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Home My WebLink AboutEAGLE CREST #1 TR A LT 15 GR'~;ER ANCHORAGE AREA BOROL'~I D~rARTMENT OF ENVIRONMENTAl. QUALI1 ~: 3500 TUDOR ROAD ANCHORAGE, ALASKA ggs07 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~'~'-~'~'-~'/~" ~?' J'~'~/~'~_/~'?~' ADDRESS ~'~-~/~'/~f'~ '/~'~"~- PHONE. LOCATION S~-~ --~'/'-~'- ~- ~ ,~'~ LEGAL DESCRIPTION SEPTIC TANK: (~'~ "~"~'~) NUMBER OF DISTANCE FROM WELL ~'~,r~T~~'~,~-~'-,~'~ MATERIAL ~'~-~"~d',,~'~,~?-~ f~-~:'~',,~'J~ COMPARTMENTS / LIQUID CAPACITY //~ GALLONS. INSIDE LENGTH ~ '~ J/ INSIDE WIDTH. ~ ~/ // LIQUID SEEPAGE SYSTEM: SEEPAGE PIT: ~'~"~-'~'~' ~'~"~'~'~'"~ NUMBER OF PITS LINING MATERIAl NEAREST LOT LINF OUTSIDE DIAMETER ~ OR WIDTH //'~( ~ LENGTH /~ , DEPTH ~ ~ -~. DISTANCE FROM WELL ~~ ~ BUILDING FOUNDATiON~ ~ TOTAL EFFECTIVE ABSORPTION AREA ~ALL AREA) ~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL ~ FOUNDATION. ., NEAREST LOT LINE. NUMBER OF LINES~ ~ES ~NCH WIDTH ABSORPTION A~.._~'~ SQ. FT. LENGTH OF EACH LINE ~ DEPIH: lOP OF TILE TO FINISH GRADE DEPIH OF FILTER MATERIAL BENEATH TILE WELL: /"/"-"~'~'--~:~ ~"'~/'"':~'~"~'~"/"'~'~-') DISTANCE FROM WATER TYPE ~''~e''~/.~,~-,'~'~ DEPTH / . BUILDING FOUNDATION / _SAMPLE NEAREST SEPTIC SEEPAGE LOT LINE 1/.. SEWER LINE ~ , TANK / SYSTEM ~ CESSPOOL TOTAL LENGTH . OF LINES IN, TOTAL EFFECTIVE IN. ABOVE TILE ~ NEAREST OTHER ,~'"'"-, SOURCES DIAGRAM OF SYSTEM DISTANCES: ~ , ' . · ..... ,. ....... . · ~ · : .- .i .... ; ...... ,.;...:. /~ .... i , ..r.,~,~,,r,.,'.~ z.,..~' , . I ~ ; . . J ' ~ : V: .... : ~ .... ~/~ ~ I . : ~. ~ l ' ': ' ' I ' : ..... ........... ~ ......... : ....... ~ .... [ ......... ~ ...... ; ~ , , _ ~ . . ( ' C~w~. . ~ ./. ,,l ry__i :' ......... . · ' :''j.-: . ..... , , . ~ .. ~ . /.~.., ~,,~_'~' :.~j~. , . . ; ..... J ~ ~ ~?'~'.'~(~ . ..... ~ I ~ ~ '~ . ~. ~ . ~ ..... J ,. . ~ . ~ ~ ~ .. '~ ... .. ..... :. ;..: -, · ~ /~ , ~ ~ ..... ~ '': g~.A.B. Gre~l'Er ANCHORAGE Area BOr~'UGh SEWAGE DISPOSAL SYSTEM ~ APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT ~ DRAIN FIELD OTHER , ROIL TEST RESULTS ~ A~Z. ~ NOTE: THIS PERMIT IS NOT VALID WITHOUT FOUNDATION TO R[PTIC TANK -- FOUNDATION TO SEEP^OE P~T /~-- SEPTIC TANK TO REEPAGE PIT WALL SEPTIC TANK DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO REPTIC TANK SEEPAGE PIT DRAIN FIELD GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. £& LICENSED DESIGNER DIAGRAM OF SYSTEM CERTIFY THAT ! AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE Perfcrr,.ed For !gavne WillielRs Eate !'erfor.v. ed 6[11/71 Depth Feet 4-- 6-- 10-- 12' brown and gray silty sand with boulders (SM) gray sandy gravel with 'scattered boulders and cob- bles (GW) with slightly silty sand seams If Yes, At ;,."hat Depth.___ ..... I.oca~isn Ske:ch ?er, xL. Of In.et _ I,,, .., ,o ~-,~t ','lencn . OM .......> · 104 SOU~~in~.~ -r~eq~,tr~ ~o~ ..... ~ts same can be used for back fill if the ~e~ ~9=~ed.. C D~,~'a Certified By: N~t~O~T~s3~.~erv~s, Inc. Date: d 0 D'FPT. OF H£ALTH & ENVIRONMFNTAL PROTECTION RECEIVEDi' ' "' 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 Lots 15 & 16: T~act A: Eagle Crest Location (si~t~ address (~r direct!ons) . Property owner" ' Merle Pect~aO ~, · ..' ., ~: : - · : Ma Ing address 19333 3rd Street "- ' g ag ,~ - ~ Lendin enc ~ ' ~;.M~[ling address"" A~nt .... " Eagle River, AK Ea~le River, Day phone AK 99577 696-6924 Day phone Day phone Address Unless otherwise requested, HAA will be held for pickup· NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well xxx Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. XXX TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. Se STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or,wastewa~er disposal system is safe, functional and adequate for the number of bedrooms and type of str~ciure 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 regu!ati, ons in effect on the date of this inspection. Name of Firm' S & S ENGINEERING · Phone ~o cl ~ .- ~-'cl '7 ~ ]7034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Address .. ~ Engineer's signature "~/L,~J~i/~" ~./~ Date IQ/~-o/¢/'7 DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date M~ici~ality -.The of A.hct?rege 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 engin6~i;'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 ana!yze 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 n~'r ,~ -~ mQ'/ ~l~k DEPARTMENT OF HEALTH a HUMAN SERVICE~'~'* ,,L~' ~'**~ Environmental Services Division 825 L Street, Room 502. Anchorage, Alaska 99501- (90~W I; D Legal Description: A. WELL DATA Health Authority Approval Checklist f Well type _]~[l~.~*lf A, B,'oc C, attach ,ADEC letter. ADEC water system number Log present(~N) tf ~.$ Date completed ~- t~- ~ Total depth -~-.Z- / Cesed to ~ ~ Cssing height iabove ground) Sanitary seal (~IN) ,,tp_'~ ' Wires propedy pr°taCtod ~I~l) FROM WELL LOG AT iNSPECTION Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform (.~ Nitrate (~. ( Other bacteria O $ & S ENGIN£ERING Data of ~ample: -I B. SEPTIC/HOLDING TANK DATA Data installed ~nda~on ~e~t Dam ~ ~Ping C. ABSOR~ON RE~ DATA Collected by: F...~e PJvar, Alaska ~$~' J I ~ ~ Number of Compartments __ Depression (Y~) ~0 High water alarm (Y/N) Pumper .'~_ e~ Datai~s~alled ~)-?) Soilrating (g.p.d./fForR'~c)drm) IO~r~/~.tSystemtype ~.P. IE, Length '. ~ ~*' Width i ~*' Gravel thickness below pipe (~! Total depth 10* Effective absorption, ama q~"~C ~ Monitoring Tube present (~IN) ~lt& Depmsalon over field (Y~) OataofadequaCYtsst '/07'~_/~)'7 Resutts~i'Fall)_._.~~Fo, 'T~EE Fluid depth in ebsorption field before test (in.); I ~* Immediately after .520 gal. water added (in.): Fluiddepth I~/* (ins)Minutes later: :37.. Absorptionmte = .4-50I. q-p.d. Peroxide treatment (past 12 months) (Y/N) ~ If yes. give data -. bedrooms IqJl2.'' 72-026 (Rev. 3/96)' D. LIFT ~ Date installed ~ Size in gallons Manhole/Access (Y/N) 'Pump ~'f~t~ "Pump off" level at* High water alarm level at* *Datum Cycles tested E. SEPARATION DISTANCES ,~,~.~, SEPARATION DISTANCES FROM WELL ON LOT TO: Sepficiholding tank on lot '~ =l~)I '~ On adjacent lots Ioo' Absorption field on lot I(;~~ On adjacent lots Public sewer main ..~.. t .+ Public sewer manhole/cleanout IoO' Sewer/septic service line Z,§ I ~- Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: -.. Foundation I0~ + Property line 10' ¥ Absorption field (O~ t' Water maln/sewice line ID''t Surface water/drainage 10¢~''1' Wells on adjacent lots IOO' + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Properly line Surface water Curtain drain IOt't Building foundation ~/O ' ~' Water main/sewice line InO t'l' Driveway, parking/vehicle storage ama ~orJ~ K~k,,,~t Wells on adjacent lots 100' ¥ F. ENGINEER'S CERTIFICATION in conformance with MOA HAA guidelines in effect on this date. ~'c ~ /~'""~/t'_~. Date ,o I 72-026 (Rev. 3/96)* 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 ~.~I'3- APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # ..~,~Z_._~._?...-~,~_ ,,~ ~ HAA# 1. GENERAL INFORMATION Complete legal description Location (site address or directions) 19333 Property owner Mailing address (u~zF~e ~ N~c~ur.a. ~Z.~.~tmz, Day phone 694-3717 19353 Th,~rl S,t..'[¢e./C EccgL~. I~u~t, A.~r.6fz~z 99577 Lending agency Mailing address' ' Day phone e e Agent A,,E~[¢~/ I~c~o~t RE/I~AX OF EAGLE RZ{/ER Day phone Address 16600 ¢e~¢~4_ZC~d p~.Zu¢, E~zq£¢ l~Zu~'~, Abz6~az 99577 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: $ 'TYPE OF WATER SUPPLY: NOTE: ' 694-4~00 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. TYPE OF WASTEWATER DISPOSAL: Individual on-site Y.X Holding tank Community on-site Public sewer NOTE: · attesting to the legality and status of system. If community wastewater system, provide written confirmation from State ADEC 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. ' Name of Firm Address Engineer's signature '- & ~ ENGfNEE,'~ING 77034 Eagle River Loop Ro3d Ne. 204 $'agJe kJver, AJaska YY577 Phone Date. DHHS SI~3NATURE ~ Approved for -~ bedrooms. Disapproved. · Conditional approval for bedrooms, with the following stipulations: Additional Comments 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. A. WELL DATA Well type Log present Total depth Sanitary seal Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Pump level "~ C:)~ ~V-- ,,_~ ~ U.I SEPARATION...DISTANCES FROM__ WELL~ ~ TO: , ,.. , . , . -,, J Septic/holding tank on lot 3~. I~ ; On adjacent lots t ~ Absorption field on lot ~ o yt,.- ; On adjacent lots ~ ~, Public sewer r~ain __ Public sewer manhole/cleanout Sewer sen~ice line 3-~" ta-- Petroleum tank '2.5"' ~ 4-- WATER SAMPLE RESULTS: Coliform (~) c~'"'/i':'°~'JL Nitrate, ~ Other bacteria Date of sample: ~ ~ ~ .. c~ 'L.-' Collected by: S & $ ENGINEERING 17034 Eagle River Loop Road NO. B. SEPTIC/HOLDING TANK DATA Eagte River, Alaska 99577 Date Installed ' ~ ..-I \ Tank size ~.~ '¥ ~,w~l.~ Compartments Cleanouts {~YN) '~ Foundation cleanout (Y,~ /,.J Depression (Y~ High water ala~:m (Y~J~ /'J" ;' =" ' ' J ~.~ Alarm tested (Y/N) Date of pum~)ing . '¥ -' 'J'"~ - ~ 7.-- Pumper ::~"TZ-, SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ';~(''': Ct L~ On adjacent lots ~'oot'4' Foundation · Topropertyline ~ '~ ~ 'f' Absorption field .. ~:~t'~ ..... Watermain/serviceline` t t3 ~'~ Surface water/drainage tt>~ t 4-- ' . 26 (Rev. 7~91) Ftcnl CONTINUED ON BACK PAGE If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~,° ~ ~'"'1~ D rille r ~..~1~.~,~[~_ Casedto '~2~.'Z-- ~ Casing height Wires properly protected ~YN) FROM WELL.. LOG AT INSPECTION : ,,~ Date of test~.',, ~2.) - ~'~ o'1% , "~.~.'~...~ : i~ ~_~ ~1.. Static water level "~*'"1~'~ ' "~ ~ 7-.~ Well flow ,{~ g.p.m. C. LIFT STATION Date Instalied Size in gallons Vent (Y/N) "Pump on" level at. ManUfacturer Uanhole/A*cce~s~ (Y/N) · ' ~ tested High water alarm level . Meets MOA'eleclr:ic~/"/ W~n lot '~ On adjacent lots *" D. ABSORPIION FIELD DATA Date Installed "' ~ -'"~ [ Soil rating Length 'l~~ ' ' Width Iz~ ~ Total absorption area Depressic~n over field (Y,l~ Results ~/faili ~,k~c~ : Surface wate~ Gravel thickness t.~{ Total depth· Cleanouts presen! .(~'N) Date of adequ,ac.y test for To existing or abandoned s.ys.,tem on lot Peroxide treatment (past 12 months) (Y~ ~'~- I/--~'~ ~J "[ , If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot' ~,c, c=. ~ ~'''' On adjacent lots ~ P_.r0Perty line t To building foundation ~.o bedrooms ' Watermain/se~iceline .' ' r ~ 0 ~ ~ On adjacentlots Surface water · ' "* Curtain drain ' Cutbank ' '"5,~. ~. · Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION t~ ,r I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in e~J~_~Jate of this inspection. ' %. ' -~*", -' L ' '"'~-~OF A'~t ; '* . . :' - S ~ S ENGINEERING ;., . , ' ~.' ~.;'~'~ ' ~ ."; Date · . - .... ~ ' HAA Fee $ 170. ~ Waiver Fee: $ - Date of Payment ~ Date of Paymen~ Receipt Number Receipt Number 72-02~ (Rev, 3/91) Back MOA 21 RECEIVED APR ~ 1]]2 Mun~cip,lll~¥ of Anchorage WHEREAS, Wayne A. and Hadara H. lditliams (hereinaFter Williams) are the Owners in {ee o{ Lots Fifteen (15) and Sl:¢teen (16). T~ac[ A Eagle Crest Subdivision. according [o the o{~lctal pla[ the~eo~, ~tled urtder F'lab ~lumbep F'-55~ Rec~ds'o~ [he Anchorage Recording District, Thir'd Judicial serves Lots 15 and t&: and wHEREAS, Willtam~ desires to assure the continuity oF septic service to LOC 16. NON, THEREFORE, Williams declares and covenal~ts as 1. There Is hereby established and reserved, ~or the benefit o~ Lot l&, T~act A Eagle Crest Subdivision, acco~d- lng to ,Plat P-55[3, Records of the Ar~chorage Recording needed for the habitation o{ Lot 16. STATE OF ALASKA THIRD OUDICIAL DISTRICT DATED this 2nd day of April, 19~2. ~!/~.~'~,-:~-~,~' ....... = ............ ~ladara N. Williams SS. THIS IS TO CERTIFY that on this 2nd day of April, 19~2, be~o~e me, the undersigned Hotary Put)itc duly commi[sioned and s~orn~ personally appea~ed WAYHE A. WILLIAHS and FIADAF~A · ~'~ta~'~'[~, {o~ the uses therein stated. · ~?~ '~ ~ ,~' ~and o~tct se~l. ~ ' - ~,%~,.,' ~ ..',~ My commission expires: ~--~ ,,[.~ .~..~-~,~ . ?,2- o 1 3 7 3 o ' RECEIVED /~_~c. MIOIIOR,tQ£ REC. APR ;) 1992 DISTRICT ,. ~ ~.,:.- :;,, ;:~.~ ,..,~¢,.- ,~....~,.~.. <~ ..... REQUESTED BY , ASBUILT-NO CORNERS SET THIS DATE. I HEREBy ClArIFY THAT I IIAVE SURVEYED TIlE ~ ~AT NO EN~HMENTS EXIST ~CE~ AS 3-2A-92 '"'""~'" ~N~ ~ D~ERMINE'TH~ EXISTENCE OF ANY G~ID~ ~ ......... .. ?..,.~...~ E~EMENTS, COVENANTS, OR RESTRICTIO,,3 WHI~DONOT~PEAR~THERE~D~DDI... VISION PLAT. UND~NO CIRCUMSTANCES S~ FB, ' %... t~-6918 ..:~ ~Y DATA H~EON BE USED FOR COt,STRU~IO,~ 27-1~ OF FENCE LINES~ OR FOR EST~LISHING ~ND- DRAWN~ ARY LINES. CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 995'18 TELEPHONE (907) 562-2343 AIIALY$I$ IYSOLT$ fez IIl~OIC! ! 52078 ChemlAb Sef.I 92.1091 Sable ! 5 %atttz: #ALES FAX: (907) 561-5301 Collectea : XIS 20 92 ~ 15:10 hts. ~ecetvea : ~ 20 92 I 16:20 hts. Client IsM :$ E S IYGIEYSIYG Client icct :$NSII~P IPO! : Analysis Co~letea : ~ 23 92 1)3 E S EIIGII~[~I~G IlT~AI[-] HD(O.IO) ng/l EPA 3S3.2 10 ~sm~ks: I Tests ~ezfo~Ma ' See ~peci&l Imtructto~ Above UA-Unavetlable ~- Jone Ootectoa ** See ~le ReMtk. lbove ~i- Jot i~l~oa [~-Less T~n, ~-Gteate~ Thn Member o! the SGS Group (Soci&t& G&n&rale de Surveillance) CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. TELEPHONE (907) 562-2343 5633 B Street Anchorage. Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER PUBLIC WATER SYSTEM I.D. # ~---"~-PRIVATE WATER SYSTEM S & S ENGINEERING 17034 Eagle River Loop Read No. 204 ~.~,~E.~j[~ River, Alaska YwlZ Mo. Day SAMPLE TYPE: ~_ Routine Check Sample ([or routine sample with lab ret'. no. Speclal Purpose Year Treated Water Untreated Water SAMPLE LOCATION I Time Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: '~. Satisfactory t'-I Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours Did at examination to indicate reliable results. Please send new sample via special delivery mail. Time Received Analytical Method: Membrane Filter "'No. of colonies/100 mi. Lab Ref. No. Result' I I BACTERIOLOGICAL WATER ANALYSIS RECORD · READ INSTRUCTIONS Uembrane Filter: Direct Count Verification: LSB BGB BEFORE t Fecal Coil.form Confirmation COLLECTING SAMPLE Final Membrane Filter Resulte ' ART ONE OF TNTC = Too Numerous To Coua . P_- :. REMAINDER TU FOLLOW - Other Bacteria Analy.~t Coliform/100 mi Coliform/100 mi '"5.71.~,'z'' MUNICIPALITY OF ANCHORA~E DIVISION OF ENVIRON,~ENTAL HEALTH DEPARTMENT OF HEALTH A}ID ENVIR0b/iENTAL PROTECTION APPLICATION FOR HF2%LTH AUTHORITY APPROVAL CZETIFICATE 1. General Informatiom Application Date 20~ (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicants Name ~ ~1~}~ Applicants ~d~ess Telephone - Hom~94~'71-~usiness 'Z-"74'~(o~! (c) Applicant is (check one) Lending Institution Buyer ~; Other ~--~ (explain); (d) Lending Institution ~-~; Owuer/builder.~; '' Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) MaLl the HAA to the follo~ng address: T. Type of Residence · Singleo~amily~ Idulti-ram~ly~ Other (describe) Number of Bedrooms ~ 3. Wate~ Supply' Individual Well ~ Co=uni~y ~ Public ~ · Note: IX community ~11 system, must Mve ~i~ten co~lma~ion from the State Department of Enviromen~al Conse~ation a=~es~i~ ~o =he legality aM status. 4. Sewage Disposal No~e: IX co~nity ~11 system, must have ~iCCen co~ima~ion from ~he S~aCe Depar~men: of Enviro~ental Conse~ation attesting ~o the legality aM status. [Page 1 of 2] 5. En~ineerin~ Firm Providin~ Ins~ections~ Tests~ File Search~ Data and Information As certified by my seai affixed hereto and 'as of the validation date shown below, I . verify that my investigation of this Health Authority Approval sho~s 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 Nunicipality of Anchorage files and from my investigation and inspection, the on-site ~rater supply and/or ~zastewater disFosal system is in compliance with all Municipal and State codes, ordinances, and regula- tions' in effect on the date of this inspection. .~. '~-. .~. ' · ..~ % ~;....'"~4.~'~'i . -. Date ~ ~c~ o~> ...... 7 .~ ~ ' - · .~ '~^-..~-'~2./i ~'~' ~'/, · ,:. · z .,.......... - . 6. DHEP Aooroval w, 4. .~ .~'."7.,,.. Approved· ~ Disapproved Conditional -- Terms of Co~ditional Approval CADTION THE I~INICIPALITY OF ANCHORAGE DEPAR~IENT OF HEALTH AND ENVIRO~iENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH $ ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF 'ALASKA. ~ DHEP DOES THIS AS A COURTESY TO PURCHASERS OF E0,~ AND THEIR LENDING INSTITUTIONS LN ORDER TO SATISFY CERTAIN FEDERAL AND STATE 1LEQUIRE- MZNTS. DIPLOYEES OF DEEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICAT~ IS ISSUED. THE MIINICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR I~ORS OR OMISSIONS IN THE PROFESSIONAl. ENGINEER'S WORK. (DHEP SEAL) RRi/e]/D18 [Page 2 Of 2] 7-19-84 Well Cl~si£icatic~ Well fog ~gesent (Y/tN) Total ~p~ ~ ZZ ~ casing ~sight Abo~ G~und I g* Sepa~etic~ Distances f~cn W~ll~ To Se~tic~Holcttr~ Tank ca Lot ~' To Nearest Edge o~ Ats~ion Field c~ Tot "~'~ ~ To Ne~st La~blic Se~e~ Line ~'~ '~ sani~a=y Seal oa c~si~ (z/~))/ Deg=essicn A~3und Wellhead (Y/N) ~J ~ c~ Adjoining ~ots ~/~0 / To Nearest Publi~ Se~e~ Receipt t Date Paid: Amount: ~ [PaGs 1 of 2] 2-15-84 Ce Soils Rating in Absu~pticn S=ata Width of Field Sgua~e Feet of i%bSot~ticm A~ea Ds~assicm ove= Field (Y/N) Rasults of r*~t ~;uac~ ~)~te of lest ~guac~ ~st Separaticn Distar~e f~a~ A~pCial Field] To ~ate~-Supply ~11 -~ / ~ ~ TO l~cgert~ Line +/~ / To Building Foundation ~ 7.~;' To Existing c~ Abandcnsd System cn +3 O' Date Installed Size in Gallons "Pump On" level at High Water Alarm level at Tested fc~ Electxical Codes(Y/N) Dimensions ~le/Access ~um90~f' level at Vent (Y/N) ~,~ing Cl.:les du~inG p~legua~ ~st. ** Chack Permitted ~ Rating Against BAA ~guest ** ! =srtify that I have checked, verified, c= ~.,%f~=msd to all ~DA ~AA Gui~e.l~e_s in effect - ...... ~/~/s I ~,~ ~ ~ ~a ; ,~,~ · ~., - .~, 2-15-84 H~NRY WILSON 96OI BUDDY WER~R DR. ANC~G[. AK 99515 (907) 34G*,2000 Constructing Engineers, Inc. Engi ne rs, Surveyors August 29, 1985 RECEI.V. ED Municipality of Anchorage Division of Environmental Health 825 L Street Anchorage, Alaska Gentlemen~ Lots 15 & 16 Tract A, Eagle Crest Subdivision, in Sec.7,T14N,RiW, S.M. waiver for HAA We request waivers for the following~ A.. The existing septic tank is a single compartment tank rather than 'the two-compartment type presently required. At the time the tank was Installed (August 1971), the tank met the GAAB requirements. Its volume (1,153 gallons) exceeds the 1,000 gallons required for a three-bedroom ho~e. It is built of durable concrete block. An adequacy test perfoL~/~ed on August 22, 1965 proved the drainfield to be adequate forthe three-bedroom ho~e it serves, The ration distance frcm the standpipe of the tank to the well is 96~eet, \ -/ #e~e~that thia small deviation frmn the required 100 feet will not cause any problems. We also note the GAAB inspection report on the installation calls out 50 feet separation required. Please advise if any further information is needed. Ve~ truly yours, CONS~I~I]CTING ENGINEERS, INC. H. H. Wilson