPTH ~ / ~/~ ~J
LINING MATERIAL~ CRIB SIZE: DIAMETER~ DEPTH ~ DISTANCE FROM: WEL~/~
BUILDING FOUNDATION~ ~ ///~/~' TOTAL EFFECTIVE
, NEAREST LOT LINE ~ ~ ABSORPTION AREA (~LL AREA) ~ SQ. ~.
ADDITIONAL ABSORPTION ~//
TYPE CONSTRUCTION __ DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE SEWER LINE TANK SYSTEM
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DISTANCES:
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form No. EQ-031
DIAGRAM OF SYSTEM
G.A.A.B.
greater aNcHorage aREa BORCiUgh
3330 °'C" STREET ANCHORAGE:, ALASKA 99503
SEWAGE D.ISPOSA~ SYSTEM -- APPLICATION AND PER~IT
INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT DRAIN FIELD OTHER
/
FINANCED THROUGH ~ TO BE INSTALLED BY
SOiL TEST RESULTS ~ ~ ~ ~ NO~t THIS PERMIT IS NOT VALID WITHOUT ~IL ~
COMPLETION DATE ANTICIPATED ~'~ ~ t~'~
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.
SEP'rlC TANK SIZE /~/~/ TYPE SEEPAGE AREA Sl'~S/~~.. ',,,~7/~7
MINIMUM DISTANCES, REQUIREMENTS
SEPTIC TANK I ~/ SEEPAGE PiT .~C' DRAIN FIELD
TO NEAREST LOT LINE.
WELLTO SEPTIC TANK /~'
ORA,. F,ELO /bO '
DRA)N FIELD /~
SEEPAOE P,T .//~ *
ALSO CONSIDER AREA
SEEPAGE PIT /C'
DIAGRAM OF SYSTEM
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAF OF
EXCAVATION S 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.
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE ARSA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
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
1. GENERAL INFORMATION
Complete legal description
Lot 8~ B~ock I0~ Elmo~ Sabdivlaion £nd Add
Location (site address or directions) 4861 East 147th Av¢~uz
Property owner .....
Mailing address
Lending agency
Mailing address
,., e-:+ Day phone ~71-4652
Andeew ......h
4~&! East 147th Avcnu~ Anchoraq¢~ Al~6ka 99514
Day phone
Agent
Address
Day phone
2, NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Unless otherwise requested, HAA will be held for pickup.
NOTE:
Individual well Y,X
Community well
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
5. STATEMENT OF INSPECTION BY ENGINEER
Se
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 ~ & $ ENGINEERING Phone
Address
Engineer's signature
DHHS SIGNATURE
Approved for
Disapproved.
Conditional approval for
17034 Eagle River Loop Road No. 204
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
By:
Date ?z
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued, The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
· -- Municipality of Anchorage
Department of Health& Human Services .,
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: /_.[,3T g, ~ I(..~ t~'~v(,,fO','~E_. =Parcel I.D..
A. WELL DATA ' -
Well type ~'~tUR-TF: If A, B, or.C, attach ADEC letter.
Log present (Y/N) ~-)~) Date completed
Totaldepth JJ~ /~.;:,,..~..~,~o~ O-;~~7-JCasedto
'Sanitary seal (~) 7'~S
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 ~Ct-
AD_.EC water system number
~:~EF-c~p'_ ~7~'~ Driller (~--
Casing height
Wires properly protected (Y/N) ~'~
g.p.m.
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
']'~. F~w,,¢~-7~o,-, (~[r=,~ Petroleum tank
'
" ~ ..... . -
WATER 8AMPLE RESULTS:
Coliform
Date of sample:
lO0
Nitrate "~'~,N i"}~"~'EC"7~'0 0ther bacteria 0
Collected by: -~' .~ Er~I~J~'----{E/'LI
B. SEPTIC/HOLDING TANK DATA
Date installed. ' ~-- "'~O-~z~ Tank size /0(~('d'+C Compartments ~,3~
Cleanouts ~U) O~' Foundation cleanout O~),,~o~ o~ H~, Depression (Y/~ ~
High water alarm ~Y~ '~/~ Alarm tested· (WN) ~/~
Date of pumping ~ -~ (--~ ~ Pumper ~PT~O
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on 10t ~ ~'' '
To property line ~20 ~'
Surface water/drainage
On adjacentlots lO0 ~'/' Foundation
'Absorptlonfield I<~ ~c/O ~. %'Wate'rmain/serviCe ne /.0
iCY} %
72-026 (Rev. 7/91) From CONTINUED ON eACK PAGE
C. LIFT STATION
High water alarm level ~ Cycles tested.
MeetsMOA, eectrca codes(Y/N) .~~ ,, ',:i . *
SEPAR
Wello~3.1ol~ - - ._' _ , On adjacent lots - --: -' ' ~Surfacewater"
D. ABSORPTION FIELD DATA
Date installed '=,;z_-~::)_~ Soil rating /~'co 5F/~L System type
Length ~(;, ~' * ' Width '~1(:, Gravelthickness ,~ Totaldepth
Total absorption ~r'ea ' ."~C~ Cleanouts present (~N)
Dep?ession over field (y~) , J"~c~ Date of adequacy test C:~_( ~, -O ")-
Re'~ults (l~/~;i,) ' :~/q'%.,5 for ~:) bedrooms
Peroxide treatment (past12 months) (Y~ ./~.~,W ~.tuo~..~ ' If'yes, givedate
SEPARATION DISTANCE FRoM ABSORPTION FIELD TO:
Weilonlot (O0 ~ ' Onadiacentlots ~'0(3 ~- .......
Property line
TO building foundati.on r~ ~ ~' To existing or abandoned system on lot
On adjacent lots {'~C~ '~ ' ' '
Cutbank · f,2//,A Water main/service line
Surface water /OG ~ Driveway. parking/vehicle storage area //(~ ~ * : '
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines !. effect ~n the d~te of this ins'pec?on.
Signature
Engineer's Name
Date
S & $ ENGINEERING
· 17034 Eagle River Loop Road No. 204
HAA Fee $
Date of Payment
Receipt Number
Waiver Fee: $ LI I ~,O;~ ....
Date of Payment ~ ~ - ~ -- ol,.~
Receipt Number ~ q L~ t ~
A&unicipality Anchorage
Department of Health and Human Services
Torn Fink. 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
November 20, 1992
Roger Shafer, P.E.
S & S Engineering
17034 Eagle River Loop Road
Suite 204
Eagle River, Alaska 99577
Subject: Waiver Request for Lot 8 Block 10 Elmore Subd. #2
Waiver Request #WR920072, P.I.D. 018-173-14
Dear Mr. Shafer:
Your request for waiver(s) of the required 100 foot horizontal
separation of a septic system to a private well has been approved.
The approved separation distance(s) is 83 feet from the on-lot
private well to the septic tank serving the single family
residence.
This waiver approval applies to the existing septic system to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this department.
Sincerely,
Daniel J. Roth
Civil Engineer
On-site Services
Concur: ;,ff J
~p~oh;raSmmiM~ah~a~;Er'
On-site Services
ljm:#6
,i
2.g
N.?
SEWER S WATER
MAIN EXTENSIONS
SEWER SWATER
iNSPECTION
SITE PLANS
ROAD DESIGN
SOIt. TEST
ROBERTSHAFER. P.E.
RCGERSHAFER.P.E.
CIVIL ENGINEERS
Noucmbe,r 2, 1992 (907)694.2979
FAX 694.1211
~UNICIPAUTY OF ANCHORAGE
£NVIRONMENTAL SERVICES DIVISION
Mu~.Lc. Zpa~y of Anchorage
DEPARTMENT OF HEALTH AN~ HUMAN SERVICES
825 L
P.0. Box
An~o~g~, A~ 99519-6650
h'OV 0 3 1992
RECEIVED
£nd AddLt~on
Req~e6t you. Z6,~ue the ct,tX, ached HectZ:~ Au.~ho~t.y Approua~ (HAA) and
gna. nt ct toaJ. ve~t {on. ,the hon, Zzon,t,a~ 6epara~Zon dZ~tance b~een the
p//J. vaA:e toe,Ct, ctnd ~ept./.c ,tm, th. a~ 85
Accord~nfl to the ,Lnfo~u,a.,t, Zon ~rorn Mua~eipa~ ~.L~e~ the z, ep.t~c ~y~tern wa6
/n~ed ctnd ctpproved on JuZy 30, 1974.
For the ~o~oa~n9 rea6on~ toe {e~ the 6epa~x~Zon d~ance pre,6c~J, be..d in
18ACC.72 mcty be toa~ved ~o 83 ft. Zn ~ ca6e.
The encroctchment a~, upon the ~ep,t,,Lc ~2nk orZy. Gea~etta~y
,6pgctk,Ln.9, ct 6ep,CZc ,t. ctnk r/oe6 not 6¢]tue ct6 ct con, C,/.a~ou.6 z~ou,/tc~
o{ co,,t, amina..~on ~ toou. t.d ,*, £ea~fie~d.
Pu.e .to dTta. i. nafle patte.'m~ of the ttef~enee, d lot (~ ~),
n~ghbo~g ~ 6~o~ ~ ~6 not
and 7, we {~ ~ev~ ~o~ ~
~fa~ a~ the aq~f~. Seu~ of thee
~y ~. The ~y ~y~6 a~ ~ a
conta~ina, t~on {~tom the ~ept~.c ~ank ,i.~ u.6'ttua~y ,i. mpo~,~Zbt, e.
Te6t. ing of ~:~. {rom the toe. Ct. 6eruing the stefe.,te,~eed prope.,~y
fou.,~ ~ ~.,t.~s {~n-de,~:e~ed). Th.~ m;ztnz, ctft~r 17 ye, ct,%6
of u~e the toe~ ctpp~re~a:t~V t~n't been ctffe, cted by ctny ,~eptZc
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER. ALASKA 99577
· EGA' El_MORE SUBDIVISION, BLOCK I0, LOT 8
DRAWN L. $. ULSH£R CKD. ~.~$, DATE 10/'25/92 I SHT' J OFI
WELL (iN WELL HOU3E, I
Of' WELL
I
HOUSE
DECK
SEPTIC TAh'K
.,,~,4~/ EXIST. SEEPAGE PiT
NO WELLS
WITHIN IO0' OF ~
S£PTIC $YST£M
-.-..5
\
I
'--- I0' UTIL. E$MT.
ROGER J.
STATI~W~,T£R it. YEt fl~p el CB~ln~), ~, '
CI¥1L I.NOINi E~
CLOCK PLAIcE'ED TIMr r'INCE DEPTHIO DRAWDOWN! PUMPING
TIME PUMPING STARTED/
STOPPED, t~IN. WATER. PT. F~ECOYERY fIATE,~t'M ~EMARK$
~Ao tOlt tour) ~' '-~" -lO'
1~0 {~ t,ours)
Comment,:
,~) t./. IrT. SOl,tEN: --
DfUtttn.
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301
i~ALYSI$ ttZSULT$ fez III70lC! S $8563
Chemlab Eeg.J 92.$t1'1 Sample t I helix: #ATZI~
Client Sample ID: DRIIII[Ill6 #AT~B. L8 BIO ELJ~RE SUBD.
~ID , UA
Collected : SEP 18 92 ~ 11:45
~eceive~ : ~EP 19 92 I 15:20 ~l.
~rese~ve~ .tth : i3 REQ~RED
Client ~amo :3 & S E~II~ERIN~
Client Acct :$NSENCP
Ordezod By :~. $1tIFZB
?OI :#0~ RZC[IVED
lrmlyeis Completed : SEP 21 92
Laboxator! Supervisor.: ~PHEJ C. EDE
Sard Repozte to:
1)3 & S E~INEEglI~
2)
PeraMter Resultt Units Metl~d Allovable Limits
NIT~TZ-N ND(O.IO) ~/l EPA 353.2 10
Sample IOU~IK SAMPLE COLLECTED BI: $.W.
I Tests ~e~forMd * See Special lnstzuction~ Above OA*Urmvaileble
iD- ~one Detected "See Saaple teme~ke Above
NA- ~ot lrmly~e~ LT-Lete T~an. GTo$~eetor Thn
~~ Member of the SGS Group (Soci~t§ G~,n~rale de Surveilfar*ce)
INVOICE~,
ROTO.ROOTER SERVICE CALL HRS."
STEAM THAWING HRS.
HRS. '. " "':'"" ~
OVERTIME CHARGE ....
ADDITIONAL LABOR CHARGE HRS.":": "~ ' ' ~' ' ' '
PUMPING SERVICE HRS. ;'- ":.";~ ' ~ '; ~..i
HYDRO.lET SERVICE HRS.':"' ' " ;'"' "
MATERIALS ~ :..... . - ~..': .: . ..;
PLEASE PAY FROM THIS INVOICE. ....... L .
TOTAL FOOTAGE
E CAUSE OF STO
LINEC
,.~.~O B NC
0 ~ef, t
Hefty
8.R.A, mox 1~] X
7H 7:~
INVOICE ...... ":~ "1
S~LUV~ W~ WE~S
I~PTH OF hELL
ST %TIC LE~'EL OF # ~.TER FT.
I)R%h' IX~N FT.
GALS. I~R HR" ' TOG ~
KIND OF CASING
' Fi_2
F!
I, Tj?S' O~ ALASKA
· ~Im,ARTIIS'NT Olr NATURAL III:IQ~t[8
I~lllllI Pi~I~ ~e,'~ ; "' ' ' .;'
DEPARTMENI:,~F HEALTH & ENVIRONMENTAL PROTEC~)t~ONM;.NTAL pROTEcTiON
IRONMENTAL ENGINEERING DIVISION
RECEIVED.
~EWER FACILITIES
REQU~ FOR~PROVAL OF INDIVIDUAL WATER ~D
/
MUI~I~IPALITY OF ANCHORAGE 'D~PT. OF Hr~',L'[H ~' __
DIRECTIONS: Compete ail~on p~ge I. Im=om~ltl r~lu~tz will ~ ~ p~. ~ allow ten (10} ~ys for pr~i~.
~ ~ PHONE
!. PROPERTY~NER (.
~ R~ORIAGENT "l ' ' Z ' __ ~ / I PHONE
STREET~TION · ' . . T/ . --
TYPE OF RESIDENCE NUMBER OF BEDROOMS
J~"N ]'--I One r-1 Four
GLE FAMILY r-1 ,~wo r-I Five
[] MULTIPLE FAMILY /1~ Three I--I Six
~ INDIVIDUAL* [] COMMUNITY
[] PUBLIC UTILITY
8. SL~V~G6 ~S3SAL SYSTEM
~ INDIVIDUAL/ON-SITE**
' [] PUBLIC UTILITY
[] Other
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to th~ date, give well
depth (attach log if available.)
**lfindividunl/on-site.§iveinstallationdate
If system is over two (2) years old an adequacy t;st ~s required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
,,' THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED *'-
INSPECTION APPOINTMENTS
I*IME TIME TIME
)ATE DATE DATE
!INSPECTOR INSPECTOR INSPECTOR
I DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOII~
~//SI NG CE FAMILY [] ONE ~THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
{~/INOIVIDUAL DEPTH OF WELL
r-'l COMMUNITY
DATE DRILLED
I-'l PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[:~DIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[--ISepticTank or r--IHoldingTank
Size: ./¢~ d IfTank ishornemade SOILS RATING
give dimensions: *
TYPE OF TANK ~ MANUFACTURER
TOTAL A~SORPT,ON A.E~ MATERIAL
-~;.~,= .
Absorption ~ree to rmere~t Lot Line
5. COMMENTS
t~
APPRO EDFOR .3 BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
i'-1 DISAPPROVED
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME -~'~/'~'~- ~.~'~)~'/,/~/ MAILING ADDRESS~ ~R. ~ --/~Z PHONE
LOCATION ~ ~~/* LEGAL DESCRIPTION ~ ~ ~ /~
SEPTIC TANK:
,,
D~STAN NUMBER OF
FROM WELI~'~/Z'~f-~C' MANUFACTURER~ MATERIAL .-)"'~""~--~'~-- COMPARTMENTS '~"~'~-
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH IIQUID CAPACITYJ~:~ GALLONS.
SEEPAGE PIT: (~--
NUMBER OF PITS z~(~/~. DIAMETER/~/ / OR WIDTH~ LENGTH ' DEPTH ~ ~ ~/~
LINING MATERIAL ~ CRIB SIZE: DIAMETER~ -DEPTH ~ DISTANCE FROM: WEL~~
BUILDING FOUNDATION ~ / ~' TOTAL EFFECTIVE
, NEAREST LOT LINE~ ~ ABSORPTION AREA (~LLAREA)
ADDITIONAL ABSORPTION ~
TYPE ,CONSTRUCTION __ DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE SEWER LINE TANK SYSTEM
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DISTANCES: ~r~'~'~-~ ~~)/~/
INSTALLED BY: ,~,~'~'''~'~;z~'~''
PIPE MATERIAL: ~ '~/ ~"~,~,~'.7-
LOT 5LOPE~
REMARKS: ~
Form No. EQ-O31
DIAGRAM OF SYSTEM
G.A.A.B.
GreAtEr ANCHORAGe AREA BOROUGH ~,~
S330 *'C"STREET ANCHORAGE, ALASKA 99503 ~U ~/~U
SEWAGE DISPOSAL SYSTE~ ~ APPLICATIOH AHD PER~IT
~ SEEPAGE PIT DRAIN FIELD OTHER
/
FINANCED THROUGH ' ~ TO BE IN$TALLED BY
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.
,.%7/~7
,5'
TO NEAREST LOT LINE.
OR^,. F.ELO /'&O '
D.A~N FIELD /~
SEEPAGE PIT /~ ·
SEPTIC: TANK. ~l'~~ S~PAG~ PiT d/'C~ / DRAIN FISLD /'~/'"'/? d
TO RIVER, LAKE. STREAM.
CAST IRON INTO AND OUT DF SEPTIC TAXX AND INTO CRIB CROSSING GAP OF
GRAVEL DACKFILL
DIAGRAM OF* e~YSTr'M
OAT.. t--/-- A'P"CANT" .'G"ATU.,
1192
~.~d=~r~2e ~ 99501
and it neud~ to be 100 feet.
Lym~ S. toad
~nitari~n II
ALASKA I hUIROFImi I TAL COI TROL Sl RblCt S, II C.
~n(linctrin~j E, (~nuironmcnl~I Slu(lics
EARL BROWlq
P.O. BOX 10-1653
ANC~OEU~E AK 99511
AUGUST 4 1983
S~.T.k~R -- F_ARL BROWN BUYER - SMITH
SUBDMSION - ELMDRE J2 BLOCK - 10 ~ - 8
~ T~P~!. O~ ABSO~IOI S~JTt)( IS A PIT WITH AN AREA OF 384 SOFT,
THE SYSTI~4 IS CAP~'~T,~, OF ,AO"~:~-').'..IENG 620 GAT.T~NS OF T/,lt~'~ PER DAY,
THE SURGE CAPACITY OF THE SYST~4 IS 630 GALLONS,
BASbu UPON THE TEST ~ATA THE SYSTEM IS ACCEPTABLE FO~ A
3 n~ROOM tK1ME,
SEPTIC TANK AD~tlACY
THE EKISTING SEPTIC TANK VOI/IME OF 1000 IS ADEQUATE FCR
THIS 3 BEDROCM HOUSE.
1200 LU¢$1 33r~ Aucnue. Suite B · A,chor.(l~. AIo,ko 99503 · {907) 276-1361
1. Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
GREATER ANCHORAGE AREA BOROUGH
~/0 ,~ / Date Received /- ,Z/- ~J-' ,
/ Time of Inspect. ion ~ff~J~Y~,:~;'~
~ Date of InsPect,on ~/~/~
~/o ~, ~~~ ~-Phone:
3. Legal Oescription: ,~'~g~/~, 'a~ ~,~~
/
4. oc,tio.:
, . // / ~
B. Type of facJlJ~ to be Jnspected,~~~ No. of bedro~s
6. Nell Da~:
' 'A. Type'S' -' ' - B.'Depth
C. Construction D. Bacterial Analysis
7. Sewage Disposal Syst~:
A. Installed ~~ B. Installer
C. Septic Tank: 1. Size.~F~ 2. Manufactu~r
D. Seepage Pit: 1. Absorption Area~~
E. Disposal Field: Total length of lines
8. Distances:
Nearest lot line ,, 'O~er con~m~t~on
B. Foundation to septic tank ~J~, Absorption area ~~
C. Absorption area to nearest 16t l~ne
EQ-034 (1/74) Page 1 of two pages
3330
GREATER ANCttORAGE AR~:. BOROUGH
Department of Environmuntal Quality
"C" St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Type of Inspection: CMRO VA FHA CONV
2. Property Owner: ~,~./ t(~. ~o~,~.-
Mailing Address: ~)~ 31~- ~[~(~x. Day Phone ~q..~
3. Name of Buyer:
)Jailing Address:
4. Name of Lending Institution:
Mailing Address: ~y~ ~. ~, ~.~/~_~ ~/~hone
5. Name of Realtor or Agent:
Mailing Address: Phone
Day Phone
6. Legal Description: Z_~ ~ I0 ~__~1,~-o-~_~- ~D>
Location: WH~ £.
7. Type of Facility to be inspected:
$. Water Supply
Type of Supply: Public Utility
If Individual, number of dwellings
If Individu&l, depth of ~ell
9. Sewa9e Disposal'System
Type o~ S~stem: Public Utility
If Individual, date of installation
No. Bdrms..~
Individual /
presently served /
Individual (on-site)
· Pa. ge 2 of two pages - Re .~st for Approval of Individual x'~i~er & Water Facilities
· .
· Lega.10escrtption
Approved Disapproved Date
· Approval \Valid for one year from date signed
Greater Anchorage Area Borough, 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 facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)
r,d:um:7 32, 3.975
~'Jr,'l Bgcsm
3192
S~133~C~'t Zot 8, ~ ~0, Z:lmm ~~ J 2.
end It .mdb ~ b~ 100 ~et.
