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EAGLE PARK BLK 3 LT 5C
Park lock Lot C 050-782 -2:1 .! Municipality of Anchorage Development;,. Services Department. Building Safety Division On-Si[e Water and Wastewater Program, 4700 Etmore St. P:.O. Box 196650 Anchorage, AK 99519-6650 Page of :: www.ci.anchorage.ak.us (907) 343-7904 ON-SiTE WASTEWATER DISPOSAL SYSTEM AND/OR WELL iNSPECTION REPORT Permit Number: Obp Iotli 5 i ,, P D Number: -4:34-~ ~:~Z- Al SA~,,'} ~'h;~/¢r~ i Wastewater System: [] New [~ Upgrade Address: i ~O~t5 ~ Or.~ t~ ~, AK ~ 577 ABSORPTION FIELD Phone: N r umber of ge~oo~ ~ ~ ~ Deep Tren~ ~ Shall~ Tm~ ~ Bed ~ Mound D Other; ~ Soil: Rating: Total Dep~ from odginal grade: LEGAL DESCRIPTION BIo~:3 Lot: ~ ~ ~Subdivis~on ~ Oep~ to ~pe bb~om from o~g na~, ~grade: FL Grave depth ben~a~ ~: Township: Range: ~ Se4tion: Fill added above o~gi~al grade: Gravel LenGth ' ClasNDcaNon (Pdvale~, B, 0): Tota Dep~ ~ ~ Cased to: To~N absorp~on area: Pipe Mateda D~le~ Date Ddlled: ~; Sta~6 Water Level lnsta le~ ~ Date In'tailed: ~.~ .~. ...........~... .~ TANK SEPARATION DiSTANC~S ' ~ .septic D Hod ng D s T.E P 'D Other: ~ Te SePtic ~so~tion Lift H~lding ~ubti~Private Man~a~r~ , ~ . _%udain Drain ~O ~O~ ~ ~j~A / ~ ~,,PumP Make & Model EI~B~I ~spe~ons pedo~ed by: Inspections pe.ormed by: L.. ~.rbt&~A Dates: 1" ~/l~/tO ~--~%~'~N~:Engin'eYsStamp Development Se~iceS~ Depa~ent Approval ' ~ c;-".&?' .... Conditional Approval ~ _Date:~: ~ ./ .......... 0 4~.5 88~0' , / ./ ! '%. ./:,i~o.o.'io - / i ~ , ss.o za.o. , TOTAL DEP~ 9 PEg ~ ~ ~or ~ ~oc.~ o~ ~.s ~w ~P~Xlmm~ ~CAR~ SPURKLAN9 SCALE, 1' = 50 F~ Sp~ ' , . , ,, . ' ~KaOO ENCINEEP/~G)~AGLE P~K B~ 8 LOT 5CsEPr/c SYSTEY 20~ W I5IR. A VENUE ~cy ~ 995o~ ~ 'rD TO/rL6~ mr~: duLr 2~ 20~0 (90~)' 2~-~9f6 2071~ RAVEN ORlV~ EAGLE R/VEP, ~ 99577 SYEED 1/~ CPI& SW58 PER~[T ~ S~080XXX PIB ff 0~0-78~-Pl 88.5' 20.0' 38.5' 20.3' $9.$'26.0' ~.s' 47.0' Siondord ?tenth: P,S' IVide 40' Long 9,2' Deep ZS' Sewer 3' Cover © ©0 Test Hole E.G. Elev.= 95.0' Elev, = 9;7.5' Elov. = 86,0' B.O.H Elev.= 80.0' ND SCALE / ~ Monitor / ~ Oeonouts . Borrier // Y , 3' Cover ~ _ _ _ 7,5 ~ oF Sep~tc Rock Effecii~e 1~ gal septic ~ank '.= 99.5' Ele~ NO SCALE Bench Ma~ Boltom S.i. djng SE House Corner Assumed Elevation 100 EAGLE PARK B1,K 3 LOT 5C ED THIELEN 20715 P, AVEbl 0£11Z£ ~1_~ £11t~, AK 99877 J J SEPTIC SYSTEM ASt~UILT I)ATEI ~.7, 2010 $/$ IL) il= 050-782-21 F-_.4 GLEPAi?KB$£5¢D $.DWG Permit Number: Tax Code Number: Work Type: On-Site Wastewater Disposal System Permit OSP101115 05078221000 Septic MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 198650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Upgrade Permit Effective Dates: July 20, 2010 to July 20, 201t Design Engineer: SPURKLAND ENGINEERING Subdivision: EAGLE PARK Site Legal Address: EAGLE PARK BLK 3 LT 5C G:0056 Owner/Address: THtELEN EDWARD J & VIRGINIA N 20715 RAVEN DR EAGLE RIVER AK 995778742 Site Mailing Address: 20715 RAVEN DR, Eagle River Lot Size in Sq Ft: 37264 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Pdvate Well N Water Storage 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 wastewater code requires inspections during the installation, The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours)° 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: Permit includes waiver OSP101116 allowing the drainfield to be 1 foot from the south property line. Received B Date:~ Issued By: , Date: Municipality' of Anchorage P,O, Box 196650 ~ 4700 Elmor¢_Road .~9~L5~!~-6650 ~ .(,~ 7) 34 3- 7904 · F ax Development Services Depadment On-Site Water a~t~ Waste~ [)aPartment **** VARIANCE/WAIVER REVIEW **** WR#: OSP10!1:!~6 HAft: ~ Permit#: OSP 101115 PID#: 050-782-21 Legal Description: Eagle Park, Block 3 Lot 5C Engineer: Spurkland Enq~ Applicant: Edward Thielen Your request for a waiver of the required 10 feet horizontal separation :from the absorption :field to the property line has been approved. The approved sepm'ation distance is 1.0 foot. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewate:r disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Gran't~¢:,=,"/~/ ¢,/~¢~¢ ~,,~/:'~¢~> ~ ~,¢~¢(~f Date: 7/.__20/2010 Approved by~;~,~'~/~:~ ,~ .... ~ ~ / ~ame'~ Rd~iewer ' Race: 032411 Amount: $200.00 Date Paid: 71812010 **** VARIANCE/WAIVER REVIEW **** Parcel BuiMing Safety Division On-Site Water and Wastewster ProCr~m 4700 Elmore Raad P.O. Box ~ 96650 Anchorage, Alaska 99507 ~¢t¢.zw.m u ni.org/on ske (907) 343-7904 ON4SITE SEWER/WELL PERMIT APPLICATION ¢~P1¢11t¢ FOR A SINGLE FAMILY DWELLING O ~ P lO Ilt~ Property owner(s). ~;P THt6LEN Mailing address ~oqt5 P. Au6t,,} PP4~)6 Site address - 5~m¢ - Legal description (Sub'd., Block & Lot) ~AG-L£ Legal description (Township, Range & Section) Lot Size Sq. Ft. THIS APPLICATION IS FOR (~ all that apply): PA~K BLK 3 Day phone ~ 6¢iq * Zo 6Z. Zip Code c1~5 ~l Zip Code LoT sc Number of Bedrooms THIS APPLICATION IS AN: Absorption Field ~ Septic Tank [] Holding Tank ~ Privy E~ Private Well [] Water Storage E~ Initial ~ Upgrade ~ Renewal E~ 1 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 Municipal Codes. Permit/Rush Fees: ~~O Waiver Fees: Date of Payment: "~-: ~i ~ Date of Payment: ReceiptNumber: ¢ .~L:~ ',~. Z¢ /1__ ReceiptNumber: (Rev, 11/05) Environmenfal Consulting and Design SEPTIC SYSTEM DESIGN Eagle Park Block 3 Lot SC Municipality of Anchorage Development Services Department On Site Water ~md Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 995 t 9 July 6, 2010 Subject: Septic System h~tallation Permit 20715 Raven Dhve Ladies and Gentlemen: I am. writing to request a perm:it to upgrade the septic system t~)r the above referenced property. The proposed system will serve a 3-bedroom single-hmily residence. The existing syste~n is over 25 years old. and failing. A soil log, design calculations, a site plan, design drawings and construction specifications are enclosed for your review. Design Calcs: No Groundwater obsetn;ed to a depth qf tS feet below gttound susface (7/Z/2010) &)il Rating: ]Ovm Tes&ole 6/23/2010 <] rain~in = 1.0 gat per sqf~&t~; NO. qf Bectrooms 3 Requbzed A~xea per Bedroom: 15W 1.0 = 150 sq:[?. 7btal area require& 150 x 3 = 450 s~ System: 'We am proposbg a 1000 galbn septic tank, and a deep trench absorption field. The absorption field, will be 40 feet long and 2.5 feet wide with 6.5 feet (520 sq.ft, efli~'ctive) of sewer rock. Soils: A test hole was excavated on June 23, 20'10. See the attachcxt soil logs.. Sands and silty sands were observed. Ground water was monitored for through July 7, 2010. Ground water was not observed. A percolation test was conducted at a depth of 5 tbet. A percolation rate of<I mitt/in was obsepred. Since the soils are sand m~d silty sand (SW, SM) a sand layer will not be required 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 3544597, Lspurkland(~)gci. net Surface Water: system upgrade. Environmental Consulting and Design There ~re no surface waters within one hundred feet of the proposed septic Topography: The tot slopes to the south. The maximmn slope approaches 20%. Waivers: Due to the configuration of the lot and the location of the existing septic system a lot line waiver will be required t~)r the proposext absorption field. The lot to the south is developed. The house and well are over 100 t~aet away from the proposed absorption field location. Gr~mting a waiver of the 10 foot set back will not negatively effect the neighboring property. To maximize the distances between the existing system and the new drain field please issue a 1 foot lot line wavier. The instaltmio:n of this septic system will not .prevent wells and septic systems tkom being instatlext on the adjaccmt lots. The proposed septic syste:m will not chm~ge the general slope of the area. Ponding and/or concentration ofsurhce runoffwill not result fi~om this installation. If you have inky questions or concerns, please contact me at 279-3916. Sincerely, Lars Spurkland~ P.E. Civil Engineer 203 West 15t~ Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland~i}gc~.net N / ! LOT SA INOIE:II{IS tS NOT A SURVEYED PLAT. #~LL ~ SEPTtO J LOOAtlONS TAKEN ENOW ON-SITE WAIEN AND WASTE WAIT. NJ DEPANT~EN[ DOCUk~ENTAIIONo A~ LOCAflO~ SNO~ AgE ~ APP~XI~ J 50 0 50 100 t50 £00 ~750 300 SCALE; 1~ = I00 / LOT 5C LLIT 7 49~h !KLAND No, C£-ll~OO SPURKL4ND ENGIN~E~T~ 20J W f STH, AVENUE ANCH. AK, 9950! EAGLE PARK BZK 3 LOT 5C ED THIELEN 20715 RAVEN DRIVE, EAGLE RIVER, AK 99577 SEPTIC SYSTE~ DESIGN DATE: JULY 7, 2010 SHEET: I/'~ GRID: SW56 PERMIT # S~/080XXX PI£ # 050-78£-~I L-og(ePorkB3LSCDt, dw9 N LOT ~ A SANDON EXIS~7N¢ SEPTIC NK PER UPC INSTALL STAKE SOUTHERN LOT UNE & I00' WELL1 RADIUS BY REGISTERED lAND SURVEYOR LOT 7 INSTALl $-BEDRO0~ SEPTIC SYSTE~d t250 GAllON SEPTIC TANK LENGTH 40 FEET WlDIH 2,5 FEET TOTAL DEPTH g FEET ROCK DEPTH 7 FEET COVER 4.0 FEET [ NOT£' MIS IS NOT A SUI~VE~O PL4T, WELL ~ SEP~C [ l~O~ TAKEN FRO~ ON-SI~ ~ATER AND ~AS~ ~A~RI D~A~T~ENT DOCUMENTATION, ~LL LOCATIONS SHO~N ARE ] APPROXI~A TE J 25 8 25 58 7S 100 I~5 t50 SCALE: 1' = 50 F~ }-PTIC SYSTEW DESIGN ANCH. AK. 9950t : , (907) 279-3~,~,~,, SHEE~' 1/3 GRID: SW56 PERHZT ~ ~V080XXX P[~ ~ 0~0-782-~1 Eog(eP~rk~3L ~CD~d~9 'french; ZS' Vide 40' L on9 9' Deep 6,5' Sewer rock 4' Cover ND SCALE - Monitor Cleanouts ---~ 4' Cover 6,5 £t of' Septic Rock Effective SCALE 1000 got sepfic tonk SPURKLAND ENGINEERING ~03 W15th Ave Anchorcge Ak 99501 EAGLE PARK BIX 3 :LOT 5C ED THIELEN 20715 RAVEN DRIVE, FA6LE RIVER, AK 99577 SEPTIC SYSTEM DESIGN DATEI JULT, 6, 2010 SHEETI J/J GRtD~ SV$6 PERMIT t1~ SWO4OOXX PARCEL ID ~ 050-782-21 EAGLEPARKBSL5CD$,DW¢ Municipality of Anchorage Developmen( Services Depadment Building Safety Division On-Sile Water and Wastewater Program 4700 EImore Road P.O. Box t96650 Anchorage, AK 99507 ?¢¢¢:d,and~ora~e ak.us (907) 343-7904 Pert'on'ned For: Legal Descciption: Soils Log - Percolation Test T~\~£ L___E/V O"L Slope Site Plan 5- 6- 7- 9- IF YES, AT WHAT DEPTH? Depth to Water After Date: 14- 15- 16- 17- 18~ 19- 20- Reading Date Gross Time Net Time DepIh to Water Net Drop PERC HOLE DIAMETER FT PERCOLATION RATE 4¢~ ¢ (mir, utes~nch) TEST RUN BETWEEN ~ ~_ ..... FT AND ~ PERFORMEO IN ACCOROANC¢ ~TH A~L STA'rE AND MUN~CmAL OU BELfNES ~N EFFECT ON TH~S Environmental Consulting and Design Single Family On-site Wastewater Disposal System Construction and Haterial Specifications Subject Property: Eagle Park Block 3 Lot 5C Date: 3uiy 6, 2010 General: The owner shall contract with a contractor to perform the work outlined in these specifications and plans in accordance with the attached HOA permit. There is not contractual arrangement between the contractor and the Engineer. The Engineer shal~ be the owner's representative and wilt inspect the work to document the contractors activities. Final acceptance of the contractors work rests with the owner and the lvlOA. The scope of the project includes the procurement and installation of a 3-bedroom omsite wastewater disposal system at the location depicted on the attached site plan drawings. The scope of the work also includes the installation of a new 1000 gallon septic tank, a drain field comprised of t trench, 2.5-feet wide x 40-feet long, 9 feet deep, with 6.5 feet of septic rock below the distribution piping. Alt components of the proposed septic system must be constructed a minimum of 100 feet from any surface water or water wells in the area. A minimum of 4 feet ol: earthen cover is required over the septic tank and a minimum of two feet of cover is required over the drain field. If there is [ess than 3 feet of earthen cover, 2~inch thick, 40 psi, direct bury board foam shall be installed directly over all installed piping. Construction shall be in accordance with the approved site plan and design drawings and any special provisions noted on the Hunidpal well and/or septic permit. All materials, components, workmanship and construction practices shall comply with the Hunicipality of Anchorage's latest ordinances regarding wells and septic systems, as wefl as HOA, Development Services Department, On-site Water and Wastewater Program (DSD) policiesx The contractor is responsible for obtaining all underground utility locates, layout of the proposed system, and verifying and maintaining all required separation distances to lot lines, surface water, wells, steep slopes, etc. The property owner shall be responsible for final grading any depressions formed from settlement of backfiJl material. The property owner is also responsible for vegetation of all areas disturbed by septic system installation activities. Contractors installing wastewater disposal systems must be certified to do so by the MOA DSD, Omsite Water Wastewater Program. Property owners installing their own systems must receive advanced approval from HOA DSD prior to system installation activities. The contractor shall ensure that ALL materials being used are in compliance with the most current guidelines established by the Hunicipatity of Anchorage. Refer to "Standards and Specifications for Component Parts and Haterials Used in the Construction of On-site Wastewater Disposal Systems'; Dated December 2000, as provided by NOA DSD, On-site Water and Wastewater Program. 203 West 15~' Avenue Suite 203, Anchorage, AK 99501, Phone: (91)7) 279-3916 Fax: (866) 354-1597, Lspurkland~;.gc~.net Environmental Consulting and Design Septic Tank Installation: 3, 4. 5, 9, 11, 13, 14. 16, A new septic tank, of the size specified in the design drawings, shatl be procured from a qualified manufacture/supplier if the existing septic tank is found to be defective. Construction shall include b, vo 4" diameter cieanouts for pumping access. The burial rating of the tank shall be adequate for the actual burial depth encountered, The tank shall be level and suffidently bedded to prevent settling of shifting of the tank. All standpipes on the tank shall extend a minimum of 12inches above the final grade, Tanks installed w~th less than 4 feet of cover shall be insulated. The sewer service line from the house to the tank shall have a minimum slope of 2% unless prior approval is obtained from the engineer. The inlet and outlet lines from the tank shall be bedded in drain rock or the soil shall be sufficiently compacted to prevent future settlement of the soil. Septic tank inlets, outlets and cleanouts shall be fitted with water tight couplings. A cleanout shall be installed 1 to 4 feet from the foundation. Post tank deanouts shall be installed per MOA requirements. Does not apply to pressurized lines. In areas with high ground water, the septic tank shall be sufficiently anchored to resist buoyancy forces when there is not adequate soil cover to resist uplift force. The contractor shall refer to the engineer for direction regarding this matter. The tank backfill shall be graded sufficiently to ensure positive drainage away from the tank. Ail holding tank and lilt stations shall have an audible and visible alarm inside the residence being served, All lift stations shall be wired in compliance with all lvtOA guidelines and the Uniform Electrical Code. A municipal electrical permit and inspections must be obtained where required by the MOA. The contractor shall verify that the septic tank/lift station is a minimum of 100 feet from any residential water well, 150' from any class 'C' well and 200 feet from any community water wells. Additional separation distances must also be maintained. The contractor shall remove or abandon the existing tank in compliance with the Uniform Plumbing Code. Drain field Construction: The drain field shall be excavated to the dimensions outlined in the design drawings. ]~f any discrepancies are noted, contact the engineer immediately for clarification. The drain field shall be installed parallel to slope contours. The bottom of the drain field shall be within 2" of level. ]f the sidewalls or bottom of the excavation become smeared, they must be raked or scarified prior to the placement of filter sand or drain rock. The drain field must be a minimum of 5 feet from the test hole excavation. Distribution pipe is to be installed level with perforations facing downward, atop a level bed of drain field rock. Septic rock shall then be placed atop the distribution piping to 21)3 West ' ,~t~, . s.> tavenue Suite 203, Anchorage, AK 99501, iPhone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland~SgcLnet Inspections: Environmental Consulting and Design provide a minimum of 2" of cover, level across the entire width and length of the trench, above the piping~ A silt barrier must be installed at between the final drain rock and the native soil backfill, The silt barrier shall cover the entire drain rock surface, Monitor tubes must be 4" in diameter, installed in the locations depicted on the design drawings, and extend a minimum of 12" above final grade, The portion of the monitoring tube below the septic rock must be perforated and the portion above the drain rock shall be solid, Backfill over the final gravel layer must not be less than 2 feet, Insulation must be installed when the backfill depth is less than 3 feet. Drain field back fill shall be mounded to prevent depressions from forming due to subsequent settlement of backfill material. The contractor shall verify that the drain field is a minimum of 100 feet from any residential water well, 150' from any class 'C' well and 200 feet from any community water wells. Additional separation distances must also be maintained, A minimum of two inspections are required by the Municipality of Anchorage. These inspections must be conducted under the supervision of a Professional Engineer licensed to practice in the State of Alaska. The first inspection must be conducted after the excavation of the drain field and before the placement of any gravel. The septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, stand pipes, cleanouts, and insulation, but before the placement of any backfill. The contractor shall provide a legible copy of all field notes relating to system layout and construction to the engineer for the use in preparin9 the record drawings. The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours notice is required prior to the start of construction, If necessary, a preconstruction meetin9 will be held on-site. 203 West 15"' Avenue Suite 203, Anchorage, AK 99501,, Phone: (907) 279-3916 Fax: (866) 354-1597, l~spurkland~),gci.net 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 ~UPGRADE ~ DISTANCE TO: ~ OISTANCE OTHER PIPE MATERIAL$ 5~ ~ SOILTESTRATINO ~ REMARKS PERMIT I-lO. MLI~-.I I C I {~L I T°'r' OF Al,ICH RAGE DEPARTMENT OF HEALTH ArID ENVIRONMENTAL PROTECTION 825 '"L'~ STREET, ANCHORAGE.. At(. 99501 2~,4-4720 Ot~--5 I TE 5EtqER IJPGRRDE PERrd I T ( 810945 > APPLICANT LOCATION LEGAL EDWARD THIELEN RAVEN RD. L5C B~ EAGLE PARK C?O S & S ENGINEERING, LOT SIZE SRB 196 694-2979 22000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUrIBER OF BEDROOMS SOIL RATING THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= '10 LEI'~iGTH= .7:-7 GRRVEL DEPTH= 6 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (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). REI~U I RED SEPT I C TRI'-IK $ I Z.E= ::1_000 GRLIOI".I__c. PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. TI-lO ( 2 > I 1'-4$PECT I Or-IS ARE REQ. U I RED BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEI.IAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUbl DISTANCE FROM 8 PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I t EXP I RES DECE{IBER ..?.-1.. -19~o.1 I CERTIFY THAT l: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SE~IER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. ISSUED B~ ....... DATE V4, ~ MUNICIPALITY OF ANCHORAGE , DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street. Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG r-I PERCOLATION TEST SLOPE / SITE PLAN 3 m 6- 7' 8 9 1/~1~ 7' J'/ Z.. 7' 10 '11 12 13 14 15. 16- 17- 18- 19- 20- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? o£' Gross Net Depth to Net Reading Date Time Time Water Drop PERCO~TION RATE ~ ,minutes/inch} TEST RUN BE~EEN A FT COMMENTS . 724)08 (6/791 CERT, F,ED ,,: ~-& s ~i,;'OSi.~ DATE: EPLfi-mss 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 i S- a0v Parcel I.D. 050-782-21 - ' – *"V—1 Expiration Date: I. GENERAL INFORMATION Complete legal description Eagle Park B3 L5C Location (site address) 20715 Raven Dr. Current property owner(s) .Justen & Cecily SheatS Day phone 530-370-4488 Mailing address 20715 Raven Dr., Eagle River, AK 99577 Real estate agent Laura Davis 2. TYPE OF DWELLING: [] Single Family ( wo'ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 907-406-0250 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well [] Private Septics (] Water Storage ❑ Holding Tank; ❑ Community Well ❑ Community . ; ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee Date of Payment��o1a�� Receipt Number _ G�� 1(0 o� COSA # Waiver Fee $ Date of Payment ;. Receipt Number r Waiver # 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, based on procedures outlined in the Certificate of On -Site Systems 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Eklutna Engineering, LLC. Address 19162 Mountain Rd., Chugiak, AK 99567 Engineer's Printed Name Curtis Townsend OF Phone (907)355-9820 Date' .: �4 T 9*� i 6. DSD SIGNATURE k System #1 Approved for bedrooms . t t- 01?,� o STA .1F k No. Cd 11System #2 Approved for bedrooms °AW Disapprovedlt�ti�+` Conditional approval for bedrooms, with the following stipulations: '�111it1R4�lUi� ABy: Original Certificate Date: -//13 4W 0 The Municipality of Anchorage Development services Division (DSD) issues Certificates of On -Site SySltems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory COSA Checklist blue sheet Nitrate Advisory )( Arsenic Advisory Other OSA Checklist Legal Description: Eagle Park B3 L5C Parcel ID: 050-782-21 If more than 9 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 ❑ Well log is filed with Onsite (or attached) Well production at time of test 6.6 gpm Date drilled unk Water storage tank volumen/a gallons Total depth unk ft _ Well disinfected for coliform test? - ❑ Yes - ❑ No Cased to unk ft ❑ Coliform bacteria is Negative r I `70 7 g ❑ Sanitary seal is functioning correctly Nitrate, mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic <MRL ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) 39 in. Collected by Brandon Date of flow test for COSA 4/1/2020 Date of Sample0 Static water level at beginning of test 74.8 ft. —'— Comments No well log on record. B. TANK DATA Age of tank(s) 10 years Tank type/material steel Measured operating fluid level in septic tank 50 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 4/3/2020 D. ABSORPTION FIELD DATA C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Which system tested (date installed) 723'2010 Adequacy test date 4/112020 ❑ ALL standpipes present per record drawing Results E✓ Pass For 3 bedrooms Total measured depth from grade 10.3 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 3.1 ft (min) Water added 450.7 gal ❑ N/A — pressurized field New depth 9.5 in ❑ Monitor tubes go to bottom of effective. If not, state 15 depth into effective Elapsed time min RMCode-requiredsoil cover over field Final fluid depth 0 in F-1Systempresoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) none date of test) Gallons introduced n/a gallons If yes, enter date y n/a Comments/Deficiencies: Old leach field monitoring tube was full to ground surface and frozen at ground surface. COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑✓ Yes Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft 0 Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line? 25'El Yes if No ft Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' ❑✓ Yes if No ft Water Main > 10' Animal Containment > 50' ❑✓ Yes if No ft 0 Yes if No ft ❑/ Yes if No ft Water Service Line > 10' ❑✓ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' ❑✓ Yes if No ft ❑✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Main > 10' ✓❑ Yes if No ft Community Wells > 200' ❑/ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Q Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No * ft Wells on Adjacent Lots: Water Main > 10'❑ Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *Double inlet line cleanouts,*WR#OSP101116, The diverter valve was originally directed towards the 1973 field. Prior to the adequacy test the diverter valve was diverted to the new 2010 field. 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 C4SA guidelines in effect on this date. ��� OF A; ��% ttGNEEfg' .•*:.49 TM . * • • • • • � l Ta.wnaeid.• . • . COSA Checklist yellow sheetl�F.'. [� C� • . No. Ct` i 1904 , .' � / �l�ti;�pROFES5l0�� �� Nitrate Advisory Certificate of On -Site Systems Approval # OSC201146 Subdivision: Eagle Park, Block: 3, Lot: 5C 907-343-7904 Fax: 343-7997 A water sample revealed a nitrate concentration of, 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. Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org 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 medi a 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. • �r Municipality of Anchorage °t1° �, ,. On-Site Water and Wastewater Program •�i.! (907) 343-7904 �� s ; ETY Certificate of On-Site Systems Approval Parcel I.D. 050-782-21 Expiration Date: 2-- 7-10 1. GENERAL INFORMATION: Complete legal description Eagle Park; Block 3, Lot 5C Location (site address) 20715 Raven Drive'Eagle River, AK 99577 Current Property owner(s) Edward&Virginia Thielen Day phone 223-8399 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: -� —� Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ i q 000 Waiver Fee $ Date of Payment 1 l 'tP 07 Date of Payment Receipt Number C) 15-3e) Receipt Number COSA# ( )C,r3-lS7? Waiver # 5. STATEMEN1:OP I ION BY ENGINEER As certified by my seal affi d 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 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road,Suite 101-Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: I I 1 3/ Q0000pD In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system OF 4 D� in accordance with the guidelines and regulations established by the Municipality of Anchorage and � .•• ' �1C1 industry practices. The reported results describe the condition of the system/s on the date/s of the 0',4: —.•" ' —.• '7v �DOJn� evaluation. Separation distances were measured to readily identifiable features. Hidden defects or � �- V encroachments may exist that were not identified during the evaluation. The operational life of all wells ¢-'. 4�s T QQ and septic systems depend upon a variety of variables, including but not limited to, soil conditions, Ai ..•'•'' '' "' groundwater levels (that may fluctuate during the year), quality of construction (materials and v / VA workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and / ,�/ I V are outside the control of GEG. Satisfactory test results do not guarantee future performance of the Qpt!•ff .rness;• system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of VA '-.I E— 953 ' iQ, the well or septic system. GEG makes no representation whether an alternative well or septic system VQ s •(8'4 can be installed on the property in the event either of the current systems fail to perform adequately in 04fPr ll . (. '.• the future. The content of this report is for the sole benefit of the person/party that retained GEG to 4Pa rofessionQ om' perform the evaluation. Reliance upon the information provided in this report by any other person or 4�DDDP party (including subsequent property purchasers) is not authorized, nor will it confer any iegal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for Li bedrooms „;�tirY�t System #2 Approved for bedrooms ti' �`( O� Cya/2,,' Disapproved 0NNd � RP • Conditional approval for bedrooms, with theladowitf�jPS ,� C �� W OG�P = NTS- Original Certificate Date: 1 1- 7- 17 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: `/� COSA Checklist 7` Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheel_10-1O.12.doc If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Eagle Park; Block 3, Lot 5C Parcel ID: 050-782-21 A. WELL DATA Well type Private If A, B, or C provide PWSID# N/A Well Log (Y/N) No 40-46.4e1 Date completed 1973 Sanitary seal (YIN) Yes Wires properly protected (Y/N) • !' Total depth 105 ft. Cased to Unk ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 8/18/2017 Static water level lie\\ "-°qft. 72.7 ft. N° Well production / g.p.m. 5.3+ g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate B 't 3 mg./L. Collected by: GEG. Ltd. Arsenic: 4 ug./L. Date of sample: t o/23 f 14 li 1 a z�c B. SEPTIC/HOLDING TANK DATA *Pre—tank double cleanouts Tank Type/Material Septic/Steel Date installed 7/22-23/2010 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Yes Foundation cleanout (Y/N) *No Depression over tank (Y/N) No High water alarm (Y/N) N/A Date of pumping f4,r -�G' 14- Pumper 7a` 5 G C. ABSORPTION FIELD D A •Below Existing Grade Date installed 7/22-23/2010 Soil rating .p.d./f 'or ft'lbdrm) 1-Q System type Deep Trench Length 40 ft. Width 2.5 ft- Gravel below pipe 7-5 ft. Total depth *10.2+ ft. Eff. absorption area 600 ft' Monitoring tube Yes Depression over field No Date of adequacy test 8/18/2017 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 655 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) None Known If yes, give date — Tested adequacy of 2010 drainfield (trench in use) only. Information on 1981 trench is in MOA records. (North (1981) trench had approximately 4.25 feet of water on 10/10/2017) Trench is approximatley 5 inches shy on soil cover (see attached email from owner regarding freezing). V I/ Pa I g 43 I ' F 4 D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off" level at . a er alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75 + Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5+ (assumed) Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *1'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain None Known Wells on adjacent lots 100'+ F. COMMENTS *WR#OSP101116 G. ENGINEER'S CERTIFICATION of VAL COQ ovPC---- •-- cisklp I certify that t have determined through field inspections and 0 91- -,7 0 review of Municipal records that the above systems are in frA . conformance with MOA COSA guidelines in effect on this 1 VAQ date. V . f 1.-If A.Garney�s_ Engineer's Printed Name JEFFREY A. GARNESS QQ a CE— 9 3 J' Date 3/ 1- 't11. edp' o��,o rofess%on o #AECC884 (Rev. 11/05) Municipality of Anchorage L: Development Services Department Building Safety Division S4 ETY On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Systems Approval # OSC171518 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 3, Lot 5C of Eagle Park subdivision. This inspection revealed a nitrate concentration of 8.13 milligrams per liter (mg/L) was reported for the property's well water sample. 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. 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. £T99 -9K L0966 71V'39VWHPNV 3ARIa 213A0219 60£6 9NIA3AZIf15 ONV1110H L -99L 83 `Sb1EL ' LIOZ ' 213801)0 30 AVa MR SIH! 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NO 21V3ddV AVW -LVH-L S3NIl32N3d 31ON (031V2IONI 553-INn ) N0313H NMOHS ION 3aV' lYld 02i003213H-L NO 9NRIV3ddV 35OHl NVHl M3HI0'02fOJ32I AO SIMMSV3 'S3NI137N3-A 210'SIN3W3AO?JMI'93Mn.L;Pn2LL5 IVNOLLI00Y 9NINOLLISOd WA 439!138 Ol ION SI 0NY S.LN3W3SV3 210/ONV S3NI.1lO1 a3I1Vld 4NV S34nl-2l12LLS 9NLLSIX3 N33NU38 912I"IANO2 ANY MORS Ol ATIV-II4D3dS SNO7.irlI ISNi 9NION31-40 3Sl13HI 210J SI NOMSH NOT LVMOdNI 3Hl 0 1.Buoissa�o JV v5QJ d4�4 bL69 Sl m� llOH'V 3NVHS e 70 a -~,L ~, INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INPUt- MUNICIPALITY OF ANCHORAGE ~'aPAL~ OF ~N~O~GE ~ DEPARTMENTOFHEALTH&ENVIRONMENTALPROTE~I~PT' O~ H~L~ & 825 L Strut - Anchore~, AI~e ~1 E~IRONMENTAL P;OTE~ION ) ENVIRONMENTAL SANITATION DIVISION 0CT 2 1 1980 T~ephone ~7~ REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND 1. PROPERTY OWNER I PHONE KELLyI -- PROPERTY RESIDENT (Il different from abow) PHONE 2. BUYER PHONE ~ ~I~G I~?ITUTION MAILING ADDRESS 6. TYPE OF RESIDENCE NUMBER OF~BEDROOM$ r-I ,One r-I Four ~X~ SINGLE FAMILY I--I Two r-I Five [] MULTIPLE FAMILY ~ Thr~ [] Six [] Other 7, WATER SUPPLY [] INDIVIDUAL' * ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth {attach log if available.) 8. SEWAGE DISPOSAL SYSTEMf~ ~"/ __~,~ /~ ') INDIVIDUAL/ON-SITE**' YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72.010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF.RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SlX [] OTHER 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified •Septic Tank or r--IHolding Tank Size: If Tank is homemade give dimensions: PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER MATERIAL TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: ~eptic/Holding Tank IAbsorption Area ISewer Line I Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ~APPROVED FOR [] CONDITIONAL APPROVAL (letter must a~ ' ~ DISAPPROVED DATE BEDROOMS .~pany certificate) 72-010 (Rev. 6/79) DAVID A. SLENKAMP ROBERT A. SHAFER MECHANICAL ENGINEER 694-9055 Beve=ber 11, 1980 CIVIL ENGINEER 694-2979 J~,4UNICIPALITY OF ANCHORAGE DEPT. OF H~ALT?I & ENVIRONMENTAL F[,OTECTION Area ~eal~y ATT~TION~· Terry Beale P.O. Box 349 Eagle River, Alaska 99577 I'lOV 1.. 3 1980 RECEIVED Dear Terry, References Lot 50; ~lock 3; Eagle Park Subdivision A sewer system adequacy test was performed on the system locsted on the referenced property per your request. The septic tank ~as pumped and verified to have a capacity of 1000 gallons. The seepage, pit was charged uith appro~m, tely 950 gallons of water and after a 24 hour period approximately 529 gallons had percolated out of the crib. It cmn be concluded from this test that the sewage system is currently functioning adequately for the three bedroom residence. If we may be of further assistance, please do not hesitate to call. ely, cc~ Hunici~lity of Anchorage Department of Health and Enviornmental Protection SRB 196X EAGLE RIVER, ALASKA ~I.1UNICIPALITY OF AHCHORAG ,DEPARTI.IEr .OF. HEALTIt AND ENVIRONHEHT~ P~OTECTION 825 L Street, Anchoran~. Alaska 99501 264-4720 Date Received: Time _h '~'~'3~~' I~3: Time Date ~ ~ ~--'~ ~h~7 ~--'~~ Date November 14, 1977 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: Mailing Address: 2. Property Owner: Ronald/Elizabeth J. Kelly Mailing Address: Post Office Box 4-43 Lot 5C Block 3 Eagle Park Subdivision 3. Legal Description: 4: Single Family Residence: ~) Multiple Family Residence: ( ) Phone: \ Phone: 279-7654/_w__o_r_k well System: Permit ~ Construction Number of B6~lrooms: Number of Bedrooms: Three Individual well W ) Com,munity/Public System ( ) Depth of Well 105' Wcll Log on File Bacterial Analysis ( ) Sewage Permit # Septic Tank Size Absorption Area Disposal System: On-site System k~ Public Utility Installed 1973 Installer Manufacturer Soils Rate Material ( ) Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot linc Absorption Area to Nearest Lot Line ('~.~UrllClPALITY Of ANCHORAGEt'''~ :'.:.:,:~:?,:,','c',::,::il(. /~__~__~-'~' Department of Health and Environmental Protec,t~Qn. : , ~~, 825 L Street, ~chorage, Alaska 99501.~' ,,/:" ~'~"~ --~'quest for Approval of Individual Sewer and Water Facilities 1. Property Owner: ~A~ ~ ~t/~~ ~ Mailing Address: ~D,~ /?/-¢-/~ Lending Institution: Mailing Address: Phone: ~ 77-7~ ~/9/ Phone: Realtor/Agent: Mailing Address: Phone: Legal Description: L~- .5-d ~&K;~ ~W~L~ ~-F~ ~'1,,'6 ~: Street Location: .. "~//'~/~--H --~7~. ~'.,4,~/.~ ~.~,~'~',, ,.Z~-.{_/~.~'(~-. Single Family Residence: Multiple Family Residence: Number of Bedrooms: Number of Bedrooms: Water Supply: *Individual Well If Individual Well, well depth Public/Community System ( ) If Community System, name of system Sewage Disposal System: *~n-site System ~ Public System If On-site System, date of installation: ~h ~9~ { ) *NOTE: 3/77 A well log is required on ALL wells drilled since 6/75. ** If on-site sewer system is over two(2) years old, an adequacy .test is required by this department. A fee of $25.00 must accompany each request before processing can be initiated. pnge-~wo~ ..'' Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 5C Block 3 Eagle Park Subdivision Comments: Affadavit Attached: ( ) Disapproved. - Letter Attached: ( ) Date: //--~ ~-~ Date: Department Worksheet: , _ ) I.) 'T'~X~ I~F ~u.,,,~',~ n,z~",-; .Z) i~v~a,',~,,, .,,,~7~:,c ( ~'~' ~.,,./~. ~'s: ,..,~'./ AT- ,~ £f~,: z- ,.,~T~. 3:.r?.~. ~,~x'/ 5z~:,,, ~-',~t, fZ-¢~,,.,,~ ;',:. SA'r ~'~.~.