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Home My WebLink AboutPREUSS #3 BLK 10 LT 9Preuss Block 10 Lot 9 #050 571-57 Municipality of Anchorage Development Services Department .-- - Building Safe~/DMslon On-Site Water & Wastewater Program, 4700 Sout~ Bragaw SL p.o. Box 196650 Anchorage, AK 99519-6650 wvw.d.anchorage.ak.us (907) 3437904 Po;e 1 of 2 On-Site Waetewater Disposal System and/or Well Inspection Report PID Number:. ~ 0§0-571-57 Permit Humber'~ SW010021 N°me:TOM SHEPARD Wastewater System: [] New · Upgrade A~r,,,: ABSORPTION FIELD 20507 LUCAS AVENUE * EAOLE RIVER. AK 99577 NO. of 6.GF~,.~;; Trench ~~ phone:(907) 263--5516 4 mDeep Trench 13Shallow LEGAL DESCRIPTION ~ '~ 9 10 PEEUSS ~/5 n. SEPARATION DISTANCES .s...= a Hold;ng 13 S.T.rP. 1:30~her ;o s. puc A~uo. Uft Hold~.g~./~'~ ANCHORAGE TANK 1250 Well 100'+ 100'+ -- -- 25'+ ~ I ELL 2 su.o=. Wo~., lOO'+ ~0o'+ _ - - LIFT STATION Lot Un° 5'+ 10'+ -- -- -- Foundation 5'+ 10'* - - - ~"' ~ ~~c IH~ ~ ~ ~.ma~k=: TH= Ex~sm~G s£~c ~ANK WAS C0V~LET~LY BENCH MARK ABANDONED, NO PORTION OF THE CRIB WAS ENCOUNTERED BOTTOM OF GARAGE DOOR THRESHOLD DURING THE EXCAVATION OF THE SEPTIC TANK. i~-''''~ ="""~"'-~ 100.00 rL nsp onsp om . ^WWC. I.C. D.tes: $t 5/ /2o0 ' ~,~ .... ./,....~ ..... ~.::...~ Department of Health and Human Services approval~I~,~,. '.. ......... .,' R~vlewed and approved by: Date: ~,~_~,o~.,,~o~?~ AS BUILT DRAWING o~o ~7, s, ~.2DBL1 L~ IA 15.9 / 15.6 I 11.3 / 15.9 / 18.o / ,~7.~ CO/ 13.5 )BL3 )BL4 .CRIB CO ,lEV/ 1250 GALLON SEPTIC TANK LO(:; CRIB. EXACT LOCATION UNKNOWN --,",RE ~'~ LUCAS AVENUE (APPROX. LOCATION) ALASKA wATER & WASTEWATER , CONSULTANTS, INC. FOR: PHONE NUMBER: TOM SHEPARD (907) 263-5316 PREUSS SUBDIVISION ~3; LOT 9, BLOCK 10 AS-BUILT OF SEPTIC TANK UPGRADE J.LM. 1" = 30' 20F2 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (90?) 343-7904 ON-SITE SEWER/WELL PERHIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.Di 050-571-57 Permit Number ~t~/0/OO2 1 Propertyowner(s) TOM SHEPARD c/o BECKIE MINTON w/ DYNAMIC Dayphone 261-7670 Mailing address (l) DYNAMIC PROP~_~(¥iES 3111 'C" STRFE'r ANCHORAGI~ AK 99503 Mailingaddrass(2) ~,.~r~ ZO~ Zt~.~$ AV£IU~ Ei ~.A&LE I~IuEI{:AK ZipCode Legaldescdption(Lot, Block&Sub'd.) LOT 9. BLOCK 10 PREUS~ SUBDM$1ON ~5 ~/^ Legal description (Section, Township & Range) Lot Size ,. ..... 2Z,~o3 Number of Bedrooms 4 THIS APPLICATION IS FOR: [~] Sewer Only ~] Well Only Sewer and Well Water Storage Sewer Upgrade [] THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Water Softening Unit Therapy Pool [] I certify that the above Information Is con'ect. I further certify that this application is being made for a Single Family Dwelling and Is In accordance with applicable Municipal codes. (Slgna~m o~p rty o~ner or authorized agent) Permit Fees: Date of Payment: Recelpt Number. Waiver Fees; Date of payment: Receipt Number. MUNICIPALITY OF ANCHORAGE Development Sen/ices Department On-Site Water & Wastewater Program 4700 South Bregaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTE~NATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Feb 15, 2001 Expiration Date: Feb 15, 2002 Permit Number: SW010021 Legal Description:[~REUSS ~3-.BI-K-nol'0 ~_T~. Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: THOMAS SHEPHARD Owner Address: 20307 LUCAS AVENUE EAGLE RIVER, AK 99577-8783 Parcel ID: 050-571-57 Site Address: 020307 LUCAS AVE Lot Size: 22303 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 construction must be in accordance with: 1. The attached approved design. 2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of A~aska 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: ALASI(A WATER & WASTEWATER , CONSULTANTS, INC. - February 6, 2001 Municipality of Anchorage Developmental Services Depart.ment Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Septic Tank Upgrade for Lot 9, Block 10, Preuss Subdivision #3 To whom it may concern: The existing 4 bedroom house is currently served by an on-site well and septic system. The conventional septic system contains a 1250 gallon septic tank and is located within the 100' well radius. In order to obtain a Health Authority Approval, the septic tank needs to be located out side this radius. We are proposing the installation of a new 1250 gallon septic tank and to abandon the existing tank completely. 1. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 2. TOPOGRAPHY: There are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. ~ P.E., M.S. NOTE: Attached b a design drawing, and a 5 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com LOT 8. BLOCK HERITAGE E~-TAT~ ~OT 9, BLOCK 1 HER~I'AG£ ESTAT[S LOT/I.0, BLOCK 1 / / wNOTE: THE CONTRACTOR MUST HAVE THE 100 FOOl ELL RADIUS FLAGGED BY A REGISTERED LAND SURV~"YOR pRIOR TO ANY CONSTRUC'RON. --%EX~"RNG LOG CRIB._ ~:XACI ~ LOCA110N UNKNOWN ........ pR~UBDM,~ON ~PROPOSED 1250 SEP~C TANK '---INSTALL DOUBLE CLF..ANOUTS C'~SEpTiC LUCAS AVENUE AlasKA WATER & WASTEWATER,,, , CONSULTANTS, INC. PHON[ NUMBER: PREPARED FOR: (907) 263-5316 TOM SHEPARD PREUSS SUBDIVISION #3; LOT 9, BLOCK 10 OF WORK: DRAWING FOR SEPTIC TANK UPGRADE 2/6/2001 J.L.M. 1" = 40' 1OF1 7953 .-' QGRE i' R ANCHORAGE AREA BOR '.IGH Department of Environmental ' 3330 C Street " Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~L~. ~)m~4,¢ ~'~ MAILING ADDRESS PHONE LOCATION SEPTIC TANK: DISTANCE FROM WELL MANUFACTURER ~'~-A-~-~_ g~'~ MATERIAL INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH NUMBER OF 'F~L~ COMPARTMENTS IIQUID CAPACITY GALLONS. SEEPAGE PIT: NUMBER OF PITS I DIAMETER '"~(~' OR WIDTH Iq' LENGTH I(~', DEPTH LINING MATERIAL LOC~ CRIB SIZE: DIAMETER DEPTH DISTANCE FROM: WELl 8" BUILDING FOUNDATION ~.~,~-t NEAREST LOT LINE ABSORPTION AREA (WALL AREA) ~'0 ~ SQ. FT. ~., TOTAL EFFECTIVE ADDITIONAL ABSORPTION WELL: TYPE BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE OTHER SOURCES DISAPPROVED DEPTH DISTANCE FROM: NEAREST SEPTIC SEEPAGE SEWER LINE TANK SYSTEM REMARKS DISTANCES: INSTALLED BY: PIPE MATERIAL: LOT SLOPE: REMARKS: ~1~'~ Form No, EQ-031 DATE DIAGRAM OF SYSTEM INSTALLATION LOCATION GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3550 "C" STREET ANCHORAGE~ ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO MAILING ADDRESS PHONE . DRAIN FIELD . OTHER INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT. TYPE AND SIZE OF FACILITY TO BE SERVED~_~75~--~?~ ~/~ FINANCED THROUGH ROIL TEST COMPLETION DATE ANTICIPATED NOTE: THIB PERMIT IS NOT VALID WITHOUT BOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTM .~NT OF ENVIRONMENTAL OUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. . MINIMUM DISTANCEB, REQUIREMENTB FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT (~ ~ SEPTIC TANK TO SEEPAGE PiT WALL SEPTIC TANK., ~ , SEEPAGE PITC~ TO NEAREST LOT LINE. WELLTO SEPT,C TANK /():h DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD , SEEPAGE PIT TO RIVER, LAKE, STREAM, . DRAIN FIELD , DRAIN FIELD . SEEPAGE P~T DRAIN FIELD DIAGRAM OF SYBTEM ,C~AST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT ~FITTED WITH AIRTIGHT ~EMCL~A~LE_~ GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. - - LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM ir IN ACCORDANCE WITH SAID CODE. F'F-'Ri~IlT AN.O CSR'I'IFICATE OF Al' F Ixl.lF Ix.I. g I ION ~ THE 3'TA'I'E OF' ALASKA UNDF_'F( A3' 46~5, THE ALA3'KA WATER USE ACT, AND THE RE(;ULATION3' Al)OF'TED UNDER IT, GRANT3' TO: 21'ANLL::Y E FOSTER 3'R BOX 5420 EA(.~LE I~IVER, Al<, 9¢5'7'7 THE RIGHT TI:) USE WATER FROM THE F'OI_LOWING SOURCE: A) ~I:'(IL. LE]) WELL WiTH A F'RIORII'Y ])ATE OF' ~/,.~, ~8~ 500,0 GAL/DAY FOR 3I .GL.E DWELLING JAN 'f'O DEC THE LOCATION TO WHICH THIS WATER RIC~FtT AF'F'FZRTAINS 13': LOT 9, BLOCK tO, F'RUE,~£ ,~UBDIVI~'ION, UNIT NO~ ~, SAID LOT L. OCA'FED WITH:[N 3'Wt/4 SWI/4 SECTION 8, I'OWNSHIF' t4 NORTH RANGE i WE3'T, SEWAR~ HERI~IAN~ ' THE LOCATION OF' I'HE WATER XOURCE I3' A DRIL. LISD WELl_, S6~ FEET DEEF', L. OCATED WITHIN THE ABOVE DESCRIBED PARCEL. OF F'ROF'ERTY~ THE CONDII'IONX THAT AF'PLY TO TFIIS APF'I~OF'I~IATION ARE F'OUND IN AI'I:ACI-I- MENT A, ATTACHED HERETO AND MADE A PART HEREOF~ THE WATER RIGHT Ig GRANTED 3'UBJECT TO THE PERTINENT XTATUTORY F'ROVI~ION~ IN AS 46.i5, AND ADMINI~'FRATIVE REtlULAT]:ONS IN it AAC 9~., F'AE.E t Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bmgaw SL P.O. Box 196850 Anchorage. AK 99519-6850 www.d.anchamge.alcus CERTIFICATE 6F HEALTH' AU*THORITY APPROVAL FOR"A SINGLE FAHILY'DWELLING ' Parcel I.D. 050-571-57 HAA# H~ C) I O o O ' Expiration Date: * 'l. GENERAL INFORMATION , ~ .... , .. ,~ Completelegaldescdpflon PREUSS SUBDMON ~3; LOT 9~ BLOCK 10 ,. Locat[o~ (e~ta address or directions) ,,~- 20307 ,LUCAS AVENUE *.EAGLE RIVER ,AK '; CU~Tent Property owner(s) . · ............ ' .. ... i, .. ~ * 10178 ·VOYAGER CIRCLE * ANCHORAGE~ AK 99,515 Lending ... , ............ ' - Da ne .; Real Estate Agent BECKY;MINTON -'DY~AMIC','PROP.- -, Da e-,,.,~ 61-;7541 ..... ' ' DSD for pl~**up ' . Unless o~herwiea .requested, HAA yeTI be held by ..... 2.'-' NUMBER, OF. BED. ROOMS: 4 .. _ .... DISPOSAL: TYPE OF WATER SUPPLY: ' TYPE OF WASTEWATER Individual Well Individual on'Site - - :: Individual Water Storage . Individual Holding tank ~ Community Clase Well ~r~ . Community On-site ' * Public'Water System · Public Sewer ' The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of He~Jth Authority Ap~r0val (HAA) based only upon Ihe representations given In pomgmph 5 by an Independent pmfsesl0nal civil engineer registered In the' State of Alaska. Certificates of Health Atdt~rity Approval am required for the transfer of title (except between 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 am valid for 90 days from the date of Issue for properties sewed by a private or Class C wall and may be reissued with new water sempl, e results less than 30 days old. (CerlJficates may be reissued for a per'kxl of up'to bne year with valid water samples.) Certificates are valid for one ~,ear for i3ropertles served I~ Class A or B wells or e public water system. The Municipality of Anchorege Is not responsible for errors or omissions In the professional engineer's work. ' Note:Aleska Waterand WastewaterConsul~mte, Ina shallbepald$14~~--~ at, orpdor to cles/ng for ff~e engineering esn4ces provided. 4. STATEMEHT OF INSPECTION BY ENGINEER As certified by my ses] affixed hereto andes office validation date shown below, I verffy that my Investigation, based on procedures ou~ined in the Health Authorfly Approval Guidelines for ~his appl/caffon, . shows ~at the on-site watorsupplyancYor wastewater d/sposalsystem is(are) safe, funcffonalandadequate for the number of bedrooms and ~ype of $~'uctum Indicated here/n. I fu~er verify ~hat based on the information ob~ined from the Municipality of Anchorage fi/es and fn~m my Invesffga#on and Inspection, the on-site water supply and/or wastewater disposal ~ystem is(are) In COmpliance with al~ applicable Municipal and State codes, ordinances, and regulations In effect at the time of Ins~alisffon. Name of Firm.. ALASKA WATER & WASTEWATER CONSULTANTS, INC. Address . 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 Engineer's Printed Name. JEFFREY A. OARNESS. P.E. Engineer's Comments:. - ' :.':' ' - "' Phone 357~6179 Date flseP~ ds~/d~ ~d~en~d~on Ute local soSs condiffofl, groundvmter levels that rrmy ,.~ ~ _ ~_ __~ ~req~ul...r~ents of Ute ADEC Or MOA DSD.,The c~ttent of fids report ts for ~eZ'e- '""~ .... - ~-~ Dso SIG.ATUaE · ~:~"" .... ".:~'Z~ WATER AND Disapproved. ' Conditional approval for bedrooms, wtth the fllowtng sllpulallons?~)?.. ..' "ore; 'l'he T~ell £or this p=opert7 meeCsexistin~ State and ~unicipal are nit=ares present. Zt is su~,;~ested that pe=~odic test~n~ he the ~ells continued Su/tabil'itT. Current nitrate 'concentration is 5.16=~/1. EPA maximum concentration is 10,0m~/1. Hore information on nftr;~e~ On-Site Services, [~.~:, .~43~7904 '~ffachments:, '- HAA Checklist Septic System Advtsory Well Flow Advisory · ..~::~'/?: ~, , , Manitenance Agreements Supplemental Engineer's Reort' ' Other / ~ o~'.~ic~t. ~.t~: $ ' 7'*'~ / D. UFT 6TATIOH ~ ~ · Pump on' level at In. ~ I-Iigh wa~r _alaml ._1~1 at. ..... In. ~ Cycles tested Meets abmn & drcult requirements? F. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: ~ept]c tenY~l~t Maflon on lot 100'+ Absoq~on 11eld on lot t00'+ Pu~c sewer nudn 100'+ Sewer/8ept~ seMce ,ne 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manl~ole/ctsanout Ho~dlng tank N/A 100'+ SEPARATION DISTANCES FROM SEPT]C/HOlDING TANK ON LOT TO: Atmorp~on 6eld · proper'o/line 5'+ , Water sen~ce line 10% Bu~dng round.on 5'+ W~er m~n 1 o°+ We~s on adjacent lots 1 oo'+ SEPARATION DISTANCE FROM .,~SORP'I1ON FIELD ON LOT TO: Surface water Property line 10'+ Water ~ewtce line 10'+ Cmlaindrain NONE KNOWN Building ~ '10% . Sut~ce water lOO'+ We]ts on adjacent lots 10o'+ §'+ 100'+ ~ OF CmO IAq~lE ~ iX~f~W~Y.J Water main 10'+ Ddvewsy, pmtdng/vehlcle ~torage F. COMMENT8 O. ENGBIEER'8 CER'nF~CATION revfew of Mur~po; ~:ord~ mat..t~e_a~. _s~?m~ ~ -: -. conformence wlZh MOA HAA gIJIde#nes in effect on mis (/am HAA F. $ 00. c; Receipt Number 0 ~' ~ ~ Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage Development Services Department e~ ea~ O~ On~ Watar & WaMewatm. program 4700 ~ou~l gragaw BL P.O. Box 196880 Anchorage, AK ~95~g-8680 A. WELL DATA Well type HEALTH AUTHORITY APPROVAL CHECKLIST PREUSS SUBDMSION ~3; LOT 9. BLOCK 10 ParcellD: 050-571-57 PFOS~IvE DRAIN~a~_,E AROUND WELL HEAD. MOUND OF DIRT/ROCKS .~U~OUND W~LL CASIN~-I, If A, B. or C provide PWSID~., .N,/A Well Log (Y/N), NO Wires properly protected (Y/N) YES /:2 Caalng height (above ground) :~t."+ In. WATER ~AMj~LE RESUL'rS: ~', I ~, Collfom~ ~ colonles/lOO, mL Nllrate. Olher bacteda Co~lecte~l by:. AWWCt INC. B. 8EPTIC~IOLDING TANK DATA Tank Type/Material STEEL Tank alze 1250 gal. Number of Compatl~ents 2 FoundaUon cteanout (Y/N) YES Oate of pumping NEW C. ABSORPTION FIELD DATA Oate Instelled, 3/1/2001 Cf~ (Y/N) '~ High water alaml (Y/N) N/A Oateofadequanytest 11/17/2000 Resulls(Pass/Fall) PASS Fluid deplh In absorption field before test as.2s In. Water added.11 ea gal. 220 Elapsed Time: 12°2~1 min. e2.~/ Final fluid depth 4s In. Absmptlon rate Any reJuvanaUon Ueatment Coast 12 mo.) (Y/N & type). For 4 bedrooms New deplh 5a.2~ln. 600+ g.p.d. *'YES If yea, give dam 10/1B/00 Depression over lank (Y/N) .NO Pumper LOO CRIB ON Date Installed ~ SoU rating (O.p.d~ 150 System type LOG CRIB Langth~ ~ lg (811k'm~ LOGS) lt. Gravelbelewplpe '4.8~ fL Totaldeplh. [a'.~.'R'fL Eff. absoq~flonama 608 ti" Monltedngtube YES Depmsalonoverflald NO .~t~_- CTSE Environmental Services Inc. 1007358001 AK Water & Wastewater Consultants Inc. Preuss S/D 3 Lot 9, Blk 10 Outside llose Bib Drinking Water Client PO# CT&E Ref.# Printed Date/Time 12/01/2000 14:14 Client Name Collected Dare'line 11/27/2000 8:45 Project Name/# Received DateYTIme 11/27/2000 10:30 Client Sample ID Matrix Technical D~ Stephen C. Edt . Ordered By Releas~~ ~ PWSID 0 Sample Remarks: - - · Allowable Prcp Analysis ~'a, aii..'let Results PQL Units Me~hod Limits Date Date Init Waters Delmar tment Nitratc-N 5.16 0.500 mg~L EPA 300.0 10 max 11/28/00 SCL Microbiology Laboratory Total Coliform col/I OOmL SMI8 9222B I 1/27/00 KAP ML%;ICIPALITY OF ANCHORAGE srv- sIo DEP~mNT OF ~L~ ~$ ~IR~q~NT~ PRO~C~ION ~PLICATICN mR ~L~ ~O~TY ~PROV~ CE~IFI~TE 1. (~mral Infection ~plication Date ~~ ~ (a) ~gal ~s~iption (inclu~ lot, block~ su~i~sion,~cticn, t~shio, range) Lo~tion (ad.ess o~ directions)' ( b ) App 1 icants Naare__f~ ~ "~-~/~ 5% lepho~m Applicants Addr e ss___~_~ ~z ~ -~) ~_f~ ~.~ ~ ~'~ (c)BuyerApplicant~'-T;is Other(Check~__--~°~e) (explain) ;Lending Institution (d) Lending Institution Te le photm Address (e) Real Estate Co. & Agent 2. Type of t~side, nce Single-Family ~ Nmmbe~ of Bedrooms Multi-Family Other (describe) 3. Water Supp. ly_ Individual Well ~ Cc.,.~nity ~ Public ~ Note: If c~,~nitl/ well system, must ha~ ~it~n ~nf~tion ~ ~e State ~nt of '~viror~ntal Conservation attesting to t~e legality ~d~atus. Is ~e ~11 adequate for the n~r of ~ s~cified in this ~) 4. ~ge Dis~al Is ~e ~stewate~ dis~sal system adequate f~ ~e ~r of ~d [Page 1 of 2] 2-15-84 ._F...ngineering Firm Providing Ins .pections, Tests, Data and Information certify ~~_~checked, verified, effect on~_2zne~~this inspection' c~ conformed to all MDA HAA Guidelines Signed ~/-/~~ Name of; Fi~m Signal by Da te (ENGINEER SEAL) 6. DHEP Approval Approved fo~ Approved ~ Tele ho Disapproved~--~ Conditional~ Terms of Conditional Approval ~Fne Municipality of Anchorage Department of Health and Envirom~ental Protection does not guarantee the. continued satisfactory ~rformance of the water supply and/or the wast~water disposal system. This approval indicates that, as of ~.~e validation date shc~n above, based on the data and information furnished ~f an e~gineer registered the State of Alaska, the water supply and wastewater disposal system is safe and tional fo~ the numbe~ of bedrocms and type. of structure' indicated. ( DflEP SEAL) 7. Mail the HAA to the following adc~ess: ~9 c ~ c,~,.4 ~t (/~ -2 ~ ,'.~ KB2/dS/s [Page 2 of 2] 2-15-84 Well Classification Well Log P~esent (~).t _~, Total Depth ~ ..~O, ~ . Cased Static Water ~ve~ Casing Height Above Ground Electzical Wiring in Conduit((~Y/~9 Separation Distanaes f~om Well: MUNICIPALITY OF ANCHORAGE (MC~NlClPALITY OF ANCHORAGE DEPT. OF HEALTH & HEAL~{ AU~4ORITY APPROVAL (~VII~ONMENTAL PROTECTiO~ Cm C LTS -198 I A¥ 1. z. 1984 RECEIVED Pump S~t At &{ ~( Sanitary Seal on Casing~(~ Depression A~ound Wetlhead~ TO Septic/~= Tank on Lot //OO ~ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot /~) ~ ; On Adjoining Lots To Nearest Public Sewer Line ~ //~ To Nearest Public Sewer ' Cleancut/Manhole /J/ ~ To Nearest Sew~ Service Lic~ on Lot Wate~ Sample Collected By ~'.~'~J~//~; Date ~T~./~ Aj Wate~ Sample Test P~sults ~.~,~3 7~/ /~-/~C ~D~ .~/ C~(~nts ~C~/~ -~/~ /C°/~/'/~ )--~0)'~ .~3~/ /~/~ ~ / ~'~/~"~/ //o Co~ ,~i41--;' /.~1 '7- ~/~/I' ~l~ ' SE~Ic~ T~ ~TA ~te Install~h ~AO/~ S,~ /~--'.~ NO. of C~,,p~nts ' ~p~ession o~ Ta~ (~-~ , ~te ~s~d ~~/~r ~-- P~ing~intenan~ ~n~a~ on Fil~ ~Y~/~ ; fo~ Holding Ta~ High-Wate~ ~a~ (Y~//~ ~a~y Holdi~ Tank ~t ~p~ation Distan~s ~ ~ptic~olding Ta~: To Water-Supply ~11 /~ ~ To ~ilding F~ndation ~ f To ~o~ty Li~ /~ ~ To Dis~sal Field ~ To Water Main/Service Line Course CoIrments -~/z~//P~0 ( /pU ~Z TO Stream, Pond, Lake, c~ Major Drainage/ [Page 1 of 2] 2-15~84 C. ABSORPTION FIELD DATA Soils Rating in Absorptioo Strata Df/~ Type of System 5~sign Date Installed //70 ./~ L/ Length of Field /~ Width of Field /~ { ~p~ of Field ,~ S~e Feet of ~sorption ~ea ~O~ Stan~i~s ~esen~) ~paration Distan~ f~ ~sorption Field: To Building Foundation ~ ~ / To Existing or ~ndo~d System To St~e~ond~ke/~ Majo~ ~aina~ C~se ~ To ~iveway, Pa~kin~ ~ea, o~ Vehicle Sto~a~ ~ea /~ Con~ents D. LIFT STATION Date Installed Size in Gallons /~ / "Pump On" Level at 'High Water Alarm Level at / Tested for Di~e ns ions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Msets MOA Electrical Codes (Y/N) Co.u~ents ** Check Permitted Becl~oom Rating A~ainst HAA Request ** I certify t~ave checked.~ verified, o~ conformed to all MOA HAA Guidelines in effect on the daw of t~i~/~n~pe~e~i/~d./ Signe Date [Pam 2 of 2] - 2-15-84 April 19, 1976 I, hereby, agree to replace any and all standpipes as necessary on Lot 9 Block t0 Preuss Subdivision, b!z June !, 1976, for the property owner, Frank Romaine. Sincerely, ~ ~~~. / ~/~ ~~ '; tl~)~) ' . GREATER ANCHORAGE AREA BOROUGH I~./ · Department of Environmental Quality ~ ~ 3330 c Street, Anchorage, Alaska 99503 274-4561 ,~l'~\''q~ ~L~I%~P~~]~'~ -~L~ Date Received ~~ ~- ~ ~C ~ _ p~' ~ 'Time of Inspection ~'~ ~c~"P~q~ ~ ~ Date of Inspection~. INDIVIDUAL SEWER & WATER FACILITIES FOR Approval requested Property Owner: Q.cr~ Mailing Address: ~ 3. Legal Description: 4. Location: I ~ ~F~q~ 5. TYpe of facility to be inspected 6. Well Data: Phone: ~ fl~-I -C't~{~C.t Phone: ~::~c~,uI_ ~/Id No. of bedrooms A. Type LL~_~, , '~ r~ C. Construction Sewage Disposal System: A. Installed B. Depth ~.o.)~_~, D. Bacterial Analysis B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines , Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - R( st for Approval of Individual Water Facilities Approved (,,iq~/~~m~isapproved ~ Date :/~>~ ~pprov~l ~V~I~ For one ~e~r from ~¢e s~gne~ ~re~er ~nc~or~ge ~e~ Boroug~ Dep~rCmen¢ of Env~ronmen¢~l ~u~1~¢~ DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation o[the subject sewer and water facili are operating sati~s;F~ctor/q~y. ~,~--~ ties and these facilities SIGNED ~.:./_,,-~,~_~,~,~c~...~U ~//~~ Date ///~:7~ EQ-034 (1/74) 4.1 ~ MUNICIPALITY OF ANCHO~ '~. F~~. ~'~ DEPARTt¢,ENT OF HEAL/I~q & GREATER ANCHORAGE AREA BOROUGH ENVIRONMENTAL PRO~:CI'ION Department of Environmental Qu.ali~ty ' 3330 "C" St., Anchorage, Alaska 99503 - 274-4561JAN 151976 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER-FACILITIES RE. CEIVED 1. Type of Inspection: CMRO VA FHA 2. Property Owner: c- lbV~tV~ Mai-ling Address: ~.~\CD~Co~e~(~'xte~r_ Day Phone 3. Name of Buyer: ~~ ~~ ~~ Mailing Address: ~~k~ ~~ Day Phone 4. Name of Lending ~nstitution: '. ~~ ~ ~ Mailing Address: ~q~O~u~[~e~ ~.~(~. Phone ~- 5. Name of Realtor or.Agent: ~,~t~. ~ Mailing Address: ~~ ~ ~ Phone (~-~k~ 6, Legal Description: Location: 7. Type of Facility to 'be inspected: 8. Water Supply No. Bdrms. z~ Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual,'depth of well '~ / 9. Sewage Disposal System jType of System: Public Utility Individua'l \ If ~ndividual,. date of installation (on-site) EQ-037 (~/74) Post Offi~ P~ i~ ~~pdl · GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "c" Street, Anchorage, Alaska 99503 274-4561 \-,~ / ~p ~ 'f~' ~ ~14~" Time of Inspection ,/-/~ ~ ! I - o ,, ~ -~---'-' -7 ~1~ .~J~_ ~' REQUEST FOR APPROVAL OF ~ . ~ ~ ~",~i INDIVIDUAL SEWER & WATER FACILITIES /..~~, x-~ ~U .~ ' FOR ~~]/~//~ 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: 4. 5. 6. Coast Mortgage Company Post Office BOx 1200 Phone: Frank Romaine Phone: General Delivery, Eagle River 279-0665 None Legal Description: Lot 9 Block l0 Preuss Subdivision Location: Eagle River, Alaska Type of facility to be inspected Well Data: Individual system A. Type C. Construction ¢' ~'~D~,I) , Single Family No. of bedrooms 4 B. Depth 258'+ D. Bacterial Analysis Sewage Disposal System: On-site system A. Installed ~/~.~/~ B. Installer C. Septic Tank: 1. Size /~2 D. Seepage Pit: E. Disposal Field: Total length of lines 2. Manufacturer I. Absorption Area ~ 2. Material Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank C. Absorption area to nearest lot line , Absorption area , Other contamination , Absorption area , Sewer Lines EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re, st for Approval of Individual er & Water Facilities ~eg~l'Description ,Lot 9 Block 10 Preuss Subdivision, Eagle River Comments Approvals. Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I 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) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & GREATER ANCHORAGE AREA BOROUGH ..... I~NViRONMENTALPROTECTION Department of Environmental quality 3330 "C" St~, Anchorage, Alaska 99503 - 274-qj}j~O ~.21g75 RE, UEST r0R APPROVAL OF RE,¢ IVliD INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA 2. Property Owner: ~-~' ,~A hi ~ &g t~l\/~ //g' ~ Mai.ling Address: ~.~_/q/~ ~LIVEC~. 3. Name of Buyer: O'/t~(t~ ~A~v~JR.c~E'. Mailing Address: 4. Name of Lending Institution: Mailing Address: 5. Name of Realtor or.Agent: '~-J] Mailing Address: o Legal Description: Location: FHA CONV,~ Day Phone ~_O/~ Day Phone Phone 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public Utility o No. Bdrms. Individual If Individual, number of dwellings presently served ]f Individual, depth of well Sewage Disposal System Type of System: .Public Utility Individual If Individual, date of installation on-site) EQ-037 (~/74)